Baseline survey for malaria prevalence in Khyber Pakhtunkhwa Province, Pakistan

Plasmodium falciparum and P. vivax are prevalent in Pakistan. Data on the epidemiology of Plasmodium infections in Khyber Pakhtunkhwa province are lacking.

This study aimed to: 1) determine the malaria prevalence in three districts of Khyber Pakhtunkhwa province with endemic malaria (Bannu, Dera Ismail Khan and Lakki Marwat); 2) determine household ownership of long-lasing insecticidal bed nets in the districts; and 3) assess malaria services in health facilities in the districts, in order to provide baseline information for malaria control in these areas.

A cross-sectional study was conducted. In total, 31 041 individuals were selected for the malaria prevalence survey, 864 households for the insecticidal net ownership survey and 98 health facilities for malaria services. Rapid diagnostic tests were used to test for malaria.

Overall, 4297 (13.8%) people tested positive for malaria. The prevalence of P. vivax, P. falciparum and mixed infection was 92.4%, 4.7% and 2.9%, respectively. The prevalence of malaria infection differed significantly between districts (P < 0.05). Prevalence was higher in people over 14 years and in women for P. vivax and P. falciparum malaria (P < 0.05). Only 44.1% of households owned one or more insecticidal nets. The most common drugs used to treat malaria were primaquine (62.5% of cases) and chloroquine (36.1%).

The prevalence of malaria infection was high in the three districts. Malaria services in the health facilities were weak. Household ownership of long-lasing insecticidal nets was low. Malaria control or elimination strategies should be strengthened in these districts.