Epidemiology of malaria in the Torres Strait Islands, Australia, 2000-2025 and the public health response to three recent outbreaks
DOI:
https://doi.org/10.33321/cdi.2026.50.065Keywords:
malaria, outbreak, First Nations health, public health, Aboriginal and Torres Strait Islander peopleAbstract
Background
Australia was declared malaria free in 1981. However, the proximity of Australia’s Torres Strait region to malaria-endemic Papua New Guinea (PNG), and the presence of the Anopheles mosquito across Northern Australia, means there is an ongoing risk of malaria for many Australian residents. This paper describes the epidemiology of malaria in the Torres Strait region between 2000 and 2025 and reports the public health response to three malaria outbreaks between 2023 and 2025.
Methods
Case data from 1 January 2000 to 31 December 2025 were extracted from the Queensland Notifiable Conditions System to describe the epidemiology of malaria in the Torres Strait. The public health responses to each of the three recent outbreaks were reported against the Queensland Health Public Health Unit Guidelines for Malaria.
Results
During the period 2000–2013, there were 171 cases of malaria reported in the Torres Strait region. Of these, 89 (52%) were positive for Plasmodium falciparum and 82 (48%) for P. vivax. Of cases during this period, 130 (76%) were imported from PNG; 13 (8%) were acquired in Australia; and 28 (16%) had an unknown place of acquisition. After a nine-year period without any confirmed malaria cases in the region, eight cases were reported across three outbreaks between 2023 and 2025. In all six of the outbreak cases in which a species could be confirmed, P. vivax was identified. The three outbreaks were managed effectively in partnership with local leaders, and included active case finding and vector control activities.
Discussion and conclusion
The public health response successfully halted transmission of malaria during three separate outbreaks in the Torres Strait Islands. However, there is an ongoing local risk due to the high incidence of malaria in PNG and cross-border movement under the Torres Strait Treaty. Ongoing collaboration with PNG stakeholders and enhanced local surveillance are essential to minimise the future importation of malaria, and other potentially life-threatening pathogens, into mainland Australia.
Downloads
References
Crutcher JM, Hoffman SL. Chapter 83. Malaria. [Online resource.] In Baron S, ed. Medical Microbiology (4th edition). Galveston: University of Texas Medical Branch at Galveston; 1996. Available from: https://www.ncbi.nlm.nih.gov/books/NBK8584/.
Zekar L, Sharman T. Plasmodium falciparum Malaria. [Online resource.] Treasure Island, Florida: StatPearls LLC Ltd.; 8 August 2023. Available from: https://www.ncbi.nlm.nih.gov/books/NBK555962/.
Poespoprodjo JR, Douglas NM, Ansong D, Kho S, Anstey NM. Malaria. Lancet. 2023;402(10419):2328–45. doi: https://doi.org/10.1016/S0140-6736(23)01249-7.
World Health Organization (WHO). Global Malaria Programme. [Webpage.] Geneva: WHO; 15 July 2025. [Accessed on 16 July 2025.] Available from: https://www.who.int/teams/global-malaria-programme/elimination/countries-and-territories-certified-malaria-free-by-who.
Preston-Thomas A, Gair RW, Hosking KA, Devine GJ, Donohue SD. An outbreak of Plasmodium falciparum malaria in the Torres Strait. Commun Dis Intell Q Rep. 2012;36(2):180–5. doi: https://doi.org/10.33321/cdi.2012.36.13.
Hanna JN, Ritchie SA, Eisen DP, Cooper RD, Brookes DL, Montgomery BL. An outbreak of Plasmodium vivax malaria in Far North Queensland, 2002. Med J Aust. 2004;180(1):24–8. doi: https://doi.org/10.5694/j.1326-5377.2004.tb05769.x.
Australian Government Department of Foreign Affairs and Trade (DFAT). The Torres Strait Treaty. [Internet.] Canberra: DFAT; 2024. [Accessed on 7 April 2025.] Available from: https://www.dfat.gov.au/geo/torres-strait/the-torres-strait-treaty.
Australian Border Force. Protecting the Torres Strait from COVID-19: Operation Overarch concludes. [Media release.] Canberra: Australian Border Force; 21 December 2022. [Accessed on 3 October 2025.] Available from: https://www.abf.gov.au/newsroom-subsite/Pages/Protecting-the-Torres-Strait-from-COVID-19-Operation-Overarch-concludes-21-12-2022.aspx.
Cleary E, Hetzel MW, Clements ACA. A review of malaria epidemiology and control in Papua New Guinea 1900 to 2021: progress made and future directions. Front Epidemiol. 2022;2:980795. doi: https://doi.org/10.3389/fepid.2022.980795.
Torres Strait Island Regional Council (TSIRC). Saibai. [Webpage.] Cairns: TSIRC; 2026. [Accessed on 20 Feburary 2026.] Available from: https://tsirc.qld.gov.au/communities/saibai/.
TSIRC. Boigu. [Webpage.] Cairns: TSIRC; 2026. [Accessed on 20 Feburary 2026.] Available from: https://tsirc.qld.gov.au/communities/boigu/.
