Malaria In Iran Research Articles

Abstruse Side of Climate Change, Impact on Malaria: A Systematic Evidence Review Comparing Iran versus Globally.

Infectious outbreaks due to disrupted social and environmental conditions after climate change-induced events complicate disasters. This research aimed to determine the contentions of bioclimatic variables and extreme events on the prevalence of the most common Climate-Sensitive Infectious Disease (CSID); Malaria in Iran. The present narrative systematic review study was conducted on the bioclimatic variable impact on the prevalence of malaria, as a common CSID. The search was conducted in 3 sections: global climate change-related studies, disaster related, and studies that were conducted in Iran. The literature search was focused on papers published in English and Persian from Mar 2000 to Dec 2021, using electronic databases; Scopus, Web of Science, PubMed, Google Scholar, SID, Magiran, and IranDoc. Overall, 41 studies met the inclusion criteria. The various types of climatic variables including; Temperature, rainfall, relative humidity, and hydrological events including; flood, drought, and cyclones has been reported as a predictor of malaria. The results of studies, inappropriately and often were inconsistent in both Iran and other parts of the world. Identifying malaria outbreak risks is essential to assess vulnerability, and a starting point to identify where the health system is required to reduce the vulnerability and exposure of the population. The finding of most related studies is not congruent to achieve reliable information, more extensive studies in all climates and regions of the country, by climatic models and high accuracy risk map, using the long period of bioclimatic variables and malaria trend is recommended.

Ace-1 Target Site Status and Metabolic Detoxification Associated with Bendiocarb Resistance in the Field Populations of Main Malaria Vector, Anopheles stephensi in Iran.

Anopheles stephensi is the main vector of malaria in Iran. This study aimed to determine the susceptibility of An. stephensi from the south of Iran to bendiocarb and to investigate biochemical and molecular resistance mechanisms in this species. Wild An. stephensi were collected from Hormozgan Province and reared to the adult stage. The susceptibility test was conducted according to the WHO protocols using bendiocarb impregnated papers supplied by WHO. Also, field An. Stephensi specimens were collected from south of Kerman and Sistan and Baluchistan Provinces. To determine the G119S mutation in the acetylcholinesterase (Ace1) gene, PCR-RFLP using AluI restriction enzyme and PCR direct-sequencing were performed for the three field populations and compared with the available GenBank data. Also, biochemical assays were performed to measure alpha and beta esterases, insensitive acetylcholinesterase, and oxidases in the strains. The bioassay tests showed that the An. stephensi field strain was resistant to bendiocarb (mortality rate 89%). Ace1 gene analysis revealed no G119S in the three field populations. Blast search of sequences revealed 98-99% identity with the Ace1 gene from Pakistan and India respectively. Also, the results of biochemical tests revealed the high activity of non-sensitive acetylcholinesterase, alpha and beta-esterase in the resistant strain compared to the susceptible strain. No G119S was detected in this study additionally the enhanced enzyme activity of esterases and acetylcholinesterase suggesting that resistance was metabolic. The use of alternative malaria control methods and the implementation of resistance management strategies are suggested in the study area.

Anti-Plasmodial Effects of Different Ecotypes of Glycyrrhiza glabra Traditionally Used for Malaria in Iran.

The online version contains supplementary material available at 10.1007/s43450-022-00353-8.

Risk mapping of malaria in Iran from 2009 to 2018: A GIS-Based survey

Background: Since the issues of public health and the spread of diseases are directly related to the region's geography. We aim to determine malaria incidence, spatial distribution, and hot spots in Iran using the GIS for a decade from 2009 to 2018. Methods: GIS was used to analyze the information acquired from the Ministry of Health and Medical Education in Tehran, Iran, and other associated centers between 2009 and 2018. Subsequently, maps of the disease's spatial distribution were constructed and using ArcGIS 10.5 software, the disease's hotspots in Iran were determined. The disease's variables, such as temperature, relative humidity, normalized difference vegetation index (NDVI), and malaria incidence, were correlated using geographically weighted regression (GWR) analysis in ArcGIS 10.5. Using descriptive statistics and the chi-square test, data were analyzed using Linear Regression Analysis and SPSS 21 software using descriptive statistics. Sistan and Baluchistan, and the Bushehr provinces were hot spots for Malaria. The geographically weighted regression analysis results showed that in Sistan and Baluchistan and Bushehr, Hormozgan, Fars, Qom, Yazd, Kohgiluyeh and Boyer-Ahmad provinces, the highest correlation between temperature, humidity, vegetation density, and the incidence of Malaria was observed (p-value = 0.019).

