Table 2 Characteristics of all included studies in the scope review of urban malaria in SSA

Acheampong et al. 2021

Case control study

298

Ghana

Urban and rural

• Urban dwellers exhibited severe forms of malaria compared to rural dwellers with malaria

• In both age and gender categories, parasitaemia was significantly higher in urban dwellers than rural dwellers

[27]

Awosolu et al. 2021

Cross- sectional study

300

Nigeria

Urban

• The study showed strong evidence that malaria is still highly prevalent in urban communities

• The prevalence of malaria was 55% with mean parasite density of 1814.70

• Age (6–10 years), the presence of streams, living near streams within ≤ 1 km and travel to rural areas were the major risk factors that often increase the odds of malaria infection in this study area

[28]

Ba et al. 2018

Cross- sectional study

4671

Senegal

Urban

• All household members underwent microscopic examination

• The prevalence of malaria infection was 0.06%

• The prevalence was 0.04% (2/4,671) for Plasmodium malariae and 0.02% (1/4,671) for Plasmodium falciparum

[29]

Ferrao et al. 2016

Cross- sectional study

490,555

Mozambique

Urban

Weekley maria data from 2006–2014 were collected from Epidemiologic bulletin and found that malaria is high in semi-urban and rural areas than urban

[30]

File and Dinka 2020

Cross- sectional study

2590

Ethiopia

Urban

• The prevalence of malaria during the study period was 3.7% (97/2590)

• Adolescents and adults (>/= 15 years of age) were found to be most affected by Plasmodium vivax (66%) and Plasmodium falciparum (20.5%)

• Analysis of the climatological data revealed a rise in environmental temperature and relative humidity during the study that coincides with the increase of malaria cases

• History of previous malaria infection was found predictor of malaria infection

[31]

File et al. 2019

Cross- sectional study

6862

Ethiopia

Urban

• A 5 years retrospective data revealed that adolescents and adults (≥ 15 years old) were the most affected by Plasmodium vivax 43.5% and Plasmodium falciparum 31.7%. It indicated that the burden of P. vivax has been increasing over the years compared to falciparum

• Plasmodium vivax emerged as the dominant species contributing to the malaria burden in the city, showing less seasonal variability

[32]

Georganos et al. 2020

cross-sectional study

–

Uganda and Tanzania

Urban (Kampala and Dar es Salaam)

• This finding indicated, within the urban, that those who were living in informal settlements show higher malaria prevalence compared to those living in planned residential neighborhoods which was

• The rapid annual expansion of informal settlements, which often accommodate a significant portion of the urban population, highlights the importance of conducting systematic and consistent malaria surveys in these areas

• This study underscores the significance of remote sensing as an epidemiological tool for mapping urban malaria variations across large spatial scales and supporting evidence-based policymaking and control strategies

[33]

Govoetchan et al. 2022

Cross- sectional study

21,008

Benin Republic

Urban and rural

• The prevalence of malaria in urban was 39% and in rural was 36%

• Severe cases were more frequent in the urban health facility than in the rural facility

• In Urban malaria prevalence was highest among individuals over 15 years old

[34]

Hassen and Dinka 2020

Cross- sectional study

175,423

Ethiopia

Urban

• A retrospective analysis of data from 2012 to 2017 revealed that, the prevalence of malaria was 12.4% of which 49.5% P. falciparum and 50.5% P. vivax

[35]

Hassen and Dinka 2022

Cross- sectional study

356

Ethiopia

Urban

• Health facility-based study indicated that the prevalence of malaria was 17.13%

• Among the malaria-positive patients, 50.8% of them were positive for Plasmodium vivax, 45.90% were positive for Plasmodium falciparum, and 3.3% had mixed infections

• Having insecticide-treated net, houses sprayed with insecticides, and living closer to stagnant water were found to be the factors associated with malaria infection

[36]

Kabaria et al. 2016

Cross- sectional study

–

Tanzania

Urban

• The study showed the existence of malaria risk in urban and which also lacks homogeneity in area

• The satellite image also showed heterogeneity in malaria risk within the town which was influenced by varying environmental factors: proximity to dense vegetation, wet/swampy areas and densely built-up areas

[37]

Kazembe and Mathanga 2016

Case control study

767

Malawi

Urban

• The finding showed that visiting rural areas, age of the child, and socio-economic were determinants of urban malaria infection

[38]

Kigozi et al. 2015

Cross- sectional study

1167

Uganda

Urban

• The study found that higher composite urbanicity score in urban was associated with a lower household density of mosquitoes (incidence rate ratio = 0.28) and a lower parasite prevalence (odds ratio, OR = 0.44)

[39]

Kouna et al. 2024

Cross- sectional study

2381

Gabon

Urban, peri-urban and rural

• In urban areas, the overall prevalence of Plasmodium spp. infection was 21.6%, the prevalence in semi-rural was 50.6% and the prevalence in rural was 51.2%

• Majority were falciparum species

• But unequal sample size employed for comparison

[40]

Larson et al. 2021

Cross- sectional study

7564

Malawi

Urban and rural

• The study showed that the prevalence of malaria was 20.6% (slide positive)

• The study found that Plasmodium parasitaemia status was strongly associated with distance to lakes, Wealth Index and Use of ITN

[9]

Mathanga et al. 2016

Case control study

473

Malawi

Urban and rural

• Having travelled in the month before testing, electricity in the house, and a higher level of education were associated with malaria infection decreased odds of malaria disease

