{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,10,23]],"date-time":"2026-10-23T20:41:53Z","timestamp":1792788113053,"version":"4.5.0"},"reference-count":32,"publisher":"Springer Science and Business Media LLC","issue":"1","license":[{"start":{"date-parts":[[2026,7,8]],"date-time":"2026-07-08T00:00:00Z","timestamp":1783468800000},"content-version":"tdm","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0"},{"start":{"date-parts":[[2026,10,2]],"date-time":"2026-10-02T00:00:00Z","timestamp":1790899200000},"content-version":"vor","delay-in-days":86,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0"}],"funder":[{"name":"The Science and Technology Program of Xi\u2019an","award":["24LLRHZDZX0028"],"award-info":[{"award-number":["24LLRHZDZX0028"]}]},{"name":"University-Industry-Research Innovation Fund of the Ministry of Education of the People's Republic of China","award":["2025MR003"],"award-info":[{"award-number":["2025MR003"]}],"id":[{"id":"https:\/\/ror.org\/01mv9t934","id-type":"ROR","asserted-by":"crossref"}]}],"content-domain":{"domain":["link.springer.com"],"crossmark-restriction":false},"short-container-title":["Malar J"],"abstract":"<jats:title>Abstract<\/jats:title>\n                  <jats:sec>\n                    <jats:title>Background<\/jats:title>\n                    <jats:p>Malaria remains a major public health challenge in Malawi, yet contemporary epidemiological data from northern Malawi are limited. This study aimed to characterize the prevalence, demographic distribution, temporal patterns, and parasite density of malaria using routine laboratory surveillance data from a tertiary referral hospital.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods<\/jats:title>\n                    <jats:p>\n                      A retrospective cross-sectional study was conducted using malaria screening records from Mzuzu Central Hospital, northern Malawi, collected between January 2017 and August 2025. Laboratory-confirmed malaria cases and malaria-negative individuals were included to estimate malaria prevalence across demographic and temporal subgroups. Malaria prevalence was compared using the \u03c7\n                      <jats:sup>2<\/jats:sup>\n                      test or Fisher's exact test, with Bonferroni correction for multiple comparisons. Parasite density, available for a subset of confirmed cases from 2024\u20132025, was summarized as median (interquartile range [IQR]) and compared using the Mann\u2013Whitney U test or Kruskal\u2013Wallis test.\n                    <\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>\n                      A total of 31,253 individuals were screened, of whom 3405 were laboratory-confirmed malaria cases, yielding an overall prevalence of 10.89%.\n                      <jats:italic>Plasmodium falciparum<\/jats:italic>\n                      accounted for 86.23% of identified infections. Malaria prevalence was significantly higher among males than females (11.85% vs. 10.01%, P\u2009&lt;\u20090.001). Children aged\u2009&lt;\u20095\u00a0years (13.11%) and 5\u201314\u00a0years (13.31%) had significantly higher prevalence than adults (P\u2009&lt;\u20090.001). Annual malaria prevalence ranged from 7.99 to 12.81% during 2018\u20132024. Clear seasonal variation was observed, with prevalence consistently peaking during the second quarter (April\u2013June) and declining during the third quarter (July\u2013September). Parasite density decreased significantly with age (p\u2009&lt;\u20090.001), with children aged 5\u201314\u00a0years showing the highest median density (6,285 parasites\/\u03bcL), but did not differ by gender or season.