Association between living in the endemic area and level of knowledge of visceral leishmaniasis.

BACKGROUND: Iran is a country with a high prevalence of visceral leishmaniasis (VL) and seven endemic provinces. In this study, we tried to identify unobserved classes of knowledge among Iranians toward VL and assess the predictors of each latent class. METHODS: This cross-sectional study was conducted among randomly selected participants from endemic and non-endemic areas of VL in Iran in 2020 and 2021. The collected data included demographic characteristics and questions about knowledge, attitude, and practice toward VL. We performed latent class analysis using a procedure for latent class analysis (PROC LCA) in SAS to identify the class membership of knowledge of participants toward VL. RESULTS: Five latent classes were identified: very low (38.9%), low (15.5%), moderate (6.2%), high (14.1%), and very high (25.2%) knowledge about VL. Living in endemic areas significantly increased the odds of belonging to the low (adjusted OR (AOR = 7.23; 95% confidence interval (CI):4.52-11.58), high (AOR = 2.71; 95%CI: 1.73-4.23), and very high (AOR = 8.47; 95%CI: 5.78-12.41) classes compared to the very low class. Also, having academic education increased the odds of membership in the very high class (AOR = 2.36; 95%CI: 1.61-3.47) compared to the very low class. CONCLUSION: This study revealed that more than 50% of the participants fell into the latent classes of very low and low knowledge toward VL. Some educational workshops in the endemic areas could be effective in enhancing knowledge about VL.

Knowledge, attitudes, and practices regarding Crimean-Congo hemorrhagic fever in a high-prevalence suburban community, southeast of Iran.

Crimean Congo Hemorrhagic Fever (CCHF) is a zoonotic viral disease with a high mortality rate. The World Health Organization has classified it as a high-priority pathogen due to its severity. To manage this disease, knowledge, attitude, and practices (KAP) of the community play an important role. This study was conducted in a suburban area in southeastern Iran, an endemic region with a high occurrence of CCHF. A cross-sectional study was performed among 176 livestock farmers in Zahedan suburb, and data were collected through an interviewer-administered questionnaire. Single-factor and multi-factor analysis of variance was used to identify factors related to participants' knowledge, attitude, and risk of CCHF. All statistical analyses were conducted using SPSS 24, and a significance level of p ≤ 0.05 was adopted to determine statistical significance. Overall, the knowledge level about CCHF was moderate. Participants demonstrated a better understanding of high-risk occupations compared to the transmission routes and symptoms of CCHF. Conversely, their knowledge about the prevention and treatment of CCHF was found to be inadequate. The participants exhibited a good attitude towards CCHF prevention; most considered it a dangerous disease, believed in the effectiveness of preventive measures, and demonstrated the ability to address perceived obstacles. High-frequency engagement in high-risk behaviors related to CCHF was observed among the study participants. In the multi-factor model, the most critical factors associated with knowledge were age (p = 0.044), CCHF infection (p = 0.047), and CCHF education (p = 0.004). Income (p = 0.001), keeping livestock at home (p = 0.028), and receiving CCHF education (p = 0.012) were the most critical factors associated with attitude toward the risk of CCHF. The most important factors related to CCHF high-risk behavior were age (p = 0.045), gender (p = 0.028), and handling livestock (p < 0.001). These findings emphasize the need for maintaining health educational efforts on CCHF.

Wolbachia infection in native populations of Blattella germanica and Periplaneta americana.

