Assessment of malaria control efficacy on malaria prevalence was conducted fromrnNovember/December, 2008 in Kemisie town and in three surrounding rural Kebeles in DawarnChefa District. Retrospective data on malaria and malaria control activities were obtained fromrnKemisie and Woledi Health Centers and the District malaria control office for the yearsrn2005/2006 up to 2007/2008. Parasitological survey was conducted during peak malariarntransmission season of the area (November/ December 2008). The retrospective clinical reports ofrnKemisie and Woledi Health Centers showed malaria to be over 31% average annual prevalence,rnmaking it a major infectious disease, constituting significant public health problem. On the otherrnhand, examination of blood films from a random sample of 300 individuals, from six Kebeles ofrnKemisie town and nearby rural Kebeles in 2008 malaria season, detected 5.3% malariarnprevalence only. This finding revealed a significant reduction in malaria prevalence, whichrnsuggests improvement in malaria control and intervention in the study area. The difference inrnmalaria prevalence between Kemisie town (2.7%) and the rural Kebeles (8.0 %) in the 2008rnsurvey was significant (P< 0.05), suggesting a less effective malaria control in the rural Kebeles.rnMalaria prevalence among different age groups showed more than half of malaria positivernindividuals to be 15 years and above, indicating lack of anti malaria immunity with increasingrnresidence in the area. The main malaria control measures in the study area were combined use ofrnIRS and ITN supplemented with source reduction activities and treatment of positive cases. Therernwas significant improvement in ITN coverage per household in 2008 compared to 2006(both inrnurban and rural settings) (P