[(INDUCED MALARIA)].

Induced malaria continues to be one of the most pressing public health problems in malaria-endemic countries. Ma- laria parasites remain viable in stored blood at a temperature of 2-6°C for 3 weeks. The paper presents current problems associated with transfusion-induced malaria. In the USSR and then in the Russian Federation, sporadic cases of induced malaria (Plasniodium vivax, P.malariae, rarely P.falciparum) were notified (230 cases in 1958 to 1990 and only 5 in 1991 to 2016). Current (immunological and molecular) methods for the laboratory diagnosis of malaria do not provide a 100% detection rMfteor its pathogens; therefore, it is necessary to search for highly efficient, rapid, and low-cost diagnostic methods to ensure the biological safety of donation.

[(THE IMPACT OF MIGRATION PROCESSES ON- BIOSAFETY AND HUMAN HEALTH)].

Infectious diseases are one of the serious threats to biosafety in modern society In recent years, there have been con- siderably increased international migrations: tourism and pilgrimage; labor migration flows; migration of refugees and settlers in times of armed conflicts, household migrations because of family ties and traditions. Since the number of Rus- sian tourists and migrants from endemic countries remains high, these contingents should receive special attention in the malaria epidemiological surveillance system. The paper discusses the risks of possible consequences of population migra- tions and prevention measures.

[(EXPERIENCE WITH GEOGRAPHIC INFORRMATION SYSTEMS USED IN EPIDEMIOLOGICAL STUDIES (AS AN EXAMPLE OF MALARIA AND DIROFILARIASIS)].

The effective application of GIS against parasitic diseases requires the patterns of spread of parasitic diseases in certain natural, climatic, and socioeconomic conditions of different regions where there are epidemically effective carriers. The epidemiological parameters defining a high risk of an epidemiological process after P.vivax importation into Russia were calculated using the developed HealthMapper controlled module with a database. Analysis of the average long-term air temperatures in the administrative territories of Russia over 78 years, namely July, the warmest month of the year when there are the largest numbers of all types of mosquito vectors and high levels of microfilaria in the peripheral blood of in- fected dogs (definitive hosts), has shown that the northern border of the maximum possible area of dirofilariasis in Russia is most fully described by the +14C July isotherm.

[THE CLINICAL AND EPIDEMIOLOGICAL CHARACTERISTICS OF MALARIA CONCURRENT WITH OTHER INFECTIONS AND INVASIONS].

The present review considers malaria infection concurrent with different species of helminths, bacterial and viral infections, as well as mixed malaria pathogens in the subtropical and tropical countries of the world, causing the clinical picture and epidemiological situation to be different. Malaria co-infections with different pathogenic micro-organisms, such as HIV, tuberculosis, viral hepatitides, and others, affect almost one third of the planet's population. It is known that people who are at risk for malaria may be also at risk for other parasitic and infectious diseases, most commonly helminthisms.

ON THE EPIDEMIOLOGY OF COMPLICATED VIVAX MALRIA.

A larger number of publications on cases of. complicated vivax malaria in the world literature can be. explained by a set of diffeetit faciors'. There has been unification of the definition of complicated tertian malaria allowing ihe clinical nianagement of a patient and the reporting of complicated cases of P.vivax to be improved. The, epidemiological characteristics of complicated vivax malaria are determined by a diversity of geographical, races, variants, gentyies and phenotypes of tertian malaia due to intensive internal and external migration. Chloroquine resistance and primaquine refractoriness contribute to increased local malaria transmission due to a rise in cases of reinfection during-epidemics of vivax malaria. From an epidemiological point of view, the increasing number of complicated vivax malaria cases indicates the untimely detection and treatment of malaria patients, the low level of medical personnel training and a negative attitude of the local population towards the recommendations of national malaria programs for prevention measures. Unsolved problems can substantially retard the time to achieve malaria elimination.

[EXPECTED CONSEQUENCES OF TARGETED HUMAN BEHAVIOR MODULATION UPON EXPOSURE TO TOXOPLASMA GONDII].

The paper shows that there are more seropositive people in a group of those who have experienced road accidents (RA) and who are responsible for the latter than in a control group. The investigations have indicated that chronic toxoplasmosis may be regarded as a potential increased risk factor of RA.

[The current status of the resistance of malaria pathogens to antimalarials].

The review presents the results of trials of the clinical efficacy of a test antimalarial drug for each malarial parasite species, which were published in 2000-2013 and supplemented by the data of in vitro studies or investigations using the molecular markers of resistance. There are data on the resistance of each medicament since many of the drugs are used in combination with artermisinin derivatives.

[Epidemiological alertness as a component of the malaria surveillance system].

