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Background: A few decades ago, the Kwahu mountain ridge in the Eastern region of Ghana at an altitude of 367 m above sea level, had very little mosquitoes and hence malaria. However in recent years mosquitoes abound there and malaria accounts for about 70% of OPD cases. To our knowledge, no research to study this phenomenon has been published. This study (part of a larger study) sought to investigate the prevalence of P. falciparum which causes the most common and fatal malaria in Ghana, in asymptomatic residents of the Kwahu-South District capital.Methods & Materials: Finger prick capillary blood of consenting residents of two communities, Ntuntuoagya and Nsuase, in the district capital Mpraeso, were tested with P. falciparum rapid diagnostic test kits. 120 participants, 20 each in the following age ranges in years: 0-5, 6-10, 11-15, 16-20, 21-40 and above 40, were studied. Information on their malaria history, active protection against mosquito bites and health seeking behaviour were assessed with a questionnaire.Results: 10.8% of the residents tested positive for P. falciparum. 15% had experienced a malaria episode within the past 3 months; however none of them admitted to having any of the malaria symptomsat time of data collection. As many as 42% did nothing actively to prevent mosquito bites, whilst the others used either mosquito nets, mosquito sprays or mosquito coils or a combination of them. However, majority of them (60%) bought antimalarials and/or went to the hospital when they got malaria, with few residents relying on herbal medicine. Conclusion:Even though residents of Mpraeso are aware of malaria in their community, not all of them actively protect themselves against infections. Some asymptomatic residents have P. falciparum which could become symptomatic and fatal in the under 5 year olds. In-spite of the inability of mosquito vectors to thrive at high altitudes; they are present in large numbers here and transmitting malaria. This could be because of climatic and weather conditions of the area.