Significant decline of malaria incidence in a low socioeconomic area in the southeast of Iran: 10 years field assessment during malaria elimination programme

Although malaria burden and its active foci have sharply declined after the implementation of elimination programme since 2010, it is still considered as a major public health problem in southeast Iran. This descriptive-analytical study aimed to determine 10-years of malaria epidemiological trends in Bashagard County. Data were collected from 7 selected malarious region of the county based on active and passive surveillance of clinical cases. For diagnosis of malaria, the examination of microscopic slides and rapid diagnostic test, were used. In total, 237 malaria cases were found from 2009 to 2018. Plasmodium vivax was the dominant parasite species and identified in 232 (97.9%) individuals. Males were infected more than females and the majority of malaria cases (67.4%) were recorded from rural areas. Although about 98% of malaria cases were indigenous, they have decreased form 200 cases in 2009 to zero indigenous transmission in 2018. During the study period, malaria cases had decreased significantly by about 99% and the incidence rate had declined from 5.47/1000 cases in 2009 to 0.002/1000 in 2018. The incidence of malaria, especially indigenous cases, in Bashagard County has decreased dramatically in the past 10 years. However, there is still probability of malaria re-introduction and outbreak in the county due to climatical and geographical conditions. Therefore, it is necessary to implement an active surveillance system to detect and treat malaria cases quickly, during the elimination phase in this county.