Spatio-temporal Prediction of the Malaria Transmission Risk in Minab District (Hormozgan Province, Southern Iran).

INTRODUCTION: Malaria is the most important parasitic disease in tropical and subtropical regions, with more than 240 million cases reported annually. In Iran, indigenous cases occur in its south-eastern region. The aim of this study is to assess the environmental risk of malaria transmission in an endemic area of southern Iran. METHODS: The study was carried out in Minab district (Hormozgan province, southern Iran), with the aim to assess the environmental risk of malaria, based on a spatio-temporal study, using Growing Degree Days (GDD)-based predictions, larval habitat ecology, MaxEnt spatial predictions and malaria transmission data. RESULTS: The Gradient Model Risk index showed the highest malaria transmission risk period to be during January-April and October-December. The ecological conditions of water bodies of larval habitats of the four vector species (Anopheles culicifacies, A. dthali, A. fluviatilis and A. stephensi) were assessed, with A. stephensi being the most prevalent and the most widely distributed species. CONCLUSION: These findings, together with the MaxEnt Anopheles predictive distribution models, allowed identifying villages in danger of malaria transmission in Minab district. This spatio-temporal prediction of malaria transmission risk should be incorporated in the design of malaria control initiatives towards a local malaria early warning system. Moreover, the proposed transmission risk model can be extrapolated, at local scale, to other malaria endemic areas of tropical and subtropical regions.

Bio-ecology of malaria vectors in an endemic area, Southeast of Iran.

OBJECTIVE: To determine some bio-ecological aspects of malaria vectors in Jask County, where is targeted for malaria elimination in the national program. METHODS: Mosquitoes were collected monthly during 2013-2014 using different collection methods. Subsequently, ELISA test was used to detect the human blood index of mosquitoes. The susceptibility status of Anopheles stephensi was evaluated against the diagnostic dosages of seven WHO recommended insecticides. RESULTS: A total of 3650 female and 4736 Anopheles larvae were collected including Anopheles stephensi, Anopheles culicifacies s.l., Anopheles dthali, Anopheles fluviatilis s.l., Anopheles moghulensis and Anopheles turkhodi species. Anopheles stephensi was the dominant collected species on human baits and indoors with high rate of unfed and gravid specimens in internal and external window traps. Human blood index was calculated as 14.3% for this species. It was also found to be resistant to DDT and Dieldrin. CONCLUSIONS: The collected species had a wide range of habitats, and resting behaviors. With regarding to the presence of most important malaria vectors in Jask, control of the disease may be so complicated; as based on the weather condition it can be transmitted during the whole year, expect for cold months. With this strong potential of transmission, existing population movements in the area may lead to imported cases of malaria and local outbreak(s). So, more specific studies on malaria vectors in high risk areas of Jask County are recommended.

Efficiency of Nested-PCR in Detecting Asymptomatic Cases toward Malaria Elimination Program in an Endemic Area of Iran.

BACKGROUND: The aim of this study was to detect low parasite and asymptomatic malaria infections by means of three malaria diagnostic tests, in a low transmission region of Minab district, Hormozgan Province, southern Iran. METHODS: Blood samples of 200 healthy volunteers from Bagh-e-Malek area were evaluated using microscopic, rapid diagnostic tests (RDT) and nested-PCR to inspect malaria parasite. RESULTS: The results showed no Plasmodium parasite in subjects by means of microscopy and RDT. However, 3 P. vivax positive samples (1.5%) were discovered by Nested-PCR while microscopy and RDT missed the cases. CONCLUSION: Microscopy as the gold standard method and RDT correctly identified 98.5% of cases, and molecular analysis is sensitive and reliable, especially in the detection of "asymptomatic" infections for active case surveillance. Regarding the existence of asymptomatic malaria in endemic area of Hormozgan, Iran, nested-PCR could be considered as a sensitive tool to interrupt malaria transmission in the country, beside the microscopic and RDT methods.