Anopheles

Vector for Malaria

Malaria vs Dengue:
what are the similarities
and differences?
Malaria and dengue are two very common Aedes
vector-borne and mosquito-borne diseases in Vector for Dengue
certain parts of the world, meaning that they
are both transmitted by mosquitoes. They are
responsible for over 600,000 deaths and have
been reported in over 80 countries. Comparison
These diseases can also be present in the same DENGUE MALARIA
countries, which can be problematic if there is Differences
an outbreak of both diseases at the same time. Flavivirus4 Parasite

Misdiagnosis between the two is common and Aedes mosquitoes Anopheles mosquitoes

contributes to the prevalence of co-infection.1 No specific treatment

Anti-malaria drugs for prevention
and treatment
Urban Rural
Both malaria and dengue are transmitted by Prefer to live indoors and outdoors Prefer to shelter indoors

female mosquitoes and cause severe fevers in Day biting mosquitoes Prefers to bite late evening and night

humans. Because of this similarity, they can be Similarities

Symptoms: Fever
confused by patients and medical personnel.
Disease vector: Mosquito-borne
However, they are two very different diseases Location: Tropical countries
caused by different pathogens2 and different Measures Vector control methods

mosquito species (Aedes and Anopheles) that

do not mate. There are around 150 million years Vector-borne diseases
of evolution separating Aedes and Anopheles
mosquitoes. Vector-borne diseases are human illnesses
caused by pathogens that are transmitted by
In this factsheet, we aim to help clarify the vectors, which cause more than 700,000 deaths
similarities and differences between malaria every year.5 They include for example, malaria
and dengue. and dengue. Their vectors are living organisms
that can transmit these infectious pathogens
At Target Malaria, our focus is on the development between humans, or from animals to humans, for
of new genetic tools to target the population of example mosquitoes. In the case of mosquitoes,
mosquitoes that transmit malaria. There are other the pathogen is passed from the vector to the
teams working on solutions for dengue control.3 human or animal when it bites them.

1 Increasing prevalence of malaria and acute dengue virus coinfection in Africa: a meta-analysis and meta-regression of cross-sectional studies | Malaria
Journal | Full Text (biomedcentral.com)
2 Pathogens are micro-organisms that can cause disease in their hosts, i.e. viruses, parasites, bacteria.
3 World Mosquito Program – www.worldmosquitoprogram.org, and Oxitec – www.oxitec.com
4 Flaviviruses are emerging arthropod-borne RNA viruses, causing a broad spectrum of life-threatening disease symptoms, such as encephalitis and
haemorrhagic fever.
5 Vector-borne diseases include malaria, dengue, schistosomiasis, human African trypanosomiasis, leishmaniasis, Chagas disease, yellow fever, Japanese
encephalitis and onchocerciasis. https://www.who.int/news-room/fact-sheets/detail/vector-borne-diseases

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Mosquito-borne diseases
Mosquitoes are vectors for a number of VECTOR DISEASE CAUSED TYPE OF PATHOGEN

pathogens that transmit a number of diseases Mosquito Aedes Chikungunya Virus

Dengue Virus
that are called “mosquito-borne diseases”. Lymphatic filariasis Parasite 6
Some include (non-exhaustive list): Rift Valley fever Virus7
Yellow Fever Virus
Zika Virus
Anopheles Lymphatic filariasis Parasite
Malaria Parasite
Culex Japanese encephalitis Virus
Lymphatic filariasis Parasite
West Nile fever Virus

Dengue
Dengue is a mosquito-borne disease.

