Abstract / Summary
Abstract Background Malaria remains an important public health challenge in tropical regions, including Indonesia, particularly in endemic areas where environmental conditions support Anopheles mosquito transmission. Sustainable malaria elimination requires not only vector control interventions but also understanding household behaviors and environmental determinants. This study aimed to investigate the association between community behaviors, mosquito breeding-related environmental factors, and malaria infection in the working area of Hanura Primary Health Center, Pesawaran District, Lampung Province, Indonesia. Methods A case-control study was conducted involving 180 participants, including 60 microscopically confirmed malaria cases and 120 malaria-negative controls. Data were collected through structured interviews and household environmental observations. Chi-square tests, stratified analysis, and multivariable logistic regression were performed to identify independent risk factors. Results Night-time outdoor activities were significantly associated with malaria infection in the bivariate analysis (OR = 2.03; 95%CI:1.035–4.011; p = 0.025). After adjustment for potential confounders, household installation of wire mesh on ventilation openings remained significantly associated with malaria risk reduction (OR = 3.15; 95%CI:1.099–9.074; p = 0.033). Mosquito repellents, bed net use, mosquito breeding sites, and breeding-site distance were not significantly associated with malaria infection Conclusions Strengthening household-level interventions, particularly improving housing protection and reducing risky night-time exposure, may contribute to malaria control strategies in endemic settings.