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Query: UMLS:C0024530 (malaria)
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The investigations made in the areas of residual endemics and the retrospective analysis of the prevalence of vivax-malaria revealed changes in its manifestations and in the functioning of parasitic systems in the past decades: selection of P. vivax strains with long-term incubation in the southern areas of the CIS and in the north of Afghanistan, which constitute a northern world areal boundary, increases in the periods of late manifestations up to 30-38 months, the minimal risk of renewal and implanting of malaria transmission in malarious territories where it was eradicated in the 1950s. The change in the habitance stimulates self-regulation for effective adaptation and species preservation. The pronounced adaptative properties of P. vivax which manifested themselves in altered changes of signs of vivax-malaria with short- and long-term incubations in the CIS should be borne in mind while planning and launching antimalarial measures in the endemic areas. These data may be useful in the comparative characterization of malarial parasitic systems in its various areas of spread.
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PMID:[Changes in the manifestations of tertian malaria on the territory of the CIS Nations]. 777 10

Profound socio-economic changes within the CIS countries in the 1990s brought a lot of negative changes in malaria prevention in targeted countries. The previously stable connection and cooperation in prophylactic activities have been interrupted. Supply of antimalarials, insecticides and equipment had been stopped. Many qualified cadres in the sanitary-epidemiological services in the countries were lost. Because of difficult economic situation they had to change their occupation and place of job. After prolonged period of a stable benign epidemiological situation within Russia the number of imported cases started to grow up. The sharp increase of imported malaria cases from Azerbaijan and Tajikistan had been noticed since 1994 (Tab. 1). For the first time in the history of malaria registration the number of cases imported from the CIS countries has been exceeded the number of malaria cases imported from all other countries in the world in 1995. Later in the end of the 1990s the imported malaria cases has been registered in Russia from some other CIS countries apart from Azerbaijan and Tajikistan. There were malaria cases imported from Armenia (13 cases), Moldavia (2), Turkmenistan (2), and Uzbekistan (2) in 1998. The number of imported malaria cases in Russia in 1999 (Jan-July) is 437. There is no information about introduced or indigenous malaria cases registered until now] within Russia. There were 13 introduced malaria cases as the result of numerous imported ones. 13 introduced cases have been registered in 10 oblasts (administrative regions of Russia). This number has been increased to 53 (!) in 1998 in 20 oblasts. There was one local outbreak of P. vivax malaria in Izberbash settlement (Dagestan). Number of indigenous malaria cases were 5 (1996), 18 (1997), 1 (1998). The contra-epidemic measures in Izberbash have included active cases detection and treatment indoor insecticide spaying and one tour of mass primaguine treatment during interseasonal period of time. Additional indigenous cases after imported and introduced ones have been detected in Krasnodar (1 cases), Samara (1), Tolyaty (1), and Cherkessk (5) in 1998. One induced P. falciparum malaria case has been detected Moscow in 1998. Medical nurse from urological branch of the Moscow hospital No. 29 has penetrated by syringe needle her hand after performing of intravenous injection to the patient with imported P. falciparum malaria. No other induced cases have been detected. Because of local administrative problems with primaquine supply not all P. vivax malaria cases have received complete treatment. As the result of these events there was malaria relapsed cases registered every year. The actual number was 20 (1993), 37 (1994), 45 (1995), 59 (1996), 99 (1997). Due to late appearance of patient with P. falciparum malaria before medical staff and as a result late diagnosis and late and some time inappropriate treatment there were several lethal malaria cases registered [table: see text] every year. Inappropriate treatment means that treatment of P. falciparum malaria cases was consisted of chloroquine only. The cumulative number of lethal cases in 1994-1997 was 12, and the same number in 1998 was 6. One should mention that one lethal case in 1998 in Volgograd was due to P. vivax. The subject was chronic alcoholic and combination with P. vivax malaria brings him to death. Some calculation reveals the risk of resurgence of malaria in Russia. If one analyses all P. vivax imported cases from the point of view of time and place of detection the following picture would be emerged: 83% of all imported cases has been localized within cities, and 17% only--in rural areas. Half of the latter has been appeared during cold part of years when transmission was impossible. The result of approximately 200 imported cases has been appeared in a right time and place there were 75 introduced cases.
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PMID:[The malaria situation in the Russian Federation (1997-1999)]. 1090 Sep 14

