Outbreak of malaria in southern Iran: How could manage this disease?

Abstract Background Iran is considered one of the countries with high rates of malaria, particularly in its southern and southeastern regions. In 2009, Iran initiated a program aimed at eliminating malaria by 2025. Proper management of the disease requires a complete knowledge of the disease. The objective of this study was to examine the malaria situation in southern Iran from 2016 to 2023. Method A cross-sectional study was carried out in Sistan-Baluchistan province as the second largest province of Iran in 2023. The clinical and demographical data were collected for the three medical universities from March 2016 to March 2023. The census method for selecting the study population was used. Demographic, population, parasitology, and epidemiology variables were investigated. Data was entered and analyzed using SPSS 25. Analytical tests such as T-test and one-way analysis of variance (ANOVA) were used. A 95% confidence interval and p-value less than 0.05 were considered. Results According to the results, from 2016 to March 2023 about 8389 cases of malaria were diagnosed by the health care system in the southeast of Iran. Most of these cases (77.4%) were reported in the southernmost region of Iran. َAlso, 78% of malaria cases occurred in individuals of Iranian nationality. An overwhelming majority of patients (94.7%) had no prior history of malaria infection. The highest occurrence of the disease was in men and this difference was significant (P = 0.001). Furthermore, 44.8% of the patients were border drivers. The occurrence of malaria cases in the region was relatively low between 2016 and 2018. However, it started to increase from 2019 onwards and reached the highest rate in 2022. The most of malaria cases during the last Iranian year were concentrated in the border cities of Rask and Saravan, which are adjacent to Pakistan. Additionally, 80% of the patients were infected with the Plasmodium vivax type of malaria parasite. Conclusion To effectively manage malaria in malaria-prone areas like Sistan-Baluchistan province, health decision-makers should focus on prompt treatment of malaria patients, prevention of mosquito circulation, raising awareness about malaria symptoms (especially among men working at borders), and monitoring the health of individuals who frequently travel to Pakistan.