TSIRC. Dauan. [Webpage.] Cairns: TSIRC; 2026. [Accessed on 14 March 2026.] Available from: https://tsirc.qld.gov.au/communities/dauan/.
Gibney KB, Cheng AC, Hall R, Leder K. An overview of the epidemiology of notifiable infectious diseases in Australia, 1991–2011. Epidemiol Infect. 2016;144(15):3263–77. doi: https://doi.org/10.1017/s0950268816001072.
Queensland State Government Department of Health (Queensland Health). Queensland Health Guidelines for Public Health Units: Malaria. [Internet.] Brisbane: Queensland Health; September 2023. [Accessed on 27 April 2026.] Available from: https://www.health.qld.gov.au/cdcg/index/malaria.
Abbott Diagnostics Scarborough Incorporated. BinaxNow Malaria Product Insert. [Webpage.] Scarborough: Abbott Diagnostics Scarborough Incorporated; September 2024. [Accessed on 1 July 2026.]
Wongsrichanalai C, Barcus MJ, Muth S, Sutamihardja A, Wernsdorfer WH. A review of malaria diagnostic tools: microscopy and rapid diagnostic test (RDT). Am J Trop Med Hyg. 2007;77(6 Suppl):119–127. doi: https://doi.org/10.4269/ajtmh.2007.77.119.
WHO. Global malaria program: nucleic acid amplification-based diagnostics. [Webpage.] Geneva: WHO; 2023. [Accessed on 5 August 2025.] Available from: https://www.who.int/teams/global-malaria-programme/case-management/diagnosis/nucleic-acid-amplification-based-diagnostics.
Asia Pacific Leaders Malaria Alliance (APLMA). Malaria in Papua New Guinea: Current Landscape and A Strengthened Push Towards Elimination. [Webpage.] Singapore: APLMA; 26 June 2026. [Accessed on 23 July 2026.] Available from: https://www.aplma.org/blog/malaria-in-papua-new-guinea-current-landscape-and-a-strengthened-push-towards-elimination.
APLMA. The Asia Pacific Leaders’ Malaria Elimination Roadmap: A 10-year Review of Progress (2015–2024). [Report.] Singapore: APLMA; 28 October 2025. [Accessed on 5 August 2025.]
WHO. World malaria report 2024: addressing inequity in the global malaria response. Geneva: WHO; 11 December 2024. [Accessed on 5 August 2025.] Available from: https://www.who.int/teams/global-malaria-programme/reports/world-malaria-report-2024.
Giduthuri J, Timbi D, Kualawi M, Are C, Micha M, Philemon G et al, for the Papua New Guinea Institute of Medical Research. Papua New Guinea Malaria Indicator Survey 2022–2023: final report on malaria prevention, infection prevalence, and treatment seeking. [Online report.] Geneva: CERN/European Organization for Nuclear Research, Zenodo; December 2023. doi: https://doi.org/10.5281/zenodo.10630065.
Gonzales SJ, Reyes RA, Braddom AE, Batugedara G, Bol S, Bunnik EM. Naturally acquired humoral immunity against Plasmodium falciparum malaria. Front Immunol. 2020;11:594653. doi: https://doi.org/10.3389/fimmu.2020.594653.
WHO. Malaria incidence (per 1000 population at risk). [Webpage.] Geneva: WHO; 8 March 2024. [Accessed on 23 July 2026.].
Prime Minister of Australia, Prime Minister of Papua New Guinea. Joint communique – Papua New Guinea and Australia on a Mutual Defence Treaty. [Media release.] Canberra: Australian Government Department of Prime Minister and Cabinet; 17 September 2025. [Accessed on 10 November 2025.] Available from: https://www.pm.gov.au/media/joint-communique-papua-new-guinea-and-australia-mutual-defence-treaty.
McBride WJH. Deaths associated with dengue haemorrhagic fever: the first in Australia in over a century. Med J Aust. 2005;183(1):35–7. doi: https://doi.org/10.5694/j.1326-5377.2005.tb06889.x.
Wilson M, Weston J, Mullen A, Knight T, Simpson G. Tuberculosis in Far North Queensland, Australia: a retrospective clinical audit. Intern Med J. 2019;49(3):333–8. doi: https://doi.org/10.1111/imj.13994.
Hanson JP, Taylor CT, Richards AR, Smith IL, Boutlis CS. Japanese encephalitis acquired near Port Moresby: implications for residents and travellers to Papua New Guinea. Med J Aust. 2004;181(5):282–3. doi: https://doi.org/10.5694/j.1326-5377.2004.tb06274.x.
The Joint United Nations Programme on HIV/AIDS Asia Pacific. National HIV crisis declared in Papua New Guinea. [Press release.] Port Moresby: The Joint United Nations Programme on HIV/AIDS Asia Pacific; 26 June 2025. [Accessed on 23 July 2026.] Available from: https://unaids-ap.org/2025/06/26/national-hiv-crisis-declared-in-papua-new-guinea/.
