Malaria is the most serious protozoan disease in the world. Its spread depends very much on climate change (1). The incidence of malaria has decreased in the past few years in Iran, and there were no indigenous cases in 2018 and 2019 (2); in other words, the disease has been under control in the south of Iran in the last decade (3). However, this disease suddenly broke out in 2022. According to statistics released by health officials in Sistan and Baluchestan Province (the southeast of Iran), the number of malaria-positive cases was about 10 times higher in 2022 than in 2021. It was estimated that about 3000 people would be infected with the disease in the province by November 7, 2022. According to public health officials, several factors caused the outbreak, including the presence of foreign nationals, heavy rains, and the increased number of cases of malaria in Pakistan (a neighboring country), as well as poor detection of new cases in this country (4). Also, Ebrahimi reported that 78% of malaria cases in Jahrom City (south of Iran) were citizens of Pakistan and Afghanistan (5). Some studies have also recognized the coexistence of COVID-19 and malaria as one of the reasons for the outbreak of this disease (6). The border region had the highest number of infected people, which may be due to the large number of people traveling across the borders. In this regard, Nili et al. predicted a warmer and more humid climate for this region in the future. They also warned that malaria would remain a health issue in this region if proper interventions were not implemented (1).
To control malaria outbreaks, the distribution of mosquito nets impregnated with insecticide, education to people, and new case screening are among the most important health measures carried out in this region.
On the other hand, the eastern neighbors, Afghanistan and Pakistan, are affected by malaria, where the elimination program has not been implemented (2). Moreover, a warmer and more humid climate has been predicted for the province in the future; therefore, there is a possibility of annual malaria outbreaks in this region. Consequently, it is recommended that proper planning should be prioritized by the health policy-makers to prevent the outbreak or spread of malaria in this region of Iran.
