Abstract
BackgroundMalaria remains a serious public health problem in Cameroon. Implementation of control interventions requires prior knowledge of the local epidemiological situation. Here we report the results of epidemiological and entomological surveys carried out in Tibati, Adamawa Region, Cameroon, an area where malaria transmission is seasonal, 6 years after the introduction of long-lasting insecticidal bed nets.MethodsCross-sectional studies were carried out in July 2015 and 2017 in Tibati. Thick blood smears and dried blood spots were collected from asymptomatic and symptomatic individuals in the community and at health centers, respectively, and used for the molecular diagnosis of Plasmodium species. Adult mosquitoes were collected by indoor residual spraying and identified morphologically and molecularly. The infection status of Plasmodium spp. was determined by quantitative PCR, and positivity of PCR-positive samples was confirmed by Sanger sequencing.ResultsOverall malaria prevalence in our study population was 55.0% (752/1367) and Plasmodium falciparum was the most prevalent parasite species (94.3%), followed by P. malariae (17.7%) and P. ovale (0.8%); 92 (12.7%) infections were mixed infections. Infection parameters varied according to clinical status (symptomatic/asymptomatic) and age of the sampled population and the collection sites. Infection prevalence was higher in asymptomatic carriers (60.8%), but asexual and sexual parasite densities were lower. Prevalence and intensity of infection decreased with age in both the symptomatic and asymptomatic groups. Heterogeneity in infections was observed at the neighborhood level, revealing hotspots of transmission. Among the 592 Anopheles mosquitoes collected, 212 (35.8%) were An. gambiae, 172 (29.1%) were An. coluzzii and 208 (35.1%) were An. funestus (s.s.). A total of 26 (4.39%) mosquito specimens were infected by Plasmodium sp. and the three Anopheles mosquitoes transmitted Plasmodium at equal efficiency. Surprisingly, we found an An. coluzzii specimen infected by Plasmodium vivax, which confirms circulation of this species in Cameroon. The positivity of all 26 PCR-positive Plasmodium-infected mosquitoes was successively confirmed by sequencing analysis.ConclusionOur study presents the baseline malaria parasite burden in Tibati, Adamawa Region, Cameroon. Our results highlight the high malaria endemicity in the area, and hotspots of disease transmission are identified. Parasitological indices suggest low bednet usage and that implementation of control interventions in the area is needed to reduce malaria burden. We also report for the first time a mosquito vector with naturally acquired P. vivax infection in Cameroon.Graphical
Highlights
Malaria remains a serious public health problem in Cameroon
We report for the first time a mosquito vector with naturally acquired P. vivax infection in Cameroon
From 2010 to 2019, the morbidity and mortality due to malaria decreased from 36 to 28% and from 31 to 18.3%, respectively; the situation is not yet under control as the whole country is still at risk of disease transmission [7, 8]. These observed reductions are due to the efforts of the Government of Cameroon and international partners, with a heavy reliance on mass distribution campaigns of long-lasting insecticidal-treated bed nets (LLINs) and the use of sulfadoxine/pyrimethamine either alone for intermittent preventive treatment in pregnant women or in combination with amodiaquine for seasonal malaria chemoprevention in children aged < 5 years
Summary
Malaria remains a serious public health problem in Cameroon. Implementation of control interven‐ tions requires prior knowledge of the local epidemiological situation. We report the results of epidemiological and entomological surveys carried out in Tibati, Adamawa Region, Cameroon, an area where malaria transmission is seasonal, 6 years after the introduction of long-lasting insecticidal bed nets. From 2010 to 2019, the morbidity and mortality due to malaria decreased from 36 to 28% and from 31 to 18.3%, respectively; the situation is not yet under control as the whole country is still at risk of disease transmission [7, 8] These observed reductions are due to the efforts of the Government of Cameroon and international partners, with a heavy reliance on mass distribution campaigns of LLINs and the use of sulfadoxine/pyrimethamine either alone for intermittent preventive treatment in pregnant women or in combination with amodiaquine for seasonal malaria chemoprevention in children aged < 5 years. The introduction of artemisinin-based combination therapies (ACTs) for the treatment of uncomplicated malaria and of free healthcare management of severe malaria cases in children aged < 5 years have contributed to malaria reduction [8]
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