This part of the site is strictly dedicated to healthcare professionals practicing in malarial endemic areas

MALARIA NEWS

Information and Training


Submit Advanced search
     


[08/05/2005]
 Morocco
 < Back to the list 


Dr Francis Louis, Yaounde, Cameroon


> General Statistics | > Epidemiological Facies | > Vectors | > Chemoresistance | > The National Anti Malaria Program | > Research | > Advice to travellers | > Bibliography

 General Statistics

Area: 698,670 km²
Population: 29,661,636 inhabitants (1999 estimation)
Capital: Rabat
Currency: Moroccan dirham
Official Language: Arabic
Bordering Countries   Mauritania, Algeria 

Out of 192 countries, Morocco ranks 131st   for life expectancy, 139th for infant mortality, 108th for GNP, 64th   for daily calorie intake, 182nd   for literacy, 139th   for the percentage of children in full-time education  (source: Atlas Encyclopédique Mondial, Nathan Ed., Paris 1996, pp.562-563).

 Epidemiological Facies

1912 was the first year when antimalarial action was launched 
1919 saw the creation of the first anti malaria service.

In 1928 and 1929, a devastating epidemic seriously compromised  countrywide harvests. As of that point, thorough sanitization projects were undertaken around the town of Kenitra, Casablanca and Meknes. From 1930 to 1934, malaria studies showed the precise extent of the disease. 

In 1945, Malaria remained localized  along the Atlantic coast where the coastal regions suffered from “Marsh Malaria“. Similarly, at the foot of the mountains "Springs and Sources Malaria” was to be found.   Between these 2 main regions were also a few tracts of land which gave cause for “Irrigation Malaria”. At the end of the 40’s the fight for vector control, and programs such as anti-larvae and the extermination of adult insects accounted for the rapid decrease in the number of cases of malaria plus prevented the spread of the disease. 

As of 1960, Morocco restructured its health policies  by creating a polyvalent health infrastructure. In 1961, the Central Bureau for the Eradication of Malaria was created. In 1962, an agreement was signed with WHO for the pre-eradication of   malaria in the country. 

Up until 1970, about 600,000 inhabitants were protectedfrom the disease by the fact that homes were sprayed with DDT From 1970 to 1973 that number jumped to 1,300,000. Likewise, blood screening and treatments were scaled up: for example, in 1965, of 300,000 blood tests taken, 27,185 tested positive for malaria. In 1978, 1,700,000 blood tests were taken of which only 64 tested positive for malaria. 

The neutralization of anopheline sites was maintained until 1978.From 1979 on however, former hotspots saw renewed activity: Khemisset in 1979 (397 cases), Beni Mellal, Chefchaouen, Nador and Al Hoceima (318 cases) in 1984, Larache in 1985 (713 cases).   In 1986, transmission was stopped at Beni Mellal, Al Hoceima and Nador, but 597 cases were still notified in Chefchaouen and Larache. In 1987 there was renewed activity in areas such as Fes, Meknes, Khourigba and Tetouan (1,287 cases). In addition to these sites, malaria also struck in Taounate and Taza (550 cases in 1988), in 1989   Settat, El Kelaa, Khénifra and Khémisset were also hit. 

In the first nine months of 1990, 639 cases were notified(3). In 1995, 164 cases and 102 in 1996, of which 57 were local. "Autochtonous   cases were recorded in micro-sites, spread out in the rural regions of the provinces of Al Hoceima, Taounate, Béni Méllal and El Kelâa" (5) 

Plasmodiumvivaxis virtually the only autochthonous parasite. The last case due to Plasmodiumfalciparum goes back to 1974, but imported cases still persist (3). 

 Vectors
According to R. Deschiens and M. Cornu, the anopheles present in Morocco are Anopheles sergenti, Anopheles multicolor, Anopheles hispaniola and Anopheles labranchiae, which is the most significant malaria vector in the country ( 2 ).
 Chemoresistance
There have been no recorded cases of Plasmodiumvivax.
 The National Anti Malaria Program
Since the fight action taken from 1912 to 1990, nothing more has been published on the subject.
 Research
There is no malaria research of note being carried out to date. 
 Advice to travellers

Morocco is classified in chemoresistance group I  

·   no Plasmodium falciparum
·   If there is Plasmodium falciparum , it is chemosensitive to usual antimalarial drugs
·   Possible presence of Plasmodium vivax 

Travelers are advised to take a chemoprophylaxis of chloroquine. In reality, the risk of actually catching the disease is so slim that the French Health Authorities (BEH n°23, 1999) admitted that this wasn’t really necessary. However, individual measures of protection against insect bites should be taken.  

 Bibliography
1. ANGEL J.L. - Porotic hyperostosis, anemias, malarias, and marshes in the prehistoric Eastern Mediterranean.  Science 1966 ; 153: 760-763.

2. DESCHIENS R., CORNU M. - Enquête épidémiologique et parasitologique concernant le barrage Hassan Addakhil et ses aménagements au Tafilalet (Maroc, mai-juin 1975).  Bull. Soc. Path. Exot. 1975 ; 68: 482-491.

3. ANONYME - Paludisme.  Rétrospective et situation actuelle. R.E.H. 1992 ; 67: 60-63.

4. IZRI M.A., LORTHOLARY O., GUILLEVIN L., ROUSSET J-J. - Accès palustre à Plasmodium vivax plus de cinq ans après un séjour à Meknès (Maroc).  Bull. Soc. Path.  Exot. 1994 ; 87: 189.

5. DIRECTION DE L'EPIDEMIOLOGIE ET DE LA LUTTE CONTRE LES MALADIES, MINISTERE DE LA SANTE PUBLIQUE - Bulletin épidémiologique.  Bilan 1996. N°28.

6. TOWNEND M. - Sources and appropriateness of medical advice for trekkers. J. Travel Med. 1998 ; 5: 73-79.
 

© Copyright sanofi-aventis 2002-2008 all rights reserved
Disease information about malaria:the parasite, the symptoms, prevention and treatment options, atlas of malaria, etc.