Diversity and spatial distribution of malaria vectors in the WHO Eastern Mediterranean region from 1900 to 2024: a systematic review

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BACKGROUND: Malaria remains a major public health challenge in the WHO Eastern Mediterranean region, transmitted by various Anopheles species. The main objective of this review was to collect the knowledge on the diversity and spatial distribution of malaria vectors in the World Health Organization (WHO) Eastern Mediterranean region. METHODS: A comprehensive literature search was conducted in PubMed, Web of Science, and Scopus through August 2024 using the terms "Anopheles", "malaria vector", and relevant country names. Eligible field studies documenting captures of adult or larval Anopheles with detailed information about the capture locations (including both rural and urban areas, as well as various breeding sites and feeding behaviours), were systematically included. Out of 3637 identified publications, 276 met the inclusion criteria. RESULTS: This systematic review identified 45 species of Anopheles mosquitoes documented across the WHO Eastern Mediterranean region, reflecting substantial ecological diversity. Most research has concentrated on five principal species: Anopheles stephensi (102 studies), Anopheles superpictus (57), Anopheles dthali (49), Anopheles culicifacies (47), and Anopheles maculipennis (45). A total of 18 countries were represented, with Iran contributing the largest share of studies (122 studies), followed by Pakistan (35), Sudan (31), Egypt (30), Morocco (14), Saudi Arabia (14), Iraq (7), Afghanistan (6), while the remaining countries had fewer than five studies each. CONCLUSIONS: This review highlights the critical need for ongoing monitoring and surveillance of Anopheles populations to identify shifts in distribution and abundance. Such information is essential for timely interventions and adapting control measures in response to emerging threats.

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