Background The issue of self-medication with anti-malarial drugs is a critical public health challenge. Despite national guidelines promoting diagnostic-confirmed treatment, evidence addressing the prevalence of self-medication with anti-malarial drugs and drivers in Ethiopia is scarce. Therefore, this study aimed to bridge this gap and to provide meaningful insights into ongoing efforts to curb the misuse of anti-malarial drugs and helping the strategy of malaria eliminationby investigating the prevalence of self-medication with anti-malaria drugs and its associated factors. Methods An institution-based cross-sectional study was conducted in Dera District, Northwest Ethiopia, from June 1–30, 2025. A total of 591 febrile patients were selected using a stratified multistage sampling technique. Data were collected through interviewer-administered structured questionnaires developed by reviewing different related literatures. Data entry and analysis were done using Epi-Data version 4. 6 and STATA 17. Multivariable binary logistic regression analysis was performed to identify factors associated with self-medication. Statistical significance was declared at a p-value less than 0. 05. Result The prevalence of self-medication with anti-malarial drugs was 42. 8% (95% CI: 38. 9%–46. 8%). Factors positively associated with self-medication included: monthly income of ≥5000 ETB (AOR = 1. 64, 95% CI: 1. 04–2. 59), poor knowledge about malaria (AOR = 1. 68, 95% CI: 1. 12–2. 55), poor risk perception towards self-medication (AOR = 2. 10, 95% CI: 1. 40–3. 14), and distance ≤5 km from private drug sellers (AOR = 1. 65, 95% CI: 1. 10–2. 47). Community-based health insurance membership was negatively associated with self-medication (AOR = 0. 60, 95% CI: 0. 41–0. 88). Conclusion Self-medication with anti-malarial drugs was moderate (33. 4%₆6. 6%) in the study area based on percentile classification. The findings highlighted the need for designing different strategies to reduce inappropriate drug use and promoting community-based health insurance enrollment.
Addis et al. (Mon,) studied this question.