The Republic of Kazakhstan is situated in the northern hemisphere on the boundary of two continents--Europe and Asia--at a longitude of 45 degrees E--87 degrees E and a latitude of 40 degrees N--55 degrees N. The total area of the republic is 2,724,900 square kilometers. Kazakhstan shares a border with the Russian Federation to the north-west, north and east: the border between the two countries is almost 6500 km long. To the south, Kazakhstan shares a border with the Central Asian states of Turkmenistan (380 km), Uzbekistan (2300 km) and Kyrgystan (980 km). To the south-east, it shares a border with China (1460 km): to the west is the Caspian Sea (600 km). Thus, the total length of Kazakhstan's external borders is 12,000 km. Because of the geographical, natural and climatic features prevailing throughout most of the Republic, there is a potential danger that local transmission of malaria may begin again if the disease is imported from abroad. The areas most at risk are the Panfilov and Uigur raions of Almaty oblast, which share a border with malaria-endemic regions of China, and the Saryagash and Makhtaral' raions of South Kazakhstan oblast along the border with Uzbekistan. The Government of the Republic of Kazakhstan places particular emphasis on malaria prevention and control, taking into account the historical data about the prevalence of malaria from the late 1920s to the early 1940s, amounting to hundreds of thousands of cases every year. Government Decree No. 840 entitled "Urgent Measures to Protect the Population from Blood-Sucking Insects and Ticks Dangerous to Humans", which lays down measures for the control of malarial mosquitoes in the areas most susceptible to malaria resurgence, was adopted in 1996. The Ministry of Health of the Republic of Kazakhstan issued instructions in 1998 and 1999 which were designed to motivate all health facilities in the field of malaria prevention and control. At present, as part of the directives developed by the Republican Health Epidemiology Posts, work is being done on the planning of malaria control measures in Kazakhstan for the period 2001-2003. In 1994 a programme of epidemiological malaria surveillance was introduced, which has enabled us to improve our monitoring of the epidemiological situation of malaria. The number of cases of imported malaria has declined: in 1997, there were 102 cases, in 1998-87 and in 1999-52. There have been occasional local cases in some years, and in 1998 there were four local cases in the south and north-west of the country: two cases in Almaty oblast, one case in Zhambyl oblast and one in West Kazakhstan oblast (see Fig. 1). Most malaria infections are imported from Tajikistan and Azerbaijan, with occasional cases from Pakistan, India, Turkey and Afghanistan. Analysis of the occupational status of patients shows that around 45% are military personnel who have served on the Tajik-Afghan border. The others are refugees, merchants, unemployed people or students. The overall aetiological structure of malaria cases is dominated by P. vivax malaria. For example, in 1999, there were 48 cases of P. vivax malaria (90.5% of the total), one case of tropical malaria (1.9%), two cases of quartan malaria (3.8%) and two cases of P. vivax + P. malariae (3.8%). In order to prevent indigenous malaria occurring within the country, a system of malaria screening has been set up; screening is carried out every year on groups who have visited neighbouring or more distant malaria-endemic countries and for patients with a persistent fever who are suspected of suffering from malaria. The area of water throughout the country within communities or within a 3-5 km radius of them which is susceptible to colonization by the Anopheles mosquito amounts to over 5000 hectares, according to the certification system in force. In addition, approximately 70,000 hectares in three oblasts used for rice cultivation also provide a habitat for Anopheles. The main malaria vector, An. messeae, is found throughout the country: in a few areas An. hyrcanus and An. claviger are found and, in the south, An. pulcherrimus. Data from recent years show the presence of An. superpictus, An. plumbeus and An. algeriensis. In 1999, from data collected during systematic observations of the phenology and seasonal variations in the number of Anopheles at 114 observation posts, the average seasonal numerical indicators for the mosquito imago reached a maximum of between 21 and 46.5 adult mosquitoes per cattle shed, up to 2.7-3.3 adult mosquitoes per residential building and 30-67.3 larvae per square metre of surface water. According to the results of large scale trapping programmes (486 communities were screened in 1999), the maximum value of the numerical indicator was 16.8-74.1 adult mosquitoes per cattle shed and 4.1-3.8 adult mosquitoes per residential building. In 1999, compared with 1998, the number of malarial mosquitoes detected throughout the country declined encouragingly, or stayed at the same level, which is one of the factors responsible for the country's favourable epidemiological situation with regard to malaria. According to data going back many years, there has been a significant increase in the number of mosquitoes at some observation posts in Almaty, East Kazakhstan and Kyzlorda oblasts. There is a tendency everywhere for the numbers of imagos detected in residential buildings to increase, which presents a definite epidemiological risk that indigenous malaria will re-emerge if the disease is imported into Kazakhstan from countries which suffer from it. If we consider the species of mosquito present in the country and the temperature factor (the number of days in the year when the average daily temperature is over 16 degrees C), the country can be divided, on the basis of incomplete 1999 data, into zones at very high risk of re-emergence of malaria (Almaty, Zhambyl and South Kazakhstan oblasts), high risk (Karaganda oblasts and Almaty city), medium risk (Aktyubinsk and Akmolinsk oblasts), and low risk (Kostanay oblast). The malaria risk of the other oblasts has been calculated using data from earlier years (map attached) [Translator's Note: map missing]. Preventive malaria control measures in Kazakhstan are divided into three categories to suit three different groups of communities. One hundred and seventy-nine communities have been allocated to the first group, at high risk of malaria resurgence; 1377 communities to the second group, at medium risk; and the remainder to the third group, at little or no risk of malaria resurgence. The following factors were used to categorize communities according to the risk that malaria might become reestablished if the disease should be imported from elsewhere: species of malarial mosquito present; changes in mosquito numbers and in the area of water susceptible to population by Anopheles; temperature conditions and, consequently, the length of the malaria transmission season and the season of effective susceptibility of the mosquito to infection; population migration; quality of laboratory testing for the diagnosis of malaria. Measures aimed at the destruction of mosquitoes are intended to reduce the numbers of Anopheles in the communities most at risk of malaria resurgence, i.e. those in group 1 above and the actual foci of malaria infection. Because of the economic crisis and financial difficulties, fewer areas have been treated in recent years. In 1999, 1387 hectares of water and 450,000 square metres of buildings were treated (see Fig. 2). Measures to control biting flies in health establishments, recreation areas, etc. Certainly also help to protect people from malarial mosquitoes. In 1999, 12,501 hectares of water and land were treated from the ground or the air (see Fig. 3). In the present situation, the main reasons for the difficulties affecting the malaria control and prevention campaign are as follows. Staff numbers in the Republic's parasitology service have been unjustifiably reduced. For example, the number of entomologists and entomology assistants employed is 58% and 48%, respectively, of the number laid down in Ministry of Health directives. At the health epidemiology posts, the number of disinfectors has been reduced to a minimum, and practically all engineer/water engineer posts have been abolished. The country does not possess the necessary education base for initial training or continuing education of staff for the parasitology service. The lack of basic scientific information about the problems of malaria control and prevention and parasitology in general. There is no research to test or introduce the most effective, safe and low-cost malaria control products and insecticides. The methodological literature required to use certain modern insecticides is not available. Entomologists are not provided with specialist insect control equipment. Entomological surveys are left incomplete because of shortages of transport and fuel at the health epidemiology posts. Because of the economic crisis and the high cost of the radical water engineering measures necessary to combat malaria, these measures cannot be implemented on the scale required. The equipment and materials stocks of the parasitology laboratories are highly inadequate: there is a lack of modern laboratory equipment, as well as a lack of opportunities for high-level professional training for staff. The exchange of information between the CIS countries is unsatisfactory, and there is no common information space: nor is there any systematic data available from other foreign countries. In the period 2000-2003, Kazakhstan plans to carry out malaria control activities (mosquito destruction) over an area of 2000 hectares of water and 1.5 million square metres of buildings.
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PMID:[Current malaria situation in the Republic of Kazakhstan]. 1154 8

