Bio-ecology of malaria vectors in an endemic area, Southeast of Iran

Host preference of Anopheles stephensi mosquitoes for blood feeding in south of Iran: Insights from Multiplex-PCR analysis

BACKGROUND

The study aims to determine the host preference for blood feeding among potential hosts of Anopheles stephensi in Iran, using the Multiplex-PCR method. An. stephensi is the primary malaria vector in urban areas of South Asia and the Middle East, including southern Iran, where approximately 30.21% of malaria cases are urban. This trend has become more evident during the recent outbreaks in Iran, driven by infections of Plasmodium falciparum, Plasmodium vivax, and as well as mixed infections. Hormozgan province, one of the most endemic areas in Iran, was selected for its critical public health significance. This study builds on the validated efficiency of Multiplex-PCR for blood meal analysis by applying it to mosquitoes in southern Iran.

METHODS

In 2021, mosquitoes were collected monthly from three coastal villages in Bandar Abbas county, Hormozgan province, using WHO-recommended collection methods. Blood-fed An. stephensi mosquitoes were dissected, and their stomach contents analysed via Multiplex-PCR to identify human and animal blood sources.

RESULTS

Of 77 An. stephensi samples analysed, humans were the most common host was humans (29.9%), followed by mammals (19%), dogs (2.6%), and birds (1.3%). Mixed blood meals were detected in 34% of samples, including 23% with human and other hosts. Informal observations suggest that domestic animals such as goats, sheep, and chickens are commonly present near homes in these areas.

CONCLUSION

Approximately 50% of An. stephensi blood meals were sourced from humans, with 29% exclusively from humans and 23% from mixed hosts. Domestic animals such as goats, sheep, and chickens appear to attract mosquitoes, highlighting their potential role in malaria dynamics. Zooprophylaxis, alongside existing measures like insecticide residual spraying, insecticide-treated bed nets, and personal protection strategies, may strengthen urban malaria control. Further research on the ecological and behavioural drivers of mosquito host selection in urban settings is warranted.

Predicting the environmental suitability for Anopheles stephensi under the current conditions in Ghana

Vector-borne diseases emergence, particularly malaria, present a significant public health challenge worldwide. Anophelines are predominant malaria vectors, with varied distribution, and influenced by environment and climate. This study, in Ghana, modelled environmental suitability for Anopheles stephensi, a potential vector that may threaten advances in malaria and vector control. Understanding this vector's distribution and dynamics ensures effective malaria and vector control programmes implementation. We explored the MaxEnt ecological modelling method to forecast An. stephensi's potential hotspots and niches. We analysed environmental and climatic variables to predict spatial distribution and ecological niches of An. stephensi with a spatial resolution of approximately 5 km2. Analysing geospatial and species occurrence data, we identified optimal environmental conditions and important factors for its presence. The model's most important variables guided hotspot prediction across several ecological zones aside from urban and peri-urban regions. Considering the vector's complex bionomics, these areas provide varying and adaptable conditions for the vector to colonise and establish. This is shown by the AUC = 0.943 prediction accuracy of the model, which is considered excellent. Based on our predictions, this vector species would thrive in the Greater Accra, Ashanti Central, Upper East, Northern, and North East regions. Forecasting its environmental suitability by ecological niche modelling supports proactive surveillance and focused malaria management strategies. Public health officials can act to reduce the risk of malaria transmission by identifying areas where mosquitoes may breed, which will ultimately improve health outcomes and disease control.

Entomological survey of malaria vectors in Dashtestan County, South of Iran

Anopheline mosquitoes are responsible for transmission of some diseases such as malaria. This study was carried out in five villages of Dashtestan county, Bushehr province, south of Iran with mountainous and plain areas. Anopheles larvae were sampled once a month from May to July 2021 by dipping method using standard dippers. Adults were captured by the total catch technique. In this study, 1062 Anopheles mosquitoes were collected including 850 adults and 212 larvae. Samples were A. superpictus, A. stephensi, A. dthali and A. fluviatilis. The dominant species at all sites (larvae and adults) were A. dthali (31.35%), A. superpictus (28.93%), A. stephensi (27.77%), and A. fluviatilis (11.95%), respectively. Among adults, A. stephensi was the most frequent species, but among larvae, A. dthali was the dominant species. The highest number of A. dthali was captured from Dalaki village with 35%, while A. superpictus and A. fluviatilis were not caught at this station. The minimum collected adults of all species occurred in Bashirabad. This result showed that A. stephensi plays an important role in south Iran, which is under the elimination phase. The fauna and niches of Anopheles has different patterns depending on ecological, climatic, and topographic features. These items affect host preferences, feeding behaviors, and distribution of these species. A monthly or annual entomological survey is necessary in regions with mobile populations since imported malaria is a problematic issue in the elimination programs of Iran.

