Study areaThe study was carried out in six major settlements along the slope of Mt Cameroon with varying malaria transmission profiles and geographic features 3, 14.
All selected settlements were geo-located using a handheld GPS (eTrex, Vista, Garmin, USA) as follows: Ombe (Located at 04.06792N and 9. 29357 E, elevation of 135m), Mutengene (Located at 04.
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09291N and 9. 31376 E, elevation of 251m), Dibanda (Located at 04.11656N and 9 30796 E, elevation of 385m), Bolifamba (Located at 04.13874N and 9. 30794 E, elevation of 487m), Muea (Located at 04.17313N and 9.
30943E, elevation of 533m) and Tole (Located at 04.11518N and 9. 24056E, elevation of 636m). Ombe and Tole are rural communities and Mutengene, Dibanda, Bolifamba and Muea are semi Urban community. The communities included this study are characterized by small bushes and stagnant water (during the raining seasons) that favors anopheles breeding through the year (Akenji 2006). The population of this area comes from many ethnic groups mainly from neighboring regions in search of its fertile volcanic land for farming and business opportunities.
This area has two main house types, namely cement brick and wooden houses ( Akenji 2006, 5, 18 ) Mount Cameroon is the highest mountain in West Africa. It is an active volcano that extends from the Atlantic Ocean at the Golf of Guinea to a summit of 4100m in Buea which is cold, windy, and occasionally brushed with snow 15. From a base of 50 m above sea level a sedimentary plain extends from Limbe to Mutengene and Tiko. From Mutengene, the Mountain elevates to an altitude of 800–1200 m in Buea town 15 In the forested area of southern Cameroon, the equatorial climate has been greatly influenced by the ocean and the mountain 15 The Mount Cameroon Region has mean temperature values of 200? in December and 180? in August with maximum temperatures of 350? in March. It has a long rainy season that starts in March and ends in October with maximum rainfall between August and September. The dry season starts in late October and ends in March.
The mean annual rainfall is 2625 mm while relative humidity is constantly high (75–80%) 16. About 400 000 people live around mount Cameroon consisting mainly of the indigenous Bakweri people but also immigrants from other parts of Cameroon, especially the North West Region 16Malaria transmission is intense and perennial in the mount Cameroon area, with peak transmission during the rainy seasons 17. The prevalence of malaria parasitaemia in the low-altitude areas ranges from 30% in the dry season to 84% in the rainy season 18. Anopheles gambiae is the dominant, most aggressive and most active vector 16, 17, 19.) Infection rates by A. gambiae are as high as 287 infective bites/person/year and overall EIR estimated recently at 3.93 infective bites/person/night 19.