Kondrashin Anatoly V, Sharipov Azizullo S, Kadamov Dilshod S, Karimov Saifuddin S, Gasimov Elkhan, Baranova Alla M, Morozova Lola F, Stepanova Ekaterina V, Turbabina Natalia A, Maksimova Maria S, Morozov Evgeny N
Sechenov First Moscow State Medical University, Moscow, Russian Federation.
Republican Centre for Control of Tropical Diseases, Ministry of Health and Social Welfare, Dushanbe, Tajikistan.
Malar J. 2017 May 30;16(1):226. doi: 10.1186/s12936-017-1861-5.
Malaria was eliminated in Tajikistan by the beginning of the 1960s. However, sporadic introduced cases of malaria occurred subsequently probably as a result of transmission from infected mosquito Anopheles flying over river the Punj from the border areas of Afghanistan. During the 1970s and 1980s local outbreaks of malaria were reported in the southern districts bordering Afghanistan. The malaria situation dramatically changed during the 1990s following armed conflict and civil unrest in the newly independent Tajikistan, which paralyzed health services including the malaria control activities and a large-scale malaria epidemic occurred with more than 400,000 malaria cases. The malaria epidemic was contained by 1999 as a result of considerable financial input from the Government and the international community. Although Plasmodium falciparum constituted only about 5% of total malaria cases, reduction of its incidence was slower than that of Plasmodium vivax. To prevent increase in P. falciparum malaria both in terms of incidence and territory, a P. falciparum elimination programme in the Republic was launched in 200, jointly supported by the Government and the Global Fund for control of AIDS, tuberculosis and malaria. The main activities included the use of pyrethroids for the IRS with determined periodicity, deployment of mosquito nets, impregnated with insecticides, use of larvivorous fishes as a biological larvicide, implementation of small-scale environmental management, and use of personal protection methods by population under malaria risk. The malaria surveillance system was strengthened by the use of ACD, PCD, RCD and selective use of mass blood surveys. All detected cases were timely epidemiologically investigated and treated based on the results of laboratory diagnosis. As a result, by 2009, P. falciparum malaria was eliminated from all of Tajikistan, one year ahead of the originally targeted date. Elimination of P. falciparum also contributed towards speedy reduction of P. vivax incidence in Tajikistan.
到20世纪60年代初，塔吉克斯坦已消除疟疾。然而，随后出现了零星的输入性疟疾病例，这可能是由于受感染的按蚊从阿富汗边境地区飞越喷赤河传播所致。在20世纪70年代和80年代，阿富汗边境的南部地区报告了疟疾的局部暴发。20世纪90年代，新独立的塔吉克斯坦发生武装冲突和内乱，疟疾形势急剧变化，包括疟疾控制活动在内的卫生服务陷入瘫痪，出现了大规模疟疾疫情，疟疾病例超过40万例。由于政府和国际社会投入了大量资金，疟疾疫情在1999年得到控制。尽管恶性疟原虫仅占疟疾病例总数的约5%，但其发病率的下降速度比间日疟原虫慢。为防止恶性疟原虫疟疾在发病率和地域方面增加，2000年在政府和全球防治艾滋病、结核病和疟疾基金的联合支持下，在该国启动了消除恶性疟原虫计划。主要活动包括定期使用拟除虫菊酯进行室内滞留喷洒、发放浸有杀虫剂的蚊帐、使用食蚊鱼作为生物杀幼虫剂、实施小规模环境管理以及让面临疟疾风险的人群采用个人防护方法。通过使用主动病例发现、被动病例发现、哨点病例发现以及选择性开展大规模血液调查，加强了疟疾监测系统。所有检测到的病例均根据实验室诊断结果及时进行流行病学调查和治疗。结果，到2009年，塔吉克斯坦全境消除了恶性疟原虫疟疾，比原定目标日期提前了一年。消除恶性疟原虫也有助于塔吉克斯坦间日疟原虫发病率的迅速下降。
