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Parasitaemia in Asymptomatic Bantu and Baka Pygmy People Living In

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Parasitaemia in Asymptomatic Bantu and Baka Pygmy People Living In ISSN: 2643-461X Diane et al. Int J Trop Dis 2020, 3:039 DOI: 10.23937/2643-461X/1710039 Volume 3 | Issue 2 International Journal of Open Access Tropical Diseases ReseARCh ARTiCle Parasitaemia in Asymptomatic Bantu and Baka Pygmy People Living in the East Region, Cameroon Gangueu Djape Clotilde Diane1*, Yondo Jeannette2, Noumedem Anangmo Christelle 2 1 1 1 Nadia , Nkouayep Vanessa Rosine , Atiokeng Tatang Rostang Joel and Mpoame Mbida Check for updates 1Department of Animal Biology, Faculty of Science, University of Dschang, Cameroon 2Department of Biological Sciences, Faculty of Medicine and Pharmaceutical Sciences, University of Dschang, Cameroon *Corresponding author: Gangueu Djape Clotilde Diane, Department of Animal Biology, Faculty of Science, University of Dschang, PO Box: 67, Dschang, Cameroon Abstract mean parasitaemia (8855 ± 7834 (1455-40000) parasites/ µl blood). In the general population short rainy season (P = Background: Asymptomatic malaria constitutes a silent 0.00) and spending more time in the forest (P = 0.04) were threat to an efficient malaria control strategy. The aim of this factors associated with higher parasitaemia. In the Bakas study was to assess the level of malaria parasitaemia toler- communities, people who went to secondary school were ated by asymptomatic individuals in Baka pygmies and the more resistant (16735 ± 21919 (5200-49600) parasites/µl Bantus of the East Region, Cameroon. blood) to malaria parasite whereas in the Bantus, they had Methods: A community-based cross-sectional study was the least mean parasitaemia (6760 ± 6177 (462-27200) par- conducted among asymptomatic Bantu and Baka pygmies asites/µl blood). from 6 months aged to 76-years-old. A questionnaire was Conclusion: At the end of this work it was noticed that in used to collect information from 1032 consenting partici- Baka as well as in Bantu, asymptomatic people were able to pants about ethnicity, gender, age, level of education, occu- handle up to 55000 trophozoites/µl blood without any sign pation, anti-malarial treatment, seasonality and time spent of the disease. Plasmodium parasitaemia depended mainly in the forest. Blood were collected in EDTA tubes and thin by the age, levels of education, season, and the time spent and thick blood smear were prepared and parasite densities in the forest, and not by ethnicity as earlier hypothesized. determined. Data was analyzed using SPSS 22.0. t-test and two-ways analyze of variance were performed to compare Keywords the log-transformed mean intensities. P-values less than 0.05 were taken as statistically significant. The results were Malaria, Asymptomatic, Parasitaemia, Ethnicity, Plasmodi- expressed as mean ± standard deviation (range). um Results: The mean malaria parasitaemia of Baka pygmies (7747, 88 ± 7149 (923-56000) trophozoïtes/µl blood) didn’t Introduction differ from that of Bantus (8239, 54 ± 8642 (462-72000) tro- phozoïtes/µl blood) (P = 0.56). Bantu’s men carried high- Despite all the invested control measure, malaria is er parasitaemia (9429 ± 3256 (667-72000) trophozoïtes/ still an important public health threat in Cameroon, the µl blood) compared to females (7280 ± 3301 (462-43429) whole country being at risk [1]. About 41% of the popu- trophozoites/µl blood). In Bakas, women had a significant lation suffers at least one episode of malaria each year, (P = 0.02) mean parasitaemia (8274 ± 8306 (923-56000) parasites/µl blood) compared to male (6888 ± 4608 (1212- with pregnant women and under five-years-old children 25333) trophozoites/µl blood). In general, infants of less being the most vulnerable [2]. In the country, Plasmodi- than 2-years-olds had the least Plasmodium parasitaemia um falciparum is responsible for the highest number of (4353 ± 3772 (636-20444) parasites/µl blood). Among Ban- cases causing about 50% of medical consultations, 48% tus, workers in logging company tolerated the highest mean of hospital admissions and 30% of total morbidity [3]. parasitaemia (9241 ± 3428 (4706-12000) parasites/µl blood respectively) whereas in Bakas, students carried the highest Asymptomatic malaria, a previously neglected par- Citation: Diane GDC, Jeannette Y, Nadia NAC, Rosine NV, Joel ATR, et al. (2020) Parasitaemia in As- ymptomatic Bantu and Baka Pygmy People Living in the East Region, Cameroon. Int J Trop Dis 3:039. doi.org/10.23937/2643-461X/1710039 Accepted: November 09, 2020; Published: November 11, 2020 Copyright: © 2020 Diane GDC, et al. This is an open-access article distributed under the terms of the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original author and source are credited. Diane et al. Int J Trop Dis 2020, 3:039 • Page 1 of 10 • DOI: 10.23937/2643-461X/1710039 ISSN: 2643-461X asite reservoir, is actually recognized as a potential lag- demic area of the East-Cameroon. Such information es- ging factor, a silent threat to an