Middle East DVEP - Armed Forces Pest Management Board

Saudi Arabia: Malaria occurs in the southwestern part of the country in rural and urbanareas up to 2,000 m in the Tihama coastal region and the Asir highlands (Jizan, Asir, andAl Bahah Provinces). In the west (Makkah and Al Madinah Provinces) it is limited torural valley foci in the Hijaz Mountains. Malaria-free areas include the eastern, centraland northern provinces, and the urban areas of Jeddah, Mecca, Medina and Taif inwestern provinces. Nearly 90% of cases are caused by P. falciparum. Transmissionoccurs year-round, with a high incidence from October through April.Syria: Malaria is endemic at low levels in rural areas below 600 m. Urban centers andthe provinces of As Suwayda and Dayr az Zawr are malaria-free. Malaria transmission ishighest in the northern provinces bordering Turkey and Iraq. Plasmodium vivax accountsfor 56% of the cases.Turkey: Malaria cases are reported countrywide, but transmission is highest in southernand eastern Turkey, particularly the provinces along the Mediterranean coast fromAntalya eastward, Diyarbakir and Siirt Provinces, and the provinces bordering Syria,Iraq, and Iran. Transmission peaks in most areas during the summer months of Junethrough November. Outbreaks of P. vivax have increased more than tenfold since 1990due to reductions in vector control programs, population increases, and the ambitiousirrigation project in southeastern Turkey.United Arab Emirates: Malaria transmission occurs primarily north of the 25th parallel,including the east coast, Hajar mountain foothill regions, along the Gulf of Oman and theOman border, and the central plateau east of Dubayy. Transmission also occurs in AlAyn oasis. Most urban areas are malaria-free. Most cases of malaria are imported; lessthan 1% are indigenous.Yemen: Malaria transmission occurs in irrigated agricultural lands, wadis, and urbanlocales in coastal and foothill areas, including Socotra. Malaria risk is elevated in thesouthern governorates. Highest levels of transmission occur from October throughMarch. Approximately 90% of all cases are caused by P. falciparum, with P. vivax andP. malariae causing an equal percentage of the remainder.Bahrain, Cyprus, Israel, Jordan, Kuwait, Lebanon, and Qatar are considered malariafree,but imported cases are reported, and indigenous transmission may occasionallyoccur in areas where competent vectors are abundant. During the 1980s, Israel reportedover 2,000 cases of imported malaria, the vast majority in immigrants from Ethiopia. In1988, more than one-fifth of the imported cases were caused by chloroquine-resistant P.falciparum.Transmission Cycle(s). Humans are the only reservoir of human malaria. Nonhumanprimates are naturally infected by many Plasmodium species that can infect humans, butnatural transmission is rare. Female mosquitoes of the genus Anopheles are the exclusivevectors of human malaria. Plasmodium species undergo a complicated development inthe mosquito. When a female Anopheles ingests blood containing the sexual stages67