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Peer-reviewedCC BY 4.0Infection

Delayed diagnosis of Plasmodium vivax malaria and associated factors among Thai patients and patients from neighboring countries at the Hospital for Tropical Diseases, Bangkok, Thailand

  • Sakarn Charoensakulchai1,2
  • Noppadon Tangpukdee3,4
  • Polrat Wilairatana3,4
  • Srivicha Krudsood4,5
  • Wiwat Chancharoenthana3
  • Sant Muangnoicharoen3
  • Panita Looareesuwan1,6
6 affiliations
  1. 1Thai Travel Clinic, Hospital for Tropical Diseases, Faculty of Tropical Medicine, Mahidol University, Bangkok, 10400 Thailand
  2. 2Department of Preventive and Social Medicine, Faculty of Medicine, Srinakharinwirot University, Nakhon Nayok, 26120 Thailand
  3. 3Department of Clinical Tropical Medicine, Faculty of Tropical Medicine, Mahidol University, Bangkok, 10400 Thailand
  4. 4Clinical Malaria Research Unit, Faculty of Tropical Medicine, Mahidol University, Bangkok, 10400 Thailand
  5. 5Department of Tropical Hygiene, Faculty of Tropical Medicine, Mahidol University, Bangkok, 10400 Thailand
  6. 6Department of Social and Environmental Medicine, Faculty of Tropical Medicine, Mahidol University, Bangkok, 10400 Thailand
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Abstract

Purpose: Plasmodium vivax is the predominant malaria species in Southeast Asia, yet diagnosis may be delayed in non-endemic urban settings where clinicians encounter malaria infrequently. This study described patient characteristics and identified factors associated with delayed diagnosis of P. vivax malaria at the Hospital for Tropical Diseases (HTD), Bangkok, Thailand.

Methods: A retrospective study was conducted among patients admitted with P. vivax malaria at HTD between 2010 and 2024. Data collected included demographics, travel history, illness and healthcare-seeking history prior to admission, clinical manifestations, laboratory findings, and outcomes. Characteristics of patients with and without delayed diagnosis were compared. Logistic regression was used to identify factors independently associated with delayed diagnosis.

Results: Among 384 patients, 58.3% experienced delayed diagnosis (> 4 days from symptom onset). Care-seeking delay (> 3 days) occurred in 73.7%, medical diagnostic delay (> 1 day) in 14.1%, and misdiagnosis at the first healthcare facility in 25.5%. Independent factors of delayed diagnosis included age 45–54 years (adjusted odds ratio [AOR] 2.79; 95% CI 1.12–6.94; p = 0.027); working as an employee/office worker/business owner (AOR 4.93; 95% CI 1.19–20.50; p = 0.028); no prior history of malaria (AOR 2.36; 95% CI 1.26–4.42; p = 0.008); and misdiagnosis at the first healthcare facility (AOR 2.99; 95% CI 1.52–5.89; p = 0.002).

Conclusion: Delayed P. vivax malaria diagnosis was common in this urban near-elimination setting, with care-seeking delay contributing more than medical diagnostic delay. Age 45–54 years, office-based occupation, no prior history of malaria, and initial misdiagnosis were independently associated with delayed diagnosis. Malaria should be considered in febrile patients with relevant epidemiological exposure.

Supplementary Information: The online version contains supplementary material available at https://doi.org/10.1007/s15010-026-02930-8.

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Cite

BibTeXRIS
BibTeX
@article{charoensakulchai2026delayed,
  title = {{Delayed diagnosis of Plasmodium vivax malaria and associated factors among Thai patients and patients from neighboring countries at the Hospital for Tropical Diseases, Bangkok, Thailand}},
  author = {Sakarn Charoensakulchai and Noppadon Tangpukdee and Polrat Wilairatana and Srivicha Krudsood and Wiwat Chancharoenthana and Sant Muangnoicharoen and Panita Looareesuwan},
  journal = {Infection},
  year = {2026},
  month = aug,
  doi = {10.1007/s15010-026-02930-8},
  url = {https://doi.org/10.1007/s15010-026-02930-8},
  note = {CC BY 4.0},
}
RIS
TY  - JOUR
TI  - Delayed diagnosis of Plasmodium vivax malaria and associated factors among Thai patients and patients from neighboring countries at the Hospital for Tropical Diseases, Bangkok, Thailand
AU  - Sakarn Charoensakulchai
AU  - Noppadon Tangpukdee
AU  - Polrat Wilairatana
AU  - Srivicha Krudsood
AU  - Wiwat Chancharoenthana
AU  - Sant Muangnoicharoen
AU  - Panita Looareesuwan
PY  - 2026
DA  - 2026/08/17
JO  - Infection
DO  - 10.1007/s15010-026-02930-8
UR  - https://doi.org/10.1007/s15010-026-02930-8
AB  - Purpose: Plasmodium vivax is the predominant malaria species in Southeast Asia, yet diagnosis may be delayed in non-endemic urban settings where clinicians encounter malaria infrequently. This study described patient characteristics and identified factors associated with delayed diagnosis of P. vivax malaria at the Hospital for Tropical Diseases (HTD), Bangkok, Thailand.  Methods: A retrospective study was conducted among patients admitted with P. vivax malaria at HTD between 2010 and 2024. Data collected included demographics, travel history, illness and healthcare-seeking history prior to admission, clinical manifestations, laboratory findings, and outcomes. Characteristics of patients with and without delayed diagnosis were compared. Logistic regression was used to identify factors independently associated with delayed diagnosis.  Results: Among 384 patients, 58.3% experienced delayed diagnosis (> 4 days from symptom onset). Care-seeking delay (> 3 days) occurred in 73.7%, medical diagnostic delay (> 1 day) in 14.1%, and misdiagnosis at the first healthcare facility in 25.5%. Independent factors of delayed diagnosis included age 45–54 years (adjusted odds ratio [AOR] 2.79; 95% CI 1.12–6.94; p = 0.027); working as an employee/office worker/business owner (AOR 4.93; 95% CI 1.19–20.50; p = 0.028); no prior history of malaria (AOR 2.36; 95% CI 1.26–4.42; p = 0.008); and misdiagnosis at the first healthcare facility (AOR 2.99; 95% CI 1.52–5.89; p = 0.002).  Conclusion: Delayed P. vivax malaria diagnosis was common in this urban near-elimination setting, with care-seeking delay contributing more than medical diagnostic delay. Age 45–54 years, office-based occupation, no prior history of malaria, and initial misdiagnosis were independently associated with delayed diagnosis. Malaria should be considered in febrile patients with relevant epidemiological exposure.  Supplementary Information: The online version contains supplementary material available at https://doi.org/10.1007/s15010-026-02930-8.
SN  - 0300-8126
SN  - 1439-0973
ER  -