Malaria epidemiology, clinical characteristics, and concurrent infections in Delhi, India: A hospital-based study

Malaria remains a public health concern in India. Here, we analysed temporal trends, clinical features, concurrent infections, and determinants of malaria in patients in Delhi-based government hospital.

A longitudinal study was conducted between July 2022 and November 2023 in febrile patients attending a government hospital in Delhi. Clinical and biological examinations were done for each patient and screened for malaria parasites by rapid malaria antigen test and light microscopy, while concurrent infections were assessed by serological tests.

A total of 4259 febrile patients were included among whom 87 (2.04 %) were infected with Plasmodium vivax and Plasmodium falciparum malaria species involved in malaria cases. The clinical presentation of cases was diverse, with a dominance of chills (80.46 %), hepatosplenomegaly (64.37), myalgia (56.32 %), generalised body ache (54.02 %), and jaundice/icterus (51.72 %). A few P. vivax- and P. falciparum-induced severe malaria cases were reported, with severe anaemia being the most frequent severe form. Nearly 45 % of malaria cases were co-infected with another pathogen (i.e., dengue virus, chikungunya virus, and Salmonella typhus). The climatic period July - September (aOR = 2.18; p < 0.05) and being male (aOR = 1.42; p < 0.05) were risk factors for malaria infection.

Plasmodium vivax and Plasmodium falciparum were found in 2.07 % patients with a slight increase between 2022 and 2023. None of the factors tested were found to be associated with co-infections (dengue, chikungunya, and typhoid fever) or severe malaria, but in contrast, the climatic period July - September and being male were risk factors for malaria infection.