Emmaculate Lum

Malaria and haematologic parameters of pupils at different altitudes along the slope of Mount Cameroon: a cross-sectional study.

BackgroundHaematologic abnormalities are features in Plasmodium falciparum infection, and anaemia is an inevitable outcome. This study examines the influence of malaria status and altitude on haematologic parameters in school-aged pupils.MethodsA cross-sectional study was conducted among 728 school pupils aged between four and 15 years at three different altitudinal ranges along the slope of the Mount Cameroon region. The investigative methods included the use of questionnaire, clinical evaluation and laboratory investigations. Blood sample collected from each child was used for the preparation of blood films for detection of malaria parasites and assessment of malaria parasite density as well as full blood count determination using an automated haematology analyzer.ResultsThe prevalence of malaria in the study population was 33.8% and 64.2% (158/246) of these were asymptomatic (AM). Pupils in lowlands had a significantly higher (P <0.05) prevalence (95% confidence interval, CI) of malaria (60.6%, CI = 54.6–65.9%) than those in middle belt (29.1%, CI = 23.9–34.8%) and highlands (7.7%, CI = 6.1–9.8%), while those in middle belt had significantly higher geometric mean parasite density (475) than those in lowlands (233) and highlands (388). The prevalence of malaria was significantly higher in children that presented with fever (40.4%, CI = 33.8–47.2%) when compared with afebrile subjects (31%, CI = 27–35.2%). Pupils with AM had a higher prevalence of leucopaenia (43.7%, CI = 35.8–51.8%), microcytosis (27.2%, CI = 20.5–34.9%), hypochromasia (27.8%, CI = 21–35.5%) and thrombocytopaenia (14.9%, CI = 8.9–22.8%) when compared with those with clinical malaria (CM). All mean haematological parameters were comparable in pupils with CM and AM, except for the mean white blood cell (WBC) counts. Pupils with AM had significantly lower (P = 0.02) mean WBC counts (5.1 ± 2.5 × 109/L) than those with CM (5.9 ± 2.3 × 109/L). Age, altitude and malaria parasitaemia was of significant influence on several haematological parameters.ConclusionAltitude influenced the distribution and density of malaria parasites and was of confounding influence on the haematologic profiles. These results highlight the insidious effects of AM on the haematologic components.

An Update of Asymptomatic Falciparum Malaria in School Children in Muea, Southwest Cameroon

Despite efforts put in by the international community to reduce malaria burden in Africa, the disease especially that is caused by Plasmodium falciparum, still remains a major health problem in sub-Saharan Africa. A cross-sectional study involving 366 pupils was conducted in Muea, Southwest Cameroon to assess an update of the burden of falciparum malaria in school children. Capillary blood samples were collected and Giemsa-stained blood films were observed microscopically for the identification and quantification of malaria parasites. Capillary tubes were filled with blood and spun at 10,000 rpm for 5 minutes, for the determination of packed cell volume (PCV). The overall prevalence of asexual parasites and anaemia were compared with the values, previously reported in a similar study at the same site in 2005. The overall prevalence of P. falciparum asexual parasites was 44.26%, as opposed to a value of 98% reported in 2005. The prevalence of asexual parasites significantly decreased with age (X 2 =20.86, p<0.0001). The values were similar in the sexes. The overall geometric mean parasite density (GMPD) of asexual P. falciparum was 1490.00 ± 1674.92 and the value was similar in the sexes and age groups. P. falciparum gametocyte prevalence was 17.49% and the value decreased significantly with age (X 2 =22.88, p< 0.0001). The overall GMPD of gametocytes was 23.48 ± 6.96 parasites/ µl. Gametocytaemia decreased with age and the difference was significant (F=62.61, p<0001). The overall prevalence of anaemia was 3.83%, as opposed to 10.6% in 2005. Generally, there was a significant drop in prevalence of asexual malarial parasites and anaemia in school children, compared to the previously reported values in 2005, and this is ascribed to the use of intervention strategies in recent years in the area.

Malarial anaemia and anaemia severity in apparently healthy primary school children in urban and rural settings in the Mount Cameroon area: cross sectional survey.

