It also takes the opportunity to ensure that children are fully immunized and given prophylactic vitamin A and that their mothers receive counselling on feeding. This approach, which other countries will follow in the next year, will ensure not only that children receive adequate care for their illnesses, including ARI, but that they are more likely to survive future attacks. Africa has the highest levels of endemicity in the world. The vast majority of malaria deaths occur among young children in Africa, especially in remote rural areas with poor access to health services. Approximately one million deaths among children under five years of age can be attributed to malaria alone or in combination with other diseases.
Mortality is concentrated in the younger age groups.
In rural areas with little access to adequate treatment these rates might be even higher. Even in non-fatal cases malaria produces considerable impact on the health of young African children, increasing susceptibility to other infections and hampering development. In May 1992, the World Health Assembly approved a target of introducing hepatitis B vaccine in all countries by 1997. Following these recommendations, over 77 countries have integrated hepatitis B vaccine into their immunization programmes. A number of countries are either planning introduction or studying its feasibility.