{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,8,18]],"date-time":"2026-08-18T05:13:18Z","timestamp":1787029998973,"version":"build-2736575974"},"reference-count":40,"publisher":"MDPI AG","issue":"4","license":[{"start":{"date-parts":[[2021,9,29]],"date-time":"2021-09-29T00:00:00Z","timestamp":1632873600000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"funder":[{"name":"ASEAN Science Technology and Innovation Fund (ASTIF) from ASEAN Secretariat","award":["FF-2019-124"],"award-info":[{"award-number":["FF-2019-124"]}]},{"name":"Geran Pembiayaan Sepadan from Faculty of Medicine UKM","award":["FF-2019-124\/1"],"award-info":[{"award-number":["FF-2019-124\/1"]}]}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["TropicalMed"],"abstract":"<jats:p>While there has been a tremendous decline in malaria disease burden in the remote parts of Malaysia, little is known about malaria incidence in its urban localities. This study aimed to analyze trends of malaria cases in urban Kuala Lumpur, Malaysia. All suspected cases presented to a university hospital in Kuala Lumpur from January 2005 to December 2020 were examined by microscopy. Infection status was analyzed using descriptive statistics and curve estimation analysis. Of 3105 blood films examined, 92 (3%) were microscopically confirmed malaria cases. Plasmodium vivax infections accounted for the majority (36.9%) of all malaria cases. Nearly half (47.8%) of cases were found among foreign cases (p &lt; 0.001). The majority of foreign cases were male (86.4%) and came from Southeast Asian countries (65.9%). The curve estimation analysis showed significant decreases in malaria cases due to P. vivax (R2 = 0.598; p &lt; 0.001) and Plasmodium falciparum (R2 = 0.298, p = 0.029), but increases for Plasmodium knowlesi (R2 = 0.325, p = 0.021) during the 16 years. This study showed that malaria incidence in urban Kuala Lumpur is low and has remained stable since 2005. However, P. knowlesi has played a significant role in the increase in overall malaria in the area, highlighting the importance of continued vigilance and improved surveillance.<\/jats:p>","DOI":"10.3390\/tropicalmed6040177","type":"journal-article","created":{"date-parts":[[2021,9,28]],"date-time":"2021-09-28T21:39:29Z","timestamp":1632865169000},"page":"177","update-policy":"https:\/\/doi.org\/10.3390\/mdpi_crossmark_policy","source":"Crossref","is-referenced-by-count":7,"title":["Malaria Cases in a Tertiary Hospital in Kuala Lumpur, Malaysia: A 16-Year (2005\u20132020) Retrospective Review"],"prefix":"10.3390","volume":"6","author":[{"given":"Nor Diyana","family":"Dian","sequence":"first","affiliation":[{"name":"Department of Parasitology and Medical Entomology, Faculty of Medicine, Universiti Kebangsaan Malaysia, Kuala Lumpur 56000, Malaysia"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Ahmad Firdaus","family":"Mohd Salleh","sequence":"additional","affiliation":[{"name":"Department of Laboratory Diagnostic Service, Universiti Kebangsaan Malaysia Medical Centre, Kuala Lumpur 56000, Malaysia"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Mohd Amirul Fitri A","family":"Rahim","sequence":"additional","affiliation":[{"name":"Department of Parasitology and Medical Entomology, Faculty of Medicine, Universiti Kebangsaan Malaysia, Kuala Lumpur 56000, Malaysia"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Mohd Bakhtiar","family":"Munajat","sequence":"additional","affiliation":[{"name":"Department of Parasitology and Medical Entomology, Faculty of Medicine, Universiti Kebangsaan Malaysia, Kuala Lumpur 56000, Malaysia"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Siti Nor Azreen","family":"Abd Manap","sequence":"additional","affiliation":[{"name":"Department of Parasitology and Medical Entomology, Faculty of Medicine, Universiti Kebangsaan Malaysia, Kuala Lumpur 56000, Malaysia"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Nuraffini","family":"Ghazali","sequence":"additional","affiliation":[{"name":"Department of Parasitology and Medical Entomology, Faculty of Medicine, Universiti Kebangsaan Malaysia, Kuala Lumpur 56000, Malaysia"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Noor Wanie","family":"Hassan","sequence":"additional","affiliation":[{"name":"Department of Parasitology and Medical Entomology, Faculty of Medicine, Universiti Kebangsaan Malaysia, Kuala Lumpur 56000, Malaysia"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-4986-5393","authenticated-orcid":false,"given":"Zulkarnain Md","family":"Idris","sequence":"additional","affiliation":[{"name":"Department of Parasitology and Medical Entomology, Faculty of Medicine, Universiti Kebangsaan Malaysia, Kuala Lumpur 56000, Malaysia"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"1968","published-online":{"date-parts":[[2021,9,29]]},"reference":[{"key":"ref_1","unstructured":"(2019). World Malaria Report, World Health Organization (WHO). Available online: https:\/\/www.who.int\/publications\/i\/item\/9789241565721."