Southern Ethiopia Research Articles

Atopic dermatitis in Ethiopian children: a multicenter study of clinical severity, characteristics, and sociodemographic factors.

Atopic dermatitis (AD) is a chronic relapsing, pruritic, inflammatory skin disease. Assessing the characteristics and risk factors of severe AD is central to healthcare workers' understanding and subsequent education of patients for the most optimal outcomes. The clinical characteristics are known to vary depending on populations and regions. AD has been well-documented in the global North in mainly Caucasian populations, while very few studies have been conducted on African patients residing in Africa. This study assessed the clinical characteristics, severity, and sociodemographic factors of children with AD in Southern Ethiopia. A hospital-based cross-sectional study was conducted among 461 children and their caregivers in four randomly selected hospitals in Southern Ethiopia from October 2022 to September 2023. A systematic sampling technique was used to enroll study participants. Clinical profile and sociodemographic data were collected by trained data collectors. The Scoring Atopic Dermatitis (SCORAD) index tool was used. The descriptive analysis was performed to characterize study participants. Univariate and ordinary logistic regression were used to identify factors associated with the SCORAD index score. The OR with 95% was used to show the strength of association, and a p-value of <0.05 was used to declare the level of significance. Out of 461 AD-diagnosed children, 212 (46%) were girls and 249 (54%) were boys. In the sample of pediatric patients, 149 (32.3%) exhibited mild AD, 231 (46.2%) presented with moderate, and 99 (21.5%) showed signs and symptoms of severe AD. All patients had itching. Dryness of skin, excoriation, and erythema, followed by lichenification, were the most observed signs. In the ordinary logistic regression model, age onset of the disease [AOR 95% CI 1.95 (1.3-2.94)], sex of caregiver or family [AOR 95% CI 0.61 (0.41-0.90)], family atopy history [AOR 95% CI 0.64 (0.44-0.93)], mother education status [95% CI 2.45 (1.1-5.47)], and use of herbal medication [AOR 95% CI 0.50 (0.33-0.79)] were significantly associated with the severity of AD. In this study, 68% of children were found to have moderate-to-severe AD. Early onset, maternal education, familial atopy history, sex of caregiver, and use of herbal medication were independent predictors of severe AD in children. We recommend further investigation into these variables for their potential to serve as markers to assess the severity of AD and improve the care and management of children with AD in Ethiopia.

Seroprevalence of Coxiella burnetii and potential tick vectors infesting domestic ruminants and community perception of the disease in pastoral areas of south Omo zone, southern Ethiopia

