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Actually one of the main tasks of health workers in the field of the tropical diseases prevention (malaria) is early detection of malaria imported cases and efficacious treatment. In order to prevent the re-establishment of local malaria transmission by Anopheles mosquitoes from imported malaria cases, and fatal cases of disease there is develop and implement the Case Management Protocol of malaria diagnosis and treatment (2014, 2019) based on long-term experience of epidemiologists and clinicians, taking into account recommendations of WHO (2013, 2015). In this article the main principles of diagnosis and treatment of different malaria species Plasmodium falciparumand Plasmodium vivax-malaria, prophylaxis measures of autochthonous cases from imported cases of the word endemic region are discussed.

Early detection of imported cases of malaria and its prompt and efficacious treatment are one of the main tasks of health workers in malaria prevention during the post-elimination period. The diagnosis and treatment of malaria should be developed and standardized to prevent the re-emergence of local transmission from imported cases of malaria. Its diagnosis must be verified by only laboratory tests during the post-elimination period. Keeping in mind the possible rapid conversion of uncomplicated P. falciparum malaria into a several disease, these all cases should be managed in a hospital setting. The healthcare personnel dealing with the treatment of malaria should be aware of its clinical manifestations in non-immune residents and semi-immune immigrants. The main principles of malaria treatment are discussed in respect of age, sex, pregnancy, and different malaria species.

Current PCR assays for the differential diagnosis of malaria need to be further developed and certified in the Russian Federation. PCR may serve as a control diagnostic method. These investigations have demonstrated that an erythrocytic clot may be used as an adjunct to microscopy and the described procedure can be employed to isolate DNA for PRC in an inpatient setting.

This communication is the first in the series consisting of two publications describing the present state of malaria control and elimination in the world. The global malaria situation in 2009-2010 demonstrated a considerable situation as compared to the previous years. This improvement is associated with a considerable global increase of investments made by both national governments and world society to the malaria control programs. Spectacular progress has been achieved even in the areas of the most infection-affected African countries situated to the south of the Sahara Desert. It has been estimated that malaria cases in the world declined from 233, 000,000 in 2000 to 225,000,000 in 2009. Malaria mortality decreased from 985,000 in 2000 to 781,000 in 2009. To maintain the results achieved and to further reduce the problem of malaria worldwide, it is necessary to ensure a long-term political and financial support for malaria control programs at the national and international levels.

To define the capacity andreadiness of the health care system of Kyrgyzstan to ensure transition of malaria control to elimination in 2005-2007, health administrators scheduled and educated 2089 public health specialists in the problem of management, diagnosis, treatment, and prevention of malaria, followed by their questioning. Areas at high risk for malaria transmission and those with local malaria foci, such as the Kadamzhaisky, Batkensky, Alamedinsky, Sokuluksky, and Issyk-Atinsky Districts and the city of Bishkek, were selected for polling. A research agency developed 5 structured questionnaires to interview respondents. The questionnaires included questions on occupation and those urgent to various groups of specialists. On the basis of the performed analysis, the following recommendations have been formulated: * to increase the duration of trainings in accordance with the amount of contained material; * to develop topical teaching modules for training and to make them more specific and detailed for individual specialists; * to conduct short (3-day) traveling on-site trainings for specialists of therapeutic-and-prophylactic institutions and state sanitary-and-epidemiological surveillance; * to assess the participants' knowledge before and after training (pre- and posttests) during education courses for further training correction.

The paper considers the age-specific features of the clinical course of tropical malaria in children in Tadjikistan. Tropic malaria in children, those of young age in particular, is characterized by the acute onset, polymorphism of clinical manifestations, high fever of mainly abnormal type, and hepatosplenomegaly. Tropical malaria takes the most severe course in children of the first three years. The severity of the disease is due to the development of the toxic syndrome, cerebral disorders, and hemolytic anemia. An association has been seen between the onset of etiotropic treatment and the degree of tropic malaria: the earlier antimalaria therapy is initiated, the milder the disease is.

