Prevalence, Demographic Patterns, and Seasonal Distribution of Malaria in District Dera Ismail Khan, Pakistan

Abstract Malaria remains the most significant vector-borne disease worldwide, with over 200 million cases reported annually, causing approximately 0.6 million deaths among children and pregnant women. In Pakistan, particularly in the southern regions of Khyber Pakhtunkhwa, malaria continues to pose a major public health challenge. This study aimed to determine the monthly prevalence of malaria parasites in the population of Dera Ismail Khan and to identify the patterns of parasite transmission. A retrospective analysis was conducted using laboratory-confirmed malaria case data obtained from the District Health Office (DHO) Dera Ismail Khan for the entire year of 2024. Cases were categorized by month and Plasmodium species, specifically P. vivax, P. falciparum , and mixed infections. Chi-square analysis was performed to assess the significance of monthly variations in species distribution. The results showed that P. vivax was the predominant species, with cases peaking from September to December. P. falciparum and mixed infections were comparatively rare. October recorded the highest number of cases, followed by September and November. Chi-square analysis confirmed a statistically significant association between month and species distribution (χ 2 = 2314.40, df = 22, p < 0.0001), indicating a strong seasonal pattern. Malaria incidence was higher in males than females, and the majority of cases occurred among individuals aged 15–24 years. Overall, the study demonstrates that P. vivax is the most common malaria parasite in Dera Ismail Khan and that malaria transmission in the region exhibits a clear seasonal trend. These findings provide valuable insight for targeted malaria control and prevention strategies in endemic areas of Khyber Pakhtunkhwa. Author Summary Malaria remains a major public health problem worldwide, but not all malaria parasites behave in the same way. In this study, we focused on malaria in District Dera Ismail Khan, Pakistan, with particular attention to Plasmodium vivax , a species that has historically received less attention than Plasmodium falciparum . Using routine health records from 2024, we analyzed nearly 37,000 laboratory-confirmed malaria cases to understand which parasite species were most common and how infections varied by age, sex, and season. We found that Plasmodium vivax caused more than four out of five malaria cases in the district, making it the dominant species across all age groups. Malaria was more common in males than females, and clear seasonal patterns were observed, with most cases occurring after the monsoon season between September and November. These findings are important because P. vivax can cause repeated illness through relapses, making malaria harder to control even when mosquito numbers are low. By documenting local patterns of malaria transmission, our study highlights the need for targeted control strategies that address P. vivax specifically. This information can help public health authorities plan more effective, seasonally timed interventions and move closer to malaria elimination.