{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"institution":[{"name":"medRxiv"}],"indexed":{"date-parts":[[2026,5,30]],"date-time":"2026-05-30T00:59:34Z","timestamp":1780102774489,"version":"3.54.0"},"posted":{"date-parts":[[2025,4,28]]},"group-title":"Infectious Diseases (except HIV\/AIDS)","reference-count":65,"publisher":"openRxiv","license":[{"start":{"date-parts":[[2025,4,28]],"date-time":"2025-04-28T00:00:00Z","timestamp":1745798400000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/creativecommons.org\/licenses\/by-nc-nd\/4.0\/"}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":[],"accepted":{"date-parts":[[2025,4,28]]},"abstract":"<jats:title>ABSTRACT<\/jats:title>\n                <jats:p>\n                  Despite global malaria control efforts, the disease caused 263 million cases and 597,000 deaths in 2023. While\n                  <jats:italic>Plasmodium falciparum<\/jats:italic>\n                  accounts for most cases in Africa, non-falciparum species, such as\n                  <jats:italic>P. ovale<\/jats:italic>\n                  spp. and\n                  <jats:italic>P. vivax<\/jats:italic>\n                  , can cause relapse infections and are increasingly recognized as significant contributors to human disease. In particular, the highlands of West Cameroon have previously been reported to have high\n                  <jats:italic>P. vivax<\/jats:italic>\n                  infection rates. This study presents preliminary results from the Relapsing Malaria in Africa (ReMA) study, conducted in Dschang, Cameroon, to assess the prevalence and epidemiology of\n                  <jats:italic>P. vivax<\/jats:italic>\n                  and\n                  <jats:italic>P. ovale<\/jats:italic>\n                  . A cross-sectional survey of 3,661 participants from 871 households across seven health areas identified a low prevalence of\n                  <jats:italic>P. vivax<\/jats:italic>\n                  (0.1%) and\n                  <jats:italic>P. ovale<\/jats:italic>\n                  spp. (0.64%) using quantitative real time PCR (qPCR), while\n                  <jats:italic>P. falciparum<\/jats:italic>\n                  remained prevalent at 8.1%. Co-infections of\n                  <jats:italic>P. ovale<\/jats:italic>\n                  spp. with\n                  <jats:italic>P. falciparum<\/jats:italic>\n                  were observed in 23.1% of\n                  <jats:italic>P. ovale<\/jats:italic>\n                  spp. cases. While gametocytemia was common among falciparum infections, leveraging a new ovale gametocyte assay, we found that gametocytemia was uncommon among the qPCR-positive ovale infections. Spatial analysis found\n                  <jats:italic>P. vivax<\/jats:italic>\n                  and\n                  <jats:italic>P. ovale<\/jats:italic>\n                  spp. infections concentrated in Penka-Michel and Baleveng, the former having higher\n                  <jats:italic>Anopheles<\/jats:italic>\n                  spp. abundance than other areas assessed. Risk factor analysis revealed children and those with recent domestic travel had higher odds of\n                  <jats:italic>P. falciparum<\/jats:italic>\n                  infection, but no significant associations were found for\n                  <jats:italic>P. ovale<\/jats:italic>\n                  spp. infections. Entomological surveys confirmed high densities of\n                  <jats:italic>Anopheles gambiae sensu lato<\/jats:italic>\n                  (\n                  <jats:italic>s.l.<\/jats:italic>\n                  ) and\n                  <jats:italic>An. funestus<\/jats:italic>\n                  (s.l.), with significantly higher human landing capture rates for\n                  <jats:italic>An. gambiae<\/jats:italic>\n                  s.l compared to other mosquito species. While these findings suggest that the relapsing malarias are not as widespread as previously thought in West Cameroon, understanding factors driving their persistent transmission, especially without prevalent gametocytemia, will be important for disease control.\n                <\/jats:p>\n                <jats:sec>\n                  <jats:title>AUTHOR SUMMARY<\/jats:title>\n                  <jats:p>\n                    Malaria caused 263 million cases and 597,000 deaths in 2023, with most cases in Africa due to\n                    <jats:italic>Plasmodium falciparum<\/jats:italic>\n                    . However, the dangers of other species like\n                    <jats:italic>P. ovale<\/jats:italic>\n                    and\n                    <jats:italic>P. vivax<\/jats:italic>\n                    , which can cause relapsing infections, are becoming more clear in Africa. The Relapsing Malaria in Africa (ReMA) study in Dschang, Cameroon, surveyed 3,661 people from 871 households to better understand these infections. Results showed low rates of\n                    <jats:italic>P. vivax<\/jats:italic>\n                    (0.1%) and\n                    <jats:italic>P. ovale<\/jats:italic>\n                    (0.64%) compared to\n                    <jats:italic>P. falciparum<\/jats:italic>\n                    (8.1%). Infections were more common in areas with high mosquito abundance and biting activity. While the relapsing malarias were less common than expected, understanding factors driving their persistent transmission, especially without prevalent gametocytemia, will be important for disease control.\n                  <\/jats:p>\n                <\/jats:sec>","DOI":"10.1101\/2025.04.28.25326551","type":"posted-content","created":{"date-parts":[[2025,4,28]],"date-time":"2025-04-28T19:30:20Z","timestamp":1745868620000},"source":"Crossref","is-referenced-by-count":1,"title":["Epidemiology of Relapsing and Falciparum Malaria in the Highlands of Cameroon: An Integrated Community Survey of Human Infection and Vector Abundance"],"prefix":"10.64898","author":[{"ORCID":"https:\/\/orcid.org\/0009-0006-1351-1020","authenticated-orcid":false,"given":"Samuel J.","family":"White","sequence":"first","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-0638-5573","authenticated-orcid":false,"given":"Valery P. 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