},{"key":"ref_2","doi-asserted-by":"crossref","first-page":"390","DOI":"10.1186\/1475-2875-13-390","article-title":"Changing epidemiology of malaria in Sabah, Malaysia: Increasing incidence of Plasmodium knowlesi","volume":"13","author":"William","year":"2014","journal-title":"Malar. J."},{"key":"ref_3","doi-asserted-by":"crossref","first-page":"417","DOI":"10.1186\/s12936-017-2064-9","article-title":"Absence of Plasmodium inui and Plasmodium cynomolgi, but detection of Plasmodium knowlesi and Plasmodium vivax infections in asymptomatic humans in the Betong division of Sarawak, Malaysian Borneo","volume":"16","author":"Siner","year":"2017","journal-title":"Malar. J."},{"key":"ref_4","first-page":"361","article-title":"Plasmodium knowlesi malaria in Sabah, Malaysia, 2015\u20132017: Ongoing increase in incidence despite near-elimination of the human-only Plasmodium species","volume":"17","author":"Cooper","year":"2019","journal-title":"Clin. Infect. Dis."},{"key":"ref_5","doi-asserted-by":"crossref","first-page":"1709","DOI":"10.4269\/ajtmh.17-1010","article-title":"Importance of proactive malaria case surveillance and management in Malaysia","volume":"98","author":"Liew","year":"2018","journal-title":"Am. J. Trop. Med. Hyg."},{"key":"ref_6","doi-asserted-by":"crossref","first-page":"168","DOI":"10.1186\/1475-2875-13-168","article-title":"High proportion of knowlesi malaria in recent malaria cases in Malaysia","volume":"13","author":"Yusof","year":"2014","journal-title":"Malar. J."},{"key":"ref_7","doi-asserted-by":"crossref","first-page":"186","DOI":"10.1186\/1756-3305-7-186","article-title":"Spatial distribution of malaria in Peninsular Malaysia from 2000 to 2009","volume":"7","author":"Alias","year":"2014","journal-title":"Parasit. Vectors"},{"key":"ref_8","doi-asserted-by":"crossref","first-page":"436","DOI":"10.1186\/1756-3305-7-436","article-title":"Plasmodium knowlesi malaria an emerging public health problem in Hulu Selangor, Selangor, Malaysia (2009\u20132013): Epidemiologic and entomologic analysis","volume":"7","author":"Vythilingam","year":"2014","journal-title":"Parasit. Vectors"},{"key":"ref_9","first-page":"166","article-title":"Plasmodium knowlesi malaria in Malaysia","volume":"65","author":"Singh","year":"2010","journal-title":"Med. J. Malays."},{"key":"ref_10","unstructured":"World Health Organization (2015). Eliminating Malaria: Case-Study 8. Progress towards Elimination in Malaysia, Ministry of Health Malaysia and the World Health Organization and the University of California. Available online: https:\/\/apps.who.int\/iris\/handle\/10665\/149677."},{"key":"ref_11","doi-asserted-by":"crossref","first-page":"45","DOI":"10.4269\/ajtmh.17-0081","article-title":"Falciparum malaria outbreak in Sabah linked to an immigrant rubber tapper","volume":"98","author":"Jeffree","year":"2018","journal-title":"Am. J. Trop. Med. Hyg."},{"key":"ref_12","doi-asserted-by":"crossref","first-page":"41","DOI":"10.3201\/eid2201.151305","article-title":"Falling Plasmodium knowlesi malaria death rate among adults despite rising incidence, Sabah, Malaysia, 2010\u20132014","volume":"22","author":"Rajahram","year":"2016","journal-title":"Emerg. Infect. Dis."},{"key":"ref_13","doi-asserted-by":"crossref","first-page":"900","DOI":"10.1016\/S0140-6736(13)60310-4","article-title":"The changing epidemiology of malaria elimination: New strategies for new challenges","volume":"382","author":"Cotter","year":"2013","journal-title":"Lancet"},{"key":"ref_14","doi-asserted-by":"crossref","first-page":"55","DOI":"10.1186\/s12936-020-3135-x","article-title":"Updates on malaria incidence and profile in Malaysia from 2013 to 2017","volume":"19","author":"Hussin","year":"2020","journal-title":"Malar. J."