article · Parasites & Vectors
Malaria control programmes often concentrate primarily on Plasmodium falciparum, potentially overlooking the impact of other species such as Plasmodium malariae. In the Ngatti Health District in Cameroon, overall malaria prevalence reached up to 64.7% by polymerase chain reaction testing, 51.8% by rapid diagnostic tests, and 50.3% using microscopy. While P. falciparum was the dominant parasite, P. malariae represented a substantial portion of infections, primarily through co-infections alongside P. falciparum and to a lesser extent as mono-infections. Infection prevalence peaked among children aged six to ten years, whereas parasite density was highest in children under five. Vector analysis revealed that Anopheles funestus sensu stricto accounted for over 97% of collected mosquitoes, carrying both P. falciparum and P. malariae sporozoites. These findings demonstrate that P. malariae actively sustains high local transmission rates.
Malaria intervention strategies often focus exclusively on Plasmodium falciparum, but overlooking other species can undermine elimination initiatives. Demonstrating that Plasmodium malariae circulates widely in human populations and local mosquito vectors shows that health programmes must address multiple parasite species to succeed. This information helps public health authorities refine control policies and adapt management strategies to the actual diversity of malaria infections.
This early-stage field research provides transmission and prevalence data that could inform diagnostic developers and public health agencies designing multi-species diagnostic assays and surveillance protocols. Because the work focuses purely on epidemiological characterisation and vector screening without testing interventions or prototypes, the abstract does not indicate an immediate commercial application pathway.
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Abstract Background Malaria control efforts are highly skewed towards Plasmodium falciparum while overlooking other Plasmodium species such as P. malariae . A better understanding of the role of Plasmodium species other than P. falciparum is needed to strengthen malaria elimination initiatives. The aim of the present study was to elucidate the contribution of P. malariae to malaria transmission in Cameroon. Methods The study was conducted in the Ngatti Health District, a forest–savannah transition area in the Adamawa Region, Cameroon. A total of 497 individuals aged from 1 to 85 years were diagnosed with malaria in November 2020 using a rapid diagnostic test (RDT) and microscopy. Adult mosquitoes were collected between September 2019 and March 2020 by indoor aspiration and identified morphologically and molecularly. The infection status of Plasmodium spp. was also determined by quantitative PCR, and dried blood spots were collected from 156 participants with the aim to detect different Plasmodium species by nested PCR. Results The overall Plasmodium prevalence was 50.3%, 51.8% and 64.7%, as detected by microscopy, the RDT and PCR, respectively. Based on the PCR results, P. falciparum was the most prevalent species (43%); followed by co-infections P. falciparum/P. malariae (17%), P . falciparum/P . ovale (1.3%), P . falciparum/P . ovale/P . malariae (1.3%); and then by P. malariae mono-infection (2.5%). The same trend was observed using microscopy, with 35% of participants infected with P. falciparum , 11% co-infected with P. falciparum/P. malariae and 4% infected with P. malariae . The prevalence and parasite density of malaria infection varied significantly with age group ( P < 0.05), with the highest prevalence rate observed in children aged 6–10 years ( P = 0.0001) while the density of Plasmodium infection increased significantly in children aged < 5 years compared to the other age groups ( P = 10 −3 ). Among the 757 Anopheles mosquitoes collected, 737 (97.35%) were An. funestus sensu stricto, 15 (1.9%) were An. gambiae and 5 (0.6%) were An. hancocki . The Plasmodium species recorded at the head/thorax level were P. falciparum and P. malariae, with a sporozoite infection rate of 8.4%; the highest sporozoite infection rate was recorded at Mibellon village (13.6%). Conclusion The results of this study reveal the significant contribution of P. malariae , in addition to P. falciparum , to the high malaria transmission rate in this region. These findings highlight the need to deploy initiatives to also tackle this Plasmodium species to eliminate malaria in the region. Graphical Abstract
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DOI: 10.1186/s13071-022-05635-7
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