Key plasma microRNAs variations in patients with Plasmodium vivax malaria in Iran

IntroductionAs the cause of RBC infection and splenomegaly, malaria remains a major parasitic disease in the world. New specific biomarkers such as MicroRNAs (miRNAs) are developed to accurately diagnose malaria and clarify its pathologic changes. This study aimed at evaluating changes in the plasma miRNAs markers of Plasmodium vivax in patients with malaria in Chabahar, Iran. Materials and methodsFor the present descriptive-analytical study conducted in 2018, we collected blood samples from 20 individuals. Real-time quantitative Polymerase Chain Reaction (RT-qPCR) was used to measure the plasma levels of miR-145, miR-155, miR-191 and miR-223-3p. ResultsThe 2-ΔΔCT method of Real-time PCR showed the plasma levels of miR-223, miR-145 and miR-155 to respectively be 5.6, 16.9 and 1.7 times higher in patients with P. vivax compared to those in healthy individuals. The expressions of all the three miRNAs significantly increased in patients with malaria compared to in the controls (P < 0.05). The expression of miR-191 was 1.405 times higher in patients with malaria compared to that in the controls, although the difference was statistically insignificant. ConclusionThe present study found P. vivax to change host miRNAs such as miR-223, miR-145 and miR-155. These small molecules thus appeared to constitute biomarkers for P. vivax malaria assessment.

The Fauna, Diversity, and Bionomics of Culicinae (Diptera: Culicidae) in Hormozgan Province, Southern Iran.

Hormozgan Province is one of the important foci of malaria in Iran. In addition to malaria pathogens, mosquitoes also transmit the pathogens that cause dirofilariasis and West Nile fever in the province. Also, the threat of emerging aedine-borne viruses that cause infections, such as Chikungunya, dengue, and Zika, is noticeable. There is little information about the fauna and bionomics of Culicinae in the province. The present investigation aimed to study the fauna, diversity, and bionomics of culicines. The study was conducted from September 2016 to April 2017 in four counties of Bandar Abbas, Bandar Khamir, Bashagard, and Jask. In total, 3,236 larvae and 1,901 adults including 16 culicine species were collected. The larvae of Culiseta longiareolata (Macquart) (25.65%), Culex pipiens Linnaeus (16.62%), and Cx. quinquefasciatus Say (16.16%) were most abundant and Cx. hortensis Ficalbi (0.09%) was least abundant. Among adults, Cx. laticinctus Edwards (33.19%), Cx. quinquefasciatus (31.09%), and Cx. pipiens (11.99%) were the most prevalent species and Cs. longiareolata (0.47%), Aedes caballus (Theobald) (0.90%), and Cx. bitaeniorhynchus Giles (0.90%) were the least prevalent species. The pairwise similarities of fauna of the counties and different collecting methods and diversity indices were investigated. More ecological data, especially on host preference, seasonality, and larval habitat characteristics, are needed as a basic knowledge for any intervention measures using integrated vector management.

Imported Malaria in an Iraqi Immigrant to Iran: Relevance for the Maintenance of Elimination Status

BackgroundEffective malaria control strategies require an accurate understanding of the epidemiology of locally transmitted Plasmodium species. Emerging evidence indicates that migrants from malaria endemic regions are at risk of delayed presentation of Plasmodium spp. and malaria infection. Cases ReportWe reported a case of P. vivax malaria occurring after arrival in Iran. Patient was originally from Iraq. A 48-year-old male patient who was hospitalized with fever attacks, chills, and headache after arriving from Iraq to Tehran.ConclusionIn this patient, new prevention and screening strategies should be studied and blood safety policies adapted. Thus, ultimate elimination of malaria in Iran will require national malaria control program to adopt policy and practice aimed at all human species of malaria since neighbor country are still face to problem to control of malaria.

