“The best data we have is from Accra, Ghana’s capital. And we see there roughly 40 to 45 percent of all outpatient visits – anyone presenting at a hospital, a healthcare facility – for any reason – are walking out of there with a presumptive malaria diagnosis, which is a staggering number in and of itself. Now, what we’re just starting to learn in the last few years is that when you actually do confirmatory blood tests -- and you look at who really has malaria -- typically it’s less than 10 percent of that group, who’s presumed to have malaria,” he said.
So, if those figures are correct, what diseases could the rest actually have?
“Well, we started with dengue because it’s widespread across the tropics. It’s recognized. It’s something many people have heard of. But in reality it’s probably just a small piece of the pie. There are bacterial infections, other viral fevers, viral infections – things like influenza – fungal diseases, other parasitic infections…really a whole menu of things that people are dealing with on a regular basis,” said Stoler.
Stoler said the findings have the potential to cause donors to re-think their anti-malaria strategies. The Roll Back Malaria Global Action Plan estimates nearly $6 billion a year is spent to fight malaria.
“At least in parts of rapidly urbanizing Africa, maybe malaria is not their biggest problem. I don’t mean to undermine the importance of fighting malaria in sub-Saharan Africa and around the world, in general. But malaria has traditionally been a rural disease and that’s probably still where most of the burden exists. But really all the action is in urban places and there a lot of other things that people are dealing with there,” he said.