Epidemiology of Plasmodium falciparum Malaria and Risk Factors for Severe Disease in Hubei Province, China

This study aimed to describe the epidemiology of malaria and identify risk factors for severe disease in Hubei Province, China, using a case-based survey of retrospective data from 2013 to 2018. From 2013 to 2018, a total of 763 imported malaria cases were reported in Hubei Province; 69.2% (528/763) cases were caused by species. The proportion of malaria caused by increased from 66.7% in 2013 to 74.0% in 2018 (χ = 21.378, < 0.05). malaria was reported in 77 counties of Hubei Province. The majority of imported cases originated from Africa (98.9%, 522/528); 9.7% (51/528) of patients infected with developed severe malaria. Three deaths (case fatality rate: 0.6%) were related to imported malaria. Risk factors for severe malaria were being female (odds ratio [OR] = 3.593, 95% CI: 1.003-12.874), age ≥ 50 years (OR = 2.674, 95% CI: 1.269-5.634), > 3 days between symptom onset and diagnosis (OR = 2.383, 95% CI: 1.210-4.693), and the first-visit medical institution at the township level or lower (OR = 2.568, 95% CI: 1.344-4.908). Malaria prevention should be undertaken among high-risk groups, infection with should be detected early to prevent severe disease and death, and healthcare providers in health facilities at the township level should be trained on early recognition of malaria.