Fc Gamma Receptor IIA and Merozoite Surface Protein 1 Gene Variants in Relation to Malaria Severity in the Buea Health District

Background: Malaria remains a major public health burden in sub-Saharan Africa, with Cameroon experiencing high endemicity and transmission intensity. While Plasmodium falciparum is the predominant species responsible for severe disease, host and parasite genetic factors are increasingly recognized as important determinants of malaria susceptibility and clinical outcomes. This study investigated the association between P. falciparum Merozoite Surface Protein 1 (MSP1) and human Fc gamma receptor IIA (FCγRIIA) gene polymorphisms with malaria severity in the Buea Health District, Cameroon. Methods: A total of 273 participants were enrolled and assessed for demographic and clinical characteristics. Nested PCR targeting P. falciparum confirmed species-specific infections. Genotyping of MSP1 block 2 (K1, MAD20, RO33) was conducted via allele-specific PCR, while FCγRIIA polymorphisms were analyzed using restriction fragment length polymorphism (RFLP). Statistical analyses, including chi-square tests and logistic regression, were used to assess associations between genetic markers, parasitaemia, and malaria severity. Results: Of the samples screened, 95 (97%) were confirmed as P. falciparum infections. The K1 allele was the most prevalent MSP1 genotype, followed by MAD20 and RO33, with several mixed infections, reflecting high transmission intensity. No significant association was found between MSP1 genotypes and malaria severity, though high parasitaemia was linked to increased odds of symptomatic malaria (OR = 4.03; 95% CI: 0.97–16.83; p = 0.054). FCγRIIA analysis revealed that individuals with homozygous or heterozygous genotypes had higher odds of symptomatic malaria compared to the wild type, although results were not statistically significant. Trends also indicated increasing FCγRIIA expression with age and parasitaemia, suggesting possible immune modulation. Conclusion: While no statistically significant associations were identified, trends observed in FCγRIIA and MSP1 polymorphisms suggest potential roles in influencing malaria severity. The high prevalence of mixed-genotype infections indicates considerable genetic diversity of P. falciparum in Buea. These findings underscore the need for larger, longitudinal studies to validate genetic markers of disease severity and inform targeted malaria interventions in Cameroon.