In many tropical and sub-tropical regions, human malaria is a widespread and sometimes fatal illness. Malaria outbreaks are thus significant public health problems. If utilized properly, insecticide treated nets (ITN) are the most effective malaria prevention measure. However, current usage is still too low. As a result, the aim of this study was to evaluate the incidence of malaria and its risk factors in Yeki District, Southwestern Ethiopia.

Nine hundred and two participants in a community based cross sectional study were chosen ny using a systematic random sampling procedure. Thin and thick Giemsa stained blood smears were examined under the microscope to diagnose malaria infection, and a malarial Rapid Diagnostic Test (RDT) was performed to identify malaria parasite species. Additionally, pre-tested structured questions were utilized to gauge the respondents' degree of knowledge and awareness of malaria as well as their socio-demographic characteristics. Furthermore, pre-tested structured questions were employed to assess the respondents' level of knowledge and awareness regarding malaria, as well as their socio-demographic information.

The findings from the RDT test and microscopic examination indicate that the overall malaria prevalence in the study area was 33.6% and 38.2%, respectively. The microscopy test revealed that the prevalence of Pf and Pv was 18.7% and 19.5%, respectively. On the other hand RDT test for malaria showed that 18.4% P. vivax and 15.1% P. vivax and 15.1% P. falciparium. The majority of the population infected by malaria visits a health center three times per year and pays 300–400 birr ($6–$8) for a single course of treatment. ITN was the most effective malaria prevention strategy at the home level, but only 79.4% of people had access to them, and most people only used them rarely and during malaria seasons Plasmodium vivax was shown to be the predominant species in the study region. The lack of ITNs, how ITNs are used, and the existence of mosquito breeding grounds near homes are the risk factors for malaria prevalence in the study population.

Malaria remains a public health problem in the study localities. The absence of insecticide-treated nets (ITNs), the manner in which ITNs are utilized, and the presence of mosquito breeding sites near residences are factors contributing to the prevalence of malaria in the population studied. It is advised to implement standard health education and sustainable health policies to inform and engage the community about the methods of transmission, prevention, and management of the disease in the specified area to enhance disease control efforts.