Cockroaches are significant pests worldwide, being important in medical, veterinary, and public health fields. Control of cockroaches is difficult because they have robust reproductive ability and high adaptability and are resistant to many insecticides. Wolbachia is an endosymbiont bacterium that infects the reproductive organs of approximately 70% of insect species and has become a promising biological agent for controlling insect pests. However, limited data on the presence or strain typing of Wolbachia in cockroaches are available. PCR amplification and sequencing of the wsp and gltA genes were used to study the presence, prevalence and molecular typing of Wolbachia in two main cockroach species, Blattella germanica (German cockroach) and Periplaneta americana (American cockroach), from different geographical locations of Iran. The Wolbachia endosymbiont was found only in 20.6% of German cockroaches while it was absent in American cockroach samples. Blast search and phylogenetic analysis revealed that the Wolbachia strain found in the German cockroach belongs to Wolbachia supergroup F. Further studies should investigate the symbiotic role of Wolbachia in cockroaches and determine whether lack of Wolbachia infection may increase this insect's ability to tolerate or acquire various pathogens. Results of our study provide a foundation for continued work on interactions between cockroaches, bacterial endosymbionts, and pathogens.

Access, utilization, and barriers to using malaria protection tools in migrants to Iran.

BACKGROUND: Imported malaria cases could be considered one of the threats to malaria elimination. Therefore, increasing migrants' access to malaria preventive measures can play an essential role in maintaining appropriate conditions and preventing malaria outbreaks. This study aimed to provide detailed information about access, utilization, and barriers to using malaria protection tools in migrants to Iran. METHODS: This study was conducted in a vast region consisting of 4 provinces and 38 cities located in the south and southeast of the country. Study participants were migrants who moved to the study area in the past three months. A sample of 4163 migrants participated in the study. They were selected through a multi-stage sampling method to obtain a representative community sample. Data were collected through interviewer-administered questionnaires about participants' socio-demographic specification, commuting characteristics, travel aim, access, ways of preparing, and reasons to use or not to use malaria protection tools. Quantitative and qualitative variables were described and analyzed finally. RESULTS: The mean age of individuals was 28.6 ± 10.8, with a range of 3-88 years old. Migrants' country of origin was Afghanistan (56.6%), Pakistan (38.4%), and Iran (5%). Most migrants (69.2%) did not have malaria protection tools while staying in Iran. Among those who procured the protection tools, 74% used long-lasting insecticidal nets (LLINs), 13.4% used mosquito repellent sticks and coil, and 12.7% did not use any tools. Respectively, lack of knowledge about where they can get LLINs, followed by being expensive, unavailability in the market, not cooperation of health officer, and no need to use were expressed as the causes for having no access. The main reasons for non-using the tools were lack of knowledge about their application, followed by a defect in protection tools, ineffectiveness, and being harmful, respectively. Migrants who were supported by an employer accessed more to LLINs. CONCLUSIONS: This study reveals significant shortcomings in knowledge, access, and utilization of malaria protection tools among migrants in Iran. Inequitable access to public health services is predictable during migration; however, access to sustainable protection tools is recommended.

First Record of Black Widow Spider Bite Latrodectus cinctus (Araneae: Theridiidae) From Iran.

The genus Latrodectus contains the most medically important spiders around the world. This study describes the first case of Latrodectus cinctus Blackwall, 1865 bite and clinical treatment from Iran. Also, it is the first collection report from the southeast of the country that can enhance prior knowledge on the geographical distribution of this species. We describe a 42-year-old female patient with neurological pain caused by the spider bite. Also, a summary of the entomological survey and morphological identification of the collected species from the patient's house is presented.

Hyalomma spp. ticks and associated Anaplasma spp. and Ehrlichia spp. on the Iran-Pakistan border.

BACKGROUND: Anaplasmosis and ehrlichiosis are tick-borne diseases affecting humans and livestock, particularly in tropical and subtropical regions. Animal husbandry is the main activity of people on the borders of Iran and Pakistan, with thousands of cattle crossing the border each week. METHODS: PCR and sequencing of the 16S rRNA gene was used to determine the percentage and geographical distribution of the pathogens carried by Hyalomma spp. (n = 306) collected from 126 goats, cattle and camels in the region between November 2017 and late March 2018. RESULTS: In total, 1124 hard ticks including 1020 Hyalomma spp. ticks belonging to six species (Hyalomma anatolicum, Hyalomma asiaticum, Hyalomma marginatum, Hyalomma dromedarii, Hyalomma schulzei, and Hyalomma detritum) were found on the borders of Iran and Pakistan, with H. anatolicum being the most prevalent tick species. Anaplasma spp. and/or Ehrlichia spp. DNA was found in 68.3% of the engorged tick specimens (n = 256). Sequencing of a subset (12.6%) of PCR-positive samples revealed Anaplasma ovis, Anaplasma marginale, and Ehrlichia ewingii DNA in 81.8%, 9.1%, and 9.1% of the ticks, respectively. To our knowledge, this is the first report of E. ewingii, an important human pathogen, in Iran. CONCLUSIONS: Based on molecular analysis, three pathogenic Anaplasmataceae were detected in six Hyalomma spp. parasitizing cattle, goats and camels, confirming the presence of these pathogens along the Iran-Pakistan border.

