Trends of neglected species infection in humans over the past century in India.

BACKGROUND

Efforts for malaria elimination in India focus solely on the more prevalent human malaria parasites of and . The three non species - and are seldom studied though they are often present as mixed infections with and thus may be misdiagnosed. This study provides a comprehensive landscape of , and infections from 1930 to 2020.

METHODOLOGY

We systematically searched for published literature on , and in India from PubMed database and collated data from 35 studies. The data, starting from 1930, were mapped decade-wise across India. The prevalence of the three neglected species and their proportional contribution to reported mixed-infection were also calculated and analysed.

PRINCIPAL FINDINGS

Amongst the three non species, infections have been reported in greater numbers across India and were mostly mono-infections till 1980. From 1983 onwards, reports of mixed infections with started to emerge. In contrast, reports on occurrence of are still rare barring few mixed infection studies. Further, mono- and mixed cases were first reported in 2004 in India and now has been found reported from four Indian states.

CONCLUSION

This is the first account of country-wide assimilation of reported malaria parasite species data that covers , and infection profiles from 1930 to 2020. This study illustrates the need to survey all 5 human malaria parasite species in India and to target them collectively during the malaria elimination phase.