Malaria in Afghan refugees in Pakistan

Suleman, Mohammad

doi:10.1016/0035-9203(88)90257-x

Cited by 32 publications

(22 citation statements)

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“…According to the recent WHO report, about half of the world's population is at risk of malaria, and an estimated 250 million cases led to nearly 1 million deaths in 2006 [5]. Among them, Pakistan is also endemic for both P. vivax, and P. falciparum associated malaria infections [6,14,15].…”

Section: Resultsmentioning

confidence: 99%

Malaria burden in human population of Quetta, Pakistan

Tareen¹,

Rafique²,

Wadood³

et al. 2012

European Journal of Microbiology and Immunology

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Malaria is a serious global health challenge, which is responsible for more than one million deaths a year. Malarial infection is more prevalent in developing countries including Pakistan. Significant efforts have been made to control malaria; however, due to socioenvironmental factors, it remains a frequent problem in Quetta. The present study was undertaken to determine the malarial incidence, species prevalence, and its demographic evaluation in human population of Quetta, Pakistan. A total of 1831 subjects, comprising 1072 male and 759 female presenting symptoms of malaria, were included in this study. Blood samples from clinically suspected individuals were subjected to the standard immunochromatographic and malaria parasite smear analysis for malaria diagnosis. Out of 1831 subjects, 338 (18.45%) patients were positive for malarial parasite while the species prevalence was found as 276 (81.66%) and 62 (18.34%) for Plasmodium vivax, and Plasmodium falciparum, respectively. Furthermore, seasonal variations gradual increase in the prevalence rate. The age group of 21-30 years (30.47%) was found more prone to malaria. The suspected malaria cases were found more frequent in rural (72.1%) as compared to urban (27.9%). In addition, the malaria burden was high in urban area (22.89%) population as compared to the rural area (16.74%) population. It was observed that the highest disease occurrence was caused by P. vivax, which reflects a serious threat for public health. The current findings will be helpful to plan effective strategies to prevent and control malaria in this area.

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Section: Resultsmentioning

confidence: 99%

Malaria burden in human population of Quetta, Pakistan

Tareen¹,

Rafique²,

Wadood³

et al. 2012

European Journal of Microbiology and Immunology

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“…Most settlements remained densely populated even though many Afghans had repatriated voluntarily. Settlements were often situated within a few km of local Pakistani villages, and malaria prevalence rates in neighbouring local and refugee communities were often homologous, suggesting a degree of 'parasite exchange' (Suleman 1988;Bouma & Rowland 1994). Because hostilities have mostly ceased in eastern and southern Afghanistan, cross-border movement of adult males was frequent, leading to import and export of malaria.…”

Section: Study Areasmentioning

confidence: 99%

Resistance of falciparum malaria to chloroquine and sulfadoxine‐pyrimethamine in Afghan refugee settlements in western Pakistan: surveys by the general health services using a simplified in vivo test

Rowland¹,

Durrani²,

Hewitt³

et al. 1997

Tropical Med Int Health

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SummarySurveys of drug resistant falciparum malaria were conducted in several Afghan refugee settlements, distributed over a 700 km range in western Pakistan, during the transmission seasons of 1994 and 1995. Symptomatic malaria patients were recruited by a process of passive case detection at the refugees' basic health units. To facilitate follow-up by local health workers, a modified version of the WHO extended in vivo test was adopted in which blood smears were taken from each subject, and clinical symptoms recorded, at weekly intervals. Resistance to chloroquine and sulfadoxine-pyrimethamine was identified in every settlement. The frequency of chloroquine resistance ranged from 18% to 62%. Resistance occurred mostly as RI, with RII resistance never exceeding 11%. Resistance to sulfadoxine-pyrimethamine occurred at much lower frequencies, ranging from 4% to 25%. There was a resumption of clinical symptoms at the onset of parasite recrudescence in over 90% of cases. The policy of using chloroquine as first-line treatment might be changed in favour of sulfadoxine-pyrimethamine in most camps and areas of western Pakistan. The modified in vivo test was almost as accurate as the normal WHO in vivo test in identifying the grade of resistance, and should prove a useful tool for the monitoring of resistance to common antimalarials by district health services.

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“…Refugees everywhere are frequently treated as scapegoats. The reality is that Afghan arrivals in the early 1980s succumbed to malaria transmitted within Pakistan (Suleman, 1988). It was speculated at the time that poverty-stricken refugees were unable to bene® t from zooprophylaxis as they lacked the domestic animals necessary to divert mosquitoes away from humans (De Zulueta, 1989).…”

Section: Epidemiology and Treatmentmentioning

confidence: 99%

“…The camps were sited on marginal land and many were waterlogged or adjoining rice cultivation, and hence prone to mosquito breeding. As the refugees were non-immune on arrival (Afghanistan had a successful malaria-control programme before the war; Suleman, 1988), malaria rapidly became a signi® cant health problem. At the height of the epidemic among the refugees in 1990, over 150 000 cases were being diagnosed and treated each year by the combined healthcare services of the United Nations High Commission for Refugees (UNHCR), the government of Pakistan and NGO (Rowland, 1999).…”

Section: Epidemiology and Treatmentmentioning

confidence: 99%

Malaria epidemiology and control in refugee camps and complex emergencies

Rowland

Nosten

2001

Annals of Tropical Medicine And Parasitology

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Owing to the breakdown of health systems, mass population displacements, and resettlement of vulnerable refugees in camps or locations prone to vector breeding, malaria is often a major health problem during war and the aftermath of war. During the initial acute phase of the emergency, before health services become properly established, mortality rates may rise to alarming levels. Establishing good case management and effective malaria prevention are important priorities for international agencies responsible for emergency health services. The operational strategies and control methods used in peacetime must be adapted to emergency conditions, and should be regularly re-assessed as social, political and epidemiological conditions evolve. During the last decade, research on malaria in refugee camps on the Pakistan-Afghanistan and Thailand-Burma borders has led to new methods and strategies for malaria prevention and case management, and these are now being taken up by international health agencies. This experience has shown that integration of research within control programmes is an efficient and dynamic mode of working that can lead to innovation and hopefully sustainable malaria control. United Nations' humanitarian and non-governmental agencies can play a significant part in resolving the outstanding research issues in malaria control.

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Malaria in Afghan refugees in Pakistan

Cited by 32 publications

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Malaria burden in human population of Quetta, Pakistan

Malaria burden in human population of Quetta, Pakistan

Resistance of falciparum malaria to chloroquine and sulfadoxine‐pyrimethamine in Afghan refugee settlements in western Pakistan: surveys by the general health services using a simplified in vivo test

Malaria epidemiology and control in refugee camps and complex emergencies

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