Descriptive, Hospital-Based, 10-Year Study of Malaria Transmission in Goa, a Southwest Indian State in the Malaria Elimination Phase

Rimi Chakrabarti Department of Chemistry, University of Washington, Seattle, Washington;
Department of Medicine, Goa Medical College and Hospital, Bambolim, Goa;

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Kevin Gillespie Fred Hutchinson Cancer Research Center, Seattle, Washington;

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Jayashri T. Walke Department of Chemistry, University of Washington, Seattle, Washington;
Department of Medicine, Goa Medical College and Hospital, Bambolim, Goa;

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Mezia Fernandes Department of Chemistry, University of Washington, Seattle, Washington;
Department of Medicine, Goa Medical College and Hospital, Bambolim, Goa;

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Anvily Almeida Department of Chemistry, University of Washington, Seattle, Washington;
Department of Medicine, Goa Medical College and Hospital, Bambolim, Goa;

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Laura Chery-Karschney Department of Chemistry, University of Washington, Seattle, Washington;

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Usheer Kanjee Department of Immunology and Infectious Diseases, Harvard T. H. Chan School of Public Health, Boston, Massachusetts

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Kristen M. Skillman Department of Immunology and Infectious Diseases, Harvard T. H. Chan School of Public Health, Boston, Massachusetts

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John White Department of Chemistry, University of Washington, Seattle, Washington;

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Prasad H. Babar Department of Chemistry, University of Washington, Seattle, Washington;
Department of Medicine, Goa Medical College and Hospital, Bambolim, Goa;

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Ligia Pereira Department of Chemistry, University of Washington, Seattle, Washington;
Department of Medicine, Goa Medical College and Hospital, Bambolim, Goa;

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Anjali Mascarenhas Department of Chemistry, University of Washington, Seattle, Washington;
Department of Medicine, Goa Medical College and Hospital, Bambolim, Goa;

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Marina Vaz Department of Medicine, Goa Medical College and Hospital, Bambolim, Goa;

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Anar Khandeparkar Department of Medicine, Goa Medical College and Hospital, Bambolim, Goa;

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Edwin Gomes Department of Medicine, Goa Medical College and Hospital, Bambolim, Goa;

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Holly Janes Fred Hutchinson Cancer Research Center, Seattle, Washington;

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Pradipsinh K. Rathod Department of Chemistry, University of Washington, Seattle, Washington;

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Manoj T. Duraisingh Department of Immunology and Infectious Diseases, Harvard T. H. Chan School of Public Health, Boston, Massachusetts

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The South Asia International Center of Excellence for Malaria Research, an NIH-funded collaborative program, investigated the epidemiology of malaria in the Indian state of Goa through health facility–based data collected from the Goa Medical College and Hospital (GMC), the state’s largest tertiary healthcare facility, between 2012 and 2021. Our study investigated region-specific spatial and temporal patterns of malaria transmission in Goa and the factors driving such patterns. Over the past decade, the number of malaria cases, inpatients, and deaths at the GMC decreased significantly after a peak in 2014–2015. However, the proportion of severe malaria cases increased over the study period. Also, a trend of decreasing average parasitemia and increasing average gametocyte density suggests a shift toward submicroscopic infections and an increase in transmission commitment characteristic of low-transmission regions. Although transmission occurred throughout the year, 75% of the cases occurred between June and December, overlapping with the monsoon (June–October), which featured rainfall above yearly average, minimal diurnal temperature variation, and high relative humidity. Sociodemographic factors also had a significant association with malaria cases, with cases being more frequent in the 15–50-year-old age group, men, construction workers, and people living in urban areas within the GMC catchment region. Our environmental model of malaria transmission projects almost negligible transmission at the beginning of 2025 (annual parasitic index: 0.0095, 95% CI: 0.0075–0.0114) if the current control measures continue undisrupted.

Author Notes

Financial support: The current study was funded by the NIH’s South Asia International Center of Excellence for Malaria program (U19 AI089688).

Authors’ addresses: Rimi Chakrabarti, Jayashri T. Walke, Mezia Fernandez, Anvily Almeida, Prasad H. Babar, Ligia Pereira, and Anjali Mascarenhas, Department of Chemistry, University of Washington, Seattle, WA, and Department of Medicine, Goa Medical College, Bambolim, Goa. E-mails: rimic@uw.edu, walkej3@uw.edu, meziaf@uw.edu, anvilyalmeida2410@gmail.com, prasadb@uw.edu, ligiap2@uw.edu, and amascar1@uw.edu. Kevin Gillespie and Holly Janes, Fred Hutchinson Cancer Research Center, Seattle, WA, E-mails: kgillesp@fredhutch.org and hjanes@fredhutch.org. Laura Chery-Karschney, John White, and Pradipsinh K. Rathod, Department of Chemistry, University of Washington, Seattle, WA, E-mails: lauraarn@uw.edu, jwhite3@uw.edu, and rathod@uw.edu. Usheer Kanjee, Kristen M. Skillman, and Manoj T. Duraisingh, Harvard T. H. Chan School of Public Health, Boston, MA, E-mails: kanjee@hsph.harvard.edu, skillmankm@gmail.com, and duraisi@hsph.harvard.edu. Marina Vaz, Anar Khandeparkar, and Edwin Gomes, Department of Medicine, Goa Medical College, Bambolim, India, E-mails: marinavaz18@yahoo.com, anar1662@gmail.com, and e_jj_gomes@hotmail.com.

Address correspondence to Rimi Chakrabarti, Department of Chemistry, University of Washington, Bagley Hall, Box 351700, Seattle, WA 98195-1700, E-mail: rimic@uw.edu or Manoj T. Duraisingh, Department of Immunology and Infectious Diseases, Harvard T. H. Chan School of Public Health, 651 Huntington Ave., FXB, Room 205, Boston, MA 02115. E-mail: duraisi@hsph.harvard.edu
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