A joinpoint regression analysis of Malaria epidemiological Indicators progression in Mizoram from 2000 to 2024

Malaria remains a persistent public health burden in Mizoram, India, which accounts for a disproportionately high share of national cases. This study employs Joinpoint Regression Analysis to examine the temporal trends in key malaria epidemiological indicators—API, ABER, Pf%, SFR, SPR, total cases, and malarial deaths—from 2000 to 2024 across nine districts of Mizoram. The analysis identifies statistically significant shifts in malaria trends and quantifies the Annual Percent Change (APC) and Average Annual Percent Change (AAPC) to assess intervention impact and surveillance dynamics. Results show substantial heterogeneity: districts like Aizawl East, Kolasib, and Serchhip exhibited marked declines in Pf cases, API, and mortality, while others like Champhai and Saiha experienced recent upsurges or fluctuating trends. Declines in ABER until 2010 followed by resurgence indicate evolving diagnostic strategies. Despite national elimination initiatives, border proximity, terrain, and sociocultural factors contribute to transmission persistence in specific districts. The study underscores the need for district-specific strategies, improved surveillance, and cross-border coordination. Joinpoint analysis proves valuable in detecting epidemiological shifts that basic models may overlook. The findings offer actionable insights for optimizing malaria control efforts and accelerating elimination in Mizoram and similar high-risk, ecologically complex regions.