Clinical burden of Plasmodium infection and associated risk factors among the local population of Chakwal, Punjab, Pakistan (2019–2023)

This study aimed to determine the clinical burden, spatial dynamics, and associated risk factors of Plasmodium infection among the natives of Chakwal, Punjab Pakistan from 2019 to 2023 to guide targeted screening and treatment interventions.

A community-based cross-sectional study was conducted using primary and secondary data sources. Participants were recruited using a multi-stage cluster sampling by taking informed consent for the primary data sources. Whereas a secondary dataset of Plasmodium infection was obtained from the database of surveyed hospitals after ethical consideration. All the participants living in the study area for at least 3 months were included, while patients with chronic illness were excluded. Sociodemographic and environmental data were collected using a structured questionnaire. Plasmodium infection was diagnosed using microscopy, rapid diagnostic tests (RDTs), and nested polymerase chain reaction (PCR) as the reference standard. A Zero-inflated negative binomial logistic regression model and interpolation of malaria distribution to environmental variables were employed to determine the association and spatiotemporal patterns of malaria in Chakwal.

Among the 2457 participants, the prevalence of Plasmodium vivax infection (99%) was significantly higher than P. falciparum (0.8%) and mixed infection (0.2%). Females had a higher infection rate than males and the infection rate was higher in adults (21–40 years) and children (0–20 years). Age category (61–100), P. vivax species, temperature, rainfall, monsoon season, and mixed infection factors were significantly associated (p < 0.05) with increased Plasmodium infection risk. Geospatial mapping indicated potential malaria hotspots in Sarkal Kasar, Chak Baili, Mulkwal, Chohan, and other close areas of the Potohar region.

The clinical burden of P. vivax was the highest during monsoon season in Chakwal. Age, gender, climatic factors, and mixed infection were significant risk factors for malaria transmission in this region. Targeted screening and treatment strategies should prioritize identified hotspots and high-risk groups to effectively control malaria in Potohar region of Pakistan.