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

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.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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“…Conversely, prevalence of malaria in the current study was not observed to be associated with gender or study site. The finding of no association between prevalence of malaria and gender is in conformity with other studies [3] [4] [5] [7].…”

“…Plasmodium falciparum was identified as the only species causing malaria in the target population, which is in line with the study by Kwenti et al [7], but contradictory to the study by Mbenda and Das [30] in which a prevalence of 4% for P. vivax infection was reported in Yaoundé. The differences in the study design may account for this discrepancy; our study targeted mainly children meanwhile theirs targeted adults and children.…”

“…The slides were only declared negative after counting to 2500 WBC. Malaria parasite density was estimated by dividing the parasites counted by 500 WBC and then multiplied by the actual WBC count of the participant to give numbers in parasite per μl [7]. …”

“…Five species are known to cause disease in humans namely; Plasmodium ovale, P. malariae, P. knowlesi, P. vivax, and P. falciparum, with the latter being the most virulent species accounting for the majority of cases and deaths attributed to malaria. Like in other SSA countries, P. falciparum is the predominant species in Cameroon [4] [6] [7].…”

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

“…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].…”