Significant headway has been made in the global fight against malaria in the past decade and as more countries enter the elimination phase, attention is now focused on identifying effective strategies to shrink the malaria map. Saudi Arabia experienced an outbreak of malaria in 1998, but is now on the brink of malaria elimination, with just 82 autochthonous cases reported in 2012. A review of published and grey literature was performed to identify the control strategies that have contributed to this achievement.
The number of autochthonous malaria cases in Saudi Arabia decreased by 99.8% between 1998 and 2012. The initial steep decline in malaria cases coincided with a rapid scaling up of vector control measures. Incidence continued to be reported at low levels (between 0.01 and 0.1 per 1,000 of the population) until the adoption of artesunate plus sulfadoxine-pyrimethamine as first line treatment and the establishment of a regional partnership for a malaria-free Arabian Peninsula, both of which occurred in 2007. Since 2007, incidence has decreased by nearly an order of magnitude. Malaria incidence is now very low, but a high proportion of imported cases, continued potential for autochthonous transmission, and an increased proportion of cases attributable to Plasmodium vivax all present challenges to Saudi Arabia as they work toward elimination by 2015.
Citation: Coleman M, Al-Zahrani MH, Coleman M, Hemingway J, Omar A, et al. (2014) A Country on the Verge of Malaria Elimination – The Kingdom of Saudi Arabia. PLoS ONE 9(9): e105980. doi:10.1371/journal.pone.0105980
Editor: Joseph A. Keating, Tulane University School of Public Health and Tropical Medicine, United States of America
Received: March 8, 2014; Accepted: July 28, 2014; Published: September 24, 2014
Copyright: © 2014 Coleman et al. This is an open-access article distributed under the terms of the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original author and source are credited.
Data Availability: The authors confirm that all data underlying the findings are fully available without restriction. All relevant data are within the paper.
Funding: This work was funded by the Kingdom of Saudi Arabia Malaria Ministry of Health who also allowed access to datasets that have not been published and the Innovative Vector Control Consortium for supporting staff from LSTM, as well as unpublished PhD student work of LSTM. The funders had no role in study design, data collection and analysis, decision to publish, or preparation of the manuscript.
Competing interests: The authors have declared that no competing interests exist.
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