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Jamshaid Iqbal, Faiza Al-Ali, Ali Sher, Parsotam R. Hira, Imported Malaria in Kuwait (1985–2000), Journal of Travel Medicine, Volume 10, Issue 6, 1 December 2003, Pages 324–329, https://doi.org/10.2310/7060.2003.9291
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Abstract
The objective of this study was to document the status of malaria infection and effect of preventive measures on the epidemiologic profile of imported malaria cases in Kuwait during 1985–2000.
The study included screening of two groups of individuals for malaria infection by microscopy; (1) all migrant workers from malaria-endemic countries on their first entry to Kuwait; and (2) all suspected malaria cases already residing in the country. The study period was divided into prewar (1985–1990), postwar (1992–1997) and proactive preventive (1998–2000) periods. During the proactive preventive period, the home countries were also involved in screening for malaria infection in all prospective immigrants to Kuwait.
The annual incidence of malaria cases detected during the prewar, postwar and proactive preventive periods ranged between 465 and 1,229, 654 and 1,379, and 248 and 393, respectively. Plasmodium vivax infection was detected in 71% of the cases and P. falciparum in 27%. The number of malaria cases detected increased to >1,300 after the war during 1992-1993. However, the number of malaria cases dropped significantly to less than 400 during 1998–2000 (p<.05). The majority (87%) of malarial infections detected were acquired in Asian countries: India, 39%; Pakistan, 20%; other Asian countries (Sri Lanka, Bangladesh, Nepal, Afghanistan), 28%. Less than 1% of the cases were seen among Kuwaitis returning from malaria-endemic countries. The number of malaria cases among the newly arrived immigrants decreased significantly from 38% to 59%, to 19% to 27%, during 1998–2000. The majority (>80%) of malaria patients were young male adults between 21 and 40 years of age. The data on drug resistance were not well defined, due to limited testing.
This study suggests that the proactive preventive program to screen all prospective immigrants for malaria infection in their home countries significantly reduced the numbers of imported infections to <400 cases/year, a drop of 52.6%. In addition, it also identified a group of settled immigrants, the majority of whom were at high risk for acquisition of malaria infection during their visit to home countries. There is an urgent need to target this group for prevention strategies such as education/information and other preventive measures against malaria infection.
