Current Malaria Situation in I'R'Iran

1
Current Malaria Situation in I.R.Iran
August 2004
2

• Malaria is still a major health problem in South
  east of I.R.Iran.

• A total of 23562 cases were reported in 2003 .

• SistanBaluchestan,Hormozgan and Kerman were
  reported 85 of malaria cases in 2003.

3
Trend of Malaria Cases in I.R.IRAN 1993 - 2003
4

• 8009 malaria cases were reported up to the 22
  August 2004 .

• The South east provinces were reported 73 of
  malaria cases .

• 9 of reported malaria cases are
  falciparum.

5
Reported Malaria Cases in I.R.IRAN by Nationality
in 2003
6
Reported Malaria Cases in Sistan Baluchestan
Province by Nationality in 2003
7
Reported Malaria Cases in I.R.IRAN by Nationality
in 2004
8
Reported Malaria Cases in Sistan Baluchestan
Province by Nationality in 2004
9
Current Malaria Control Measures
Antivector measures

• Historical background
• DDT
• Dieldrin
• Malathion
• Propoxur
• Lambdacyhalothrin
• Deltamethrin

1 Residual House Spraying
10
2 -Chemical Larviciding

• Temephos
• Pirimiphos methyl
• Chlorpyrifos methyl

Biological Control

• Gambussia affinis
• Some native larvivourus fish
• Bacillus thuringiensis

11
Bed net

• Promoting of using impregnated bednet in
  malarious areas has been started .

• Some large scale project on ITNs have been
  started in Sistan Baluchestan

12
19 of malaria cases were falciparum in 2003 .
Parasitologic issues
13
Trend of Falciparum Rate in I.R.IRAN (1990 -
2003)
14
The Basic Policies of Malaria Treatment

• Treatment of malaria is free of charge .

• Treatment are based on laboratory confirmation

• Private sectors are obliged to follow the
  national guideline

• Distribution and delivery of drugs are carried on
  by government through PHC system

15
Summary of malaria treatment protocol

• Treatment Of Falciparum Malaria
• - First line Chloroquine
  Primaquine
• - Second line Fansidar Quinine
• - Third Line Quinine Doxycycline
  Or Artimisinin
• Treatment Of Vivax Malaria
• Chloroquine Primaquine

16

• Although lot of researches have been done in some
  part of the country in two recent decades ,but
  there was no routine programme for monitoring of
  antimalarial drugs therapeutic efficacy up to
• 2002.

17
The Results of Therapeutic Efficacy Monitoring of
Chloroquine for Uncomplicated falciparum Malaria
in 5 sentinels in I. R. Iran 2002 , 2003
      The Results of Therapeutic Efficacy
Monitoring of Chloroquine for Uncomplicated
falciparum Malaria by site
      The Results of Therapeutic Efficacy
Monitoring of Chloroquine for Uncomplicated
falciparum Malaria by site
18
The Results of Therapeutic Efficacy Monitoring of
Chloroquine for Uncomplicated falciparum Malaria
in 5 sentinels in I. R. Iran 2002 , 2003
19

• Malaria control activities have been integrated
  in the PHC since 1988 .

• At present there are more than 16000 Health House
  run by two community Health Workers ( Behvarz )
  ,one male and one female .

• Around 1000 population are covered by one H.H.

20

• In the areas with high Malaria Transmission

• Implementation of the malaria control activities
  are the main responsibility of the Behvarz .

• At the village level all cases suffering from
  Malaria symptom are referred to the Health House
  for blood slide taking and also receiving
  antimalaria drugs .

21

• Usually the blood slides , in particular for the
  passive cases, are sent to the nearest Rural
  Health Center on the same day .

• About 80 of all slides are examined and will
  receive the treatment according to available
  guideline in less than 24 hours .

22

• In those areas which are not covered by PHC the
  antimalaria activities are carried by mobile
  teams .

• The great majority of the areas not covered by
  PHC are located in the three South - east
  provinces , namely Sistan Baluchestan ,
  Hormozgan and Kerman which report 73 of total
  malaria cases .

23

• The great majority of the areas not covered by
  PHC are located in the three South - east
  provinces , namely Sistan Baluchestan ,
  Hormozgan and Kerman which report 73 of total
  malaria cases .

24
(No Transcript)