Background This study examines the relative importance of living in an urban versus rural setting and malaria in contributing to the public health problem of malarial anaemia (MA) and anaemia respectively in apparently healthy primary school children. Methods A cross-sectional study was conducted among 727 school children aged between four and 15 years living in an urban (302) and rural (425) settings in the Mount Cameroon area. Blood sample collected from each child was used for the preparation of blood films for detection of malaria parasites and assessment of malaria parasite density as well as full blood count determination using an automated haematology analyzer. Based on haemoglobin (Hb) measurements, children with malaria parasitaemia were stratified into MA (Hb<11g/dL); mild MA (Hb of 8–10.9g/dL); moderate MA (Hb of 6.1–7.9g/dL) and severe MA (Hb≤6g/dL). Evaluation of potential determinants of MA and anaemia was performed by multinomial logistic-regression analysis and odds ratios used to evaluate risk factors. Results Out of the 727 children examined, 72 (9.9%) had MA. The prevalence of MA and anaemia were significantly higher (χ2 = 36.5, P <0.001; χ2 = 16.19, P <0.001 respectively) in children in the urban (17.9%; 26.8% respectively) than in the rural area (4.2%; 14.8% respectively). Majority of the MA cases were mild (88.9%), with moderate (5.6%) and severe MA (5.6%) occurring in the urban area only. The age group ≤6years was significantly (P <0.05) associated with both MA and anaemia. In addition, low parasite density was associated with MA while malaria parasite negative and microcytosis were associated with anaemia. Conclusions Malarial anaemia and anaemia display heterogeneity and complexity that differ with the type of settlement. The presence of severe MA and the contributions of the age group ≤6 years, low parasite density and microcytosis to the public health problem of MA and anaemia are noteworthy.

Co-Infections of Asymptomatic Malaria and Soil-Transmitted Helminths in School Children in Localities with Different Levels of Urbanization in the Mount Cameroon Region

Malaria and Soil-Transmitted Helminths (STHs) do co-infect hosts and it has been speculated that urbanization alters the frequency and transmission dynamics of both infections. This study was aimed at finding out the influence of urbanization on the prevalence and intensity of co-infections of asymptomatic malaria and STHs in schoolchildren in the Mount Cameroon Region. A total of 235 and 208 children from Ekona (rural) and Great Soppo (urban) respectively aged 4-14 years were enrolled into a cross-sectional study. Blood films were Giemsa-stained for the determination of malaria parasite density and speciation. Capillary blood was spun for the determination of packed cell volume. Stool samples were examined by the Kato-Katz technique for the presence and intensity of STHs. The prevalences of malaria in Ekona and Great Soppo were, 92.34 % and 82.70 % respectively (X2 = 9.60, p = 0.002). Malaria Geometric Mean Parasite Density (GMPD) in Ekona (277 ± 1988) was higher than that in Great Soppo (251±2400 parasites/ µl). Prevalence of helminths was higher in Ekona (43.82%) than Great Soppo (11.54%) (X2 = 60.12, p < 0.001). Coinfections were higher in Ekona (41.70 %) than Great Soppo (10.58%) (X2 = 45.83, p < 0.001). Ascaris lumbricoides was the most prevalent helminth and also had the highest Geometric Mean Egg Density (GMED) in Ekona, followed by Trichuris trichiura and hookworm. A similar pattern was observed in Great Soppo except for T. trichiura which was the most prevalent helminth. Prevalences of anemia in Ekona and Great Soppo were 6.00% and 1.00% respectively. The highest prevalence of anemia, GMPD and GMED occurred in co-infected participants when compared to those infected only with malaria or STHs. The prevalence of the infeections decreased with increase in level of urbanization. Schoolbased control of these infections especially in rural areas will reduce their related morbidities.

