Malaria-Associated Mortality in the 19th Century.

Malaria can kill directly, as well as contribute to indirect or malaria-associated mortality. Data from French prison colonies and the Panama Canal in the 19th century had high mortality rates and comparison populations, which allowed the estimation of malaria-associated mortality. French Guiana and New Caledonia had similar French Imperial Prison systems with consistent mortality records, but French Guiana had malaria whereas New Caledonia did not, enabling rough estimates of malaria-associated mortality by comparing death rates in these otherwise similar colonies. A statistical model developed from the prison colonies estimated that malaria-associated mortality was equal to or greater than the number of deaths directly attributed to malaria in Panama consistent with the contemporaneous civilian records in Panama City. Malaria mortality in French Panama Canal workers was highly correlated (R2 = 0.73) with deaths because of all other causes in the late 19th century. Malaria control and elimination programs are successful beyond direct impacts on malaria deaths by helping to prevent many additional deaths due primarily to other causes.