Abstract:
Background and Aims: Malaria is a life-threatening parasitic disease transmitted by female
Anopheles mosquitoes. Plasmodium falciparum and Plasmodium vivax are the most prevalent
species and P. falciparum is the most dangerous.
Objective: To determine the prevalence and associated factors of malaria among pregnant women
visiting Gabiley regional hospital in Gabiley district, Western Somaliland from April 15 to June
30, 2025
Methods: A facility-based cross-sectional study was conducted among 279 pregnant women in
Gabiley district to determine the prevalence of malaria and associated factors. Participants were
selected through random sampling based on antenatal clinic attendance. Socio-demographic and
clinical data was collected by trained data collectors. Data were collected structured questionnaire
via interviews and blood tests using RDTs and microscopy. Analysis was done using Epi Data
3.1 and SPSS 26, with bivariable and multivariable logistic regression employed to identify
significant factors. Associations were reported as odds ratios (95% CI), with p < 0.05 considered
statistically significant.
Result: The prevalence of malaria was found to be 28.0% (78/279; 95% CI: 22.8%–33.2.) Multivariable
logistic regression analysis identified environmental factors as the main predictors of malaria infection.
Place of residence was significantly associated, with pregnant women living in rural areas having lower
odds of malaria compared with urban residents (AOR = 0.48, 95% CI: 0.24–0.95). Use of tap or borehole
water was independently associated with increased malaria risk (AOR = 1.95, 95% CI: 1.01–3.75), as was
traveling 20–30 minutes to a water source (AOR = 1.19, 95% CI: 1.11–4.32). In contrast, socio
demographic and obstetric factors including age, educational status, income, parity, gestational age,
antenatal care attendance, malaria knowledge, ITN ownership, and ITN utilization were not independently
associated with malaria infection.
Conclusion: The prevalence of malaria was remained high despite good antenatal care attendance, malaria
education, and bed net coverage. Malaria infection was independently associated with environmental factors
particularly residence, water source, and distance to water with higher risk among urban residents and those using
tap or borehole water, likely due to water storage–related mosquito breeding. Socio-demographic and obstetric
factors showed no independent association, highlighting the need to prioritize environmental management and safe
water storage to reduce malaria risk during pregnancy.
