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Madagascar: malaria zones

According to the World Health Organization's World Malaria Report 2008, about half the world's population was at risk from malaria in 2006. Half of the high-risk group within that group were in Africa. There were an estimated 247 million cases of malaria in 2006, with 86% of them in Africa. An estimated 881,000 people died of malaria that year, of which over 90% came from Africa and the vast majority were children under five.

Malaria is the leading cause of morbidity and mortality in Madagascar, with more than 1.4 million cases and nearly 30,000 deaths reported in 2000.

The mosquito-born disease has an overwhelming impact on children under the age of five, who are estimated to account for up to 90 percent of malaria deaths.

Malaria is responsible for about 16% of all outpatient visits and 20% of all children under five years of age admitted to a hospital are diagnosed with severe malaria. It is ranked as a leading cause of under-five mortality, and according to UNICEF, kills approximately 20,000 Malagasy children every year.

The epidemiology of malaria varies considerably in different regions of the country.On the East and West Coasts transmission is stable and perennial, while in the Central Highlands it is seasonal and moderately unstable with occasional epidemics.

In the most recent large-scale epidemic in the late 1980s, an estimated 30,000 people died.In the semi-desert region of the South, malaria transmission is seasonal, very unstable and in many years almost completely absent.

The last Demographic Health Survey (DHS) was conducted in 2003-2004, well before the recent, rapid scale up of Insecticide Treated Nets (ITNs) distribution and the introduction of Artemisinin-based combination therapy (ACTs) as a first-line treatment for severe malaria.