Malaria Control Efforts in Kuwait

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State of Kuwait Ministry of Health
Malaria Control Efforts in Kuwait
Presented by Dr. Abdulla-Haider Ministry of
Health, Kuwait Syria, June 2005
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• Introduction
• State of Kuwait lies at the north-eastern tip of
  Arabian peninsula .
• Th estimated population was 2644777 Inhabitants
  in 2004. Majority Arabs ,Muslims
• Kuwaitis were 942892 ( 35.6 )
• Non Kuwaitis were 1701885 ( 64.4 )

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• Malaria progress efforts -
• More than 25 years of achievement in interruption
  of local malaria transmission in Kuwait
• Marked reduction in notified malaria cases in
  last 15 years ( 1991 2004 ) due to well control
  effort
• All malaria cases reported in last 15 years were
  imported
• No autochthonous cases were reported .
• No deaths were reported.
• Majority of reported cases were adult male , age
  group (20- 44 years ).
• Asians predominant ( specially from India
  Pakistan ).
• Plasmodium vivax is most commonly detected.
• No marked seasonal variation noticed (all cases
  were imported )

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Malaria in Kuwait, 2004 1- Total of 293 cases
were reported ( all were imported ). 2- No
autochthonous case was reported. 3- No death case
was reported. 4-Vivax cases were the majority (
127 cases 43 ) 5- 95 cases were mixed
infections( 32.4 of the total)
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Malaria in Kuwait 2004

• 6- No marked seasonal variation , but the
  increased cases from May to September 2004 was
  due to the importation of expatriates and new
  labors to Kuwait and Iraq.
• 7- Most of reported cases were Indian nationality
  (192 cases 65.5 )
• 8- 6 cases recorded as Kuwaitis with origin of
  infestation from Africa and Pakistan.

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Malaria in Kuwait 2004
9 - All cases were laboratory confirmed and
diagnosed. 10 - All cases were treated clinically
, treatment is free of charge and according to
WHO recommendation , then 2 surveillance done
one on the hospital during treatment,another in
preventive centers with follow up radical
treatment.
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Distribution of reported cases of malaria during
1991 2004
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Distribution of reported malaria according
species in Kuwait 2004
Source of data M.O.H V F
Mixed Plasmodium vivax and Plasmodium
falciparum V F Mixed Plasmodium
vivax and Plasmodium malariae
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NOTIFIED CASES OF MALARIA BY AGE- GROUPS,AND
PARASITE SPECIES STATE OF KUWAIT, 2004
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MALARIA CASES IN KUWAIT , 2004BY THE SOURCE OF
INFECTION
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Cases of malaria in Kuwait, 2004 by nationality
and source of infection
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MONTHLY DISTRIBUTION OF MALARIA CASES IN KUWAIT
((2000 - 2004
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Anopheline Mosquito Larva surveys
activitiesKuwait 2004

• Category N
• Breeding places for mosquito larvae examined
• (at farms) 722
• Breeding places for mosquito larvae examined
  (other areas )
  1720
• Breeding places for mosquito larvae examined
  (around malaria positive cases) 807
• Total 3249

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Anopheline Mosquito Larva surveys
activitiesKuwait 2004

• Positive finding ( Anopheline stephensi)
• Number 12 sites
• Percentage 0.36

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State of Kuwait Ministry of Health
Malaria control strategies The main objective
is The Elimination of malaria in Kuwait by
keeping on the achievement of interruption of
local transmission I Vector control 1
Screening for mosquito breeding places. 2
Mechanical removal of unnecessary water
collection. 3 Spraying insecticides with
environmental healthy manner. 4 Continuous
collection of water samples. 5 Testing
mosquito sensitivity for insecticides. 6
Surveillance of suspected ships / plans and
cars. 7 surveillance of new methods of non
chemical vector control.
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State of Kuwait Ministry of Health

• II Screening for early detection -
• All new (non Kuwaiti ) arrivals before residence
  are screened for malaria.
• Routine chick up for overseas student from
  suspected area.
• High risk groups like workers in farms , in
  insect control activity, and when medically
  indicated ( especially cases of fever for
  investigation) The following is done according
  WHO recommendation blood film for malaria
  ,examined at Central Malaria lab., and all cases
  positive are treated in fever hospital.
• New random screening samples from all arrival in
  airport ( planed ) .
• All travelers to endemic areas who are received
  prophylactic malaria treatment should be
  screened( planed ).

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State of Kuwait Ministry of Health

• III Management of detected cases -
• Clinical management of detected cases
  (symptomatic and asymptomatic ) all positive
  cases referred to hospitals notification sheet
  must written and informed to preventive centers
• Radical treatment for 8 week
• Blood testing after 8 weeks of follow up to
  ensure eradication of the parasite
• Changing treatment regimen for resistant and
  relapsing cases
• Regular reporting of cases (weekly, monthly and
  annually)

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State of Kuwait Ministry of Health

• IV - Medical research
• Case study (for each detected case)
• Periodic reporting and data management
• Anti-malarial drug sensitivity tests
• Insecticides sensitivity tests
• Collaboration with scientific centers (Kuwait
  University, K.R.I)
• V - Strengthening surveillance system
• Monitoring and evaluation
• Training courses
• Health education
• Intensify efforts for blood testing after radical
  treatment
• VI - International collaboration with G.C.C
  countries , Iraq ,EMERO , WHO
• To roll back of malaria

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Thank you