Spatio-temporal Prediction of the Malaria Transmission Risk in Minab District (Hormozgan Province, Southern Iran)

INTRODUCTION

Malaria is the most important parasitic disease in tropical and subtropical regions, with more than 240 million cases reported annually. In Iran, indigenous cases occur in its south-eastern region. The aim of this study is to assess the environmental risk of malaria transmission in an endemic area of southern Iran.

METHODS

The study was carried out in Minab district (Hormozgan province, southern Iran), with the aim to assess the environmental risk of malaria, based on a spatio-temporal study, using Growing Degree Days (GDD)-based predictions, larval habitat ecology, MaxEnt spatial predictions and malaria transmission data.

RESULTS

The Gradient Model Risk index showed the highest malaria transmission risk period to be during January-April and October-December. The ecological conditions of water bodies of larval habitats of the four vector species (Anopheles culicifacies, A. dthali, A. fluviatilis and A. stephensi) were assessed, with A. stephensi being the most prevalent and the most widely distributed species.

CONCLUSION

These findings, together with the MaxEnt Anopheles predictive distribution models, allowed identifying villages in danger of malaria transmission in Minab district. This spatio-temporal prediction of malaria transmission risk should be incorporated in the design of malaria control initiatives towards a local malaria early warning system. Moreover, the proposed transmission risk model can be extrapolated, at local scale, to other malaria endemic areas of tropical and subtropical regions.

Current Situation of Malaria and Resistance of Main Vectors to WHO Recommended Insecticides in an Endemic Area, Southeastern Iran

Although malaria is endemic in some areas of southeastern Iran, following the successful national malaria elimination plan, the local transmission area has been shrunk. The main cases in Iran are due to Plasmodium vivax followed by P. falciparum. This study was aimed to determine the current situation of malaria in Kerman Province of Iran and evaluate the insecticide resistance of main vectors. The field study was conducted in 2019. Data of new malaria cases were obtained from the health centers for the period of 2009-2018. Susceptibility status of Anopheles stephensi and An. dthali was evaluated against dichlorodiphenyltrichloroethane, Dieldrin, Malathion, Bendiocarb, Deltamethrin, and Temephos at the diagnostic dose. A total of 522 malaria cases were recorded and divided into indigenous (33.14%) and imported (66.86%) categories. The highest incidence of the disease was reported from the southern areas of the province, where all indigenous cases occurred. Adults of An. stephensi were resistant to dichlorodiphenyltrichloroethane while its resistance to be confirmed to dieldrin, bendiocarb and deltamethrin. As An. dthali had less than 98% mortality against bendiocarb, the resistance status should be confirmed with more tests. Our findings showed both species had less than 98% mortality against bendiocarb and deltamethrin insecticides which are used in malaria vector control program in Iran. Due to the susceptibility of these vectors to temephos, larviciding can be advised for vector control in this area.

Monitoring of synthetic insecticides resistance and mechanisms among malaria vector mosquitoes in Iran: A systematic review

BACKGROUND

In Iran, the prospect of malaria control relies mainly on insecticides used against the genus Anopheles (Diptera: Culicidae) as important vectors of malaria, arboviruses, and so on. Only eight out of 30 malaria mosquito vectors (Anopheles species) have been examined for insecticide resistance in Iran. This study aimed to review articles related to the incremental trend in insecticide resistance and their mechanisms among anopheline malaria vectors in Iran.

METHODS

A literature review was conducted based on such search engines as Iran doc, Web of Science, SID, PubMed, Scopus, and Google Scholar websites using the following keywords: "Anopheles," "Malaria," "Resistance," "Vectors," "Insecticide Resistance," and "Iran" for data collection. Published papers in English or Persian covering 1980 to 2020 were reviewed.