BackgroundQ fever is a worldwide occurring neglected zoonotic disease with great economic importance. The etiological agent, Coxiella burnetii, is a bacterium usually associated with subclinical infections in livestock, but may also cause reproductive pathology and spontaneous abortions in artiodactyl species including goats, sheep and cattle which are deemed to be the primary reservoirs of this disease. AimsThe present cross-sectional and questionnaire survey was undertaken in three districts of the South Omo zone with the aims to comprehend the community perception of livestock keepers and professionals about the disease, estimate the seroprevalence of Coxiella burnetii (C. burnetii) in cattle and small ruminants and to determine the species of potential tick vectors of C. burnetii infesting cattle, sheep and goats. MethodsA standard questionnaire was used to assess the community perception of livestock keepers and animal health professionals in the area about Q fever. Sera samples were collected from 1350 ruminants comprising 450 cattle, 450 goats and 450 sheep to detect C. burnetii antibodies using the ELISA technique. Furthermore, a total of 279 cattle, 197 goats and 73 sheep were examined for the presence of ticks, and overall, 2720 ticks were collected (1299 from cattle, 1020 from goats and 401 from sheep) and identified to the species level using morphologically identification keys. ResultsFindings of the study indicated that 43% of animal owners were aware of the main symptoms of the disease while the remaining 57% did not notice these symptoms in their animals. Additionally, majority of animal health professionals 76.2% in the area reported they were familiar with the causative agent of Q fever, while 23.8% expressed uncertainty regarding the cause of coxiellosis. An overall seroprevalence of C. burnetii of 37.6% in cattle (37.4% in female and 37.8% in male cattle) and 28.7% in small ruminants was recorded (which is significantly higher in goats than in sheep). The study indicated statistically significantly higher seroprevalence of C. burnetii (49.8%) in cattle infested with ticks than in those cattle free of ticks (24.2%), with three times higher seropositivity (OR = 2.97, p = 0.000) as compared to those cattle free of ticks (24.2%). Similarly, statistically significantly higher seroprevalence of C. burnetii was recorded in both sheep and goats infested with ticks (43.6%) as compared to those animals without ticks (22.9%), with the former being twice as likely to test seropositive (OR = 2.15, p = 0.000). A total of nine different tick species were identified, namely Amblyomma variegatum (Am. variegatum) with 26.3% (342; 217 males, 101 females and 24 nymphs), Amblyomma cohaerens (Am. cohaerens) with 47.96% (370 males, 253 females), Amblyomma gemma (Am. gemma) with 4.00% (52; 29 males, 23 female), Rhipicephalus pulchellus (Rh. pulchellus) with 10.6% (138; 87 males, 51 females), Rhipicephalus pravus (Rh. pravus) with 0.2% (3; 2 males, 1 females), Rhipicephalus evertsi (Rh. evertsi) with 4.7% (61; 39 males, 22 females), Rhipicephalus praetextatus (Rh. praetextatus) with 0.8% (10; 7 males, 3 females), Rhipicephalus decoloratus (Rh decoloratus) with 2.9% (38; 4 males, 34 females) and Hyalomma truncatum (Hy. truncatum) with 2.5% (32 females). ConclusionThe present study highlighted the significance of Q fever in ruminants and compiled information about the community perception of livestock keepers and veterinary professionals of the study areas. The role of ruminants and their ticks in the epidemiology of C. burnetii requires further research using molecular tools to better understand appropriate method of intervention that will help to reduce negative impacts on the productivities of livestock and the health of humans in Ethiopia.

Quality of medicines for Cardio-Vascular Diseases (CVDs) in the Ethiopian border with Kenya: The case of enalapril maleate and furosemide tablet quality in Borena and Gedeo zones.

Hypertension (HTN), a cardiovascular disease (CV), is a major public health challenge. Therefore, the quality of drugs used to treat it has become a major concern. Enalapril and furosemide are among the drugs prescribed to manage hypertension. Hence, this study is aimed at evaluating the quality of different brands of enalapril and furosemide tablets available in the Gedeo and Borena zones, southern Ethiopia. Thirteen generic brands of enalapril maleate (5 mg) and furosemide (40 mg) tablets were evaluated for visual defects, in vitro dissolution test, weight variations, friability, hardness, and disintegration tests. The analysis of active pharmaceutical ingredient (API) content was performed by high performance liquid chromatography (HPLC). Out of 55 samples, 7 (12.73%) failed to comply with the criteria for visual inspection; otherwise, all samples passed the identification test. Except for one brand of each of enalapril maleate and furosemide, all passed the dissolution test. The assay value showed that all enalapril maleate samples were within the limits of United States Pharmacopoeia (USP), 2020. Additionally, except for two batches, all furosemide samples were within the USP and British Pharmacopoeia (BP), 2020 standards. Out of 55 samples, 8% (2/25) and 6.67% (2/30) of enalapril maleate and furosemide tablets failed the uniformity of dosage units test per the USP-2020, respectively. All samples passed the disintegration test, and selected furosemide samples passed the microbial limit tests. However, 36% (9/25) and 20% (6/30) of enalapril maleate and furosemide samples failed to pass hardness test. Generally, from the total samples, 50.91% (28/55) were substandard (did not meet the specifications failing any one or more parameters assessed). The studied drugs circulating in the market did not meet some of the needed quality specifications. This could have brought a risk of reduced efficacy due to the distribution of poor quality medicines in the area.

