One of the most protracted post-Soviet conflicts of the 1990s was a territorial dispute between Armenia and Azerbaijan over the contested Karabakh region. Years of ethnic violence led to the displacement of nearly a million refugees, as well as a public health crisis that included epidemics of malaria, diphtheria and other preventable diseases. Malaria is not usually considered a health risk in temperate climates, but seasonal epidemics were widespread throughout the Caucasus in the early decades of the twentieth century. This paper combines qualitative historical research with geospatial analysis to explore how endemic malaria was controlled during the Soviet era, and how ethnic conflict reconfigured local ecologies to facilitate the re-emergence of P. vivax after the Soviet collapse in the 1990s. This research reveals that ethnic conflicts have specific qualities that increase risks of infectious and vector borne disease outbreaks, even in places that have successfully achieved a modern health and mortality profile. The risk amplifiers of ethnic conflicts include 1) the creation of contested spaces controlled by separatists that are outside of any national public health surveillance system; 2) mass population movements and refugee outflows due to ethnic violence; and 3) changes in land use that expand potential mosquito breeding sites throughout the conflict zone. Continued hostilities between Armenia and Azerbaijan, combined with the repopulation of key vector species (specifically An. sacharovi) lead us to conclude that populations in the Caucasus remain vulnerable to resurgent outbreaks of ethno-nationalist violence as well as the return of seasonal malaria, even after decades of successful control.

1990 年代苏联解体后最旷日持久的冲突之一是亚美尼亚和阿塞拜疆之间关于有争议的卡拉巴赫地区的领土争端。多年的种族暴力导致近百万难民流离失所，并引发了一场公共卫生危机，其中包括疟疾、白喉和其他可预防疾病的流行。在温带气候中，疟疾通常不被认为是健康风险，但在 20 世纪初的几十年里，季节性流行病在整个高加索地区普遍存在。本文将定性历史研究与地理空间分析相结合，探讨在苏联时代如何控制地方性疟疾，以及种族冲突如何重新配置​​当地生态以促进间日疟原虫的重新出现1990 年代苏联解体后。这项研究表明，种族冲突具有增加传染病和媒介传播疾病暴发风险的特定性质，即使在已成功实现现代健康和死亡率状况的地方也是如此。种族冲突的风险放大器包括 1) 在任何国家公共卫生监测系统之外创建由分离主义者控制的有争议的空间；2）由于种族暴力导致的大规模人口流动和难民外流；3) 土地利用的变化扩大了整个冲突地区潜在的蚊子滋生地。亚美尼亚和阿塞拜疆之间持续的敌对行动，加上关键病媒物种（特别是An. sacharovi）的重新繁殖使我们得出结论，即使经过数十年的成功控制，高加索地区的人口仍然容易受到再次爆发的民族主义暴力以及季节性疟疾的复发的影响。