RESULTS

A total of 1125 articles were screened, only 16 of which were filtered to be pertinent in this review. While most of the mosquito vectors of malaria, such as Anopheles stephensi, were resistant to DDT, dieldrin, malathion, and becoming less susceptible to deltamethrin and other synthetic pyrethroid insecticides, few like Anopheles fluviatilis s. l. were susceptible to all insecticides. A disseminating trend in insecticide resistance among different anopheline mosquito vector species was evident. Metabolic and insecticide target-site resistance mechanisms were involved with organochlorines and pyrethroids, respectively.

CONCLUSIONS

Insecticide resistance is becoming a severe scourge to the effectiveness of vector-borne disease management measures. This event is especially critical in developing and marginalized communities that applied chemical-based vector elimination programs for malaria; therefore, it is crucial to monitor insecticide resistance in malaria vectors in Iran using biochemical and molecular tools.

Ecology of Malaria Vectors in an Endemic Area, Southeast of Iran

Background:

Malaria has long been regarded as one of the most important public health issues in Iran. Although the country is now in the elimination phase, some endemic foci of malaria are still present in the southeastern areas of the country. In some endemic foci, there are no data on the malaria vectors. To fill this gap, the present study was designed to provide basic entomological data on malaria vectors in the southeastern areas of Iran.

Methods:

Adult and larval stages of Anopheles mosquitoes were collected by using different catch methods. Resistance of the main malaria vector in the study area to selected insecticides was evaluated using diagnostic doses advised by the World Health Organization in 2013–2014.

Results:

A total of 3288 larvae and 1055 adult Anopheles mosquitoes were collected, and identified as: Anopheles stephensi (32.1%), Anopheles culicifacies s.l. (23.4%), Anopheles dthali (23.2%), Anopheles superpictus s.l. (12.7%), and Anopheles fluviatilis s.l. (8.6%). Anopheles stephensi was the most predominant mosquito species collected indoors at the study area, with two peaks of activity in May and November. This species was found to be resistant to DDT 4%, tolerant to malathion 5% and susceptible to other tested insecticides.

Conclusion:

All the five malaria vectors endemic to the south of Iran were collected and identified in the study area. Our findings on the ecology and resting/feeding habitats of these malaria vectors provide information useful for planning vector control program in this malarious area.

Evolution of insecticide resistance and its mechanisms in Anopheles stephensi in the WHO Eastern Mediterranean Region

BACKGROUND

While Iran is on the path to eliminating malaria, the disease with 4.9 million estimated cases and 9300 estimated deaths in 2018 remains a serious health problem in the World Health Organization (WHO) Eastern Mediterranean Region. Anopheles stephensi is the main malaria vector in Iran and its range extends from Iraq to western China. Recently, the vector invaded new territories in Sri Lanka and countries in the Horn of Africa. Insecticide resistance in An. stephensi is a potential issue in controlling the spread of this vector.

METHODS

Data were collated from national and international databases, including PubMed, Google Scholar, Scopus, ScienceDirect, SID, and IranMedex using appropriate search terms.

RESULTS

Indoor residual spaying (IRS) with DDT was piloted in Iran in 1945 and subsequently used in the malaria eradication programme. Resistance to DDT in An. stephensi was detected in Iran, Iraq, Pakistan, and Saudi Arabia in the late 1960s. Malathion was used for malaria control in Iran in 1967, then propoxur in 1978, followed by pirimiphos-methyl from 1992 to 1994. The pyrethroid insecticide lambda-cyhalothrin was used from 1994 to 2003 followed by deltamethrin IRS and long-lasting insecticidal nets (LLINs). Some of these insecticides with the same sequence were used in other malaria-endemic countries of the region. Pyrethroid resistance was detected in An. stephensi in Afghanistan in 2010, in 2011 in India and in 2012 in Iran. The newly invaded population of An. stephensi in Ethiopia was resistant to insecticides of all four major insecticide classes. Different mechanisms of insecticide resistance, including metabolic and insecticide target site insensitivity, have been developed in An. stephensi. Resistance to DDT was initially glutathione S-transferase based. Target site knockdown resistance was later selected by pyrethroids. Esterases and altered acetylcholinesterase are the underlying cause of organophosphate resistance and cytochrome p450s were involved in pyrethroid metabolic resistance.

CONCLUSIONS

Anopheles stephensi is a major malaria vector in Iran and many countries in the region and beyond. The species is leading in terms of development of insecticide resistance as well as developing a variety of resistance mechanisms. Knowledge of the evolution of insecticide resistance and their underlying mechanisms, in particular, are important to Iran, considering the final steps the country is taking towards malaria elimination, but also to other countries in the region for their battle against malaria. This systematic review may also be of value to countries and territories newly invaded by this species, especially in the Horn of Africa, where the malaria situation is already dire.

