Epidemiological status of malaria in Iran, 2011-2014

Objective: To determine the status and epidemiological aspects of malaria in Iran in favor of gaining a better understanding of the national control of malaria. Methods: This epidemiological study examined the status of malaria from 2011 to 2014 in Iran. Data were collected from the Ministry of Health's protocol for controlling and eliminating malaria, which is currently in use. This malaria information reporting system is automated in all Iranian provinces and cities, and all information is submitted online to the center for communicable disease control in the Ministry of Health. Information about malaria is available for researchers to evaluate. Results: The incidence rates decreased from 2011 to 2014. There were 4.76, 2.12, 1.80, and 1.59 per 100 000 people, respectively from 2011 to 2014. During the four-year period (2011-2014), the highest numbers of cases occurred in those aged 16-25 years, by age, and in men, by sex. Most of the cases were workers and located in rural areas. An average 52.58% of cases were Iranian. The highest incidence rates from 2011 to 2014 were located in Sistan and Baluchestan province. There were 89.94, 43.9. 38.3, and 30.66 per 100 000 people. The highest numbers of malaria cases were recorded in the cities Sarbaz, Nickshahr, and Chabahar in Sistan and Baluchestan province and Bandar Abbas, Bandar Jask, and Bandar Lengeh in Hormozgan province. During the four-year period, 57.05% of cases were caused by imported factors. The majority of cases were related to the trophozoite lifecycle of parasites. Regarding surveillance, there was inactive care in the majority of cases. Vivax malaria was the most prevalent. Conclusions: Despite the recently declining trend in reported cases, the expansion of local transmission, especially in areas with cross-border travel, is very worrying. Improved malaria control interventions can be effective for elimination of malaria in Iran; these can include programs to control border travel and focused interventions for high incidence areas and high-risk groups such as rural residents, men, workers, and people < 35 years old.