Previous studies indicated the presence of paragonimiasis in two zones of the Southwest Province of Cameroon including the Kupe mountain focus in the Lower Bakossi area, Kupe Manengumba Division [3–6] and the Mundani focus  in Lebialem Division. This study was aimed at investigating the presence and epidemiology of paragonimiasis in the peri-urban zone of Kumba, Meme Division, located about 50 km away from the Kupe mountain focus. A total of 1482 school pupils in five village schools in the periphery of Kumba town were examined for the presence of paragonimus eggs in their stools and/or sputum. The results show an overall prevalence of 2.56% for paragonimiasis in the five neighbouring villages. This value is certainly an underestimate of the actual situation in the study zone, given the stringency of the standard diagnostic method used to identify typical operculated ova in stool and sputum. In a similar study carried out at the Kyusyu Island, Japan, Mukae and others  detected paragonimus eggs in the sputum and/or stools of only 31% of patients, the other cases being detected either by immunodiagnosis or bronchoscopic examination which appear more sensitive than the standard methods. Such sensitive tools were unfortunately not employed in this study due to their costs. The main differential diagnosis of paragonimiasis is pleuropulmonary tuberculosis. We had no case of Mycobacterium tuberculosis infection. This observation is rather surprising giving the recent increase in the prevalence of tuberculosis following the spread of HIV infection in Tropical Africa. However, it should be noted that the age of our study population, made-up of primary school children, is below that of the population at risk of HIV infection. In any case, clinicians should consider paragonimiasis in the differential diagnosis of tuberculosis, especially in cases of resistance to anti-tuberculosis treatment.
In the Kupe mountain focus, a significantly higher prevalence was noted in females compared to the males group. This sex difference was attributed to the believe by the Bakossi tribe which constitutes the population of the zone that crabs are a valuable aid to fertility in females [3, 5, 6]. On the contrary, in the present study, males are more infected than females (17.0% versus 8.0%) even though the difference was not significant. In fact the population of the present study is rather cosmopolitan and the pattern of infection should be different.
Geographical difference in prevalence could not be traced to the rate of infestation of crabs. Most of the streams in this area, have a common watershed, the Rumpi Hills and crabs can migrate from one stream to the other. Also, children from neighbouring villages can harvest crabs from the same streams.
All the children who were examined declared that they consumed crabs and that during the cooking of their crustaceans, they associated the change of colour of the shell of the crab with its readiness for consumption, the duration of cooking not withstanding. Thus, it could be said that these children consumed inadequately cooked crabs. These observations appear to support the results of others [1, 9]. The present study also shows that common symptoms are similar to those reported elsewhere [10–12].
In conclusion, this study has enabled the identification of autochthonous cases of paragonimiasis in the peri-urban zone of Kumba, Meme Division, Cameroon. It is however uncertain in this study wether this zone is independent or belongs to the Kupe mountain focus, thus calls for further investigations. In any case, the South West Province appears to be the most endemic zone of paragonimiasis in Cameroon at present.