Volume 71, Issue 2_suppl
  • ISSN: 0002-9637
  • E-ISSN: 1476-1645


In many countries in sub-Saharan Africa, estimates of malaria occurrence used by health planners at all levels are based on data from formal sector health facilities. Since the majority of fever episodes are treated at home and within the community, the burden estimates obtained this way are the tips of the iceberg. A case study from Ghana comparing household data on acute morbidity and treatment-seeking behavior in two districts with health facility data is used as an illustration. For every case of febrile illness seen in the health facilities, there were approximately 4-5 in the community. Many sub-Saharan African countries recommend that all febrile episodes, especially in children, be treated with an antimalarial. Since several countries extend malaria treatment to include the community and the home through public and private, formal and informal sectors, the need for more comprehensive burden estimates becomes urgent.


Article metrics loading...

The graphs shown below represent data from March 2017
Loading full text...

Full text loading...



  1. Snow RW, Craig M, Deichmann U, Marsh K, 1999. Estimating mortality, morbidity, and disability due to malaria among Africa’s non pregnant population. Bull World Health Organ 77 : 624–640. [Google Scholar]
  2. Breman JG, 2001. The ears of the hippopotamus: manifestations, determinants, and estimates of the malaria burden. Am J Trop Med Hyg 64 (suppl): 1–11. [Google Scholar]
  3. Kloos H, Etea A, Degefa A, Aga H, Solomon B, Abera K, Abegaz A, Belemo G, 1987. Illness and health behaviour in Addis Ababa and rural central Ethiopia. Soc Sci Med 25 : 1003–1019. [Google Scholar]
  4. Asenso-Okyere WK, Anum A, Osei-Akoto I, Adukonu A, 1998. Cost recovery in Ghana: are there changes in health care seeking behaviour? Health Policy Plann 13 : 181–188. [Google Scholar]
  5. Chawla M, Eellis R, 2000. The impact of financing and quality changes on health care demand in Niger. Health Policy Plann 15 : 76–84. [Google Scholar]
  6. Mugisha F, Kouyate B, Gbangou A, Sauerborn R, 2002. Examining out of pocket expenditure on health care in Nouna, Burkina Faso: implications for health policy. Trop Med Int Health 7 : 18–196. [Google Scholar]
  7. Kloos H, 1990. Utilization of selected hospitals, health centres and health stations in central, southern and western Ethiopia. Soc Sci Med 31 : 101–114. [Google Scholar]
  8. Walker G, Gish O, 1977. Inequality in the distribution and differential utilization of health services: a Botswana case study. J Trop Med Hyg 80 : 238–243. [Google Scholar]
  9. Ministry of Health Ghana, 2000. Health of the Nation. Accra, Ghana, Ministry of Health.
  10. Agyepong IA, Aryee B, Asiedu A, Owusu G, Wellington E, 1998. Integrating Health Education into Malaria Control at the District Level. Accra, Ghana: Ministry of Health.
  11. Afari EA, Dunyo SK, Koram KA, Nkrumah FK, 1992. Epidemiology of Malaria with Special Emphasis on Transmission, Morbidity, Mortality and Disease Control in Ghana. Part 1. Malaria Transmission, Morbidity and Mortality in Coastal Savanna and Forest Areas in Southern Ghana. Legon: Ghana: Noguchi Memorial Institute for Medical Research. University of Ghana.
  12. Agyepong IA, 1992. Malaria: ethnomedical perceptions and practice in an Adangme farming community and implications for control. Soc Sci Med 35 : 131–137. [Google Scholar]
  13. Agyepong IA, Manderson L, 1994. The diagnosis and management of fever at household level in the greater Accra region, Ghana. Acta Trop 58 : 317–330. [Google Scholar]
  14. Agyepong IA, Wellington E, Ablordey AM, 1997. A comparative study of clinical and sociocultural aspects of anaemia among adolescent girls in rural Ghana. Acta Trop 65 : 123–138. [Google Scholar]
  15. Warsame M, Abdillahi A, Duale ON, Ismail AN, Hassan AM, Mohamed A, Warsame A, 2002. Therapeutic efficacy of chloroquine and sulfadoxine/pyrimethamine against Plasmodium falciparum infection in Somalia. Bull World Health Organ 80 : 704–708. [Google Scholar]
  16. Shretta R, Omumbo J, Rapuoda B, Snow RW, 2000. Using evidence to change antimalarial drug policy in Kenya. Trop Med Int Health 5 : 755–764. [Google Scholar]

Data & Media loading...

  • Received : 21 Aug 2003
  • Accepted : 07 Oct 2003

Most Cited This Month

This is a required field
Please enter a valid email address
Approval was a Success
Invalid data
An Error Occurred
Approval was partially successful, following selected items could not be processed due to error