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Review
. 2023 Jun 19;22(1):187.
doi: 10.1186/s12936-023-04545-y.

Public health impact of the spread of Anopheles stephensi in the WHO Eastern Mediterranean Region countries in Horn of Africa and Yemen: need for integrated vector surveillance and control

Samira M Al-Eryani  1 , Seth R Irish  2 , Tamar E Carter  3 , Audrey Lenhart  4 , Adel Aljasari  5 , Lucia Fernández Montoya  2 , Abdullah A Awash  6 , Elmonshawe Mohammed  7 , Said Ali  8 , Mohammed A Esmail  9 , Abdulhafid Hussain  10 , Jamal G Amran  11 , Samatar Kayad  12 , Mujahid Nouredayem  7 , Mariam A Adam  7 , Lina Azkoul  13 , Methaq Assada  9 , Yasser A Baheshm  14 , Walid Eltahir  15 , Yvan J Hutin  13
Affiliations
Review

Public health impact of the spread of Anopheles stephensi in the WHO Eastern Mediterranean Region countries in Horn of Africa and Yemen: need for integrated vector surveillance and control

Samira M Al-Eryani et al. Malar J. .

Abstract

Background: Anopheles stephensi is an efficient vector of both Plasmodium falciparum and Plasmodium vivax in South Asia and the Middle East. The spread of An. stephensi to countries within the Horn of Africa threatens progress in malaria control in this region as well as the rest of sub-Saharan Africa.

Methods: The available malaria data and the timeline for the detection of An. stephensi was reviewed to analyse the role of An. stephensi in malaria transmission in Horn of Africa of the Eastern Mediterranean Region (EMR) in Djibouti, Somalia, Sudan and Yemen.

Results: Malaria incidence in Horn of Africa of EMR and Yemen, increased from 41.6 in 2015 to 61.5 cases per 1000 in 2020. The four countries from this region, Djibouti, Somalia, Sudan and Yemen had reported the detection of An. stephensi as of 2021. In Djibouti City, following its detection in 2012, the estimated incidence increased from 2.5 cases per 1000 in 2013 to 97.6 cases per 1000 in 2020. However, its contribution to malaria transmission in other major cities and in other countries, is unclear because of other factors, quality of the urban malaria data, human mobility, uncertainty about the actual arrival time of An. stephensi and poor entomological surveillance.

Conclusions: While An. stephensi may explain a resurgence of malaria in Djibouti, further investigations are needed to understand its interpretation trends in urban malaria across the greater region. More investment for multisectoral approach and integrated surveillance and control should target all vectors particularly malaria and dengue vectors to guide interventions in urban areas.

Keywords: Anopheles stephensi; Breeding sites; Eastern Mediterranean Region; Invasive vector; Malaria; Vector surveillance.

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Conflict of interest statement

None declare.

Figures

Fig. 1
Fig. 1
Estimated malaria incidence and timeline of first reported detection of invasive An. stephensi, in 4 EMR countries, 2010–2020. Boxes indicate the date of first An. stephensi detection in each country
Fig. 2
Fig. 2
Reported malaria incidence in Aden City, Yemen, 2016–2021. Box indicates the date of first An. stephensi detection in the country
Fig. 3
Fig. 3
Reported malaria incidence in Bossaso City, Somalia, 2012–2021. Box indicates the date of first An. stephensi detection in the country
Fig. 4
Fig. 4
Reported malaria incidence in Khartoum City, Sudan, 2016–2021
Fig. 5
Fig. 5
Detections of An. stephensi in countries in the Eastern Mediterranean Region in the Horn of Africa and the Arabian Peninsula reported to WHO, overlaid with population density, 2012–2021. Maps credit: WHO GIS Centre for Health
Fig. 6
Fig. 6
Common breeding sites for invasive Anopheles stephensi and Aedes aegypti in Djibouti (A–D), Somalia (G), Sudan (E, F) and Yemen (H–J), 2019–2022
See this image and copyright information in PMC

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