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Caucasus/Central Asia: War Refugees Cause A Surge In Malaria Cases




London, 1 April 1998 (RFE/RL) -- The World Health Organization (WHO) reports that the movement of refugees fleeing war zones in Central Asia and the Caucasus has been partly responsible for a sudden upsurge in cases of malaria.

A WHO report says there have been new epidemics of malaria in Tajikistan, Azerbaijan and Turkey, a worrying trend after decades in which the often-fatal disease -- spread by the bites of female mosquitoes -- was largely brought under control.

The report says that Tajikistan is the worst-hit country, with the number of malaria cases soaring from under 300 just five years ago to a reported 30,000 last year. Tajikistan has been hit by a four-year civil war that has resulted in a refugee exodus, a breakdown of health services, and a failure of disease surveillance.

Other war-torn areas of Central Asia and the Caucasus, such as Nagorno-Karabakh and Georgia, have experienced similar problems.

The WHO report says the resurgence of malaria has also been triggered by hotter weather brought about by global climate change, and the problem caused by large areas of unmanaged surface water, particularly in large development projects. Both phenomena have accelerated the breeding of mosquitoes.

Malaria cannot be contracted through direct contact with another person. It is spread from an infected person by mosquitoes, which themselves becomes infected, and transmit the disease through bites. Malaria causes an intermittent and recurrent fever. Its malignant version causes dangerous complications and death.

The WHO report says, globally, up to 2.7 million people die of malaria each year, the majority in tropical Africa.

The report says malaria in Europe was eradicated in the 1940s and 1950s, but it remains endemic in three countries on the fringes of Europe -- Tajikistan, Azerbaijan and Turkey.

The report says that unofficial estimates of malaria cases in Tajikistan are more pessimistic than the official figure of 30,000, but it is difficult to keep count when large outbreaks occur.

The report also says there has been a re-emergence of malaria in Turkey, where the disease was almost eradicated in the 1960s.

The WHO recently sent missions to Tajikistan, Azerbaijan and Turkey to help their health ministries prepare plans for epidemic control, and it is also coordinating plans for international help.

One problem is that health care workers in these countries, like those in northern Europe, are no longer so familiar with malaria.

The WHO is now setting up a malaria surveillance unit at its European regional offices in Copenhagen. One aim of the program is to prevent malaria spreading to other Central Asian and Caucasus regions, and to prevent its importation into Europe.

WHO experts will meet in London next year for a major conference to consider whether hotter weather will increase the global incidence of malaria and other infectious diseases.

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