A never-ending childhood of malaria

I’ve never had malaria, but I know several people who have.

我从未患过疟疾，但我认识几个人患过疟疾。

They describe it as one of the worst experiences of their life.

他们形容这是他们一生中最糟糕的经历之一。

What starts out feeling like the flu — which is bad enough — can quickly progress into something far worse.

一开始感觉像流感——这已经够糟糕了——很快就会发展成更糟糕的情况。

The body swings from intense fever and sweats to chills deep enough to make you shake uncontrollably.

身体从高烧、出汗到深沉的寒意，让你无法控制地颤抖。

Everything aches, from your muscles and joints to the pounding headache that makes it impossible to think clearly.

从肌肉和关节到剧烈头痛，一切都疼痛，让人无法清晰思考。

Your body is so fatigued that it’s a battle to make it to the bathroom when the nausea and vomiting arrive.

你的身体太疲劳了，当恶心和呕吐袭来时，你很难去洗手间。

That’s what a pretty standard infection feels like.

这就是相当标准的感染的感觉。

For some, it goes much further.

对于一些人来说，它更进一步。

Here is how one account describes it:

以下是一个帐户的描述：

“I awoke to what felt like lightning going through my legs, and then spreading through my body and in my head.

“我醒来时感觉闪电穿过我的双腿，然后传遍我的身体和我的头脑。

Probably the worst headache, body aches, and chills you could possibly imagine.

可能是你能想象到的最严重的头痛、身体疼痛和发冷。

It felt like I was being stung repeatedly by an electric shock gun and could barely control my movements.

感觉就像被电击枪反复蛰刺一样，几乎无法控制自己的动作。

The pain was so intense; I actually believed I was dying, literally crying out in pain so bad that I was taken to a 24-hour clinic that night at 3am.”

疼痛是如此剧烈；我真的相信自己快要死了，疼得大哭起来，以至于那天晚上凌晨 3 点我被带到了一家 24 小时诊所。”

Imagine (or remember) what a bout of this pain feels like.

想象一下（或记住）这种疼痛的感觉。

Then imagine having to suffer through that more than 100 times.

然后想象一下要经历 100 多次这样的痛苦。

That’s the reality for some children in the world.

这就是世界上一些孩子的现实。

I often donate to the Against Malaria Foundation .

我经常向抗击疟疾基金会捐款。

When I do so, I become obsessed with one single metric: the number of lives my money might save.

当我这样做时，我会痴迷于一个指标：我的钱可以挽救多少生命。

That’s because malaria kills a lot of people: over 600,000 every year, and most of them are children .

这是因为疟疾夺去了很多人的生命：每年有超过 60 万人死亡，其中大多数是儿童。

While focusing on deaths, I gloss over the number of infections that donated bed nets might prevent.

在关注死亡人数的同时，我忽略了捐赠蚊帐可能预防的感染数量。

Donating £10,000 saves around four lives and prevents 2,500 infections.

捐赠 10,000 英镑挽救了大约 4 人的生命并预防了 2,500 例感染。

1 Saving four lives is great.

1 拯救四个生命是伟大的。

But so, too, is sparing 2,500 people from the awful experiences described above.

但这样也能让 2,500 人免遭上述可怕的经历。

That suffering is what these donations are protecting against.

这些捐款就是为了防止这种痛苦。

Before digging into the data, I didn’t quite grasp how brutal the non-fatal side of this illness is.

在深入研究数据之前，我不太明白这种疾病的非致命性有多么残酷。

It’s estimated that there are around 280 million cases of malaria every year.

据估计，每年约有 2.8 亿例疟疾病例。

That means one case for roughly every 30 people.

这意味着大约每 30 人就有 1 例。

In some parts of the world, though, those rates are much, much higher.

然而，在世界某些地区，这一比例要高得多。

The map shows how concentrated malaria is.

该地图显示了疟疾的集中程度。

It is still a significant problem across much of the tropics — including South and Southeast Asia, and South America — but its focal point is Africa.

这仍然是大部分热带地区（包括南亚、东南亚以及南美洲）的一个重大问题，但其焦点是非洲。

We also get this perspective from the chart below.

我们也从下面的图表中得到了这个观点。

In countries like Benin, Mozambique, Nigeria, and Sierra Leone, there are roughly 30 new cases of malaria for every 100 people, every year.

在贝宁、莫桑比克、尼日利亚和塞拉利昂等国家，每年每 100 人中大约有 30 例新发疟疾病例。

That’s around 100 times higher than in high-burden countries in other regions, such as India or Colombia.

这比印度或哥伦比亚等其他地区的高负担国家高出约 100 倍。

When I first saw this data, my initial thought was: if there are 30 cases per 100 people, that means around one-third of Nigerians or Beninese must be infected every year .