Provincial clustering of malaria in Iran between 2005 and 2014

Objective: To reveal the provincial clustering of malaria in Iran between 2005 and 2014 based on the epidemiologic factors and the climatic indicators affecting the disease. Methods: This was a descriptive-analytical study using malaria and meteorological data from the Malaria Elimination Programme of the Ministry of Health and Medical Education and National Meteorological Organization. After standardization, the aggregate data was used to produce 10-year means for each province. The data analysis included grouping the provinces with respect to factors using hierarchical clustering method and Kruskal-Wallis test to examine the difference between clusters using SPSS ver.23. Results: The hierarchical clustering stratified the provinces’ in 5 clusters. Kruskal-Wallis H test revealed a significant difference in the incidence rate per 100 000 population (P=0.001), male gender (P=0.001), Iranian nationality (P=0.001), Afghan nationality (P=0.003), Pakistani nationality (P=0.001), urban residence (P=0.006), rural residence (P=0.004), autochthonous cases (P=0.007), average minimum temperature (P=0.001), average maximum temperature (P=0.007), average relative humidity (P=0.011), average pressure level (P=0.038), prevailing wind direction (P=0.023), average wind speed (P=0.031) and average precipitation sum (P=0.002) among the clusters. Conclusions: The results of this study and stratification of the provinces could help health policy makers to better manage malaria by allocating resources accordingly.

Blood Donor Deferrals for Malaria in Iran: A Five-Year Retrospective Study

Malaria is one of the most important transfusion-transmitted infections (TTIs) worldwide. To prevent the occurrence of transfusion-transmitted malaria (TTM), potential blood donors with a history of malaria or travel to, or residence in, malarious areas are permanently or temporarily deferred from donating blood. The objective of the present study was to evaluate the blood donor deferrals for malaria in Iran. This descriptive cross-sectional study was conducted in the Iranian Blood Transfusion Organization (IBTO) from 21 Mar 2011 to 19 Mar 2016 (5 yr). The data were collected and extracted from IBTO comprehensive database, namely Negareh, and then recorded in a structured template form. Statistical analysis was performed using SPSS. Of the 12,790,859 blood donation volunteers, 23,084 (0.18%) were deferred due to the risk of malaria. More than 90% of malaria-deferrals were because of travel to and residence in malaria endemic areas. Among the malaria-deferred volunteers, 22,139 (95.91%) were male and 945 (4.09%) were female; 2,053 (8.89%) were permanently deferred, while 21,031 (91.11%) were temporarily deferred. The highest malaria-deferral rates were observed in South Khorasan (0.82%), Razavi Khorasan (0.79%) and Yazd (0.54%) provinces, respectively. Given the prevalence of malaria in neighboring countries (Pakistan and Afghanistan) and several provinces of Iran and the increasing human migration and movement between malaria non-endemic and endemic areas, the malaria-deferral rate might be higher than 0.18% in Iran. Thus, the changing, as well as the precise and accurate implementation of donor selection process must be considered in all blood transfusion centers of Iran.

The Challenges of the Malaria Elimination Program in the South East of Iran, a Qualitative Study

Despite all the efforts made to control and eliminate malaria in Iran, this disease is still considered as a priority health problem in the South East of Iran. We aimed to determine the cultural obstacles which have prevented the elimination of malaria in this region. This study was carried out through qualitative content analysis. Purposeful sampling was done from people who had malaria or were involved with malaria patients in 2015, in Sarbaz City, Sistan and Baluchestan Province, Eastern Iran. Data were collected through interviews using open questions and continued until data saturation. The most important barriers in malaria prevention was delay in visiting health centers, delay in diagnosis and treatment due to superstitious beliefs, lack of information about the disease, misdiagnosis and fake doctors. Other obstacles were lack of trust and cooperation with interventions offered by the health system, lack of proper use of the available facilities to prevent malaria and commuting in the high-risk neighbor countries. Raising awareness in people, officials and health workers about malaria and preventive health interventions as well as health risks associated with fake doctors, following up and re-examination of peripheral blood smear in suspected cases, establishing malaria control stations in border areas and specific measures to refer immigrants and people crossing the border toward malaria diagnosis stations is suggested.

