Current Status and the Epidemiology of Malaria in the Middle East Region and Beyond

Abstract

Vector-borne parasitic infectious diseases are important causes of morbidity and mortality globally. Malaria is one of the most common vector-borne parasitic infection and is caused by five Plasmodium species, namely P. falciparum, P. vivax, P. ovale, P. malariae, and P. knowlesi. Epidemiologically, differences in the patterns of malaria cases, causative agent, disease severity, antimicrobial resistance, and mortality exist across diverse geographical regions. The world witnessed 229 million malaria cases which resulted in 409,000 deaths in 2019 alone. Although malaria cases are reported from 87 countries globally, Africa bears the brunt of these infections and deaths as nearly 94% of total malaria cases and deaths occur in this continent, particularly in sub-Saharan Africa. Most of the Middle East Region countries are malaria-free as no indigenous cases of infection have been described in recent years. However, imported cases of malaria continue to occur as some of these countries. Indeed, the six Gulf Cooperation Council (GCC) countries have large expatriate population originating from malaria endemic countries. In this review, the current status and epidemiology of malaria in the Middle East Region countries and other malaria-endemic countries that are home to a large migrant workforce being employed in Middle East Region countries are discussed.

A Large Case Series of Neurocysticercosis in Kuwait, a Nonendemic Arabian Gulf Country in the Middle East Region

“…The remaining 3.21 million people are expatriate workers or their dependents (https: //www.paci.gov.kw/stat/Default.aspx, accessed on 9 March 2021) [24]. Most expatriates, including domestic helpers and food handlers in restaurants, originate from countries such as India, Bangladesh, Nepal, Sri Lanka, Philippines and Ethiopia, which are endemic for T. solium taeniasis and other infectious diseases [25][26][27][28][29][30]. Currently, infected individuals in Kuwait are usually screened for taeniasis by stool microscopy for the detection of ova and proglottids.…”

Current Epidemiological Characteristics of Imported Malaria, Vector Control Status and Malaria Elimination Prospects in the Gulf Cooperation Council (GCC) Countries

“…A new paradigm shift that has occurred in many malaria non-endemic countries/regions, particularly among those located in the temperate climate of Europe and North America and a few oil-rich Arabian Gulf countries, is the emergence of imported malaria cases [ 12 , 13 , 14 , 15 ]. Many countries which were malaria free until a few years ago have seen a sharp increase in the number of imported malaria cases in recent years [ 12 , 13 , 14 , 15 ].…”

“…A new paradigm shift that has occurred in many malaria non-endemic countries/regions, particularly among those located in the temperate climate of Europe and North America and a few oil-rich Arabian Gulf countries, is the emergence of imported malaria cases [ 12 , 13 , 14 , 15 ]. Many countries which were malaria free until a few years ago have seen a sharp increase in the number of imported malaria cases in recent years [ 12 , 13 , 14 , 15 ]. This increase has occurred as a result of increased international travel for business or tourism particularly from or to malaria-endemic countries, migratory movements for employment and migration of large number of refugees from war-torn countries into non-endemic/malaria-free countries [ 12 , 16 , 17 , 18 ].…”

“…Many countries which were malaria free until a few years ago have seen a sharp increase in the number of imported malaria cases in recent years [ 12 , 13 , 14 , 15 ]. This increase has occurred as a result of increased international travel for business or tourism particularly from or to malaria-endemic countries, migratory movements for employment and migration of large number of refugees from war-torn countries into non-endemic/malaria-free countries [ 12 , 16 , 17 , 18 ].…”

“…We recently reviewed the epidemiology of malaria in Middle Eastern countries [ 12 ]. In this narrative review, all studies indexed in PubMed describing epidemiological characteristics of indigenous and imported malaria cases, status of malaria vectors and how these infections can be controlled to achieve malaria elimination in the six (Bahrain, Kuwait, Qatar, Oman, Saudi Arabia and United Arab Emirates, UAE) Gulf Cooperation Council (GCC) countries were reviewed and discussed.…”