The resurgence of malaria in Northern Iran in 2023: a wake-up call

Abstract Background Control and elimination programs for malaria in Iran have consistently faced significant challenges due to various factors, including the presence of neighboring malaria-endemic countries such as Afghanistan and Pakistan. In recent years, Golestan Province in northern Iran has re...

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Main Authors: Faramarz Koohsar, Roghiyeh Faridnia, Ogholniaz Jorjani, Mohammad Taher Hojjati, Ganesh Yadagiri, Ghasem Noshak, Hosein Tavakoli Pirzaman, Hamed Kalani
Format: Article
Language:English
Published: BMC 2025-07-01
Series:BMC Infectious Diseases
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Online Access:https://doi.org/10.1186/s12879-025-11266-x
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author Faramarz Koohsar
Roghiyeh Faridnia
Ogholniaz Jorjani
Mohammad Taher Hojjati
Ganesh Yadagiri
Ghasem Noshak
Hosein Tavakoli Pirzaman
Hamed Kalani
author_facet Faramarz Koohsar
Roghiyeh Faridnia
Ogholniaz Jorjani
Mohammad Taher Hojjati
Ganesh Yadagiri
Ghasem Noshak
Hosein Tavakoli Pirzaman
Hamed Kalani
author_sort Faramarz Koohsar
collection DOAJ
description Abstract Background Control and elimination programs for malaria in Iran have consistently faced significant challenges due to various factors, including the presence of neighboring malaria-endemic countries such as Afghanistan and Pakistan. In recent years, Golestan Province in northern Iran has recorded few cases of imported malaria, with a sudden increase of 22 cases in 2023. This article provides an overview of the malaria situation in northern Iran, along with a detailed report of these 22 cases. Methods The study population comprises all individuals exhibiting symptoms suspected of malaria (n = 445) who were referred to the Malaria Diagnosis Center in Golestan Province, located in northeastern Iran, for diagnosis between March 23, 2023, and December 23, 2023. A drop of peripheral blood, collected from a finger prick of each patient, was utilized for Plasmodium falciparum/P. vivax antigen detection. Moreover, thin and thick smears were prepared for each patient to investigate morphological characteristics and parasitemia percentage of the parasites. Results In total, 4.94% (22/445) of individuals with malaria-suspected symptoms were infected with Plasmodium species. All 22 infected individuals were native to Golestan Province, and none had a previous history. The mean ± standard error of mean (SEM) for the number of parasites/µL of blood sample was 16,029 ± 5,060 for P. vivax and 105,460 ± 102,146 for P. falciparum. Among the patients, 77.27% (17/22) were infected with P. vivax, 18.18% (4/22) were infected with P. falciparum, and 4.54% (1/22) were co-infected with both P. vivax and P. falciparum. In the case of P. falciparum, 40% (1/5) of the samples presented the ring form, 60% (3/5) trophozoite form, and 20% (1/5) gametocyte form. All patients demonstrated a positive response to the treatment, with a decrease in both the number of parasites and the number of clinical symptoms over time. Conclusions This study discussed 22 cases of malaria diagnosed in 2023 in Golestan Province in northern Iran. Given the presence of malaria vectors in this area and the observation of gametocytes in specimens from some patients, the increase in reported malaria cases could be worrisome in terms of establishing local transmission in this area.
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spelling doaj-art-9ddfdb8fa31a40cfbdbbfc98e9502b712025-08-20T03:45:48ZengBMCBMC Infectious Diseases1471-23342025-07-0125111010.1186/s12879-025-11266-xThe resurgence of malaria in Northern Iran in 2023: a wake-up callFaramarz Koohsar0Roghiyeh Faridnia1Ogholniaz Jorjani2Mohammad Taher Hojjati3Ganesh Yadagiri4Ghasem Noshak5Hosein Tavakoli Pirzaman6Hamed Kalani7Laboratory Sciences Research Center, Golestan University of Medical SciencesLaboratory Sciences Research Center, Golestan University of Medical SciencesLaboratory Sciences Research Center, Golestan University of Medical SciencesLaboratory Sciences Research Center, Golestan University of Medical SciencesDepartment of Veterinary Biosciences, The Ohio State UniversityInfectious Diseases Research Center, Golestan University of Medical SciencesInfectious Diseases Research Center, Golestan University of Medical SciencesInfectious Diseases Research Center, Golestan University of Medical SciencesAbstract Background Control and elimination programs for malaria in Iran have consistently faced significant challenges due to various factors, including the presence of neighboring malaria-endemic countries such as Afghanistan and Pakistan. In recent years, Golestan Province in northern Iran has recorded few cases of imported malaria, with a sudden increase of 22 cases in 2023. This article provides an overview of the malaria situation in northern Iran, along with a detailed report of these 22 cases. Methods The study population comprises all individuals exhibiting symptoms suspected of malaria (n = 445) who were referred to the Malaria Diagnosis Center in Golestan Province, located in northeastern Iran, for diagnosis between March 23, 2023, and December 23, 2023. A drop of peripheral blood, collected from a finger prick of each patient, was utilized for Plasmodium falciparum/P. vivax antigen detection. Moreover, thin and thick smears were prepared for each patient to investigate morphological characteristics and parasitemia percentage of the parasites. Results In total, 4.94% (22/445) of individuals with malaria-suspected symptoms were infected with Plasmodium species. All 22 infected individuals were native to Golestan Province, and none had a previous history. The mean ± standard error of mean (SEM) for the number of parasites/µL of blood sample was 16,029 ± 5,060 for P. vivax and 105,460 ± 102,146 for P. falciparum. Among the patients, 77.27% (17/22) were infected with P. vivax, 18.18% (4/22) were infected with P. falciparum, and 4.54% (1/22) were co-infected with both P. vivax and P. falciparum. In the case of P. falciparum, 40% (1/5) of the samples presented the ring form, 60% (3/5) trophozoite form, and 20% (1/5) gametocyte form. All patients demonstrated a positive response to the treatment, with a decrease in both the number of parasites and the number of clinical symptoms over time. Conclusions This study discussed 22 cases of malaria diagnosed in 2023 in Golestan Province in northern Iran. Given the presence of malaria vectors in this area and the observation of gametocytes in specimens from some patients, the increase in reported malaria cases could be worrisome in terms of establishing local transmission in this area.https://doi.org/10.1186/s12879-025-11266-xGolestan provinceMalariaNorth IranPlasmodium falciparumPlasmodium Vivax
spellingShingle Faramarz Koohsar
Roghiyeh Faridnia
Ogholniaz Jorjani
Mohammad Taher Hojjati
Ganesh Yadagiri
Ghasem Noshak
Hosein Tavakoli Pirzaman
Hamed Kalani
The resurgence of malaria in Northern Iran in 2023: a wake-up call
BMC Infectious Diseases
Golestan province
Malaria
North Iran
Plasmodium falciparum
Plasmodium Vivax
title The resurgence of malaria in Northern Iran in 2023: a wake-up call
title_full The resurgence of malaria in Northern Iran in 2023: a wake-up call
title_fullStr The resurgence of malaria in Northern Iran in 2023: a wake-up call
title_full_unstemmed The resurgence of malaria in Northern Iran in 2023: a wake-up call
title_short The resurgence of malaria in Northern Iran in 2023: a wake-up call
title_sort resurgence of malaria in northern iran in 2023 a wake up call
topic Golestan province
Malaria
North Iran
Plasmodium falciparum
Plasmodium Vivax
url https://doi.org/10.1186/s12879-025-11266-x
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