Malaria and Older Adults

Recent research has stressed the increase risk of death from malaria that elderly tourists face. Mortality from P. falciparum malaria increased steadily with increasing age with case fatality rate peaking in the group aged over 65 years. The authors explain that, “These data are supported by previous reports of increased case fatality and higher levels of parasitaemia in elderly people,” but the three studies cited focus only on travelers and tourists back in the UK, not adults and elderly people living in endemic regions.

This leads on to wonder about the risks malaria poses to elderly people in endemic countries, especially as populations throughout the world are aging.

While the recent controversial study that suggests that malaria deaths in adults have been underestimated world-wide, it does not specifically address the suspected prevalence of malaria morbidity and mortality in older adults. Specifically the authors “estimated more deaths in individuals aged 5 years or older than has been estimated in previous studies: 435 000 (307 000-658 000) deaths in Africa and 89 000 (33 000-177 000) deaths outside of Africa in 2010.”

Concerning the “outside Africa” component mentioned above, a study of adult and child malaria mortality (both falciparum and vivax) in India published in 2010 did report a higher malaria mortality risk in persons over 60 years of age.

More documentation on malaria morbidity and mortality in persons over 60 years in age in endemic countries is needed. Although portions of this segment of the population may no longer be in their productive years, they do consume health care resources, and as grandparents play important roles in child care.

scan_io-012-sm.jpgIn addition there is need to ascertain reasons for any differing patterns that may be detected. The study on tourists did not think that co-morbidity in elderly patients was responsible but instead implied that older people on holidays may forget to take their prophylaxis.

What differences in health behavior might be found in elderly populations in malaria endemic countries – maybe greater reliance on less efficacious indigenous concoctions? Are there differences in terms of perceptions of severity and seriousness of illness? Are there differences in care access?

The respect and quality of care we give the elderly says a lot about the societies in which we live.

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