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Omoleye OJ, Freeman JQ, Oluwasanu M, Adeniji-Sofoluwe A, Woodard AE, Aribisala BS, Adejumo PO, Ntekim A, Makumbi T, Ndom P, Ajayi IO, Olopade OI, Huo D. Benign breast disease and breast cancer risk in African women: a case-control study. Cancer Causes Control 2024; 35:787-798. [PMID: 38177455 DOI: 10.1007/s10552-023-01837-1] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/28/2023] [Accepted: 11/27/2023] [Indexed: 01/06/2024]
Abstract
PURPOSE To examine the association between benign breast disease (BBD) and breast cancer (BC) in a heterogeneous population of African women. METHODS BC cases and controls were enrolled in three sub-Saharan African countries, Nigeria, Cameroon, and Uganda, between 1998 and 2018. Multivariable logistic regression was used to test the association between BBD and BC. Risk factors dually associated with BBD and BC were selected. Using a parametric mediation analysis model, we assessed if selected BC risk factors were mediated by BBD. RESULTS Of 6,274 participants, 55.6% (3,478) were breast cancer cases. 360 (5.7%) self-reported BBD. Fibroadenoma (46.8%) was the most commonly reported BBD. Women with a self-reported history of BBD had greater odds of developing BC than those without (adjusted odds ratio [aOR] 1.47, 95% CI 1.13-1.91). Biopsy-confirmed BBD was associated with BC (aOR 2.25, 95% CI 1.26-4.02). BBD did not significantly mediate the effects of any of the selected BC risk factors. CONCLUSIONS In this study, BBD was associated with BC and did not significantly mediate the effects of selected BC risk factors.
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Affiliation(s)
- Olasubomi J Omoleye
- Department of Medicine, University of Chicago, Chicago, IL, USA
- Center for Clinical Cancer Genetics and Global Health, University of Chicago, Chicago, IL, USA
| | - Jincong Q Freeman
- Department of Public Health Sciences, University of Chicago, Chicago, IL, USA
| | - Mojisola Oluwasanu
- Department of Health Promotion and Education, College of Medicine, University of Ibadan, Ibadan, Oyo State, Nigeria
| | | | - Anna E Woodard
- Center for Clinical Cancer Genetics and Global Health, University of Chicago, Chicago, IL, USA
- Data Science Institute, University of Chicago, Chicago, IL, USA
| | | | - Prisca O Adejumo
- Department of Nursing, College of Medicine, University of Ibadan, Ibadan, Oyo State, Nigeria
| | - Atara Ntekim
- Department of Radiation Oncology, College of Medicine, University of Ibadan, Ibadan, Oyo State, Nigeria
| | - Timothy Makumbi
- Department of Surgery, Mulago Hospital, Mulago, Kampala, Uganda
| | - Paul Ndom
- Hôpital Général Yaoundé, Yaoundé, Cameroon
| | - IkeOluwapo O Ajayi
- Department of Epidemiology and Medical Statistics, University of Ibadan, Ibadan, Oyo State, Nigeria
| | - Olufunmilayo I Olopade
- Department of Medicine, University of Chicago, Chicago, IL, USA
- Center for Clinical Cancer Genetics and Global Health, University of Chicago, Chicago, IL, USA
| | - Dezheng Huo
- Center for Clinical Cancer Genetics and Global Health, University of Chicago, Chicago, IL, USA.
- Department of Public Health Sciences, University of Chicago, 5841 S. Maryland Avenue, MC 2000, Chicago, IL, 60637, USA.
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Amani A, Mboussou F, Impouma B, Cabore J, Moeti MR. Introduction and rollout of malaria vaccines in Cameroon and Burkina Faso: early lessons learned. Lancet Glob Health 2024; 12:e740-e741. [PMID: 38614624 DOI: 10.1016/s2214-109x(24)00101-3] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/29/2024] [Accepted: 03/01/2024] [Indexed: 04/15/2024]
Affiliation(s)
- Adidja Amani
- World Health Organization Regional Office for Africa, Brazzaville, Republic of the Congo.
| | - Franck Mboussou
- World Health Organization Regional Office for Africa, Brazzaville, Republic of the Congo
| | - Benido Impouma
- World Health Organization Regional Office for Africa, Brazzaville, Republic of the Congo
| | - Joseph Cabore
- World Health Organization Regional Office for Africa, Brazzaville, Republic of the Congo
| | - Matshidiso R Moeti
- World Health Organization Regional Office for Africa, Brazzaville, Republic of the Congo
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Ngatchou W, Barche B, Temgoua M, Metouguena SE, Jutcha I, Mvondo CM, Kamdem F, Dzudie A, Ndjoh S, Johne M, Metogo J, Ndom MS, Sango J, Ngo Yon C, Moulium S, Lade V, Kuaté LM, Menanga AP, Sobngwi E, Njock R, Blazquez SB, Ngowe Ngowe M. Prevalence, clinical presentation, and risk factors of chronic venous disease in Cameroon: A general population-based study. Phlebology 2024; 39:259-266. [PMID: 38158837 DOI: 10.1177/02683555231224111] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/03/2024]
Abstract
INTRODUCTION Chronic venous disease is a global public health problem, with high morbidity and economic distress. There is scarcity of data on this disease in sub-Saharan Africa. METHODS We conducted the first population-based study over a period of 20 months from 1st February 2020 to 30th September 2021 in the 10 regions of Cameroon. A stratify sampling method was chose to select study site. Socio-demographic data, personal and family history, anthropometric parameters, clinical signs, illustrative images, CEAP (Clinical-Etiological-Anatomical-Pathophysiological) classification revised in 2004, VCSS (venous Clinical Severity Score) and risk factor assessment score were used to construct the survey form. Chi-squared test and Fischer exact test were used to compare the prevalence of chronic venous disease across different potential risk factors (sex, age category, previous history of deep vein thrombosis, hypertension, diabetes, smoking status, obesity). Simple and multiple logistic regression models were used to obtain crude and adjusted odds ratio for risk factors associated with chronic venous insufficiency. Statistical analyses were done with R version 4.2 for Linux and the threshold for statistical significance was 0.05. RESULTS A total of 6578 participants were included in the study, with a mean age of 41.09 ± 16.02 years with female predominance (54.3%). The prevalence of chronic venous disease was 21.8% (95% CI: 20.8-22.9) and the prevalence of chronic venous insufficiency (C3-C6) was 7.02% (n = 462). Night cramps (43.2%), oedema (21.7%), lower limbs pain (20.4%) mostly worsens by walking and heavy legs (16.2%) were more common symptoms. The mean total venous clinical severity score was 0.69 ± 1.76 and this score had a significant positive correlation with C classification (p < .001). In the multivariate analysis, the following factors were independently associated with CVD: Male gender (aOR: 1.27; 95%CI: 1.04-1.56; p = .021), retired people (aOR: 46.9; 95% CI: 12.6-174.5; p < .001), hypertension (aOR: 289.5; 95%CI: 169.69-493.1; p < .001), diabetes (aOR: 2.19; 95% CI: 1.21-3.96; p = .009), obesity (aOR: 10.22; 95%CI: 7.67-13.62; p < .001). Smoking appears as a protective factor (aOR: 0.18; 95%CI: 0.10-0.30; p < .001). CONCLUSION Chronic venous disease is frequent in Cameroon and main traditional cardiovascular risk factors are associated to this condition. Systematic screening of the CVD in these specific groups could reduce the burden of the disease and its economic impact.
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Affiliation(s)
- William Ngatchou
- Department of Surgery and Specialities, Faculty of Medicine and Pharmaceutical Sciences, University of Douala, Douala, Cameroon
| | - Blaise Barche
- Clinical Research Education Networking and Consultancy, Douala, Cameroon
| | - Mazou Temgoua
- Department of Cardiology, Faculty of Medicine, University of Toulouse-Rangueil, Toulouse, France
| | - Serge Erwich Metouguena
- Department of Surgery and Specialities, Faculty of Medicine and Pharmaceutical Sciences, University of Douala, Douala, Cameroon
| | - Ivan Jutcha
- Department of Surgery and Specialities, Faculty of Medicine and Pharmaceutical Sciences, University of Douala, Douala, Cameroon
| | - Charles Mve Mvondo
- Department of Surgery and Specialities, Faculty of Medicine and Pharmaceutical Sciences, University of Douala, Douala, Cameroon
| | - Félicité Kamdem
- Department of Cardiology General Hospital, Douala, Cameroon
- Department of Medicine and Specialities, Faculty of Medicine and Pharmaceutical Sciences, University of Douala, Douala, Cameroon
| | - Anastase Dzudie
- Clinical Research Education Networking and Consultancy, Douala, Cameroon
- Department of Cardiology General Hospital, Douala, Cameroon
| | - Samuel Ndjoh
- Department of Surgery and Specialities, Faculty of Medicine and Pharmaceutical Sciences, University of Douala, Douala, Cameroon
| | - Marcel Johne
- Department of Surgery and Specialities, Faculty of Medicine and Pharmaceutical Sciences, University of Douala, Douala, Cameroon
| | - Junette Metogo
- Department of Surgery and Specialities, Faculty of Medicine and Pharmaceutical Sciences, University of Douala, Douala, Cameroon
| | - Marie Solange Ndom
- Department of Medicine and Specialities, Faculty of Medicine and Pharmaceutical Sciences, University of Douala, Douala, Cameroon
| | - Joseph Sango
- Department of Surgery and Specialities, Faculty of Medicine and Pharmaceutical Sciences, University of Douala, Douala, Cameroon
| | - Carole Ngo Yon
- Department of Surgery and Specialities, Faculty of Medicine and Pharmaceutical Sciences, University of Douala, Douala, Cameroon
| | - Sidick Moulium
- Department of Cardiology General Hospital, Douala, Cameroon
- Department of Medicine and Specialities, Faculty of Medicine and Pharmaceutical Sciences, University of Douala, Douala, Cameroon
| | - Viche Lade
- Department of Cardiology General Hospital, Douala, Cameroon
| | - Liliane Mfeukeu Kuaté
- Department of Medicine and Specialities, Faculty of Medicine and Biomedical Sciences, University of Yaounde, Yaounde, Cameroon
| | - Alain Patrick Menanga
- Department of Medicine and Specialities, Faculty of Medicine and Biomedical Sciences, University of Yaounde, Yaounde, Cameroon
| | - Eugène Sobngwi
- Department of Medicine and Specialities, Faculty of Medicine and Biomedical Sciences, University of Yaounde, Yaounde, Cameroon
| | - Richard Njock
- Department of Surgery and Specialities, Faculty of Medicine and Pharmaceutical Sciences, University of Douala, Douala, Cameroon
| | | | - Marcelin Ngowe Ngowe
- Department of Surgery and Specialities, Faculty of Medicine and Pharmaceutical Sciences, University of Douala, Douala, Cameroon
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Simo FBN, Akoue RN, Demanou M. Clinical description of dengue and chikungunya virus infections amongst acute febrile patients in a malaria endemic area of Mfou, the Centre region of Cameroon. Diagn Microbiol Infect Dis 2024; 109:116204. [PMID: 38402756 DOI: 10.1016/j.diagmicrobio.2024.116204] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/30/2022] [Revised: 01/30/2024] [Accepted: 01/30/2024] [Indexed: 02/27/2024]
Abstract
This study aims to determine the frequency and clinical manifestations of dengue and chikungunya viral infections in the district hospital of Mfou, Centre region of Cameroon where malaria is endemic. Blood samples were collected from suspected cases and tested for Plasmodium parasites and for the molecular detection of viral RNAs (dengue, zika and chikungunya viruses) using TRIOPLEX qPCR. A total of 108 patients were clinically suspected among which 25 % were male and 50 % were less than 15.5 years old. Of these 14.8 % (16/108) and 2.8 % (3/108) had acute dengue and chikungunya fevers respectively. Co-infection with malaria was reported in 56.3 % (9/16) of Dengue cases and 33.3 % (1/3) of chikungunya cases. Clinical profiling further revealed that nausea and vomiting show a significant difference in dengue infected individuals to those of non-infected individuals (P = 0.027). The presence of dengue fever and chikungunya fever and the absence of specific clinical manifestations highlight the need to strengthen surveillance of acute febrile infections for a better estimation of the burden of arboviruses.
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Affiliation(s)
- Fredy Brice Nemg Simo
- Laboratory of Pharmacology and Toxicology, Department of Biochemistry, Faculty of Science, The University of Yaoundé 1, Yaoundé, Cameroon.
| | | | - Maurice Demanou
- Departement of Virology, Centre Pasteur of Cameroun, Yaoundé, Cameroun
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Youngui BT, Atwine D, Otai D, Vasiliu A, Ssekyanzi B, Sih C, Kana R, Arinaitwe R, Cuer B, Simo L, Okello R, Tchendjou P, Casenghi M, Kuate AK, Turyahabwe S, Cohn J, Bonnet M, Tchounga BK. Integration of HIV Testing in a Community Intervention for Tuberculosis Screening Among Household Contacts of Patients with Tuberculosis in Cameroon and Uganda. J Acquir Immune Defic Syndr 2024; 95:431-438. [PMID: 38489492 PMCID: PMC10927301 DOI: 10.1097/qai.0000000000003379] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/09/2023] [Accepted: 12/18/2023] [Indexed: 03/17/2024]
Abstract
INTRODUCTION People living with HIV are considered at higher risk of developing severe forms of tuberculosis (TB) disease. Providing HIV testing to TB-exposed people is therefore critical. We present the results of integrating HIV testing into a community-based intervention for household TB contact management in Cameroon and Uganda. METHODS Trained community health workers visited the households of index patients with TB identified in 3 urban/semiurban and 6 rural districts or subdistricts as part of a cluster-randomized trial and provided TB screening to all household contacts. Voluntary HIV counseling and testing were offered to contacts aged 5 years or older with unknown HIV status. We describe the cascade of care for HIV testing and the factors associated with the acceptance of HIV testing. RESULTS Overall, 1983 household contacts aged 5 years or older were screened for TB. Of these contacts, 1652 (83.3%) did not know their HIV status, 1457 (88.2%) accepted HIV testing, and 1439 (98.8%) received testing. HIV testing acceptance was lower among adults than children [adjusted odds ratio (aOR) = 0.35, 95% confidence interval (CI): 0.22 to 0.55], those living in household of an HIV-positive vs HIV-negative index case (aOR = 0.56, 95% CI: 0.38 to 0.83), and contacts requiring a reassessment visit after the initial TB screening visit vs asymptomatic contacts (aOR = 0.20, 95% CI: 0.06 to 0.67) and was higher if living in Uganda vs Cameroon (aOR = 4.54, 95% CI: 1.17 to 17.62) or if another contact of the same index case was tested for HIV (aOR = 9.22, 95% CI: 5.25 to 16.18). CONCLUSION HIV testing can be integrated into community-based household TB contact screening and is well-accepted.
