<p>A facility-based unmatched case-control study (1:2) was conducted in Maekel Adyabo from November 16, 2022, to February 25, 2023. Cases included individuals with malaria symptoms confirmed by RDT or microscope, while controls had no acute febrile illness symptoms a month before data collection. A total of 240 participants (80 cases, 160 controls) were selected via systematic random sampling from eight kebeles. Data collection was done by trained nurses, health officers, and health extension workers using a semi-structured questionnaire translated into Tigrigna. Data entry used EpiData, and analysis employed SPSS version 27, with P &lt; 0.05 deemed significant.</p>