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

Abstract

Background: 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. Method: 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. Results: 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. Conclusion: 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.

Malaria diagnostic methods with the elimination goal in view

“…The malaria elimination goal program in Iran began in 2009 with aim of achieving elimination by the year 2025. There was a great decline in Iran between 2002 and 2017 (Soofi et al 2019 ; Vatandoost et al 2019a , b ). The country has successfully reduced its local cases of malaria over a period of 16 years, from an incidence of 0.24/1000 cases in 2002 to 0.01/1000 in 2017 with most cases limited to the South and Southeast of Iran (Nejati et al 2018 ; Vatandoost et al 2019a , b ), while the East Azerbaijan Province of Iran has attained a zero-malaria level since 2018, which qualifies it to be classed in elimination phase (Azizi et al 2020 ).…”

The impact of climate change on mosquito-borne diseases in Africa

“…In addition, migration plays an important role in all vector-borne diseases (VBD) [ 79 ]. Furthermore, under- and misdiagnosis, as well as delayed diagnosis and treatment as a result of superstitious beliefs, poor healthcare assistance and political instability pose challenges to malaria control and elimination [ 80 , 81 ]. The problem here is how to integrate this variety and diversity of factors in complex mathematical models.…”

The Considerable Cases of Imported Malaria in Larestan in the South of Iran During 2008-2018

“…Therefore, finding the cases of relapse, especially imported malaria, can accommodate this program greatly. Thus, if the two factors are not taken into account, the eradication project in a region will be defeated and it may also be impossible (18,19). Hence, the accurate understanding of the number of cases and imported malaria in addition to reflecting the health status of malaria reflects our success in achieving the main goal of disease eradication in 2020.…”