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Affiliation(s)
- Boris Tchakounte Youngui
- TransVIHMI, University of Montpellier, Institut de Recherche pour le Développement (IRD), Institut National de la Santé et de la Recherche Médicale (INSERM), Montpellier, France
- Elizabeth Glaser Pediatric AIDS Foundation, Yaoundé, Cameroun
| | - Daniel Atwine
- Department of Clinical Research, Epicentre Research Center, Mbarara, Uganda;
- Department of Community Health, Mbarara University of Science and Technology, Mbarara, Uganda;
| | - David Otai
- Department of Clinical Research, Epicentre Research Center, Mbarara, Uganda;
| | - Anca Vasiliu
- TransVIHMI, University of Montpellier, Institut de Recherche pour le Développement (IRD), Institut National de la Santé et de la Recherche Médicale (INSERM), Montpellier, France
| | - Bob Ssekyanzi
- Department of Clinical Research, Epicentre Research Center, Mbarara, Uganda;
| | - Colette Sih
- Elizabeth Glaser Pediatric AIDS Foundation, Yaoundé, Cameroun
| | - Rogacien Kana
- Elizabeth Glaser Pediatric AIDS Foundation, Yaoundé, Cameroun
| | - Rinah Arinaitwe
- Department of Clinical Research, Epicentre Research Center, Mbarara, Uganda;
| | - Benjamin Cuer
- TransVIHMI, University of Montpellier, Institut de Recherche pour le Développement (IRD), Institut National de la Santé et de la Recherche Médicale (INSERM), Montpellier, France
| | - Leonie Simo
- Elizabeth Glaser Pediatric AIDS Foundation, Yaoundé, Cameroun
| | - Richard Okello
- Elizabeth Glaser Pediatric AIDS Foundation, Kampala, Uganda;
| | | | - Martina Casenghi
- Elizabeth Glaser Pediatric AIDS Foundation, Geneva, Switzerland;
| | | | - Stavia Turyahabwe
- Tuberculosis Leprosy Control, Ministry of Health, Kampala, Uganda; and
| | - Jennifer Cohn
- Division of Infectious Diseases, Perelman School of Medicine at the University of Pennsylvania, Philadelphia, PA
| | - Maryline Bonnet
- TransVIHMI, University of Montpellier, Institut de Recherche pour le Développement (IRD), Institut National de la Santé et de la Recherche Médicale (INSERM), Montpellier, France
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Mforteh AAA, Pisoh DW, Boten M, Andoh NEL, Tameh TY, Mbi-Kobenge AFE, Ombaku KS, Takang WA, Mbu RE. Stillbirth rate and associated factors at the Bamenda Regional hospital, North-West region, Cameroon, from 2018 to 2022: a case control study. BMC Pregnancy Childbirth 2024; 24:270. [PMID: 38609848 PMCID: PMC11010432 DOI: 10.1186/s12884-024-06486-z] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/27/2023] [Accepted: 04/05/2024] [Indexed: 04/14/2024] Open
Abstract
BACKGROUND Stillbirth is a common adverse pregnancy outcome worldwide, with an estimated 2.6 million stillbirths yearly. In Cameroon, the reported rate in 2015 was 19.6 per 1000 live births. Several risk factors have been described, but region-specific risk factors are not known in the northwest region of Cameroon. This study aims to determine the stillbirth rate and associated factors at the Bamenda Regional hospital, North-West region of Cameroon. MATERIALS AND METHODS A Hospital-based case‒control study conducted from December 2022 to June 2023 on medical files from 2018 to 2022 at the Bamenda Regional Hospital. Cases were women with stillbirths that occurred at a gestational age of ≥ 28 weeks, while controls were women with livebirths matched in a 1:2 (1 case for 2 controls) ratio using maternal age. Sociodemographic, obstetric, medical, and neonatal factors were used as exposure variables. Multivariable logistic regression was used to determine adjusted odds ratios of exposure variables with 95% confidence intervals and a p value of < 0.05. RESULTS A total of 12,980 births including 116 stillbirths giving a stillbirth rate of 8.9 per 1000 live births. A hundred cases and 200 controls were included. Factors associated with stillbirths after multivariable analysis include nulliparity (aOR = 3.89; 95% CI: 1.19-12.71; p = 0.025), not attending antenatal care (aOR = 104; 95% CI: 3.17-3472; p = 0.009), history of stillbirth (aOR = 44; 95% CI: 7-270; p < 0.0001), placenta abruption (aOR = 14; 95% CI: 2.4-84; p = 0.003), hypertensive disorder in pregnancy (aOR = 18; 95% CI: 3.4-98; p = 0.001), malaria (aOR = 8; 95% CI: 1.51-42; p = 0.015), alcohol consumption (aOR = 9; 95% CI: 1.72-50; p = 0.01), birth weight less than 2500 g (aOR = 16; 95% CI: 3.0-89; p = 0.001), and congenital malformations (aOR = 12.6; 95% CI: 1.06-149.7;p = 0.045). CONCLUSION The stillbirth rate in BRH is 8.9 per 1000 live births. Associated factors for stillbirth include nulliparity, not attending antenatal care, history of stillbirth, placental abruption, hypertensive disorder in pregnancy, malaria, alcohol consumption, birth weight less than 2500 g, and congenital malformations. Close antenatal care follow-up of women with such associated factors is recommended.
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Affiliation(s)
- Achuo Ascensius Ambe Mforteh
- Faculty of Health Sciences, University of Bamenda, P.O. Box 39, Bamenda, Cameroon.
- Bamenda Regional Hospital, Bamenda, Cameroon.
| | - Dobgima Walter Pisoh
- Faculty of Health Sciences, University of Bamenda, P.O. Box 39, Bamenda, Cameroon
- Bamenda Regional Hospital, Bamenda, Cameroon
| | - Merlin Boten
- Faculty of Health Sciences, University of Bamenda, P.O. Box 39, Bamenda, Cameroon
| | | | | | | | | | - William Ako Takang
- Faculty of Health Sciences, University of Bamenda, P.O. Box 39, Bamenda, Cameroon
| | - Robinson Enow Mbu
- Faculty of Medicine and Biomedical Sciences, University of Yaoundé 1, Yaounde, Cameroon
- Yaoundé Gyneco-Obstetric and Paediatric Hospital, Yaounde, Cameroon
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Tanue EA, Omam LA, Ayuk GT, Noukeme BM, Metuge A, Nganmou I, Ebob MB, Donovan L, Stratil AS, Counihan H, Nkfusai CN, Hawkings H, Homolova B, Berryman E, Kolawole M, Zoungrana Y, Achu D, Wanji S, Omam EN. A formative cross-sectional study to assess caregiver's health-seeking behaviour and knowledge surrounding malaria, and understand the burden of malaria among children under-five in conflict-affected communities of Cameroon. Malar J 2024; 23:99. [PMID: 38589868 PMCID: PMC11003128 DOI: 10.1186/s12936-024-04902-5] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/18/2023] [Accepted: 03/05/2024] [Indexed: 04/10/2024] Open
Abstract
BACKGROUND Malaria remains a major global health problem often worsened by political instability and armed conflict. The purpose of the study was to explore community knowledge, attitudes and practices on malaria prevention, and to understand the burden of malaria and health-seeking behaviours of caregivers of children under-five in conflict-affected communities of the South West and Littoral Regions of Cameroon. METHODS A cross-sectional survey involving internally displaced persons (IDPS), host population, and their children under-five was conducted across 80 communities. The survey was conducted from May to June 2021. Participants were interviewed using a structured questionnaire. Malaria prevalence for children under-five was determined using rapid diagnostic tests (RDT) on blood samples. Association between variables and displacement status was measured using chi square test and multivariate logistic regression model was fitted to identify factors associated with adequate knowledge on malaria prevention. RESULTS A total of 2386 adults participated in the study and 1543 RDTs were conducted for children under-five. Adequate levels of knowledge and attitudes on malaria prevention was recorded among 1258 (52.9%) of the participants, with very strong evidence to suggest the level to be higher among the host (59.5%) compared to the IDPs (49.5%) and returnees (39.7%) (p < 0.001). Good practices towards malaria prevention was 43.3%, with very strong evidence indicating lower levels among IDPs (42.8%) and returnees (28.5%) compared to the host (49.4%) (p < 0.001). Malaria prevalence for children under-five was 54.0% and adequate health-seeking for suspected episodes of malaria was 53.0%, without any difference among IDPs (51.78%) and returnees (48.7%) compared to host populations (55.4%) (p = 0.154). Multivariate logistic regression model showed that there was quite strong evidence to suggest primary and secondary levels of education have higher odds of having correct knowledge of malaria prevention (adjusted odds ratio (AOR) 1.71, 95% confidence interval (CI): 1.11-2.64, p = 0.015 and AOR 1.80, 95% CI 1.15-2.82, p = 0.010 respectively). There was very strong evidence to suggest that owning a radio or a television was associated with greater odds of having a higher knowledge on malaria prevention (AOR 1.49, 95% CI 1.233-1.81, p = 0.000 and AOR 1.47, 95% CI 1.18-1.84, p = 0.001). CONCLUSION Over half of the population have correct knowledge and attitudes towards malaria prevention but gaps in complete knowledge remained. Some of the caregivers know the correct malaria preventive practices coupled with largely unsatisfactory treatment approaches and reflected by the high prevalence of malaria among their children. In order to effectively treat malaria, innovative strategies should target community participation.
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Affiliation(s)
- Elvis Asangbeng Tanue
- Reach Out Cameroon, Small Soppo, P.O Box 88, Buea, Cameroon.
- Department of Public Health and Hygiene, Faculty of Health Sciences, University of Buea, P.O Box 63, Buea, Cameroon.
| | - Lundi-Anne Omam
- Reach Out Cameroon, Small Soppo, P.O Box 88, Buea, Cameroon
- Department of Public Health and Primary Care, University of Cambridge, Cambridge, CB2 0SR, UK
| | - Glennis T Ayuk
- Reach Out Cameroon, Small Soppo, P.O Box 88, Buea, Cameroon
| | | | - Alain Metuge
- Reach Out Cameroon, Small Soppo, P.O Box 88, Buea, Cameroon
| | | | - Margaret Besem Ebob
- Reach Out Cameroon, Small Soppo, P.O Box 88, Buea, Cameroon
- Malaria Consortium, the Green House, 244-254 Cambridge Heath Rd, London, E2 9DA, UK
| | - Laura Donovan
- Malaria Consortium, the Green House, 244-254 Cambridge Heath Rd, London, E2 9DA, UK
| | - Ann-Sophie Stratil
- Malaria Consortium, the Green House, 244-254 Cambridge Heath Rd, London, E2 9DA, UK
| | - Helen Counihan
- Malaria Consortium, the Green House, 244-254 Cambridge Heath Rd, London, E2 9DA, UK
| | - Claude Ngwayu Nkfusai
- Malaria Consortium, the Green House, 244-254 Cambridge Heath Rd, London, E2 9DA, UK
- Department of Public Health, School of Nursing and Public Health, University of Kwa-Zulu Natal, Durban, South Africa
| | - Helen Hawkings
- Malaria Consortium, the Green House, 244-254 Cambridge Heath Rd, London, E2 9DA, UK
| | - Blanka Homolova
- Malaria Consortium, the Green House, 244-254 Cambridge Heath Rd, London, E2 9DA, UK
| | - Elizabeth Berryman
- Malaria Consortium, the Green House, 244-254 Cambridge Heath Rd, London, E2 9DA, UK
| | - Maxwell Kolawole
- Malaria Consortium, the Green House, 244-254 Cambridge Heath Rd, London, E2 9DA, UK
| | - Yakouba Zoungrana
- Malaria Consortium, the Green House, 244-254 Cambridge Heath Rd, London, E2 9DA, UK
| | - Dorothy Achu
- National Malaria Control Programme, Ministry of Public Health, P.O Box 14386, Yaounde, Cameroon
| | - Samuel Wanji
- Department for Microbiology and Parasitology, University of Buea, P.O Box 12, Buea, Cameroon
- Research Foundation in Tropical Diseases and Environment, Buea, Cameroon
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Takougang I, Lekeumo Cheuyem FZ, Ze BRS, Tsamoh FF, Moneboulou HM. Awareness of standard precautions, circumstances of occurrence and management of occupational exposures to body fluids among healthcare workers in a regional level referral hospital (Bertoua, Cameroon). BMC Health Serv Res 2024; 24:424. [PMID: 38570843 PMCID: PMC10993453 DOI: 10.1186/s12913-024-10855-x] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/23/2023] [Accepted: 03/12/2024] [Indexed: 04/05/2024] Open
Abstract
BACKGROUND Healthcare workers (HCW) are exposed to infectious agents within biological materials including blood, tissues, other body fluids and on medical supplies, contaminated surfaces within the care delivery environment. Trends in occupational injuries are influenced by the level of awareness and observance of standard precautions (SP) among HCWs. This study aimed to assess the level of awareness of SP, exposure to body fluids, reporting pattern and management among HCWs in a Referral Hospital. METHODS The present hospital-based cross-sectional study was carried out from 1st November 2020 to 31st May 2021. The exhaustive sampling method was used and a total of 120 consenting HCWs were invited to participate. A self-administered questionnaire addressed questions related to knowledge, experience, circumstances of exposure, reporting, management of occupational exposure to body fluids, hepatitis B vaccination status. Data were analyzed using R Statistic version 4.3.1. A p-value < 0.05 was considered significant. RESULTS Out of the 120 participating HCWs, 104 (86.7%) reported at least one accidental exposure to body fluids over the last year. Men (aOR = 4.19; p = 0.277) and HCWs aged 35 and over (aOR = 4.11; p = 0.114) were more at risk for AEB even though the difference was not statistically significant. Nurses/midwives (aOR = 65.9; p-value = 0.0005) and cleaners (aOR = 14.7; p-value = 0.0438) faced the highest risk of exposure. Lack of knowledge (79%) and patient agitation (49%) were the most reported reasons for exposure. Half of the participants (53%) reported that they used a personal protective equipment during care. Face mask (59.2%) and gowns (30.8%) were the most commonly used PPE. Most HCWs (62%) did not report AEB. Half of the affected HCWs (50.8%) received a course of post-exposure antiretroviral therapy. Few HCWs (4.2%) were fully immunized against Hepatitis B. CONCLUSIONS Most HCWs reported an accidental exposure to body fluids over the last year. Midwives and nurses were disproportionally affected socio-professional groups. Two-thirds of the AEB were undeclared. Only half of the participants reported using PPE systematically. Hepatitis B vaccination coverage was low. There is need to strengthen the observance of standard precautions, including preventive vaccination and the systematic reporting and management of AEB.