当我第一次看到这个数据时，我最初的想法是：如果每100人有30例，那就意味着每年大约有三分之一的尼日利亚人或贝宁人会被感染。

That in itself is quite staggering.

这本身就相当令人震惊。

Yet that is quite far from the truth.

但这与事实相去甚远。

Looking at this data by age group, we see that malaria infections are incredibly common among children; much less so among adults, who have built up immunity.

按年龄组查看这些数据，我们发现疟疾感染在儿童中非常常见；对于已经增强免疫力的成年人来说更是如此。

In Benin, there are 98 cases for every 100 children under five years old.

在贝宁，每 100 名 5 岁以下儿童就有 98 例病例。

In Nigeria, 79 cases.

尼日利亚有 79 例。

Almost one case for every child.

几乎每个孩子都有一个案例。

But again, this doesn’t mean that every child in Benin gets malaria once a year.

但这并不意味着贝宁的每个儿童每年都会患一次疟疾。

It’s an average: some regions see much less transmission of the disease, while children living in very high-burden areas will often be infected five or six times over.

这是一个平均值：一些地区的疾病传播要少得多，而生活在高负担地区的儿童往往会被感染五六次以上。

Studies in high-transmission areas of Burkina Faso find that the number of episodes among children reaches up to six per year.

对布基纳法索高传播地区的研究发现，儿童中每年发病次数高达六次。

2 In parts of Uganda, the median was more than 5 infections per year.

2 在乌干达部分地区，每年感染人数中位数超过 5 例。

3 That’s roughly once every two months.

3 大约每两个月一次。

You’ve barely recovered from the previous infection before you’re floored with another one.

你刚刚从上一次感染中恢复过来，就又被另一次感染击倒了。

One of the most extensive (and tragic) studies I’ve seen followed 111 children in Senegal over an average span of 17 years.

我见过的最广泛（也是悲剧性）的研究之一对塞内加尔的 111 名儿童进行了平均 17 年的跟踪调查。

4 The children were monitored almost daily for malaria infection.

4 几乎每天都会对孩子们进行疟疾感染监测。

The median child experienced 43 attacks of malaria over the course of their childhood.

儿童在童年时期经历过 43 次疟疾发作。

5

5

In the chart, you can see the number of malaria infections each child experienced over that period, with one bar representing one child.

在图表中，您可以看到该时期每个孩子经历的疟疾感染数量，一个条形代表一个孩子。

What’s staggering is that four children were infected 100 times or more.

令人震惊的是，有四个孩子被感染了100次甚至更多。

The highest suffered through 112 episodes.

最高的经历了112集。

Even the boy who experienced the fewest was still infected 11 times.

即使是经历最少的男孩也被感染了11次。

This level of suffering is hard for me to get my head around.

这种程度的痛苦让我难以接受。

For most children growing up in areas with very high rates of malaria, their childhood is a constant and relentless series of malaria episodes.

对于在疟疾高发地区长大的大多数儿童来说，他们的童年就是一系列持续不断的疟疾发作。

The symptoms themselves must be hard to deal with.

症状本身一定很难处理。

But the toll this takes on the body is extreme, too.

但这对身体造成的伤害也是极大的。

It is not surprising that so many become malnourished and have their development hindered.

如此多的人营养不良并阻碍其发育也就不足为奇了。

This extensive study spanned decades, from 1990 to 2015.

这项广泛的研究跨越了数十年，从 1990 年到 2015 年。

Many living there didn’t have access to insecticide-treated bed nets or other preventive measures.

许多住在那里的人没有经过杀虫剂处理的蚊帐或其他预防措施。

Over the course of those 25 years, people did start to get them.

在那 25 年里，人们确实开始得到它们。

Infection rates fell 25-fold as a result.

感染率因此下降了 25 倍。

Clearly, this is a problem we can do something about.

显然，这是一个我们可以采取措施解决的问题。

As it turns out, it can be done fairly cheaply, too.

事实证明，这也可以相当便宜地完成。

An insecticide-treated bed net costs just $2.

经杀虫剂处理的蚊帐仅需 2 美元。

Many children and families in the world still lack this basic tool.

世界上许多儿童和家庭仍然缺乏这种基本工具。

That is why I’m happy to donate to organizations trying to change that.

这就是为什么我很乐意向试图改变这种状况的组织捐款。

I would love to see humanity beat malaria in my lifetime.

我很高兴看到人类在我有生之年战胜疟疾。

Not just to stop the 600,000 deaths that happen every year, but to give millions of kids something back that no chart can capture: their childhood.

不仅是为了阻止每年发生的 60 万人死亡，也是为了给数百万孩子一些图表无法捕捉到的东西：他们的童年。

Many thanks to Edouard Mathieu for comments and feedback on this article.

