Malaria Cases in a Tertiary Hospital in Kuala Lumpur, Malaysia: A 16-Year (2005–2020) Retrospective Review

Abstract

While there has been a tremendous decline in malaria disease burden in the remote parts of Malaysia, little is known about malaria incidence in its urban localities. This study aimed to analyze trends of malaria cases in urban Kuala Lumpur, Malaysia. All suspected cases presented to a university hospital in Kuala Lumpur from January 2005 to December 2020 were examined by microscopy. Infection status was analyzed using descriptive statistics and curve estimation analysis. Of 3105 blood films examined, 92 (3%) were microscopically confirmed malaria cases. Plasmodium vivax infections accounted for the majority (36.9%) of all malaria cases. Nearly half (47.8%) of cases were found among foreign cases (p < 0.001). The majority of foreign cases were male (86.4%) and came from Southeast Asian countries (65.9%). The curve estimation analysis showed significant decreases in malaria cases due to P. vivax (R2 = 0.598; p < 0.001) and Plasmodium falciparum (R2 = 0.298, p = 0.029), but increases for Plasmodium knowlesi (R2 = 0.325, p = 0.021) during the 16 years. This study showed that malaria incidence in urban Kuala Lumpur is low and has remained stable since 2005. However, P. knowlesi has played a significant role in the increase in overall malaria in the area, highlighting the importance of continued vigilance and improved surveillance.

Naturally acquired antibody response to Plasmodium falciparum and Plasmodium vivax among indigenous Orang Asli communities in Peninsular Malaysia

“…The decline is attributed to enhanced coverage of indoor residual spraying (IRS) and better passive case detection and management practices ( WHO, 2015 ). Subsequently, the program was strengthened, and malaria has been on the national list of notifiable diseases since 1988 ( Dian et al., 2021 ). Despite having zero indigenous human malaria cases in Malaysia since 2018 ( WHO, 2020 ; Dian et al., 2022b ), malaria is still one of the public health problems.…”

Profiling the imported human malaria in Sarawak, Malaysia in 2011–2019

“…Concisely, Sarawak maintained a high number of imported cases (greater than 160 cases annually) from 2013 to 2017. Previous surveillance-based studies in Peninsular Malaysia suggested that imported malaria cases are mainly attributable foreign migrant workers [18][19][20]. To date, the demographic profile of imported malaria patients in Malaysia, especially in Sarawak, has not been studied in detail.…”

Non-Human Primate Malaria Infections: A Review on the Epidemiology in Malaysia

“…Despite the decline, approximately 627,000 malaria deaths were still recorded worldwide in 2020, with children under five and service disruptions during the COVID-19 pandemic accounting for 77% and 68% of all malaria deaths, respectively [2]. Malaria is still considered a public health problem in Malaysia and has been on the list of the national notifiable diseases since 1988 [3]. Since the early nineteenth century, it has been recognized as a serious disease in Peninsular Malaysia.…”

“…Despite the significant decrease in human malaria, the emergence of simian malaria is a major public health problem in the less developed areas of Malaysia. In particular, it is a problem among the hard-to-reach indigenous populations (i.e., Orang Asli) in Peninsular Malaysia and the remote interior communities in Malaysian Borneo [3,5,7,8]. In 2019, Malaysia recorded 3222 zoonotic malaria with six fatalities [9].…”

“…Furthermore, the influx of migrant workers from malaria-endemic countries and challenges of drug resistance have exacerbated the risk of re-emergence of the disease. Due to the large-scale clearing of forest areas for logging and agricultural purposes, Malaysia faces the problem of increasing cases of simian malaria driven by the migration of macaques to human settlements, particularly in the remote areas where the aboriginal populations live [3,5,8,10]. Although Malaysia has been recognized as one of the countries free from indigenous human malaria since 2018 [1], it is essential to acknowledge the prevalence of non-human malaria and strengthen the effectiveness of the national elimination program.…”