Abstract
BackgroundMalaria in Cameroon was previously known to be caused solely by Plasmodium falciparum but today, evidence points to other Plasmodium species including P. vivax, P. ovale and P. malariae. The purpose of this study was to identify the Plasmodium species in clinical samples from children residing in five epidemiological strata of malaria in Cameroon, so as to advise control policies.MethodsOne thousand six hundred nine febrile children (≤15 years) were recruited from five epidemiological strata of malaria including the Sudano-sahelian (SS) strata, the High inland plateau (HIP) strata, the South Cameroonian Equatorial forest (SCEF) strata, the High western plateau (HWP) strata and the Coastal (C) strata. Malaria parasites were detected by Giemsa microscopy (GM) while a multiplex polymerase chain reaction (PCR) was used to identify the Plasmodium species. Statistical analysis performed included the Pearson chi-square test, and statistical significance was set at p < 0.05.ResultsThe PCR-adjusted prevalence of malaria was 17.6%. The detection rate of PCR was higher than GM (p = 0.05). However, GM demonstrated a high sensitivity (85.5%) and specificity (100%) and, overall, a perfectly correlated agreement with PCR (97.5%). The prevalence of malaria was significantly higher in children between 60 and 119 months (p < 0.001) and in Limbe (in the Coastal strata) (p < 0.001). Contrariwise, the prevalence of malaria was not associated with gender (p = 0.239). P. falciparum was identified in all (100%) the cases of malaria; P. ovale, P. vivax, P. malariae and P. knowlesi were all absent. No case of mixed infection was identified.ConclusionsP. falciparum was the only species causing clinical malaria in the target population, which is contrary to studies that have reported P. vivax, P. malariae and P. ovale as causing clinical malaria in Cameroon.
Highlights
Malaria in Cameroon was previously known to be caused solely by Plasmodium falciparum but today, evidence points to other Plasmodium species including P. vivax, P. ovale and P. malariae
In Cameroon, malaria is the major cause of morbidity and mortality among the most vulnerable groups including children aged under 5 years (18%), pregnant women (5%), people living with HIV/AIDS (5.5%) and the poor (40%) [3, 4]
A marginal difference was observed in the detection rate between Giemsa microscopy (GM) and polymerase chain reaction (PCR) (p = 0.05)
Summary
Malaria in Cameroon was previously known to be caused solely by Plasmodium falciparum but today, evidence points to other Plasmodium species including P. vivax, P. ovale and P. malariae. Six epidemiological strata have been identified and mapped in Cameroon, namely, the Sudanosahelian (SS) strata, High inland plateau (HIP) strata, Savannah-forest transmission (SF) strata, South Cameroon Equatorial forest (SCEF) strata, High western plateau altitude (HWP) strata and Coastal (C) strata [7]. These epidemiologic strata differ in terms of their geographical and ecological characteristics, transmission pattern and endemicity level and in terms of the main vectors transmitting malaria parasites [7]
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