非常感谢 Edouard Mathieu 对本文的评论和反馈。

We do not have to live in a world where 1,320 children die from a preventable disease every day.

我们不必生活在这样一个世界：每天有 1,320 名儿童死于可预防的疾病。

To reduce child mortality, we need to understand what children are dying from.

为了降低儿童死亡率，我们需要了解儿童死于什么原因。

Deaths from other animals are mostly caused by just two types: mosquitoes and snakes.

其他动物的死亡大多由两种类型引起：蚊子和蛇。

£10,000 is equivalent to roughly $12,700.

10,000 英镑大约相当于 12,700 美元。

I recently donated this amount (from an award prize); the Against Malaria Foundation emailed with estimates that this would buy 5,100 bed nets, protecting roughly 9,200 people.

我最近捐赠了这笔金额（来自奖项）；抗击疟疾基金会通过电子邮件估计，这将购买 5,100 个蚊帐，保护大约 9,200 人。

That would prevent 2,500 infections and save an estimated four lives.

这将预防 2,500 例感染，并挽救大约 4 条生命。

GiveWell also runs through the numbers.

GiveWell 也贯穿了这些数字。

This ranges from $3,000 to $8,000 per life saved, so four lives is on the optimistic end of that range.

每个拯救生命的费用从 3,000 美元到 8,000 美元不等，因此有 4 条生命处于该范围的乐观范围内。

These numbers obviously vary widely depending on the local situation and the demographics of the populations they’re going to.

这些数字显然有很大差异，具体取决于当地情况和目的地人口的人口统计数据。

Ouédraogo, A., Tiono, A.

韦德拉奥戈，A.，蒂奥诺，A.

B., Diarra, A., Sanon, S., Yaro, J.

B.、Diarra, A.、Sanon, S.、Yaro, J.

B., Ouedraogo, E., ...

B.、韦德拉奥戈、E.、...

& Sirima, S.

& 西丽玛，S.

B.

B.

(2013).

（2013）。

Malaria morbidity in high and seasonal malaria transmission area of Burkina Faso.

布基纳法索疟疾高发和季节性传播地区的疟疾发病率。

PLoS One.

公共科学图书馆一号。

Jagannathan, P., Muhindo, M.

贾格纳坦 (Jagannathan)，P.，穆欣多 (Muhindo)，M.

K., Kakuru, A., Arinaitwe, E., Greenhouse, B., Tappero, J., ...

K.、卡库鲁，A.、阿瑞奈特韦，E.、温室，B.、塔佩罗，J.，...

& Dorsey, G.

＆多尔西，G.

(2012).

（2012）。

Increasing incidence of malaria in children despite insecticide-treated bed nets and prompt anti-malarial therapy in Tororo, Uganda.

在乌干达托罗罗，尽管使用了杀虫剂处理的蚊帐并及时进行抗疟疾治疗，儿童疟疾发病率仍在增加。

Malaria Journal.

疟疾杂志。

The timeframe for each child varied, depending on when they were born.

每个孩子的时间范围各不相同，具体取决于他们的出生时间。

The minimum evaluation period was 10 years, and the maximum was 25 years.

评估期限最短为10年，最长为25年。

Trape, J.

特拉普，J.

F., Diagne, N., Diene-Sarr, F., Faye, J., Dieye-Ba, F., Bassène, H., ...

F.、Diagne, N.、Diene-Sarr, F.、Faye, J.、Dieye-Ba, F.、Bassène, H.、...

& Sokhna, C.

& 索赫纳，C.

(2024).

（2024）。

One hundred malaria attacks since birth.

自出生以来已有一百次疟疾发作。

A longitudinal study of African children and young adults exposed to high malaria transmission.

对遭受疟疾高传播的非洲儿童和年轻人进行的纵向研究。

EClinicalMedicine.

电子临床医学。

The text in the paper itself states a median of 46 attacks, but from the individual supplementary data used to build the chart, I find the median to be 43.

论文本身的文本指出攻击的中位数为 46 次，但从用于构建图表的各个补充数据来看，我发现中位数为 43 次。

Our articles and data visualizations rely on work from many different people and organizations.

我们的文章和数据可视化依赖于许多不同的人和组织的工作。

When citing this article, please also cite the underlying data sources.

引用本文时，请同时注明底层数据来源。

This article can be cited as:

这篇文章可以引用为：

We are a live site and we keep our work maintained.

我们是一个活跃的网站，我们会保持我们的工作。

So our articles are often changed, including the data.

所以我们的文章经常改，包括数据。

You can browse previous versions of this work here.

您可以在此处浏览此作品的先前版本。