Evaluation of Epidemiological Data of Malaria Between 2001-2011 in Sanliurfa, Turkey

Abstract

Although Plasmodium vivax is the only cause of malaria cases detected in Turkey, an increase number of imported P.falciparum cases have begun to be observed recently. Sanliurfa is a province located at Southeastern region of Turkey where malaria is endemic and also one of the two largest malaria epidemics of Turkey was experienced with 84.345 cases in 1994. As this region has borders with countries like Iraq, Iran and Syria, cross border migration caused an increase in imported cases. In addition, climate change, alteration in temperature and humidity due to the Southeastern Anatolian Irrigation Project have led an increase in suitable breeding grounds for mosquitoes. Since new indigenous malaria cases, except imported ones are not detected in Sanliurfa nowadays, there is not enough data on the malaria epidemiology in this region including recent years. The aim of this study was to evaluate the epidemiological data in connection with malaria cases observed in Sanliurfa which is a critical region for this infection for a 11-year-period, between the years of 2001 to 2011, retrospectively. Data obtained from the Malaria Control Unit of the Communicable Diseases Division of Sanliurfa Provincial Health Directorate were analized in terms of frequency of the cases, distribution of the cases in years and months, demographical characteristics, the source and species distribution of the parasite and the locations of the disease. A total of 1.149.196 blood smear samples have been examined during 11-year-period as part of surveillance programme and 4394 (0.4%) of them were positive for Plasmodium spp. The agent was P.vivax in 99.9% (4391/4394) of the cases, while in three cases (0.07%) who were diagnosed after 2010, it was P.falciparum. Of the patients 2351 (53.5%) were male and 2043 (46.5%) were female (p> 0.05), whose age ranging from 3 months to 80 years (mean age: 19.21 ± 16.12 years). The frequencies of the cases according to the age groups 0-11 months, 1-4 years, 5-9 years, 10-14 years and 15 years were as follows; 2.5%, 15.1%, 18%, 13.9% and 50.5%, respectively. The detection of Plasmodium spp. in the samples examined in 2002 (1244/110.533; 1.1%) was the highest, and in 2011 (1/50.981; 0.002%) was the lowest. The distribution rates of 4394 cases according to the years between 2001 to 2011, were found as 25.4%, 28.3%, 17.8%, 10.9%, 8.9%, 5.6%, 1.4%, 1.4%, 0.2%, 0.009% and 0.02%, respectively. Of all cases, 80.6% were autochthonous and 19.4% were imported. Most of the cases were detected in Siverek county with a rate of 71.4%, followed by Ceylanpınar (13.5%) and Viranşehir (6.6%) counties. Although malaria cases were detected throughout the year in Sanliurfa in respect to the climate, the highest numbers were recorded in September (832/4394; 18.9%) and November (1054/4394; 24%). This study emphasized that malaria cases due to local transmission declined to zero in Sanliurfa like the recent situation in Turkey. However, P.falciparum malaria cases are being reported due to the travels to endemic countries or migrations ...

Detection of Plasmodium using filter paper and nested PCR for patients with malaria in Sanliurfa, in Turkey

“…The study sample comprised 153 suspected malaria patients, aged between 1 month and 77 years, from three provinces of Sanliurfa between 2008–2011 (Table 2 ) [ 24 ]. The mean age of the participants was 21.10 ± 16.10, of which 50.4 % were female and 49.6 % were male.…”

Evaluation of Malaria Cases Detected in Antalya Province between 2012 and 2017

“…In the previous study in Antalya province, 66 malaria cases were detected between 2001 and 2011 and the species of parasite responsible for the disease in 57 (86%) of these cases was P. vivax and in nine (14%) was P. falciparum (1). Similarly, in previous studies in Adana, Mersin and Şanlıurfa provinces, P. vivax was responsible for the majority of malaria cases (18,23,24). The findings of these studies are different from the findings obtained from our study.…”

“…In the previous study conducted in Antalya province, 52 (78.8%) of 66 malaria cases between 2001 and 2011 were reported to be in the 15 years old and over (1). Likewise, most of the malaria cases in the studies carried out in Adana, Bursa (two studies), Çorum, Hatay, Kayseri, Manisa, Mersin and Şanlıurfa provinces were reported to be in the 15 years old and over group (10,(17)(18)(19)(21)(22)(23)(24)26). This situation is thought to be because of the fact that individuals in the 15 years old and over group travel more for business, education and tourism purposes, and they stay longer in outdoor areas compared to the other age groups during the active hours of mosquitoes.…”

“…Beside, increasing travel abroad for business, tourism and educational purposes due to the ease of transportation and large numbers of migrants arriving in our country due to the wars in our region are other important risk factors. In addition, there is a risk of malaria in our country which should not be ignored due to some factors such as many regions of Turkey have suitable ecological features for Anopheles mosquitoes and important effects of global warming and climate changes on vector and parasites (16)(17)(18)(19)(20).…”

“…In these years, malaria cases were mostly seen in the period between April and November, when mosquitoes were active seasonally, especially in summer and autumn, while the least cases were seen in winter (4,16). In addition, people spend more time in outdoor environments and travels also increase in these months (1,23 (18,23,24). Since the indigenous malaria cases have not been seen and all of cases have been imported from abroad, the seasonal distribution of malaria cases has been partially altered in Turkey in recent years.…”