The strategies pursued by urban households to cope with food insecurity: Insights from selected towns in Southern Ethiopia.

Food security has become a major global concern, particularly in urban areas where households are struggling to address the issue of basic necessities mainly food that crucially dictates human health. Overcoming these challenges will require effective management mechanisms to inform policy interventions and enhance resilience at both local and global levels. This study aimed to explore the coping strategies (CS) pursued by urban households in the Southern Ethiopia. Furthermore, the focus is on how households to cope with food insecurity and how using these strategies varies within households. A household survey questionnaire was conducted using a cross-sectional design, combining both qualitative and quantitative methods to collect data. A total of 310 household heads were targeted for the required data acquisition with: The coping strategy index (CSI) to capture how people perceive and cope with food insecurity that threatens human health. The results indicate that households used the top seven CS to address the problem of food insecurity: limiting the size of portions at mealtimes (83.9%), depending on less expensive or seasonal foods (68.1%), reducing adult consumption (66.1%), reducing the amount of food consumed (65.8%), purchasing food on credit (60.3%), renting household assets (54.8%), and migrating household members for wage labor (53.5%). Moreover, the finding shows that the frequency of CS used by urban households in response to food insecurity is rated differently as never, rarely, sometimes, and more than 4 times per week. Therefore, targeted support programs for vulnerable groups should be implemented to ensure they receive adequate food during times of food insecurity wherein the victims' health status is imperatively to be bettered.

The value of traditional milk products among smallholder farmers of Southern Ethiopia: handling, consumption and making of butter

The value of traditional milk products among smallholder farmers of Southern Ethiopia: handling, consumption and making of butter

Disparities in satisfaction among insured and uninsured adult outpatient department service users in Southern Ethiopia, 2022: a comparative cross-sectional study

BackgroundPatient satisfaction is a critical measure of the quality of healthcare services provided by healthcare facilities. However, very few studies, particularly in Ethiopia, which includes the study area, have specifically examined these discrepancies among people who use outpatient care. In this study, satisfaction levels and associated factors were compared between insured and uninsured patients receiving outpatient services at public health institutions in Hadiya Zone, southern Ethiopia.MethodsA facility-based comparative cross-sectional study design was employed on 630 patients using multistage and systematic random sampling. Data were collected using a pretested and structured interviewer-administered questionnaire. Results of the analysis were presented in text, tables, and graphs as appropriate. Multivariable logistic regression was used to predict associations between predictors and the outcome variable. Statistical significance was declared at p-value < 0.05.ResultsOverall, 344(55.48%) patients were satisfied with the service they received, of which 206(65.8%) out of 313 with a 95% CI [60.7–71.2%] were insured and 138(44.95%) out of 307 with a 95% CI [39.4–5.1%] were uninsured. Among insured patients, factors associated with higher satisfaction included having a family size less than five members [AOR = 3.3, 95% CI; 1.5, 7.4], perceived fair waiting time to be seen[AOR = 2.35, 95% CI; 1.02, 5.5], perceived short waiting time to be seen[AOR = 8.12, 95% CI; 1.6, 41.3], having all ordered laboratory tests available within the facility[AOR = 7.89, 95% CI; 3.5, 17.5], having some ordered laboratory tests within the facility[AOR = 2.97, 95% CI; 1.25, 7.01] having all prescribed medications available within the facility[AOR = 16.11, 95% CI; 6.25, 41.5], having some prescribed medications available within the facility[AOR = 13.11, 95% CI; 4.7, 36.4]. Among non-insured patients, factors associated with higher satisfaction included urban residency, a fair and short perceived time to be seen, having ordered laboratory tests within the facility, and having prescribed drugs within the facility.ConclusionThis study identified lower overall satisfaction, particularly among uninsured patients. Enrollment in the CBHI program significantly impacted satisfaction, with both groups reporting lower levels compared to enrollment periods. Access to essential services, wait times, and socio-demographic factors identified as associated factors with patient satisfaction regardless of insurance status.

