Fatal and non-fatal health outcomes of malaria among reproductive age women in Eastern Sub-Saharan Africa, from 1990 to 2023

BACKGROUND: Malaria is a life-threatening disease that is transmitted by the bites of infected female Anopheles mosquitoes. Women of reproductive age (WRA) are a more vulnerable group to malaria, which increases the risk of severe anemia, maternal death, and unfavorable birth outcomes. However, only limited comprehensive studies are available in the Eastern Sub-Saharan African (ESSA) region. The Global Burden of Diseases (GBD) 2023 estimates were to assess the fatal and non-fatal health outcomes of malaria among WRA in ESSA region from 1990 to 2023. METHOD: The Cause of Death Ensemble Model (CODEm) modeling platform was used to estimate mortality and Years of Life Lost (YLLs) in the GBD 2023 study. Years Lived with Disability (YLDs), prevalence, and incidence of malaria disease was estimated by using Bayesian meta-regression for Disease modeling. The net change from 1990 to 2023 was evaluated by percentage change. All estimates were presented together with the 95% uncertainty intervals (95% UIs). RESULTS: In 2023, the highest prevalence rate of malaria among WRA was recorded in Mozambique [19627 cases per 100,000 WRA (95% UI: 12,347, 27,601)]. However, the lowest prevalence rate was estimated in Eritrea [842 (95% UI: 450, 1430)] and Rwanda [1603 (95% UI: 587, 3180)]. Mozambique had the highest incidence rate [16076 new cases per 100,000 WRA (95% UI: 11,890, 21,714)], whereas Eritrea had the lowest rate [2267 new cases per 100,000 WRA (95% UI: 962, 4539)]. The highest rates of mortality, YLLs and Disability-Adjusted Life Years (DALYs) were estimated in Mozambique, whereas the lowest rates were recorded in Ethiopia. There were substantial reductions in the rates throughout the region in 2023 compared to 1990, except in Djibouti and Ethiopia. CONCLUSION: This study has revealed that there was substantial reduction in the rates of non-fatal and fatal health outcomes of malaria among WRA in the ESSA region in 2023 compared to 1990. However, the rates remain high and heterogeneous across the region. Therefore, strengthening the health service system and sustaining strong malaria control programs across the countries are crucial to end malaria epidemics by 2030.