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Affiliation(s)
- Innocent Takougang
- Department of Public Health, Faculty of Medicine and Biomedical Sciences, The University of Yaoundé I, Yaoundé, Cameroon.
| | - Fabrice Zobel Lekeumo Cheuyem
- Department of Public Health, Faculty of Medicine and Biomedical Sciences, The University of Yaoundé I, Yaoundé, Cameroon
| | - Billy Ralph Sanding Ze
- Department of Public Health, Faculty of Medicine and Biomedical Sciences, The University of Yaoundé I, Yaoundé, Cameroon
| | - Forlemu Fabiola Tsamoh
- Department of Public Health, Faculty of Medicine and Biomedical Sciences, The University of Yaoundé I, Yaoundé, Cameroon
| | - Hortense Mengong Moneboulou
- Department of Odonto-Stomatology & Maxillofacial Surgery, Faculty of Medicine & Biomedical Sciences, The University of Yaoundé I, Yaoundé, Cameroon
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Ngomtcho SCH, Njike Ngo Biyong O, Ekwere TA, Wandji Takemegni JM, Mbah H, Makamdoum Bogne SM, Nkengkanna OA, Fouamno Kamga HL. Trends in immunological markers of transfusion transmissible infections among blood donors in Mamfe District Hospital, Southwest Cameroon. BMC Infect Dis 2024; 24:370. [PMID: 38566025 PMCID: PMC10985861 DOI: 10.1186/s12879-024-09119-0] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/02/2023] [Accepted: 02/08/2024] [Indexed: 04/04/2024] Open
Abstract
BACKGROUND Blood transfusion is associated with exposure to blood Transfusion Transmissible Infection (TTIs). The threat posed by the blood-borne pathogens is disproportionately distributed in different healthcare facilities in Cameroon. Thus, there is a need for continuous surveillance of TTIs in the country. This study aimed to assess the screening procedure for blood transfusion and determine the trend in immunological markers of TTIs among blood donors at the Mamfe District Hospital. METHODS A prospective descriptive, cross-sectional and analytical study was conducted at Mamfe District Hospital from March to May 2022. A total of 165 blood donors were recruited by the consecutive sampling method. Donors were screened using both Rapid diagnostic tests,T. pallidum haemagglutination test and indirect enzyme-linked immunosorbent assay (ELISA) for the detection of TTIs. Data generated was entered into an Excel spreadsheet and analysed using the statistical software R, version 4.2.0. Statistical analysis included descriptive statistics of percentages, means ± standard deviation, and student t-test was used to compare both diagnostic techniques, and was considered significant when p < 0.05. RESULTS A hundred and sixty-five donors were enrolled in the study with a male preponderance giving a male-female sex ratio of 22.5 and a mean age of 32.23 ± 8.60 years. The majority (75.2%) of the donors were of the O-positive blood type, repeat donors (69.1%) and were mainly family replacement and paid donors as against the voluntary blood donors (39.4% and 37.0% vs. 23.6% respectively). overall TTIs prevalence was 18.78% (31/165) (), with HBsAg being the most predominant marker at 12.12% (20/165) followed by Treponema pallidum, HCV and HIV antibodies at 4.85 (8/165), 1.21%(2/165), 0.60% (1/165) respectively. Except for the HBV, The prevalence of TTIs was higher when using a single RDT than the ELISA test, and the difference was significant (p < 0.05). CONCLUSION Bloodborne pathogens remain a major menace to safe blood transfusion practice in Mamfe district hospital and their detection could be easily missed if the RDT method alone is used for donor screening. Therefore, the donor screening protocol in Mamfe District Hospital should systematically incorporate a confirmation diagnostic test such as ELISA.
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Affiliation(s)
- Sen Claudine Henriette Ngomtcho
- Department of Microbiology, Immunology and Hematology, Faculty of Medicine and Pharmaceutical Sciences, University of Dschang, Dschang, Cameroon.
- Molecular biology and serology units, National Public Health Laboratory, Ministry of Public Health , Yaoundé, Cameroon.
| | - Olive Njike Ngo Biyong
- Department of Microbiology, Immunology and Hematology, Faculty of Medicine and Pharmaceutical Sciences, University of Dschang, Dschang, Cameroon
- Mamfe District Hospital, Mamfe, Cameroon
| | - Timothy Amos Ekwere
- Department of Haematology, University of Uyo/University of Uyo Teaching Hospital, Uyo, Akwa Ibom State, Nigeria
| | - Jonas Merlin Wandji Takemegni
- Department of Biomedical Sciences, Faculty of Health Sciences, University of Buea, Buea, Cameroon
- Department of Medical Laboratories Sciences, New-bell District Hospital, Douala, Cameroon
| | | | - Sandra Maella Makamdoum Bogne
- Department of Microbiology, Immunology and Hematology, Faculty of Medicine and Pharmaceutical Sciences, University of Dschang, Dschang, Cameroon
| | - Omer Aurelle Nkengkanna
- Department of Microbiology, Immunology and Hematology, Faculty of Medicine and Pharmaceutical Sciences, University of Dschang, Dschang, Cameroon
| | - Henri Lucien Fouamno Kamga
- Department of Microbiology, Immunology and Hematology, Faculty of Medicine and Pharmaceutical Sciences, University of Dschang, Dschang, Cameroon
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Gams Massi D, Niakam Mbouleup FT, Dissongo JI, Mapoure YN. Epidemiology, clinical features and outcome of stroke in rural versus urban hospitals in Cameroon. J Stroke Cerebrovasc Dis 2024; 33:107580. [PMID: 38325033 DOI: 10.1016/j.jstrokecerebrovasdis.2024.107580] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/03/2023] [Revised: 01/07/2024] [Accepted: 01/11/2024] [Indexed: 02/09/2024] Open
Abstract
OBJECTIVES Stroke is a major public health problem worldwide with disparities between urban and rural areas. The aim of this study was to compare the epidemiological, clinical features and outcomes of stroke between rural and urban hospitals in Cameroon. MATERIALS AND METHODS We conducted a retrospective cohort study at the Douala General Hospital (urban) and Ad Lucem Hospital of Banka (rural) from January 1st, 2014, to December 31st, 2019. The medical records of all patients admitted for stroke, and meeting the inclusion criteria were reviewed. Diagnosis of stroke was based on brain imaging and/or the World Health Organization definition. Data were analyzed using SPSS version 20.0. RESULTS Among the 15277 files reviewed, 752 were included with 623 cases (82.80%) in urban areas. The percentage of patients hospitalized for stroke were 9.06% and 2.85% in urban and rural hospitals respectively. The frequency of patients admitted for severe stroke (Glasgow coma scale ≤ 8) was higher in the rural hospital (p = 0.004). In-hospital mortality (p = 0.010), cumulative mortality at one-month (p = 0.018), poor functional recovery (p = 0.002), one-year stroke recurrence (p = 0.020) were significantly higher in rural setting. Undefined stroke was predictor of mortality in the rural hospital, while hemorrhagic stroke was predictor of mortality at one-month in the urban hospital. CONCLUSIONS Stroke cases were significantly more severe with poor outcomes in the rural hospital. Efforts are needed to improve prevention, and access to stroke care for communities, especially in rural setting.
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Affiliation(s)
- Daniel Gams Massi
- Douala General Hospital, Faculty of Health Sciences, University of Buea, PO Box: 4856, Douala, Cameroon.
| | | | - Jean Ii Dissongo
- Faculty of Medicine and Pharmaceutical Sciences, University of Douala, Cameroon
| | - Yacouba Njankouo Mapoure
- Douala General Hospital, Faculty of Medicine and Pharmaceutical Sciences, University of Douala, Cameroon
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Masong MC, Mengue MT, Marlene NT, Dean L, Thomson R, Stothard R, Theobald S. Illness experiences and mental health challenges associated with female genital schistosomiasis in Cameroon: a gender analysis. Int Health 2024; 16:i42-i51. [PMID: 38547346 PMCID: PMC10977947 DOI: 10.1093/inthealth/ihae004] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/03/2023] [Revised: 09/29/2023] [Accepted: 01/10/2024] [Indexed: 04/02/2024] Open
Abstract
BACKGROUND This paper highlights the role of cultural and structural gaps that shape illness experiences of women with manifestations of female genital schistosomiasis (FGS) and their impacts upon mental well-being. METHODS Using ethnography, case study narrative accounts of women manifesting symptoms of FGS, as well as interviews with health workers within FGS-endemic rural fishing communities in Cameroon, we present experiences of women affected by FGS, alongside information on FGS health service provision. RESULTS Our results show how gendered power dynamics in decision making, gendered experiences around menstrual health and structural gaps in service provision, combine and lead to poor mental well-being. Subfertility brings a heavy psychosocial toll from external blame and rejection, exacerbated by internalised stigma and the challenge of not being able to fulfil cultural and gendered social norms. CONCLUSIONS Gender analysis is key to developing context-embedded understanding and addressing FGS-related challenges. With context-specific experiences demonstrating FGS comorbidity with mental ill health, there is a need to prioritise mental health integration at policy level through a person-centred approach. Furthermore, to address stigma and discrimination, campaigns to raise awareness in Cameroon, and beyond, are needed. CONTEXTE Cet article met en évidence le rôle des lacunes culturelles et structurelles qui façonnent les expériences des femmes atteintes de schistosomiase génitale féminine (SGF) et leur impact sur le bien-être mental. LA MÉTHODE À l'aide de l'ethnographie, de récits d'études de cas de femmes présentant des symptômes de schistosomiase génitale féminine, et d'entretiens avec des agents de santé au sein de communautés de pêcheurs ruraux endémiques de la schistosomiase génitale féminine au Cameroun, nous présentons les expériences des femmes touchées par le SGF, ainsi que des informations sur les services de santé liés au SGF. RÉSULTATS Nos résultats montrent comment la dynamique du pouvoir dans la prise de décision, les expériences de la santé menstruelle et les lacunes structurelles dans la fourniture de services, interagissent et conduisent à un manque de bien-être psychologique. La sous-fécondité entraîne un lourd fardeau psychosocial du fait du blâme et de rejet externes auxquelles sont assujetties les personnes souffrant de la maladie, ce qui est exacerbé par la stigmatisation intériorisée et le défi que représente leur incapacité à respecter les normes sociales culturelles et sexospécifiques. CONCLUSION L'analyse de genre est essentielle pour développer une compréhension intégrée au contexte et pour relever les défis liés aux SGF. les défis liés à l'ESF. Avec des expériences spécifiques au contexte démontrant la comorbidité de la FGS avec la mauvaise santé mentale, il est nécessaire de donner la priorité à l'intégration de la santé mentale au niveau politique par le biais d'une approche centrée sur la personne. l'intégration de la santé mentale au niveau politique par une approche centrée sur la personne. En outre, pour lutter contre la stigmatisation et la stigmatisation et la discrimination, des campagnes de sensibilisation sont nécessaires au Cameroun et au-delà. ANTECEDENTES En este documento se pone de relieve el papel de las brechas culturales y estructurales que dan forma a las experiencias de enfermedad de las mujeres con manifestaciones de Esquistosomiasis Genital Femenina (EGF), y sus impactos en el bienestar mental. MÉTODO Utilizando la etnografía, estudios de caso mediante relatos narrativos de mujeres que manifiestan síntomas de EGF y entrevistas con trabajadores sanitarios de comunidades pesqueras rurales endémicas en Camerún, presentamos las experiencias de las mujeres afectadas por la EGF, junto con información sobre la prestación de servicios sanitarios para la EGF. RESULTADOS Nuestros resultados muestran cómo la dinámica de poder de género en la toma de decisiones, las experiencias de género en torno a la salud menstrual y las deficiencias estructurales en la prestación de servicios se combinan y conducen a un bienestar mental deficiente. La subfertilidad conlleva un alto coste psicosocial debido a la culpa y el rechazo externos, exacerbados por el estigma interiorizado y el reto de no poder cumplir las normas culturales y de género. CONCLUSIÓN El análisis de género es clave para desarrollar una comprensión integrada en el contexto y abordarlos retos relacionados con la EGF. Dado que las experiencias específicas de cada contexto demuestran la comorbilidad de las EGF con la enfermedad mental, es necesario priorizar la integración de la salud mental en las políticas a través de un enfoque centrado en la persona. Además, para hacer frente al estigma y la discriminación, son necesarias campañas de sensibilización en Camerún y en otros lugares.
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Affiliation(s)
- Makia Christine Masong
- Catholic University of Central Africa, Department of Social Sciences and Management, Yaoundé, Cameroon
- Institut des Politiques et Initiatives Sociales (IPIS)
| | - Marie-Therese Mengue
- Catholic University of Central Africa, Department of Social Sciences and Management, Yaoundé, Cameroon
- Institut des Politiques et Initiatives Sociales (IPIS)
| | - Nstinda Tchoffo Marlene
- Institut des Politiques et Initiatives Sociales (IPIS)
- Catholic University of Louvain, Faculty of Public Health, Belgium
| | - Laura Dean
- Liverpool School of Tropical Medicine, Department of International Public Health, Liverpool, United Kingdom
| | - Rachael Thomson
- Liverpool School of Tropical Medicine, Department of Clinical Sciences, Liverpool, United Kingdom
| | - Russell Stothard
- Liverpool School of Tropical Medicine, Department of Tropical Disease Biology, Liverpool, United Kingdom
| | - Sally Theobald
- Liverpool School of Tropical Medicine, Department of International Public Health, Liverpool, United Kingdom
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Kuate Tegueu C, Dzudie Tamdja A, Kom F, Forgwa Barche B, Ebasone P, Magnerou M, Mbonda P, Doumbe J, Husøy A, Thomas H, Steiner TJ. Headache in the adult population of Cameroon: prevalence estimates and demographic associations from a cross-sectional nationwide population-based study. J Headache Pain 2024; 25:42. [PMID: 38515027 PMCID: PMC10956204 DOI: 10.1186/s10194-024-01748-9] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/21/2024] [Accepted: 03/11/2024] [Indexed: 03/23/2024] Open
Abstract
BACKGROUND Knowledge of headache prevalence, and the burdens attributable to headache disorders, remains incomplete in sub-Saharan Africa (SSA): reliable studies have been conducted only in Zambia (southern SSA) and Ethiopia (eastern SSA). As part of the Global Campaign against Headache, we investigated the prevalence of headache in Cameroon, in Central SSA. METHODS We used the same methodology as the studies in Zambia and Ethiopia, employing cluster-randomized sampling in four regions of Cameroon, selected to reflect the country's geographic, ethnic and cultural diversities. We visited, unannounced, randomly selected households in each region, and randomly selected one adult member (aged 18-65 years) of each. Trained interviewers administered the Headache-Attributed Restriction, Disability and Impaired Participation (HARDSHIP) structured questionnaire, developed by an international expert consensus group and translated into Central African French. Demographic enquiry was followed by diagnostic questions based on ICHD-3 criteria. RESULTS Headache was a near-universal experience in Cameroon (lifetime prevalence: 94.8%). Observed 1-year prevalence of headache was 77.1%. Age- and gender-adjusted estimates were 76.4% (95% confidence interval: 74.9-77.9) for any headache, 17.9% (16.6-19.3) for migraine (definite + probable), 44.4% (42.6-46.2) for tension-type headache (TTH; also definite + probable), 6.5% (5.7-7.4) for probable medication-overuse headache (pMOH) and 6.6% (5.8-7.6) for other headache on ≥ 15 days/month (H15 +). One-day prevalence ("headache yesterday") was 15.3%. Gender differentials were as expected (more migraine and pMOH among females, and rather more TTH among males). pMOH increased in prevalence until age 55 years, then declined somewhat. Migraine and TTH were both associated with urban dwelling, pMOH, in contrast, with rural dwelling. CONCLUSIONS Headache disorders are prevalent in Cameroon. As in Zambia and Ethiopia, estimates for both migraine and TTH exceed global mean estimates. Attributable burden is yet to be reported, but these findings must lead to further research, and measures to develop and implement headache services in Cameroon, with appropriate management and preventative strategies.
