Abstract : Malaria remains a significant public health problem in East Sumba Regency, particularly in rural areas with ecological conditions favorable for Anopheles vector breeding. This study aimed to analyze the relationship between behavioral and household environmental risk factors and malaria incidence and to map the spatial distribution of cases in Mau Bokul Village. An analytical observational study with a cross-sectional design was conducted among 194 respondents during August–September 2025. Data were obtained through microscopic examination of thick blood smears, structured questionnaire interviews, and geographic coordinate mapping using Avenza Maps. Statistical analysis used Fisher’s Exact Test, while spatial analysis applied buffering and overlay techniques. The prevalence of malaria was 4.1% (8 cases). Significant associations were found between malaria incidence and not using bed nets (p < 0.001), nighttime outdoor activities (p < 0.001), sleeping outdoors (p < 0.001), non-permanent house walls (p = 0.001), absence of window screens (p = 0.028), and proximity to rivers (p = 0.001). Spatial analysis demonstrated clustering of cases within a 500-meter buffer radius from the river. These findings indicate that sleeping outdoors and residence near river areas were the most strongly associated factors with malaria incidence. The study provides spatial evidence that malaria transmission in rural endemic settings tends to cluster around river buffer zones, emphasizing the importance of integrating GIS-based surveillance with environmental management and behavior-focused interventions to support malaria control and elimination strategies in similar endemic regions.
Rambu et al. (Fri,) studied this question.