[Current malaria situation and its control in Tadjikistan].Med Parazitol (Mosk). 2001 Jan-MarMP
Malaria was a widespread disease in Tajikistan in the past. Many travellers who visited eastern Bukhara last century wrote about this serious disease in their accounts. Surveys conducted in 1925-1926 showed that the whole population in the valleys was affected by malaria. Its control campaign was launched in the 1930s when the annual incidence of malaria reached 100-200 thousand persons. It is well known that malaria was virtually eradicated in Tajikistan in the late 1950s, as in the other republics of the USSR. It was only in the late 1970s and early 1980s, there was tertian malaria resurgence showing very low rates in the regions bordering Afghanistan. In some years, the number of malaria cases were as many as 200-500 cases a year, but due to the efforts of local health services that had used a whole range of methods for controlling the infection, the good situation remained until 1994. However, given the fact that the county is an high-risk area and malaria is endemic in neighbouring Afghanistan, its epidemic potential remained high. The epidemiological situation has become progressively worse since 1995. Its reasons are serious social conflicts which has taken the form of civil war. In 1997 with the support of WHO, ECHO (European Community Humanitarian Office), UNICEF (United Nations Children's Fund), WFP (World Food Programme), a number of international non-governmental organizations, the National Tropical Disease Control Programme for 1997-2005 was drafted and energetic actions were taken to implement malaria control measures in the country. In 1998-1999 great efforts were made to halt the spread of the serious epidemic outbreak in the country. During this period, a great deal of attention was paid to staff training for parasitology service, the Center for Tropical Disease Control and the general medical network. A large number of malaria control measures were taken, including vector control with special emphasis on treatment of buildings with persistent contact insecticides, mass preventive treatment with primaquine, and on the diagnosis of radical treatment of all identified malaria patients. The application of these preventive, therapeutical and vector control measures, together with an improvement in organization, resulted in a more than 2-fold fall in the incidence over 2 years (29,794, 19,351, and 13,493 cases in 1997, 1998, and 1999, respectively). The malaria control measures taken in the country in such a short period yielded positive results. A further reduction in the incidence of malaria and in the number of foci in Tajikistan can be achieved. Work towards this end should be systemic and goal-oriented by using a scientifically grounded and adequate range of prevention and control measures within the framework of the National Tropical Disease (Malaria) Control Programme and WHO "Roll Back Malaria" Programme. Improvements in parasitological service, tropical disease control centers and general health care network should form the basis of any future implementation of malaria control measures in the country at a regional level; monitoring the local malaria situation should be planned by constantly and qualitatively assessing the measures being implemented. It is very important to develop a system for preventing the spread of malaria throughout the country and its importation from foreign countries.