Insecticide Resistance Status of Malaria Vectors in a Malarious Area, Southeast of Iran.

Background: Malaria continues to be the main vector-borne disease in Iran. The endemic foci of malaria are in Sistan and Baluchistan Province, the borderline of Iran and Pakistan. By the year 2020 the program of the country is malaria elimination. The main vector control is using insecticide as Indoor Residual Spraying. The aim of the study was to evaluate the susceptibility of main malaria vectors to different insecticides recommended by WHO. Methods: All the insecticides papers supported by WHO and evaluation of insecticide resistance of Anopheles stephensi, Anopheles culicifacies, Anopheles superpictus to different chemical groups of imagicides including DDT 4%, malathion 5%, propoxur 01.%, lambdacyhalothrin 0.05%, deltamethrin 0.025% and permethrin 0.75% were followed by the WHO guideline. Results: Results of the susceptibility test against different insecticides revealed that An. stephensi and An. culicifacies are resistant to DDT and susceptible to other insecticides. An. superpictus is susceptible to all groups of pesticides. Conclusion: Knowledge on insecticide resistance in target species is a basic requirement to guide insecticide use in malaria control programmes in local and global scales.

Predicting the Potential Distribution of Major Malaria Vectors Based on Climate Changes in Sistan and Baluchistan Province, Southeastern Iran.

Background: Given the significance of climate change and its substantial effects on mosquitoes' habitats, this study was aimed to model the spatial distribution of the main malaria vectors in the south east of Iran. Methods: Several scientific databases between 1980 and 2019 were reviewed to find mosquito species and their spatial information in this area. The archived folders in the center for diseases control and prevention were used to exploit essential data on malaria cases and foci. Three representative concentration pathways (RCP2.6, RCP4.5 and RCP8.5) were chosen to stand for three possible climate scenarios. Finally the potential species distribution of Anopheles stephensi and An. culicifacies s.l. in the 2030s and 2050s horizons were estimated by the Maximum Entropy Model. Results: So far, a total of 39 mosquito species belonging to the family Culicidae have been reported from the study area. In 2019, the total malaria cases have increased by 91% compared to 2015, as well as a sharp rise than 2018 (249%). In that year, 91% of cases were imported from other countries, which caused 40% increase in the new potential foci than in 2018. The Jackknife test demonstrated the annual mean temperature and precipitation of the coldest quarter with the greatest impact on the environmental suitability of the mentioned two species. Conclusion: The effect of climate change on the appearance and recurrence of mosquito-borne diseases has been demonstrated in various studies. Collecting further data and conducting investigation on this issue will improve control management, especially for the malaria vectors.

Employing Different Traps for Collection of Mosquitoes and Detection of Dengue, Chikungunya and Zika Vector, Aedes albopictus, in Borderline of Iran and Pakistan.

