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Background: Asymptomatic malaria constitutes a silent threat to an efficient malaria control strategy. The aim of this study was to assess the level of malaria parasitaemia tolerated by asymptomatic individuals in Baka pygmies and the Bantus of the East Region, Cameroon. Methods: A community-based cross-sectional study was conducted among asymptomatic Bantu and Baka pygmies from 6 months aged to 76-years-old. A questionnaire was used to collect information from 1032 consenting participants about ethnicity, gender, age, level of education, occupation, anti-malarial treatment, seasonality and time spent in the forest. Blood were collected in EDTA tubes and thin and thick blood smear were prepared and parasite densities determined. Data was analyzed using SPSS 22.0. t-test and two-ways analyze of variance were performed to compare the log-transformed mean intensities. P-values less than 0.05 were taken as statistically significant. The results were expressed as mean ± standard deviation (range). Results: The mean malaria parasitaemia of Baka pygmies (7747, 88 ± 7149 (923-56000) trophozoïtes/μl blood) didn’t differ from that of Bantus (8239, 54 ± 8642 (462-72000) trophozoïtes/μl blood) (P = 0.56). Bantu’s men carried higher parasitaemia (9429 ± 3256 (667-72000) trophozoïtes/ μl blood) compared to females (7280 ± 3301 (462-43429) trophozoites/μl blood). In Bakas, women had a significant (P = 0.02) mean parasitaemia (8274 ± 8306 (923-56000) parasites/μl blood) compared to male (6888 ± 4608 (121225333) trophozoites/μl blood). In general, infants of less than 2-years-olds had the least Plasmodium parasitaemia (4353 ± 3772 (636-20444) parasites/μl blood). Among Bantus, workers in logging company tolerated the highest mean parasitaemia (9241 ± 3428 (4706-12000) parasites/μl blood respectively) whereas in Bakas, students carried the highest mean parasitaemia (8855 ± 7834 (1455-40000) parasites/ μl blood). In the general population short rainy season (P = 0.00) and spending more time in the forest (P = 0.04) were factors associated with higher parasitaemia. In the Bakas communities, people who went to secondary school were more resistant (16735 ± 21919 (5200-49600) parasites/μl blood) to malaria parasite whereas in the Bantus, they had the least mean parasitaemia (6760 ± 6177 (462-27200) parasites/μl blood). Conclusion: At the end of this work it was noticed that in Baka as well as in Bantu, asymptomatic people were able to handle up to 55000 trophozoites/μl blood without any sign of the disease. Plasmodium parasitaemia depended mainly by the age, levels of education, season, and the time spent in the forest, and not by ethnicity as earlier hypothesized.

Parasitaemia in Asymptomatic Bantu and Baka Pygmy People Living in the East Region, Cameroon