A Comparative Study of the Risk Factors of Malaria within Urban and Rural Settings in the Sahelian Region of Cameroon and the Role of Insecticide Resistance in Mosquitoes
International Journal of TROPICAL DISEASE & Health, Volume 44, Issue 8,
Background: Cameroon is among the 11 countries that account for 92 % of malaria infection in sub-Saharan-Africa in 2018, and Maroua III Health District and her environs witnessed a malaria outbreak in 2013 with hundredths of deaths.
Aim: To determine the risk factors of malaria in the urban and rural population and to investigate the level of mosquito’s resistance to Deltamethrin and Permethrin.
Methods: It was a cross-sectional community-based study carried out in August, September and October 2019, in which questionnaires were administered to 500 participants, to obtain information on demographics, socioeconomics, behavioral, and environmental factors thought to be associated with malaria infection in both rural and urban settings. Blood samples were collected for diagnosis of malaria and bivariate and multivariate regression analysis were used to identify risk factors of malaria. Mosquito resistance to Deltamethrin and Permethrin were determined using the CDC Bottle Bioassay test.
Results: Malaria prevalence was 52.2 % which was significantly higher (P = 0.016) in rural areas (57.6%) than urban areas (46.8%). The prevalence of asymptomatic malaria was 43.4% and the geometric mean parasite density was 6333.60 parasites/µL of blood. Malaria infection was significantly (P<0.001) associated with children (64.1%) and teenagers (58.1%). Likewise, the infection was significantly associated with the presence of crops around homes (P=0.031), usage of old LLINs for more than three years and in urban settings, with primary education level (P=0.023). The overall mortality of Anopheles species was 93.57% (91.19% in rural and 95.83% in urban areas) for deltamethrin which was more sensitive than 83.85% (85.24% in rural and 82.46% in urban areas) for permethrin.
Conclusion: Relevant data for malaria control in Maroua III health district, a typical Sahelian environment has been generated, and indicates that most of the burden of malaria is borne by children and teenagers.
- risk factors
- insecticide resistance
How to Cite
WHO | World malaria report. 20 years of global progress and challenges; 2020. [Internet] [WHO].].
Available:https://www.who.int/publications/i/item/9789240015791. Access on 21 Jan 20
USAID: President’s Malaria Initiative Cameroon: Malaria Operational Plan FY 2018 and FY; 2019.
Available:https://www.pmi.gov/docs/default-source/default-document-library/malaria-operational-plans/fy-2018/fy-2018-cameroon-malaria-operational-plan.pdf?sfvrsn=5 Access on 2021 Jan 22
Massoda Tonye SG, Kouambeng C, Wounang R, Vounatsou P. Challenges of DHS and MIS to capture the entire pattern of malaria parasite risk and intervention effects in countries with different ecological zones: the case of Cameroon. Malar J. 2018;17:156.
WHO | World malaria report; 2017 [Internet]. WHO. Available:https://reliefweb.int/sites/reliefweb.int/files/resources/WMR-2017-slide-deck-briefings.pdf
Access on 2021 Jan 21
CCAM in partnership with CDBPH: Policy brief on scaling up malaria control interventions in Cameroon.
Access on 2021 Jan 25
VOA News: Severe Malaria Outbreak in Northern Cameroon Town.
Access on 2021 Jan 26
National Malaria Control Program, Regional Delegation Far North Cameroon: 2019 First Semester Report on Malaria Control
WHO | World malaria report; 2019. WHO.
Access on 2021 Jan 27
Boussougou-Sambe ST, Awono-Ambene P, Tasse GC, Etang J, Binyang JA, Nouage LD, et al. “Physical integrity and residual bio-efficacy of used LLINs in three cities of the south-west region of Cameroon 4 years after the first national mass-distribution campaign.” Malar J. 2017;16(1):31. DOI: 10.1186/s12936-017-1690-6
WHO. World Health Organization; Geneva: 2016. Test procedures for insecticide resistance monitoring in malaria vector mosquitoes. Available:https://www.who.int/malaria/publications/atoz/9789241511575/en/
Access on 2021 Jan 28
Rooth I, Perlmann H, Bjorkman A. Plasmodium falciparum reinfection in children from a holoendemic area in relation to seroreactivities against oligopeptides from different malarial antigens. Am J Trop Med Hyg. 1991;45:309–318.
Gillies MT, Coetzee M. A Supplement to the Anophelinae of Africa South of the Sahara (Afrotropical Region). South African Institute for Medical Research. 1987;55:1-143
Lehman LG, Foko LP, Tonga C, Nyabeyeu HN, Eboumbou EC, Nono LK, et al. Epidemiology of malaria using LED fluorescence microscopy among schoolchildren in Douala, Cameroon. International Journal of Infectious and Tropical Diseases. 2018;29:1-13.
Kimbi HK, Nana Y, Sumbele IN, Anchang-Kimbi JK, Lum E, Tonga C, et al. Environmental Factors and Preventive Methods against Malaria Parasite Prevalence in Rural Bomaka and Urban Molyko, Southwest Cameroon. J Bacteriol Parasitol. 2013;4:1.
Kimbi HK, Lum E, Wanji S, Mbuh JV, Ndamukong-Nyanga L, et al. Coinfections of asymptomatic malaria and soil-transmitted helminths in school children in localities with different levels of urbanization in the Mount Cameroon Region. J Bacteriol Parasitol. 2012;3:134.