Malaria does not belong to a group of diseases that are markers of HIV infection; a combined transmission of malaria and HIV infection does not occur (except for cases of vertical and syringe-associated transmission of causative organisms), but HIV infection is more common in the malaria-endemic areas since both diseases are socially related. Expansion of both infections is associated with the same social processes in society. This paper analyzes the relationship of the spread of HIV-infection to the routes of migration of narcotic agents in case of Russia, by comparing the spread of HIV infection with the regional distribution of cases of malaria imported by Tadjikistan inhabitants. Importation of malaria from other CIS countries was compared as a control. The authors estimated the coefficients of correlation between the affliction of Russia's population with HIV infection and the rate of malaria importation from Tadjikistan (0.733) and other CIS countries (0.496), as well as between the importation of malaria to Russia and the total volume of a migratory flow from Tadjikistan in the period of 1992 to 2001 (-0.931). The findings indirectly support the assumption that there is a relationship of malaria importation from Tadjikistan to illegal migration, which suggests that the intensive importation of malaria from Tadjikistan may serve as a marker of importation of injectable narcotic drugs and hence that the spread of HIV infection in Russia may be intensified. The authors again emphasize that prevention of the spread of socially related infections requires that the whole society should combine efforts since public health care should not be a hostage of social problems.
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PMID:[Imported cases of malaria and HIV infection in Russia]. 1504 40