\n                    <\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusions<\/jats:title>\n                    <jats:p>Malaria remains highly endemic in northern Malawi, with substantial age- and season-related heterogeneity in transmission. Children younger than 15\u00a0years experienced both the highest malaria prevalence and parasite densities, while transmission increased during and immediately after the rainy season. These findings provide updated region\u2011specific evidence to support targeted, age\u2011 and season\u2011tailored malaria control strategies, and highlight the need for strengthened surveillance and preventive interventions in high\u2011risk populations.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1186\/s12936-026-06046-0","type":"journal-article","created":{"date-parts":[[2026,7,8]],"date-time":"2026-07-08T16:55:02Z","timestamp":1783529702000},"update-policy":"https:\/\/doi.org\/10.1007\/springer_crossmark_policy","source":"Crossref","is-referenced-by-count":0,"title":["Malaria prevalence and epidemiological characteristics in Northern Malawi: a nine-year retrospective hospital-based study"],"prefix":"10.1186","volume":"25","author":[{"given":"Qian","family":"Wu","sequence":"first","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Qi","family":"Zhang","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Dokani Michael","family":"Ndovi","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Shangwu","family":"Liu","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Xiaoxuan","family":"He","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Yanfen","family":"Ma","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Jian","family":"Hu","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Ying","family":"Li","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Thomas Stuart","family":"Mughogho","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Xiaoqin","family":"Wang","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"297","published-online":{"date-parts":[[2026,7,8]]},"reference":[{"issue":"7","key":"6046_CR1","doi-asserted-by":"publisher","first-page":"640","DOI":"10.1016\/j.cmi.2015.03.017","volume":"21","author":"SB Millar","year":"2015","unstructured":"Millar SB, Cox-Singh J. Human infections with Plasmodium knowlesi--zoonotic malaria. Clin Microbiol Infect. 2015;21(7):640\u20138.","journal-title":"Clin Microbiol Infect"},{"issue":"8","key":"6046_CR2","doi-asserted-by":"publisher","DOI":"10.1371\/journal.pmed.1000324","volume":"7","author":"JT Griffin","year":"2010","unstructured":"Griffin JT, Hollingsworth TD, Okell LC, Churcher TS, White M, Hinsley W, et al. Reducing Plasmodium falciparum malaria transmission in Africa: a model-based evaluation of intervention strategies. PLoS Med. 2010;7(8):e1000324.","journal-title":"PLoS Med"},{"issue":"7657","key":"6046_CR3","doi-asserted-by":"publisher","first-page":"1362","DOI":"10.1136\/bmj.a153","volume":"336","author":"DG Lalloo","year":"2008","unstructured":"Lalloo DG, Hill DR. Preventing malaria in travellers. BMJ. 2008;336(7657):1362\u20136.","journal-title":"BMJ"},{"key":"6046_CR4","volume-title":"World malaria report 2024: addressing inequity in the global malaria response","author":"World Health Organization","year":"2025","unstructured":"World Health Organization. World malaria report 2024: addressing inequity in the global malaria response. Geneva: World Health Organization; 2025."},{"key":"6046_CR5","unstructured":"World Health Organization. 2020 World malaria report. vol. WHO\/HTM\/GM, World Health. 2020;238."},{"key":"6046_CR6","volume-title":"World malaria report","author":"World Health Organization","year":"2023","unstructured":"World Health Organization. World malaria report. Geneva: World Health Organization; 2023."},{"key":"6046_CR7","doi-asserted-by":"publisher","DOI":"10.30875\/9789287074560","volume-title":"World malaria report 2025","author":"World Health Organization","year":"2025","unstructured":"World Health Organization. World malaria report 2025. Geneva: World Health Organization; 2025."},{"key":"6046_CR8","unstructured":"Malawi health management information systems.