Trend of malaria prevalence in Iran, 2013–2023

Background & objectives: Malaria, the most important infectious disease in southern and southeastern Iran, has been part of the WHO-supported elimination program since 2009. Every year, malaria affects millions of people and poses a threat to health care worldwide. The aim of this study is to investigate the epidemiological status of malaria in Iran over a 10-year period.

Methods: The research is based on the statistics provided by the World Health Organization showing malaria statistics from 2013 to 2023. The focus of the research was on case numbers, parasite species, treatment outcomes, mortality, costs, and control measures.

Results: The Annual Parasite Incidence (API), calculated based on indigenous malaria cases, showed a continuous decline from 2013 to 2017 and reached zero between 2018 and 2021, indicating the interruption of local transmission. Indigenous transmission reappeared in 2022 (API = 2.16) and reached its highest level in 2023 (API = 6.94). Plasmodium vivax was the predominant species, accounting for most reported cases, followed by Plasmodium falciparum. Only three deaths were recorded. Artemether and lumefantrine replaced quinine in combination therapies with artemisinins. Global Fund, Iranian government, and WHO funds were used mostly for those purposes, which later switched to national funds.

Interpretation & conclusion: Due to effective prevention and treatment strategies, Iran experienced a sustained reduction in malaria cases, achieving interruption of local transmission between 2018 and 2021. However, a resurgence of indigenous malaria occurred in 2022 and 2023, highlighting the importance of maintaining and enhancing surveillance systems.