Published in PLOS One on 2026-02-05, 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: Hiwot Teka, Saron Fekadu, Legesse Alamerie Ejigu, Solomon Sisay, Melat Abdo, Mulugeta Demisse, Hassen Mamo, Chris Drakeley, Isabel Byrne, Girmay Medhin, Lemu Golassa, Endalamaw Gadisa, Fitsum Girma Tadesse, Myat Nyunt
Source: PLOS One • DOI 10.1371/journal.pone.0328118
Read the complete primary study ↗ · Creative Commons Attribution licence
From the researchers
Abstract
Malaria remains a significant public health concern in Ethiopia, affecting both rural and urban populations. In urban settings, rapid unplanned expansion, poor drainage, and population movement are increasingly creating aquatic habitats that support vectors such as Anopheles stephensi, thereby leading to complex and underestimated transmission patterns. Serology-based risk factor analyses offer a sensitive indicator of recent and past exposure, helping to reveal underlying transmission patterns and more tailored interventions. This study assessed malaria seroprevalence and associated risk factors among residents of three towns in Ethiopia: Adama, Metehara, and Awash Sebat Kilo to better characterize transmission dynamics and identify context-specific vulnerabilities. A community-based cross-sectional survey was conducted from January 30 to March 14, 2020, involving 912 individuals from randomly selected 196 households. Malaria infection was diagnosed using rapid diagnostic tests (RDTs) and quantitative polymerase-chain reaction (qPCR). Serological analyses were performed to determine exposure to Plasmodium falciparum and Plasmodium vivax. The study found a low malaria prevalence of 0.78% by RDT and 4% by qPCR, with 1.7% of cases due to P. falciparum and 2.3% due to P. vivax. The overall seroprevalence was 19.4% (149/767) for P. falciparum and 18% (139/767) for P. vivax using combined short-lived response markers. Seroprevalence rates varied among towns, with Awash Sebat Kilo showing the highest exposure for recent markers (36.5% for P. falciparum; 28% for P. vivax) compared to lower rates in Adama (2.8% and 2.8%, respectively). Proximity to breeding sites (OR = 2.8, 95% CI: 1.1–7.4; p = 0.037) and being older than 15 years (OR = 4.0 95% CI: 2.1–7.6; p < 0.001) were significant risk factors for P. falciparum and P. vivax malaria exposure, respectively. This study demonstrates marked heterogeneity in malaria exposure across urban settings, with the lowest seroprevalence observed in Adama and higher levels in Awash Sebat Kilo. The findings emphasize the importance of incorporating serological surveillance into routine monitoring and highlight the need for targeted, locally tailored control strategies. Such tailored approaches will be increasingly critical, particularly in the context of emerging urban transmission risks driven by the expansion of An. stephensi in the region.
Introduction
Despite notable progress in malaria control since the early 2000s, the disease remains a major global health challenge. In 2023, an estimated 263 million cases and 597,000 deaths were reported globally, representing an increase of 11 million cases compared to the previous year [1]. The African region continues to bear a disproportionate burden, with Ethiopia ranking among the top five countries in terms of malaria cases, contributing approximately 4% of the global caseload [1].
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 Hiwot Teka, Saron Fekadu, Legesse Alamerie Ejigu, Solomon Sisay, Melat Abdo, Mulugeta Demisse, Hassen Mamo, Chris Drakeley, Isabel Byrne, Girmay Medhin, Lemu Golassa, Endalamaw Gadisa, Fitsum Girma Tadesse, Myat Nyunt. 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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