Abstract / Summary
Malaria continues to pose a major public health threat, especially in sub-Saharan Africa. In Ethiopia, approximately 68–75% of the landmass is malarious, exposing over 60% of the population to infection. Despite intensified control measures, there has been a resurgence in recent years across various regions. This study aimed to analyze 5-year malaria trends in the Gedeo Zone of Southern Ethiopia to illustrate epidemiological patterns. A retrospective study was conducted using secondary health-facility data from surveillance records maintained by the Gedeo Zone Health Department. The study period spanned 5 years, from January 2021 to December 2025. Data on malaria cases diagnosed by microscopy or rapid diagnostic tests were extracted. Data on Plasmodium species and demographic characteristics were analyzed using SPSS version 25. Descriptive statistics were used to summarize frequencies, proportions, and temporal trends. A total of 436,673 individuals were tested for malaria, of which 86,879 were confirmed, yielding an overall malaria test positivity rate of 19.9% (95% CI 19.4–20.3%). The annual number of confirmed malaria cases increased substantially from 4,648 cases in 2021 to 39,727 cases in 2025. P. falciparum was the dominant species, accounting for 63.4% of cases, followed by P. vivax (28.0%) and mixed infections (8.6%). The number of individuals tested was higher among males (233,451; 53.5%) than females (203,222; 46.5%) (p < 0.001). Individuals aged ≥15 years accounted for the highest proportion of suspected and tested cases (189,288; 43.3%) (p < 0.001). Malaria burden in the Gedeo Zone increased substantially between 2021 and 2025, with clear spatial and seasonal patterns. The predominance of P. falciparum and identification of high-transmission areas highlight the need for targeted, stratified interventions. Strengthening surveillance, optimizing seasonal control measures, and implementing location-specific strategies are essential to reverse the current trend.