review · Parasites & Vectors
A review of eighty-five studies across Cameroon from 2002 to 2021 examined mosquito-borne disease patterns across thirty-seven urban and twenty-eight rural sites. Ten mosquito-borne human diseases were recorded, concentrated primarily in the Northwest, North, Far North, and Eastern regions. In urban settings, dengue prevalence doubled from 14.55 percent in 2002 to 2011 to 29.84 percent in 2012 to 2021, while malaria prevalence remained unchanged at 67 percent. Over the same timeframe, rural malaria prevalence decreased significantly from 45.87 percent to 39 percent, while lymphatic filariasis and Rift Valley fever emerged as new burdens. Seventeen vector species were identified, with higher species diversity in rural environments. Reports of Anopheles gambiae sensu lato in urban areas increased, and Aedes aegypti was detected exclusively in urban locations, pointing to distinct transmission risks between rural and urban communities.
Rapid urbanisation in sub-Saharan Africa alters disease environments in complex ways. Understanding how mosquito populations and infection rates diverge between expanding cities and rural communities allows public health programmes to tailor interventions. Instead of relying solely on malaria interventions, control programmes can deploy targeted measures against specific emerging threats, including dengue in cities and Rift Valley fever or lymphatic filariasis in rural areas.
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BACKGROUND: Over the past two decades, Cameroon has recorded one of the highest rates of urban population growth in sub-Saharan Africa. It is estimated that more than 67% of Cameroon's urban population lives in slums, and the situation is far from improving as these neighbourhoods are growing at an annual rate of 5.5%. However, it is not known how this rapid and uncontrolled urbanization affects vector populations and disease transmission in urban versus rural areas. In this study, we analyse data from studies conducted on mosquito-borne diseases in Cameroon between 2002 and 2021 to determine the distribution of mosquito species and the prevalence of diseases they transmit with regards to urban areas versus rural areas. METHODS: A search of various online databases, such as PubMed, Hinari, Google and Google Scholar, was conducted for relevant articles. A total of 85 publications/reports were identified and reviewed for entomological and epidemiological data from the ten regions of Cameroon. RESULTS: Analysis of the findings from the reviewed articles revealed 10 diseases transmitted by mosquitoes to humans across the study regions. Most of these diseases were recorded in the Northwest Region, followed by the North, Far North and Eastern Regions. Data were collected from 37 urban and 28 rural sites. In the urban areas, dengue prevalence increased from 14.55% (95% confidence interval [CI] 5.2-23.9%) in 2002-2011 to 29.84% (95% CI 21-38.7%) in 2012-2021. In rural areas, diseases such as Lymphatic filariasis and Rift valley fever, which were not present in 2002-2011, appeared in 2012-2021, with a prevalence of 0.4% (95% CI 0.0- 2.4%) and 10% (95% CI 0.6-19.4%), respectively. Malaria prevalence remained the same in urban areas (67%; 95% CI 55.6-78.4%) between the two periods, while it significantly decreased in rural areas from 45.87% (95% CI 31.1-60.6%) in 2002-2011 to 39% (95% CI 23.7-54.3%) in the 2012-2021 period (*P = 0.04). Seventeen species of mosquitoes were identified as involved in the transmission of these diseases, of which 11 were involved in the transmission of malaria, five in the transmission of arboviruses and one in the transmission of malaria and lymphatic filariasis. The diversity of mosquito species was greater in rural areas than in urban areas during both periods. Of the articles reviewed for the 2012-2021 period, 56% reported the presence of Anopheles gambiae sensu lato in urban areas compared to 42% reported in 2002-2011. The presence of Aedes aegypti increased in urban areas in 2012-2021 but this species was absent in rural areas. Ownership of long-lasting insecticidal nets varied greatly from one setting to another. CONCLUSIONS: The current findings suggest that, in addition to malaria control strategies, vector-borne disease control approaches in Cameroon should include strategies against lymphatic filariasis and Rift Valley fever in rural areas, and against dengue and Zika viruses in urban areas.
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DOI: 10.1186/s13071-023-05737-w
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