Climate Change and the Risk of Malaria Transmission in Iran

Climate change is an important factor affecting the dynamics of the vectors population and, hence, the risk of vector-borne diseases. This study aimed to predict the environmental suitability for malaria vectors in Iran under climate change scenarios in 2030s and 2050s. Literature search was performed to find documents on the spatial distribution of Anopheles stephensi Liston, 1901, Anopheles culicifacies s.l. Giles, 1901, Anopheles fluviatilis s.l. James, 1902, Anopheles superpictus s.l. Grassi, 1899, Anopheles dthali Patton, 1905, Anopheles maculipennis s.l. Meigen, 1818, and Anopheles sacharovi Favre, 1903 (Diptera: Culicidae) published between 1970 and 2017. The bioclimatic data under three climate change scenarios (representative concentration pathway 2.6 [RCP2.6], RCP4.5, and RCP8.5) and MaxEnt model were used to predict the ecological niches for each species. Comparison between the two study periods under the three scenarios for each species revealed that RCP8.5 would reduce the area at risk for An. culicifacies s.l., An. dthali and An. superpictus s.l. in the 2050s compared to the 2030s, but the reverse will be induced by RCP2.6 and RCP4.5 scenarios. For An. fluviatilis s.l., RCP2.6 will reduce the risk areas in the 2050s, whereas an increase is expected under the two other scenarios. Moreover, all scenarios would decrease the high-risk areas of An. maculipennis s.l. in the 2050s. For An. sacharovi, RCP2.6 would increase its high-risk areas, whereas RCP4.5 and RCP8.5 would decrease its exposure. The high-risk area of An. stephensi is expected to increase under RCP8.5 in the 2030s and RCP4.5 in 2050s, but it will be almost unchanged or reduced under other scenarios.

Host-feeding patterns of Culex mosquitoes in Iran

Background

Different mosquito-borne pathogens are circulating in Iran including Sindbis virus, West Nile virus, filarioid worms and malaria parasites. However, the local transmission cycles of these pathogenic agents are poorly understood, especially because ecological data on vector species are scarce and there is limited knowledge about the host range; this understanding could help to direct species-specific vector control measurements or to prioritize research.

Methods

In the summers of 2015 and 2016, blood-fed mosquitoes were collected at 13 trapping sites on the coast of the Caspian Sea in northern Iran and at an additional trapping site in western Iran. Mosquitoes were generally collected with either a Biogents Sentinel trap or a Heavy Duty Encephalitis Vector Survey trap installed outside. A handheld aspirator was used at the trapping site in western Iran, in addition to a few samplings around the other trapping sites. On average, eight trapping periods were conducted per trapping site. The sources of blood meals were identified using a DNA barcoding approach targeting the cytochrome b or 16S rRNA gene fragment.

Results

The source of blood meals for 580 blood-fed mosquito specimens of 20 different taxa were determined, resulting in the identification of 13 different host species (9 mammals including humans, 3 birds and 1 reptile), whereby no mixed blood meals were detected. Five mosquito species represented more than 85.8% of all collected blood-fed specimens: Culex pipiens pipiens form pipiens (305 specimens, 55.7% of all mosquito specimens), Cx. theileri (60, 10.9%), Cx. sitiens (51, 9.3%), Cx. perexiguus (29, 5.3%) and Anopheles superpictus (25, 4.6%). The most commonly detected hosts of the four most abundant mosquito species were humans (Homo sapiens; 224 mosquito specimens, 40.9% of all mosquito specimens), cattle (Bos taurus; 171, 31.2%) and ducks (Anas spp.; 75, 13.7%). These four mosquito species had similar host-feeding patterns. The only exceptions were a relatively high proportion of birds for Cx. pipiens pipiens f. pipiens (23.2% of detected blood meal sources) and a high proportion of non-human mammals for Cx. theileri (73.4%). Trapping month, surrounding area, or trapping method had no statistically significant impact on the observed host-feeding patterns of Cx. pipiens pipiens f. pipiens.

Conclusions

Due to the diverse and overlapping host-feeding patterns, several mosquito species must be considered as potential enzootic and bridge vectors for diverse mosquito-borne pathogens in Iran. Most species can potentially transmit pathogens between mammals as well as between mammals and birds, which might be the result of a similar host selection or a high dependence on the host availability.

