Epidemiology of Plasmodium vivax malaria infection in Colombia

Despite being preventable and curable, malaria remains a major economic and social burden, with 249 million global cases and 608,000 deaths in 2022. Although Plasmodium vivax cases have decreased globally, it still poses significant challenges, particularly in the Americas. In Colombia , P. vivax continues to be a major concern due to its wide distribution and recurrent nature. The objective of the study was to determine the temporal and spatial distribution and epidemiological behavior of P. vivax malaria in Colombia from 2000 to 2023 . A comprehensive time-series study using official secondary data on malaria-associated morbidity and mortality in Colombia from 2000 to 2023. Temporal-spatial and population variables were analyzed, and the absolute and relative frequency measures of general and regional morbidity and mortality were estimated. Overall, P. vivax cases decreased, but complications, mortality, and recurrences have risen. Colombia reported 2193,233 malaria cases, with P. vivax causing 60.1 % (1318,820 cases). Men were notably affected, constituting 62.9 % of cases. The most vulnerable age groups were 15–29 years (36.7 %) and 5–14 years (22.9 %). The Uraba-Bajo Cauca-Sinu-San Jorge region had the highest prevalence (51.1 %). Severe malaria resulted in 15,575 complications (1.1 % of cases), with 68 % being hematological. Recurrences totalled 327,067 episodes (24.8 % recurrence rate). Epidemics were observed in 2001, 2002, 2004, 2007, 2010 and 2023, reflecting cyclical patterns. This 24-year study of P. vivax in Colombia reveals a high prevalence and widespread distribution of the disease, marked by unstable and varied endemic-epidemic transmission. While overall cases have decreased, there has been a concerning rise in complications, mortality, and recurrence rates. These findings underscore persistent challenges in managing and controlling P. vivax malaria and highlight the need for enhanced strategies to address these ongoing issues • P. vivax causes 60.1% of malaria cases in Colombia, highlighting its significant role in the national malaria burden. • Cases of P. vivax fluctuated from 112,464 in 2001 to 20,316 in 2014, showing an irregular endemic-epidemic pattern. • Over 70% of P. vivax cases occur in Uraba-Bajo Cauca-Sinu-San Jorge and the Pacific, revealing regional disparities. • Recurrent P. vivax infections (24.8%) mainly affect children and pregnant women, complicating eradication efforts. • P. vivax causes 64.5% of malaria complications, often severe hematological cases, requiring focused interventions.