A social network analysis on immigrants and refugees access to services in the malaria elimination context

BackgroundThere has been significant progress in eliminating malaria in Iran. The aim of this study is to investigate the structure of inter-organizational collaboration networks in the field of unauthorized immigrants and refugees access to services in order to eliminate malaria.MethodsThis study employed social network analysis, in which nodes represented stakeholders associated with providing access of immigrants and refugees to services in the field of malaria elimination, and ties indicated the level of collaboration. This study adopted socio-centric analysis and the whole network was studied. In this regard, 12 districts of the malaria-endemic area in Iran were selected. Participants included 360 individuals (30 representatives of the organization/group in each district). The data were gathered by interview, using the levels of collaboration scale. UCINET 6 was used for data analysis. The indices of density, centralization, reciprocity, and clustering were investigated for each twelve network and at each level of collaboration.ResultsThe average density of the networks was 0.22 (SD: 0.04). In districts with a high incidence of imported malaria, the values of network density and centralization were high and the networks comprised of a larger connected component (less isolated clusters). There were significant correlations between density of network (r = 0.66, P = 0.02), degree centralization (r = 0.65, P = 0.02), betweenness centralization (r = 0.76, P = 0.004), and imported malaria cases. In general, the degree centrality and betweenness centrality of the organizations of health, district governor, and foreign immigrants’ affairs were higher. In all networks, 60% of the relationships were bilateral. At a higher level of collaboration, the centralization declined and reciprocity increased. The average of betweenness centralization index was 22.76 (SD = 3.88).ConclusionsHigher values of network indices in border districts and districts with more cases of imported malaria, in terms of density and centralization measures, can propose the hypothesis that higher preparedness against the issue and centralization of power can enable a better top-down outbreak management, which needs further investigations. Higher centrality of governmental organizations indicates the need for involving private, non-governmental organizations and representatives of immigrant and refugee groups. Recognition of the existing network structure can help the authorities increase access to malaria prevention, diagnosis, and treatment services among immigrants and refugees.

Laboratory and semi-field evaluations on lethal and residual effects of temephos and pyriproxyfen insecticides to control malaria mosquito larvae, Anopheles stephensi Liston

BackgroundThe application of insecticides against vector mosquito larvae is a crucial step to control human malaria. Insecticide resistance is a major impediment to vector control strategies. The main aim of this study was to conduct laboratory and semi-field evaluations on lethal and residual effects of temephos and pyriproxyfen insecticides against malaria mosquito larvae, Anopheles stephensi.MethodsBoth susceptibility test and residual bioassay were performed to assess the lethal concentrations of each insecticide on 50% (LC50) of the IV instars larval populations and their activity periods according to standard protocols of WHO. Nine and eleven different concentrations with two sets of control in each case were applied for temephos and pyriproxyfen, respectively. Data were analyzed using probit analysis and SPSS software.ResultsThe LC50 and LC90 for temephos and pyriproxyfen under laboratory conditions were 0.4 and 0.63, and 1.69 × 10-4 and 4.036 × 10-4 ppm, respectively. Although the field strain of An. stephensi larvae was completely susceptible to pyriproxyfen, there was noticeable resistance (8% mortality at the diagnostic dose) to temephos in Nikshahr County, Southeast Iran. This is the first report of resistance to temephos for this malaria main vector in Iran. Depending on the applied variable doses, the residual effects of temephos and pyriproxyfen under semi-field conditions lasted maximally for 3 and 10 weeks, respectively.ConclusionThe high lethal and residual effects of pyriproxyfen on mosquito larvae confer an unprecedented opportunity in vector control operations leading to elimination of malaria in Iran.