Fischer L, Gültekin N, Kaelin MB, Fehr J, Schlagenhauf P. Rising temperature and its impact on receptivity to malaria transmission in Europe: a systematic review. Travel Med Infect Dis. 2020;36:101815. doi: https://doi.org/10.1016/j.tmaid.2020.101815.
Fatima SH, Zaidi F, Rafiq J, Bhandari D, Ali A, Bi P. Impact of temperatures on malaria incidence in vulnerable regions of Pakistan: empirical evidence and future projections. Epidemiol Infect. 2025;153:e33. doi: https://doi.org/10.1017/s0950268825000111.
Colón-González FJ, Sewe MO, Tompkins AM, Sjödin H, Casallas A, Rocklöv J et al. Projecting the risk of mosquito-borne diseases in a warmer and more populated world: a multi-model, multi-scenario intercomparison modelling study. Lancet Planet Health. 2021;5(7):e404–14. doi: https://doi.org/10.1016/S2542-5196(21)00132-7.
Fairhead LJ, Smith S, Sim BZ, Stewart AGA, Stewart JD, Binotto E et al. The seasonality of infections in tropical Far North Queensland, Australia: a 21-year retrospective evaluation of the seasonal patterns of six endemic pathogens. PLOS Glob Public Health. 2022;2(5):e0000506. doi: https://doi.org/10.1371/journal.pgph.0000506.
Hanson J, Smith S, Stewart J, Horne P, Ramsamy N. Melioidosis–a disease of socioeconomic disadvantage. PLoS Negl Trop Dis. 2021;15(6):e0009544. doi: https://doi.org/10.1371/journal.pntd.0009544.
Merga H, Degefa T, Birhanu Z, Tadele A, Lee MC, Yan G et al. Urban malaria in sub-Saharan Africa: a scoping review of epidemiologic studies. Malar J. 2025;24(1):131. doi: https://doi.org/10.1186/s12936-025-05368-9.
Fox T, Furnival-Adams J, Chaplin M, Napier M, Olanga EA. House modifications for preventing malaria. Cochrane Database Syst Rev. 2022;10(10):CD013398. doi: https://doi.org/10.1002/14651858.CD013398.pub4.
Chu CS, White NJ. Management of relapsing Plasmodium vivax malaria. Expert Rev Anti Infect Ther. 2016;14(10):885–900. doi: https://doi.org/10.1080/14787210.2016.1220304.
Crooks K, Law C, Taylor K, Brett K, Murray P, Kolhkagen J et al. Embedding Aboriginal cultural governance, capacity, perspectives and leadership into a local Public Health Unit Incident Command System during COVID-19 in New South Wales, Australia. BMJ Glob Health. 2023;8(7):e012709. doi: https://doi.org/10.1136/bmjgh-2023-012709.
Hawthorn L, Matysek R, Neville J, Gibson I, Taunton C, Thomas R et al. A mixed-methods evaluation: COVID Care in the Home, a public health response to the first omicron wave across the Torres and Cape region, Queensland. Aust N Z J Public Health. 2024;48(2):100147. doi: https://doi.org/10.1016/j.anzjph.2024.100147.
Hempenstall A, Pyke A, Taunton C, Sabatino U, Kaigey S, Pickering E et al. An outbreak of dengue virus type 3 on Mer Island in the Torres Strait, Australia in 2024. Commun Dis Intell (2018). 2024;48. doi: https://doi.org/10.33321/cdi.2024.48.63.
Brasil P, de Pina Costa A, Pedro RS, da Silveira Bressan C, da Silva S, Tauil PL et al. Unexpectedly long incubation period of Plasmodium vivax malaria, in the absence of chemoprophylaxis, in patients diagnosed outside the transmission area in Brazil. Malar J. 2011;10(1):122. doi: https://doi.org/10.1186/1475-2875-10-122.
Huestis DL, Dao A, Diallo M, Sanogo ZL, Samake D, Yaro AS et al. Windborne long-distance migration of malaria mosquitoes in the Sahel. Nature. 2019;574(7778):404–8. doi: https://doi.org/10.1038/s41586-019-1622-4.
Kavanaugh MJ, Azzam SE, Rockabrand DM. Malaria rapid diagnostic tests: literary review and recommendation for a quality assurance, quality control algorithm. Diagnostics (Basel). 2021;11(5):768. doi: https://doi.org/10.3390/diagnostics11050768.
McMorrow ML, Aidoo M, Kachur SP. Malaria rapid diagnostic tests in elimination settings—can they find the last parasite? Clin Microbiol Infect. 2011;17(11):1624–31. doi: https://doi.org/10.1111/j.1469-0691.2011.03639.x.
Golden A, Slater HC, Jang IK, Walke S, Phan TT, Bizilj GT et al. Analytical sensitivity analysis and clinical impact modeling of Rapigen rapid diagnostic tests for malaria. Am J Trop Med Hyg. 2024;111(5):956–66. doi: https://doi.org/10.4269/ajtmh.24-0003.
Published
How to Cite
Issue
Section
Categories
License
Copyright (c) 2026 Communicable Diseases Intelligence
This work is licensed under a Creative Commons Attribution-NonCommercial-NoDerivatives 4.0 International License.
