Malaria Prevalence and Risk Factors Among Pregnant Women: A Retrospective Record Review at the Buea Regional Hospital, South West Region of Cameroon

Background Notwithstanding global efforts to curb the spread of malaria, it has remained one of the most common public health challenges to mothers, foetuses, and neonates with devastating effects in pregnancy. The study, therefore, sought to determine the prevalence and risk factors of malaria in pregnancy among those who attended the antenatal clinic at the Buea Regional Hospital, South West region of Cameroon. Methods A five-year hospital-based retrospective study was carried out using ANC registration logbooks. Data was collected from January 2018 to December 2022. A total of 1,200 records meeting the inclusion criteria were assessed. Data on demographics such as age, marital status, gravidity, gestational age, malaria results and preventive factors were obtained and analyzed using SPSS version 25. Chi-square tests and Fisher’s Exact Test were used to evaluate associations, with a significance level of p  < 0.05. Logistic regression was used to determine independent risk factors for malaria infection. Results The overall prevalence of malaria among pregnant women was 12.8% (153/1200). Prevalence rose from 14% in 2018 to a peak of 20.6% in 2019, then declined steadily to 8.1% by 2022. Women aged ≥ 35 years had significantly higher odds of infection compared to adolescents (OR = 1.98; p  = 0.039). Multigravid women had 2.2 times higher odds of malaria compared to primigravid women (OR = 2.21; p  = 0.020). Use of long-lasting insecticidal nets (LLINs) reduced infection odds by 55% (OR = 0.45; p  = 0.001), and receipt of three IPTp doses reduced odds by 56% (OR = 0.44; p  = 0.044). Married women had 29% lower odds of malaria as opposed to unmarried women (OR = 0.71; p  = 0.006). Conclusions This study showed that malaria remains a significant threat to maternal health in Buea, despite recent declines in prevalence. Age ≥ 35 years, multigravidity, and unmarried status were major risk factors, while LLIN use and adequate IPTp dosing were protective. Despite these, there is still a call for scaled-up preventive and control strategies. Strengthening malaria prevention through expanded LLIN coverage, improved IPTp uptake, and strategies to maintain healthcare access during crises could substantially reduce malaria burden among pregnant women in this region.