Spatial Distribution, seasonal dynamics and molecular confirmation of malaria in District Malakand, Khyber Pakhtunkhwa, Pakistan.

BACKGROUND

Malaria is a serious public health issue in Pakistan. This study investigated the spatiotemporal patterns, seasonal dynamics, and molecular confirmation of malaria in District Malakand, Khyber Pakhtunkhwa, from 2011 to 2017.

METHODS

Clinical data were collected from the District Headquarters Hospital over 7 y. A random sample of 120 patients from 2017 was used for microscopic and molecular identification. Spatial-temporal patterns were analysed using ArcGIS (Environmental Systems Research Institute (Esri), Redlands, California, United States). Statistical analyses were performed using SPSS (IBM Corporation, Armonk, New York, United States) and R software (R Foundation for Statistical Computing, Vienna, Austria).

RESULTS

Of 41 863 tests, 6246 were positive, yielding an overall test positivity rate of 14.92%. Males (58.89%) were more affected than females. The highest proportion of cases was in the 1-20-y age group. The annual test positive rate declined from 32.97% in 2011 to 10.77% in 2017. Seasonally, autumn had the highest case proportion (46.73%); winter the lowest (7.09%). Spatial analysis identified Gharhi, Dargai and Haryankot as high-burden areas. Inverse distance weighting highlighted these as hotspots for potential transmission. PCR confirmed microscopy-based species identification.

CONCLUSIONS

Malaria in Malakand peaks in autumn, affecting males and individuals aged <20 y most. Neighbouring villages are at risk from hyper-endemic areas. Microscopy remains a dependable diagnostic tool here.