Antiplasmodial Property of Glycyrrhiza glabra Traditionally Used for Malaria in Iran: Promising Activity with High Selectivity Index for Malaria

Development of resistance against the frontline anti-malarial drugs has created an alarming situation, which requires intensive drug discovery to develop new, more effective, affordable and accessible anti-malarial agents. The aim of this study was to assess antiplasmodial activity of the different fractions of root extract of Glycyrrhiza glabra. Roots of G. glabra were collected from Tarom district of Zanjan Province in 2016 and then dried root material was chopped and consecutively extracted by the percolation method using solvents of different polarity. Resulting extracts were assessed for in vitro and in vivo anti-malarial and cell cytotoxicity activities. Among the three different solvent fractions studied, water-methanol and ethyl acetate fractions showed promising in vitro antiplasmodial activity against CQ-sensitive Plasmodium falciparum 3D7 strain (IC50= 9.95 and 13μg/ml, respectively). Further, the selectivity indices (HeLa cells versus P. falciparum) for the promising water-methanol fraction showed selectivity for P. falciparum and potential safer therapy for human. Interestingly, water-methanol and ethyl acetate fractions showed a significant suppression of parasite growth (72.2% and 65%, respectively) in comparison with control group in mice infected with P. berghei (P< 0.05). The promising antiplasmodial activity of the aqueous fraction of G. glabra obtained in our study warrant bioassay-guided fractionation of this fraction to identify active principles responsible for antiplasmodial activity.

A systematic evidence review of the effect of climate change on malaria in Iran.

Climate is an effective factor in the ecological structure which plays an important role in control and outbreak of the diseases caused by biological factors like malaria. With regard to the occurring climatic change, this study aimed to review the effects of climate change on malaria in Iran. In this systematic review, Cochrane, PubMed and ScienceDirect (as international databases), SID and Magiran as Persian databases were investigated through MESH keywords including climate change, global warming, malaria, Anopheles, and Iran. The related articles were screened and finally their results were extracted using data extraction sheets. Totally 41 papers were resulted through databases searching process. Finally 14 papers which met inclusion criteria were included in data extraction stage. The findings indicated that Anopheles mosquitoes are present at least in 115 places in Iran; they are compatible with climatic zones of Iran. Malaria and it's vectors are affected by climate change. Temperature, precipitation, relative humidity, wind intensity and direction are the most important climatic factors affecting the growth and proliferation of Anopheles, Plasmodium and the prevalence of malaria. The transmission of malaria in Iran is associated with the climatic factors of temperature, rainfall, and humidity. Therefore, with regard to the occurring climatic change, the incidence of the disease may also change which needs to be taken into consideration while planning of malaria control.

Comparison of PfHRP-2/pLDH RDTs with Light Microscopy in a Low Prevalence Setting in Southeastern Iran, Sistan and Baluchestan: Due to Implementation of Malaria Elimination Program

Background: The gold standard for diagnosing malaria in Iran is using light microscopy; however, this method requires equipment, time and skilled microscopists. In some circumstances, rapid diagnostic test (RDTs) can be a proper substitute. Assessing the diagnostic performance of RDT relative to microscopy, for the diagnosis of malaria in Southeastern Iran, Sistan and Baluchestan, was the purpose of this study. Methods: From March to July 2016, which was a peak transmission season in Iran, 318 patients with suspected malaria were taken for a blood sample at the health center in Saravan, in Sistan and Baluchestan Province. The samples were surveyed instantly by light microscopy and RDT. Comparison analysis included: sensitivity, specificity, positive and negative predictive values, and other diagnostic screening performance measures for detecting malaria infections. Results: Of the 318 malaria cases (6.6%), 21 were identified by a microscopy compared to 22 of 318 (6.9%) by RDT. RDT sensitivity and specificity for the diagnosis of malaria were 95.5% (77.2% - 99.9%, 95% CI) and 100% (98.8% - 100%, 95% CI), respectively, compared to standard microscopy, the sensitivity and specificity for vivax malaria were 100% (79.4-100%, 95% CI) and 99.7% (98.14% - 99.99%, 95% CI), and for falciparum malaria: 80% (28.4% - 99.5%, 95% CI) and 100% (98.8% - 100%, 95% CI). Two tests showed an amazing agreement with a kappa estimation of 0.975. Conclusions: The study proved that the RDT test performs appropriately for the identification of infections with P. falciparum and P. vivax malaria in cross-border malaria. Moreover, the RDT can be a useful instrument for the identification of new clinical cases of malaria in this region.

