Strategies and perceptions towards flood control and waste management in Limbe city, Cameroon

Limbe city in Cameroon is prone to annual flood disasters. The Limbe City Council (LCC) has been making efforts to address the problem of floods and municipal solid waste management (MSWM). This article presents an: (1) assessment of the different strategies by the council towards MSWM and floods; (2) evaluation of public perception on waste disposal practices and (3) examination of the nexus between waste disposal and flooding. The methods employed included qualitative data collection through semi-structured interviews with the aid of questionnaires (open- and closed-ended questions) field observations and interview; and the use of the Benefit Value Tree method (BVT) to analyse sustainability strategies by LCC. The BVT method provided, the following scores for the four strategies used: sustainable basin management against floods and/or landslides = 7; mechanical dredging of river beds = 4; Keep Limbe Clean = 3; manual dredging and cleaning of rivers, gutters, culverts and bridges = 1. An evaluation of the municipal solid waste collection system revealed that (1) over 85% of plastic bins do not meet standard physical conditions; (2) bins at all collection points are insufficient for waste at such points and (3) residents engage in wanton disposal practices because of insufficient service coverage of residential areas. Field observations and interview with authorities established a clear connection between floods and poor waste management. In addition to existing efforts by LCC, it needs to upgrade and expand waste collection services through provision of numerous suitable bins and community awareness raising on the nexus between floods and waste disposal.

Contribution

This is a transdisciplinary research which presents the constraints and challenges in waste generation and collection, its relationship with recurrent floods in Limbe city, and presents a way forward to improve on the situation using the BVT method.

Prevalence and risk factors associated with cryptosporidiosis among children within the ages 0-5 years attending the Limbe regional hospital, southwest region, Cameroon

Background

Cryptosporidiosis is a pathological condition caused by infection with coccidian protozoan parasites Cryptosporidium. Cryptosporidium is one of the most common causes of childhood diarrhea in developing countries. So far, no data has been published on its prevalence among children with diarrhea in Cameroon. This study was therefore, designed to assess the prevalence and risk factors associated with Cryptosporidiosis among children within the ages 0–5 years suffering from diarrhea and being attended to at the Limbe Regional Hospital.

Methods

The study was a hospital based analytical cross-sectional study involving children within the ages 0–5 years (n = 112) hospitalized or consulted in the pediatric departments of the hospital between April 2018 and May 2018. Stool specimens were processed using the modified acid-fast staining method, and microscopically examined for Cryptosporidium infection.

Results

A total of 112 participants were recruited out of which 67 presented with diarrhea. A high prevalence 9/67 (13.40%) of Cryptosporidium was noticed in children with diarrhea than children without diarrhea 1/45 (2.2%). There was a significant relationship (p = 0.041) between prevalence of Cryptosporidium and the presence of diarrhea in children within the ages 0–5 years in the Limbe Regional Hospital. It was realized that children from parents with primary level of education, children whose parents did not respect exclusive breastfeeding and those whose parents were giving them pipe borne water for drinking recorded a higher prevalence.

Conclusions

This study revealed an overall prevalence of 8.9% for Cryptosporidium among children of ages 0–5 years that attended the Limbe Regional Hospital. The prevalence among children that presented with diarrhea was 13.4%. The study clearly demonstrated that Cryptosporidium is an important protozoal etiologic agent for children with diarrhea in Limbe.

Electronic supplementary material

The online version of this article (10.1186/s12889-019-7484-8) contains supplementary material, which is available to authorized users.

[In vivo confocal microscopy and optical coherence tomography as innovative tools for the diagnosis of limbal stem cell deficiency (French translation of the article)]

The limbus is the anatomical and functional barrier between corneal and conjunctival epithelia. It is characterized by presence of the limbal stem cell niche which allows corneal homeostasis to be maintained. Limbal stem cell deficiency is characterized by a dual process: insufficient regeneration of corneal epithelium, which cannot therefore assure its function of physiological support, associated with corneal invasion by conjunctival proliferation. Diagnosis is currently made via routine clinical examination, corneal impression cytology and in vivo confocal microscopy (IVCM). Slit lamp examination shows abnormal limbal anatomy, thin and irregular epithelium with late fluorescein staining, and superficial vascularization. With its high resolution, IVCM allows identification of limbal and corneal epithelial changes at a cellular level in en face views, parallel to the corneal surface, but with a restricted viewing field of the corneal surface. It shows a poor transition between the corneal and conjunctival epithelia, associated with a loss of the normal corneal epithelial stratification, low basal cell and sub-basal nerve plexus densities, even with sub-epithelial fibrosis. Optical coherence tomography in central cornea and at the limbus, with scans in different orientations, allows a quick, global and non-invasive analysis of normal eyes and those with limbal stem cell deficiency. It shows a thin limbal epithelium, lacking normal thickening, featuring absence of stromal undulations and limbal crypts in cross-sections and sections parallel to the limbus, lack of visible limbal crypts in en face sections, loss of clear transition between the hyporeflective corneal epithelium and the hyperreflective conjunctival epithelium, and hyperreflective sub-epithelial fibrosis.

[Limbal stem cell deficiency management. A review]

Limbal stem cell deficiency is predominantly caused by severe eye burns resulting in a decreased or a complete ablation of the regenerative potential of these stem cells. The inability to reconstruct the corneal epithelium further leads conjunctivalization of the gimbal-epithelial barrier. These abnormalities collectively result in the progressive opacification of the cornea responsible for blindness that is driven by chronic corneal ulceration and neovascularization. The underlying pathology of the cornea affects the homeostasis of the neighboring conjunctiva, eyelids, and tear film. Therefore, the ocular reconstruction to treat limbal stem cell deficiency is quite prolonged and involves a continued treatment plan. The management of limbal stem cell deficiency has undergone a multitude of changes over the past several decades. The understanding of limbal anatomy and physiology, as well as therapeutic advances in the stem cell field have propelled the development of new treatments offering new hope to severely disabled patients. Cultivated limbal epithelial and oral mucosal epithelial transplantations are therefore viable alternatives that could be utilized for the treatment of limbal stem cell deficiency.