Significant Decline of Malaria Incidence in Southwest of Iran (2001–2014)

Iran is considered as one of the malaria endemic countries of the Eastern Mediterranean Region (EMR) and is at risk due to neighboring Afghanistan, Pakistan in the east, and Iraq to the west. Therefore the aim of the present investigation is the evaluation of the trend of malaria distribution during the past decade (2001–2014) in Khuzestan province, southwestern Iran. In this retrospective cross-sectional investigation, blood samples were taken from all malaria suspicious cases who were referred to health centers across Khuzestan province. For each positive subject a questionnaire containing demographic information was filled out. Data analysis was performed using SPSS 18. From a total of 541 malaria confirmed cases, 498 (92.05%) were male and 43 (7.95%) were female. The highest number of infections was seen in 2001 with 161 (29.75%) cases and the lowest was in 2014 with 0 (0%). Also, Plasmodium vivax was identified as dominant species in 478 (88.35%) individuals and P. falciparum comprised 63 (11.65%). The highest infection rate was observed in non-Iranian populations with number 459 (84.85%) and imported cases 508 (93.90%). Also, the majority of subjects were over 15 years of age, 458 (84.65%). Due to proximity to endemic countries which has made the malaria campaign difficult, more effort is needed to control the infection in order to achieve malaria elimination

Predicting the Probability of Phlebotomus papatasi Presence in Khuzestan Province: Combining Hierarchical Analysis Process and Geographic Information System

Background and purpose: Khuzestan Province in Iran is one of the endemic foci of zoonotic cutaneous leishmaniasis (ZCL) caused by Leishmania major and Phlebotomus papatasi as the main vector. The aim of this study was to predict the probability of presence of Ph. papatasi in this province using Hierarchical Analysis Process (AHP) and Geographic Information System (GIS). Materials and methods: In order to determine the distribution of Ph. papatasi, sand flies were collected in five counties, including Izeh, Mahshahr, Ahvaz, Dasht-e-Azadegan, and Andimeshk by sticky paper traps in spring and summer, 2018. Six criteria, including average annual temperature, average annual rainfall, average annual relative humidity, land use, soil texture, and elevation were selected. Maps of criteria were prepared in ArcGIS 10.5 software. The weights of the criteria and sub-criteria were determined using Expert Choice 11. Then, the final map of the probability of vector presence was prepared by combination of weighted maps and including the weight of the criteria. Results: In this study, 13 species of sand flies of two genera, Phlebotomus and Sergentomyia, were collected. The abundance of Ph. papatasi from samples collected in Izeh, Dasht-e-Azadegan, Mahshahr, Andimeshk, and Ahvaz was 55%, 72%, 69.4%, 3%, and 66.5%, respectively. Based on the analysis of matrix tables, average annual temperature (0.406), average annual relative humidity (0.233), and average annual rainfall (0.156) had the highest weight in probability of the vector presence, respectively. Conclusion: This study provides useful information for health authorities in determining the distribution of Ph. papatasi to act properly based on facilities and budget in case of outbreak