Malaria vigilance is a continuation of the functions of the malaria surveillance system in the countries that have achieved malaria elimination on their territories. The main function of the malaria vigilance during the post-elimination period is a continuous monitoring and evaluation and implementation of necessary prevention measures against the possible re-establishment of local malaria transmission due to the importation of malaria from its endemic countries by residents and/or migrants. Various epidemiological aspects of malaria vigilance, such as standard identification of a malaria case during the post-elimination period; notification procedures and reporting systems; training of personnel; free access to malaria diagnosis and treatment; mandatory laboratory confirmation of malaria diagnosis; and prompt efficacious treatment, are discussed. Other aspects include epidemiological classification of cases, seasonal pattern of imported cases, its territorial confinement, time-lag between the detection of a case, its diagnosis and treatment initiation, evaluation of the efficacy of individual chemoprophylaxis and treatment.

[Malaria alertness in the post-elimination period: clinical and laboratory aspects].

Early detection of imported cases of malaria and its prompt and efficacious treatment are one of the main tasks of health workers in malaria prevention during the post-elimination period. The diagnosis and treatment of malaria should be developed and standardized to prevent the re-emergence of local transmission from imported cases of malaria. Its diagnosis must be verified by only laboratory tests during the post-elimination period. Keeping in mind the possible rapid conversion of uncomplicated P. falciparum malaria into a several disease, these all cases should be managed in a hospital setting. The healthcare personnel dealing with the treatment of malaria should be aware of its clinical manifestations in non-immune residents and semi-immune immigrants. The main principles of malaria treatment are discussed in respect of age, sex, pregnancy, and different malaria species.

[The tasks to maintain the achieved results of malaria elimination in the post-elimination period].

The experience of the countries who have achieved malaria elimination on their territories suggests that the main tasks of a malaria program in the post-elimination period are as follows: to maintain healthcare workers' alertness for possible malaria importation from outside and for a risk of its renewed transmission in the malaria-free area; to preserve the medical staff and to improve its professional skills in malaria diagnosis, treatment, and prevention in both the public and private sectors; to maintain malaria alertness among the population, among higher-risk population groups in particular; to elaborate and implement an effective program for collaboration with neighboring malaria-endemic countries, in the boundary regions in particular. The national governments' determination to continue long-term financial support of the prevention program of malaria in its elimination period is the guarantee of successful solution of the tasks set.

[The specific features of imported Plasmodium vivax malaria, Chesson strain type].

The details of imported case of Chesson strain of P. vivax malaria to Russian Federation (Moscow) from border areas between Myanmar and Thailand is given. It might further confirm the expansion of this strain from its original place in the Western Pacific towards other territories in the World, described in various publications.

[Urgent tasks of malaria elimination programs].

The state-of-the-art of malaria elimination programs worldwide and the advances made in the past decade were analyzed and assessed. The factors contributing to or reducing the achievement of the final objective of malaria elimination--to interrupt the local transmission of the infection and to steadily maintain the achieved successes are given. Technical problems are defined at the final stages of a malaria elimination program. The problems include difficulties in identifying patients and asymptomatic parasite carriers due to the low level of malaria transmission and the absence of highly effective methods for detecting malaria parasites with low parasitemia, as well as mixed malaria infections requiring the use of different treatment regimens and antimalarial drugs. Large-scale uncontrolled population migration is noted to be of importance in spreading the infection in a malaria-free area. The solution of urgent tasks is to improve the existing methods and develop new ones for the detection and treatment of the infection and a package of antimalarial measures.

[Prospects for malaria elimination in Azerbaijan].

Epidemiological analysis of the malaria in the Republic of Azerbaijan has revealed that: 1. In the past year, malaria problem has considerably improved in reducing morbidity and the number of active foci of malaria in the republic. 2. All active foci of malaria have been in its endemic area. 3. Despite the presence of favorable climatic preconditions for malaria in a large part of the republic, socioeconomic preconditions are considerably decreased, causing the malariogenic potential to substantially reduce. 4. All sets a favorable stage for possible interruption of local malaria transmission on the whole territory of the republic provided that financial support for the national malaria elimination program will be increased from the country's government and other sources in conjunction with the implementation of revised malaria control strategy and with the use of current methods for the detection, diagnosis, treatment, and prevention of malaria.

[Global trends in malaria control. Progress and topical tasks in malaria control programs].

This communication is the first in the series consisting of two publications describing the present state of malaria control and elimination in the world. The global malaria situation in 2009-2010 demonstrated a considerable situation as compared to the previous years. This improvement is associated with a considerable global increase of investments made by both national governments and world society to the malaria control programs. Spectacular progress has been achieved even in the areas of the most infection-affected African countries situated to the south of the Sahara Desert. It has been estimated that malaria cases in the world declined from 233, 000,000 in 2000 to 225,000,000 in 2009. Malaria mortality decreased from 985,000 in 2000 to 781,000 in 2009. To maintain the results achieved and to further reduce the problem of malaria worldwide, it is necessary to ensure a long-term political and financial support for malaria control programs at the national and international levels.

