Prevalence of Plasmodium Species Using Rapid Diagnostic Tests in Cameroon: First-Year Data From Routine Malaria...

Malaria remains a major public health concern in Cameroon. Although Plasmodium falciparum is the predominant parasite, the prevalence of other Plasmodium species remains poorly documented due to the absence of a formal surveillance system. This study is aimed at assessing the prevalence of Plasmodium species through routine malaria surveillance using P.f/Pan rapid diagnostic tests (RDTs).

A nationwide malaria surveillance program was conducted over 1 year (January-December 2024), covering health facilities across all regions and levels of care. Malaria cases were diagnosed using P.f/Pan RDTs, which detect P. falciparum and non-falciparum infections but cannot reliably differentiate individual non-falciparum species. Data were systematically compiled through the National Health Information System and analysed to determine the prevalence and distribution of Plasmodium species across regions.

Of the 3,843,507 individuals tested, 43% were malaria-positive. P. falciparum monoinfection accounted for 82% of cases, mixed infections (P. falciparum + Pan) for 15%, and Pan infection for 3%. Regional analysis showed the highest prevalence of P. falciparum monoinfection in the Far North region (92.1%), followed by the North (85.7%), Central (82.5%), West (81.7%), and East (80.6%) regions. Seasonal variations revealed a peak in positive cases between June and July, whereas mixed and Pan infections remained consistently low.

Findings confirm the presence of non-falciparum and mixed infections beyond P. falciparum. However, P.f/Pan RDTs have inherent limitations in species differentiation, underscoring the need for molecular techniques to improve species-specific identification. Strengthening malaria genomic surveillance, including monitoring of Plasmodium species diversity and HRP2/3 gene deletions that affect RDT performance, will be critical to enhance routine surveillance and guide effective malaria control strategies in Cameroon.