Anopheles stephensi bionomics and epidemiology in Ethiopia: A systematic review and meta-analysis with implications for urban malaria control

Abstract Background An. stephensi , an invasive malaria vector originally endemic to South Asia, has rapidly expanded across East Africa. Its emergence in Ethiopia threatens malaria elimination progress, particularly in urban areas where populations were previously considered at lower risk. We conducted a systematic review to synthesise evidence on its bionomics and epidemiological role in Ethiopia, with implications for urban malaria control strategies. Methods We conducted a PRISMA 2020-compliant systematic review and meta-analysis registered with PROSPERO (CRD420251176953). Searches of PubMed, Scopus, Web of Science, and regional repositories (2016–February 2026) identified studies reporting An. stephensi bionomics and epidemiological role in Ethiopia. Eligible studies required ≥ 50% quality score on JBI appraisal tools. Random-effects meta-analysis estimated pooled proportions of An. stephensi among total Anopheles , with subgroup analyses by geography, habitat, and behavioural traits. Publication bias was assessed using Egger’s and Begg’s tests. Results Eighteen studies (9 epidemiological, 11 bionomical) met inclusion criteria. The pooled proportion of An. stephensi was 0.51 (95% CI: 0.28–0.75) in epidemiological studies and 0.46 (95% CI: 0.26–0.66) in bionomics studies, with extreme heterogeneity (I² > 99%). Geographic variation was marked: South-eastern Ethiopia showed near-total dominance (0.73), while Central Ethiopia reported lower proportions (0.13). Extreme heterogeneity reflected genuine ecological variation across Ethiopia. No evidence of publication bias was detected. Conclusion An. stephensi has very rapidly emerged as a major malaria vector in Ethiopia, utilising urban environments and showing behavioural adaptability. The presence of this vector poses a threat to malaria elimination efforts and highlights the importance of integrated urban vector management, which includes reducing larval sources, using targeted insecticides, and engaging in community-based interventions. Future research should prioritise longitudinal surveillance and insecticide resistance management to inform evidence-based control.