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

BACKGROUND

Malaria in Cameroon was previously known to be caused solely by but today, evidence points to other species including , and . The purpose of this study was to identify the species in clinical samples from children residing in five epidemiological strata of malaria in Cameroon, so as to advise control policies.

METHODS

One 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 species. Statistical analysis performed included the Pearson chi-square test, and statistical significance was set at  < 0.05.

RESULTS

The PCR-adjusted prevalence of malaria was 17.6%. The detection rate of PCR was higher than GM ( = 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 ( < 0.001) and in Limbe (in the Coastal strata) ( < 0.001). Contrariwise, the prevalence of malaria was not associated with gender ( = 0.239). was identified in all (100%) the cases of malaria; , , and were all absent. No case of mixed infection was identified.

CONCLUSIONS

was the only species causing clinical malaria in the target population, which is contrary to studies that have reported , and as causing clinical malaria in Cameroon.