Performance evaluation of multi-satellite rainfall products for analyzing rainfall variability in Abaya–Chamo basin: Southern Ethiopia

Performance evaluation of multi-satellite rainfall products for analyzing rainfall variability in Abaya–Chamo basin: Southern Ethiopia

Fresh Moringa Stenopetala leaves consumption and its determinants among pregnant women in southern Ethiopia.

A woman's health and nutritional status has significant impact on her pregnancy situation. However, many pregnant women are undernourished. Moringa stenopetala is a plant consumed worldwide in various forms, and its consumption showed a reduction in the incidence of malnutrition. Although Moringa stenopetala is rich in essential macro- and micronutrients, there is little evidence on the proportion and determinants of fresh Moringa stenopetala leaf intake among pregnant women. The objective of this study was to fill this gap in the littérature and provide a baseline evidence for further research or intervention by investigation the proportion and determinants of fresh Moringa stenopetala leaf intake among pregnant women in the Gamo zone, south Ethiopian region. A community-based cross-sectional study was conducted among 623 randomly selected pregnant women using a pre-tested and structured questionnaire via a face-to-face interview. The consumption pattern was assessed based on a self-reported dietary history over the last 30 days before data collection. Multivariable logistic regression model was fitted using STATA version 14. An adjusted odds ratio with a 95% confidence interval was reported to show an association between the dependent and independent variables with level of statistical significance at a p-value of <0.05. The proportion of fresh Moringa stenopetala leaves intake among pregnant women was 49.60% (95% CI: 45.67, 53.52%). The déterminants of fresh moringa leaf intake were being below 24 years old (AOR: 2.92; 95% CI: 1.51, 5.63), rural résidence (AOR: 1.97; 95% CI: 1.10, 3.50), antenatal care attendance (AOR: 2.08; 95% CI: 1.03, 4.21), history of contraceptive use (AOR: 1.88; 95% CI: 1.03, 3.55), and having a good knowledge about the importance of moringa Stenopetala (AOR: 9.76; 95% CI: 5.30, 17.95). The study showed that almost half of the pregnant women consumed fresh Moringa stenopetala leaves. Women's age, place of residence, prenatal care, history of contraceptive use, and knowledge of the benefits of Moringa Stenopetala were positively associated with the consumption of fresh Moringa Stenopetala leaves. Therefore, health authorities and stakeholders involved in maternal and child health need to target older women, and urban residents and promote the benefits of consumption by strengthening uptake of maternal health services and raising awareness about Moringa Stenopetela. Future studies involving large scale and longitudinal designs evidence are required to further validate the findings so that this nutritious diet can be promoted widely among pregnant women in the study area and Ethiopia at large.

Psychological distress and its associated factors among people with specific chronic conditions (diabetes and/or hypertension) in the Sidama region of southern Ethiopia: A cross-sectional study.

The majority of people with long-term, non-communicable medical conditions experience significant psychological anguish. Poor mental health or psychological distress influences low lifestyle decisions that result in obesity, inactivity, and cigarette use as well as poor health literacy and limited access to health promotion activities. The study's purpose was to measure the prevalence of psychological distress and it's predictors in patients with chronic non-communicable diseases who were being treated in selected hospitals in the Sidama region of southern Ethiopia in 2022. Institutional based cross-sectional study was carried out using a sample of 844 patients receiving medication for either high blood pressure or diabetes mellitus or both between May1 and August 31, 2022. To gauge psychiatric distress, the Amharic translation and Ethiopian validation of the Kessler 6 scale (K-6) was employed. The analysis was done using binary logistic regression and an odds ratio with the corresponding 95% confidence interval was estimated to measure the strength of the association. P value <0.05 was considered to declare the significance. Patients with diabetic mellitus, hypertension or both had a 49.6% prevalence of psychological distress at selected Sidama hospitals. Age, drug side effects, history medical complications following diabetic mellitus/hypertension, and body mass index of the patient were all significantly linked with psychological distress (P<0.05). According to the results of this study, psychological distress is far more prevalent than it was in past studies in Ethiopia and other African countries. To lessen the problem, all stakeholders must cooperate, but health agencies, policymakers, and NGOs particularly need to put in extra effort. The study also showed a significant association between body mass index, patient age, drug side effects, and history of medical complications following diabetic mellitus /hypertension.

