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Epidemiological and clinical characteristics of imported malaria patients admitted to a specialized hospital: a retrospective study (2021- June 2026).

Created on 06 Oct 2026

Authors

Kun Peng, Wenjing Gong, Xuan Dong, Yunjing Zhao, Li Zhang, Chuanbing Zhu, Nuo Xu, Xiang Li, Yihan Guo, Yanmei Shen, Hongli Zhao

Published in

Frontiers in cellular and infection microbiology. Volume 16. Pages 1952587. Epub Sep 21, 2026.

Abstract

China was certified malaria-free by the World Health Organization in 2021; however, imported malaria remains a significant challenge to maintaining malaria elimination due to increasing international travel and overseas population mobility. Imported malaria cases have been continuously reported in Shandong Province, but detailed clinical characteristics, parasite species distribution, travel history, and treatment patterns among hospitalised malaria patients following elimination remain insufficiently characterised.
We conducted a retrospective hospital-based observational study of malaria patients admitted to our hospital in Shandong Province, China, from January 2021 to June 2026. Demographic information, travel history, clinical manifestations, laboratory findings, Plasmodium species identification, and antimalarial treatments were analysed. The associations between travel regions and Plasmodium species distribution were evaluated using chi-square tests.
A total of 120 hospitalised malaria patients were included in the analysis. The number of malaria admissions increased from two cases in 2021 to 45 cases in 2025, with seasonal clustering during the second and third quarters of the year. All patients were male, and 98.3% were aged 30-59 years. Most patients had a travel history to Africa (95.8%), particularly West Africa (54.2%) and Central Africa (28.3%). Among the 120 patients with confirmed parasite identification, Plasmodium falciparum (P. falciparum) was the predominant species (67.5%), followed by Plasmodium ovale (P. ovale) (20.0%), Plasmodium vivax (P. vivax) (7.5%), and Plasmodium malariae (P. malariae) (5.0%). Fever was observed in all patients. The distribution of Plasmodium species differed significantly according to travel regions (Monte Carlo simulated P < 0.001). Further analysis within Africa revealed a significant difference among West, Central, and East Africa (Monte Carlo simulated P = 0.016). All patients received antimalarial treatment. Artemisinin-based therapies were the main treatment strategies, with dihydroartemisinin-piperaquine used in 90.0% of patients and intravenous artesunate administered in 41.7% of cases.
Imported malaria remains a significant clinical and public health challenge following malaria elimination in Shandong Province. Cases are predominantly identified among working-age males returning from sub-Saharan Africa, with P. falciparum as the dominant parasite species. Therefore, strengthening surveillance of overseas travellers, improving early diagnosis, and maintaining standardised treatment protocols are essential to prevent the re-establishment of malaria.

PMID:
42835030
Bibliographic data and abstract were imported from PubMed on 06 Oct 2026.

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