Malaria was eradicated on the territory of Moscow in 1960; its imported cases mainly from the countries of Asia and Africa and sporadic cases secondary to the imported ones were recorded during the following 40 years. Mass migration of the population (businessmen, seasonal workers, etc.) from the endemic CIS countries in the late 1990s, particularly to the Moscow Region, increased cases of tertian malaria, resulting from the transmission of the infection by the mosquitoes Anopheles. A total of 793 cases of malaria, including 27 parasitic carriers, were recorded from 2000 to 2004. The proportion of Muscovites was 24.1% of the total cases of malaria in 2002 and increased up to 50% in 2004. The causative agents of tertian malaria (Plasmodium vivax) were detected in 74.8% of the total number of cases. The ongoing importation of malaria from Tadjikistan and Azerbaijan, the late establishment of final diagnosis, the shortage of antimalarial drugs make the malaria situation worse in Moscow, which requires that antiepidemic measures should be intensified in the coming 3 years.

The paper presents the results of a study of immunological parameters in the indigenous adult population of an endemic area of Guinea in tropical malaria of varying severity and the time course of changes in these parameters in different phases of the disease during delagil treatment. Examination of 101 patients has established that tropical malaria in re-infected patients is not accompanied by severe immunosuppression though there is a clear tendency towards lymphocytic immunodeficiency in patients with higher parasitemia and a severe course of the disease. The greatest manifestations of immunosuppression coincide with the high oxygen metabolism of phagocytes, which confirms their important role in the pathogenesis of immune disorders and common syndrome in malaria.

The paper describes a method for mastering and maintaining skills at the parasitological diagnosis of malaria. The number of educational blood smears, which are to be studied to develop reliable skills at the detection of malaria parasites in the smear preparations showing different level of parasitemia, has been determined. It has been ascertained that parasites that develop with the use of antimalaria drugs may be reliably detected by a skilled parasitologist who constantly uses his experience in practical work. The experiment has indicated that parasitologists and laboratory assistants should monthly view collections of educational smear preparations in nonendemic areas in order to maintain their skills at the parasitological diagnosis of malaria.

The specific features of initial period of vivax and tropical malaria were defined with the help of clinical-and-laboratory methods in two groups of servicemen (70 persons in each group) differed by the period of stay in tropics. For comparison 30 similar patients, the tropics inhabitants, were investigated. In local inhabitants the course of all forms of malaria was rather mild with development of disease characteristic paroxysms in most of them. The reverse correlation of disease severity and period of servicemen' stay in tropics was revealed. For both forms of malaria the migrants compared with local inhabitants had the prodromal period and initial fever without typical paroxysms. The following debuts of malaria were revealed in servicemen: the frequent (influenza-like, arthralgia-like, gastrointestinal, bronchopneumonic, typhoid-like) and the rare (abdominal and painful, cerebral: meningeal and comatose, dysentery-like, tuberculosis-like, hemorrhagic). The shown features of malaria initial period in servicemen caused difficulties in its early diagnosis.

Stages life cycle of the malaria parasite differ in the rate of replication and the structural properties of functionally active A-, S-, and O-type ribosomes. Regions of A-type rDNA including ITS1, 5.8S, and ITS2 from two strains of Plasmodium vivax with different incubation periods were amplified and sequenced. No substantial differences in the sequences of two strains were revealed. Phylogenetic analysis of the obtained and homologous sequences of ITS1 rDNA of A, S, and O types of P. vivax; A and S types of P. falciparum; and Cryptosporidium parvum, Eimeria maxima, Toxoplasma gondii as outgroup, by the maximum parsimony method using PAUP 4.0 revealed that divergence of ITS1 might have occurred after speciation and at different rates in individual lineages of the Plasmodium genus. Basing on the results of the analysis of orthologous sequences of P. vivax and P. falciparum, we developed genus- and species-specific primers for PCR diagnostics of malaria, as well as a one-step effective method of DNA isolation from Giemsa-Romanovsky-stained thick blood smears. It was demonstrated that stained preparations could be a reliable source of plasmodial DNA, and the quality of preparations and storage time (10-20 years) did not interfere with the results of PCR analysis.