Malaria in Iran: Is the elimination phase?

Malaria in Iran: Is the elimination phase?

Epidemiological status of malaria in Iran, 2011-2014.

To aim to determine the status and epidemiological aspects of malaria in Iran in favour of gaining a better understanding of the national control of malaria. 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. The incidence rates decreased from 2011 to 2014. There were 4.76, 2.12, 1.80, and 1.59 per 100000 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 100000 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. 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.

Burden of Malaria in Iran, 1990-2010: Findings from the Global Burden of Disease Study 2010.

Malaria is a major public health challenge in tropical and semi-tropical countries in terms of high morbidity and mortality. The present study aimed to report the burden of malaria in Iran, extracted from the global burden of disease 2010 study (GBD 2010) covering the period 1990 to 2010, to compare these findings with similar results, and to present some recommendations as potential solutions for gaining more accurate estimations regarding the burden of the disease in Iran. Data covering the period from 1990 to 2010 were derived from the GBD 2010, which is published by the Institute for Health Metrics and Evaluation (IHME). The findings were used to estimate the years lived with disability (YLDs), the years of life lost (YLLs), the disability-adjusted life-years (DALYs), and the death rate of malaria in Iran. The GBD 2010 estimated that there was a sharp declining death trend with regard to DALYs and death rate, showing that 4,647.63 DALYs were due to malaria in Iranian people of all ages and both genders, and that DALYs per 100,000 individuals declined from 37.15 in 1990 to 5.87 in 2010. The total number of malaria deaths over the 20 years was 73.37. The findings revealed that the burden of malaria decreased remarkably between 1990 and 2010. The explanation for this decrease is the establishment of a malaria surveillance system in various parts of Iran, and utilization of proper intervention and the improvement of infrastructures, which play a role in disease transmission, especially in endemic areas.

Genetic Diversity Block 2 of Surface Protein-1 in Plasmodium Falciparum Merozoite by Nested-PCR Method in Southeastern Iran

Background and Objectives: Plasmodium falciparum merozoite surface protein-1 (PfMSP-1) is a promising vaccine against malaria during its blood stages which play an important role in immunity to this disease. Polymorphic nature of this gene is a major obstacle in making an effective vaccine against malaria. In this study, the genetic diversity of Plasmodium falciparum isolates was investigated in Sistan-Baluchestan Province using allelic families of the MSP-1. Methods: From March/April 2011 to August/September 2012, 94 blood samples were collected from patients with falciparum malaria who were living in four districts of Sistan-Baluchestan Province. The extracted genomic DNA and genetic diversity of MSP-1 block 2 were evaluated by nested polymerase chain reaction. Results: From a total of 94 patients, 89 patients (94.7%) had positive PCR results and the remaining five patients were excluded. Seven different alleles of MSP-1 were identified through size difference on agarose gel. Comprising 46.1% of the samples, MAD20 was identified as the predominant MSP-1 allelic family, while the RO33 family had the lowest frequency (with 7.9%). In 10% of samples infection with two alleles was observed. Conclusion: The results of this study suggest that genetic diversity of PfMSP-1 in Southeastern Iran is relatively low and most infections originate from a clone that is consistent with an area of low malaria transmission. This information is useful for the prevention and control of malaria in Iran.

Brief historical perspectives of malaria in Iran.

The history of malaria as a serious human disease dates back to ancient times. For centuries, malaria has been a deadly disease with high morbidity and mortality that profoundly impacted the socioeconomic status of endemic countries. However, its causative agent remained unidentified until the last decades of the nineteenth century. There were no effective synthetic anti-malarial agents until the mid-twentieth century. Currently malaria has been eliminated or pre-eliminated in numerous countries; however, this preventable and curable disease remains a significant global health problem. A major concern is drug resistance. Presented here, is a brief look at the history of malaria in Iran and the rest of the world, particularly during the nineteenth and twentieth centuries.