Bioko Island possesses a high prevalence of the Pfdhfr triple mutation (CIRNI) and Pfdhps single mutation (SGKAA), which will undermine the pharmaceutical effect of SP for malaria treatment strategies.
Owing to the high number of false negatives in microscopy, it is necessary to reinforce training in microscopy, the “Gold Standard” in endemic areas.
This study has contributed to reinforce the importance of living conditions associated to a high risk of malaria infection and vulnerability to develop high parasitaemia.
Improvements in educational programs are needed to empower the most vulnerable households such that they can pro-actively implement malaria control measures. This
The high level of mutations detected in P. falciparum genes related to SP resistance could be linked to the unsuccessful withdrawal of SP treatment in this area.
The results are suggestive of bendiocarb being more effective at preventing malaria on Bioko although evidence for this was weak.
To decrease malaria morbidity and mortality in Bata district, efforts should be addressed to reduce household delays in seeking care.
The prevalence of malaria was high in Bata district, especially in rural villages.
The delays in seeking treatment, the type of malaria therapy received and the cost of treatment are the principal problems found in Bata District.