The overall prevalence rate of malaria parasite infection was 5.2%. This prevalence is lower than the studies done in different parts of Ethiopia, Tselemt district north Ethiopia (20.5%) [9], Jima town(11%) [10], and Benishangul 15.9% [11]and in African countries such as Uganda(19.04%) [12],Malawi(33%) [13],Ghana(20.9%) [14]. However, the prevalence of malaria in this study was higher than the prevalence determined by studies conducted in Sherkole refugee camp, Ethiopia (3.9%) [15]. The discrepancy could possibly be a result of the different geographical variations and malaria prevention and control initiatives carried out in the studied locations.
Both P. falciparum and P. vivax have been occurred in the area, however P. falciparum was found to be the most common species (3.7%), followed by P. vivax (1.3%) and mixed infections (0.2%). Similar to study conducted in Sanja Town, Northwest Ethiopia, where the prevalence of P.falciparum and P.vivax was 5.2% and 1.6% respectively [16]. But lower than that of study conducted in Damote Gale district, Southern Ethiopia where prevalence of P.falciparum and P.vivax and mixed infection was 44.1%, 42.1% and 13.2% respectively [17]. This discrepancy may be associated caused by the fact that the study area’s relatively lowland climatic conditions, where P. falciparum is a common species in the lowlands, as well as the possibility of treatment failure or recrudescence for P. falciparum, cannot be ruled out.
The prevalence of malaria was found to be greater in age groups between 48 -59months (15.8%) than in other age groups, which is in consistent with studies conducted in Tanzania that indicate the prevalence of (14.8%) [18] and in Malawi (13.7%) [13]. But lower than study conducted in Arba Minch “Zuria” district that indicated the prevalence of (27.9%) [19]. In this investigation it was observed that malaria cases increased with age and were lowest in infants under one year old ones. The finding was supported by investigation conducted in Ghana by [14]. This might be because maternal antimalarial antibodies transferred to the fetus in the last trimester of pregnancy protect the infant from early infections before they wane [20]. Malaria prevalence was found to be greater in rural (5.7%) as compared to urban dwellers (4.1%). Similar findings were documented in Kenya by [21] and Uganda [22]. This may be due to favorable condition for vector proliferation, lower housing quality, and poor drainage systems [23].
The majority of infected children had a low (< 1000 Parasites / µL blood) (53.6%) and followed by high parasite density which accounts for 46.4% of malaria positive children. The finding was in line with study conducted in Sanja Town, Northwest Ethiopia [16]. But lower than a high parasite density found in East Central Tanzania 69.4% [18]. The immunological conditions, age category, and dietary status of the study participants could have an impact on parasite density [24].
Children who stayed out doors at night were 3.09 times more likely to be exposed from malaria infection than those that did not. It was in line with the previous studies conducted in other places in Ethiopia Armachiho [25], Dembia district [26] and Sherkole [15], and in Zimbabwe [26]. This could be explained by exophagic-exophilic mosquito biting behavior [27]. As compared to those children who don’t utilize ITN, children that utilize ITN had a reduced risk of malaria infection. The finding is in coherence with earlier studies conducted in East Shewa zone of Oromia regional state [7], Southern Ethiopia [28], West Ethiopia Sherkole [15] and in Nigeria [29].
Children who living in house with eave were 4.08 times more likely have a higher risk of acquiring malaria infection than those in the houses without eave. This is supported by the study conducted in some localities in Ethiopia [30]. The presence of eave(s) might enable mosquitoes to enter inside houses, and this increases the probability of indoor mosquito bites.
Presence of river in close proximity to house (< 1 km) has shown a significant association. Children who lived proximity to river(< 1km) were 4.3 times more likely have a risk of getting malaria infection than those who lived far from the river(≥ 1km). This is supported by the study conducted in Southwestern Nigeria [31]. Studies also witness that the relationship between malaria vector density and the distance of settlement from a water body like river is an important indicator of malaria transmission [10].
Stagnant water around home was observed as a significant risk factor and was found to increase the odds of malaria disease among children by approximately eleven times compared with those without stagnant water around their homes. The finding is in line with supported by the study conducted in Southwestern Ethiopia [28] and North west Ethiopia [26]. Previous studies have demonstrated that stagnant water is a favorable breeding site for mosquito development and proliferation, leading to increased malaria transmission [32].