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Background  The suburban transmission of malaria in Selangor, Malaysia’s most developed and populous state still remains a concern for public health in this region. Despite much successful control efforts directed at its reduction, sporadic cases, mostly brought in by foreigners have continued to occur. In addition, cases of simian malaria caused by  Plasmodium knowlesi , some with fatal outcome have caused grave concern to health workers. The aim of this study was to investigate the possibility of local malaria transmission in suburban regions of Selangor, which are adjacent to secondary rainforests.    Findings  A malaria survey spanning 7 years (2006 - 2012) was conducted in Selangor. A total of 1623 laboratory confirmed malaria cases were reported from Selangor’s nine districts. While 72.6% of these cases (1178/1623) were attributed to imported malaria (cases originating from other countries), 25.5% (414/1623) were local cases and 1.9% (31/1623) were considered as relapse and unclassified cases combined. In this study, the most prevalent infection was  P. vivax  (1239 cases, prevalence 76.3%) followed by  P. falciparum  (211, 13.0%),  P. knowlesi  (75, 4.6%),  P. malariae  (71, 4.4%) and  P. ovale  (1, 0.06%). Mixed infections comprising of  P. vivax  and  P. falciparum  were confirmed (26, 1.6%). Entomological surveys targeting the residences of malaria patients’ showed that the most commonly trapped  Anopheles  species was  An. maculatus . No oocysts or sporozoites were found in the  An. maculatus  collected. Nevertheless, the possibility of  An. maculatus  being the malaria vector in the investigated locations was high due to its persistent occurrence in these areas.    Conclusions  Malaria cases reported in this study were mostly imported cases. However the co-existence of local cases and potential  Plasmodium  spp. vectors should be cause for concern. The results of this survey reflect the need of maintaining closely monitored malaria control programs and continuous extensive malaria surveillance in Peninsula Malaysia.

Is There a Risk of Suburban Transmission of Malaria in Selangor, Malaysia?