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Background  Malaria remains a serious public health problem in Cameroon. Implementation of control interventions requires prior knowledge of the local epidemiological situation. Here we report the results of epidemiological and entomological surveys carried out in Tibati, Adamawa Region, Cameroon, an area where malaria transmission is seasonal, 6 years after the introduction of long-lasting insecticidal bed nets.    Methods  Cross-sectional studies were carried out in July 2015 and 2017 in Tibati. Thick blood smears and dried blood spots were collected from asymptomatic and symptomatic individuals in the community and at health centers, respectively, and used for the molecular diagnosis of  Plasmodium  species. Adult mosquitoes were collected by indoor residual spraying and identified morphologically and molecularly. The infection status of  Plasmodium  spp. was determined by quantitative PCR, and positivity of PCR-positive samples was confirmed by Sanger sequencing.    Results  Overall malaria prevalence in our study population was 55.0% (752/1367) and  Plasmodium falciparum  was the most prevalent parasite species (94.3%), followed by  P. malariae  (17.7%) and  P. ovale  (0.8%); 92 (12.7%) infections were mixed infections. Infection parameters varied according to clinical status (symptomatic/asymptomatic) and age of the sampled population and the collection sites. Infection prevalence was higher in asymptomatic carriers (60.8%), but asexual and sexual parasite densities were lower. Prevalence and intensity of infection decreased with age in both the symptomatic and asymptomatic groups. Heterogeneity in infections was observed at the neighborhood level, revealing hotspots of transmission. Among the 592  Anopheles  mosquitoes collected, 212 (35.8%) were  An. gambiae , 172 (29.1%) were  An. coluzzii  and 208 (35.1%) were  An. funestus  ( s.s. ). A total of 26 (4.39%) mosquito specimens were infected by  Plasmodium  sp. and the three  Anopheles  mosquitoes transmitted  Plasmodium  at equal efficiency. Surprisingly, we found an  An. coluzzii  specimen infected by  Plasmodium vivax , which confirms circulation of this species in Cameroon. The positivity of all 26 PCR-positive  Plasmodium -infected mosquitoes was successively confirmed by sequencing analysis.    Conclusion  Our study presents the baseline malaria parasite burden in Tibati, Adamawa Region, Cameroon. Our results highlight the high malaria endemicity in the area, and hotspots of disease transmission are identified. Parasitological indices suggest low bednet usage and that implementation of control interventions in the area is needed to reduce malaria burden. We also report for the first time a mosquito vector with naturally acquired  P. vivax  infection in Cameroon.    Graphical abstract

parasites and vectors

Epidemiological and entomological studies of malaria transmission in Tibati, Adamawa region of Cameroon 6 years following the introduction of long-lasting insecticide nets