},{"key":"ref_15","doi-asserted-by":"crossref","first-page":"83","DOI":"10.1016\/j.actatropica.2017.07.027","article-title":"Over two decades of Plasmodium knowlesi infections in Sarawak: Trend and forecast","volume":"176","author":"Ooi","year":"2017","journal-title":"Acta Trop."},{"key":"ref_16","doi-asserted-by":"crossref","first-page":"e2026","DOI":"10.1371\/journal.pntd.0002026","article-title":"Increasing incidence of Plasmodium knowlesi malaria following control of P. falciparum and P. vivax malaria in Sabah, Malaysia","volume":"7","author":"William","year":"2013","journal-title":"PLoS Negl. Trop. Dis."},{"key":"ref_17","doi-asserted-by":"crossref","first-page":"395","DOI":"10.1186\/s12936-020-03470-8","article-title":"Malaria distribution and performance of malaria diagnostic methods in Malaysia (1980\u20132019): A systematic review","volume":"19","author":"Rahim","year":"2020","journal-title":"Malar. J."},{"key":"ref_18","first-page":"41","article-title":"A retrospective study on malaria cases admitted to Hospital Universiti Kebangsaan Malaysia (HUKM)","volume":"2","author":"Amal","year":"2006","journal-title":"Malays. J. Med. Heath Sci."},{"key":"ref_19","doi-asserted-by":"crossref","first-page":"102055","DOI":"10.1016\/j.tmaid.2021.102055","article-title":"Malaria in urban Kuala Lumpur, Malaysia from 2005 to 2017","volume":"41","author":"Idris","year":"2021","journal-title":"Travel Med. Infect. Dis."},{"key":"ref_20","doi-asserted-by":"crossref","first-page":"840","DOI":"10.47102\/annals-acadmedsg.V38N10p840","article-title":"Epidemiological characteristics of imported and locally-acquired malaria in Singapore","volume":"38","author":"Lee","year":"2009","journal-title":"Ann. Acad. Med. Singapore"},{"key":"ref_21","doi-asserted-by":"crossref","first-page":"738","DOI":"10.1016\/j.tmaid.2014.10.016","article-title":"Malaria in a tertiary hospital in Singapore--clinical presentation, treatment and outcome: An eleven-year retrospective review","volume":"12","author":"Chung","year":"2014","journal-title":"Travel. Med. Infect. Dis."},{"key":"ref_22","doi-asserted-by":"crossref","first-page":"299","DOI":"10.3347\/kjp.2009.47.3.299","article-title":"Imported malaria in Korea: A 13-year experience in a single center","volume":"47","author":"Cheong","year":"2009","journal-title":"Korean J. Parasitol."},{"key":"ref_23","doi-asserted-by":"crossref","first-page":"682","DOI":"10.1016\/j.jiac.2018.02.003","article-title":"Characteristics of health problems in returned overseas travelers at a tertiary teaching hospital in a suburban area in Japan","volume":"24","author":"Hirata","year":"2018","journal-title":"J. Infect. Chemother."},{"key":"ref_24","doi-asserted-by":"crossref","first-page":"e0243617","DOI":"10.1371\/journal.pone.0243617","article-title":"Decreasing trend of imported malaria cases but increasing influx of mixed P. falciparum and P. vivax infections in malaria-free Kuwait","volume":"15","author":"Iqbal","year":"2020","journal-title":"PLoS ONE"},{"key":"ref_25","doi-asserted-by":"crossref","first-page":"286","DOI":"10.1186\/s12936-018-2438-7","article-title":"Imported and autochthonous malaria in West Saudi Arabia: Results from a reference hospital","volume":"17","author":"Soliman","year":"2018","journal-title":"Malar. J."},{"key":"ref_26","doi-asserted-by":"crossref","first-page":"e2018050","DOI":"10.4084\/mjhid.2018.050","article-title":"Epidemiology of malaria in the State of Qatar, 2008-2015","volume":"10","author":"Farag","year":"2018","journal-title":"Mediterr. J. Hematol. Infect. Dis."},{"key":"ref_27","doi-asserted-by":"crossref","first-page":"201","DOI":"10.1111\/jtm.12110","article-title":"Epidemiological and clinical characteristics of imported malaria in the United Arab Emirates","volume":"21","author":"Nilles","year":"2014","journal-title":"J. Travel. Med."},{"key":"ref_28","doi-asserted-by":"crossref","first-page":"239","DOI":"10.4103\/JPBS.JPBS_48_17","article-title":"Factors affecting primaquine combination treatment in malaria patients in Selangor, Malaysia","volume":"9","author":"Ariffin","year":"2017","journal-title":"J. Pharm. Bioallied. Sci."