Declining Malaria Burden and Changing Species Distribution: A Twenty-Four-Year Retrospective Hospital-Based Study (2002–2025) in Mangaluru, India
4 affiliations
- 1University of South Florida Health, Tampa, Florida, USA.
- 2ICMR-National Institute of Malaria Research, New Delhi, India.
- 3Department of Applied Zoology, Mangaluru University, Mangaluru, India.
- 4ICMR-Regional Medical Research Centre, Bhubaneswar, Odisha, India
Abstract
Background:: Malaria elimination is hindered by incomplete treatment and inadequate post- treatment follow-up, particularly among migrant and socioeconomically vulnerable populations. The increasing predominance of Plasmodium vivax further complicates elimination efforts.
Methods:: We conducted a 24-year retrospective hospital-based study (2002–2025) at Government Wenlock Hospital, Mangaluru, Karnataka, India, a tertiary health care center serving a historically malaria-endemic region characterized by rapid urbanization and a large migrant workforce. Suspected cases were clinically evaluated and confirmed by blinded microscopic examination of peripheral blood smears. Species distribution, parasitemia, treatment status, day-7 follow-up, and temporal and seasonal trends were analyzed using R and Python.
Results:: Among 345,544 suspected cases, 78,053 (22.59%) were microscopy-confirmed. Malaria positivity declined from 24.83% in 2002 to 0.35% in 2025. In 2025, P. vivax accounted for 66.7% of infections and P. falciparum for 33.3%; no mixed infections were detected. Parasitemia was highest in P. falciparum, followed by mixed and P. vivax infections. The proportion of P. vivax increased from 53.39% in 2005 to 86.95% in 2022, whereas P. falciparum declined from 45.15% to 10.81%. Although malaria cases were often concentrated during the post-monsoon period, the timing and magnitude of seasonal peaks varied substantially across years.
Conclusions:: Malaria declined markedly over the study period, but poor post-treatment follow-up and the increasing predominance of P. vivax remain important barriers to elimination. Strengthened patient tracking, treatment-completion monitoring, and species- specific surveillance are needed, particularly for migrant populations.
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BibTeX
@article{mukhi2026declining,
title = {{Declining Malaria Burden and Changing Species Distribution: A Twenty-Four-Year Retrospective Hospital-Based Study (2002–2025) in Mangaluru, India}},
author = {Benudhar Mukhi and Chandan Kumar and Prince Kumar and D Pradeep and Mahesh Chandra Sahu and Anup Kumar R. Anvikar and Susanta Kumar Ghosh and Dipak Kumar Raj},
journal = {Fortune journal of health sciences},
year = {2026},
month = oct,
doi = {10.26502/fjhs.447},
url = {https://doi.org/10.26502/fjhs.447},
note = {CC BY 4.0},
}
RIS
TY - JOUR
TI - Declining Malaria Burden and Changing Species Distribution: A Twenty-Four-Year Retrospective Hospital-Based Study (2002–2025) in Mangaluru, India
AU - Benudhar Mukhi
AU - Chandan Kumar
AU - Prince Kumar
AU - D Pradeep
AU - Mahesh Chandra Sahu
AU - Anup Kumar R. Anvikar
AU - Susanta Kumar Ghosh
AU - Dipak Kumar Raj
PY - 2026
DA - 2026/10/05
JO - Fortune journal of health sciences
DO - 10.26502/fjhs.447
UR - https://doi.org/10.26502/fjhs.447
AB - Background:: Malaria elimination is hindered by incomplete treatment and inadequate post- treatment follow-up, particularly among migrant and socioeconomically vulnerable populations. The increasing predominance of Plasmodium vivax further complicates elimination efforts. Methods:: We conducted a 24-year retrospective hospital-based study (2002–2025) at Government Wenlock Hospital, Mangaluru, Karnataka, India, a tertiary health care center serving a historically malaria-endemic region characterized by rapid urbanization and a large migrant workforce. Suspected cases were clinically evaluated and confirmed by blinded microscopic examination of peripheral blood smears. Species distribution, parasitemia, treatment status, day-7 follow-up, and temporal and seasonal trends were analyzed using R and Python. Results:: Among 345,544 suspected cases, 78,053 (22.59%) were microscopy-confirmed. Malaria positivity declined from 24.83% in 2002 to 0.35% in 2025. In 2025, P. vivax accounted for 66.7% of infections and P. falciparum for 33.3%; no mixed infections were detected. Parasitemia was highest in P. falciparum, followed by mixed and P. vivax infections. The proportion of P. vivax increased from 53.39% in 2005 to 86.95% in 2022, whereas P. falciparum declined from 45.15% to 10.81%. Although malaria cases were often concentrated during the post-monsoon period, the timing and magnitude of seasonal peaks varied substantially across years. Conclusions:: Malaria declined markedly over the study period, but poor post-treatment follow-up and the increasing predominance of P. vivax remain important barriers to elimination. Strengthened patient tracking, treatment-completion monitoring, and species- specific surveillance are needed, particularly for migrant populations.
SN - 2644-2906
ER -