\u00a0https:\/\/dhis2.health.gov.mw\/dhis-web-commons\/security\/login.action#\/"},{"key":"6046_CR9","volume-title":"The National Malaria Strategic Plan 2023\u20132030","author":"National Malaria Control Programme (NMCP)","year":"2023","unstructured":"National Malaria Control Programme (NMCP). The National Malaria Strategic Plan 2023\u20132030. Lilongwe: Ministry of Health, Malawi; 2023."},{"issue":"3","key":"6046_CR10","doi-asserted-by":"publisher","first-page":"212","DOI":"10.1016\/j.actatropica.2011.06.017","volume":"121","author":"DP Mathanga","year":"2012","unstructured":"Mathanga DP, Walker ED, Wilson ML, Ali D, Taylor TE, Laufer MK. Malaria control in Malawi: current status and directions for the future. Acta Trop. 2012;121(3):212\u20137.","journal-title":"Acta Trop"},{"issue":"4","key":"6046_CR11","first-page":"277","volume":"9","author":"B Kim","year":"2016","unstructured":"Kim B, Chang S, Shin MJ, Hong P, Lee G, Koh MJ, et al. Patterns of pediatric malaria incidence and outcomes in Kasungu, Malawi in 2016. Adv Infect Dis. 2016;9(4):277\u201384.","journal-title":"Adv Infect Dis"},{"issue":"12","key":"6046_CR12","first-page":"897","volume":"4","author":"V Mpanga","year":"2014","unstructured":"Mpanga V, Maluwa A, Kafulafula U, Pindani M, Bultemeier K. Comprehension of risk factors of malaria during pregnancy among pregnant women attending antenatal care in Malawi. Open J Nurs. 2014;4(12):897\u2013905.","journal-title":"Open J Nurs"},{"key":"6046_CR13","doi-asserted-by":"publisher","DOI":"10.4102\/SAJPSYCHIATRY.v31i0.2591","volume":"31","author":"N Chidzere","year":"2025","unstructured":"Chidzere N, Munthali C, Chapweteka G, Munthali T, Kumwenda P, Chikasema B, et al. Prevalence of anxiety and associated factors among guardians of children admitted with severe malaria at Thyolo District Hospital in Malawi. S Afr J Psychiatr. 2025;31:2591.","journal-title":"S Afr J Psychiatr"},{"key":"6046_CR14","doi-asserted-by":"publisher","first-page":"3219","DOI":"10.2147\/IDR.S312519","volume":"14","author":"OB Awosolu","year":"2021","unstructured":"Awosolu OB, Yahaya ZS, Farah Haziqah MT. Prevalence, Parasite Density and Determinants of Falciparum Malaria Among Febrile Children in Some Peri-Urban Communities in Southwestern Nigeria: A Cross-Sectional Study. Infect Drug Resist. 2021;14:3219\u201332.","journal-title":"Infect Drug Resist"},{"key":"6046_CR15","doi-asserted-by":"publisher","DOI":"10.1186\/s12936-024-05035-5","volume":"23","author":"R Carshon-Marsh","year":"2024","unstructured":"Carshon-Marsh R, Bondy S, Witek T, Jha P. Validation of malaria-attributed deaths using verbal autopsy studies: a systematic review. Malar J. 2024;23:217.","journal-title":"Malar J"},{"key":"6046_CR16","doi-asserted-by":"publisher","DOI":"10.1016\/j.jinf.2024.01.006","volume":"88","author":"IU Ogbuanu","year":"2024","unstructured":"Ogbuanu IU, Otieno K, Varo R, Sow SO, Ojulong J, Duduyemi B, et al. Burden of child mortality from malaria in high endemic areas: results from the CHAMPS network using minimally invasive tissue sampling. J Infect. 2024;88:106107.","journal-title":"J Infect"},{"issue":"9","key":"6046_CR17","doi-asserted-by":"publisher","DOI":"10.1371\/journal.pone.0045542","volume":"7","author":"I Felger","year":"2012","unstructured":"Felger I, Maire M, Bretscher MT, Falk N, Tiaden A, Sama W, et al. The dynamics of natural Plasmodium falciparum infections. PLoS ONE. 2012;7(9):e45542.","journal-title":"PLoS ONE"},{"key":"6046_CR18","doi-asserted-by":"publisher","DOI":"10.7554\/eLife.35832","volume":"7","author":"I Rodriguez-Barraquer","year":"2018","unstructured":"Rodriguez-Barraquer I, Arinaitwe E, Jagannathan P, Kamya MR, Rosenthal PJ, Rek J, et al. Quantification of anti-parasite and anti-disease immunity to malaria as a function of age and exposure. Elife. 