Prevalence and associated risk factors of malaria among febrile patients at Kidist Hana Health Center Fogera District, Amhara Regional State, Northwest Ethiopia

Abstract

Malaria remains a major public health problem in Ethiopia. Monitoring local prevalence and associated risk factors is essential for effective control and elimination strategies. This study aimed to determine the prevalence of malaria and identify associated risk factors among patients attending Kidist Hana Health Center. A facility-based cross-sectional study was conducted. Blood samples were collected from febrile patients and examined using both microscopy and First response malaria Ag P.f and P.v rapid diagnostic tests (RDTs). A structured questionnaire was used to gather socio-demographic and environmental data. Data were analyzed using SPSS version 26. Bivariable and multivariable logistic regression analysis was carried out to measure the strength of association. An Adjusted Odds Ratio (AOR) with 95% Confidence Interval (CI) was used. Moreover, variables with p -value ≤0.05 were considered as statistically significant with the outcome variable. The overall prevalence of malaria by microscopy was 40.5%, with Plasmodium falciparum (78.4%) being the most predominant species. The prevalence varied significantly across different kebeles. Multivariate analysis revealed that malaria infection was significantly associated with marital status (widowed), age below five years, low household income, lack of insecticide-treated net (ITN) ownership, presence of stagnant water near the residence, and outdoor sleeping habits. Microscopy demonstrated a higher detection rate compared to First response malaria Ag P.f and P.v RDTs (40.5% vs. 38.9%). The sensitivity of RDT test was 95.91%. The specificity of RDT was 91.24%. The Positive Predictive Value was 88.16%. The Negative Predictive Value was 97.04%. The study reveals a high malaria burden in the study area, driven by a combination of socio-demographic, environmental, and behavioural factors. To reduce transmission, intensified public health interventions are recommended, including ensuring universal ITN coverage and use, implementing community-based environmental management to eliminate mosquito breeding sites, and targeting high-risk groups with focused health education.