Prevalence of malaria in the United Villages region, Northern Khartoum State, during armed conflict

Malaria remains a major public health concern in sub-Saharan Africa, where under-resourced health systems and environmental conditions continue to facilitate transmission. In Sudan, the situation has been further aggravated by the ongoing armed conflict that began in April 2023, which has disrupted healthcare services, population movement, and vector control programs. This study was carried out based on data collected amid aggravated war situations in the United Villages region, Northern Khartoum State, to draw a picture of malaria transmission and burden. This retrospective cross-sectional study included 509 patients from two resource-limited centers (Alfaki Hashim and Algaalyn) in the United Villages region with clinical complaints of fever and headache from August 1, 2025, and December 1, 2025. Variables included age, gender, and the result of the thick blood film for malaria. Of 509 patients analyzed, 487 (96%) tested positive for Plasmodium infections by microscopy, while 22 (4%) were negative. The study population comprised 335 females (66%) and 174 males (34%). Plasmodium falciparum (P. falciparum) was overwhelmingly dominant, accounting for 454 of 487 confirmed infections (93.2%), followed by Plasmodium vivax (P. vivax) (26/487; 5.3%) and mixed P. falciparum/P. vivax infections (7/487; 1.4%). Positivity rates were similarly high in both females (96%) and males (95.4%), with no statistically significant gender difference (p > 0.9). Across age groups, the highest positivity rate was observed in patients aged 25–64 and 15–24 years (97%); age-related differences in positivity did not reach statistical significance (p = 0.096). Species distribution did not differ significantly by gender (p = 0.1) or age group (p = 0.3). This study demonstrates a high prevalence of malaria among febrile patients in the United Villages region during the ongoing armed conflict. The findings highlight the substantial impact of disrupted healthcare systems and environmental conditions on malaria transmission and emphasize the urgent need for strengthened surveillance, diagnostic capacity, and vector-control interventions in conflict-affected areas of Sudan.