Past Trend, Current Prevalence, and Determinants of Malaria in Boreda District, Gamo Zone, South Ethiopia

Abstract

Background: Malaria remains a major public health problem in sub-Saharan African countries, including Ethiopia, where it continues to cause significant morbidity and mortality. The presence of asymptomatic carriers challenges the control efforts. Objective: To determine past trends, current prevalence, and determinants of malaria among communities in Boreda District, South Ethiopia. Methods: Retrospective and community-based cross-sectional studies were conducted from May to October 2024 in malaria-endemic Kebeles of the Boreda district. Data on malaria cases over the past seven years (2018-2024) were collected from two health centers (Gagagocho and Zefano) by reviewing laboratory registration books. A multistage sampling technique was used to select 564 individuals from six Kebeles for the cross-sectional study. Malaria parasites were identified using light microscopy and rapid diagnostic tests. Sociodemographic and other malaria-related data were collected using a pretested structured questionnaire. Bivariate and multivariate logistic regression analyses were performed to identify factors associated with malaria. A p-value of < 0.05 was considered statistically significant during the analysis. Results: Over the past seven years, a total of 52,256 febrile cases were examined. Of these, 27,748 individuals (53.0%) were positive for malaria, with P. falciparum, P. vivax, and mixed infections accounting for 83.8%, 12.8%, and 3.4% of the positive cases, respectively. The malaria prevalence rate showed an increment from 28.8% in 2018 to 48.2% in 2024. The prevalence of malaria in the community was 28.0% (n = 157), with P. falciparum, P. vivax, and mixed infections accounting for 65.0%, 22.3%, and 12.7%, respectively. The majority, 86.6% (n = 136), of the positive cases were asymptomatic infections. Individuals without fever were more likely to have malaria infection (AOR = 2.8, 95% CI: 1.48–5.37, p = 0.002) and having eaves (AOR = 1.48, 95% CI: 1.004–2.20, p = 0.048) was significant a significant predictor of malaria infection in the community. Conclusion: The study revealed a high prevalence of malaria in Boreda District, with a significant increase in the number of cases over the past seven years. Factors such as asymptomatic cases and housing conditions (e.g., open eaves) may contribute to sustained transmission in the area. Preventive measures should be prioritized, and community engagement in malaria eliminatio strategies must be strengthened.