Published in PLOS One on 2026-07-06, this study is presented as an attributed evidence briefing. The excerpts below are the original researchers’ words, reproduced under their Creative Commons Attribution licence. Health Signal has selected the abstract and, where needed, opening background paragraphs; the complete methods, results, limitations and references remain in the linked paper.
Original authors: Wondimnew Desalegn Addis, Agmas Wassie Abate, Negede Yiheyis Tasew, Amare Yirga Abate, Belete Asnake Sitotaw, Abay Semagn Kassie, Elelta Mulugeta Ayalew, Birhanemaskal Malkamu, Kindie Mitiku
Source: PLOS One • DOI 10.1371/journal.pone.0352762
Read the complete primary study ↗ · Creative Commons Attribution licence
From the researchers
Abstract
The issue of self-medication with anti-malarial drugs is a critical public health challenge. Despite national guidelines promoting diagnostic-confirmed treatment, evidence addressing the prevalence of self-medication with anti-malarial drugs and drivers in Ethiopia is scarce. Therefore, this study aimed to bridge this gap and to provide meaningful insights into ongoing efforts to curb the misuse of anti-malarial drugs and helping the strategy of malaria eliminationby investigating the prevalence of self-medication with anti-malaria drugs and its associated factors.
An institution-based cross-sectional study was conducted in Dera District, Northwest Ethiopia, from June 1–30, 2025. A total of 591 febrile patients were selected using a stratified multistage sampling technique. Data were collected through interviewer-administered structured questionnaires developed by reviewing different related literatures. Data entry and analysis were done using Epi-Data version 4.6 and STATA 17. Multivariable binary logistic regression analysis was performed to identify factors associated with self-medication. Statistical significance was declared at a p-value less than 0.05.
The prevalence of self-medication with anti-malarial drugs was 42.8% (95% CI: 38.9%–46.8%). Factors positively associated with self-medication included: monthly income of ≥5000 ETB (AOR = 1.64, 95% CI: 1.04–2.59), poor knowledge about malaria (AOR = 1.68, 95% CI: 1.12–2.55), poor risk perception towards self-medication (AOR = 2.10, 95% CI: 1.40–3.14), and distance ≤5 km from private drug sellers (AOR = 1.65, 95% CI: 1.10–2.47). Community-based health insurance membership was negatively associated with self-medication (AOR = 0.60, 95% CI: 0.41–0.88).
Self-medication with anti-malarial drugs was moderate (33.4%_66.6%) in the study area based on percentile classification. The findings highlighted the need for designing different strategies to reduce inappropriate drug use and promoting community-based health insurance enrollment.
1 Introduction
Malaria is a life-threatening parasitic disease caused by Plasmodium species and transmitted by the infected female Anopheles mosquitoes [1,2]. It remains a major health challenge; elimination efforts are hampered by weak diagnostic coverage, anti-malarial resistance, and widespread self-treatment practices [3,4]. Self-medication is defined as the use of medicines without the advice or prescription of healthcare professionals [5]. In malaria, this often involves taking anti-malarial drugs such as Artemisinin-based Combination Therapies (ACTs), chloroquine, or quinine without prior diagnostic testing [6,7]. Contributing factors include perceived familiarity with malaria symptoms, financial constraints, poor access to health facilities, and the ready availability of drugs from pharmacies, shops, or informal vendors [8–10].
Self-medication with anti-malarial drugsdelays the correct diagnosis of other febrile illnesses, increases the risk of complications, and sustains malaria transmission within communities [11]. Critically, inappropriate and incomplete treatment contributes to the development of drug-resistant parasites. Artemisinin resistance, characterized by delayed parasite clearance and linked to molecular mutations, has already been detected in parts of Africa, with early warning signals emerging from Ethiopia [12–14].
Reading this evidence
Use the full paper to check the study design, participant selection, comparator and outcome definitions before drawing a practical conclusion. An association does not by itself show cause and effect. A reported performance measure needs its denominator and uncertainty. A finding from a particular facility, sample or time period should retain that scope when it is discussed elsewhere.
This briefing makes the source accessible within the wider technology & industry desk. It does not assess an individual patient or certify a product. When considering relevance to another health system, examine the original authors’ account of context and limitations, then seek local implementation evidence. The related reporting below provides other studies to read alongside this one; it is a topic connection, rather than a claim that their results are directly comparable.
© 2026 Wondimnew Desalegn Addis, Agmas Wassie Abate, Negede Yiheyis Tasew, Amare Yirga Abate, Belete Asnake Sitotaw, Abay Semagn Kassie, Elelta Mulugeta Ayalew, Birhanemaskal Malkamu, Kindie Mitiku. Excerpts reproduced under CC BY. Selection, formatting and contextual notes by Health Signal. The researchers are the authors of the source study, not members of Health Signal’s staff.
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- Evidence brief: Investigating barriers to adherence to antimalarial prescribing guidelines in public healthcare facilities in Arba Minch, South Ethiopia: A qualitative study
- Evidence brief: Implementation fidelity of Ethiopia’s Malaria test-and-treat guideline amid a resurgence in Amhara Region: A mixed-methods study
- Evidence brief: Patients’ trust in healthcare providers and associated factors among hospitalized patients in Awi Zone Public Hospitals, Northwest Ethiopia
