Malaria in Laconia, Greece, then and now: a 2500-year-old pattern (original) (raw)
Related papers
Malaria in Greece, 1975 to 2010
Eurosurveillance, 2012
Malaria, which was endemic in Greece in the past, was officially eliminated in 1974. Since that time and up to 2010, a number of imported cases (ranging from 19 to 76) have been annually reported. The total number of reported laboratory-confirmed cases between 1975 and 2010 was 1,419. Plasmodium falciparum was identified in 628 (44%) of these cases, while P. vivax was found in 524 (37%). Of the total cases, 1,123 (79%) were male (ratio males vs. females: 3.78). Age was only available for 490 cases, of which 352 (72%) belonged to the 18-40 year-age group. Of the 382 malaria cases reported from 1999 to 2010 for which the region/country of acquisition was known, 210 (55%) were from Africa and 142 (37%) from Asia. The massive introduction of economic migrants, in the period from 1990 to 1991 and from 2006 onwards, mainly from countries where malaria is endemic, resulted in the appearance of introduced sporadic cases. In Peloponnese, Central and East Macedonia, Thrace and East Attica, mosquitoes of the genus Anopheles (e.g. Anopheles sacharovi, A. superpictus and A. maculipenis) that can act as plasmodia vectors are abundant and during the summer of 2011, 27 P. vivax cases were reported in Greek citizens residing in the agricultural area of Evrotas in Lakonia and without travel history. As further P. vivax malaria cases occurred in the Lakonia and East Attica areas in 2012, it is becoming urgent to strengthen surveillance and perform integrated mosquito control that will help eliminate the potential risk of malaria reintroduction and reestablishment.
Seroepidemiological Study of Malaria in A Former High Endemic Region of Greece
Biomedical Journal of Scientific & Technical Research, 2020
After malaria elimination in Greece, in 1974, a few sporadic indigenous malaria cases have been reported, up until 2009 that the country experienced the threat of disease re-emergence due to sociological and environmental factors. Northern Greece, a highly malarious place in the past, reported autochthonous cases attributed to P. vivax, a parasite that can cause asymptomatic infections. In the present study 347 residents of Drama province (median age: 53 years, age range: 11-94 years, 62% women), Northern Greece, were screened, by serology, smear microscopy and Rapid Diagnostic Tests (RDTs), to evaluate and detect asymptomatic malaria cases. No seropositive individuals were identified by ELISA and blood smear microscopy was negative for all participants. ELISA borderline results were furtherly tested with RDT (sensitivity for P. vivax infection: 97.4%, specificity for P. vivax infection: 99.4%) and proved to be negative for active plasmodium parasitaemia. It is concluded that currently, Drama population remains malaria naive and as a result unable to serve as a reservoir and infect mosquitoes, contributing to the malaria transmission cycle.
Malaria constitutes an important cause of human mortality. After 2009 Greece experienced a resurgence of malaria. Here, we develop a model-based framework that integrates entomological, geographical, social and environmental evidence in order to guide the mosquito control efforts and apply this framework to data from an entomological survey study conducted in Central Greece. Our results indicate that malaria transmission risk in Greece is potentially substantial. In addition, specific districts such as seaside, lakeside and rice field regions appear to represent potential malaria hotspots in Central Greece. We found that appropriate maps depicting the basic reproduction number, 0 R , are useful tools for informing policy makers on the risk of malaria resurgence and can serve as a guide to inform recommendations regarding control measures.
Mapping Environmental Suitability for Malaria Transmission, Greece
Emerging Infectious Diseases, 2013
Greece experienced a resurgence of domestic malaria transmission. To help guide malaria response efforts, we used spatial modeling to characterize environmental signatures of areas suitable for transmission. Nonlinear discriminant analysis indicated that sea-level altitude and land-surface temperature parameters are predictive in this regard.
Malaria constitutes an important cause of human mortality. After 2009 Greece experienced a resurgence of malaria. Here, we develop a model-based framework that integrates ento-mological, geographical, social and environmental evidence in order to guide the mosquito control efforts and apply this framework to data from an entomological survey study conducted in Central Greece. Our results indicate that malaria transmission risk in Greece is potentially substantial. In addition, specific districts such as seaside, lakeside and rice field regions appear to represent potential malaria hotspots in Central Greece. We found that appropriate maps depicting the basic reproduction number, R 0 , are useful tools for informing policy makers on the risk of malaria resurgence and can serve as a guide to inform recommendations regarding control measures.
