Abstract
Azerbaijan in the south caucasus region of far southeastern Europe has a long history of malaria endemicity but just successfully eliminated local transmission. After a period of relatively stable malaria situation (1960–1970), the country witnessed an epidemic followed by a series of outbreaks of various magnitudes in the following two decades, all caused by Plasmodium vivax. Compared with 1993, the number of malaria cases in the country jumped 29 times in 1994, 123 times in 1995, and 571 times in 1996 at the peak of the epidemic, when 13,135 cases were officially registered. Incidence rate increased dramatically from 0.2/100,000 population in 1991 to over 17/100,000 population in 1996. Scaled-up malaria control led to the containment of the epidemic and to a dramatic decrease of malaria burden nationwide. Azerbaijan has applied contemporary, complex control and surveillance strategies and approaches and is currently in the prevention of reintroduction phase. This article describes Azerbaijan's public health experience in conducting malaria control and elimination interventions over several decades until 2013 when the country reached an important milestone—no indigenous malaria cases were recorded.
Highlights
The results indicated that chloroquine was fully effective over the first 14 days, and the combination of chloroquine and primaquine was fully effective over 28 days.[8]
Several indicators had been used for the assessment of the efficacy of antimalarial measures and evaluation of progress made toward interruption of local transmission such as: timelines between diagnosis and reporting, treatment and epidemiological investigation, number of active foci reported/year, proportion of cases reported to surveillance system, total population at risk within country, proportion of cases confirmed by microscopy, proportion of cases treated according to guidelines, proportion of at-risk households/proportion of reported active foci that were sprayed, proportion of known/potential breeding sites treated with chemicals/fish, proportion of breeding sites positive for larvae, etc
In the 1990s, there was a massive return of P. vivax malaria to many countries in eastern European, central Asia, and the caucasus region
Summary
For 15 years, MPPT was implemented several times in a number of districts with an average coverage of 92%.The campaigns have been successful showing primaquine to be a highly effective tool for controlling P. vivax outbreaks/ epidemics leading to several-fold reduction in morbidity in a single malaria season. These forms are 1) Urgent Notification, 2) Epidemiological Investigation (patient data, possible source of infection, related malaria focus data, and result of case investigation), 3) Laboratory Report (microscopy findings), 4) Malaria Focus Monthly Report (population and malaria cases, demographic distribution, active/passive case detection (PCD) results including time between onset of illness and detection), and 5) Vector Control Report.
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