WO RLD HEALTH
ORGANIZA TION
WORKSHOP ON THE ENTOMOLOGICAL
SERVICES IN VECTOR-BORNE
DISEASES CONTROL PROGRAMMES
Lahore, 13 to 27 October 1984
ORGANISATION MONDIALE
DE LA SANTt
EM/'WKP.ENT.SRV.VED.CNT.PRG/5.2
VECTOR-BORNE DISEASES PREVALENT IN IRAN
AND METitODS OF VECTOR CONTROL AND EVALUATION
* Expert of Field Operation Malaria Eradication Ministry of Health Teheran
by
Shahpoor Moin Amini*
The important
- Malaria
vector borne diseases in Iran are as follows:
- Bilhariziasis
- Leishmaniasis
1. Malaria
The Malaria Eradication programme in Iran covers two areas:
1.1 Consolidation area
This area includes the major part of nort Iran and extends to the
north of the Zagros ranges and the central plateau. It comprises
42168 villages, 15.2 million rural population and 16.6 million urban population.
The yearly epidemiological data for 1983 was:
1) A.B.E.R. = 3.98 2) A.P.R. = 0.31 3) A.P.I. = 0.127
During last year, due to imported cases amongst Afghani refugees and
incoming persons from southeast Iran, localized malaria transmission has
resumed in several provinces (Gilan, M�zandaran, East-Azarbaijan, Tehran,
Central Khorasan and Isfahan) necessitating focal imagocidal operations.
Activities carried out in the consolidation area include:
- Active Case Detection (A.C. D.) and Passive Case Detection (P.C.D.) in
rural population.
- Treatment of positive cases.
- Epidemiological and entemological studies.
- Local spraying (with a suitable insecticide) whenever necessary.
- Larviciding with Abate or oil whenever applicable.
1) Annual Blood Examination Rate
2) Annual Parasite Rate
3) Annual Parasite Incidence
- 2 -
1.2 Attack phase area (South part of Iran)
This area comprises 29183 villages, about 7 million rural population
and 4.5 million urban population.
About 76% of positive cases are from the eastern part of this area
(Hormozgan, Baluchestan and South of Kerman).
The anopheline population includrs various species, namely, �• maculipenis,
A.sacharovi, A.superpictus, A.stephensi, A.fluviatilis, A.culicifacies and
A.d'thali.
Spraying operations in Southern Iran have caused the appearance of DDT,
dieldrine and malnutrition resistance in A.stephensi and DDT resistance in
A.culicifacies.
Other problems being faced are:
Use of insecticides with a short residual effect
Exophily and exophagy oI A.superpictus, A.fluviatilis and A.d'thali
scattering, movement and outdoor sleeping habitsof local populations.
Poor communications and lack of the roads in some areas.
Periodic tribal movement.
The epidmiological data (A.P.I., P.R. and A.B.E.R.) vary from place
to place. During the last year the following aats were obtained:
./ . . .
- 3 -
Shah res tan A.B.E.R. A.P.R. A.P.1. ---
Iranshahr 43.22 15.29 66 . 118
Chahbahar 19.29 14.57 28.069
Minab 46.17 4.36 20.158
Bandar-Ahas 28.03 2.30 6.470
Kahnuj 28.48 4.52 12.900
Izeh 55.38 0.81 4.486
Masdjed-Sleiman 30.45 1.04 3.93
The field operations programme in the attack zone include:
One or two annual rounds of spraying with propoxur (2g.a.i./Sq.m.)
in A.stephensi areas, and one or two annual rounds spraying with D.D.T
(2g.a.i./sq.m.) in the non-A.stephensi nrea.
Larviciding: with Abate (l.5cc/m2) or oil (during the transmission
season)
Distribution of Gambusia fish.
A.C.D.&P.C.D. in rural population.
Treatment of positive cases.
Epidemiological and entomological studies.
1.3 Vector anophelines in Iran
The studies carried out show that the following anophelines are
vectors in Iran.
• I • • •
Anophelines
1. A.maculipenis
2. A.sacharovi
3. A.superpictus
4. A.Fluviatilis
5. A.culicifacies
6. A. dethali
7. A.stephensi
Resistance to insecticides
1. A.sacharovi
2. A.stephensi
3. A.culicifacies
- 4 -
Zone of distribution
Maznndaran & Gilan provinces, some placed of
central plateau and West of Iran
Except the Khyzistan, Bluchestan, Hormozgan
and Busher provinces is present in all places
In nll the central plateau, the mountaineous
pla�es of the Alborz and Zagros, and the
littoral plain of Southern Iran
In all the South of Iran, (Hormozgan
Balnchcstan, Kerman, Fars and Khuziastan
provinces) .
In Sistan and Baluchistan provinces.
In Baluchestan, Honnozgan, Khuzistan,
Bnkhtaran and some places of Yazd, Hamedan
and Isfahan provinces.
In the south littoral plain and Baluchestan,
Hormozgan, Fars, Kerman, Bushehr, Khuzistan,
Boyerahmad and !lam.
is resistent·to DDT and D L D.
is resistent to DDT, D L D and Malathion
is resistent to DDT
• I • • •
2. Bilharziasis
- 5 -
In Iran histosoma haematobium is transmitted by Bulinus troncatus.
2.1 Distribution area
Bulinus troncatus is distributed in Khuzistan province (Dezful, Dasht
Azadegan, Ahwaz and Shushtar)
The Bilharzia control project is under the direction of Malaria Eradication
and Conmunicable Disease Control.
2.2 Surveillance
The number of people examined during last year was 101692 and the number
of infected cases was 214. The infection rate is as follows:
Dezful 0.18
Ahwaz 0.03
Dasht-Azadegan 0.06
Shush tar 0.0l
2.3 Technical operations carried out
1. A.C.D. and P.C.D. in rural population
2. Treatment of positive cases
3. Malacology (Snail survey and evaluation of the molusciciding).
4. Sanitation
5. Spraying (to spray the breeding place with Bayluscide) We have
not seen any resistance to Bayluscjde.
• I • • •
3. Leishmaniasis
- 6 -
Leishmania is one of the important and endemic disease in Iran.
Foci are seen in all the country (especially in lsfahan 1 Khorasan and
Khuzistan) except West Azarbaijan, Kord�stan, Bakhtaran and Hormozgan.
Studies on Phlebotomus in Iran have been initiated in 1943 and now
are continued by the School of Public Health and Institute of Health Research.
In Iran 41 species of Phlebotomus have been diserved so far. The studies
show that in our country Leishmaniasis transmittedd by Phlebotomus sergenty 1
Phlebotomus papatassi and Phlebotomus cocazicus. (rural leishmaniasis transmitted
by Ph.papatassi in Isfahan and urban leishmaniasis transmitted by Ph.Sergenty
in Mashhad).
We have not seen any signs of resiRtance to insecticides. Dogs and rodents
· are the sources of Leishmania.
Studies carried out show that urban Lcishmania disappeared in most part
of Iran at the beginning of the Malaria Eradication Project, and that rural
Leishmania is also diminished following insecticide applications but the trans
mission is not stopped.
During last year 15635 positive ca�es have been seen in Iran, the majority
is distributed as following:
Khuzistan province
Khorasan II
Isfahan "
4834
2444
'>219
case
II
"
• I •••
4. Recommendations
- 7 -
1. The development of basic health care networkmst be promoted with
the establishment of dispensaries and health houses in rural areas.
2. The Specific studies about vector - borne diseases must continue.
J. The specific control projects must continue till the complete
establishment of Health care network.
4. T�aining or retraining of technical personnel in control methodology
and evaluation of specific activities for the different health projects
must be strengthened.