A Cross-Sectional Study of Malarial Patients in District Faisalabad, Pakistan: Frequency of Infection, Species Distribution, and Diagnostic Efficiency Comparison

BACKGROUND/AIMS: Malarial infection, caused by Plasmodium parasites transmitted by female Anopheles mosquito, is still a serious public health concern, especially in endemic areas such as Sub-Saharan Africa and Pakistan.The study aims to investigate the frequency of malarial infection in district Faisalabad. MATERIALS AND METHODS:A cross-sectional study was conducted across the district Faisalabad to study the frequency of malarial infection.Blood samples were collected from 1460 suspected malaria cases between May 2023 and April 2024 at various government sector hospitals across the six administrative units (tehsil) of district, Faisalabad.For the purpose of the diagnosis of malarial patients, rapid diagnostic tests (RDTs), microscopy, and polymerase chain reaction (PCR) methods were employed. RESULTS:RDTs detected 649 (44.4%) positive cases, while microscopy and PCR detected 452 (30.6%) and 459 (31.4%) cases, respectively.Among Plasmodium species, P. vivax was the most frequently detected, followed by P. falciparum and mixed infections.Significant differences were observed in diagnostic outcomes across the three methods.Notably, 55 RDT-positive cases were found to be negative by both microscopy and PCR, indicating potential false positives due to antigen persistence.The highest positivity rate was observed in the 1-15 years age group among males as well as in the months of June and July.These findings highlight the need for confirmatory diagnostics alongside RDTs to improve accuracy and support malaria surveillance and control efforts in endemic regions.Positivity rates varied across municipalities, with Faisalabad city showing the highest burden. CONCLUSION:This study demonstrates that while RDTs offer rapid malaria detection, they are prone to false positives due to persistent parasite antigens, especially in mixed infections.PCR and microscopy provided more accurate results and revealed significant differences in diagnostic outcomes.Moreover, the study highlights a significant frequency of malaria in district Faisalabad, with P. vivax being the dominant species.The data indicate higher susceptibility among males and children aged 1-15 years, particularly during the peak months of June and July.These findings highlight the need for confirmatory diagnostics to accompany further investigations.RDTs to improve accuracy and support malaria surveillance and control efforts in endemic regions.