BackgroundThe draft Global Technical Strategy for malaria aims to eliminate malaria from at least 10 countries by 2020. Yemen and Saudi Arabia remain the last two countries on the Arabian Peninsula yet to achieve elimination. Over the last 50 years, systematic efforts to control malaria in the Kingdom of Saudi Arabia has successfully reduced malaria cases to a point where malaria is now constrained largely to Jazan Province, the most south-western area along the Red Sea. The progress toward elimination in this province is reviewed between 2000 and 2014.MethodsData were obtained from the Ministry of Health case-reporting systems, activity reports, unpublished consultants reports, and relevant scientific published papers. Sub-provincial population data were obtained the national household censuses undertaken in 2004 and 2010. Rainfall data were obtained from the Meteorological Department in Jazan.ResultsBetween 2000 and 2014 there were 5522 locally acquired cases of malaria and 9936 cases of imported malaria. A significant reduction in locally acquired malaria cases was observed from 2000 to 2014, resulting in an average annual incidence (2010–2014) of 0.3 cases per 10,000 population. Conversely imported cases, since 2000, remain consistent and higher than locally acquired cases, averaging between 250 and 830 cases per year. The incidence of locally acquired cases is heterogeneous across the Province, with only a few health districts contributing the majority of the cases. The overall decline in malaria case incidence can be attributed to coincidental expansion of control efforts and periods of exceptionally low rainfall.ConclusionsJazan province is poised to achieve malaria elimination. There is a need to change from a policy of passive case detection to reactively and proactively detecting infectious reservoirs that require new approaches to surveillance. These should be combined with advanced epidemiological tools to improve the definitions of epidemiological receptive and hotspot malaria risk mapping. The single largest threat currently remains the risks posed by imported infections from Yemen.
Significant headway has been made in the global fight against malaria in the past decade and as more countries enter the elimination phase, attention is now focused on identifying effective strategies to shrink the malaria map. Saudi Arabia experienced an outbreak of malaria in 1998, but is now on the brink of malaria elimination, with just 82 autochthonous cases reported in 2012. A review of published and grey literature was performed to identify the control strategies that have contributed to this achievement. The number of autochthonous malaria cases in Saudi Arabia decreased by 99.8% between 1998 and 2012. The initial steep decline in malaria cases coincided with a rapid scaling up of vector control measures. Incidence continued to be reported at low levels (between 0.01 and 0.1 per 1,000 of the population) until the adoption of artesunate plus sulfadoxine-pyrimethamine as first line treatment and the establishment of a regional partnership for a malaria-free Arabian Peninsula, both of which occurred in 2007. Since 2007, incidence has decreased by nearly an order of magnitude. Malaria incidence is now very low, but a high proportion of imported cases, continued potential for autochthonous transmission, and an increased proportion of cases attributable to Plasmodium vivax all present challenges to Saudi Arabia as they work toward elimination by 2015.
Abstract. Two hundred and three Plasmodium falciparum isolates from Jazan area, southwest Saudi Arabia, were typed for Pfcrt, Pfmdr1, dhps, and dhfr mutations associated with resistance to chloroquine, mefloquine, halofantrine, artemisinin, sulfadoxine-pyrimethamine, and the neutral polymorphic gene Pfg377. A large proportion (
The present study was designed to provide information on the susceptibility status of the adult and larvae of Aedes aegypti mosquitoes in Jazan region of Saudi Arabia. Bioassay tests were performed on adults and larvae by using WHO recommended concentrations and test kits. Adults of Ae. aegypti mosquitoes were exposed to test papers impregnated with Lambda-cyhalothrin (0.05%), Cyfluthrin (0.15%), Deltamethrin (0.05%), Permethrin (0.75%), Fenitrothion (1%), Bendiocarb (0.1%) and DDT (4%) insecticides. Ae. aegypti mosquitoes were found to be susceptible only to Cyfluthrin; (mortality rate was 100 %), whereas variable resistances were observed from the rest of the other insecticides tested (mortality rates ranged between 93.6 and 17%).
Background: Dengue is endemic in Saudi Arabia especially in Jeddah, Makkah, Asir, and Jazan areas where pyrethroids are widely used to control the vector, Aedes aegypti. Resistance of Ae. aegypti to pyrethroid insecticides has been reported from most of these areas. Aims: The present study was carried out in Jazan region in southwest Saudi Arabia to explore the resistance status of Ae. aegypti to pyrethroids and the consequent underlying mechanisms. Methods: Three pyrethroids (permethrin, lambda-cyhalothrin, and cyfluthrin) were used to investigate the resistance status of Ae. aegypti adults following World Health Organization (WHO) standard methods: PCR and sequencing techniques were used to detect the S989P, V1016G and F1534C kdr mutations. Results: Ae. aegypti populations were susceptible to cyfluthrin and having a possibility of resistance to permethrin while resistant to lambda-cyhalothrin. Three potential kdr mutations were detected for the first time in Ae. aegypti population, F1534C, V106G, and S989P. It was found that F1534C often co-exists with V1016G and this haplotype was strongly associated with permethrin and lambda-cyhalothrin resistance. On the other hand, S989P mutation was detected as RR in 18.8% with a low-frequency rate (R) of 18.8%, and in 55.5% as R with 58.3% frequency rate in permethrin and lambda-cyhalothrin-resistant female mosquitoes, respectively. Conclusions: Early detection of resistance alleles should be considered the essential tool for the successful implementation of insecticide resistance management strategies by providing early warning of insect resistance.
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