Malaria was eradicated on the territory of Moscow in 1960; its imported cases mainly from the countries of Asia and Africa and sporadic cases secondary to the imported ones were recorded during the following 40 years. Mass migration of the population (businessmen, seasonal workers, etc.) from the endemic CIS countries in the late 1990s, particularly to the Moscow Region, increased cases of tertian malaria, resulting from the transmission of the infection by the mosquitoes Anopheles. A total of 793 cases of malaria, including 27 parasitic carriers, were recorded from 2000 to 2004. The proportion of Muscovites was 24.1% of the total cases of malaria in 2002 and increased up to 50% in 2004. The causative agents of tertian malaria (Plasmodium vivax) were detected in 74.8% of the total number of cases. The ongoing importation of malaria from Tadjikistan and Azerbaijan, the late establishment of final diagnosis, the shortage of antimalarial drugs make the malaria situation worse in Moscow, which requires that antiepidemic measures should be intensified in the coming 3 years.
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PMID:[Malaria in Moscow in 2000-2004]. 1644 28

At present, a favorable malaria situation that contributes to the elimination of local vivax malaria transmission has established in Russia by 2010 due to the following factors: 1) a considerable reduction in the number of imported cases ofvivax malaria from endemic CIS countries; 2) a low malariogenic potential of the territory of the Moscow region where the basic importation of malaria occurs; 3) a higher awareness about the prevention of malaria in the population; 4) medical workers' alertness and timely detection of patients with malaria; 5) failure for sporadic cases of vivax malaria to be rooted in the urban area due to episodic carriage of various pathogenic phenotypes.
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PMID:[Why has malaria not been rooted in present-day Russia?]. 2061 24

The authors studied the population-and-species-specific structure of malaria mosquitoes in the Caspian Lowland and Kuma-Manych Hollow (Republic of Kalmykia, Stavropol Territory). Five Anopheles mosquito species were identified. An. messeae and An. atroparvus were dominant; An. maculipennis, An. hyrcanus, and An. sacharovi were ecologically specialized and relatively rare. An. sacharovi was first found in Kalmykia, which is the most dangerous malaria vector in the south regions of the CIS. This allows the former known borders of its area to be expanded to the northwest Paleartics. An. messeae showed a high rate of inversions along both arms of chromosome 3 in homo- and heterozygous states, as well as a unique inversion in sex chromosome. The An. atroparvus population in the region was found to have a high rate of inversion on the 3L arm, which had been previously recognized as rare in Ukraine only.
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PMID:[The population-and-species-specific structure of malaria (Diptera, Culicidae) mosquitoes in the Caspian Lowland and Kuma-Manych Hollow]. 2253 32

In the last 3 years, the malaria situation has considerably improved in the CIS countries: Three CIS countries, such as Turkmenistan, Armenia, and Kazakhstan, received the malaria-free status (in 2010, 2011, and 2012, respectively) confirmed by the WHO certificate; Azerbaijan, Kyrgyz Republic, Uzbekistan, and Tajikistan are in the elimination period. Despite the continuing intensive migration of CIS citizens to Russia, its malaria situation has been favorable, which is associated with the significant reduction of imported infection cases among migrants.
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PMID:[The current malaria situation in the CIS countries (2011-2012)]. 2464 Jan 23

A total of 436 malaria cases, including 12 from the CIS countries and 424 from far foreign countries (of Africa and Central and South-East Asia), were imported into the Russian Federation in 2010-2014. Most (96.6%) cases were notified in the urban areas of 52 administrative subjects of Russia. The largest number of the imported cases were seasonal workers (39.2%), tourists (31.3%), students and foreign postgraduate students (19.5%), and ship or aircraft crews (10%). During a short malaria transmission season (June to August), there were 150 cases of different types, out of them there were only 63 cases of tertian malaria (its pathogen is Plasmodium vivax, to which malaria mosquitoes of Russia's fauna are susceptible). The relatively small number of infection sources in the short transmission (June to August) season of malaria, its importation into low-susceptibility large towns, and a small proportion of imported vivax malaria cases substantially reduce the risk of malaria in the highrisk areas of the country.
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PMID:[MALARIA IMPORTATION BY RUSSIA'S CITIZENS AND FOREIGNERS, INTO THE CITIES AND TOWNS OF THE RUSSIAN FEDERATION]. 2740 8

The paper presents the scientific studies of malaria pathogens and vectors, which have been specially conducted in the endemic areas of the CIS countries and Georgia for use in an epidemiological surveillance system. The main ones investigate the structure of malaria foci and the level of G-6-PD deficiency among residents, determine the malariogenic potential. of the territory and the risk of infection in the population, and specify the taxonomy, systematics, and spread of major malaria vectors in .the countries ofWHO European Region. In addition, the time and magnitude of manifestations of long-term post-incubation tertian malaria were established; th6 susceptibility of P.vivax to antimalarials and the levels of resistance and irritability of malaria vectors to insecticides were studied. The experience in using a geographic information system for the epidemiological surveillance of malaria is given.
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PMID:SCIENTIFIC AND PRACTICAL STUDIES OF MALARIA IN THE CIS COUNTRIES AND GEORGIA. 3038 65


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