Prevalence of asymptomatic malaria and its associated factors in the Al Zuhrah district, Al-Hodeidah Government, Yemen, 2022

BACKGROUND: Asymptomatic malaria represents a significant health issue, especially in endemic regions where asymptomatic individuals serve as reservoirs. In Yemen, the Al-Hodeidah governorate is the primary endemic area. This study aims to determine the prevalence of asymptomatic malaria and its associated factors in Al-Zuhra District, Al-Hodeidah Governorate. METHODS: A cross-sectional community-based study was conducted using a multistage sampling method with probability proportional to size to select villages and households. In each household, one eligible member who had not experienced malaria symptoms and had consented to participate was randomly selected. Data were collected using a semi-structured questionnaire, and blood samples were tested for malaria using a Rapid Diagnostic Test. Logistic regression was used to calculate crude and adjusted prevalence odds ratios (APOR) with 95% confidence intervals (CI). A P value < 0.05 was considered statistically significant. RESULTS: A total of 422 participants were enrolled, with a mean age of 35.7 ± 11 years; 47% were male, and 62% were from a family with more than five members. The overall prevalence of asymptomatic malaria was 5%, with Plasmodium falciparum accounting for 95% of infections. Being educated was protective against infection (APOR = 0.35; 95% CI 0.13-0.97; p = 0.043). Absence of window screens (APOR = 9.56; 95% CI 2.15-42.51; p = 0.003), and living near stagnant water (APOR = 4.93; 95% CI 1.50-16.23; p = 0.009) were significantly associated with asymptomatic malaria. CONCLUSION: Asymptomatic malaria remains present in Al-Zuhra District, with Plasmodium falciparum accounting for the majority of infections. Environmental and household factors, particularly absence of window screening and proximity to stagnant water were strongly associated with infection, while education showed a protective effect. These findings highlight the importance of strengthening household-level vector control measures, improving environmental management, and enhancing community awareness to reduce asymptomatic malaria transmission in the area.