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.

Conflict in Neighboring Countries, a Great Risk for Malaria Elimination in Southwestern Iran: Narrative Review Article.

The intensity of the conflict such as war is one of the determinants of the flow of migrants and refuges with consequence of introducing infectious disease to other countries. This paper investigates the relationship between malaria incidence and forced immigration due to war from neighboring countries in Dezful district, southwestern Iran. All available data and accessible archived documentary records on malaria cases in the period 1988-2011 in Dezful Health Centers were reviewed. Retrospective analysis of routine surveillance data from the Health authority of Dezful district was conducted to assess the trend of malaria incidence and prevalence in the last two decades. Malaria transmission dynamics was described using surveillance indicators viz, Annual Parasite Incidence (API), Slide Positivity Rate (SPR), Annual Blood Examination Rate (ABER) and based on personal information of patients. Two peaks of malaria incidence occurred during past two decades. The first one arisen by Iran-Iraq war due to residential instability in Dezful while the API reached to 8 per 1000. The second peak happened after to civil war of Afghanistan began which caused large immigrates moved into the study area. During the second peak, API reached 1.7 per 1000 at maximum and the majority of patients were immigrants. This study describes the linkage between incidence and prevalence of malaria and immigration due to civil conflict. Therefore, malaria screening of immigrants and early warning programme are effective to prevent outbreak of disease in a potential risk area such Dezful.

Epidemiological and clinical survey of scorpionism in Khuzestan province, Iran (2003).

Epidemiological and clinical survey of scorpion envenomation was carried out by statistical method of stratified cluster random sampling in Khuzestan, the southern province of Iran, cross-sectionally. We analyzed 12,150 cases recorded in Emergency Unit of the hospitals of six cities in Khuzestan province during the year 2003. The prevalence rate of human scorpion stings in the province is 3.1/1000 inhabitants. The percentage of prevalence in selected cities was as follows: Masjed-Soleiman (27.1%), Ramhormoz (26.6%), Izeh (15.3%), Shush (12%), Baghmalek (11.7%), and Behbahan (7.3%). The scorpions, responsible for the majority of stings in Khuzestan province of Iran were identified as 53.3% yellow (Mesobuthus eupeus, Hottentotta saulcyi, Odonthobuthus doriae and Hemiscorpius lepturus), and 17.4% black (Androctonus crassicauda and Hottentotta schach), and 29.3% unknown colors. Most stings occurred throughout the year, however, the highest and lowest frequency occurs in June (16.0%) and February (0.6%), respectively. Nocturnal envenomations (60.9%) were more common than diurnal (39.1%), and 39.3% of stings were on the hands and 37.3% on the feet Most envenomings were mild (74.5%) that all evolved to cure, except for three deaths. Envenomation was characterized by local pain (63.3%), erythema (10.1%), vomiting (1.3%), restlessness (0.6%), hyperthermia (0.5%), sweating (0.4%), and spasmic (0.3%). With respect to the outcoming results, scorpionism in Khuzestan province of Iran is a public health problem, which needs to be monitored carefully by the government.