Electronic supplementary material

The online version of this article (10.1186/s13071-018-3237-2) contains supplementary material, which is available to authorized users.

A systematic evidence review of the effect of climate change on malaria in Iran

Climate is an effective factor in the ecological structure which plays an important role in control and outbreak of the diseases caused by biological factors like malaria. With regard to the occurring climatic change, this study aimed to review the effects of climate change on malaria in Iran. In this systematic review, Cochrane, PubMed and ScienceDirect (as international databases), SID and Magiran as Persian databases were investigated through MESH keywords including climate change, global warming, malaria, Anopheles, and Iran. The related articles were screened and finally their results were extracted using data extraction sheets. Totally 41 papers were resulted through databases searching process. Finally 14 papers which met inclusion criteria were included in data extraction stage. The findings indicated that Anopheles mosquitoes are present at least in 115 places in Iran; they are compatible with climatic zones of Iran. Malaria and it's vectors are affected by climate change. Temperature, precipitation, relative humidity, wind intensity and direction are the most important climatic factors affecting the growth and proliferation of Anopheles, Plasmodium and the prevalence of malaria. The transmission of malaria in Iran is associated with the climatic factors of temperature, rainfall, and humidity. Therefore, with regard to the occurring climatic change, the incidence of the disease may also change which needs to be taken into consideration while planning of malaria control.

Predicting environmentally suitable areas for Anopheles superpictus Grassi (s.l.), Anopheles maculipennis Meigen (s.l.) and Anopheles sacharovi Favre (Diptera: Culicidae) in Iran

BACKGROUND

Malaria is an important mosquito-borne disease, transmitted to humans by Anopheles mosquitoes. The aim of this study was to gather all records of three main malaria vectors in Iran during the last decades, and to predict the current distribution and the environmental suitability for these species across the country.

METHODS

All published documents on An. superpictus Grassi (s.l.), An. maculipennis Meigen (s.l.) and An. sacharovi Favre during 1970-2016 in Iran were obtained from different online data bases and academic libraries. A database was created in ArcMap 10.3. Ecology of these species was analyzed and the ecological niches were predicted using MaxEnt model.

RESULTS

Anopheles superpictus (s.l.) is the most widespread malaria vector in Iran, and exists in both malaria endemic and non-endemic areas. Whereas An. maculipennis (s.l.) is reported from the northern and northwestern parts, Anopheles sacharovi is mostly found in the northwestern Iran, although there are some reports of this species in the western, southwestern and eastern parts. The area under receiver operating characteristic (ROC) curve (AUC) for training and testing data was calculated as 0.869 and 0.828, 0.939 and 0.915, and 0.921 and 0.979, for An. superpictus (s.l.), An. maculipennis (s.l.) and An. sacharovi, respectively. Jackknife test showed the environmental variable with highest gain in the predicting power of the model when used in isolation was annual precipitation for An. superpictus (s.l.) and An. maculipennis (s.l.), and precipitation of the driest quarter for An. sacharovi.

CONCLUSIONS

Despite this range, global warming may increase the potential risk for malaria transmission in some cleared-up areas, where these proven vectors are active. Mapping and prediction of spatial/temporal distribution of these vectors will be beneficial for decision makers to be aware of malaria transmission risk, especially in the western parts of the country.

Knowledge, attitude and practice (KAP) on malaria, from high malaria burden rural communities, southeastern Iran

Nowadays, community based control strategies are considered efficient in reaching the malaria elimination goal. For this reason, this study was conducted to access the knowledge, attitude and practice of people on malaria from rural areas with high malaria incidence. In this descriptive-analytic study, a total of 200 rural residents of southeastern Iran were recruited. They were selected based on cluster and simple random sampling methods. Data collection was done using questionnaire with reliability confirmation by Cronbach's alpha and data was analyzed using SPSS. Mosquito's bite was answered as the main route of malaria transmission. Also, majority of the participants correctly expressed most important symptoms of malaria. Most of them believed that malaria is preventable and the best strategy for its control is indoor residual spraying. Very few number of the respondents mentioned sleeping under insecticide treated bed net as a method for controlling the transmission of malaria. Chi square test shows significant difference between the level of education and usage of mosquito nets, but there was no significant difference between the use of bed nets and time of usage. Another significant relationship was seen between malaria infection, use of mosquito nets and place of sleeping at nights during summer. The current study showed the appropriate level of KAP among rural communities in southeast of Iran. Alongside of people's knowledge and attitudes, their practice about malaria should be increased as an effective factor for achieving to great goal of malaria elimination.

