Seasonal Distribution and Trend Analysis of Urban Malaria Prevalence in a Malaria Clinic, South Delhi, India, between 2012 and 2019

Abstract

ABSTRACT. It is important to study the recent malaria incidence trends in urban areas resulting from rapid urbanization that can lead to changes in environmental conditions for malaria. This retrospective study assessed trends in malaria patients, their distribution according to parasite species, patient demographics, and weather data for the past 8 years at a malaria clinic in the National Institute of Malaria Research, New Delhi, India. We overlaid the effects of environmental factors such as rainfall, relative humidity, and temperature on malaria incidence. The malaria data were digitized for a period spanning 2012 to 2019, during which 36,892 patients with fever attended the clinic. Of these, 865 (2.3%) were diagnosed with malaria microscopically. Plasmodium vivax was predominant (96.2%), and very few patients were of Plasmodium falciparum (3.5%) or mixed infections (0.3%). The patients with malaria were within a 10-km radius of the clinic. Males (70.9%) were more commonly affected than females (29.1%). Of the total malaria patients, a majority (∼78%) belonged to the > 15-year age group. A total of 593 malaria patients (68.6%) received primaquine. These patients were most commonly diagnosed in April through October. Furthermore, there was a lag of 1 month between the rainfall peak and the malaria case peak. The peak in malaria cases corresponded to a mean temperature of 25 to 30°C and a relative humidity of 60% to 80%. This analysis will be useful for policymakers in evaluating current interventions and in accelerating malaria control further in urban areas of India.