Analyzing 66 cases of imported malaria, recorded among the patients treated at Moscow Infective Clinical Hospital No. 1 has indicated that despite its typical clinical picture and specific epidemiological history, the prehospital diagnosis of tropical and vivax malaria was correctly made in 20 and 22% of patients, respectively. As few as 3 patients had chemoprophylaxis on an individual basis during their stay in the focus, but they did not comply with the regimen recommended. The severity of the disease, in non-immunized patients with tropical malaria, in particular, is related to the time of admittance (diagnosis) and to that of the initiation of adequate specific treatment.

Aim: The study of possibility of reappearance of malaria foci in the Donets region., Materials and Methods: 322 cases of imported malaria (IM) in the Donets region registered in 1979-1997 have been analysed clinically and epidemiologically. Malaria was diagnosed in immigrants from and visitors to Africa, Asia and Latin America, malaria-endemic Azerbaidjan, Tadzhikistan, Afghanistan., Results: Late diagnosis of malaria occurred in immigrants and businessmen who got infected during their business trips. Causative agents of malaria imported from Azerbaijan and Asia were resistant to chemoprophylaxis with delagil and primaxine. Clinical forms of IM are described., Conclusion: There is a real danger of malaria reappearance in the Donetsk region as the residents are at risk of being infected from late-diagnosis foreign tourists, immigrants, refugees.

The paper gives a review of present-day drugs effective against malaria, provides the result of a clinical trial of melloquine, fansidar, fansimeph, chlorochine in diverse malaria forms. The choice of the drug should be individual, basing on the disease severity, form and resistance of tropical malaria causative agent.

To develop new approaches to diagnostics and therapy of malaria, we carried out immunochemical study of the surface proteins of the tropical malaria parasite Plasmodium falciparum with the use of synthetic peptides corresponding to the suggested antigenic determinants of the parasite proteins. Rabbit antisera raised against the synthetic peptides bound to parasite proteins as shown by ELISA and immunoblotting. Affinity purified anti-peptide antibodies inhibited, in some cases, the parasite growth in the human erythrocytes culture.

415 nonimmune patients with acute signs and symptoms of falciparum malaria have been examined. The study has shown that 2/3 of patients had a moderate form of the disease, a severe form was noted only in 4.57% of patients. Classical symptoms of malaria--chill, body ache, headache--were observed only in half of the patients, 1/3 of patients had so-called masks of malaria--respiratory catarrh, pharyngitis, allergy, symptoms of enterocolitis. Early diagnosis and complex treatment with chloroquine or chloroquine combined with fansidar (1.16% of patients) promoted to a rapid improvement of the clinical symptoms and to favourable outcome. No fatal outcomes or severe complications have been observed. The mean duration of the disability period was 8.9 days. The first-degree resistance to chloroquine (clinical data) was noted in 11 patients, repeated manifestations of malaria occurred in 8.12% of patients and were more severe.

A relatively high sensitivity and specificity of indirect enzyme immunoassay using the antibody obtained from the blood of patients with P. falciparum-induced malaria in the acute period have been demonstrated. The substrate for antigen isolation is available and can be easily obtained in sufficient quantities.

In a colony with nonimmune foreigners in Maputo city (Mozambique People's Republic) active detection and treatment of patients suffering from malaria has been carried out for 1.5 years. It was shown that even in a city with some hyper- and mesoendemic regions where less than 10% of colony members were treated with chemoprophylaxis, yearly morbidity among them did not surpass 20-30 cases per 1000 population. Such index is considered to be admissible risk for health if adequate diagnosis and treatment of infection is available. Despite predominance of drug-resistant strains of tropical malaria agents among the local population, resistance to chlorochin or phancidar was observed in 3 foreign patients out of 31. In one case the clinical pattern of infection was atypical.

The authors analyze 36 cases of malaria, mainly imported. It was noted that local cases of malaria appear against the background of an increase of the incidence of imported malaria. The authors stress the fact of defects of primary diagnosis of malaria, the possibility of vaccinated cases and pathogen carrier state. The tactics of chemoprophylaxis of malaria is discussed.