**Question:** Urban malaria is due to

A. Plasmodium vivax
B. Plasmodium falciparum
C. Anopheles mosquitoes
D. Human behavior and urbanization

**Core Concept:** Urban malaria refers to malaria cases occurring in non-endemic areas primarily due to the expansion of the disease into urban settings. This phenomenon is associated with the spread of the disease caused by the transmission of Plasmodium parasites through the bites of infected Anopheles mosquitoes. The disease is primarily caused by two species: Plasmodium falciparum and Plasmodium vivax.

**Why the Correct Answer is Right:** Urban malaria is primarily due to Plasmodium falciparum and Plasmodium vivax because these two species are responsible for causing malaria in humans. Both Plasmodium falciparum and Plasmodium vivax can survive and reproduce within the liver and red blood cells, leading to severe clinical manifestations. Urbanization, migration, and increasing global travel facilitate the spread of these parasites to previously malaria-free areas.

**Why Each Wrong Option is Incorrect:**

A. Plasmodium vivax is less severe and less likely to cause severe complications compared to Plasmodium falciparum. Urban malaria is caused by Plasmodium falciparum, not Plasmodium vivax.

B. Plasmodium falciparum is the primary cause of severe malaria, while Plasmodium vivax can cause severe malaria in certain cases. However, urban malaria is primarily caused by Plasmodium falciparum.

C. Anopheles mosquitoes are the vectors responsible for transmitting malaria parasites. Although Anopheles mosquitoes are involved in malaria transmission, urban malaria is primarily caused by the parasites themselves (Plasmodium falciparum and Plasmodium vivax) and not the mosquitoes.

D. Human behavior and urbanization contribute to the spread of malaria to urban areas. While these factors do play a role, the primary cause of urban malaria is the presence of Plasmodium falciparum and Plasmodium vivax parasites in the human population.

**Clinical Pearl:** Understanding the causes of urban malaria is crucial for healthcare professionals to diagnose and treat patients appropriately. By recognizing that urban malaria is primarily caused by Plasmodium falciparum and Plasmodium vivax, clinicians can accurately identify the causative agents and initiate targeted treatment strategies. Additionally, addressing the factors contributing to urban malaria, such as mosquito control and public health education, is essential for preventing and controlling the disease in urban settings.