Does malaria epidemiology project Cameroon as ‘Africa in miniature’?

Mbenda, Huguette Gaelle Ngassa; Awasthi, Gauri; Singh, Pratap; Gouado, Inocent; Das, Ashim

doi:10.1007/s12038-014-9451-y

Cited by 29 publications

(27 citation statements)

References 67 publications

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“…Molecular analysis further confirmed this [49]. The finding of P. falciparum as the sole cause of malaria in the target population is contrary to studies that have reported other Plasmodium species causing malaria including P. vivax [24, 50]. These discrepancies could be attributed to differences in the study designs; our study targeted febrile children presenting to hospitals in the different study sites meanwhile theirs targeted asymptomatic adults and children.…”

Section: Discussionsupporting

confidence: 61%

“…The epidemiology of malaria in Cameroon has been described as unique, having all the different epidemiological strata present in all of Africa [24, 25]. Six epidemiological strata have been identified and mapped in Cameroon namely: the Sudano-sahelian strata, High inland plateau strata, Savannah-forest transmission strata, South Cameroon Equatorial forest strata, High western plateau altitude strata, and the Coastal strata [25].…”

Section: Introductionmentioning

confidence: 99%

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Epidemiological and clinical profile of paediatric malaria: a cross sectional study performed on febrile children in five epidemiological strata of malaria in Cameroon

Kwenti¹,

Kwenti²,

Latz³

et al. 2017

BMC Infect Dis

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BackgroundIn the wake of a decline in global malaria, it is imperative to describe the epidemiology of malaria in a country to inform control policies. The purpose of this study was to describe the epidemiological and clinical profile of paediatric malaria in five epidemiological strata of malaria in Cameroon 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.MethodsThis study involved 1609 febrile children (≤15 years) recruited using reference hospitals in the five epidemiological strata. Baseline characteristics were determined; blood glucose level was measured by a glucometer, malaria parasitaemia was assessed by Giemsa microscopy, and complete blood count was performed using an automated hematology analyser. Severe malaria was assessed and categorized based on WHO criteria.ResultsAn overall prevalence of 15.0% (95% CI: 13.3–16.9) for malaria was observed in this study. Malaria prevalence was significantly higher in children between 60 and 119 months (p < 0.001) and in Limbe (C strata) (p < 0.001). The overall rate of severe malaria (SM) attack in this study was 29.3%; SM was significantly higher in children below 60 months (p < 0.046). Although not significant, the rate of SM was highest in Maroua (SS strata) and lowest in Limbe in the C strata. The main clinical phenotypes of SM were hyperparasitaemia, severe malaria anaemia and impaired consciousness. The majority (73.2%) of SM cases were in group 1 of the WHO classification of severe malaria (i.e. the most severe form). The malaria case-fatality rate was 5.8%; this was higher in Ngaoundere (HIP strata) (p = 0.034).ConclusionIn this study, malaria prevalence decreased steadily northward, from the C strata in the South to the SS strata in the North of Cameroon, meanwhile the mortality rate associated with malaria increased in the same direction. On the contrary, the rate of severe malaria attack was similar across the different epidemiological strata. Immunoepidemiological studies will be required to shed more light on the observed trends.

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Section: Discussionsupporting

confidence: 61%

Section: Introductionmentioning

confidence: 99%

Epidemiological and clinical profile of paediatric malaria: a cross sectional study performed on febrile children in five epidemiological strata of malaria in Cameroon

Kwenti¹,

Kwenti²,

Latz³

et al. 2017

BMC Infect Dis

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“…In Cameroon, malaria accounts for 48% of all hospital admissions, 30% of morbidity and 67% of childhood mortality per year [5, 6]. The epidemiology of malaria in Cameroon has been described as unique, having all the different epidemiological strata present in all of Africa [7, 8]. Six epidemiological strata have been identified and mapped in Cameroon, namely, the Sudano-sahelian (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].…”

Section: Introductionmentioning

confidence: 99%

Identification of the Plasmodium species in clinical samples from children residing in five epidemiological strata of malaria in Cameroon

Kwenti

Njunda

et al. 2017

Trop Med Health

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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.Conclusions P. 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.

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“…[10] Malaria accounts for 26% of work absences and 40% of household health expenses. [11] Due to gender inequalities, low education and socio-economic status resulting from patriarchal structures, more women are trapped in a cycle of poverty, thereby compounding their susceptibility to infections.…”

Section: Introductionmentioning

confidence: 99%

Enhancing Malaria Prevention in Cameroon Through Community Participation: An in-Depth Review

Mbako¹

2017

CAJPH

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Abstract:Despite 66 percent reduction in mortality between 2000 and 2015, malaria remains a major global public health problem, affecting mostly Sub-Saharan Africa. Cameroon remains endemic to malaria, with about 41 percent suffering at least one episode of malaria, annual overall mortality of 30 to 35 percent and 67 percent childhood mortality. Cameroon government's subsidy on artemisinin combination therapy (ACT) for uncomplicated malaria, intermittent preventive treatment for pregnant women (IPTp), free distribution of insecticide treated bed nets (ITNs) to pregnant women and under-fives have been more of a top-down approach, with the affected communities mainly at the receiving end. Challenges of failed adherence to test results, drug and insecticide resistance, substandard and self-medication, low ITN ownership and utilisation have been identified, especially in the rural areas. This study reviews malaria prevention in Cameroon and proposes community based context-specific complementary interventions strategies that will promote community participation in prevention and mitigate the effects of poverty towards achievement of the sustainable development goals targets for malaria. The study involved an in-depth review of secondary data from electronic and non-electronic documents. Electronic search was done in Global Health, PubMed, governmental and non-governmental organisation websites, journals and google scholar. Non-electronic documents from the University of Leeds and World Health Organisation (WHO), Geneva libraries were also used. A conceptual framework on integrated community-based approach on intervention to prevent neglected tropical diseases and infectious diseases of poverty was adapted and used, while different intervention strategies were analysed. A total of 96 publications were eligible for inclusion. Analysis of the factors influencing malaria prevention in Cameroon, reveals that current measures alone are insufficient. Therefore, a combination of multiple delivery strategies using an integrated community-based approach is likely to be more effective in breaking the transmission cycle than single programme interventions. Concurrent implementation of community mobilisation through social groups and Village Development Committees, education on house screening, training of mothers and caregivers and health promotion through environmental management were recommended as the best and most feasible strategies to complement current interventions in Cameroon.

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Does malaria epidemiology project Cameroon as ‘Africa in miniature’?

Cited by 29 publications

References 67 publications

Epidemiological and clinical profile of paediatric malaria: a cross sectional study performed on febrile children in five epidemiological strata of malaria in Cameroon

Epidemiological and clinical profile of paediatric malaria: a cross sectional study performed on febrile children in five epidemiological strata of malaria in Cameroon

Identification of the Plasmodium species in clinical samples from children residing in five epidemiological strata of malaria in Cameroon

Enhancing Malaria Prevention in Cameroon Through Community Participation: An in-Depth Review

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