Epidemiology and Laboratory Features of Imported Malaria in a Tertiary Care Hospital, Hangzhou, China: A 12-Year Retrospective Cohort (2013–2024)

Background Malaria remains a significant public health threat globally, especially because of the increasing number of imported cases in non-endemic areas such as China, despite the successful local elimination of the disease. Methods This study aimed to investigate the epidemiological trends, clinical characteristics, and laboratory parameters of severe and uncomplicated imported malaria cases at Hangzhou Xixi Hospital, between January 2013 and December 2024. Results A retrospective analysis of 120 confirmed cases revealed that Plasmodium falciparum was the predominant species (77.5%), with 48.33% originating from West Africa, and severe cases constituting 89.2% of the total. Notably, the overlap with the COVID-19 pandemic, and severe cases were characterized by older age of patients, longer diagnostic delays, and significantly higher parasitemia levels (67.86% versus 15.22%). Laboratory findings indicated that severe cases exhibited lower hemoglobin and platelet counts, along with elevated inflammatory markers and impaired liver and kidney function. Conclusion This research underscores the complexities of managing imported malaria and emphasizes the urgent need for the development of comprehensive early warning systems incorporating epidemiological data, clinical manifestations, and laboratory biomarkers to facilitate early identification and treatment of severe cases. The findings contribute essential insights towards enhancing malaria prevention and control initiatives in low-risk, non-endemic areas, ultimately aiming for improved patient outcomes and public health safety.