2018;7:e35832.","journal-title":"Elife"},{"issue":"2","key":"6046_CR19","doi-asserted-by":"publisher","first-page":"192","DOI":"10.1093\/infdis\/jit116","volume":"208","author":"NJ White","year":"2013","unstructured":"White NJ, Turner GD, Day NP, Dondorp AM. Lethal malaria: Marchiafava and Bignami were right. J Infect Dis. 2013;208(2):192\u20138.","journal-title":"J Infect Dis"},{"issue":"1","key":"6046_CR20","doi-asserted-by":"publisher","DOI":"10.1016\/j.heliyon.2021.e05975","volume":"7","author":"OB Awosolu","year":"2021","unstructured":"Awosolu OB, Yahaya ZS, Farah Haziqah MT, Simon-Oke IA, Fakunle C. A cross-sectional study of the prevalence, density, and risk factors associated with malaria transmission in urban communities of Ibadan, Southwestern Nigeria. Heliyon. 2021;7(1):e05975.","journal-title":"Heliyon"},{"issue":"1","key":"6046_CR21","doi-asserted-by":"publisher","first-page":"55","DOI":"10.1186\/s13071-018-2654-6","volume":"11","author":"D Gebretsadik","year":"2018","unstructured":"Gebretsadik D, Feleke DG, Fiseha M. Eight-year trend analysis of malaria prevalence in Kombolcha, South Wollo, north-central Ethiopia: a retrospective study. Parasit Vectors. 2018;11(1):55.","journal-title":"Parasit Vectors"},{"issue":"1","key":"6046_CR22","doi-asserted-by":"publisher","DOI":"10.1186\/s12936-020-03353-y","volume":"19","author":"DF Escobar","year":"2020","unstructured":"Escobar DF, Lucchi NW, Abdallah R, Valenzuela MT, Udhayakumar V, Jercic MI, et al. Molecular and epidemiological characterization of imported malaria cases in Chile. Malar J. 2020;19(1):289.","journal-title":"Malar J"},{"issue":"3","key":"6046_CR23","doi-asserted-by":"publisher","first-page":"167","DOI":"10.1016\/j.actatropica.2010.08.005","volume":"116","author":"GH Stresman","year":"2010","unstructured":"Stresman GH. Beyond temperature and precipitation: ecological risk factors that modify malaria transmission. Acta Trop. 2010;116(3):167\u201372.","journal-title":"Acta Trop"},{"key":"6046_CR24","doi-asserted-by":"publisher","first-page":"83","DOI":"10.1186\/1475-2875-10-83","volume":"10","author":"J Pulford","year":"2011","unstructured":"Pulford J, Hetzel MW, Bryant M, Siba PM, Mueller I. Reported reasons for not using a mosquito net when one is available: a review of the published literature. Malar J. 2011;10:83.","journal-title":"Malar J"},{"issue":"2","key":"6046_CR25","doi-asserted-by":"publisher","first-page":"65","DOI":"10.4103\/1117-1936.181014","volume":"15","author":"EI Ikeh","year":"2008","unstructured":"Ikeh EI, Teclaire NN. Prevalence of malaria parasitaemia and associated factors in febrile under-5 children seen in Primary Health Care Centres in Jos, North Central Nigeria. Niger Postgrad Med J. 2008;15(2):65\u20139.","journal-title":"Niger Postgrad Med J"},{"issue":"5","key":"6046_CR26","doi-asserted-by":"publisher","first-page":"264","DOI":"10.4314\/afrrev.v5i5.21","volume":"5","author":"OC Nwaorgu","year":"2011","unstructured":"Nwaorgu OC, Orajaka BN. Prevalence of malaria among children 1\u201310 years old in communities in awka north local government area, Anambra State South East Nigeria. African Res Rev. 2011;5(5):264\u201381.","journal-title":"African Res Rev"},{"key":"6046_CR27","first-page":"154","volume":"3","author":"HK Kimbi","year":"2012","unstructured":"Kimbi HK, Keka FC, Nyabeyeu HN, Ajeagah HU, Tonga CF. An update of asymptomatic falciparum malaria in school children in Muea. Southwest Cameroon J Bacteriol Parasitol. 2012;3:154.","journal-title":"Southwest Cameroon J Bacteriol Parasitol"},{"issue":"1","key":"6046_CR28","first-page":"14","volume":"38","author":"OB Awosolu","year":"2021","unstructured":"Awosolu OB, Yahaya ZS, Farah Haziqah MT, Simon-Oke IA, Olanipekun IT, Oniya MO. Epidemiology of falciparum malaria among residents of some rural and periurban communities in Ekiti State. Southwestern Nigeria Trop Biomed. 