Abstract
Background: Malaria remains a major public health concern in India, particularly in rural settings, where accurate and rapid diagnosis is crucial for effective management. Although peripheral blood smear (PBS) examination remains the gold standard, immunochromatographic tests (ICT) offer a rapid alternative. The present study was undertaken to evaluate the diagnostic performance and concordance of ICT in comparison with PBS in a rural tertiary care setting, alongside the prevalence, species distribution, and demographic and seasonal patterns of malaria. This retrospective observational study was conducted in a rural tertiary care hospital, in which 12,183 blood samples from febrile patients were analysed by both PBS and ICT. Of the total samples, 32 (0.26%) were positive by PBS and 31 (0.25%) by ICT. <em>Plasmodium vivax</em> was the predominant species (93.75%), whereas <em>P. falciparum</em> accounted for 6.25% of cases. A high level of concordance (96.9%) between PBS and ICT was observed, with a single discordant case. Most cases occurred in males aged 21–30 years and during the monsoon months (August–October). A marked decline in malaria prevalence was noted relative to previous institutional data (4.636% vs. 0.262%). ICT demonstrates high diagnostic concordance with PBS and serves as a valuable tool in resource-limited settings, while the declining prevalence reflects the impact of effective public health interventions.
Keywords: Immunochromatographic test; Malaria diagnosis; Peripheral blood smear; Plasmodium vivax; Rural health epidemiology