• Travel was the main factor influencing the incidence of malaria illness among urban respondents compared with peri-urban areas

[41]

Merga et al. 2024

Case control study

396

Ethiopia

Urban

• Travel history, presence of eves and holes on the walls, history of malaria diagnosis, owning any livestock, presence of stagnant water, sleeping under bed net the previous night and knowledge on malaria and its prevention were determinants of urban malaria infection

[42]

Mutala et al. 2019

Cross- sectional study

598

Ghana

Urban, peri-urban and rural

• Participants from the rural settlement had the highest malaria prevalence (21.3%) compared to urban (11.8%) and peri-urban areas (13.3%)

• However, unequal sample size was taken from each: urban, peri-urban and rural respondents

• The peri-urban area had the highest median parasite density

• Age was significantly associated with the odds of malaria positivity

[43]

Mwalimu 2019

Cross- sectional study

830

Tanzania

Urban

• Malaria prevalence in the study areas was 4.5%

• Low proportion of net ownerships, residing in the households surrounded by mosquito breeding sites and residing in houses with unscreened windows were independently associated with malaria infection

[44]

Ncogo et al. 2015

Cross- sectional study

444

Guinea

Urban

• This study found the high prevalence of malaria infection in rural (58.9%) than urban (33.9%)

• But unequal sample size used for this study

• Age, having fever in the last 24 months, and ITN utilization were statistically significant variables for the malaria infection in urban

[45]

Ngom and Siegmund 2015

Literature review

–

Cameroon

Urban data

• The findings indicated that the prevalence of urban malaria was strongly influenced by population density and the socio-economic status of the community

[46]

Nyasa et al. 2023

Cross- sectional study

500

Cameroon

Urban and rural

• Malaria prevalence was higher in rural areas 57.6% than urban areas 46.8%

• Malaria infection was significantly associated with presence of crops around homes, usage of old LLINs for more than three years and educational status

[47]

Okangba 2019

Literature review

–

sub-Saharan Africa

Urban

• The review showed Lack of education, low income, low wealth, living in poorly constructed houses, and having an occupation in farming may increase risk of Plasmodium infection among people in sub-Saharan Africa

[48]

Paintsil et al. 2024

Cross- sectional study

550

Ghana

Urban

• The finding showed the overall malaria prevalence rate was 7.8%

• Plasmodium falciparum constituted the majority (97.6%) of the infections, with Plasmodium ovale being responsible for only one (2.3%) case

• Age and sex were found predictors of malaria infection

[49]

Teka et al. 2023

Cross- sectional study

9,468,970

Ethiopia

Urban

• A retrospective study was done among a total of 9,468,970 malaria cases between 2014 and 2019

• Of these, 1.45 million (15.3%) cases were reported from urban settings

• The prevalence of Plasmodium falciparum was (67%) and Plasmodium vivax (28%) with higher proportion of P. vivax infections in urban areas

• The study showed that in 2019, An. stephensi was identified in 17 towns, where over 19,804 malaria cases were reported, with P. falciparum accounting for the majority (56%) of the cases

[50]

Zhou et al. 2016

Cross- sectional study

1434

Ethiopia

Urban

• The prevalence of malaria was 29.8% (with a 1434 suspected malaria cases and 428 confirmed malaria cases)

• Among them, 327 (76.4%) cases were Plasmodium vivax, 97 (22.7%) were Plasmodium falciparum, and 4 (0.9%) were mixed infection of P. vivax and P. falciparum

• Occupation status, sex, history of malaria illness during the preceding 30 days and history of travel were the determinants of malaria in Jimma town

[51]

Adah et al. 2022

Cross- sectional study

1101

Nigeria

Urban and peri-urban

• The prevalence of malaria was 47% compared to 42% in peri-urban showing that the prevalence was higher in urban than peri-urban

[52]

Arinaitwe et al. 2020

Case control study

567

Uganda

Urban

• Recent overnight, age, staying at relatives’ home, failure to sleep under an ITN during travel and travel to districts that had not received IRS were determinants of malaria infection

[53]

Savi et al. 2022

–

–

Ghana

Urban

• The study found that the prevalence of malaria was impacted by seasonality, but the trend of the seasonal signature is not noticeable in urban and peri-urban areas

• While urban districts have a slightly lower prevalence, there are still pockets with higher rates within these regions

• The areas of high prevalence of malaria in urban were linked to proximity to water bodies and waterways

[54]

García et al. 2023

Cross sectional

25,920

Bioko Island

Urban and peri-urban

• This survey compared the malaria prevalence between 2015 and 2018 by comparing urban and rural population included in the survey

• The prevalence of urban malaria was 12% in 2015 and 10.9% in 2018. The prevalence reported from urban in 2018 was higher than the prevalence reported from rural (10.1%) in the same year

• Age, sex, travel history and ITN utilization were determinants of urban malaria

[55]

Molla et al. 2024

Cross sectional

504

Ethiopia

Urban and rural

• The prevalence of urban malaria was 29.6%

• For all seasons, malaria infection was significantly higher in the urban setting

• Residence, anemia status, mosquito net utilization and distance from mosquito breeding places were determinants of urban malaria

[56]

Chiziba et al. 2024

Cross-sectional study

14,139

Nigeria

Urban

• The study reported malaria positivity rate by clusters (988 clusters) from 2010 to 2021

• Vegetation index, population density, age, wealth index, educational level

[57]