Malaria dynamics in Iran: insights from autochthonous and asymptomatic

The global efforts to eliminate malaria infection are continuing. Certain countries such as Belize and Cabo Verde were declared free status and Iran ended up in the elimination phase, but imported and subsequent autochthonous cases pose a public health challenge. Primary data on autochthonous and imported malaria were collected from Hormozgan province, Iran from CDC surveillance and control programmes between April 2018 and May 2023. Health professionals entered the data of malaria patients into Microsoft Excel and separated them into two categories: public data (demographic and socioeconomic) and clinical symptoms relevant to the local community, such as age, sex, nationality, occupation, residential status, and parasite species. The data was organized and statistical analyses were done using SPSS. The study included 289 cases (including imported and autochthonous cases): 87.5% male, and 12.5% female; Most of them were 11-29 years old. Vivax malaria was found in 78.9% of the total malaria cases. Afghans (imported) represented 56.7%, Pakistanis (imported) 30.8% and Iranians (autochthonous) 12.5%. In 2023, the number of cases reached its peak, especially in Jask County. Asymptomatic cases accounted for 45.25%, and the majority were treated. Imported malaria significantly contribute to maintenance of malaria transmission among native populations and has the potential to increase autochthonous malaria. The issue of illegal entry and unauthorized immigration demand systemic solutions through formal legal processes, such as legalization or deportation. There is a requirement to develop cost-effective approach, including active surveillance, rapid diagnosis, treatment, and follow-up for imported and asymptomatic cases.