Abstract

Malaria transmission dynamics in sub-Saharan Africa (SSA) exhibit significant spatial heterogeneity, with rural 
areas historically accounting for the majority of cases. However, the rapid urbanization of SSA has led to an 
increasing incidence of malaria in urban and peri-urban areas, where unplanned settlements, poor sanitation, and 
the emergence of urban-adapted mosquito vectors are driving new transmission patterns. This comparative review 
examines the malaria transmission dynamics across urban, peri-urban, and rural settings, highlighting the 
ecological, environmental, and socio-economic factors influencing malaria burden in each context. Urbanization has 
altered traditional transmission patterns, creating focal points in informal settlements, while peri-urban zones 
experience a blend of rural and urban transmission drivers. Understanding these distinct dynamics is critical for 
tailoring malaria control strategies. The review emphasizes the need for fine-scale surveillance, targeted 
interventions, and integrated environmental and vector management across diverse settings. By synthesizing the 
key factors that influence transmission, the study aims to improve the effectiveness of malaria control programs, 
ensuring they are context-specific and responsive to evolving transmission challenges in SSA.