Determinants Of Malaria Infection Among Patients At Health Facilities In Guduru District, Horo Guduru Wollega Zone, Oromia, Ethiopia

Abstract

Background: Malaria continues to be one of the worst public health issues in the world, causing a high rate of morbidity, especially in poor nations. One of the sub-Saharan countries with high malaria endemic is Ethiopia. The disease remains a significant health issue in Ethiopia, despite community efforts to mitigate its impact and to the best of my knowledge, no research has been conducted to identify associated factors in the study area. Furthermore, according to the Guduru district health office report of 2023/2024, malaria cases are currently spreading widely in previously unconventional areas, especially the highland part of the district. Objective: The main objective of the study was to identify determinants of malaria infection among patients at health facilities in Guduru district, Horo Guduru Wollega Zone, Oromia, Ethiopia, 2024. Methods: A facility-based, unmatched case-control study design was conducted from November 10 to December 10, 2024. A total of 328 sample sizes (82 cases and 246 controls) were selected by systematic random sampling from selected health facilities in Guduru district. A pretested, interviewer-based structured questionnaire was used to gather data. The gathered data were entered into Epi Info Version 7.2.5 and then exported to SPSS Version 27 for analysis. Bivariable logistic regression analysis was conducted to identify candidate variables at a P-value < 0.25. Multivariable logistic regression analysis was made to identify independently significant variables. A p-value< 0.05 was used to report statistical significance and AOR with 95% CI for strength of association. Result: A total of 328 study participants, consisting of 82 cases and 246 controls, were included in the study, giving a response rate of 100% for both cases and controls. In the multivariable logistic regression, males (AOR = 3.56, 95% CI = 1.67–7.58), younger children (AOR = 7.93, 95% CI = 1.52– 21.26 for <5 years and AOR = 7.36, 95% CI = 3.34–14.18 for 5–14 years), the presence of holes in the walls (AOR = 4.51, 95% CI = 1.26–16.12 ), the absence of insecticide-treated nets (ITNs) (AOR = 3.19, 95% CI = 1.70–5.97), and travel history (AOR = 3.33, 95% CI = 1.17–9.48) were found to have a statistically significant association with malaria infection. Conclusion: Male sex, younger children (less than five years old and those aged five to fourteen), presence of holes in the wall, the lack of insecticide-treated nets and past travel history were all associated with an increased risk of contracting malaria in the Guduru district. These results emphasize the need for focused interventions that target male populations and vulnerable age groups, improve housing conditions, promote the consistent use of insecticide-treated nets and address travel-related risk to lower the spread of malaria.