Rapid responses are electronic comments to the editor. They enable our users
to debate issues raised in articles published on bmj.com. A rapid response
is first posted online. If you need the URL (web address) of an individual
response, simply click on the response headline and copy the URL from the
browser window. A proportion of responses will, after editing, be published
online and in the print journal as letters, which are indexed in PubMed.
Rapid responses are not indexed in PubMed and they are not journal articles.
The BMJ reserves the right to remove responses which are being
wilfully misrepresented as published articles or when it is brought to our
attention that a response spreads misinformation.
From March 2022, the word limit for rapid responses will be 600 words not
including references and author details. We will no longer post responses
that exceed this limit.
The word limit for letters selected from posted responses remains 300 words.
The following three references [found in BMJ search in one minute]
show that malaria kills more people in Africa then HIV. Once again HIV
steals the limelight from more prevalent serious disease with comments
from this article such as:
"A joint report.... concludes that AIDS is the leading cause of death
in sub-Saharan Africa and the fourth biggest killer worldwide. Since the
epidemic began 20 years ago, 60 million people worldwide have been
infected with the virus, and currently 40 million people live with HIV. "
Sounds impressive but as seen below:
"[Malaria] ..... infects 300-500 million and kills 1-3 million people
annually".
Sixty million people in twenty years for HIV sounds a little boring
by comparison.
And thats before we start on Tuberculosis et c.
Here are the three references:
1.
BMJ 1997;315:730-732 (20 September)
Clinical review
Science, medicine, and the future : malaria
Sanjeev Krishna, Wellcome Trust Senior Research Fellow in Clinical Science
a
a Division of Infectious Diseases, Department of Cell and Molecular
Sciences, St George's Hospital Medical School, London SW17 0RE s.krishna@sghms.ac.uk
Series edited by: John Savill
Malaria is a huge and growing problem, especially in Africa: it kills
one to two million children each year, causes disease in a further 400
million individuals, and accounts for 25-50% of all hospital admissions.
Moreover, mortality associated with cerebral malaria (caused by infection
with Plasmodium falciparum) has not improved in the past 30 years.1 P
falciparum is now virtually untreatable with chloroquine in most parts of
the world, and many strains of P vivax are also resistant. Although
quinine is often the antimalarial drug of choice for chloroquine resistant
strains, it is poorly tolerated and compliance is therefore low. Newer
antimalarials such as mefloquine are both expensive and not always
effective. Some parasites are now resistant to most antimalarials. This
drug resistance makes choice of chemoprophylaxis for travellers difficult
as well.
2.
BMJ 1997;314:1707 (14 June)
Editorials
Today, malaria is a public health problem in more than 90 countries,
inhabited by 40% of the world's population, and is responsible for up to
500 million clinical episodes and 2.7 million deaths a year, predominantly
in young children in sub-Saharan Africa.1
Fighting malaria
3.
BMJ 2000;320:490-494 ( 19 February )
Clinical review
Recent advances
Tropical medicine
Henry W Murray, professor a, Jacques Pépin, associate professor of
medicine b, Thomas B Nutman, head c, Stephen L Hoffman, director,
malaria programme d, Adel A F Mahmoud, president e.
a Department of Medicine, Weill Medical College of Cornell
University, New York, NY 10021, USA, b Centre for International Health,
University of Sherbrooke, Sherbrooke, Quebec J1H 5N4, Canada, c Helminth
Immunology Section and Clinical Parasitology Unit, Laboratory of Parasitic
Diseases, National Institutes of Health, Bethesda, MD 20892, USA, d Naval
Medical Research Center, Rockville, MD 20852, USA, e Merck Vaccines,
Whitehouse Station, NJ 08889, USA
Plasmodium falciparum results in the death of more children each year
than any other single infectious agent, and together with P vivax, P
malariae, and P ovale, infects 300-500 million and kills 1-3 million
people annually. Ninety percent of malaria cases and deaths are believed
to occur in sub-Saharan Africa.23 Fortunately, HIV coinfection has not
materially altered the course of malaria.1 Resistance of P falciparum to
chloroquine, and more recently to pyrimethamine-sulfadoxine (Fansidar), is
now widespread; however, out of necessity, both drugs are still often used
as initial treatment in Africa. Mortality from severe infection in rural
hospitals also remains substantial, and malaria looms as a potential
health calamity in the tropics.23 Nevertheless clinically useful advances
in management have occurred.
