Cross-sectional surveys for parasite infection, and factors that possi
bly influence human malaria transmission were carried out to character
ize the epidemiology of urban malaria in Nazareth. Thick and thin bloo
d films for parasite diagnosis were collected from individuals residin
g in 6 representative kebeles in the town. A questionnaire was used to
obtain socioeconomic information. An overall parasite rate of 2.8%, P
. falciparum (1.6%) and P. vivax (1.2%)- was observed among the 3890 i
ndividuals examined during the 4 surveys. Significant intra-urban diff
erences (X(2) = 27.31; P < 0.0001), in parasite rates, were observed w
ith a much higher prevalence in the peripheral kebeles. A marked seaso
nal variation in parasite rates was evident during the sampling period
and the peak occurred in Sept./Oct. There was no apparent decrease in
parasite rate with increase in age, suggesting a delayed acquired imm
unity, typical of hypoendemic settings. The study has indicated that i
n Nazareth the prevalence of malaria is seasonally variable and relati
vely low, showing that a is unstable. Hence, if appropriate control me
asures are not instituted, malaria situation in-Nazareth is subject to
epidemics.