Author/Authors :
Raeisi Ahmad نويسنده , Bahrampour Abbas نويسنده Professor of biostatistics, Department of biostatistics and Epidemiology, Kerman University of Medical Sciences, Kerman, Iran , Zolala Farzaneh نويسنده Regional Knowledge Hub for HIV/ AIDS Surveillance, Biostatistics and Epidemiology Department, Kerman University of Medical Sciences , Haghdoost Ali Akbar نويسنده Research Center for Modeling of Health, Kerman University of Medical Sciences, Kerman , Kasaeian Amir نويسنده Non-Communicable Diseases Research Center, Endocrinology and Metabolism Population Sciences Institute, Tehran University of Medical Sciences, Tehran, Iran. , Farzadfar Farshad نويسنده Non-Communicable Diseases Research Center, Endocrinology and Metabolism Research Institute, Tehran University of Medical Sciences, Tehran, Iran , Parsaeian Mahboubeh نويسنده , Sheikhzadeh Khodadad نويسنده Modeling in Health Research Center, Institute for Futures
Studies in Health, Kerman University of Medical Sciences, Kerman,
Iran
Abstract :
Background Over the past years, the malaria elimination program
has considerably decreased the malaria indigenous cases and confined
their incidence to the southeastern areas of Iran encompassing 28 less
developed counties with favorable transmission conditions. Objectives
The aim of the study was to investigate the effects of climatic and
socioeconomic indicators on malaria transmission and to predict malaria
transmission risk until 2025 for all the southeastern endemic counties
in Iran. Methods The aggregated data from indigenous malaria cases, as
well as, climatic and socioeconomic indicators of malaria endemic areas
were collected on the monthly basis from each county between 2005 and
2015. The collected variables were, then, estimated until 2025 using
time series analysis. Considering the nature of these data, two
different multilevel models were implemented for
vivax and falciparum based on the
socioeconomic variable that was used. Finally, applying two different
models, two sets of estimates were obtained for malaria transmission
risk in each county. Results The annual decline of malaria transmission
was estimated to be 17% based on model 1, and 25% based on the model 2
for vivax (P < 0.001). These estimates were
13% and 21% for falciparum (P < 0.001),
respectively. For every increased unit in the wealth index, malaria
transmission for vivax and
falciparum decreased by 33% (P = 0.001) and 12% (P =
0.54), respectively. Also, for every increase in the mean years of
schooling, the transmission decreased by 65% (P < 0.001) and 57%
(P = 0.001) for vivax and
falciparum. Conclusions The results of this study,
using climatic variables along with socioeconomic variables, indicated
the obvious influence of socioeconomic status improvement on decreasing
malaria transmission. According to the results, malaria transmission
risk will considerably diminish in the next few years. The pattern of
malaria transmission decline was consistent with the declining trend of
malaria incidence which will move from the west to the east and from the
north to the south in the years to come. The transmission risk for
falciparum was considerably lower than that of
vivax and the endemic areas of
falciparum move towards 0 faster than
vivax.
