This study adopts ground survey and questionnaire administration to determine environmental and socio-economic factors contributing to malaria risk in Koton Karfe watershed catchment. A health facilty-based survey is carried out to assess tbe ratio of population to health facility. The study reveals that poverty is the overriding risk factor determining the high malaria incidence rate which ranges from 40/1000 per annum to 288/1000 per annum across watershed catchment and prevelant among infants and school age children. The nearest neighbour index of 1.48 suggests the randomness in the spatial distribution of health facilities. The increase in the burden of malaria on the populace may deter the attainment of the millennium development goals (MDGs) if urgent measures to control it by the government and private/donor agencies are not initiated.
Key word: Malaria, incidence rates, burden, watershed ecology, catchment.
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