Bridging the Knowledge Gap: Associations between malaria infections, personally used prevention measures, and risk factors in Al Gezira State, Sudan

Abstract Background: The burden of malaria continues to disproportionately affect Low- and middle-income countries (LMICs), including Sudan, due to various risk factors that influence malaria transmission. This study aimed at investigating the risk factors associated with malaria in three hyper-endemic areas in Al Gezira state, central Sudan. Where malaria transmission extend from January to September and get interrupted by the heavy rains during October-December. Methods: a descriptive cross-sectional study was implemented between January and September 2022. Febrile patients attending to the healthcare facilities seeking medical care in randomly selected healthcare facilities in the three localities were recruited. In addition to the results of malaria diagnosis, we interviewed the participants using a well-established questionnaire to collect data about potential risk factors for malaria infection. The risk estimates with Odds Ratio of 95% Confidence Interval was used to test the association of risk factors with malaria positive cases. A logistic regression model was used to analyze the association between the risk factors and malaria positive cases. A p-value < 0.5 was considered a statistically significant. Results: A total of 469 patients were enrolled, of them, 334 (71.2%) tested positive for malaria. The analysis of preventive measures and risk factors showed that wearing protective clothing (covering most of the mosquito-biting body-sites) is significantly protective against malaria, with a negative beta coefficient of -0.757 ( p-value 0.003). The relationship of using insecticides and presence of trees with reduced malaria infection was found statistically significant; p-values were 0.040 and 0.035, respectively. Similarly, the presence of stagnant water was a significant risk factor for malaria, with a negative beta coefficient of -0.483 ( p-value 0.022). Conclusions: The study's outcomes highlight the importance of advocating towards using preventive measures such as wearing clothes that reduce mosquito bites, and avoid being close to potential breeding sites (bodies of stagnant water) in malaria-endemic regions.