An insight to better understanding cross border malaria in Saudi Arabia

Abstract

Background Border malaria is a major obstacle for the malaria elimination in Saudi Arabia. Today, the southern border of Saudi Arabia is a region where malaria cases are resurging, and malaria control is dwindling mainly due to the humanitarian crisis and the conflict in Yemen. This study analyses the current border malaria epidemiology along the southern border of Saudi Arabia from 2015 to 2018. Methods All reported cases maintained by the malaria elimination centres in Aledabi and Baish, Jazan Province, Saudi Arabia, from 2015 to 2018 were analysed to examine the epidemiological changes over time. Pearson’s Chi-Square test of differences was utilized to assess differences between the characteristics of imported and local causes and between border cases. A logistic regression model was used to predict imported status was related to living along side of the border area. Results A total of 3210 malaria cases were reported in Baish and Aledabi malaria centres between 2015 and 2018, of which 170 were classified as local cases and 3040 were classified as imported cases. Reported malaria cases were mainly among males, within the imported cases 61.5% (1868/3039) were residents of the border areas. Conclusions Given the complexity of cross-border malaria, creating a malaria buffer zone that covers a certain margin from both sides of the border would allow for a joint force, cross-border malaria elimination programme. To initiate a malaria elimination activity and cases reported as belonging to this zone, rather than being pushed from one country to the other, would allow malaria elimination staff to work collaboratively with local borderland residents and other stakeholders to come up with innovative solutions to combat malaria and reach malaria-free borders.

Spatiotemporal distribution of malaria in the Kingdom of Saudi Arabia

“…The results of the study indicate that Plasmodium falciparum is the dominant malaria parasite in Jazan which is similar to the finding of the study that found that (94.3%) were infected with Plasmodium falciparum [8]. This research emphasises the need for focused treatments to control and prevent Plasmodium Plasmodium falciparum in Jazan, which has yet to reach elimination but has achieved public health achievements [19]. In contrast, the central provinces of KSA (Riyadh, Qassim, and Ta'if) showed varying percentages of malaria species infections, with the dominance of Plasmodium vivax and Plasmodium ovale over the five years of the study.…”

“…The findings showed that the percentage of malaria cases in the KSA in 2021 that were either locally introduced or imported. The results reveal that no local cases were reported, and only Jazan and Aseer had introduced cases, whereas all other provinces had imported cases [19,16]. This illustrates the continuous problem of imported malaria in the KSA, notably among migrant workers from East Africa, Yemen and South Asia.…”

Prevalence of Plasmodium species in Badr Governorate, Madinah Province, Saudi Arabia using microscopy and rapid diagnostic test

“…In Saudi Arabia, imported malaria remains a major problem with a constant flow of imported malaria, mostly among immigrant workers from south Asia (Pakistan, India and Bangladesh), East Africa (Sudan and Ethiopia), and Yemen. [6][7][8] In the current study, a total of 493 suspected patients were tested; CBFME identified 34 (6.89%) while CareStart RDT kit identified 29 (5.88%). Moreover, Using CBFME as reference, CareStart RDT kit failed to detect 5 positive cases that were confirmed by microscopy as P vivax (3) and P falciparum (2).…”

“…Additionally, Plasmodium parasites can also be transmitted either from a mother to her baby during pregnancy (trans-placentally) or through contaminated blood transfusion from an infected blood donor. [4,5] The Global incidence of malaria is increasing due to 3 main factors that play an important role in disease transmission; factors due to human immunity, migrations to malaria epidemic areas and imported malaria cases into non-endemic countries, [6][7][8] factors related to the vector increasing breeding possibilities that result from climatic and ecological conditions, such as rainfall patterns, humidity, water reservoirs, presence of plants, change in whether patterns, appearance of new vectors by the continuous broken down of vectors control programs due to lack of quality control and growing insecticide resistance. [5,9] Finally, factors directly related to the parasite, as the appearance of resistance to conventional anti-malarial drugs.…”

“…The Hajj and Umrah religious rituals may introduce malaria into KSA, as many Muslim countries have a high malaria prevalence. [6][7][8]16,17] Symptomatic diagnosis alone can be misleading for suspected malaria patients due to many other diseases have similar symptoms to malaria. Malaria symptom is a fever due the toxins release when erythrocytic schizonts rupture.…”