Awolola TS, Oduola AO, Obansa JB, Chukwurar NJ, Unyimadu JP. Anopheles gambiae s. s breeding in polluted water bodies in urban Lagos, Southwestern Nigeria. J Vector Borne Dis. 2007;44:241-244.
Guthmann JP, Hall AJ, Jaffar S, Palacios A, Lines J, Llanos-Cuentas A. Environmental risk factors for clinical malaria: a case-control study in the Grau region of Peru. Transactions of the Royal Society of Tropical Medicine and Hygiene. 2001;95(6):577–583.
Nyasa RB, Zofou D, Kimbi HK, Kum KM, Ngu RC, Titanji VPK. The current status of malaria epidemiology in Bolifamba, a typical Cameroonian rainforest zone: an assessment of intervention strategies and seasonal variations. BioMed Central Public Health. 2015;15:1105
Couprié B, Claudot Y, Same-Ekobo A, Issoufa H, Léger-Debruyne M, Tribouley J, et al. [Epidemiologic study of malaria in the rice-growing regions of Yagoua and Maga (North Cameroon)]. Bull Soc Pathol Exot Filiales. 1985;78(2):191-204
Noor AM, Gething PW, Alegana VA, Patil AP, Hay SI, Muchiri E, et al. The risks of malaria infection in Kenya in 2009. BioMed Central Infectious Diseases. 2009;9:180.
Smith DL, Guerra CA, Snow RW, Hay SI. Standardizing estimates of the Plasmodium falciparum parasite rate. Malaria Journal. 2007;6:131
Hay SI, Smith DL, Snow RW. Measuring malaria endemicity from intense to interrupted transmission. Lancet Infectious Diseases. 2008;8(6):369-78.
Njie M, Dilger E, Lindsay SW, Kirby MJ. Importance of eaves to house entry by anopheline, but not culicine, mosquitoes. J Med Entomol. 2009;46:505–10.
Tusting LS, Ippolito MM, Willey BA, Kleinschmidt I, Dorsey G, Gosling RD. The evidence for improving housing to reduce malaria: a systematic review and meta‐analysis. Malar J. 2015;14:209.
Kirby MJ, Green C, Milligan PM, Sismanidis C, Jasseh M, Conway DJ, et al. Risk factors for house entry by malaria vectors in a rural town and satellite villages in The Gambia. Malar J. 2008;7:2.
Ngadjeu CS, Doumbe-Belisse P, Talipouo A, Djamouko-Djonkam L, Awono-Ambene P, Kekeunou S, et al. Influence of house characteristics on mosquito distribution and malaria transmission in the city of Yaoundé, Cameroon Malar J. 2020;19(1):53. DOI: 10.1186/s12936-020-3133-z
Nkuo-Akenji T, Ntonifor NN, Ndukum MB, Abongwa EL, Nkwescheu A, Anong DN, et al. Environmental factors affecting malaria parasite prevalence in rural Bolifamba, South West Cameroon. Afr J Health Sci. 2006;13(1-2):40-6.
Ekoko WE, Awono-Ambene P, Bigoga J, Mandeng S, Piameu M, Nvondo N, et al. Patterns of anopheline feeding/resting behaviour and Plasmodium infections in North Cameroon, 2011–2014: implications for malaria control. Parasit Vectors. 2019;12(1):297. DOI: 10.1186/s13071-019-3552-2
Mouchet J, Et Hamon J. Les Problemes Techniques de l’êradication du Paludisme en Afrique. Entomologistes mbdicaux 0. R. S. T. 0. M.
Available:https://horizon.documentation.ird.fr/exl-doc/pleins_textes/cahiers/entomo/18778.pdf Access on 2021 Jan 27
Antonio-Nkondjio C, Sonhafouo-Chiana N, Ngadjeu CS, Doumbe-Belisse P, Talipouo A, Djamouko-Djonkam L, et al. Review of the evolution of insecticide resistance in main malaria vectors in Cameroon from 1990 to 2017. Parasites Vectors. 2017;10(1):472. Available:https://doi.org/10.1186/s13071-017-2417-9
Antonio-Nkondjio C, Fossog BT, Ndo C, Djantio BM, Togouet SZ, Awono-Ambene P, et al. Anopheles gambiae distribution and insecticide resistance in the cities of Douala and Yaoundé (Cameroon): Influence of urban agriculture and pollution. Malar J. 2011;10:154. Available:https://doi.org/10.1186/1475-2875-10-154
Fadel AN, Ibrahim SS, Tchouakui M, Terence E, Wondji MJ, Tchoupo M, et al. A combination of metabolic resistance and high frequency of the 1014F kdr mutation is driving pyrethroid resistance in Anopheles coluzzii population from Guinea savanna of Cameroon. Parasites and Vectors. 2019;12(1):263.
Salako AS, Ahogni I, Aïkpon R, Sidick A, Dagnon F, Sovi A, et al. Insecticide resistance status, frequency of L1014F Kdr and G119S Ace-1 mutations, and expression of detoxification enzymes in anopheles gambiae (s.l.) in two regions of northern Benin in preparation for indoor residual spraying. Parasites Vectors. 2018;11(1):618.
Nwane P, Etang J, Chouaїbou M, Toto JC, et al. Multiple insecticide resistance mechanisms in Anopheles gambiae s.l. populations from Cameroon, Central Africa. Parasit Vectors. 2013;6:41.
Abstract View: 64 times
PDF Download: 32 times