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Affiliation(s)
- Callixte Kuate Tegueu
- Department of Neurology, Douala Laquintinie Hospital, Douala, Cameroon
- Faculty of Medicine and Biomedical Sciences, University of Yaoundé, Yaoundé, Cameroon
| | - Anastase Dzudie Tamdja
- Faculty of Medicine and Biomedical Sciences, University of Yaoundé, Yaoundé, Cameroon
- Department of Internal Medicine, Douala General Hospital, Douala, Cameroon
- Clinical Research Education, Networking and Consultancy (CRENC), Yaoundé, Cameroon
| | - Franklin Kom
- Clinical Research Education, Networking and Consultancy (CRENC), Yaoundé, Cameroon
| | - Blaise Forgwa Barche
- Clinical Research Education, Networking and Consultancy (CRENC), Yaoundé, Cameroon
| | - Peter Ebasone
- Clinical Research Education, Networking and Consultancy (CRENC), Yaoundé, Cameroon
| | - Mélanie Magnerou
- Department of Neurology, Douala Laquintinie Hospital, Douala, Cameroon
| | - Paul Mbonda
- Faculty of Medicine and Biomedical Sciences, University of Yaoundé, Yaoundé, Cameroon
| | - Jacques Doumbe
- Department of Neurology, Douala Laquintinie Hospital, Douala, Cameroon
| | - Andreas Husøy
- Department of Neuromedicine and Movement Science, Norwegian University of Science and Technology (NTNU), Edvard Griegs Gate, Trondheim, Norway
| | - Hallie Thomas
- Department of Neuromedicine and Movement Science, Norwegian University of Science and Technology (NTNU), Edvard Griegs Gate, Trondheim, Norway
| | - Timothy J Steiner
- Department of Neuromedicine and Movement Science, Norwegian University of Science and Technology (NTNU), Edvard Griegs Gate, Trondheim, Norway.
- Department of Neurology, University of Copenhagen, Copenhagen, Denmark.
- Division of Brain Sciences, Imperial College London, London, UK.
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Goatley LC, Freimanis G, Tennakoon C, Foster TJ, Quershi M, Dixon LK, Batten C, Forth JH, Wade A, Netherton C. Full genome sequence analysis of African swine fever virus isolates from Cameroon. PLoS One 2024; 19:e0293049. [PMID: 38512923 PMCID: PMC10956809 DOI: 10.1371/journal.pone.0293049] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/03/2023] [Accepted: 03/06/2024] [Indexed: 03/23/2024] Open
Abstract
African swine fever (ASF) is a devastating disease of domestic pigs that has spread across the globe since its introduction into Georgia in 2007. The etiological agent is a large double-stranded DNA virus with a genome of 170 to 180 kb in length depending on the isolate. Much of the differences in genome length between isolates are due to variations in the copy number of five different multigene families that are encoded in repetitive regions that are towards the termini of the covalently closed ends of the genome. Molecular epidemiology of African swine fever virus (ASFV) is primarily based on Sanger sequencing of a few conserved and variable regions, but due to the stability of the dsDNA genome changes in the variable regions occur relatively slowly. Observations in Europe and Asia have shown that changes in other genetic loci can occur and that this could be useful in molecular tracking. ASFV has been circulating in Western Africa for at least forty years. It is therefore reasonable to assume that changes may have accumulated in regions of the genome other than the standard targets over the years. At present only one full genome sequence is available for an isolate from Western Africa, that of a highly virulent isolate collected from Benin during an outbreak in 1997. In Cameroon, ASFV was first reported in 1981 and outbreaks have been reported to the present day and is considered endemic. Here we report three full genome sequences from Cameroon isolates of 1982, 1994 and 2018 outbreaks and identify novel single nucleotide polymorphisms and insertion-deletions that may prove useful for molecular epidemiology studies in Western Africa and beyond.
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Affiliation(s)
- Lynnette C. Goatley
- The Pirbright Institute, Ash Road, Pirbright, Woking, Surrey, United Kingdom
| | - Graham Freimanis
- The Pirbright Institute, Ash Road, Pirbright, Woking, Surrey, United Kingdom
| | - Chandana Tennakoon
- The Pirbright Institute, Ash Road, Pirbright, Woking, Surrey, United Kingdom
| | - Thomas J. Foster
- The Pirbright Institute, Ash Road, Pirbright, Woking, Surrey, United Kingdom
| | - Mehnaz Quershi
- The Pirbright Institute, Ash Road, Pirbright, Woking, Surrey, United Kingdom
| | - Linda K. Dixon
- The Pirbright Institute, Ash Road, Pirbright, Woking, Surrey, United Kingdom
| | - Carrie Batten
- The Pirbright Institute, Ash Road, Pirbright, Woking, Surrey, United Kingdom
| | - Jan Hendrik Forth
- Institute of Diagnostic Virology, Friedrich-Loeffler-Institut, Greifswald, Insel Riems, Germany
| | - Abel Wade
- National Veterinary Laboratory (LANAVET), Garoua, Cameroon
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Ashton RA, Worges M, Zeh Meka A, Yikpotey P, Domkam Kammogne I, Chanda-Kapata P, Vanderick C, Streat E, Yukich J. Can Outreach Training and Supportive Supervision Improve Competency in Malaria Service Delivery? An Evaluation in Cameroon, Ghana, Niger, and Zambia. Am J Trop Med Hyg 2024; 110:10-19. [PMID: 38052082 PMCID: PMC10919235 DOI: 10.4269/ajtmh.23-0150] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/08/2023] [Accepted: 08/17/2023] [Indexed: 12/07/2023] Open
Abstract
Outreach Training and Supportive Supervision (OTSS) of malaria services at health facilities has been adopted by numerous malaria-endemic countries. The OTSS model is characterized by a hands-on method to enhance national guidelines and supervision tools, train supervisors, and perform supervision visits. An independent evaluation was conducted to evaluate the effectiveness of OTSS on health worker competence in the clinical management of malaria, parasitological diagnosis, and prevention of malaria in pregnancy. From 2018 to 2021, health facilities in Cameroon, Ghana, Niger, and Zambia received OTSS visits during which health workers were observed directly during patient consultations, and supervisors completed standardized checklists to assess their performance. Mixed-effects logistic regression models were developed to assess the impact of increasing OTSS visit number on a set of eight program-generated outcome indicators, including overall competency and requesting a confirmatory malaria test appropriately. Seven of eight outcome indicators showed evidence of beneficial effects of increased OTSS visits. Odds of health workers reaching competency thresholds for the malaria-in-pregnancy checklist increased by more than four times for each additional OTSS visit (odds ratio [OR], 4.62; 95% CI, 3.62-5.88). Each additional OTSS visit was associated with almost four times the odds of the health worker foregoing antimalarial prescriptions for patients who tested negative for malaria (OR, 3.80; 95% CI, 2.35-6.16). This evaluation provides evidence that successive OTSS visits result in meaningful improvements in indicators linked to quality case management of patients attending facilities for malaria diagnosis and treatment, as well as quality malaria prevention services received by women attending antenatal services.
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Affiliation(s)
- Ruth A. Ashton
- School of Public Health and Tropical Medicine, Tulane University, New Orleans, Louisiana
- Tropical Health, New Orleans, Louisiana
| | | | | | | | | | | | | | | | - Joshua Yukich
- School of Public Health and Tropical Medicine, Tulane University, New Orleans, Louisiana
- Tropical Health, New Orleans, Louisiana
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Tchinda Meli E, Bernard YM, Ateba JM, Tchoutang L, Mouliom A, Ciceron AC, Mostel J, Tchadjeu C, Palata O, Wirngo M, Fofana A, Barat LM. Impact of the Severe Malaria "Champions Program" on the Management of Severe Malaria Cases in 12 Hospitals of the North and Far North Regions of Cameroon. Am J Trop Med Hyg 2024; 110:76-82. [PMID: 38320307 PMCID: PMC10919230 DOI: 10.4269/ajtmh.23-0528] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/09/2023] [Accepted: 12/07/2023] [Indexed: 02/08/2024] Open
Abstract
Malaria remains a main cause of morbidity and mortality in Cameroon. Since 2021, the U.S. President's Malaria Initiative Impact Malaria Project has supported the National Malaria Control Program to develop the Champions program in two northern regions. We assessed this program's preliminary effectiveness on the performance of hospitals in the management of severe malaria and reduction of malaria-related deaths. We conducted a secondary analysis of Outreach Training and Supportive Supervision (OTSS) data from four rounds (one round pre-Champions program and three rounds post-Champions program and 2020-2022 malaria-related mortality data for 12 hospitals). Using linear regressions, we measured changes in hospital readiness and competency of health workers in the management of severe malaria between baseline and subsequent rounds. There were statistically significant improvements in overall management of severe malaria scores in post-Champions OTSS rounds, with post-Champions round 3 exhibiting an increase of +14% (P = 0.013) over baseline. Overall health facility readiness scores exhibited an increase of +7% (P = 0.006) from baseline to post-Champions round 3. There were no statistically significant findings associated with providing the right treatment, as nearly all patients hospitalized with severe malaria were treated with a recommended severe malaria treatment. Reported inpatient malaria deaths and case fatality rates trended downward from 2020 to 2022, but these differences were not statistically significant. The Champions program resulted in significant improvements in quality of inpatient care for severe malaria. The downward trends in malaria deaths and case fatality rate will require further monitoring to determine whether the Champions program is having the desired impact of reducing inpatient deaths from malaria.
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Affiliation(s)
- Eric Tchinda Meli
- U.S. President’s Malaria Initiative Impact Malaria Project, Jhpiego, Yaoundé, Cameroon
| | - Yves-Marie Bernard
- U.S. President’s Malaria Initiative Impact Malaria Project, Population Services International, Washington, District of Columbia
| | | | - Landry Tchoutang
- U.S. President’s Malaria Initiative Impact Malaria Project, Association Camerounaise pour le Marketing Social, Yaoundé, Cameroon
| | - Abas Mouliom
- U.S. President’s Malaria Initiative Impact Malaria Project, Association Camerounaise pour le Marketing Social, Yaoundé, Cameroon
| | - Annie Coriolan Ciceron
- U.S. President’s Malaria Initiative Impact Malaria Project, Population Services International, Washington, District of Columbia
| | - Jadmin Mostel
- U.S. President’s Malaria Initiative Impact Malaria Project, Population Services International, Washington, District of Columbia
| | - Christophe Tchadjeu
- U.S. President’s Malaria Initiative Impact Malaria Project, Association Camerounaise pour le Marketing Social, Yaoundé, Cameroon
| | - Olivier Palata
- U.S. President’s Malaria Initiative Impact Malaria Project, Association Camerounaise pour le Marketing Social, Yaoundé, Cameroon
| | - Mohamadu Wirngo
- U.S. President’s Malaria Initiative, U.S. Agency for International Development, Yaoundé, Cameroon
| | - Aissata Fofana
- U.S. President’s Malaria Initiative, U.S. Agency for International Development, Yaoundé, Cameroon
| | - Lawrence M. Barat
- U.S. President’s Malaria Initiative Impact Malaria Project, Population Services International, Washington, District of Columbia
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16
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Bernard YM, Ahmed J, Mostel J, Ba T, Ciceron AC, Busiga M, Koné A, Kamaté B, Sidibé F, Diallo C, Makayi A, Koko DC, Djibrilla A, Ateba J, Tchinda Meli E, Tchadjeu C, Griffith K, Burns J, Barat LM. Clinical Outreach Training and Supportive Supervision Quality-of-Care Analysis: Impact of Readiness Factors on Health Worker Competencies in Malaria Case Management in Cameroon, Mali, and Niger. Am J Trop Med Hyg 2024; 110:35-41. [PMID: 38150737 PMCID: PMC10919239 DOI: 10.4269/ajtmh.23-0479] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/21/2023] [Accepted: 10/02/2023] [Indexed: 12/29/2023] Open
Abstract
Improving the quality of malaria clinical case management in health facilities is key to improving health outcomes in patients. The U.S. President's Malaria Initiative Impact Malaria Project has supported implementation of the Outreach Training and Supportive Supervision (OTSS) approach in 11 African countries to improve the quality of malaria care in health facilities through the collection and analysis of observation-based data on health facility readiness and health provider competency in malaria case management. We conducted a secondary analysis of longitudinal data collected during routine supervision in Cameroon (April 2021-March 2022), Mali (October 2020-December 2021), and Niger (November 2020-September 2021) using digitized checklists to assess how service readiness affects health worker competencies in managing patients with fever correctly and providing those with confirmed uncomplicated malaria cases with appropriate treatment and referral. Linear or logistic regression analyses were conducted to assess the effect of facility readiness and its components on observed health worker competencies. All countries demonstrated significant associations between health facility readiness and malaria case management competencies. Data from three rounds of OTSS visits in Cameroon, Mali, and Niger showed a statistically significant positive association between greater facility readiness scores (including the availability of commodities, materials, and trained staff) and health worker competency in case management. These findings provide evidence that health worker performance is likely affected by the tools and training available to them. These results reinforce the need for necessary tools and properly trained staff if high-quality malaria case management services are to be delivered at health facilities.