The historical distribution of main malaria foci in Spain as related to water bodies
2014
The possible connectivity between the spatial distribution of water bodies suitable for vectors of malaria and endemic malaria foci in Southern Europe is still not well known. Spain was one of the last countries in Western Europe to be declared free of malaria by the World Health Organization (WHO) in 1964. This study combines, by means of a spatial-temporal analysis, the historical data of patients and deceased with the distribution of water bodies where the disease-transmitting mosquitos proliferate. Therefore, data from historical archives with a Geographic Information System (GIS), using the Inverse Distance Weighted (IDW) interpolation method, was analyzed with the aim of identifying regional differences in the distribution of malaria in Spain. The reasons, why the risk of transmission is concentrated in specific regions, are related to worse socioeconomic conditions (Extremadura), the presence of another vector (Anopheles labranchiae) besides A. atroparvus (Levante) or large areas of water bodies in conditions to reproduce theses vectors (La Mancha and Western Andalusia). In the particular case of Western Andalusia, in 1913, the relatively high percentage of 4.73% of the surface, equal to 202362 ha, corresponds to wetlands and other unhealthy water bodies. These wetlands have been reduced as a result of desiccation policies and climate change such as the Little Ice Age and Global Climate Change. The comprehension of the main factors of these wetland changes in the past can help us interpret
Heliyon, 2020
This Historical Epidemiological study aims to evaluate malaria in Greek refugees during the 1926-1940 period in the region of Imathia, Central Macedonia, Greece, in the context of the Anti-Malaria Battle in Greece. Materials and methods: The archives of the Refugee Hospital of Veria, Imathia were examined (March 5, 1926 to October 27, 1940); this is a report of previously unpublished primary material comprising 15,921 cases, of whom 8,408 patients were hospitalized due to malaria. Multivariate logistic regression analysis was performed to identify independent risk factors for hospitalization due to malaria; adjusted odds ratios (ORs) and 95% Confidence Intervals (CIs) were estimated. Results: Residence in lower elevation (adjusted OR ¼ 0.95, 95% CI: 0.92-0.97, per increments of elevation), refugee status (from Bulgaria/Balkans, Caucasus, Constantinople and Thrace, Pontus and inland of Turkey), female gender, and younger age (adjusted OR per 10-year increase ¼ 0.88, 95% CI: 0.86-0.90) correlated independently with hospitalization due to malaria. Conclusions: Malaria was the leading cause of admission to the hospital in the region of Imathia during the studied period. The association with elevation reflects the aggravating role of marshes before the drainage of Lake Giannitsa.
PLOS Neglected Tropical Diseases, 2015
Greece was declared malaria-free in 1974 after a long antimalarial fight. In 2011-2012, an outbreak of P. vivax malaria was reported in Evrotas, an agricultural area in Southern Greece, where a large number of immigrants from endemic countries live and work. A total of 46 locally acquired and 38 imported malaria cases were detected. Despite a significant decrease of the number of malaria cases in 2012, a mass drug administration (MDA) program was considered as an additional measure to prevent reestablishment of the disease in the area. During 2013 and 2014, a combination of 3-day chloroquine and 14-day primaquine treatment was administered under direct observation to immigrants living in the epicenter of the 2011 outbreak in Evrotas. Adverse events were managed and recorded on a daily basis. The control measures implemented since 2011 continued during the period of 2013-2014 as a part of a national integrated malaria control program that included active case detection (ACD), vector control measures and community education. The MDA program was started prior to the transmission periods (from May to December). One thousand ninety four (1094) immigrants successfully completed the treatment, corresponding to 87.3%
Endemic malaria: an 'indoor' disease in northern Europe. Historical data analysed
Malaria journal, 2005
Endemic northern malaria reached 68 degrees N latitude in Europe during the 19th century, where the summer mean temperature only irregularly exceeded 16 degrees C, the lower limit needed for sporogony of Plasmodium vivax. Because of the available historical material and little use of quinine, Finland was suitable for an analysis of endemic malaria and temperature. Annual malaria death frequencies during 1800-1870 extracted from parish records were analysed against long-term temperature records in Finland, Russia and Sweden. Supporting data from 1750-1799 were used in the interpretation of the results. The life cycle and behaviour of the anopheline mosquitoes were interpreted according to the literature. Malaria frequencies correlated strongly with the mean temperature of June and July of the preceding summer, corresponding to larval development of the vector. Hatching of imagoes peaks in the middle of August, when the temperature most years is too low for the sporogony of Plasmodium...
Active case detection to prevent re-establishment of malaria, Greece, 2012
BACKGROUND: Greece has been malaria-free since 1974. In 2011, P. vivax malaria reemerged with 42 locally-acquired cases, 36(86%) of whom in Evrotas, Lakonia, an agricultural area with many migrants from malariaendemic countries. In 2012, we actively searched for cases to ensure early diagnosis and treatment. We evaluated this practice in terms of reduction of locally-acquired cases and timeliness of diagnosis. METHODS: We interviewed all reported cases in Greece regarding their travel history to identify locally-acquired cases. In areas with at least one locally acquired case, we a) tested for malaria all immigrants using Rapid Diagnostic Tests and microscopy and b) screened all residents for fever, weekly for one month. Additionally, in Evrotas, we visited all houses of immigrants, twice per month, and tested for malaria those with fever. We compared the number of locally-acquired cases in 2011 and 2012 all over Greece and in Evrotas. We evaluated timeliness of diagnosis before and...