Background <p>Malaria remains a major global health concern. Although China was certified malaria-free, imported cases have continued to emerge in recent years, and public awareness of the disease remains limited. As a major social media platform in China, Sina Weibo provides a large volume of malaria-related textual data suitable for analysing public discussion patterns and attention focus online. This study analysed discussions on Sina Weibo to help relevant institutions understand the netizens’ key concerns and level of awareness regarding malaria. By characterizing discourse patterns and exploring underlying dynamics, the findings aim to inform the design of more targeted and effective health communication strategies, ultimately enhancing netizen awareness of malaria prevention and promoting a deeper understanding of relevant knowledge.</p> Method <p>Using “malaria” as the keyword, relevant posts from Sina Weibo were collected between January 2019 and August 2024. Guided by the social media analysis framework, descriptive analyses and natural language processing techniques—including topic modelling, sentiment analysis, and named entity recognition—were conducted to systematically analyze netizen attention and discussion patterns related to malaria across temporal, spatial, and netizen-type dimensions.</p> Results <p>A total of 81,010 malaria-related posts were collected. Netizens’ attention to malaria is event-driven, with peaks around China’s health assistance to Africa, public health incidents, and <i>World Malaria Day</i>, <i>China’s National Malaria Day</i>, with posts related to malaria day accounting for approximately 20% of the annual total. Positive events typically trigger only short-lived peaks in attention, whereas negative events sustain engagement for a considerably longer period—approximately 1.5 times the duration of their positive counterparts. Although discussions concerning Africa have experienced a slight decline, they continue to constitute over 60% of region-specific posts annually; by contrast, discussions related to Asia and the Americas remain comparatively fragmented. Official health-related accounts focus on malaria prevention but post infrequently; personal accounts are more inclined to discuss treatment approaches and first-hand narratives of health experiences; unofficial health-related accounts show a more balanced distribution of topics, with particular emphasis on vaccines and scientific research; while organizational accounts provide institutional information on malaria control.</p> Conclusion <p>Malaria-related discussions on Sina Weibo exhibit a clear event-driven pattern, with regional disparities possibly shaped by both disease prevalence and the visibility of international health collaborations involving China. Official health-related accounts show limited engagement. Tailored communication strategies are required to enhance netizens’ awareness of malaria disease and strengthen their understanding of related knowledge.</p>