},{"key":"ref_29","unstructured":"Vector Borne Disease Sector (2021, June 20). Management Guidelines of Malaria in Malaysia, Available online: https:\/\/www.moh.gov.my\/index.php\/file_manager\/dl_item\/554756755a584a69615852686269394859584a70637942515957356b645746754c31426c626d6431636e567a595734675330567a615768686447467549435967613246335957786862694277655774706443394e515535425230564e52553555583064565355524654456c4f52564e6654305a665455464d51564a4a5156394a546c394e5155784257564e4a515335775a475978587935775a47593d."},{"key":"ref_30","first-page":"1","article-title":"A retrospective prevalence study of malaria in an aborigine hospital in Gombak, Selangor, Malaysia","volume":"37","author":"Jamaiah","year":"2006","journal-title":"Southeast Asian J. Trop. Med. Public Health"},{"key":"ref_31","doi-asserted-by":"crossref","unstructured":"Braima, K.A., Sum, J.S., Ghazali, A.R., Muslimin, M., Jeffery, J., Lee, W.C., Shaker, M.R., Elamin, A.E., Jamaiah, I., and Lau, Y.L. (2013). Is there a risk of suburban transmission of malaria in Selangor, Malaysia?. PLoS ONE, 8.","DOI":"10.1371\/journal.pone.0077924"},{"key":"ref_32","doi-asserted-by":"crossref","first-page":"202","DOI":"10.1186\/s12936-021-03741-y","article-title":"Perceptions and prevention practices on malaria among the indigenous Orang Asli community in Kelantan, Peninsular Malaysia","volume":"20","author":"Munajat","year":"2021","journal-title":"Malar. J."},{"key":"ref_33","doi-asserted-by":"crossref","first-page":"1017","DOI":"10.1016\/S0140-6736(04)15836-4","article-title":"A large focus of naturally acquired Plasmodium knowlesi infections in human beings","volume":"363","author":"Singh","year":"2004","journal-title":"Lancet"},{"key":"ref_34","doi-asserted-by":"crossref","first-page":"386","DOI":"10.1186\/s12936-015-0856-3","article-title":"Simian malaria in wild macaques: First report from Hulu Selangor district, Selangor, Malaysia","volume":"14","author":"Akter","year":"2015","journal-title":"Malar. J."},{"key":"ref_35","first-page":"20182351","article-title":"Predictive analysis across spatial scales links zoonotic malaria to deforestation","volume":"286","author":"Brock","year":"2019","journal-title":"Proc. Biol. Sci."},{"key":"ref_36","doi-asserted-by":"crossref","first-page":"638","DOI":"10.1007\/s10393-019-01403-9","article-title":"Long-tailed macaque response to deforestation in a Plasmodium knowlesi-endemic area","volume":"16","author":"Stark","year":"2019","journal-title":"Ecohealth"},{"key":"ref_37","doi-asserted-by":"crossref","first-page":"201","DOI":"10.3201\/eid2202.150656","article-title":"Association between landscape factors and spatial patterns of Plasmodium knowlesi infections in Sabah, Malaysia","volume":"22","author":"Fornace","year":"2016","journal-title":"Emerg. Infect. Dis."},{"key":"ref_38","doi-asserted-by":"crossref","first-page":"189","DOI":"10.1179\/136485906X91512","article-title":"A global assessment of closed forests, deforestation and malaria risk","volume":"100","author":"Guerra","year":"2006","journal-title":"Ann. Trop. Med. Parasitol."},{"key":"ref_39","doi-asserted-by":"crossref","first-page":"69","DOI":"10.1186\/s12936-021-03599-0","article-title":"Achieving global malaria eradication in changing landscape","volume":"20","author":"Fornace","year":"2021","journal-title":"Malar. J."},{"key":"ref_40","doi-asserted-by":"crossref","first-page":"e97","DOI":"10.1016\/S2542-5196(17)30031-1","article-title":"Individual-level factors associated with the risk of acquiring human Plasmodium knowlesi malaria in Malaysia: A case-control study","volume":"1","author":"Grigg","year":"2017","journal-title":"Lancet Planet Health"}],"container-title":["Tropical Medicine and Infectious Disease"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/www.mdpi.com\/2414-6366\/6\/4\/177\/pdf","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2025,10,11]],"date-time":"2025-10-11T07:06:59Z","timestamp":1760166419000},"score":1,"resource":{"primary":{"URL":"https:\/\/www.mdpi.com\/2414-6366\/6\/4\/177"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2021,9,29]]},"references-count":40,"journal-issue":{"issue":"4","published-online":{"date-parts":[[2021,12]]}},"alternative-id":["tropicalmed6040177"],"URL":"https:\/\/doi.org\/10.3390\/tropicalmed6040177","relation":{"has-preprint":[{"id-type":"doi","id":"10.20944\/preprints202108.0108.v1","asserted-by":"object"}]},"ISSN":["2414-6366"],"issn-type":[{"value":"2414-6366","type":"electronic"}],"subject":[],"published":{"date-parts":[[2021,9,29]]}}}