Predicting the potential distribution of main malaria vectors Anopheles stephensi, An. culicifacies s.l. and An. fluviatilis s.l. in Iran based on maximum entropy model

Malaria is considered as a major public health problem in southern areas of Iran. The goal of this study was to predict best ecological niches of three main malaria vectors of Iran: Anopheles stephensi, Anopheles culicifacies s.l. and Anopheles fluviatilis s.l. A databank was created which included all published data about Anopheles species of Iran from 1961 to 2015. The suitable environmental niches for the three above mentioned Anopheles species were predicted using maximum entropy model (MaxEnt). AUC (area under Roc curve) values were 0.943, 0.974 and 0.956 for An. stephensi, An. culicifacies s.l. and An. fluviatilis s.l respectively, which are considered as high potential power of model in the prediction of species niches. The biggest bioclimatic contributor for An. stephensi and An. fluviatilis s.l. was bio 15 (precipitation seasonality), 25.5% and 36.1% respectively, followed by bio 1 (annual mean temperature), 20.8% for An. stephensi and bio 4 (temperature seasonality) with 49.4% contribution for An. culicifacies s.l. This is the first step in the mapping of the country's malaria vectors. Hence, future weather situation can change the dispersal maps of Anopheles. Iran is under elimination phase of malaria, so that such spatio-temporal studies are essential and could provide guideline for decision makers for IVM strategies in problematic areas.

Insecticide susceptibility of Anopheles stephensi to DDT and current insecticides in an elimination area in Iran

BACKGROUND

Iran has recently initiated a malaria elimination program with emphasis on vector control strategies which are heavily reliant on indoor residual spraying and long-lasting insecticidal nets. Insecticide resistance seriously threatens the efficacy of vector control strategies. This study was conducted to determine the insecticide susceptibility of Anopheles stephensi to DDT and current insecticides in Jask county as an active malaria focus in southeastern Iran.

METHODS

In this study, the anopheline larvae were collected from different aquatic habitats in Jask county and transported to insectarium, fed with sugar and then 3-day-old adults were used for susceptibility tests. WHO insecticide susceptibility tests were performed with DDT (4 %), malathion (5 %), lambda-cyhalothrin (0.05 %), deltamethrin (0.05 %) and permethrin (0.75 %).

RESULTS

The field strain of An. stephensi was found resistant to DDT and lambda-cyhalothrin. The LT50 values for DDT and lambda-cyhalothrin in this species were 130.25, and 37.71 min, respectively. Moreover, An. stephensi was completely susceptible to malathion and permethrin and tolerant to deltamethrin.

CONCLUSION

The present study results confirm the resistance of the major malaria vector, An. stephensi, to DDT and lambda-cyhalothrin, and tolerance to deltamethrin, which could gradually increase and spread into other malaria endemic areas. Thus, there is a need for regular monitoring of insecticide resistance in order to select suitable insecticides for vector control interventions towards malaria elimination.

Some probable factors affecting the malaria situation before and at the beginning of a pre-elimination program in southeastern Iran

The area southeast of Iran still copes with malaria as an unstable infectious disease and includes the most autochthonous malaria reports in the country. This comprehensive study was carried out for the evaluation of environmental factors, welfare indicators and health facilities on the malaria situation before and at the beginning of a pre-elimination programme in this area. The probable factors affecting the malaria situation, including the water-pipe network, electricity, rainfall, long-lasting integrated nets (LLINs), indoor residual spraying and malaria diagnosis-treatment centres were analysed using SPSS software. The Pearson correlation test showed no significant correlation between some factors such as piped water networks, annual precipitation, number of sprayed villages and autochthonous cases as well as autochthonous foci. But a significant correlation between electricity coverage, number of diagnoses of malaria-treatment centres and autochthonous cases\foci was observed. Also, the number of distributed LLINs didn't have any correlation with the number of total malaria cases, but a significant correlation between LLINs and autochthonous foci was seen. Detailed studies on the correlation of various variables, such as piped water, spraying coverage and number of malaria diagnosis centres, with the malaria situation is limited in Asia and other parts of the world. This study and others like it can help malaria managers and directors in the more accurate allocation of financial resources.