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Affiliation(s)
- Yves-Marie Bernard
- PMI Impact Malaria, Population Services International, Washington, District of Columbia
| | - Jehan Ahmed
- PMI Impact Malaria, Population Services International, Washington, District of Columbia
| | - Jadmin Mostel
- PMI Impact Malaria, Population Services International, Washington, District of Columbia
| | - Thierno Ba
- PMI Impact Malaria, Population Services International, Washington, District of Columbia
| | | | - Moses Busiga
- PMI Impact Malaria, Population Services International, Washington, District of Columbia
| | - Aissata Koné
- Programme National de Lutte contre le Paludisme du Mali, Bamako, Mali
| | - Beh Kamaté
- PMI Impact Malaria, Population Services International, Bamako, Mali
| | - Fatoumata Sidibé
- PMI Impact Malaria, Population Services International, Bamako, Mali
| | - Chebou Diallo
- PMI Impact Malaria, Population Services International, Bamako, Mali
| | - Alzouma Makayi
- Programme National de Lutte contre le Paludisme du Niger, Niamey, Niger
| | | | - Arouna Djibrilla
- PMI Impact Malaria, Population Services International, Niamey, Niger
| | - Joël Ateba
- Programme National de Lutte contre le Paludisme du Cameroun, Yaoundé, Cameroon
| | | | - Christophe Tchadjeu
- PMI Impact Malaria, Association Camerounaise pour le Marketing Social, Yaoundé, Cameroon
| | - Kevin Griffith
- U.S. President’s Malaria Initiative, United States Agency for International Development, Washington, District of Columbia
| | - Jordan Burns
- U.S. President’s Malaria Initiative, United States Agency for International Development, Washington, District of Columbia
| | - Lawrence M. Barat
- PMI Impact Malaria, Population Services International, Washington, District of Columbia
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Satapathy P, Kaur G, Asumah MN, Ainavi II, Rustagi S, Pradhan KB, Al-Qaim ZH, Sah R, Padhi BK. Fighting the neglected tropical disease: Cameroon's battle against river blindness. Trans R Soc Trop Med Hyg 2024; 118:e1-e2. [PMID: 37861331 DOI: 10.1093/trstmh/trad073] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/19/2023] [Accepted: 10/06/2023] [Indexed: 10/21/2023] Open
Affiliation(s)
- Prakasini Satapathy
- Center for Global Health Research, Saveetha Medical College and Hospital, Saveetha Institute of Medical and Technical Sciences, Saveetha University, Chennai, India
- School of Pharmacy, Graphic Era Hill University, Dehradun 248001, India
| | - Gurmanjeet Kaur
- Department of Community Medicine, Government Medical College, and Rajindra Hospital, Patiala 147001 Punjab, India
| | - Mubarick Nungbaso Asumah
- Ministry of Health, Nurses' and Midwives' Training College, P.O. Box 565, Tamale, Northern Region, Ghana
| | - Isah Idris Ainavi
- Department of Chemical Pathology and Immunology, Kaduna State University, Kaduna, Nigeria
| | - Sarvesh Rustagi
- School of Applied and Life Sciences, Uttaranchal University, Dehradun, Uttarakhand, India
| | - Keerti Bhusan Pradhan
- Department of Healthcare Management, Chitkara Business School, Chitkara University Punjab, Patiala 140401, India
| | - Zahraa Haleem Al-Qaim
- Department of Anesthesia Techniques, Al-Mustaqbal University College, 51001 Hillah, Babylon, Iraq
| | - Ranjit Sah
- Tribhuvan University Teaching Hospital, Kathmandu 46000, Nepal
- Department of Clinical Microbiology, DY Patil Medical College, Hospital and Research Centre, DY Patil Vidyapeeth, Pune 411000, Maharashtra, India
- Department of Public Health Dentistry, Dr D.Y. Patil Dental College and Hospital, Dr D.Y. Patil Vidyapeeth, Pune 411018, Maharashtra, India
| | - Bijaya K Padhi
- Department of Community Medicine and School of Public Health, Postgraduate Institute of Medical Education and Research, Chandigarh 160012, India
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Strahan EK, Witherbee J, Bergl R, Lonsdorf EV, Mwacha D, Mjungu D, Arandjelovic M, Ikfuingei R, Terio K, Travis DA, Gillespie TR. Potentially Zoonotic Enteric Infections in Gorillas and Chimpanzees, Cameroon and Tanzania. Emerg Infect Dis 2024; 30:577-580. [PMID: 38407249 PMCID: PMC10902540 DOI: 10.3201/eid3003.230318] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/27/2024] Open
Abstract
Despite zoonotic potential, data are lacking on enteric infection diversity in wild apes. We employed a novel molecular diagnostic platform to detect enteric infections in wild chimpanzees and gorillas. Prevalent Cryptosporidium parvum, adenovirus, and diarrheagenic Escherichia coli across divergent sites and species demonstrates potential widespread circulation among apes in Africa.
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Grosso A, Bowring AL, Njindam IM, Decker MR, Lyons C, Rao A, Tamoufe U, Fako GH, Fouda G, Levitt D, Turpin G, Billong SC, Zoung-Kanyi Bissek AC, Njoya O, Baral S. Sexually Transmitted Infection Risks and Symptoms Heightened Among Female Sex Workers who Started Selling Sex Before the Age of 18 in Five Cities in Cameroon. AIDS Behav 2024; 28:898-906. [PMID: 37843686 PMCID: PMC10896857 DOI: 10.1007/s10461-023-04196-9] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 09/21/2023] [Indexed: 10/17/2023]
Abstract
Many adolescents under 18 years old who sell sex are at elevated risk for sexually transmitted infection (STI) acquisition, which may persist into adulthood. There has been limited study of the burden of the risks and vulnerabilities among women who started selling sex as adolescents across Sub-Saharan Africa. In this study, a Adult female sex workers (FSW) recruited through respondent-driven sampling in five cities in Cameroon from December 2015 to October 2016 completed a questionnaire and human immunodeficiency virus (HIV) and syphilis testing. Multivariable logistic regression analysis controlling for age was used to identify factors associated with reporting selling sex before age 18. Selling sex before age 18 was reported by 11.5% (256/2,220) of FSW. Initiation of selling sex as an adolescent was positively associated with experiencing dysuria (adjusted odds ratio [aOR]:1.50, 95% confidence interval [CI]:1.08-2.10) or genital warts (aOR:1.78, 95% CI:1.08-2.94) and negatively associated with prior recent testing for HIV (aOR:0.71, 95% CI:0.53-0.96) or STIs (aOR:0.65, 95% CI:0.44-0.96). Consistent condom use with clients was negatively associated with early initiation of selling sex (aOR:0.58, 95% CI:0.42-0.80), while experience of recent sexual violence was positively associated with early initiation (aOR:1.74, 95% CI:1.15-2.63). There were no independent significant differences in HIV (24.5%) or syphilis (8.3%) prevalence. Given the limited use of HIV and STI testing services by women who sold sex as adolescents, the prevalence of forced sex, condomless sex, and STI symptoms were high. Programs serving FSW should more vigorously aim to serve adolescents and adults who began selling sex early.
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Affiliation(s)
- Ashley Grosso
- Institute for Health, Health Care Policy and Aging Research, Rutgers University, 112 Paterson Street, New Brunswick, NJ, 08901, USA.
| | - Anna L Bowring
- Department of Epidemiology, Johns Hopkins University, 615 N Wolfe , MD, Baltimore, 21205, USA
- Burnet Institute, 85 Commercial Road, Melbourne, VIC, 3004, Australia
| | | | - Michele R Decker
- Department of Population, Family, and Reproductive Health, Johns Hopkins University, 615 N Wolfe St Baltimore, MD, Baltimore, 21205, USA
| | - Carrie Lyons
- Department of Epidemiology, Johns Hopkins University, 615 N Wolfe , MD, Baltimore, 21205, USA
| | - Amrita Rao
- Department of Epidemiology, Johns Hopkins University, 615 N Wolfe , MD, Baltimore, 21205, USA
| | - Ubald Tamoufe
- Metabiota, Avenue Mvog-Fouda Ada, Av 1.085, Carrefour Intendance BP, Yaoundé, 15939, Cameroon
| | - Guy H Fako
- Care and Health Program, Yaoundé, Cameroon
| | - Ghislaine Fouda
- CARE Cameroon, Villa La Rose (3è étage, Av. Churchill, Yaoundé, Cameroon
| | - Daniel Levitt
- CARE USA, 115 Broadway, 5th floor, New York, NY, 10006, USA
- FHI 360, New York, United States
| | - Gnilane Turpin
- Department of Epidemiology, Johns Hopkins University, 615 N Wolfe , MD, Baltimore, 21205, USA
| | - Serge C Billong
- Groupe Technique Central, CNLS, Rue Henri Dunant, Yaoundé, Cameroon
| | | | - Oudou Njoya
- Department of Internal Medicine, Yaoundé University Hospital Center, Joseph Tchooungui Akoa, Yaoundé, Cameroon
| | - Stefan Baral
- Department of Epidemiology, Johns Hopkins University, 615 N Wolfe , MD, Baltimore, 21205, USA
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Ambadiang M, Fouet C, Ashu F, Bouaka C, Penlap-Beng V, Kamdem C. Anopheles gambiae larvae's ability to grow and emerge in water containing lethal concentrations of clothianidin, acetamiprid, or imidacloprid is consistent with cross-resistance to neonicotinoids. Parasit Vectors 2024; 17:98. [PMID: 38429846 PMCID: PMC10905935 DOI: 10.1186/s13071-024-06188-7] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/29/2023] [Accepted: 02/08/2024] [Indexed: 03/03/2024] Open
Abstract
BACKGROUND For decades, various agrochemicals have been successfully repurposed for mosquito control. However, preexisting resistance caused in larval and adult populations by unintentional pesticide exposure or other cross-resistance mechanisms poses a challenge to the efficacy of this strategy. A better understanding of larval adaptation to the lethal and sublethal effects of residual pesticides in aquatic habitats would provide vital information for assessing the efficacy of repurposed agrochemicals against mosquitoes. METHODS We reared field-collected mosquito larvae in water containing a concentration of agrochemical causing 100% mortality in susceptible mosquitoes after 24 h (lethal concentration). Using this experimental setup, we tested the effect of lethal concentrations of a pyrrole (chlorfenapyr, 0.10 mg/l), a pyrethroid (deltamethrin, 1.5 mg/l), and three neonicotinoids including imidacloprid (0.075 mg/l), acetamiprid (0.15 mg/l), and clothianidin (0.035 mg/l) on mortality rates, growth, and survival in third-instar larvae of the two sibling species Anopheles gambiae and Anopheles coluzzii collected from Yaoundé, Cameroon. RESULTS We found that An. gambiae and An. coluzzii larvae were susceptible to chlorfenapyr and were killed within 24 h by a nominal concentration of 0.10 mg/l. Consistent with strong resistance, deltamethrin induced low mortality in both species. Lethal concentrations of acetamiprid, imidacloprid, and clothianidin strongly inhibited survival, growth, and emergence in An. coluzzii larvae. By contrast, depending on the active ingredient and the population tested, 5-60% of immature stages of An. gambiae were able to grow and emerge in water containing a lethal concentration of neonicotinoids, suggesting cross-resistance to this class of insecticides. CONCLUSIONS These findings corroborate susceptibility profiles observed in adults and suggest that unintentional pesticide exposure or other cross-resistance processes could contribute to the development of resistance to neonicotinoids in some Anopheles populations.
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Affiliation(s)
- Marilene Ambadiang
- Centre for Research in Infectious Diseases (CRID), Yaoundé, Cameroon
- Department of Biochemistry, Faculty of Science, University of Yaoundé 1, Yaoundé, Cameroon
| | - Caroline Fouet
- Department of Biological Sciences, The University of Texas at El Paso, El Paso, TX, USA
| | - Fred Ashu
- Centre for Research in Infectious Diseases (CRID), Yaoundé, Cameroon
- Department of Biochemistry, Faculty of Science, University of Yaoundé 1, Yaoundé, Cameroon
| | - Calmes Bouaka
- Centre for Research in Infectious Diseases (CRID), Yaoundé, Cameroon
- Department of Biochemistry, Faculty of Science, University of Yaoundé 1, Yaoundé, Cameroon
| | - Véronique Penlap-Beng
- Department of Biochemistry, Faculty of Science, University of Yaoundé 1, Yaoundé, Cameroon
| | - Colince Kamdem
- Department of Biological Sciences, The University of Texas at El Paso, El Paso, TX, USA.
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Nkeck JR, Pelda A, Singwé MN. Rheumatology in Cameroon: History, Challenges, and Future. J Rheumatol 2024; 51:313. [PMID: 37967908 DOI: 10.3899/jrheum.2023-0955] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/17/2023]
Affiliation(s)
- Jan René Nkeck
- Cameroon College of Rheumatology, and Department of Internal Medicine and Specialties, Faculty of Medicine and Biomedical Sciences, University of Yaoundé I, Yaoundé, Cameroon.
| | - Adeline Pelda
- Cameroon College of Rheumatology, and Department of Internal Medicine and Specialties, Faculty of Medicine and Biomedical Sciences, University of Yaoundé I, Yaoundé, Cameroon
| | - Madeleine Ngandeu Singwé
- Cameroon College of Rheumatology, and Department of Internal Medicine and Specialties, Faculty of Medicine and Biomedical Sciences, University of Yaoundé I, Yaoundé, Cameroon
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Djuicy DD, Sadeuh-Mba SA, Bilounga CN, Yonga MG, Tchatchueng-Mbougua JB, Essima GD, Esso L, Nguidjol IME, Metomb SF, Chebo C, Agwe SM, Ankone PA, Ngonla FNN, Mossi HM, Etoundi AGM, Eyangoh SI, Kazanji M, Njouom R. Concurrent Clade I and Clade II Monkeypox Virus Circulation, Cameroon, 1979-2022. Emerg Infect Dis 2024; 30:432-443. [PMID: 38325363 PMCID: PMC10902553 DOI: 10.3201/eid3003.230861] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/09/2024] Open
Abstract
During 1979-2022, Cameroon recorded 32 laboratory-confirmed mpox cases among 137 suspected mpox cases identified by the national surveillance network. The highest positivity rate occurred in 2022, indicating potential mpox re-emergence in Cameroon. Both clade I (n = 12) and clade II (n = 18) monkeypox virus (MPXV) were reported, a unique feature of mpox in Cameroon. The overall case-fatality ratio of 2.2% was associated with clade II. We found mpox occurred only in the forested southern part of the country, and MPXV phylogeographic structure revealed a clear geographic separation among concurrent circulating clades. Clade I originated from eastern regions close to neighboring mpox-endemic countries in Central Africa; clade II was prevalent in western regions close to West Africa. Our findings suggest that MPXV re-emerged after a 30-year lapse and might arise from different viral reservoirs unique to ecosystems in eastern and western rainforests of Cameroon.
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Eposse Ekoube C, Heles Nsang E, Épée P, Mandeng Ma Linwa E, Djike Puepi Y, Mbono Betoko R, Noukeu Njinkui D, Enyama D, Mbonjo Bitsie D, Disso Massako J, Abba S, Ngo Linwa EE, Ida Penda C. Predictors of prolonged length of hospital stay and in-hospital mortality in patients aged 1-24 months with acute bronchiolitis in Douala, Cameroon. BMC Pediatr 2024; 24:150. [PMID: 38424505 PMCID: PMC10903055 DOI: 10.1186/s12887-024-04653-x] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/26/2023] [Accepted: 02/17/2024] [Indexed: 03/02/2024] Open
Abstract
INTRODUCTION In Cameroon, acute bronchiolitis has been reported as the third commonest lower respiratory infection and is usually associated with low mortality. Nonetheless, respiratory distress associated with non-adherence to management guidelines can prolong hospital stay. This study aimed to explore predictors of prolonged hospital stay (≥ 5 days) and mortality in patients aged < 2years hospitalised for acute bronchiolitis. METHODOLOGY We conducted a retrospective cohort study at three paediatric units in the city of Douala, Cameroon. Factors associated with prolonged hospital stay and mortality were determined using multivariable linear regression model. Threshold for significance was set at p ≤ 0.05. RESULTS A total of 215 patients with bronchiolitis were included with mean age of 6.94 ± 5.71 months and M/F sex ratio of 1.39/1. Prolonged hospital stay was reported in 46.98% and mortality in 10.70% of patients hospitalised for bronchiolitis. Factors independently associated with prolonged hospital duration were oxygen administration [b = 0.36, OR = 2.35 (95% CI:1.16-4.74), p = 0.017], abnormal respiratory rate [b = 0.38, OR = 2.13 (1.00-4.55), p = 0.050] and patients presenting with cough [b = 0.33, OR = 2.35 (95% CI: 1.22-4.51), p = 0.011], and diarrhoea [b = 0.71, OR = 6.44 (95% CI: 1.6-25.86), p = 0.009] on admission. On the other hand, factors independently associated with mortality were age of the patient [b= -0.07, OR = 0.84 (95% CI: 0.74-0.97), p = 0.014] and oxygen administration [b = 1.08, OR = 9.64 (95% CI:1.16-79.85), p = 0.036] CONCLUSION: Acute bronchiolitis represented 1.24% of admissions and was common in the rainy season, in males and 3-11-month-old patients. Management guidelines were poorly respected. Prolonged length of stay was reported in half of the patients hospitalized and mortality was high, especially in younger patients and in patients receiving oxygen.