Environmental Factors and Preventive Methods against Malaria Parasite Prevalence in Rural Bomaka and Urban Molyko, Southwest Cameroon

Malaria remains a major public health problem in Cameroon. This work was aimed at determining the influence of environmental factors and control measures on malaria parasite prevalence, and anaemia in pupils in rural Bomaka and urban Molyko, Southwest Cameroon. A total of 303 pupils (174 and 129 from Bomaka and Molyko, respectively), aged 4-15 years were studied. Information on demographic data, environmental and anti-malarial measures was recorded. Malaria was diagnosed from Giemsa-stained blood smears. Packed Cell Volume (PCV) was determined. The overall malaria parasite prevalence was 33.0%, and children from Bomaka had a significantly higher value (38.51%) than those from Molyko (25.58%). Malaria parasite prevalence was significantly higher in males and highest in children aged ≤ 6 years. Overall location, age and stagnant water were associated with malaria parasite prevalence. Although malaria parasite prevalence was higher in pupils who had bushes around their homes, lived in plank houses, and did not use Insecticide Residual Spraying (IRS), the differences were, however, not significant. The overall prevalence of anaemia was 14.0%, with the ≤ 6 years old pupils having the highest anaemia prevalence. Parasite density was significantly higher in anaemic ((1369, CI=504.25-2511.89) than non-anaemic children ((507, CI=313.74-603.32). A combination of environmental and preventive measures (especially in rural areas) as well as community participation will reduce malaria transmission.

Malaria Parasite and Anaemia Prevalence in Adult HIV-patients Attending Care and Treatment Centre in Baptist Hospital Mutengene, Cameroon

Aim: This study was aimed at investigating malaria parasite and anaemia prevalence, the impact of co-infection on immune-haematological parameters, clinical/treatment profiles and how malaria preventive measure associate with malaria and anaemia in adult HIV-patients attending care and Original Research Article Lum et al.; IJTDH, 15(4): 1-11, 2016; Article no.IJTDH.25022 2 treatment centre in Baptist Hospital Mutengene. Study Design: Cross-sectional study. Place and Duration of Study: This study was carried out in Mutengene from June to August, 2012. Methodology: A semi-structured questionnaire was used to record information on demographic factors and use of preventive measures from adult HIV-patients. Venous blood was collected; blood films were prepared and Giemsa-stained for malaria parasite detection. Haemoglobin concentration was determined. A total of 470 adults HIV-patients aged 20 68 years were studied. Results: There was an overall malaria parasite prevalence of 36.38% but there was no significant difference in malaria parasite prevalence between the various categories examined. The overall anaemia prevalence in the study was 24.89% with a significant difference (p=0.02) between males and females. There was a highly significant difference (p<0.001) in anaemia prevalence between different CD4+ levels, WHO clinical stages, fever status, clinical symptoms status, HAART consumption status, NRTIs and NNRTIs classes of HAART. There was however no significant difference in anaemia prevalence between the various malaria preventive measures applied in the study. Conclusion: This study demonstrates that malaria infection in HIV patients can lead to a reduction in CD4+ count and increase anaemia and fever. This can facilitate the HIV-patient’s change from clinical stage 1 to 4 where the patients will find it difficult to manage the disease and stay healthy. HIV-patients need to implement malaria control measures such as use of ITN and keep the environment clean in order to avoid malaria-related morbidity and mortality and improve generally on their health.

Efficacy and Tolerability of Malartin and Sulphadoxine-Pyrimethamine Combination against Uncomplicated Falciparum Malaria in Dibanda, Southwest Cameroon.

Artemisinin derivatives are now the most potent and rapidly acting antimalarials. The aim of this study was to assess the in vivo efficacy and tolerability of a combination of Malartin (an artesunate) and sulphadoxine-pyrimethamine (SP) in the treatment of uncomplicated falciparum malaria in Dibanda, Cameroon. A total of 197 subjects were recruited into the study and administered Malartin for 3 days and SP as a single dose on day 0. Only 174 of the subjects were successfully followed up on days 3, 7, and 14. The overall success rate of the drug combination was 92.53%. Parasite density decreased during the follow-up period in different age groups, sexes, and social classes. The prevalence of anaemia decreased from 22.99% at enrolment to 9.77% on day 14, and the difference was significant (P < 0.05) on all days of followup. The drug combination did not give rise to any serious side effects.