Approaches to global public health are increasingly driven by an understand
ing of regional patterns of disease-specific mortality and disability. Curr
ent estimates of disease risks associated with Plasmodium falciparum in sub
-Saharan Africa remain poorly defined. Through the integration of high-reso
lution population and climate probability models of P. falciparum transmiss
ion, geographical information systems have been used to define the spatial
limits of populations exposed to the risk of infection in Africa. These est
imates were combined with a range of annual malaria-specific mortality rate
s, derived from a variety of epidemiological approaches, among children age
d 0-4 years. The best estimates of malaria-attributable mortality using thi
s approach ranged between 0.43 million and 0.68 million deaths per annum am
ong nn exposed population of similar to 66 million children in 1990. Despit
e the limitations of modelled transmission and population distributions, th
ese empirical approaches to probabilities of infection risk and epidemiolog
ical data on mortality provide a novel approach to present and projected bu
rdens of malaria mortality, as discussed here by Bob Snow, Marlies Craig, U
we Deichmann and Dave le Sueur.