Bacteriological quality and physicochemical analysis of the Kalte River at Wolaita Sodo Town, southern Ethiopia

ObjectiveThe current research aimed to investigate the physicochemical and bacteriological quality status of the Kalte River in Wolaita Sodo Town, southern Ethiopia.MethodsA total of 42 water samples were collected using sterile glass bottles from three different river sites: Damota (upstream), Kera (midstream), and Gututo (downstream). All the water samples were examined for the presence of heterotrophic bacteria, total coliform and fecal coliform using direct plate count method and membrane filtration method. Standard methods suggested by American water works association were used to analysis the physicochemical parameters of the water samples.ResultsThe results revealed that the total heterotrophic bacteria, total coliform, and fecal coliform count ranged from 8.9 to 12.6 × 104 cfu/ml, 7.5–11.3 × 102 cfu/ml and 5.7–9.7 × 104 cfu/ml, respectively. The bacterial count results indicated that the river water crossed the WHO-recommended limit of potable water. Escherichia coli, Pseudomonas aeruginosa, Staphylococcus aureus, Salmonella, and Shigella species were the common bacterial pathogens isolated from river water samples. The results of the physicochemical analysis revealed that some of the parameters Biological Oxygen Demand (BOD), Chemical Oxygen Demand (COD), and turbidity exceeded the maximum permissible limits of WHO and other parameters were below the WHO permissible limits.ConclusionTherefore, the presence of bacterial pathogens, fecal coliform indicators, and some physicochemical parameters of the Kalte River exceeding the recommended limits may expose users of the river water to the risk of infection.

Plant-parasitic nematodes associated with maize, and their relationship with soil properties in southern and southwestern Ethiopia

Summary Maize is an important cereal crop in sub-Saharan Africa (SSA). Plant-parasitic nematodes significantly impact maize production. However, research on maize nematodes in SSA is limited. The current study aimed to assess the occurrences and densities of nematodes associated with maize and to assess the correlation of some soil physicochemical properties with nematodes in southern and southwestern Ethiopia. One hundred and eighty-six soil and root samples were collected from 62 maize fields (31 from Hawassa Zuria and 31 from Mana districts). Eleven plant-parasitic nematode genera were identified. The most important genera of plant-parasitic nematodes identified were Meloidogyne and Pratylenchus, followed by Helicotylenchus and Tylenchorhynchus. The nematodes Pratylenchus and Criconemoides were significantly and positively associated with pH, soil organic carbon (SOC) and soil organic matter (SOM). Additionally, Tylenchorhynchus, Pratylenchus and Rotylenchulus were significantly positively correlated with soil available phosphorus (SAP). However, Criconemoides and Meloidogyne had a strong negative correlation with soil bulk density (SBD). This study provides useful baseline information on maize-associated nematodes, and will be useful for agricultural policy makers, private farmers, non-governmental organisations and agricultural extension workers enabling them to establish sustainable maize nematode management strategies.

