[show abstract][hide abstract] ABSTRACT: The transmission of malaria across the Arabian Peninsula is governed by the diversity of dominant vectors and extreme aridity. It is likely that where malaria transmission was historically possible it was intense and led to a high disease burden. Here, we review the speed of elimination, approaches taken, define the shrinking map of risk since 1960 and discuss the threats posed to a malaria-free Arabian Peninsula using the archive material, case data and published works. From as early as the 1940s, attempts were made to eliminate malaria on the peninsula but were met with varying degrees of success through to the 1970s; however, these did result in a shrinking of the margins of malaria transmission across the peninsula. Epidemics in the 1990s galvanised national malaria control programmes to reinvigorate control efforts. Before the launch of the recent global ambition for malaria eradication, countries on the Arabian Peninsula launched a collaborative malaria-free initiative in 2005. This initiative led a further shrinking of the malaria risk map and today locally acquired clinical cases of malaria are reported only in Saudi Arabia and Yemen, with the latter contributing to over 98% of the clinical burden.
Advances in Parasitology 01/2013; 82:205-51. · 3.78 Impact Factor
[show abstract][hide abstract] ABSTRACT: Bashagard district is one of the important malaria endemic areas in southern Iran. From this region a total of 16,199 indigenous cases have been reported in recent years. The aim of this study was to determine the situation of the disease and provide the risk map for the area. ArcGIS9.2 was used for mapping spatial distribution of malaria incidence. Hot spots were obtained using evidence-based weighting method for transmission risk. Environmental factors including temperature, relative humidity, altitude, slope and distance to rivers were combined by weighted multi criteria evaluation for mapping malaria hazard area at the district level. Similarly, risk map was developed by overlaying weighted hazard, land use/land cover, population density, malaria incidence, development factors and intervention methods. Our results reveal that the disease mainly occurs in north and east of the study area. Consequently the district is divided into three strata. Appropriate interventions are recommended for each stratum based on national malaria policy. Malaria hazard and risk map, stratification based on relevant information and data analyzing provide a useful method preparedness and early warning system for malaria control, although regular updating is required timely.
[show abstract][hide abstract] ABSTRACT: Species identification and information on transmission pattern of malaria parasite in any malaria endemic area is key to success for a malaria control programme. In this investigation, malaria diagnosis using molecular method was used to assess the transmission pattern of malaria parasite in three malaria endemic regions: Afghanistan, Iran and Pakistan.
Blood samples were collected from the patients presenting with vivax malaria from Afghanistan (n=108), Iran (n=200) and Pakistan (n=199). Malaria parasite detection was made by the gold standard (microscopy) and also nested-PCR assay, using 18S small sub-unit ribosomal RNA (ssrRNA) gene.
Based on microscopy method, the level of mixed infection was zero to 2.5 per cent; however, nested-PCR assay detected 6.5, 22 and 23.5 per cent mixed infections in samples collected from Afghanistan, Iran and Pakistan, respectively. The present results showed that the co-infection of P. vivax with P. falciparum was frequent in malaria endemic regions of Iran and Pakistan.
The present data suggest the need for improving microscopy diagnosis method and the clinician should also have careful clinical observation, along with the reports on Giemsa- stained thick blood films, particularly in summer time when P. vivax is predominant. Also sharing information on transmission pattern of mixed infection among these countries may help in designing better control strategies for malaria.
The Indian Journal of Medical Research 07/2010; 132:31-5. · 2.06 Impact Factor
[show abstract][hide abstract] ABSTRACT: In this study, the nature and extent of genetic diversity of Plasmodium vivax populations circulating in Afghanistan have been investigated by analyzing three genetic markers: csp, msp-1, and msp-3 alpha. Blood samples (n=202) were collected from patients presenting with vivax malaria from south-western (Herat) and south-eastern (Nangarhar) parts of Afghanistan, and analysed using nested-PCR/RFLP and sequencing methods. Genotyping pvmsp-1 revealed type 1, type 2 and recombinant type 3 allelic variants, with type 1 predominant in parasites in both study areas. The sequence analysis of 57 P. vivax isolates identified a total of 26 distinct alleles. Genotyping pvcsp gene showed that VK210 type (86.6%) is predominant in Afghanistan. Moreover, three major types of the pvmsp-3 alpha locus: type A, type B and type C were distinguished among Afghani isolates. The predominant fragments among Nangarhar and Herat parasites were type A (70.8% and 67.9%, respectively). PCR/RFLP products with Hha I and Alu I were detected 52 and 38 distinct variants among Nangarhar and Herat isolates, respectively. These results strongly indicate that the P. vivax populations in Afghanistan are highly diverse.
[show abstract][hide abstract] ABSTRACT: In this study, the diversity of Plasmodium vivax populations circulating in Pakistan and Iran has been investigated by using circumsporozoite protein (csp) and merozoite surface proteins 1 and 3alpha (msp-1 and msp-3alpha) genes as genetic markers. Infected P. vivax blood samples were collected from Pakistan (n=187) and Iran (n=150) during April to October 2008, and were analyzed using nested-PCR/RFLP and sequencing methods. Genotyping pvmsp-1 (variable block 5) revealed the presence of type 1, type 2 and recombinant type 3 allelic variants, with type 1 predominant, in both study areas. The sequence analysis of 33 P. vivax isolates from Pakistan and 30 from Iran identified 16 distinct alleles each, with one allele (R-8) from Iran which was not reported previously. Genotyping pvcsp gene also showed that VK210 type is predominant in both countries. Moreover, based on the size of amplified fragment of pvmsp-3alpha, three major types: type A (1800bp), type B (1500bp) and type C (1200bp), were distinguished among the examined isolates that type A was predominant among Pakistani (72.7%) and Iranian (77.3%) parasites. PCR/RFLP products of pvmsp-3alpha with HhaI and AluI have detected 40 and 39 distinct variants among Pakistani and Iranian examined isolates, respectively. Based on these three studied genes, the rate of combined multiple genotypes were 30% and 24.6% for Pakistani and Iranian P. vivax isolates, respectively. These results indicate an extensive diversity in the P. vivax populations in both studies.