efficient malaria control pecially concerning indigenous asymptomatic people, is strategy [4]. The persistence of asymptomatic parasi- lacking in our country although it may be important in taemia inside indigenous communities is a threat since setting up new malaria control programs. asymptomatic individuals are parasite reservoirs who prevent the achievement of the malaria elimination goal Methods [5]. So this study on asymptomatic people is important Study period, area and population to evaluate the threshold parasite density above which a clinical malaria episode can start. In high malaria en- This community-based cross-sectional study was demic areas, partial immunity against malaria tends to conducted from May 2018 to April 2019 in the Nkouak be high to the extent that majority of malaria infected health sector, East Region of Cameroon. individuals are normally asymptomatic. Estimating ma- Nkouak is a Congo Basin forest village situated be- laria parasite density is necessary for patients’ manage- tween Abong Mbang (24 km West) and Mindourou (29 ment especially when parasite resistance to available km East), in the Upper Nyong division of Cameroon. The therapy is increasing [6]. Not withstanding, a good mas- study area is situated at latitude 3°N and longitude 13°E tery of the parasite control strategies, nature of trans- and it covers an area of about 20 km of distance [8,9]. mission, epidemiological features, type of habitat as Nkouak Integrated Health Sector covers two health fa- well as the role of ethnicity may be important to control cilities including Nkouak integrated health sector where parasitic load among asymptomatic individuals. the study was conducted. The sector serves 4315 resi- In fact, studies have shown that there isa disparity dents distributed among 8 small villages. Some of these between the malaria risks of different tribes’ sharing are occupied mainly with Bantus (Nkouak, Nongbwala, the same geographical area, with indigenous people Djouyaya, Etsiek, Kagnol) while others are occupied mainly with Baka Pygmies (Mballam II, Cyrie, Mayos) often being more at risk [7]. Therefore, some peculiar- ities linked to ethnic groups may influence the level of Figure 1. tolerance to parasitic load and also fuels the spread of Nkouak health sector is supplied by several perma- the infection from the reservoirs. The aim of this study nent rivers like Dja and Nyong rivers which surround the was to assess the level of malaria parasitaemia that an study area. The climate of the area is a classical equa- asymptomatic individual can tolerate in the malaria en- torial one characterized by two rainy seasons (from Figure 1: Nkouak health sector (Source: Laboratory of geomatic, University of Dschang, 2020). Diane et al. Int J Trop Dis 2020, 3:039 • Page 2 of 10 • DOI: 10.23937/2643-461X/1710039 ISSN: 2643-461X March to June and from August to November) and two smear (2 µl of blood) were prepared from each blood dry seasons (from June to August and from November sample. The smears were stained with 10% Giemsa af- to March). The annual average temperature varies be- ter fixing the thin smear with absolute methanol [12]. tween 23 °C and 28 °C, with a high atmospheric humid- The blood smears were then examined using the oil ity all year round [9,10]. The average rainfall varied be- immersion objective. Slides were reported negative for tween 1600 mm and 2000 mm/year. The vegetation is parasites only after observing at least 50 fields. Para- characterized with an evergreen transitional forest and site density was determined by counting the number of a semi-deciduous dense and moist forest [8]. malaria parasites against 200 white blood cells and ex- Nkouak is mainly a farming locality. Some of the peo- pressing the resultant number of parasites/µl blood as- ple are employed by Forest logging Companies like PAL- suming a white blood cell count of 8000 per µl of blood LISCO, FIPCAM, DINO et Fils. Malaria is the main mos- [13]. Thin films were examined to confirm the parasite quito-borne disease in that locality and as such a public species identified on the thick film. Blood slide was de- health problem of primary importance. clared positive when a concordant result was produced Sampling technique by two competent microscopists. To obtain the sample size, the statistical formula of Estimation of parasite density Yamane (1967) was used: Parasite densities were recorded as a ratio of para- N sites to WBC in thick films as follows [12]: n = 2 Number of parasites counted × 9000 Parasite density(in parasite/μl blood) = 1+ Ne( ) Number of WBC counted n: sample size; N: population size; e: sampling error Data analysis or precision (5%). Data was analyzed with the Statistical Package for According to the last population inventory in the Social Sciences (SPSS), version 22.0. Those data were Abong-Mbang health district in 2018, the population of firstly log-transformed. t-test for independent sample the Nkouak health sector was estimated at 4315 individ- and two ways analyze of variances were performed to uals.
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