Corporate social responsibilities contribution for sustainable community development: evidence from industries in Southern Ethiopia

Corporate social responsibilities contribution for sustainable community development: evidence from industries in Southern Ethiopia

Tax evasion attitude and taxpayers’ perception of government legitimacy: evidence from Southern Ethiopia

Tax evasion attitude and taxpayers’ perception of government legitimacy: evidence from Southern Ethiopia

On-farm performance evaluation of indigenous sheep in the Gedeo zone, Southern Ethiopia

ABSTRACT This study was conducted to identify the productive and reproductive performance of sheep in the Gedeo zone. Flock of 50 households was randomly selected for a household survey. A total of 189 lambs’ growth data and reproductive traits from 125 ewes were collected. A general linear model was employed for the analysis. Sheep flock size shows (8.6 ± 0.11) a significant difference (P < 0.05) among age categories. Weight at birth (3.01 ± 0.3 kg), weaning (14.2 ± 0.9 kg) and six months (22.4 ± 1.1) of lambs were significant (P < 0.01) among parties, birth type, lamb sex and birth season. Body size and growth rate were important traits for breeding sheep selection. The average age at first lambing and lambing interval was 12.3 ± 0.12 and 7.7 ± 0.06, respectively. Other reproductive traits, such as fertility rate (76.7%), litter size (1.51), weaning percentage (81.6%) and lamb survival rate (86.2%), were observed. In conclusion: parity, birth type, lamb sex and birth season are important sources of variation in sheep growth performance that were considered fixed effects during the analysis. Thus, as policy direction, genetic improvement combined with nutrition, health and participatory breeding would contribute to sheep genetic improvement that should be given proper attention.

Impact of integrated land management technology adoption on rural livelihoods in the Goyrie watershed, Southern Ethiopia: Endogenous switching regression modeling estimation

Impact of integrated land management technology adoption on rural livelihoods in the Goyrie watershed, Southern Ethiopia: Endogenous switching regression modeling estimation

Prevalence of traditional eye medicine and self-treatment in Gurage Zone, Rural Ethiopia

IntroductionTraditional medicines are commonly used worldwide, especially in Africa—however, there is limited information on the prevalence and types of traditional eye medicine utilization in Ethiopia. The goal of this study was to determine the prevalence, the type and nature of traditional eye medicine use and practices related to self-medication for ophthalmic diseases in a rural Ethiopian population.MethodsA cross-sectional study was conducted in six randomly selected primary health centers in rural Gurage Zone, Southern Ethiopia. Health-seeking behavior, use of self-medication, and traditional eye medicine were assessed in the population using a semi-structured questionnaire.Descriptive statistics and multivariable logistic regression analysis were computed to determine associated factors for using self-medication and traditional eye medicine.ResultOf the 814 participants interviewed, 487 (59.8%) reported using traditional eye medicine, mainly for combinations of symptoms of ocular redness, irritation, and eye discharge (95.5%). Besides, 604 (74.2%) participants reported self-treatment with tetracycline 1% eye ointment. Older age, females, low income, no formal education, and lack of access to media were risks for utilizing traditional eye medicine.ConclusionThe use of traditional eye medicine and self-treatment are common in this population. Regulatory legislation, public awareness, and making eye care are vital activities required to monitor such practices.

Ontological Insecurity and Peace Process: Southern Ethiopia’s Conflict in the Space-Time Continuum

Ontological Insecurity and Peace Process: Southern Ethiopia’s Conflict in the Space-Time Continuum

Adolescent utilization of sexual and reproductive health services in Gamo Zone, Southern Ethiopia. Insights from multilevel and latent class analysis.