Cause: Flavivirus Geography

Dengue infections are caused by four closely related Dengue is found in tropical and sub-tropical climates
viruses named DEN-1, DEN-2, DEN-3, and DEN-4. worldwide, mostly in urban and semi-urban areas. Local
These four viruses are called serotypes because each variations in risk are influenced by rainfall, temperature,
has different interactions with the antibodies in human relative humidity and unplanned rapid urbanization.
blood serum. Global burden
Recovery from infection by one provides lifelong immunity The global incidence of dengue has grown dramatically
against that particular serotype. However, cross-immunity in recent decades. Cases reported to WHO increased
to the other serotypes after recovery is only partial and from 505,430 cases in 2000 to 6.5 million in 2023. About
temporary. Subsequent infections by other serotypes half of the world's population is now at risk.
increase the risk of developing severe dengue. The disease is now endemic in more than 100 countries
Disease: Dengue fever in the WHO Regions of Africa, the Americas, the Eastern
Severe Dengue including Dengue haemorrhagic fever Mediterranean, South-East Asia and the Western
(DHF) and Dengue Shock Syndrome (DSS) are potentially Pacific. The Americas, South-East Asia and Western
deadly complications that have become a leading cause Pacific regions are the most seriously affected, with Asia
of hospitalization and death among children/adults in representing around 70% of the global disease burden.
Asia and Latin America. There is good evidence that Dengue is spreading to new areas worldwide, and
sequential infection with the different serotypes of dengue multiple outbreaks are occurring.6 The transmission
virus increases the risk of more severe disease that can
is cyclic and large outbreaks every 3-4 years can be
result in shock syndrome and death.
expected in those affected regions.
Symptoms
Treatment
High fever, headache, body aches, nausea, and rash
There is no specific treatment for dengue, but appropriate
that affects infants, young children and adults. Recovery
medical care frequently saves the lives of patients with
normally takes 1-2 weeks, in some cases, hospitalization is
Severe Dengue.Early detection of warning signs and access
required, and in severe cases dengue can be fatal. It is also
to proper medical care lowers fatality rates below 1%.
referred to as bone break fever because of the symptoms.
Vector control
Vector
At present, the main method of controlling or preventing
Female mosquitoes of the Aedes mosquitoes (mainly
dengue virus transmission is to combat the vector
Ae. aegypti and, to a lesser extent, Ae. albopictus)
mosquitoes using environmental management, source
species. This mosquito also transmits chikungunya,
reduction, and chemical methods.7 Community support is
yellow fever and zika infection
essential to sustain control measures
Transmission
Vaccine development
The virus is transmitted to humans through the bites of
At present, one vaccine (QDenga) has been approved
infected female mosquitoes. After virus incubation for
and licensed in some countries. However, it is
4–10 days, an infected mosquito can transmit the virus
recommended only for children aged 6 to 16 in high-
for the rest of its life.
transmission settings. Several additional vaccines are
under evaluation.

6 A parasite is a eukaryotic organism

7 A virus is an infectious agent that can only replicate within a host organism.
8 https://www.who.int/emergencies/disease-outbreak-news/item/2023-DON498
9 https://www.afro.who.int/health-topics/dengue

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Malaria
Malaria is a mosquito-borne disease.