BACKGROUND: Southeastern Iran has been established as an area with the potential to harbor Asian tiger mosquito populations. In 2013, a few numbers of Aedes albopictus were detected in three sampling sites of this region. This field study was aimed to evaluate the efficacy of various traps on monitoring mosquitoes and status of this dengue vector, in five urban and 15 suburban/rural areas. METHODS: For this purpose, four adult mosquito traps (BG-sentinel 2, bednet, Malaise, and resting box trap) were used and their efficacy compared. In addition, large numbers of CDC ovitraps were employed, within 12 months. RESULTS: A total of 4878 adult samples including 22 species covering five genera were collected and identified from traps. It was not revealed any collection of Ae. albopictus. Statistical analysis showed no significant difference in meteorological variables between the two periods, the previous report and the current study. There were significant differences in the total number of mosquitoes collected by various traps in the region across different months. CONCLUSION: The resulting data collected here on the efficiency of the various trap types can be useful for monitoring the densities of mosquito populations, which is an important component of a vector surveillance system. While the presence of Ae. albopictus was determined in this potential risk area, there is no evidence for its establishment and further monitoring needs to be carried out.

Effect of Meteorological Factors on Hyalomma Species Composition and Their Host Preference, Seasonal Prevalence and Infection Status to Crimean-Congo Haemorrhagic Fever in Iran.

BACKGROUND: The impact of environmental factors and host on Hyalomma spp. community structure and abundance in the main Crimean-Congo haemorrhagic fever (CCHF) foci of Iran is largely unknown. METHODS: Biotic and abiotic factors, including host, temperature, humidity, altitude, Köppen-Geiger climate types, season, and precipitation on Hyalomma spp. community structure and abundances in 11 provinces of Iran were investigated. Additionally, the possible infection of ticks with CCHF virus was evaluated using reverse transcription PCR technique. RESULTS: Species analyses demonstrated the presence of Hyalomma anatolicum, H. marginatum, H. dromedarii, H. asiaticum, H. detritum and H. schulzei in the study area. Hyalomma anatolicum was the dominant species in the southern and northern parts, whereas H. dromedarii was distributed mostly in central parts of the country. The highest tick infestation was recognized in hot season. Spatial variation in tick relative density was observed between habitat types where more ticks were collected in deserts, semi-deserts, and Mediterranean habitats. Except for H. dromedarii, which was more prevalent on camel (P= 0.044), there were no significant variations in the frequencies of other Hyalomma species on different hosts. Hyalomma anatolicum, H. dromedarii frequencies had significant positive and negative association with temperature and precipitation respectively. Also humidity has positive impact on H. asiaticum frequency. CONCLUSION: Data presented here will help improve ecological models to forecast the distribution of Hyalomma spp. ticks, to evaluate the risk of CCHF and other tick-borne diseases, and to design proper vector control measures to suppress Hyalomma populations in Iran.

Malaria situation in Iran: 2002-2017.

BACKGROUND: Malaria is considered as a major threat to health systems. It is still considered as one of the most important infectious diseases in Iran, but with an elimination goal in 2025. This study aimed to review the malaria situation in Iran over the 16 years. METHODS: The data was collected from epidemiological registration forms that had been completed by physicians and malaria focal points in the National Centers for Disease Control and Prevention. RESULTS: During the study period, 134,273 malaria cases were reported. The malaria incidence decreased from 0.24/1000 cases in 2002 to 0.01/1000 in 2017. From 2009 onward, the number of imported cases increased in comparison with the autochthonous and indigenous cases. Most cases were seen in males and people over 15 years of age. Moreover, the dominant registered reports were from rural areas. Most malaria cases were reported from the south and southeastern of Iran. Plasmodium vivax was the dominant species. CONCLUSION: The dramatic drop in the incidence of autochthonous cases can hopefully support malaria elimination as a major goal in the near future.

Efficacy of Extractions of Iranian Native Plants against Main Malaria Vector, Anopheles stephensi in Iran for Making Appropriate Formulation for Disease Control.

