Determinants of malaria infection in Mopeia district, Mozambique: a population-based cross-sectional study

Abstract Background Malaria continues to be a public health concern, especially in poor and developing countries. Mozambique is one of the countries with higher rates of malaria infection worldwide. Thus, this study aims to assess malaria prevalence and associated sociodemographic and environmental determinants of infection in the Mopeia district, Central Mozambique. Methods A community-based cross-sectional study was conducted in 2022, with 1181 participants of all age groups (< 5; 5–15 and 15+), under the scope of the BOHEMIA project. Sociodemographic, environmental, and vector control strategies information was collected. Malaria was diagnosed using rapid diagnostic tests (RDTs). Multivariable logistic regression models were adjusted to identify which drivers best explain the infection prevalence. Results The prevalence of malaria among all age groups in Mopeia was more than a third (36%). Children under five years of age had the highest prevalence (56%). Age had a non-linear association with the odds of malaria. For each additional year of age up to age 30, there was a 6% decrease in the odds of malaria infection (aOR=0.94, 95% CI: 0.91–0.96). And from 30 and older, the odds of contracting malaria stabilise (aOR = 1.06, 95% CI: 1.01–1.12). Residents of Rovuma/Conho (aOR = 2.79, 95% CI: 1.18–6.62) and Luala (aOR = 2.33, 95% CI: 1.21–4.49) have an increased probability of being infected. Ownership of livestock by the household was related to a 59% increase in the odds of malaria infection (aOR = 1.59, 95% CI: 1.02–2.48) in the adjusted model 1; however, this association became non-significant (aOR=1.53, 95% CI: 0.96–2.45) after adjusting for variables (household size and persons per LLIN). Access to communication devices tended to reduce the probability of infection in the crude and initial adjusted models (aOR = 0.70, 95% CI: 0.49–1.01), but the model was not statistically significant after adding the variables household size and persons per LLIN. Conclusions Malaria is hyperendemic in Mopeia. The prevalence was more pronounced among younger people, and geographical inequalities were observed in Mopeia. Household livestock ownership was also linked to increased risk for malaria, whereas access to communication suggested a reduction in the risk of infection, likely due to improved access to health information.