Cause: Children under 5 years of age accounted for about 78%

There are 5 Plasmodium parasite species that cause of all malaria deaths in the Region.
malaria in humans and 2 of these species – P. Four African countries accounted for just over half
falciparum and P. vivax – pose the greatest threat. P. of all malaria deaths worldwide: Nigeria (26.8%), the
falciparum is the deadliest malaria parasite and the Democratic Republic of the Congo (12.3%), Uganda
most prevalent on the African continent. P. vivax is the (5.1%) and Mozambique (4.2%).11
dominant malaria parasite in most countries outside of
sub-Saharan Africa. The other malaria species which can Global burden
infect humans are P. malariae, P. ovale and P. knowlesi. In 2022, the global tally of malaria deaths reached
608,000, and cases reached 249 million – well above
Disease:
the estimated number of cases before the COVID-19
Malaria
pandemic, and an increase of five million over 2021.12
Symptoms
Treatment
Symptoms usually start within 10 – 15 days of getting
Early diagnosis and treatment of malaria with anti-malaria
bitten by an infected mosquito. Symptoms can be mild
drugs reduces disease, prevents deaths and contributes
or life-threatening. Mild symptoms are fever, chills and
to reducing transmission. WHO recommends that all
headache. Severe symptoms include fatigue, confusion,
suspected cases of malaria be confirmed using parasite-
seizures, and difficulty breathing. The first symptoms
based diagnostic testing (through either microscopy or a
may be mild, similar to many febrile illnesses, and
rapid diagnostic test).
difficult to recognize as malaria. Left untreated, P.
falciparum malaria can progress to severe illness and Malaria is a serious infection and always requires
death within 24 hours. treatment with medicine.
Vector Vector control
Anopheles mosquitoes Vector control is a vital component of malaria control and
elimination strategies as it is highly effective in preventing
Transmission
infection and reducing disease transmission. The 2 core
Malaria spreads to people through the bites of infected
interventions are insecticide-treated nets (ITNs) and
female Anopheles mosquitoes.
indoor residual spraying (IRS).
The incubation period in most cases of malaria ranges
Vaccine development
from 7 – 30 days. Different species of parasites that
Since October 2021, WHO has recommended broad use
cause malaria in humans can cause shorter or longer
of the RTS,S/AS01 malaria vaccine among children living
incubation periods.10 Just like Aedes, once infected the
in regions with moderate to high P. falciparum malaria
mosquito is able to spread the parasite for life. transmission. The vaccine has been shown to
Geography significantly reduce malaria, and deadly severe malaria,
Although malaria is present is many countries of the among young children.
tropical belt around the world, the WHO African Region In October 2023, WHO recommended a second safe and
continues to carry a disproportionately high share of the effective malaria vaccine, R21/Matrix-M. The availability
global malaria burden. In 2022 the Region was home of two malaria vaccines is expected to make broad-scale
to about 94% of all malaria cases and 95% of deaths. deployment across Africa possible.

10 https://www.cdc.gov/malaria/symptoms/index.html
11 World Malaria Report 2023
12 World Malaria Report 2023

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Global upsurge in dengue
After a slight decline of cases between the year Since the beginning of 2024, over 9 million
2020-2022 due to the COVID-19 pandemic and dengue cases and over 4500 dengue-related
lower reporting rate, the global incidence of deaths have been reported globally. Most
dengue has markedly increased over the past cases were reported in the WHO Pan-American
two decades, posing a substantial public health region with a cumulative number of over 7
challenge. From 2000 to 2023, the World Health million suspected cases reported until June of
Organization (WHO) documented a ten-fold 2024. According to the Pan-American Health
surge in reported cases worldwide increasing Organization report of 7 March 2024, this is an
from 500,000 to 6.5 million13, characterized by increase of 249% compared to the same period
a significant increase in the number, scale, and in 2023.16
simultaneous occurrence of multiple outbreaks,
spreading into regions previously unaffected In comparison malaria cases and deaths have not
by dengue.14 Urbanization, international travel, seen an upsurge of this magnitude although the
climate change, and socioeconomic factors have prevalence is higher now than it was pre-COVID.
fueled these recent dengue upsurges.15

Dengue outbreak in Burkina Faso in 2023

In Burkina Faso, dengue has been endemic The transmission is cyclic and large outbreaks
since 2013, a consequence of the increase in are expected to occur every 3-5 years. During
Aedes aegypti and Aedus albopictus species in the 2016-2017 outbreak in Burkina Faso, the
the country. In 2023, Burkina Faso grappled predominant circulating serotype was DEN-2.
with an epidemic of dengue fever, marked by Recent analysis by Prof. Armel Poda (CHU Sourô
a cumulative total of 154,867 suspected cases Sanou, Bobo-Dioulasso, Burkina Faso) indicates
(diagnosed through syndromic diagnosis). Among that during the 2023 outbreak20, serotype DEN-
these, 70,433 cases were probable (confirmed by 3 was circulating21. The difference in serotypes
rapid detection test), resulting in 709 recorded could explain the increased severity of dengue
deaths. All thirteen regions of the country cases (hospitalisations and deaths) last year
reported at least one dengue-related death in Burkina Faso due to the higher number of
(with the highest number of deaths being in the secondary infections, several years after the end
Central region (Ouagadougou; 318 deaths) and of serotype cross-protection. However, other
in the Hauts-Bassins region (Bobo-Dioulasso; factors such as climate change, urbanisation and
228 deaths)17, marking this as the largest dengue socioeconomic factors that are responsible for
epidemic ever witnessed in Africa.18 As a the global surge could also apply here.
comparison, in Burkina Faso, there were 8 million
malaria infections and 16,669 deaths in 2022.19