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Affiliation(s)
- Charlotte Eposse Ekoube
- Faculty of Medicine and Pharmaceutical Sciences, University of Douala, Douala, Cameroon.
- Paediatric unit, Douala Laquintinie Hospital, Douala, Cameroon.
| | - Emmanuel Heles Nsang
- Faculty of Medicine and Pharmaceutical Sciences, University of Douala, Douala, Cameroon
| | - Patricia Épée
- Faculty of Medicine and Pharmaceutical Sciences, University of Douala, Douala, Cameroon
| | | | | | - Ritha Mbono Betoko
- Faculty of Medicine and Pharmaceutical Sciences, University of Douala, Douala, Cameroon
| | - Diomède Noukeu Njinkui
- Faculty of Medicine and Pharmaceutical Sciences, University of Dschang, Dschang, Cameroon
| | - Dominique Enyama
- Faculty of Medicine and Pharmaceutical Sciences, University of Dschang, Dschang, Cameroon
| | - Dora Mbonjo Bitsie
- Faculty of Medicine and Pharmaceutical Sciences, University of Douala, Douala, Cameroon
| | | | - Soumaiyatou Abba
- Faculty of Medicine and Pharmaceutical Sciences, University of Douala, Douala, Cameroon
| | | | - Calixte Ida Penda
- Faculty of Medicine and Pharmaceutical Sciences, University of Douala, Douala, Cameroon
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Njile DK, Sadeuh-Mba SA, Tabonfack Atemkeng M, Ahanda A, Momo JB, Pekekue Nforifum R, Etéré E, Endegue-Zanga MC, Boyomo O, Djoumetio MD, Anfumbom Kfutwah J, Diop OM, Njouom R. Occurrence of poliovirus and non-polio enterovirus among children with acute flaccid paralysis in Cameroon from 2015 to 2020. J Infect Dev Ctries 2024; 18:291-298. [PMID: 38484358 DOI: 10.3855/jidc.18279] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/27/2023] [Accepted: 07/05/2023] [Indexed: 03/19/2024] Open
Abstract
INTRODUCTION Poliovirus (PV) and non-polio enteroviruses (NPEV) belong to the Picornaviridae family. They are found worldwide and are responsible for a wide range of diseases such as acute flaccid paralysis (AFP). This study aimed to evaluate the detection rate of PV and NPEV in stool samples from children under fifteen years of age presenting with AFP in Cameroon and their distribution over time. METHODOLOGY Stool samples were collected as part of poliovirus surveillance throughout Cameroon from 2015 to 2020. Virus isolation was performed using RD and L20B cells maintained in culture. Molecular methods such as intratypic differentiation were used to identify PVs serotypes and analysis of the VP1 genome was performed. RESULTS A total of 12,354 stool samples were analyzed. The EV detection rate by virus isolation was 11.42% (1411/12354). This rate varied from year to year with a mean distribution of 11.41 with a 95% confidence interval [11.37; 11.44]. Of the viruses detected, suspected poliovirus accounted for 31.3% (442/1411) and NPEV 68.67% (969/1411). No wild poliovirus (WPV) was isolated. Sabin types 1 and 3 were continuously isolated. Surprisingly, from February 2020, vaccine-derived PV type 2 (VDPV2) was detected in 19% of cases, indicating its resurgence. CONCLUSIONS This study strongly supports the successful elimination of WPV in Cameroon and the resurgence of VDPV2. However, as long as VDPV outbreaks continue to be detected in Africa, it remains essential to monitor how they spread.
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Affiliation(s)
- Daniel K Njile
- Virology Service, National Reference and Public Health Laboratory, Centre Pasteur of Cameroon, Yaoundé, Cameroon
| | - Serge A Sadeuh-Mba
- Virology Service, National Reference and Public Health Laboratory, Centre Pasteur of Cameroon, Yaoundé, Cameroon
| | - Michel Tabonfack Atemkeng
- Virology Service, National Reference and Public Health Laboratory, Centre Pasteur of Cameroon, Yaoundé, Cameroon
| | - Anicet Ahanda
- Virology Service, National Reference and Public Health Laboratory, Centre Pasteur of Cameroon, Yaoundé, Cameroon
| | - Jean Blaise Momo
- Virology Service, National Reference and Public Health Laboratory, Centre Pasteur of Cameroon, Yaoundé, Cameroon
| | - Raissa Pekekue Nforifum
- Virology Service, National Reference and Public Health Laboratory, Centre Pasteur of Cameroon, Yaoundé, Cameroon
| | - Ernestine Etéré
- Virology Service, National Reference and Public Health Laboratory, Centre Pasteur of Cameroon, Yaoundé, Cameroon
| | - Marie Claire Endegue-Zanga
- Virology Service, National Reference and Public Health Laboratory, Centre Pasteur of Cameroon, Yaoundé, Cameroon
| | - Onana Boyomo
- Department of Microbiology University of Yaoundé 1, Yaoundé, Cameroon
| | | | | | - Ousmane M Diop
- The Polio Eradication Department, World Health Organization, Geneva 27, Switzerland
| | - Richard Njouom
- Virology Service, National Reference and Public Health Laboratory, Centre Pasteur of Cameroon, Yaoundé, Cameroon
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Modiyinji AF, Tankeu LTA, Monamele CG, Yifomnjou Moumbeket MH, Tagnouokam Ngoupo PA, Tchetgna Simo H, Njei Ngu A, Mirdad K, Njouom R. Hepatitis E virus infections among patients with acute febrile jaundice in two regions of Cameroon: First molecular characterization of hepatitis E virus genotype 4. PLoS One 2024; 19:e0298723. [PMID: 38346054 PMCID: PMC10861035 DOI: 10.1371/journal.pone.0298723] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/13/2023] [Accepted: 01/29/2024] [Indexed: 02/15/2024] Open
Abstract
BACKGROUND Febrile jaundice is a common indicator of certain infectious diseases, including hepatitis E. In Cameroon, the yellow fever virus is the only pathogen that is monitored in patients who present with this symptom. However, more than 90% of the samples received as part of this surveillance are negative for yellow fever. This study aimed to describe the prevalence and hepatitis E virus (HEV) genotype among yellow fever-negative patients in the Far North and West regions of Cameroon. METHODS In a cross-sectional study, yellow fever surveillance-negative samples collected between January 2021 and January 2023 were retrospectively analyzed. Anti-HEV IgM and IgG antibodies were tested using commercially available ELISA kits. Anti-HEV IgM and/or IgG positive samples were tested for HEV RNA by real-time RT-PCR, followed by nested RT-PCR, sequencing and phylogenetic analysis. RESULTS Overall, 121 of the 543 samples (22.3%, 95% CI: 19.0% - 26.0%) were positive for at least one anti-HEV marker. Amongst these, 8.1% (44/543) were positive for anti-HEV IgM, 5.9% (32/543) for anti-HEV IgG, and 8.3% (45/544) for both markers. A total of 15.2% (12/79) samples were positive for HEV RNA real-time RT-PCR and 8 samples were positive for HEV RNA by nested RT-PCR. Phylogenetic analysis showed that the retrieved sequences clustered within HEV genotypes/subtypes 1/1e, 3/3f and 4/4b. CONCLUSION Our results showed that HEV is one of the causes of acute febrile jaundice in patients enrolled in the yellow fever surveillance program in two regions of Cameroon. We described the circulation of three HEV genotypes, including two zoonotic genotypes. Further studies will be important to elucidate the transmission routes of these zoonotic HEV genotypes to humans in Cameroon.
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Affiliation(s)
| | | | | | | | | | | | - Abanda Njei Ngu
- Virology Unit, Centre Pasteur du Cameroun, Yaoundé, Cameroon
| | - Kazanji Mirdad
- Virology Unit, Centre Pasteur du Cameroun, Yaoundé, Cameroon
| | - Richard Njouom
- Virology Unit, Centre Pasteur du Cameroun, Yaoundé, Cameroon
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Changoh CM, Tatah L, Aroke D, Nsagha D, Choukem SP. Noncommunicable diseases behavioural risk factors among secondary school adolescents in Urban Cameroon. BMC Public Health 2024; 24:377. [PMID: 38317170 PMCID: PMC10840178 DOI: 10.1186/s12889-024-17753-1] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/07/2023] [Accepted: 01/11/2024] [Indexed: 02/07/2024] Open
Abstract
Adolescence is a crucial period for noncommunicable disease (NCD) risk factors, and interventions to reduce the NCD burden must target this age group. This study aimed to evaluate the NCD behavioural risk factors in adolescents attending state secondary schools in an urban setting in Cameroon. We conducted a cross-sectional survey using adapted structured questionnaires to assess the prevalence and correlates of NCD behavioural risk factors among adolescents attending selected urban state secondary schools in Douala IV, one of the six subdivisions in Douala, Cameroon. Of the 645 students who completed the study questionnaires, half of them did not have adequate knowledge about NCDs and their risk factors. Only 20% met recommended physical activity levels, nearly half lived sedentary lifestyles, and only 7% ate a healthy diet. Almost half of all participants reported drinking alcohol during the month, while 3% reported cigarette smoking. Participants with inadequate knowledge of NCDs were more likely to have elevated blood pressure values, and males had increased odds of high blood pressure. Contrarily, being male appeared to be protective against overweight and obesity. The odds of being sedentary decreased with age, and the odds of alcohol drinking seemed to grow with a higher maternal level of education. Our survey shows inadequate knowledge about NCDs and a high prevalence of NCD behavioural risk factors in adolescents in urban state secondary schools in Cameroon. These findings predict a higher NCD burden in future adults in the country, reinforcing the need for urgent public health interventions, especially regarding knowledge and sedentary living. Further research is needed to establish the transition of adolescent risk factors to adult disease through life course approaches in these settings.
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Affiliation(s)
- Changoh Marvel Changoh
- Faculty of Health Sciences, University of Buea, Buea, Cameroon
- Health and Human Development (2HD) Research Network, Douala, Cameroon
| | - Lambed Tatah
- Health and Human Development (2HD) Research Network, Douala, Cameroon
- Medical Research Council Epidemiology Unit, University of Cambridge, Cambridge, CB2 0QQ, UK
| | - Desmond Aroke
- Health and Human Development (2HD) Research Network, Douala, Cameroon
| | - Dickson Nsagha
- Faculty of Health Sciences, University of Buea, Buea, Cameroon
| | - Simeon-Pierre Choukem
- Faculty of Health Sciences, University of Buea, Buea, Cameroon.
- Health and Human Development (2HD) Research Network, Douala, Cameroon.
- Faculty of Medicine and Pharmaceutical Sciences, The University of Dschang, Dschang, Cameroon.
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Cozzi GD, Ye Y, Mbah R, Mbunwe DM, Pekwarake S, Yui Bunwi E, Fondzeyuf A, Ngong MG, Dionne JA, Harper LM, Jauk VC, Carlo WA, Halle-Ekane G, Tih PM, Szychowski JM, Tita AT, Subramaniam A. Predicting peripartum infection in laboring patients at high risk in Cameroon, Africa. Eur J Obstet Gynecol Reprod Biol 2024; 293:9-14. [PMID: 38096705 DOI: 10.1016/j.ejogrb.2023.12.003] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/19/2023] [Revised: 11/07/2023] [Accepted: 12/04/2023] [Indexed: 02/09/2024]
Abstract
OBJECTIVE To develop a predictive model for peripartum infection among high risk laboring patients in Cameroon, Africa. STUDY DESIGN We conducted a secondary analysis of the Cameroon Antibiotic Prophylaxis Trial (NCT03248297), a multicenter 3-arm double-blind randomized controlled trial of oral azithromycin ± amoxicillin among term pregnancies with prolonged labor or rupture of membranes in Cameroon 1/2018-5/2020. Patients with chorioamnionitis prior to randomization, study drug contraindications, or planned cesarean were excluded. The outcome of interest was a composite of maternal peripartum infection (chorioamnionitis, endometritis, sepsis by World Health Organization criteria, wound infection/abscess) diagnosed up to 6 weeks postpartum. Potential predictors were compared between patients with and without the composite outcome, and evaluated at a 0.05 alpha level. Statistically significant exposures were analyzed using multivariable regression (to generate adjusted odds ratios and 95 % confidence intervals) with backwards selection to generate a parsimonious model. Receiver operating characteristic curves with associated area under the curve assessed the model's predictive ability. A nomogram based on the final best fit multivariable model was constructed. RESULTS Of 756 patients in the parent trial, 652 were analyzed: 45 (7 %) had peripartum infection. Those with infection were more likely to be nulliparous, lower education level, higher gestational age, receive antibiotics per hospital protocols, and undergo cesarean. In our best-fit multivariable model, none/primary education (vs university), cesarean birth, and antibiotic receipt per physician discretion (vs for cesarean prophylaxis) were significantly associated with increased infection risk. This model was moderately predictive (AUC = 0.75, 95 % CI 0.67-0.82). When using this 3 factor model, for a patient with a cesarean birth, receipt of antibiotics per physician discretion, and university education, the probability of peripartum infection was 35 % (95 % CI 0.11-0.73). CONCLUSIONS While several variables such as parity are associated with infectious morbidity within 6 weeks among high risk laboring patients in Cameroon, only education level, antibiotic indication, and cesarean birth were independently associated, and a model including these 3 factors was moderately predictive. Validation of our findings in a larger population is warranted.
