Burden of malaria infection among most vulnerable populations in Ethiopia: an umbrella review of systematic reviews and meta-analyses

Abstract

Background: Malaria is a protozoan disease caused by species of plasmodium. Despite the expanded control efforts, it continues to threaten vulnerable groups in Ethiopia. It remains a leading cause of illness and death, particularly among pregnant women, children, and migrant populations. Though previous studies report varying estimates of prevalence and risk factors, findings remain inconsistent. This umbrella review synthesizes existing systematic reviews and meta-analyses studies to clarify the burden and key predictors of malaria, offering consolidated evidence to guide targeted interventions. Methods: This umbrella review included six systematic reviews and meta-analyses identified through comprehensive searches of PubMed, Hinari, Science Direct, and Google Scholar. Eligible studies were published in English up to June 20, 2025, and focused on malaria prevalence or risk factors among children, pregnant women, or migrant populations in Ethiopia. The quality of included studies was assessed using Measurement Tool to Assess Systematic Reviews version 2 checklists. For analyses, a random-effects model was used. STATA software version 17 was used to conduct the analyses. Result: From 3388 total records, six systematic reviews and meta-analyses were included. The overall pooled prevalence of malaria among vulnerable populations was 10.10% (95% CI: 0.36–19.85), with low heterogeneity (I² = 0.0%, P = 0.982). Not utilizing insecticide-treated mosquito net (pooled odds ratio: 5.22, 95% CI: 3.93–6.94) and proximity to stagnant water (pooled odds ratio: 4.21, 95% CI: 2.75–6.46) were independently associated with increased malaria risk. Conclusion: This umbrella review highlights a considerable burden of malaria among the most vulnerable populations in Ethiopia, not utilizing insecticide-treated net and exposure to stagnant water emerging as consistent risk factors. By consolidating fragmented evidence from prior reviews, these findings offer clear guidance for targeted, evidence-based malaria prevention and control strategies. PROSPERO registration number: CRD420251083494.