Parasitology International 07/2009; 59(1):15-21. · 2.30 Impact Factor
[show abstract][hide abstract] ABSTRACT: We evaluated the measles-rubella mass vaccination campaign in the Islamic Republic of Iran in December 2003. Vaccination coverage, community awareness of the campaign and the quality of vaccination services were assessed in the population covered by Tehran University of Medical Sciences. At the end of the campaign 96.4% (95% CI: 94.6%-98.2%) of the population sample (n = 390) had been vaccinated. Awareness of the campaign was 80.59% of the sample (n = 190) at the start, rising to 96.8% during and 100.0% at the end of the campaign. None of the 24 vaccination teams sampled were over the threshold for unacceptable performance. The mass media and vaccination teams demonstrated good performance and have achieved their goals.
Eastern Mediterranean health journal = La revue de santé de la Méditerranée orientale = al-Majallah al-ṣiḥḥīyah li-sharq al-mutawassiṭ 01/2008; 14(4):810-7.
[show abstract][hide abstract] ABSTRACT: Anopheles stephensi Liston is an important malaria vector in Hormozgan province, where it is the most prevalent anopheline mosquito. It shows two annual activity peaks, one in spring and another in the autumn. In mountainous areas the second peak starts earlier than in coastal regions. Adults are endophilic and endophagic, but in the hot season when people sleep outside buildings they frequently bite outdoors. Larvae are found in a wide-range of habitats, both natural and man-made. All three biological forms of the species, occur in the province, i.e. An. stephensi stephensi (type form), An. stephensi mysorensis, and the intermediate form. An. stephensi mysorensis is found only in rural-mountainous areas, whereas the type and intermediate forms occur in urban-coastal regions and the rural plains, with the type form predominant. The presence of the type form in urban areas and mysorensis in rural areas is consistent with the available epidemiological data for malaria in the region and with the finding in India that the type form is an efficient malaria vector inhabiting urban areas whereas mysorensis is rural and has a lower vectorial capacity. Insecticide susceptibility tests on field collected adult mysorensis and adults from laboratory strains of the type and intermediate forms were carried out according to WHO standard methods. These showed that all three forms are susceptible to bendiocarb, propoxur, malathion, fenitrothion, deltamethrin, permethrin, cyfluthrin, and lambdacyhalothrin, but are resistant to DDT and show low level of tolerance to dieldrin. Examination of the larvicidal activity of malathion, fenitrothion, temephos and chlorpyrifos at diagnostic doses showed that these stephensi forms are susceptible to all larvicides except fenitrothion. Irritability tests to pyrethroid insecticides showed high levels of irritability to permethrin and lambdacyhalothrin, but low irritability to cyfluthrin and deltamethrin. The importance of these findings for the epidemiology and control of malaria in the region are discussed.
[show abstract][hide abstract] ABSTRACT: Hormozgan Province is located in the south of Iran bordering the Persian Gulf. In this area, malaria is still considered a major health problem. In the province, eleven species of Anopheles were identified: An. pulcherrimus, An. sergenti, An. apoci, An. multicolor, An. subpictus, An. turkhudi, An. fluviatilis, An. stephensi, An. d'thali, An. superpictus, and An. culicifacies, among which only the last five species play an important role in malaria transmission. Larval habitats of malaria vectors varied from clean to brackish water, as well as sewage water, under palm trees, marshland, pools, pounds, drainage, irrigation canals, wells, and water containers. Malathion, fenitrothion, chlorpyrifos, and temephos were tested against An. stephensi, An. fluviatilis and An. d' thali larvae at diagnostic doses recommended by WHO. The results showed susceptibility to malathion, chlorpyrifos and temephos, but fenitrothion was not able to yield 100% mortality.
The Southeast Asian journal of tropical medicine and public health 02/2004; 35 Suppl 2:22-5. · 0.61 Impact Factor
[show abstract][hide abstract] ABSTRACT: The resurgence of malaria has highlighted the need for training health professionals in malaria control planning. The course described here was organized jointly by the World Health Organization, the Ministry of Health and Medical Education and the School of Public Health in Iran. The first course was held in 1997 and the fifth WHO-approved course is now in progress. The course focuses on dynamic, interactive, practical and problem-solving learning methods. It provides the participants with the knowledge, skills, competence and confidence to be able to analyse the malaria problem. The course fulfils the requirements of the Roll Back Malaria campaign. In the 8-week training period subjects such as basic bio-statistics and epidemiology, microcomputing, malaria parasitology, malaria entomology, vector control, case management, epidemiological approach to malaria control, field work and planning for malaria control are taught. Each participant is evaluated in each subject. A total of 71 participants from 17 countries in the WHO African and Eastern Mediterranean Regions, mainly those with a malaria problem, have graduated.
Eastern Mediterranean health journal = La revue de santé de la Méditerranée orientale = al-Majallah al-ṣiḥḥīyah li-sharq al-mutawassiṭ 01/2004; 10(1-2):215-24.