Spatial and Temporal Trends in Malaria Incidence, Relapses and Associated Hematological Complications in Hajjah, Yemen from 2019 to 2022: A Hospital-based Retrospective Study

Abstract

Malaria continues to be a significant public health issue in numerous developing countries, emphasizing the need for monitoring disease trends and epidemiological patterns to guide effective control strategies. This study aimed to provide a comprehensive description of trends in malaria admissions, hematological profiles, demographics, and spatial variations over a four-year period at a health facility located in a malaria-endemic region. A retrospective review of inpatient malaria records from 2019 to 2022 was conducted. Data pertaining to case classification, hematological parameters, demographics, and regions of residence were extracted and analysed. The analysis revealed an increasing trend in the proportion of relapse cases among malaria admissions, rising from 50.8% in 2019 to 72.7% in 2022. Furthermore, relapse cases consistently exhibited more severe anemia, lower levels of hemoglobin, red blood cell counts, and platelets compared to initial episodes (p<0.001). Among relapse cases, children under 5 years old and adolescents constituted the majority. Significant spatial variations were observed in malaria incidence and relapse rates across the regions served by the health facility. In conclusion, recurrent malaria presents a growing challenge, particularly affecting vulnerable groups. Recognizing epidemiological shifts and spatial variations is crucial for implementing targeted interventions effectively. Continuous monitoring of trends, along with prompt public health responses, remains essential for successful malaria control.