Demonstration of malaria situation analysis, stratification and planning in Minab District, southern Iran

To demonstrate malaria situation analysis, stratification and planning for an endemic area in southern Iran.

Data on health system, population, meteorological parameters, malaria cases, anopheline vectors, and control activities during 2005-2007 was obtained from Minab Health Center, Minab Meteorological Station and published documents about malaria elements in the study area. A datasheet was created in excel 2003 for analysis.

There were 644 health staff working in Minab District including 99 health staff in malaria control program. The health facilities are distributed as follow: 1 hospital with 96 beds, 23 health centers including private centers (10 in Minab city and 13 in rural area of Minab District) and 119 health houses in rural areas of Minab District. A nopheles stephensi was the dominant species in Minab District, however, Anopheles dthali, Anopheles superpictus, Anopheles fluviatilis, Anopheles multicolor, Anopheles pulcherrimus and Anopheles turkhudi can also be found in the area. Anopheles stephensi was reported susceptible to malathion, propoxur, primphos-methyl, lambda-cyhalothrin permethrin and deltamethrin, and resistant to DDT and dieldrin in the area. During the study period a total of 10 665 positive cases were reported, mainly due to local transmission (99.6%). Plasmodium vivax was the main causative agent followed by Plasmodium falciparum. There were reports about drug resistance of Plasmodium falciparum in the area.

Using different parameters, Minab was classified into 3 strata. A plan was designed based on described goal, objectives and targets. The approaches of this plan were categorized into: health education, early detection and correct treatment, and vector control. Main constraints of these approaches are population movement between Iran, Pakistan and Afghanistan; vector control challenges at district, inadequate skilled medical staff in malaria case management and weak inter-sectorial coordination for malaria control, especially in urban areas.