[Milestones and major results of studies on leishmaniasis and sand fly fevers in Turkmenistan].

Among the countries endemic for tropical diseases, Turkmenistan along with Uzbekistan has a special role to play in having basic scientific knowledge of leishmaniasis. This article summarizes the principal scientific findings in the course of the 20th century in respect of leishmaniasis and sand fly fevers. The most important results of studies on cutaneous and visceral leishmaniasis are cited. The role of different researchers in the epidemiology, epizootology, natural focality of these diseases, their clinical aspects, diagnosis, treatment, and prevention are described in detail. The paper gives information obtained by the latest studies on the etiology of leishmaniasis. The most important publications on this topic are assessed. Particular emphasis is laid on the results of the Anti-Leishmaniasis Expedition carried out by the researchers of the E.I. Martsinovsky Institute of Medical Parasitology and Tropical Medicine to the Tedjen oasis of Turkmenistan.

[Widespread use of primaquine for control of Plasmodium vivax epidemics in a population with varying degrees of G6PD deficiency].

The major benefit of mass primaquine administration in the Republic of Azerbaijan and the Democratic People's Republic of Korea was a considerable reduction in malaria case load in the situation where there is acute inadequacy of various means for malaria control, as well as in the containment of a large-scale malaria epidemic caused exclusively by P. vivax in a relatively short period of time. Success of mass treatment can be achieved only through high coverage (about 90% of the target population), the elaboration of clear instructions for all categories of the personnel engaged in the treatment, with the provision of regular efficient supervision, the accessibility of first medical aid at the site in case of probable severe side effects. Adherence to these prerequisites results in the safety of the treated population with very high degree of G6PD deficiency.

[The modulation of Plasmodium falciparum virulence as a factor in the self-regulation of the malarial parasitic system]. / Moduliatsiia virulentnosti Plasmodium falciparum kak faktor samoreguliatsii parazitarnoi sistemy maliarii.

Higher Plasmodium falciparum virulence is one of the major factors that contributes to the development of severe malaria and leads to death. However, the nature of virulence and its time course are not so far fully understood. The authors have made a published data-based hypothesis that the virulence of P. falciparum strains circulating in the malaria endemic areas of tropical Africa is not strictly genetically determined. The virulence of P. falciparum increases with its passage through the non-immune organisms of the infected persons. This mechanism of virulence modulation ensures the survival of the parasite in the human population with a considerable communal immunity. To test the validity of the hypothesis, the authors have used a mathematical analytical method to assess the published data on malaria mortality in some areas of tropical Africa. The results of the analysis have shown close values of actual and expected data.

Malaria in the WHO Southeast Asia region.

PIP: Malaria endemic countries in the southeast Asia region include Bangladesh, Bhutan, India, Indonesia, Maldives, Myanmar, Nepal, Sri Lanka, and Thailand. Population movement and rapid urbanization, both largely caused by unemployment, and environmental deterioration change the malaria pattern. They also increase the incidence of drug-resistant malaria, especially resistance to 4-aminoquinolines. In India, Plasmodium falciparum is linked to the density and distribution of tribals, and, in southern Thailand, rubber tappers have the highest malaria incidence rate (46.29%). Since the population is young and the young are highly sensitive to malaria infection, the region has low community immunity. High malaria priority areas are forests, forested hills, forest fringe areas, developmental project sites, and border areas. High risk groups include infants, young children, pregnant women, and mobile population groups. Malaria incidence is between 2.5-2.8 million cases, and the slide positivity rate is about 3%. P. falciparum constitutes 40% for all malaria cases. In 1988 in India, there were 222 malaria deaths. Malaria is the 7th most common cause of death in Thailand. 3 of the 19 Anopheline species are resistant to at least 1 insecticide, particularly DDT. Posteradication epidemics surfaced in the mid-1970s. Malaria control programs tend to use the primary health care and integration approach to malaria control. Antiparasite measures range from a single-dose of an antimalarial to mass drug administration. Residual spraying continues to be the main strategy of vector control. Some other vector control measures are fish feeding on mosquito larvae, insecticide impregnated mosquito nets, and repellents. Control programs also have health education activities. India allocates the highest percentage of its total health budget to malaria control (21.54%). Few malariology training programs exist in the region. Slowly processed surveillance data limit the countries' ability to forecast and to combat malaria epidemics. Almost all control programs have a special research unit but capabilities are limited. Political commitment is needed to control malaria.^ieng