Epidemiological Profile of Malaria and HIV Infection in Rural Communities of Ondo State, Nigeria: Prevalence, Co-Infection Risks, and the Role of Traditional Herbal Treatment

Abstract

Malaria and HIV remain major public health challenges in sub-Saharan Africa, with their co-occurrence contributing significantly to disease burden and mortality. This study investigated the prevalence, epidemiological determinants, and co-infection risk of malaria and HIV in ten rural communities of Ondo State, Nigeria, while also assessing the role of traditional herbal medicine in disease management. A cross-sectional survey was conducted among 892 consenting adults and adolescents recruited from ten villages. Participants underwent malaria rapid diagnostic testing, HIV screening using standard point-of-care protocols with counseling, and structured questionnaire interviews. Data were analyzed using contingency coefficient tests and odds ratio (OR) estimates. Malaria prevalence was 25.8% (230/892), varying significantly across communities (p<0.05), while HIV seroprevalence was 0.9% (8/892). Malaria infection was associated with an increased risk of HIV acquisition (OR=8.64; 95% CI: 1.76–42.48). Unprotected sexual intercourse with casual partners emerged as the strongest HIV risk factor (OR=224.26; 95% CI: 28.58–1759.50), followed by prolonged fever (OR=69.13) and multiple sexual partners (OR=68.97). Herbal medicine use for malaria treatment was widespread (75.5%) but showed no significant association with malaria prevalence (p=0.956). Living in unscreened houses without mosquito nets was significantly associated with increased fever incidence (p=0.027). Knowledge of HIV etiology was limited, with only 27.5% of respondents correctly identifying the causative pathogen. The findings indicate a substantial malaria burden alongside persistent HIV transmission in rural Ondo State. Integrated malaria-HIV control strategies, strengthened community education, improved vector control, and culturally responsive healthcare interventions are recommended to reduce disease burden and improve public health outcomes.