13 https://www.who.int/emergencies/disease-outbreak-news/item/2023-DON498
14 https://www.who.int/news-room/fact-sheets/detail/dengue-and-severe-dengue
15 https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11035754/
16 https://www.ecdc.europa.eu/en/dengue-monthly
17 Ministry of Health, Weekly epidemiological bulletin 52, epidemiological surveillance. Ministry of Health, Burkina Faso, 2023
18 https://www.thelancet.com/journals/lancet/article/PIIS0140-6736(23)02803-9/fulltext
19 WHO, World Malaria Report 2023
20 Estimating dengue burden among family contacts through cluster investigation around probable cases in 2022 and 2023 in the Central Region, Burkina Faso
21 Predominance of DENV-3 among patients in Ouagadougou, Burkina Faso

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Conclusion
While malaria and dengue present similarities, The increase in dengue cases is happening
in particular in the symptoms and the fact that globally and is not limited to Burkina Faso. In fact,
they are both transmitted both my mosquitoes, from 2000 to 2023, the World Health Organization
it is fundamental to consider these two diseases (WHO) documented over ten-fold surge in
very differently. reported dengue cases worldwide, 2023 and 2024
are showing record case numbers globally. These
The mosquitoes that transmit those two diseases numbers are likely to be an underestimate of the
belong to distinct species that do not mate true burden as most of the primary infections
and the pathogens that they transmit are also are asymptomatic. Dengue reporting is also not
very different: a virus, in the case of dengue; mandatory in many countries.
and a parasite, in the case of malaria. Aedes
mosquitoes occur in more urban areas, whilst Efforts are ongoing to better understand the
Anopheles mosquitoes stay in more rural areas. transmission dynamics of dengue and other
arboviruses in the African region. The WHO
In the case of dengue, increased urbanisation and Regional Office for Africa has endorsed the
climate change may have contributed to a change Framework for the integrated control, elimination
in the vectors distribution and spread.22 Further, and eradication of tropical and vector-borne
difficulties in the timely detection (crucial for the diseases in the African Region 2022-2030.24
reporting of cases and prevention of spread) and Equally, the Regional Office has also drafted the
adequate surveillance may have emphasized the Framework for implementation of the Global
increase of dengue in affected countries.23 Arbovirus Initiative by targeted Member States
in the WHO African Region.25

Références

• Dengue and severe dengue (who.int)

• https://www.afro.who.int/health-topics/dengue
• Malaria (who.int)
• https://www.afro.who.int/health-topics/malaria
• Dengue fever explained: from disease spread to prevention | News | Wellcome
• https://www.who.int/emergencies/disease-outbreak-news/item/2023-DON498
• Setting Dengue Fever Epidemic Thresholds Between 2016 and 2021 in the Central Health Region,
Burkina Faso: An Ecological Study

22 https://www.who.int/emergencies/disease-outbreak-news/item/2023-DON498
23 https://www.thelancet.com/journals/lancet/article/PIIS0140-6736(23)02803-9/fulltext
24 Regional Committee for Africa, 72. (2022). Framework for the integrated control, elimination and eradication of tropical and vector-borne diseases in the
African Region 2022–2030: report of the Secretariat. World Health Organization. Regional Office for Africa. https://iris.who.int/handle/10665/361856
25 https://www.who.int/initiatives/global-arbovirus-initiative

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