Burden of Malaria and Prospective Challenges in South-East Asia Region: A Review

Malaria caused 350 to 500 million clinical episodes in the year 2000 and remains the fifth most deadly infectious disease worldwide after respiratory infections, HIV/AIDS, diarrhoeal diseases, and tuberculosis. Though malaria remains a global health concern in developing nations, the approximate malaria-infected cases reduced from 227 million cases in 2000 to 198 million cases in 2013 globally. Notably in Africa over the last decades, malaria eradication programmes have received greater international attention leading to reduction of parasite-infected cases by 26%, with a decrease in cases from 173 million in 2000 to 128 million in 2013. Nevertheless malaria remains a global health concern in developing nations. The World Health Organization (WHO) South-East Asia Region (SEAR) comprises of 11 member states (Bangladesh, Bhutan, Democratic People's Republic of Korea, India, Indonesia, Maldives, Myanmar, Nepal, Sri Lanka, Thailand, Timor-Leste) of which 10 countries are malaria endemic while Maldives has been declared malaria-free nation since 1984. Presently no licensed malaria vaccine is available and vaccine developers are working on several novel approaches to make a breakthrough as these vaccines would probably be crucial factor to prevent the transmission and onset of malaria. Further due to excessive dependence on artemisinin-based combination therapy (ACTs), emergence of drug resistant parasites, malaria co-infection in immunocompromised patients and newer P. knowlesi strains are fuelling this severe public health problem. Effective measures such as routine surveillance of the antimalarial drug efficacy, newer rapid diagnostic tools (RDTs) and appropriate treatment regimes will help to monitor and limit this deadly disease especially in the malaria-endemic countries. In this review, the various intertwined factors leading to malaria burden – a continuing problem for global health- specially in South-East Asia region are highlighted.