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The objective of the study was to assess the burden of asymptomatic and sub-microscopic\n                      <jats:italic>Plasmodium<\/jats:italic>\n                      infection, altitudinal influence on it, their effect on haematological parameters as well as identify the risk factors of infection.\n                    <\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methodology<\/jats:title>\n                    <jats:p>\n                      A cross-sectional community-based survey involving 1319 children of both sexes aged 6\u00a0months to 14\u00a0years was conducted between July 2017 and May 2018. Malaria parasitaemia was confirmed by Giemsa-stained microscopy, sub-microscopic\n                      <jats:italic>Plasmodium<\/jats:italic>\n                      infection by 18S mRNA using nested PCR and full blood count analysis was done using an auto haematology analyser.\n                    <\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>\n                      Malaria parasite, asymptomatic malaria parasitaemia and sub-microscopic\n                      <jats:italic>Plasmodium<\/jats:italic>\n                      infection and anaemia were prevalent in 36.4%, 34.0%, 43.8% and 62.3% of the children, respectively. The risk of having sub-microscopic\n                      <jats:italic>Plasmodium<\/jats:italic>\n                      infection was highest in children 5\u20129 (OR\u2009=\u20093.13, P\u2009&lt;\u20090.001) and 10\u201214\u00a0years of age (OR\u2009=\u20098.18, P\u2009&lt;\u20090.001), non-insecticide treated net users (OR\u2009=\u20091.69, P\u2009&lt;\u20090.04) and those anaemic (OR\u2009=\u20099.01, P\u2009&lt;\u20090.001). Children with sub-microscopic infection had a significantly lower mean haemoglobin (9.86\u2009\u00b1\u20091.7\u00a0g\/dL, P\u2009&lt;\u20090.001), red blood cell counts (4.48\u2009\u00b1\u20091.1\u2009\u00d7\u200910\n                      <jats:sup>12<\/jats:sup>\n                      \/L, P\u2009&lt;\u20090.001), haematocrit (31.92%, P\u2009&lt;\u20090.001), mean corpuscular haemoglobin concentration (313.25\u2009\u00b1\u200947.36, P\u2009=\u20090.035) and platelet counts (280.83\u2009\u00b1\u2009112.62, P\u2009&lt;\u20090.001) than their negative counterparts. Children\u2009&lt;\u20095\u00a0years old (73.8%), having asymptomatic (69.8%) and sub-microscopic\n                      <jats:italic>Plasmodium<\/jats:italic>\n                      infection (78.3%) as well as resident in the middle belt (72.7%) had a higher prevalence of anaemia than their peers.\n                    <\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusion<\/jats:title>\n                    <jats:p>\n                      The meaningful individual-level heterogeneity in the burden of asymptomatic and sub-microscopic\n                      <jats:italic>Plasmodium<\/jats:italic>\n                      infection in addition to its corollary on haematological variables among children in the different attitudinal sites of the Mount Cameroon Region accentuate the need for strategic context specific planning of malaria control and preventative measures.\n                    <\/jats:p>\n                  <\/jats:sec>","DOI":"10.1186\/s12936-021-03916-7","type":"journal-article","created":{"date-parts":[[2021,9,26]],"date-time":"2021-09-26T13:06:53Z","timestamp":1632661613000},"update-policy":"https:\/\/doi.org\/10.1007\/springer_crossmark_policy","source":"Crossref","is-referenced-by-count":18,"title":["Asymptomatic and sub-microscopic Plasmodium falciparum infection in children in the Mount Cameroon area: a cross-sectional study on altitudinal influence, haematological parameters and risk factors"],"prefix":"10.1186","volume":"20","author":[{"ORCID":"https:\/\/orcid.org\/0000-0003-2607-8845","authenticated-orcid":false,"given":"Irene Ule Ngole","family":"Sumbele","sequence":"first","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Rene Ning","family":"Teh","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Gillian Asoba","family":"Nkeudem","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Sorelle Mekachie","family":"Sandie","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Marcel Nyuylam","family":"Moyeh","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Robert Adamu","family":"Shey","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Cabirou Mounchili","family":"Shintouo","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Stephen Mbigha","family":"Ghogomu","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Gaber El-Saber","family":"Batiha","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Luay","family":"Alkazmi","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Helen Kuokuo","family":"Kimbi","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"297","published-online":{"date-parts":[[2021,9,26]]},"reference":[{"key":"3916_CR1","unstructured":"WHO. 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Written informed consent\/assent forms were given or read and explained to parents or caregivers of the children at presentation. The purpose and benefits of the study as well as the amount of blood to be collected from each child were clearly stated in the information sheet and consent\/assent forms, respectively. Only participants who gave written and\/or verbal consent or assent documented by the investigator took part in the study. Participation was strictly voluntary, and parents or caregivers were free at any point in time to stop the participation of the child\/children in the study.","order":2,"name":"Ethics","group":{"name":"EthicsHeading","label":"Ethics approval and consent to participate"}},{"value":"Not applicable.","order":3,"name":"Ethics","group":{"name":"EthicsHeading","label":"Consent for publication"}},{"value":"The authors declare that they have no competing interests.","order":4,"name":"Ethics","group":{"name":"EthicsHeading","label":"Competing interests"}}],"article-number":"382"}}