BACKGROUND: Malaria is the main vector-borne disease worldwide. There are several reports of insecticide resistant in malaria vectors worldwide due to using different insecticides. The aim of this study was to evaluate different native plant extortions against main malaria vector, Anopheles stephensi in Iran for choosing the appropriate plant for formulation and use for vector control. METHODS: The larvae of An. stephensi were reared in insectary, extraction of plants were carried out at department of Pharmacology. The standard WHO method for biological tests was used for calculation of LC50 and LC90. Probit regration lines were plotted for calculation of LC50 and LC90. RESULTS: In this study several plants including: Mentha spicata, Cymbopogon olivieri, Azadirachta indica, Melia azedarach, Lagetes minuta, Calotropis procera, Eucalyptus camaldulensis, Cupressus arizonica, Thymus vulgaris, Lawsonia inermis, Cedrus deodara, Cionura erecta, Bunium persicum, Carum carvi, Artemisia dracunculus, Rosmarinus officinalis were used. Results showed that Mentha spicata and Eucalyptus camaldulensis, had the lowest and highest LC50 respectively. CONCLUSION: Results indicated that Mentha spicata and Eucalyptus camaldulensis, had the lowest and highest LC50 respectively. Several other plant extract also showed significant mortality. The formulation of these plants should be prepared and evaluate at the field condition against malaria vectors.

Scorpion composition and scorpionism in a high-risk area, the southwest of Iran.

BACKGROUND: Scorpions are usually defined as predatory arachnids having venomous and painful stings. Scorpionism is considered as one of the health and medical problems in undeveloped tropical and subtropical countries in the world that endangers thousands of people annually. OBJECTIVE: This study was done for identification of scorpion fauna and scorpionism location in a high-risk area in southwest of Iran. METHODS: This study was carried out in Andimeshk district located in Khuzestan province which has the highest frequency of scorpionism in Iran. In total, 4 urban and 15 rural areas with various climates and topography were selected for monthly scorpion collection in 2016. Additionally, clinical data was obtained from questionnaires over a 5-year period (2012 to 2016) which were completed by physicians and health staff in hospitals and health centers. The data were analyzed by IBM-SPSS Version 20. RESULTS: A total of 850 scorpion samples with the most frequency in rural areas were collected. Eight species belonging to three families; Buthidae, Scorpionidae and Hemiscorpiidae were identified. A. crassicauda was the dominant species followed by H. lepturus. The largest collection due to scorpion's activity was recorded in summer. The five-year prevalence of scorpion sting were 9.1/1000 inhabitants. The highest frequency of scorpionism was observed in the male age group of 25-34 years. Most cases had been treated with polyvalent scorpion antivenom within 6-12 hours of the sting. CONCLUSION: Based on the findings, six species of medically important scorpions that were previously reported from Iran were also collected and caught in this study area. The findings of this study can be useful for policymakers at the Andimeshk Healthcare Center to prevent scorpionism and provide appropriate treatment for scorpionism cases.

Bionomics of Anopheles subpictus (Diptera: Culicidae) in a Malaria Endemic Area, Southeastern Iran.

Anopheles subpictus Grassi is considered a secondary malaria vector in parts of Asia. The current study determined some ecological and bionomical characteristics of this species in southeastern Iran. The temporal patterns of abundance, resting behavior, blood feeding activity, host selection, adult susceptibility to insecticides and larval habitats were investigated. Most adults were collected by pyrethrum space-spray collection, followed by pit shelters and outlet window traps, respectively. The abdominal condition index of gravid to blood fed females resting outdoors was more than one, thereby showing exophilic resting behavior. Only 25% of engorged females tested positive for human blood, even though most of the samples were collected from houses. The host seeking activity of An. subpictus was bimodal with peaks at 22-2300 h and 03-0400 h. Also, the relative abundance showed peaks in March and December. The results of susceptibility tests showed a resistance of field strains to DDT. Future studies are needed to investigate the possible role of this species in malaria transmission in southeastern Iran.

Geographic and ecological features of phlebotomine sand flies (Diptera: Psychodidae) as leishmaniasis in Central Iran.

