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Background  Malaria in Cameroon was previously known to be caused solely by  Plasmodium falciparum  but today, evidence points to other  Plasmodium  species including  P. vivax ,  P. ovale  and  P. malariae . The purpose of this study was to identify the  Plasmodium  species in clinical samples from children residing in five epidemiological strata of malaria in Cameroon, so as to advise control policies.    Methods  One thousand six hundred nine febrile children (≤15 years) were recruited from five epidemiological strata of malaria including the Sudano-sahelian (SS) strata, the High inland plateau (HIP) strata, the South Cameroonian Equatorial forest (SCEF) strata, the High western plateau (HWP) strata and the Coastal (C) strata. Malaria parasites were detected by Giemsa microscopy (GM) while a multiplex polymerase chain reaction (PCR) was used to identify the  Plasmodium  species. Statistical analysis performed included the Pearson chi-square test, and statistical significance was set at  p  < 0.05.    Results  The PCR-adjusted prevalence of malaria was 17.6%. The detection rate of PCR was higher than GM ( p  = 0.05). However, GM demonstrated a high sensitivity (85.5%) and specificity (100%) and, overall, a perfectly correlated agreement with PCR (97.5%). The prevalence of malaria was significantly higher in children between 60 and 119 months ( p  < 0.001) and in Limbe (in the Coastal strata) ( p  < 0.001). Contrariwise, the prevalence of malaria was not associated with gender ( p  = 0.239).  P. falciparum  was identified in all (100%) the cases of malaria;  P. ovale ,  P. vivax ,  P. malariae  and  P. knowlesi  were all absent. No case of mixed infection was identified.    Conclusions    P. falciparum  was the only species causing clinical malaria in the target population, which is contrary to studies that have reported  P. vivax ,  P. malariae  and  P. ovale  as causing clinical malaria in Cameroon.

Identification of the Plasmodium species in clinical samples from children residing in five epidemiological strata of malaria in Cameroon