Competing interests:
No competing interests
01 December 2001
Stuart Dwyer
part time medical officer, part time GP,
Settlers Hospital and 1 Hemming Street, Grahamstown, 6140
HIV statistics sound impressive but ...
The following three references [found in BMJ search in one minute]
show that malaria kills more people in Africa then HIV. Once again HIV
steals the limelight from more prevalent serious disease with comments
from this article such as:
"A joint report.... concludes that AIDS is the leading cause of death
in sub-Saharan Africa and the fourth biggest killer worldwide. Since the
epidemic began 20 years ago, 60 million people worldwide have been
infected with the virus, and currently 40 million people live with HIV. "
Sounds impressive but as seen below:
"[Malaria] ..... infects 300-500 million and kills 1-3 million people
annually".
Sixty million people in twenty years for HIV sounds a little boring
by comparison.
And thats before we start on Tuberculosis et c.
Here are the three references:
1.
BMJ 1997;315:730-732 (20 September)
Clinical review
Science, medicine, and the future : malaria
Sanjeev Krishna, Wellcome Trust Senior Research Fellow in Clinical Science
a
a Division of Infectious Diseases, Department of Cell and Molecular
Sciences, St George's Hospital Medical School, London SW17 0RE
s.krishna@sghms.ac.uk
Series edited by: John Savill
Malaria is a huge and growing problem, especially in Africa: it kills
one to two million children each year, causes disease in a further 400
million individuals, and accounts for 25-50% of all hospital admissions.
Moreover, mortality associated with cerebral malaria (caused by infection
with Plasmodium falciparum) has not improved in the past 30 years.1 P
falciparum is now virtually untreatable with chloroquine in most parts of
the world, and many strains of P vivax are also resistant. Although
quinine is often the antimalarial drug of choice for chloroquine resistant
strains, it is poorly tolerated and compliance is therefore low. Newer
antimalarials such as mefloquine are both expensive and not always
effective. Some parasites are now resistant to most antimalarials. This
drug resistance makes choice of chemoprophylaxis for travellers difficult
as well.
2.
BMJ 1997;314:1707 (14 June)
Editorials
Today, malaria is a public health problem in more than 90 countries,
inhabited by 40% of the world's population, and is responsible for up to
500 million clinical episodes and 2.7 million deaths a year, predominantly
in young children in sub-Saharan Africa.1
Fighting malaria
3.
BMJ 2000;320:490-494 ( 19 February )
Clinical review
Recent advances
Tropical medicine
Henry W Murray, professor a, Jacques Pépin, associate professor of
medicine b, Thomas B Nutman, head c, Stephen L Hoffman, director,
malaria programme d, Adel A F Mahmoud, president e.
a Department of Medicine, Weill Medical College of Cornell
University, New York, NY 10021, USA, b Centre for International Health,
University of Sherbrooke, Sherbrooke, Quebec J1H 5N4, Canada, c Helminth
Immunology Section and Clinical Parasitology Unit, Laboratory of Parasitic
Diseases, National Institutes of Health, Bethesda, MD 20892, USA, d Naval
Medical Research Center, Rockville, MD 20852, USA, e Merck Vaccines,
Whitehouse Station, NJ 08889, USA
Correspondence to: H W Murray hwmurray@mail.med.cornell.edu
Plasmodium falciparum results in the death of more children each year
than any other single infectious agent, and together with P vivax, P
malariae, and P ovale, infects 300-500 million and kills 1-3 million
people annually. Ninety percent of malaria cases and deaths are believed
to occur in sub-Saharan Africa.23 Fortunately, HIV coinfection has not
materially altered the course of malaria.1 Resistance of P falciparum to
chloroquine, and more recently to pyrimethamine-sulfadoxine (Fansidar), is
now widespread; however, out of necessity, both drugs are still often used
as initial treatment in Africa. Mortality from severe infection in rural
hospitals also remains substantial, and malaria looms as a potential
health calamity in the tropics.23 Nevertheless clinically useful advances
in management have occurred.
Competing interests: No competing interests