Background: Malaria remains a severe public health concern in Borno State, Nigeria. While conventional vector control tools face operational hurdles and insecticide resistance, many endemic populations depend heavily on locally sourced botanical remedies. This study aimed to evaluate the prevalence, exact usage patterns, processing modalities, and independent socio-demographic predictors of natural mosquito remedy reliance in the region.

Methods: A multi-stage cross-sectional survey was conducted across three distinct communities (Lagos Street in the Maiduguri Metropolitan Council (MMC) Local Government Area (LGA), Furi and Mairi in the Jere LGA). Households were chosen using systematic random sampling governed by a calculated household jump-interval. Data were collected via face-to-face interviews using a structured questionnaire adapted from the validated World Health Organization (WHO) Malaria Indicator Survey (MIS) instrument, which was peer-reviewed by an expert medical entomologist and translated into the local Kanuri language. Statistical predictors of natural remedy consumption were isolated using Pearson's Chi-square tests and multivariate binary logistic regression modeling.

Results: Of the 450 households, 437 completed the survey (response rate of 97.1%). Natural mosquito remedy utilization was notably high at 68.4% (N = 299). Azadirachta indica (Neem) leaf/seed extract spraying was the most common individual modality (45.9%), followed by Cymbopogon citratus (Lemon Grass) at 31.2%. Indoor fumigation through the thermal combustion of dried plant biomass (C. citratus and Eucalyptus globulus) was practiced by 37.3% of the active users. Alarmingly, 70.6% of users relied exclusively on unstandardized, crude home preparations. Multivariate binary logistic regression confirmed that a rural residential setting (Odds Ratio [OR] = 2.11; 95% CI: 1.34 to 3.32; p = 0.001) and a lower formal educational background (primary school or less) (OR = 1.80; 95% CI: 1.10 to 2.95; p = 0.020) were significant independent predictors of higher botanical remedy reliance.