Abstract
Background Despite ongoing control and elimination efforts, malaria continues to impose a substantial burden on healthcare systems and communities in Ethiopia. Understanding the epidemiology of malaria and identifying associated risk factors are essential for guiding targeted interventions and improving health outcomes. This study thus aimed to assess malaria prevalence and associated risk factors among febrile patients in selected healthcare facilities of Jawi District, northwest Ethiopia.Methods A health facility-based cross-sectional study was conducted from April to November 2023 in Jawi District, northwest Ethiopia. The study involved 420 participants who visited government-owned health facilities seeking treatment for febrile illnesses. Socio-demographic data and malaria-related factors were collected using structured questionnaires. Additionally, blood samples were obtained from study participants and examined for malaria parasites using microscopy. Multivariate logistic regression was employed to identify the major explanatory risk factors associated with malaria prevalence.Results The study revealed a malaria prevalence rate of 41.2% (173/420), and Plasmodium falciparum being the predominant species (64.8%) detected. Socio-demographic factors such as lack of formal education (AOR = 2.222; 95% CI: 0.354–13.924, p = 0.041) and proximity of residence to mosquito breeding sites (AOR = 222.484; 95% CI: 5.085–973.440, p = 0.005) appeared as significant risk factors for malaria. Furthermore, awareness gaps regarding malaria transmission in the community (AOR = 1.744; 95% CI: 0.232–3.848, p = 0.039) were found to influence malaria vulnerability. Housing characteristics and inconsistent utilization of preventive measures were also identified as contributors to malaria prevalence among study participants.Conclusion The findings of the present study revealed that the rate of malaria transmission was high. The malaria transmission had a multifactorial nature including socio-demographic, environmental and behavioral factors. Integrated control strategies that address socio-demographic, environmental, and behavioral determinants are crucial for mitigating the burden of the disease. Strengthening education and awareness programs, improving housing conditions, and ensuring sustainable access to malaria diagnosis, treatment, and preventive services are essential components of effective malaria control in the study area.