Clinical Presentation, Haematological Indices and Management of 
 Children with Severe and Uncomplicated Malaria in Douala, Cameroon

Mfonkeu, Joël Bertrand Pankoui; Gouado, Inocent; Kuaté, Honoré Fotso; Zambou, Odile; Grau, Georges E.; Combes, Valéry; Zollo, Paul Henri Amvam

doi:10.3923/pjbs.2008.2401.2406

Cited by 11 publications

(4 citation statements)

References 14 publications

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“…The data are consistent with parasitological and clinical records revealing a high prevalence of malarial disease in the population, however [38]. Malaria transmission was detected only during the rainy season, despite the continuous presence of An.…”

Section: Discussionsupporting

confidence: 89%

High mosquito burden and malaria transmission in a district of the city of Douala, Cameroon

et al. 2012

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BackgroundRapid demographic growth in Douala city, Cameroon, has resulted in profound ecological and environmental changes. Although demographic changes can affect anopheline mosquito breeding sites, there is a lack of understanding about the epidemiological impact that such changes might have on vector ecology and malaria transmission.MethodsA 12-month entomological study was conducted in a highly populated district of Douala called Ndogpassi. Adult mosquitoes were collected using two methods: 1) human landing catches (HLC); and 2) Centers for Disease Control and Prevention (CDC) light traps; these methods were used twice monthly from January to December 2011. Mosquito genus and species were identified with morphological and molecular diagnostic tools. The sampling efficiency of the CDC light trap and HLC were compared. Anopheles gambiae infection with Plasmodium falciparum was detected using ELISA. Susceptibility to DDT, permethrin, and deltamethrin insecticides were also determined.ResultsA total of 6923 mosquitoes were collected by HLC (5198) and CDC light traps (1725). There was no equivalence in the sampling efficiency between light traps and human landing catches (P > 0.01). With 51% of the total, Culex was the most common, followed by Anopheles (26.14%), Mansonia (22.7%) and Aedes (0.1%). An. gambiae ss (M form) comprised ~98% of the total anophelines collected. An. gambiae had a biting rate of 0.25 to 49.25 bites per human per night, and was the only species found to be infected with P. falciparum. A P. falciparum infection rate of 0.5% was calculated (based on enzyme-linked immunosorbent assays using the circumsporozoite surface protein). The entomological inoculation rate was estimated at 31 infective bites per annum. Insecticide susceptibility tests on An. gambiae females revealed a mortality rate of 33%, 76% and 98% for DDT, permethrin and deltamethrin, respectively. The West African kdr allele (L1014F) was detected in 38 of the 61 An. gambiae analyzed (62.3%).ConclusionsThe present study revealed seasonal malaria transmission in Douala. High levels of An. gambiae were detected along with a high prevalence of insecticide resistance in this vector population. These findings highlight the need to promote use of insecticide-impregnated bed nets in Douala.

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Section: Discussionsupporting

confidence: 89%

High mosquito burden and malaria transmission in a district of the city of Douala, Cameroon

et al. 2012

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“…A decline of malaria morbidity and mortality has been reported during the past decade in several sub-Saharan countries [27,28], whereas, the disease still has a devastating impact on public health and welfare in Cameroon [2,29,30]. The situation requires a thorough assessment of factors affecting directly or indirectly control operations in order to find lasting solutions.…”

Section: Discussionmentioning

confidence: 99%

Impact of cyfluthrin (Solfac EW050) impregnated bed nets on malaria transmission in the city of Mbandjock : lessons for the nationwide distribution of long-lasting insecticidal nets (LLINs) in Cameroon

