Attack rate and determinants of malaria outbreak in Ethiopia: A systematic review and meta-analysis

Abstract

<h2>Abstract</h2><h3>Background</h3> Malaria remains a public health challenge in Ethiopia. Despite progress in reducing cases and deaths, there has been a resurgence. This highlights the need to identify driving factors for malaria outbreaks and sustain progress toward elimination. This study aims to determine the overall attack rate of malaria outbreaks and identify the key determinants. <h3>Methods</h3> The study was registered with PROSPERO with the registration code CRD42025645940. Databases, including PubMed, EMBASE, Google Scholar, Google, and Web of Science. Analyzed using R version 4.2.3 and Stata version 17.0. <h3>Results</h3> In this study, the pooled estimated attack rate of malaria outbreaks in Ethiopia was 3 % (95 % CI: 2 %–5 %). Presence of stagnant water (OR = 3.45; 95 % CI: 2.06, 4.84), staying outside at night (OR = 3.79; 95 % CI: 2.39, 5.20), not using insecticide-treated bed nets (OR = 3.52; 95 % CI: 3.13, 3.92), lack of knowledge about transmission and preventions methods (OR = 4.73; 95 % CI: 1.67, 7.80), knowing transmission and prevention methods (OR = 0.38; 0.13, 0.64), presence of breeding sites (OR = 3.40; 95 % CI: 1.35, 5.44), not using indoor chemical sprays (OR = 3.19; 1.76, 4.63). <h3>Conclusion</h3> To combat these outbreaks, a comprehensive approach is recommended, involving environmental management to eliminate mosquito breeding sites, public health education, and increasing access to preventive tools such as ITNs and indoor residual spraying. Addressing these determinants effectively can reduce malaria outbreaks, leading to a decrease in morbidity and mortality, and improve public health outcomes.