Cases of malaria double in a year

More than 2,000 cases were found in people arriving in the UAE and experts say a better surveillance system is a contributing factor.

Workers from Eagle, environmental services & pest control, look for malaria mosquitos in the irrigation water of a farm in Al Bahia town. (Jaime Puebla / The National
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ABU DHABI // More than 2,000 cases of malaria were reported in Abu Dhabi last year, more than double the number in 2010.

They all came from outside the UAE, maintaining the country's malaria-free status, which it has held since 2007.

There were 2,129 cases in the first nine months of 2011, an increase of more than 1,000 on the whole of 2010. Figures for the last three months of last year have not yet been released.

Dr Farida Al Hosani, section head of communicable diseases at the Health Authority Abu Dhabi (Haad), said the rise was both expected and welcomed.

"We shifted in 2010 to an electronic surveillance system. Previously it was a manual system so the compliance was less, and as the number increases, so does our view of what is happening," the doctor said.

The UAE gained its malaria-free status from the World Health Organisation a decade after reporting its last local case in 1997, and was the first country in the Middle East to achieve the status.

Overall, the GCC region has a good record of controlling the disease, said Dr Ziad A Memish, Assistant Deputy Minister for Preventive Medicine for the Ministry of Health in Saudi Arabia and Director of the GCC Centre for Infection Control.

"Out of the whole GCC region, only the southern part of Saudi Arabia and Yemen have cases of malaria. That's where the activity is."

The constant flow of expats to and from the UAE, as well as its status as a holiday destination, has led to Haad increasing its focus to pinpoint cases of the disease, said Dr Al Hosani.

"For malaria the numbers from 2009 until today have almost doubled. This is not only because the reporting improved, but because there were some outbreaks in nearby countries."

Flooding in Pakistan added to the problem, she said. Other countries where malaria is endemic include India and Malaysia.

"The country is receiving large numbers of travellers and foreign workers every year, many of whom come from endemic areas and may have the malaria infection. With the continuing existence of local Anopheles mosquitoes, which pass the disease to humans, transmission of malaria will continue to be a risk," according to the latest volume of Haad's communicable diseases bulletin, which was made public yesterday.

It revealed the number of cases of HIV in Abu Dhabi. During the third quarter of last year, 256,546 people were screened as part of their visa medical, with 39 new cases of HIV detected, while eight were discovered when people tried to renew their visas. The prevalence of HIV per 100,000 people in the UAE was 18.3 per cent.

Last year the WHO reported reported 216 million cases of malaria worldwide, 655,000 of which resulted in death.

The most obvious symptom of the disease is a fever, said Dr Mohamed Hamad, the infection control chief at Lifeline Hospital.

Abdominal pain can also be a sign, said the doctor, who receives on average three patients a month with malaria.

Following guidelines issued by Haad, any cases are reported to the authority's infectious diseases department for further assessment.

"We send for a blood test and if it comes back positive, we send it to the Centre for Disease Control department at Haad."

Most of the doctor's cases come from Pakistan, India and Sudan.

Given the somewhat vague symptoms, Dr Memish said doctors must check a patient's history to analyse the problem.

"Usually it is a fever, body aches, back pain or headaches. They are very non-specific and unless you are conscious of it and aware of the person's travel history, then you won't be able to pick it up."

According to Haad's report, the mortality rate worldwide has dropped by more than a quarter in the past 12 years, although the drop is marginally higher in Africa.

For now, to ensure the UAE remained malaria free, preventive measures will be carried out more frequently.

Alongside workshops for healthcare professionals, farms will be checked thoroughly for their methods of control, said Dr Al Hosani.

"We coordinate with the environmental agency to ensure that malaria breeding is under control. and we inspect farms. The malaria surveillance team will go on a regular basis to farms to monitor the breeding and the control of mosquitoes."

Workshops have also been given to companies that supply insecticides to farms, she said.

"Since the number of cases of malaria has increased, we need to increase our efforts as well to ensure the best control."