et al. 2013

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BackgroundInsecticide treated materials remain the mainstay for malaria prevention. The current study reports on the entomological impact of cyfluthrin impregnated bed nets on malaria transmission in Mbandjock, a semi urban locality in southern Cameroon. Several findings pertaining to the recent distribution of LLINs across Cameroon are discussed.MethodsMalaria transmission and vector bionomics were monitored before and after impregnated net coverage. Bed nets were distributed in Mbandjock, whereas the locality of Nkoteng was free of bed nets during the entire study period. January to June 1997 represented the period before bed net coverage and September 1997 to September 1998 was the period after bed net coverage. Adult mosquitoes were collected by human landing catches. Mosquito genus and species were identified with morphological and molecular diagnostic tools. Anopheline salivary glands and ovaries were dissected to determine female infectious status and parity rates respectively.ResultsA total of 6959 anophelines corresponding to 6029 in Mbandjock and 930 in Nkoteng were collected in the course of the study. Seven species were recorded in both cities : Anopheles coustani, An. funestus, An. gambiae sl, An. moucheti, An. ziemanni, An. nili and An. paludis. An. gambiae s.l. (>95% An. gambiae S molecular form) was the most abundant species representing 75.6% and 86.6% of the total anophelines caught in Mbandjock before and after bed net coverage respectively. The human biting rate (HBR) in Mbandjock decreased from 17 bites/human/night before bed net coverage to less than 4 bites/human/night during the first 7 months following impregnated bed net coverage. A significant decrease of mosquito parity rate was recorded when comparing the period before (52%) and after (46.5%) bed net distribution. The average infection rate of malaria vectors significantly decreased from 5.3% before to 1.8% after bed net coverage (p < 0.0001). The entomological inoculation rate in Mbandjock was reduced by 74% varying from 124.1 infected bites/human/year before bed net distribution, to 32.5 infected bites/human/year after bed net coverage. All entomological indexes were relatively stable in Nkoteng and no reduction of malaria transmission was recorded in this locality.ConclusionThe study confirms the effectiveness of cyfluthrin impregnated nets in reducing malaria transmission. Lessons from this study could be essential to draw guidelines for the management of the recent nationwide distribution of LLINs across Cameroon in 2011.

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“…Considering the fact that a case definition of malaria requires the presence of asexual parasites in the blood[39,40], it is most likely that the patients who had no parasitaemia could have other infections with cerebral manifestations mimicking cerebral malaria, like cerebrospinal meningitis [41]. The proportion of patients who had cerebral malaria (47.3%) was actually higher than that recorded by Pankoui Mfonkeu (20.2%) in Douala, Cameroon [42]. …”

Section: Discussionmentioning

confidence: 99%

Prospective study on severe malaria among in-patients at Bombo regional hospital, Tanga, north-eastern Tanzania

et al. 2011

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BackgroundIn Tanzania, malaria is the major cause of morbidity and mortality, accounting for about 30% of all hospital admissions and around 15% of all hospital deaths. Severe anaemia and cerebral malaria are the two main causes of death due to malaria in Tanga, Tanzania.MethodsThis was a prospective observational hospital-based study conducted from October 2004 to September 2005. Consent was sought from study participants or guardians in the wards. Finger prick blood was collected from each individual for thick and thin smears, blood sugar levels and haemoglobin estimations by Haemocue machine after admission.ResultsA total of 494 patients were clinically diagnosed and admitted as cases of severe malaria. Majority of them (55.3%) were children below the age of 5 years. Only 285 out of the total 494 (57.7%) patients had positive blood smears for malaria parasites. Adults aged 20 years and above had the highest rate of cases with fever and blood smear negative for malaria parasites. Commonest clinical manifestations of severe malaria were cerebral malaria (47.3%) and severe anaemia (14.6%), particularly in the under-fives. Case fatality was 3.2% and majority of the deaths occurred in the under-fives and adults aged 20 years and above with negative blood smears.ConclusionProper laboratory diagnosis is crucial for case management and reliable data collection. The non-specific nature of malaria symptomatologies limits the use of clinical diagnosis and the IMCI strategy. Strengthening of laboratory investigations to guide case management is recommended.

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Clinical Presentation, Haematological Indices and Management of Children with Severe and Uncomplicated Malaria in Douala, Cameroon

Cited by 11 publications

References 14 publications

High mosquito burden and malaria transmission in a district of the city of Douala, Cameroon

High mosquito burden and malaria transmission in a district of the city of Douala, Cameroon

Impact of cyfluthrin (Solfac EW050) impregnated bed nets on malaria transmission in the city of Mbandjock : lessons for the nationwide distribution of long-lasting insecticidal nets (LLINs) in Cameroon

Prospective study on severe malaria among in-patients at Bombo regional hospital, Tanga, north-eastern Tanzania

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