Malaria stratification in a malarious area, a field exercise

Objective: To conducted a spatial analysis for stratification of priority malaria control areas in Kahnuj County, as part of field exercise. Methods: Information of Health Centers of Kahnuj County has been used for stratification retrospectively. A knowledge, attitudes and practices (KAP) study was arranged to provide preliminary information about the knowledge, attitude and practice related to malaria in the area. Results: Numbers of malaria cases has been decreased in year 2008. There were five important vectors of malaria in this region including: Anopheles stephensi (An. stephensi), Anopheles dthali (An. dthail), Anopheles superpictus (An. superpictus), Anophels culicifacies (An. culicifacies), and Anopheles fluviatilis (An. fluviatilis), but majority of malaria cases in this county was related to Plasmodium vivax (P. vivax). Educational levels of community were 38%, 20%, 10% and 32% for illiterate, primary, secondary and university levels, respectively. KAP study revealed that about 37% of people have got malaria at least once and only 27% of people knew that mosquito is the vector of malaria. Conclusions: Malaria in Kalinin represents a real threat. Transmission occurs in city center. An stephensi can be suspected for the first peak of malaria cases in late spring in Kahnuj city. An. fluviatilis has a relatively high density in autumn while two malaria cases due to P. falciparum were reported in 2008. Based on KAP study, the knowledge of respondents seems good but the attitude and practice is low. According to the data such as API, main malaria vector, transmission rate, and foreign migrants, the Kahnuj County has been spatially divided into three strata based on various characteristics. The authorities should implement all the interventions based on stratification.