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Affiliation(s)
- Gabriella D Cozzi
- Center for Women's Reproductive Health, University of Alabama at Birmingham, Birmingham, AL, USA; Department of Obstetrics and Gynecology, University of Alabama at Birmingham, Birmingham, AL, USA.
| | - Yuanfan Ye
- Center for Women's Reproductive Health, University of Alabama at Birmingham, Birmingham, AL, USA; Department of Epidemiology, School of Public Health, University of Alabama at Birmingham, Birmingham, AL, USA
| | - Rahel Mbah
- Cameroon Baptist Convention Health Services, Cameroon, Africa
| | - Doreen M Mbunwe
- Cameroon Baptist Convention Health Services, Cameroon, Africa
| | | | - Edwan Yui Bunwi
- Cameroon Baptist Convention Health Services, Cameroon, Africa
| | | | - Mary G Ngong
- Cameroon Baptist Convention Health Services, Cameroon, Africa
| | - Jodie A Dionne
- Center for Women's Reproductive Health, University of Alabama at Birmingham, Birmingham, AL, USA; Department of Medicine, Division of Infectious Diseases, University of Alabama at Birmingham, Birmingham, AL, USA
| | - Lorie M Harper
- Department of Women's Health, Division of Maternal Fetal Medicine, University of Texas at Austin, Dell School of Medicine, Austin, TX, USA
| | - Victoria C Jauk
- Center for Women's Reproductive Health, University of Alabama at Birmingham, Birmingham, AL, USA; Department of Obstetrics and Gynecology, University of Alabama at Birmingham, Birmingham, AL, USA
| | - Waldemar A Carlo
- Center for Women's Reproductive Health, University of Alabama at Birmingham, Birmingham, AL, USA; Department of Pediatrics, Division of Neonatology, University of Alabama at Birmingham, Birmingham, AL, USA
| | - Gregory Halle-Ekane
- Cameroon Baptist Convention Health Services, Cameroon, Africa; University of Buea, Cameroon, Africa
| | - Pius M Tih
- Cameroon Baptist Convention Health Services, Cameroon, Africa
| | - Jeff M Szychowski
- Center for Women's Reproductive Health, University of Alabama at Birmingham, Birmingham, AL, USA; Department of Obstetrics and Gynecology, University of Alabama at Birmingham, Birmingham, AL, USA; Department of Biostatistics, University of Alabama at Birmingham, Birmingham, AL, USA
| | - Alan T Tita
- Center for Women's Reproductive Health, University of Alabama at Birmingham, Birmingham, AL, USA; Department of Obstetrics and Gynecology, University of Alabama at Birmingham, Birmingham, AL, USA
| | - Akila Subramaniam
- Center for Women's Reproductive Health, University of Alabama at Birmingham, Birmingham, AL, USA; Department of Obstetrics and Gynecology, University of Alabama at Birmingham, Birmingham, AL, USA
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Tejiokem MC, Abessolo HA, Nkodo JM, Ouethy M, Mayaka GB, Touha Y, Dikoume UA, Tchatchueng‐Mbougua JB, Noumbissi DC, Ndjeukam WT, Mbarga HOO, Ngoupo PAT, Moussi C, Garoua BH, Njouom R, Richard V. High seroprevalence of severe acute respiratory syndrome coronavirus 2 among healthcare workers in Yaoundé, Cameroon after the first wave of Covid-19 pandemic and associated factors. Influenza Other Respir Viruses 2024; 18:e13239. [PMID: 38342486 PMCID: PMC10859237 DOI: 10.1111/irv.13239] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/01/2023] [Revised: 11/19/2023] [Accepted: 11/27/2023] [Indexed: 02/13/2024] Open
Abstract
BACKGROUND Healthcare workers (HWs) are at a high risk of exposure to emerging health threats. Following the first wave of the coronavirus disease 2019 pandemic in Cameroon, we explored the presence and persistence of naturally acquired antibodies against severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) and the factors associated with seropositivity in HWs. METHODS Staff at two referral hospitals in Yaoundé or two Health District Hospitals in Obala and Mbalmayo were included in a 6-month prospective cohort analysis or cross-sectional survey, respectively. Seroprevalence and associated factors were determined, and Kaplan-Meier curves and Cox proportional hazards models were used to assess antibody persistence or positive seroconversion over time. RESULTS From August 2020 to March 2021, 426 HWs (median age: 31 years, interquartile range: 27-37 years; 66.4% female) were enrolled. The overall seroprevalence of anti-SARS-CoV-2 antibodies was 54.0% (95% confidence interval [CI]: 49.1-58.8) and was significantly different between study sites (p = 0.04). Of the 216 HWs included in the 6-month cohort, 109 (50.5%) HWs were seropositive at inclusion; the probability of persistent antibodies or of becoming seropositive was 93.8% (95% CI: 84.2-100) and 78.9% (95% CI: 61.7-88.4), respectively. Seroconversion was associated with study site and occupation but not with infection prevention and control (IPC) practices. CONCLUSIONS We observed high seroprevalence of SARS-CoV-2 antibody and seroconversion among HWs associated with occupational risk. This suggests low compliance to the COVID-19 control measures. Continued training and implementation of IPC measures and accelerated preparedness are needed to better tackle future threats.
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Affiliation(s)
| | - Hermine Abessolo Abessolo
- Centre Spécialisé de Prise en Charge des Patients Covid‐19annexe 2 Hôpital Central de YaoundéYaoundéCameroon
| | | | | | | | | | | | | | | | | | | | | | - Charlotte Moussi
- Délégation Régionale de la Santé Publique du CentreYaoundéCameroon
| | - Bonaventure Hollong Garoua
- Centre Spécialisé de Prise en Charge des Patients Covid‐19annexe 2 Hôpital Central de YaoundéYaoundéCameroon
| | - Richard Njouom
- Service de virologieCentre Pasteur du CamerounYaoundéCameroon
| | - Vincent Richard
- Direction Internationale, Institut Pasteur, Réseau International des Instituts PasteurParisFrance
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Nsounfon AW, Massongo M, Kuaban A, Komo MEN, Mayap VP, Ekongolo MC, Yone EWP. Prevalence and determinants of health-related quality of life in chronic obstructive pulmonary disease patients in Yaoundé, Cameroon: a pilot study. Pan Afr Med J 2024; 47:39. [PMID: 38586064 PMCID: PMC10998251 DOI: 10.11604/pamj.2024.47.39.39701] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/16/2023] [Accepted: 12/28/2023] [Indexed: 04/09/2024] Open
Abstract
Introduction the present study aimed to assess the health-related quality of life (HRQL) and identify the factors associated with poor quality of life, among chronic obstructive pulmonary disease (COPD) patients. Methods we conducted a cross-sectional study at Jamot Hospital and Polymere Medical Center, Yaoundé, from February 1 to June 30, 2020. All consent adult COPD patients who were followed in both centers during the recruitment period were included. The Saint George's Respiratory Questionnaire (SGRQ) was used to assess HRQL. Poor quality of life was defined by an SGRQ score ≥30. Data analysis was performed using IBM SPSS Statistics 23.0 (IBM Corp., Armonk, New York, USA) software. Multiple logistic regression was used to identify the factors associated with poor quality of life. The statistical significance threshold was set at 0.05. Results of the 63 patients invited to participate in the study, only 29 were finally included. Almost 3/5 (58.6%) were males, and their median age (interquartile range, IQR) was 68.0 (57.0 - 74.5) years. The median HRQL score (IQR) was 44.2 (23.2 - 65.0). The prevalence (95% confidence interval, 95% CI) of poor HRQL was 65.5% (48.3 - 82.8) %. The history of exacerbations during the last 12 months [odds ratio (95% CI) = 12.3 (1.1 - 136.7); p=0.04] emerged as the sole independent predictor of poor HRQL. Conclusion the prevalence of poor health-related quality of life was high in these COPD patients. The presence of exacerbations in the past 12 months was an independent factor associated with poor HRQL in patients with COPD.
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Affiliation(s)
- Abdou Wouoliyou Nsounfon
- Department of Internal Medicine and Specialties, Faculty of Medicine and Biomedical Sciences, University of Yaoundé I, Yaoundé, Cameroon
- Internal Medicine and Specialties Unit, Central Hospital of Yaoundé, Yaoundé, Cameroon
| | - Massongo Massongo
- Department of Internal Medicine and Specialties, Faculty of Medicine and Biomedical Sciences, University of Yaoundé I, Yaoundé, Cameroon
| | - Alain Kuaban
- Department of Internal Medicine and Specialties, Faculty of Medicine and Biomedical Sciences, University of Yaoundé I, Yaoundé, Cameroon
- Respiratory Medicine Unit, Jamot Hospital, Yaoundé, Cameroon
| | - Marie Elisabeth Ngah Komo
- Department of Internal Medicine and Specialties, Faculty of Medicine and Biomedical Sciences, University of Yaoundé I, Yaoundé, Cameroon
- Respiratory Medicine Unit, Jamot Hospital, Yaoundé, Cameroon
| | - Virginie Poka Mayap
- Department of Internal Medicine and Specialties, Faculty of Medicine and Biomedical Sciences, University of Yaoundé I, Yaoundé, Cameroon
- Respiratory Medicine Unit, Jamot Hospital, Yaoundé, Cameroon
| | | | - Eric Walter Pefura Yone
- Department of Internal Medicine and Specialties, Faculty of Medicine and Biomedical Sciences, University of Yaoundé I, Yaoundé, Cameroon
- Respiratory Medicine Unit, Jamot Hospital, Yaoundé, Cameroon
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Tofel HK, Abongwa LE, Ndifor RF, Ntonifor HN. Intestinal helminthiasis, anaemia and associated risk factors in a cross-section of the population of Melong, Littorial Region of Cameroon. Sci Rep 2024; 14:649. [PMID: 38182648 PMCID: PMC10770123 DOI: 10.1038/s41598-023-46446-9] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/25/2023] [Accepted: 11/01/2023] [Indexed: 01/07/2024] Open
Abstract
Assessment of risk factors of intestinal helminths and anaemia in various geographical regions is important for the development of appropriate control strategies. This study aimed at determining the risk factors associated with intestinal helminths and anaemia in Melong, Cameroon. A total of 325 participants were recruited in this study between September-December 2021. Faecal samples were examined using the formol-ether sedimentation technique while haemoglobin level was measured using a HemoCue spectrometer. Data on demographic and behavioural factors was collected and used to determine the risk factors using a pretested structured questionnaire and analysed using SPSS. The overall prevalence of intestinal helminths was 24.6% (80/325). Helminths recovered from the study included hookworm (16%; 52/325), Schistosoma mansoni (10.8% 35/325) Ascaris lumbricoides (1.9%; 6/325), and Trichuris trichiura (0.6%; 2/325) with 15 participants having multiple infections (4.6%). The geometric mean egg density was 77epg and ranged from 20 to 560 epg of faeces. Males and age group ≤ 5 years had the highest parasite intensity (248epg). The overall prevalence of anaemia was 33.5% (109/325). Anaemia was significantly (p = 0.001) high at 48.8% (39/80) in those infected with intestinal parasites compared to non-infected individuals. Age group of 31-45 years; [3.42(1.05-11.21)] and > 65 years [6.21(1.75-12.47)], poor knowledge [0.41(0.67-6.07)], no regular deworming [0.70(1.76-21.96)], mud floors toilet [6.18(1.61-23.79)], toilets made of sticks [16.5(4.24-64.31)], and participants who did not have stomach/abdominal pains [0.22(0.07-0.67)] were significant predictors of helminth infections. Age group < 15 years [2.58(1.09-6.11)], geophagia [3.69(1.91-9.33)], hookworm infection [3.26(1.49-7.11)], S. mansoni [1.72 (1.16-3.41)] and those with multiple infections [1.76(1.04-2.88)] were identified as risk factors for anaemia. Risk factors identified in this study can be used to improve the control mechanism put in place by the government.
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Affiliation(s)
- Haman Katamssadan Tofel
- Department of Biological Sciences, Faculty of Science, The University of Bamenda, BP 39, Bambili, North West Region, Cameroon
| | - Lem Edith Abongwa
- Department of Biological Sciences, Faculty of Science, The University of Bamenda, BP 39, Bambili, North West Region, Cameroon
- African Centre of Excellence for Genomics of Infectious Diseases (ACEGID), Redeemer's University, Ede, Osun State, Nigeria
| | - Ruth Fri Ndifor
- Department of Biological Sciences, Faculty of Science, The University of Bamenda, BP 39, Bambili, North West Region, Cameroon
| | - Helen Ngum Ntonifor
- Department of Biological Sciences, Faculty of Science, The University of Bamenda, BP 39, Bambili, North West Region, Cameroon.
- African Centre of Excellence for Genomics of Infectious Diseases (ACEGID), Redeemer's University, Ede, Osun State, Nigeria.
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Tejiokem MC, Barry A, Ratovoson R, Yambiyo B, Hamidou Lazoumar R, Herrant M, Madaha E, Richard V. African countries from the Pasteur Network reexamine their syndromic sentinel surveillance system associated with household contact within the AFROSCREEN program. Front Public Health 2024; 11:1292435. [PMID: 38249384 PMCID: PMC10796548 DOI: 10.3389/fpubh.2023.1292435] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/11/2023] [Accepted: 12/18/2023] [Indexed: 01/23/2024] Open
Abstract
Surveillance to better detect and respond to new pathogens remains a major challenge for global public health. The Pasteur Network recently held a brainstorming workshop located in Cameroon attended by Pasteur epidemiological teams from Niger, Central African Republic (CAR), Cameroon, Senegal, and Madagascar to discuss how the Pasteur Network in Africa could use the lessons of COVID-19 to set-up a pilot sentinel surveillance scheme given its expertise and involvement during the pandemic. The possibility of coupling sentinel syndromic and biological surveillance already implemented for influenza surveillance with the recent sequencing capacity put in place by the AFROSCREEN program prompted us to consider strengthening surveillance tools to target "Pathogen X" detection in Africa. The perspective project provided by the Pasteur Network teams and shared with other partners of the AFROSCREEN program will target strengthening of the diagnosis of severe acute respiratory infections (IRAS) and the surveillance of IRAS, the evaluation of the impact of SARS-CoV-2 on the epidemiology of IRAS, and the addition of the detection of new pathogens, called "Pathogen X," based on sequencing capacity and epidemiological criteria from One Health approaches.
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Affiliation(s)
| | | | - Rila Ratovoson
- Institut Pasteur de Madagascar, Antananarivo, Madagascar
| | - Brice Yambiyo
- Institut Pasteur de Bangui, Bangui, Central African Republic
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Kamga SLS, Ali IM, Ngangnang GR, Ulucesme MC, Keptcheu LTD, Keming EM, Tchuenkam VPK, Foyet JV, Aktas M, Noubom M, Payne VK. Uptake of intermittent preventive treatment of malaria in pregnancy and risk factors for maternal anaemia and low birthweight among HIV-negative mothers in Dschang, West region of Cameroon: a cross sectional study. Malar J 2024; 23:6. [PMID: 38178125 PMCID: PMC10768405 DOI: 10.1186/s12936-023-04816-8] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/01/2023] [Accepted: 12/06/2023] [Indexed: 01/06/2024] Open
Abstract
BACKGROUND Approximately 32 million pregnant women are at risk of malaria with up to 10,000 maternal deaths and 200,000 neonates at risk annually. Intermittent Preventive Treatment (IPT) with sulfadoxine-pyrimethamine (SP) is recommended by the World Health Organization (WHO) to reduce disease in pregnancy and adverse maternal and newborn outcomes. At least three doses of SP should be taken by pregnant women during antenatal consultation (ANC) beginning from the thirteenth week of pregnancy till parturition. The aim of this study was to assess uptake of IPT during pregnancy and risk factors for maternal anaemia and infant birth weight in Dschang, West region of Cameroon. METHODS A total of 380 consenting pregnant women at delivery were recruited in a cross- sectional prospective survey between January to December 2021. Data on ANC attendance, total dose of IPT and history of malaria were abstracted from hospital ANC records while socio-demographic characteristics, bed net use and obstetrics history of each participant were also recorded through an interview. Further, blood samples were collected from the intervillous space for assessment of maternal anaemia and microscopic parasitology. Nested PCR based on amplification of the Plasmodium 18S sRNA was carried out to detect submicroscopic infection. IPTp coverage was calculated per WHO recommendation and the prevalence of anaemia and low birth weight were estimated as proportions in the total sample of pregnant women and live births, respectively. Crude and adjusted odds ratios and their 95% confidence intervals were used to estimate associations between pregnancy outcomes considered and risk factors in specific and general models. A p < 0.05 was considered significant. The R software (V4.1.4) was used for all analyses. RESULTS A majority of pregnant women was aged between 24 and 34 years old (59.2%) and had secondary education (58.8%). Uptake of ≥ 3 IPTp was 64.99% with 77.20% of all who received at least one IPTp doses taking a mix of SP and DP or DP alone in successive ANC contacts. Those with four or more ANC contacts (73.42%) were more likely to have received at least one IPTp. Furthermore, 13.9% of live births had low birthweights (BW < 2500 g) and one in four parturient women with moderate anaemia by WHO criteria. Microscopy (blood smear examination) and PCR-based diagnosis revealed between 0% and 1.57% of parasite-infected placental samples, respectively. Reported malaria in pregnancy predicted maternal anaemia at birth but not birth weight. Only gestational age (< 37 weeks) and bed net use (< 5 months) significantly predicted infant birth weight at delivery. CONCLUSION The uptake of WHO recommended IPT doses during pregnancy was moderately high. Reported malaria in pregnancy, poor bed net coverage, gestational age less than 37 weeks adversely affect maternal haemoglobin levels at birth and infant birth weight. Asymptomatic and submicroscopic placental parasite infections was found at low prevalence. Together these results highlight the importance of maintaining aggressive measures to prevent malaria in pregnancy and protect the health of mother and baby.
