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[08/04/2005]
 Eritrea | |
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Dr Francis Louis, Yaoundé, Cameroon
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General Statistics
Area: 121,320
km²
Population:
3,985,723 inhabitants (1999 estimation)
Capital:
Asmara
Currency:
birr
Official
Languages: Tigrina and Arabic
Bordering
Countries: Sudan, Ethiopia, Djibouti 
Out of 192 countries, Eritrea ranks 169th
for life expectancy, 169th for infant mortality,
125th for GNP, 189th for daily calorie
intake, 188th for literacy, 188th
for the percentage of children in full-time education (source:
Atlas Encyclopédique Mondial, Nathan Ed., Paris 1996,
pp.118-119).
The climate is hot and dry with a very short rainy season limited
to July and August. | Epidemiological Facies
Eritrea gained its independence in 1991. It is perhaps for this
reason that there is so little information concerning malaria in
the country.
According to Masala et al., malaria affects 2/3rd of the
population, spread-out over 75% of the surface of the country. It
is not limited to the plains and in certain years can present a
risk of epidemic in regions of up to 2,200 m of
altitude. Plasmodiumfalciparum represents 90%
of isolated cases and Plasmodiumvivax 10% (3).
According to Mouchet et al’s classification. (Typologie du
paludisme en Afrique. Cahiers Santé 1993 ; 3: 220-238),
malaria here is unstable and transmission of the
disease is low and periodical .
| Vectors
J. Brunhes et al.(Les anophèles de la région afro-tropicale,
logiciel ORSTOM Ed., 1998) compiled a list of 21 different species
of anopheles in the country: Anopheles christyi, Anopheles
cinereus cinereus, Anopheles coustani s.l., Anopheles culifacies
adenensis, Anopheles dancalicus, Anopheles demeilloni, Anopheles
dthali, Anopheles erythraeus, Anopheles funestus, Anopheles
garnhami, Anopheles gambiae s.l., Anopheles pharoensis, Anopheles
pretoriensis, Anopheles rhodesiensis rhodesiensis, Anopheles
rhodesiensis rupicolus, Anopheles rivulorum, Anopheles rufipes
s.l., Anopheles salbaii, Anopheles sergentii macmahoni, Anopheles
squamosus and Anopheles turkhudi.
Anopheles gambiae is
the principal vector (3).
| Chemoresistance
The only documented study is that of Alene et al. on the period
between 1989 -1991: Out of the 17,386 patients treated with
chloroquine in what was then the northern region of Ethiopia
(Eritrea + regions of Gondar, Tigray and Wollo in Ethiopia), 873
complained of the ineffectiveness of their treatment. The same
treatment was re-administered this time under medical supervision
and with a daily dosage of the parasitemia: 108 were classified S
or RI, 644 RII and 121 RIII (2).
| The National Anti Malaria Program
The National Program works in association with the Italian
Corporation to put in place concrete action plans against Malaria.
The strategy is built upon methods of Vector Control (diffusion
of Aphanius
dispar, distribution and treating of mosquito nets),
distribution of antimalarial drugs to well trained Health Officers
and the training of 1,500 Health Officers.
| Research Institutions
There is no research into malaria being conducted in Eritrea at
this time. On the other hand, studies into the chemosensitivity
of Plasmodiumfalciparum are underway in
12 sentinel units (3).
| Advice to Travelers
The « Centre National Français de Surveillance de la
Chimiosensibilité » (“French National Center For
Chimiosensitivity Survey”) placed Eritrea in chloroquine-resistance
group III, which includes countries that have " highly
chemo-resistant Plasmodiumfalciparum or even
poly-resistant". The most likely reason for this classification is
probably due to the country’s close proximity to
Ethiopia.
According to the B.E.H. n°24-25 of the 14 june 2005, this signifies
that a traveler spending less than 3 months in Eritrea must undergo
treatment with Mefloquine or with Atovaquone-Proguanil
combination.
The circumstances of the trip must be taken into account: humid
season Vs dry ? Staying in towns or in the countryside ? Staying at
a hotel or in a traditional dwelling ? etc More often than not
simple measures of precaution against mosquito bites are largely
sufficient.
| Bibliography
(Only the first author is mentioned)
1. MOURANT A.E. et Coll. - The blood groups and haemoglobins of the
Kunama and Baria of Eritrea, Ethiopia. Ann. Hum. Biol. 1974 ;
1: 383-392.
2. ALENE G.D. et Coll. - Chloroquine resistance of Plasmodiumfalciparum in Ethiopia and
Eritrea. Trop. Med. Int. Health 1996 ; 1: 810-815.
3. MASALA G. et Coll. - Italian Development Cooperation: the
commitment for the struggle against malaria in Africa.
Parassitologia 1999 ; 41: 361-366.
4. KASSAKOGNO Y. - Aperçu sur le programme de lutte contre le
paludisme africain pour la période 1996-1997. Malaria and
Infectious Diseases in Africa 1999 ; n°9bis: 52-61.
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Version française 
