Abstract
BACKGROUND: Malaria is the most prevalent and deadly mosquito-borne disease worldwide. In Ethiopia, Plasmodium falciparum and Plasmodium vivax coexist, adding to the country's malaria burden. Assessing the prevalence of malaria and identifying the factors linked to its transmission are essential strategies for effective prevention and control. OBJECTIVES: To determine the prevalence and associated factors of malaria among febrile patients at two sites with different transmission intensities. METHODS: An institution-based comparative cross-sectional study was conducted from April to May 2021. The sample size was determined using the double population proportion formula, and participants were selected through a convenient sampling technique in which study participants were selected based on their easy convenience or willingness to participate until the expected sample size was obtained. Malaria diagnosis was performed via Geimsa-based microscopy. Data entry was performed using EpiData version 4.6.0, and analysis was carried out using Statistical Package for the Social Sciences (SPSS) version 20. Bivariate and multivariate analyses were conducted to identify factors associated with malaria, with a p-value <0.05 considered statistically significant. Additionally, the difference in malaria prevalence between the two study areas was assessed using the chi-square test. RESULTS: Among the 528 study participants, the overall malaria prevalence was 16.1 % (85/528). Specifically, the prevalence was 13.6 % (36/264) at Maksegnit Health Center and 18.6 % (49/264) at Sanja Health Center. The difference in malaria prevalence between the two study sites was not statistically significant (p > 0.05). In Maksegnit Health Center, malaria prevalence was significantly associated with the age groups 6-14 years: 16.09 (2.65-37.80) and 15-24 years: 8.21 (2.74-20.98), as well as rural residence 14.25 (3.13-44.86). In Sanja Health Center, significant associations were observed with the age group 15-24 years: 8.21 (2.74-20.98), lack of bed net availability: 11.84 (3.36-41.66), and recent travel history: 5.58 (1.32-23.70). CONCLUSION: This study revealed that malaria prevalence was moderately high in both study areas, with no statistically significant difference between the two sites. However, unique factors were associated with malaria prevalence in each location. These findings underscore the importance of targeted interventions to address area-specific risk factors, such as improving bed net distribution, enhancing housing conditions, and eliminating mosquito-breeding sites.