Prevalence of Malaria and Plasmodium Species Composition in the Western Highlands of the North West Region, Cameroon
Cleopas Nfor Njomekah Kilo
Department of Microbiology and Parasitology, Faculty of Science, The University of Bamenda, P. O. Box 39 Bamenda, Cameroon.
Elvis Achondou Akomoneh
Department of Microbiology and Parasitology, Faculty of Science, The University of Bamenda, P. O. Box 39 Bamenda, Cameroon.
Fotso Nick Kouokam
Department of Microbiology and Parasitology, Faculty of Science, The University of Bamenda, P. O. Box 39 Bamenda, Cameroon.
Sidney Warra Abonge Tamufor
Department of Microbiology and Parasitology, Faculty of Science, The University of Bamenda, P. O. Box 39 Bamenda, Cameroon.
Helen Ngum Ntonifor *
Department of Microbiology and Parasitology, Faculty of Science, The University of Bamenda, P. O. Box 39 Bamenda, Cameroon and Department of Zoology, Faculty of Science, The University of Bamenda, P. O. Box 39 Bamenda, Cameroon.
*Author to whom correspondence should be addressed.
Abstract
Background: Malaria persists as a major public health challenge in Cameroon, particularly in rural highland agro-ecological zones affected by unique environmental conditions and the ongoing Anglophone socio-political crisis since 2016
Aim: To determine the epidemiology and Plasmodium species prevalence in the western highlands of the Northwest Region of Cameroon.
Study Design: The study was a community-based study with a cross-sectional study design.
Place and Duration of Study: Ndop (Ngoketunjia division) and Nkambe (Donga Mantung division) from April 2024 to March 2025.
Methods: A community-based cross-sectional survey was conducted between April 2024 and March 2025, enrolling 966 participants. Socio-demographic and behavioural data were collected using structured questionnaires. Venous blood samples were analysed by microscopy and real-time PCR to determine parasite prevalence, density, and species distribution. Statistical analyses included Chi-square, Mann–Whitney U, Kruskal–Wallis, and logistic regression, with significance set at p ≤ 0.05.
Results: Malaria prevalence among participants was 31.9% (308/966), with the 11-20 years age group most affected (36.1%). University graduates recorded the highest prevalence (37.2%), followed by civil servants (36.1%) and retired individuals (34.5%). Use and ownership of LLINs showed no statistically significant association with parasite density. Non‑users had a higher geometric mean parasitaemia density (379.11 parasites/µL; p=0.676). Participants living in favourable vector breeding environments recorded an even higher mean density (417.12 parasites/µL; p=0.118). Age‑specific analysis revealed the highest mild parasitaemia in the 11–20 years age group (32.4%; p=0.382). Moderate parasitaemia was most common in the 6–10 years age group (6.5%; p=0.356). None of these associations reached statistical significance. Plasmodium falciparum was the predominant species among positive cases (66.9%). Plasmodium malariae had the lowest prevalence (12.3%).
Conclusion: Malaria remains highly prevalent in Cameroon’s western highlands, with geographic variation and behavioral risk factors sustaining transmission. Strengthened vector control, improved LLIN usage, and targeted interventions for high-risk groups are essential.
Keywords: Malaria prevalence, parasitaemia density, molecular methods, long-lasting insecticidal nets (LLINs), Plasmodium falciparum, Cameroon western highlands