Adolescents face unique challenges related to their sexual and reproductive health (SRH), with access to timely services being critical for positive outcomes. However, SRH service utilization among adolescents remains low. This study aimed to identify factors influencing SRH service use among adolescents in Gamo Zone, Ethiopia. A community-based cross-sectional study involved 1172 adolescents selected through stratified sampling. Structured face-to-face interviews were employed for data collection. Multilevel mixed logistic regression was fitted to identify factors and latent class analysis was conducted to understand population heterogeneity. The findings of this study reveal that 198 (16.89%) adolescents (95% CI: 14.8%-19.2%) utilized SRH services within the past 12 months. Factors significantly associated with SRH service utilization included good knowledge about SRH rights (AOR = 4.65; 95% CI: 2.68, 8.07), belonging to one-parent families (AOR = 4.13; 95% CI: 2.39, 7.12), engaging in parental discussions regarding SRH issues (AOR = 3.17; 95% CI: 1.89, 5.29), high family support (AOR = 1.96; 95% CI: 1.09, 3.51), and enrolling in school (AOR = 0.19; 95% CI: 0.11, 0.33). Additionally, access to social media was associated with increased SRH service utilization among adolescents (AOR = 1.98; 95% CI: 1.25, 3.15). Latent class analysis identified four groups: rural school-enrolled adolescents living with parents, urban school-enrolled adolescents with both parents, urban disadvantaged female adolescents, and early adolescents with limited social media access. In conclusion, our study sheds light on the utilization of SRH services among adolescents, revealing that 16.89% of the participants accessed these services within the past year. Significant factors associated with SRH service utilization included good knowledge about SRH rights, belonging to one-parent families, engaging in parental discussions regarding SRH issues, high family support, and enrollment in school. Interestingly, access to social media was also linked to increased utilization of SRH services among adolescents. Furthermore, our latent class analysis identified four distinct classes of adolescents based on socio-demographic indicators, highlighting the heterogeneity within this population. These findings underscore the importance of tailored interventions and targeted approaches to address the diverse needs of adolescents in accessing and utilizing SRH services.

Drilling in an African Lake to Find Out Whether Climate Change Drove Human Evolution

Why does drilling into a dried-out lake in eastern Africa get scientists excited? Simple answer: the lake’s sediments store valuable information about how past climate change shaped the environment where our earliest ancestors lived. Those sediments serve as a natural record of Earth’s ancient climate. While much is known about human evolution from fossil discoveries in eastern Africa, the role that climate change might have played for human biological and cultural evolution remained unclear for a long time. But now we have drilled 278 m into the ground at the bottom of the old Chew Bahir Lake in southern Ethiopia, which has given us some detailed answers. This natural record covers the last 620,000 years of climate history from one of the proven habitats of ancient Homo sapiens, and it can help us to unravel connections between climate and human evolution.

Seasonal Dynamics of Symptomatic and Asymptomatic Plasmodium falciparum and Plasmodium vivax Infections in Coendemic Low-Transmission Settings, South Ethiopia.

Ethiopia has a plan to eliminate malaria in selected low-transmission districts by 2025. However, complex factors such as seasonality, focal heterogeneity, and coendemicity of Plasmodium vivax and Plasmodium falciparum, and asymptomatic cases, along with other factors, pose challenges. This longitudinal study assessed these dynamics and associated factors in three elimination-targeted settings in southern Ethiopia. The study included rural districts (Wonago and Yirgacheffe) and an urban setting (Dilla town) with 504 participants from 168 households per season. The study covered the peak and minor malaria transmission seasons and the dry season. Finger-prick blood was collected for microscopy, rapid diagnostic tests, and 18S-rRNA-based quantitative polymerase chain reaction (qPCR). During the dry season, P. vivax accounted for most infections (64.5%, 71/110) and symptomatic malaria (50.9%, 29/57), whereas P. falciparum dominated during the peak transmission season (45.7%, 42/92 infections and 58.1%, 25/43 of symptomatic cases). Treatment-seeking behavior was low, with 65.3% (143/219) of symptomatic individuals not seeking treatment. Dilla town had significantly higher infection prevalence (29.6%, 149/504, P <0.001) in all seasons compared with the rural sites. The incidence rate was 12/1,000 person-seasons by qPCR and 5/1,000 person-seasons by microscopy. Urban residents, those with low hemoglobin levels, nonuse of mosquito nets, and proximity to stagnant water had a significantly higher risk of infection (P <0.001). Tailored approaches are needed in elimination-targeted areas, focusing on urban settings, Plasmodium species, and strengthening community-level interventions for behavioral change and active case detection.