Urban–Rural Dynamics of Malaria Transmission in Imo State, Nigeria: Evidence from Temporal Trends, Migration, and Parasite Density Analysis

Abstract

Malaria remains a major public health challenge in Nigeria, with rural–urban dynamics increasingly shaping transmission. This study examined temporal trends, gender and age variations, migration influences, and rural–urban differences in malaria prevalence across three urban centers of Imo State (Owerri, Orlu, and Okigwe). A hospital-based survey was conducted between 2022 and 2025, complemented with meta-analysis of published rural studies. Blood smears were examined for Plasmodium species, and data were analyzed using chi-square and ANOVA tests. Results showed a rising prevalence in Owerri (42% in 2022 to 62% in 2025) and Okigwe (>70%), with males and children <15 years disproportionately affected. Meta-analysis revealed higher parasite densities in rural communities (>70–80%) compared to urban centers (34–62%). Migration significantly contributed to parasite importation. These findings highlight intensifying malaria transmission in urban Imo, emphasizing the need for micro-stratified interventions that integrate urban vulnerabilities, rural hotspots, and population mobility into control strategies.