2021;38(1):14\u201321.","journal-title":"Southwestern Nigeria Trop Biomed"},{"issue":"4","key":"6046_CR29","doi-asserted-by":"publisher","first-page":"1371","DOI":"10.1007\/s40121-022-00647-3","volume":"11","author":"JC Semenza","year":"2022","unstructured":"Semenza JC, Rockl\u00f6v J, Ebi KL. Climate change and cascading risks from infectious disease. Infect Dis Ther. 2022;11(4):1371\u201390.","journal-title":"Infect Dis Ther"},{"issue":"23","key":"6046_CR30","doi-asserted-by":"publisher","DOI":"10.3390\/ijerph192315578","volume":"19","author":"L Pascoe","year":"2022","unstructured":"Pascoe L, Clemen T, Bradshaw K, Nyambo D. Review of importance of weather and environmental variables in agent-based arbovirus models. Int J Environ Res Public Health. 2022;19(23):15578.","journal-title":"Int J Environ Res Public Health"},{"issue":"1","key":"6046_CR31","doi-asserted-by":"publisher","DOI":"10.1186\/s12889-019-6565-z","volume":"19","author":"T Rouamba","year":"2019","unstructured":"Rouamba T, Nakanabo-Diallo S, Derra K, Rouamba E, Kazienga A, Inoue Y, et al. Socioeconomic and environmental factors associated with malaria hotspots in the Nanoro demographic surveillance area, Burkina Faso. BMC Public Health. 2019;19(1):249.","journal-title":"BMC Public Health"},{"issue":"1","key":"6046_CR32","doi-asserted-by":"publisher","DOI":"10.1038\/s41598-022-05056-7","volume":"12","author":"JB Yaro","year":"2022","unstructured":"Yaro JB, Tiono AB, Ouedraogo A, Lambert B, Ouedraogo ZA, Diarra A, et al. Risk of Plasmodium falciparum infection in south-west Burkina Faso: potential impact of expanding eligibility for seasonal malaria chemoprevention. Sci Rep. 2022;12(1):1402.","journal-title":"Sci Rep"}],"container-title":["Malaria Journal"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/link.springer.com\/article\/10.1186\/s12936-026-06046-0","content-type":"text\/html","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/link.springer.com\/content\/pdf\/10.1186\/s12936-026-06046-0.pdf","content-type":"application\/pdf","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/link.springer.com\/content\/pdf\/10.1186\/s12936-026-06046-0.pdf","content-type":"application\/pdf","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2026,10,1]],"date-time":"2026-10-01T23:07:06Z","timestamp":1790896026000},"score":1,"resource":{"primary":{"URL":"https:\/\/link.springer.com\/10.1186\/s12936-026-06046-0"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2026,7,8]]},"references-count":32,"journal-issue":{"issue":"1","published-online":{"date-parts":[[2026,12]]}},"alternative-id":["6046"],"URL":"https:\/\/doi.org\/10.1186\/s12936-026-06046-0","relation":{},"ISSN":["1475-2875"],"issn-type":[{"value":"1475-2875","type":"electronic"}],"subject":[],"published":{"date-parts":[[2026,7,8]]},"assertion":[{"value":"7 May 2026","order":1,"name":"received","label":"Received","group":{"name":"ArticleHistory","label":"Article History"}},{"value":"6 July 2026","order":2,"name":"accepted","label":"Accepted","group":{"name":"ArticleHistory","label":"Article History"}},{"value":"8 July 2026","order":3,"name":"first_online","label":"First Online","group":{"name":"ArticleHistory","label":"Article History"}},{"value":"This study was performed in compliance with the ethical principles set forth in the Declaration of Helsinki and received approval from the Research Ethics Committee of the Mzuzu University (Approval No. MZUNIERC\/DOR\/24\/166). The requirement for written informed consent was waived by the Ethics Committee in accordance with national legislation and institutional guidelines.","order":1,"name":"Ethics","label":"Ethics approval and consent to participate","group":{"name":"EthicsHeading","label":"Declarations"}},{"value":"The authors declare no competing interests.","order":2,"name":"Ethics","label":"Competing interests","group":{"name":"EthicsHeading","label":"Declarations"}}],"article-number":"349"}}