Elimination of Plasmodium falciparum malaria in Tajikistan

Anatoly V Kondrashin,Elkhan Gasimov,Natalia A Turbabina,Dilshod S Kadamov,Azizullo S Sharipov,Saifuddin S Karimov,Evgeny N Morozov,Maria S Maksimova,Lola F Morozova,Alla M Baranova,Ekaterina V Stepanova

doi:10.1186/s12936-017-1861-5

Abstract

Malaria was eliminated in Tajikistan by the beginning of the 1960s. However, sporadic introduced cases of malaria occurred subsequently probably as a result of transmission from infected mosquito Anopheles flying over river the Punj from the border areas of Afghanistan. During the 1970s and 1980s local outbreaks of malaria were reported in the southern districts bordering Afghanistan. The malaria situation dramatically changed during the 1990s following armed conflict and civil unrest in the newly independent Tajikistan, which paralyzed health services including the malaria control activities and a large-scale malaria epidemic occurred with more than 400,000 malaria cases. The malaria epidemic was contained by 1999 as a result of considerable financial input from the Government and the international community. Although Plasmodium falciparum constituted only about 5% of total malaria cases, reduction of its incidence was slower than that of Plasmodium vivax. To prevent increase in P. falciparum malaria both in terms of incidence and territory, a P. falciparum elimination programme in the Republic was launched in 200, jointly supported by the Government and the Global Fund for control of AIDS, tuberculosis and malaria. The main activities included the use of pyrethroids for the IRS with determined periodicity, deployment of mosquito nets, impregnated with insecticides, use of larvivorous fishes as a biological larvicide, implementation of small-scale environmental management, and use of personal protection methods by population under malaria risk. The malaria surveillance system was strengthened by the use of ACD, PCD, RCD and selective use of mass blood surveys. All detected cases were timely epidemiologically investigated and treated based on the results of laboratory diagnosis. As a result, by 2009, P. falciparum malaria was eliminated from all of Tajikistan, one year ahead of the originally targeted date. Elimination of P. falciparum also contributed towards speedy reduction of P. vivax incidence in Tajikistan.

Highlights

Malaria was known in Tajikistan since ancient times
Since 2006, with the arrival in the country of the long-lasting insecticide-treated net (LLIN), additional priorities for distribution were as follows: (a) populations living in areas with the highest levels of P. falciparum transmission, (b) populations living in P. falciparum malaria foci close to the border with Afghanistan
Community participation community members had not been directly involved in the implementation of various anti-malarial activities, their role was important in the acceptance of all carried out interventions by the programme and adherence to all its recommendations in respect of personal protection measures

Summary

Introduction

Malaria was known in Tajikistan since ancient times. The first organized studies on malaria during the 1920s revealed that all the population of the mountainous valleys was affected by malaria. The scope of malaria surveillance system during that period consisted of capacity building, large-scale use of the IRS, supported by anti-larval measures, selective use of MDA, case detection and treatment activities jointly with the staff of health treatment facilities.

Results

Conclusion