Phlebotomine sand flies occur throughout the tropics and subtropics, as well as in temperate regions of the world. They are vectors of human and canine leishmaniasis and sand fly fevers caused by phleboviruses. This study was aimed to determine the geographic and ecological characteristics of phlebotomine sand flies as vectors of leishmaniasis and to prepare a checklist of phlebotomine sand flies. The study was conducted in Qom province, central Iran, between April and November 2016. Qom is located in latitude 34.6399°N and longitude 50.8759°E with average annual minimum and maximum temperatures of 16.5 and 49 °C, annual rainfall of 150 mm and relative humidity of 84 and 28%, respectively. Sand flies were collected by sticky paper traps from Qom city and its six districts. The sand flies collected were separated from the sticky paper traps using an insulin syringe and kept in 70% ethanol for species identification using taxonomic keys. Also, a literature review was performed using all published reports on phlebotomine sand flies in this province during 1999-2015. A total of 28,410 sand flies from two genera and 14 species were collected. Phlebotomus papatasi, the main vector of zoonotic cutaneous leishmaniasis and arboviruses, and Phlebotomus sergenti, the vector of anthroponotic cutaneous leishmaniasis, were the predominant species followed by Phlebotomus kandelakii, P. major and P. alexandri. Fourteen species from two genera mostly from wet and mountainous areas were identified in the study area. Kahak and Markazi districts were identified as high-risk foci with numerous leishmaniasis vectors species; we recommend intensifying and strengthening of vector control programme in the area of study.

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.

Prevalence and Risk Factors of Pediculosis in Primary School Children in South West of Iran.

BACKGROUND: Pediculosis or louse infestation is a public health problem in many developing countries where the WHO's primary health-care program is inefficient and haphazard. The present study aimed to determine the prevalence of Pediculus capitis infestation and its related risk factors in the primary school children in Andimeshk, Dezful and Shoosh counties; Khuzestan Province, Iran. METHODS: Overall, 28410 students in the age range of 7-11 years old in primary schools of North of Khuzestan Province, southern Iran were examined individually and privately under the flash light for all life cycle stages of lice or their nits in 2016. A questionnaire was filled for each school child before hair examination; then examination was carried out to detect head lice as well as eggs/nits. RESULTS: Overall, 2995 students (10.5%) were infested with pediculosis. There was a significant difference in the prevalence of pediculosis among the boys and girls students. The prevalence of infestation was also significantly (P<0.05) higher in students of living in nomad tribes (23.8%) in comparison of rural (12.4%) and urban areas (6.5%). CONCLUSION: Several risk factors significantly (P<0.05) related to pediculosis included gender of female, nomad habitat, parents education, father's occupation, having health staff, history of infestation and number of combing per day. Increasing awareness and training of teachers and relatives, as well as for improving standards of personal health, can significantly reduce the prevalence of pediculosis.

Potential Risk Areas of Aedes albopictus in South-Eastern Iran: A Vector of Dengue Fever, Zika, and Chikungunya.

The possibility of the rapid and global spread of Zika, chikungunya, yellow fever, and dengue fever by Aedes albopictus is well documented and may be facilitated by changes in climate. To avert and manage health risks, climatic and topographic information can be used to model and forecast which areas may be most prone to the establishment of Ae. albopictus. We aimed to weigh and prioritize the predictive value of various meteorological and climatic variables on distributions of Ae. albopictus in south-eastern Iran using the Analytical Hierarchy Process. Out of eight factors used to predict the presence of Ae. albopictus, the highest weighted were land use, followed by temperature, altitude, and precipitation. The inconsistency of this analysis was 0.03 with no missing judgments. The areas predicted to be most at risk of Ae. albopictus-borne diseases were mapped using Geographic Information Systems and remote sensing data. Five-year (2011-2015) meteorological data was collected from 11 meteorological stations and other data was acquired from Landsat and Terra satellite images. Southernmost regions were at greatest risk of Ae. albopictus colonization as well as more urban sites connected by provincial roads. This is the first study in Iran to determine the regional probability of Ae. albopictus establishment. Monitoring and collection of Ae. albopictus from the environment confirmed our projections, though on-going field work is necessary to track the spread of this vector of life-threatening disease.

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.