Prevalence and associated factors of malaria among general population in Ethiopia: a systematic review and meta-analysis

Malaria continues to be a major public health concern globally, with a significant burden concentrated in Africa. Ethiopia is one of the countries contributing to this burden. Despite ongoing preventive efforts, a comprehensive, national-level understanding of malaria prevalence and its associated risk factors among the general population remains lacking. This systematic review and meta-analysis aimed to fill this knowledge gap by pooling the prevalence of malaria and identifying factors influencing its spread in Ethiopia. We systematically searched databases for studies investigating Ethiopia’s malaria prevalence and associated factors. Relevant data were extracted, pooled using random-effects models, and assessed for heterogeneity and publication bias. The pooled prevalence of malaria was 14% (95% Confidence Interval (CI) [10–19]. Plasmodium (P) falciparum accounting 51% of the pooled prevalence followed by P. Vivax (37.5%) and mixed infection (11.5%). Factors such as male sex (Odd Ratio (OR) = 1.93; 95% CI: 1.40, 2.66), rural place of residence (OR = 2.37; 95% CI: 1.31–4.27), ITN non-utilization (OR = 2.72; 95% CI = 1.13–6.53), non-IRS service (OR = 2.28; 95% CI = 1.57–3.32), presence of mosquito breeding site (OR = 5.77; 95% CI: 3.15–10.55), and previous malaria infection (OR = 3.25; 95% CI = 1.85–5.72) were found to have a significant association with malaria infection. This SRMA reveals high malaria prevalence in Ethiopia, highlighting the need for targeted interventions. Emphasize the crucial role of ITNs, particularly in rural areas, and ensure wider coverage, prioritizing high-prevalence areas with abundant mosquito breeding sites.