Study disputes India's low malaria death figures

LONDON — The number of people dying from malaria in India may be more than 10 times higher than World Health Organization (WHO) figures suggest, a new study says.

But WHO has disputed the findings.

In the study, international experts examined 122,000 deaths from 2001 to 2003 in 6,671 parts of India thought to be representative of the entire country. Trained workers interviewed family members or friends about the deaths, asking questions about things like the symptoms people had before they died and if they got any treatment. They found 90 percent of people who died were in rural areas and 86 percent were not treated in any health facility.

Those reports were e-mailed to two of 130 physicians who determined whether the person had died from malaria. Researchers found among people aged 1 month to 70 years, malaria likely killed 3.6 percent of them.

Based on their findings, experts guessed from 125,000 to 277,000 people die of malaria in India every year. Official numbers from the World Health Organization put that figure at about 15,000. The study was published online Thursday in the journal Lancet. It was paid for by the U.S. National Institutes of Health, the Canadian Institute of Health Research and the Li Ka Shing Knowledge Institute.

Prabhat Jha, director of the Centre for Global Health Research at the University of Toronto, one of the study authors, said he and colleagues also found a geographical link between the deaths the doctors attributed to malaria and government-reported malaria deaths, patterns of the disease's seasonal spread, among other indicators.

Jha said past estimates of malaria deaths have mostly been done in treated patients in hospitals or health clinics, so experts are unlikely to find many deaths. He said adult deaths have been seriously underestimated, which could change global strategies to fight the disease.

Robert Newman, director of the agency's Global Malaria Programme, questioned the validity of diagnosing malaria based on the recollections of family members or friends.