PREVALENCE OF MALARIA AND ASSOCIATED FACTORS AMONG PREGNANT WOMEN VISITING GABILEYR EGIONAL HOSPITAL, WESTERN SOMALILAND

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.