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Affiliation(s)
- Sabrina Lynda Simo Kamga
- Research Unit of Biology and Applied Ecology, Department of Animal Biology, Faculty of Science, University of Dschang, Dschang, Cameroon
| | - Innocent Mbulli Ali
- Research Unit of Microbiology and Antimicrobial Substances, Department of Biochemistry, Faculty of Science, University of Dschang, Dschang, Cameroon.
- The Biotechnology Centre, University of Yaounde 1, Yaounde, Cameroon.
| | - Ghislain Romeo Ngangnang
- Research Unit of Biology and Applied Ecology, Department of Animal Biology, Faculty of Science, University of Dschang, Dschang, Cameroon
| | - Mehmet Can Ulucesme
- Laboratory of Molecular Parasitology, Department of Parasitology, University of Firät, Elazig, Turkey
| | - Leonard T D Keptcheu
- Research Unit of Biology and Applied Ecology, Department of Animal Biology, Faculty of Science, University of Dschang, Dschang, Cameroon
| | - Eva Mai Keming
- Research Unit of Microbiology and Antimicrobial Substances, Department of Biochemistry, Faculty of Science, University of Dschang, Dschang, Cameroon
- The Biotechnology Centre, University of Yaounde 1, Yaounde, Cameroon
| | - Valery-Pacome Kom Tchuenkam
- Research Unit of Microbiology and Antimicrobial Substances, Department of Biochemistry, Faculty of Science, University of Dschang, Dschang, Cameroon
- The Biotechnology Centre, University of Yaounde 1, Yaounde, Cameroon
| | - Juluis Visnel Foyet
- Research Unit of Biology and Applied Ecology, Department of Animal Biology, Faculty of Science, University of Dschang, Dschang, Cameroon
| | - Münir Aktas
- Laboratory of Molecular Parasitology, Department of Parasitology, University of Firät, Elazig, Turkey
| | - Michel Noubom
- Department of Clinical Biology, Faculty of Medicine and Pharmaceutical Sciences, University of Dschang, Dschang, Cameroon
| | - Vincent K Payne
- Research Unit of Biology and Applied Ecology, Department of Animal Biology, Faculty of Science, University of Dschang, Dschang, Cameroon.
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Keneh NK, Kenmoe S, Bowo-Ngandji A, Tatah Kihla Akoachere JF, Gonsu Kamga H, Ndip RN, Ebogo-Belobo JT, Kengne-Ndé C, Mbaga DS, Tendongfor N, Ndip LM, Esemu SN. A mapping review of methicillin-resistant Staphylococcus aureus proportions, genetic diversity, and antimicrobial resistance patterns in Cameroon. PLoS One 2023; 18:e0296267. [PMID: 38134014 PMCID: PMC10745167 DOI: 10.1371/journal.pone.0296267] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/23/2023] [Accepted: 12/09/2023] [Indexed: 12/24/2023] Open
Abstract
BACKGROUND The emergence of methicillin-resistant Staphylococcus aureus (MRSA) has increased and poses a significant threat to human and animal health in Cameroon and the world at large. MRSA strains have infiltrated various settings, including hospitals, communities, and livestock, contributing to increased morbidity, treatment costs, and mortality. This evidence synthesis aims to understand MRSA prevalence, resistance patterns, and genetic characterization in Cameroon. METHODS The methodology was consistent with the PRISMA 2020 guidelines. Studies of any design containing scientific data on MRSA prevalence, genetic diversity, and antimicrobial resistance patterns in Cameroon were eligible for inclusion, with no restrictions on language or publication date. The search involved a comprehensive search strategy in several databases including Medline, Embase, Global Health, Web of Science, African Index Medicus, and African Journal Online. The risk of bias in the included studies was assessed using the Hoy et al tool, and the results were synthesized and presented in narrative synthesis and/or tables and graphs. RESULTS The systematic review analyzed 24 studies, mostly conducted after 2010, in various settings in Cameroon. The studies, characterized by moderate to low bias, revealed a wide prevalence of MRSA ranging from 1.9% to 46.8%, with considerable variation based on demographic and environmental factors. Animal (0.2%), food (3.2% to 15.4%), and environmental samples (0.0% to 34.6%) also showed a varied prevalence of MRSA. The genetic diversity of MRSA was heterogeneous, with different virulence gene profiles and clonal lineages identified in various populations and sample types. Antimicrobial resistance rates showed great variability in the different regions of Cameroon, with notable antibiotic resistance recorded for the beta-lactam, fluoroquinolone, glycopeptide, lincosamide, and macrolide families. CONCLUSION This study highlights the significant variability in MRSA prevalence, genetic diversity, and antimicrobial resistance patterns in Cameroon, and emphasizes the pressing need for comprehensive antimicrobial stewardship strategies in the country.
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Affiliation(s)
- Nene Kaah Keneh
- Department of Microbiology and Parasitology, University of Buea, Buea, Cameroon
- Laboratory for Emerging Infectious Diseases, University of Buea, Buea, South West Region, Cameroon
| | - Sebastien Kenmoe
- Department of Microbiology and Parasitology, University of Buea, Buea, Cameroon
| | - Arnol Bowo-Ngandji
- Department of Microbiology, The University of Yaounde I, Yaounde, Cameroon
| | | | - Hortense Gonsu Kamga
- Faculty of Medicine and Biomedical Sciences, The University of Yaounde I, Yaoundé, Cameroon
| | - Roland Ndip Ndip
- Department of Microbiology and Parasitology, University of Buea, Buea, Cameroon
| | - Jean Thierry Ebogo-Belobo
- Center for Research in Health and Priority Pathologies, Institute of Medical Research and Medicinal Plants Studies, Yaounde, Cameroon
| | - Cyprien Kengne-Ndé
- Epidemiological Surveillance, Evaluation and Research Unit, National AIDS Control Committee, Douala, Cameroon
| | | | | | - Lucy Mande Ndip
- Department of Microbiology and Parasitology, University of Buea, Buea, Cameroon
- Laboratory for Emerging Infectious Diseases, University of Buea, Buea, South West Region, Cameroon
| | - Seraphine Nkie Esemu
- Department of Microbiology and Parasitology, University of Buea, Buea, Cameroon
- Laboratory for Emerging Infectious Diseases, University of Buea, Buea, South West Region, Cameroon
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Tendongfor N, Fokam J, Chenwi CA, Nwabo FLT, Nangmo A, Debimeh N, Moyo STN, Halle MP, Njom-Nlend AE, Ndombo PK, Ndjolo A. Determinants of survival of adolescents receiving antiretroviral therapy in the Centre Region of Cameroon: a multi-centered cohort-analysis. AIDS Res Ther 2023; 20:88. [PMID: 38098059 PMCID: PMC10722663 DOI: 10.1186/s12981-023-00584-2] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/04/2023] [Accepted: 11/29/2023] [Indexed: 12/17/2023] Open
Abstract
BACKGROUND In spite of the global decreasing mortality associated with HIV, adolescents living with HIV (ADLHIV) in sub-Saharan Africa still experience about 50% mortality rate. We sought to evaluate survival rates and determinants of mortality amongst ADLHIV receiving antiretroviral therapy (ART) in urban and rural settings. METHODS A multi-centered, 10-year retrospective, cohort-study including ADLHIV on ART ≥ 6 months in the urban and rural settings of the Centre Region of Cameroon. Socio-demographic, clinical, biological, and therapeutic data were collected from files of ADLHIV. The Kaplan-Meier method was used to estimate survival probability after ART initiation; the log rank test used to compare survival curves between groups of variables; and the Cox proportional hazard model was used to identify the determinants of mortality. RESULTS A total of 403 adolescents' records were retained; 340 (84%) were from the urban and 63 (16%) from the rural settings. The female to male ratio was 7:5; mean age (Standard deviation) was 14.1 (2.6) years; at baseline, 64.4% were at WHO clinical stages I/II, 34.9% had ≥ 500 CD4 cells/mm3, 91.1% were anemic, and the median [Inter Quartile Range] duration on ART was5.3 [0.5-16] years. The survival rate at 1, 5 and 10 years on ART was respectively 97.0%, 55.9% and 8.7%; with mean survival time of 5.8 years (95% CI 5.5-6.1). In bivariate analysis, living in the rural setting, non-disclosed HIV status, baseline CD4 count < 500 cells/mm3, not being exposed to nevirapine prophylaxis at birth and being horizontally infected were found to be the determinants of higher mortality with poor retention in care slightly associated with mortality. In multivariate analysis, living in rural settings, poor retention in care and anemia were independent predictors of mortality (p < 0.05). CONCLUSION Although ADLHIV have good survival rate on ART after 1 year, we observe poor survival rates after 5 years and especially 10 years of treatment experience. Mitigating measures against poor survival should target those living in rural settings, anemic at baseline, or experiencing poor retention in care.
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Affiliation(s)
| | - Joseph Fokam
- Faculty of Health Sciences, University of Buea, P.O. Box 63, Buea, Cameroon.
- Chantal BIYA International Reference Centre for Research on HIV/AIDS Prevention and Management (CIRCB), PO Box 3077, Yaoundé, Cameroon.
- Faculty of Medicine and Biomedical Sciences, University of Yaoundé I, Yaoundé, Cameroon.
| | - Collins Ambe Chenwi
- Chantal BIYA International Reference Centre for Research on HIV/AIDS Prevention and Management (CIRCB), PO Box 3077, Yaoundé, Cameroon.
- Faculty of Medicine and Biomedical Sciences, University of Yaoundé I, Yaoundé, Cameroon.
| | - Fabrice Léo Tamhouo Nwabo
- Faculty of Health Sciences, University of Buea, P.O. Box 63, Buea, Cameroon
- Chantal BIYA International Reference Centre for Research on HIV/AIDS Prevention and Management (CIRCB), PO Box 3077, Yaoundé, Cameroon
| | - Armanda Nangmo
- Chantal BIYA International Reference Centre for Research on HIV/AIDS Prevention and Management (CIRCB), PO Box 3077, Yaoundé, Cameroon
| | - Njume Debimeh
- Chantal BIYA International Reference Centre for Research on HIV/AIDS Prevention and Management (CIRCB), PO Box 3077, Yaoundé, Cameroon
- Faculty of Medicine and Biomedical Sciences, University of Yaoundé I, Yaoundé, Cameroon
| | | | - Marie Patrice Halle
- Department of Internal Medicine, Douala General Hospital, Douala, Cameroon
- Faculty of Medicine and Pharmaceutical Science, University of Douala, Douala, Cameroon
| | - Anne-Esther Njom-Nlend
- Pediatric Department, National Social Welfare Centre, Essos Health Centre, Yaoundé, Cameroon
- Higher Institute of Medical Technology, University of Douala, Yaoundé, Cameroon
| | - Paul Koki Ndombo
- Mother and Child Centre, Chantal BIYA Foundation, Yaoundé, Cameroon
| | - Alexis Ndjolo
- Chantal BIYA International Reference Centre for Research on HIV/AIDS Prevention and Management (CIRCB), PO Box 3077, Yaoundé, Cameroon
- Faculty of Medicine and Biomedical Sciences, University of Yaoundé I, Yaoundé, Cameroon
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Nkemngo FN, Raissa LW, Nguete DN, Ndo C, Fru-Cho J, Njiokou F, Wanji S, Wondji CS. Geographical emergence of sulfadoxine-pyrimethamine drug resistance-associated P. falciparum and P. malariae alleles in co-existing Anopheles mosquito and asymptomatic human populations across Cameroon. Antimicrob Agents Chemother 2023; 67:e0058823. [PMID: 37947766 PMCID: PMC10720508 DOI: 10.1128/aac.00588-23] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/07/2023] [Accepted: 09/28/2023] [Indexed: 11/12/2023] Open
Abstract
Malaria molecular surveillance remains critical in detecting and tracking emerging parasite resistance to anti-malarial drugs. The current study employed molecular techniques to determine Plasmodium species prevalence and characterize the genetic diversity of Plasmodium falciparum and Plasmodium malariae molecular markers of sulfadoxine-pyrimethamine resistance in humans and wild Anopheles mosquito populations in Cameroon. Anopheles mosquito collections and parasitological survey were conducted in villages to determine Plasmodium species infection, and genomic phenotyping of anti-folate resistance was accomplished by sequencing the dihydrofolate-reductase (dhfr) and dihydropteroate-synthase (dhps) genes of naturally circulating P. falciparum and P. malariae isolates. The malaria prevalence in Elende was 73.5% with the 5-15 years age group harboring significant P. falciparum (27%) and P. falciparum + P. malariae (19%) infections. The polymorphism breadth of the pyrimethamine-associated Pfdhfr marker revealed a near fixation (94%) of the triple-mutant -A16I51R59N108I164. The Pfdhps backbone mediating sulfadoxine resistance reveals a high frequency of the V431A436G437K540A581A613 alleles (20.8%). Similarly, the Pmdhfr N50K55L57R58S59S114F168I170 haplotype (78.4%) was predominantly detected in the asexual blood stage. In contrast, the Pmdhps- S436A437occured at 37.2% frequency. The combined quadruple N50K55L57R58S59S114F168I170_ S436G437K540A581A613 (31.9%) was the major circulating haplotype with similar frequency in humans and mosquitoes. This study highlights the increasing frequency of the P. malariae parasite mostly common in asymptomatic individuals with apparent P. falciparum infection. Interventions directed at reducing malaria transmission such as the scaling-up of SP are favoring the emergence and spread of multiple drug-resistant alleles between the human and mosquito host systems.
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Affiliation(s)
- Francis N. Nkemngo
- Centre for Research in Infectious Diseases (CRID), Yaoundé, Cameroon
- Department of Microbiology and Parasitology, Faculty of Science, University of Buea, Buea, Cameroon
| | - Lymen W. Raissa
- Centre for Research in Infectious Diseases (CRID), Yaoundé, Cameroon
| | - Daniel N. Nguete
- Centre for Research in Infectious Diseases (CRID), Yaoundé, Cameroon
| | - Cyrille Ndo
- Centre for Research in Infectious Diseases (CRID), Yaoundé, Cameroon
- Department of Biological Sciences, Faculty of Medicine and Pharmaceutical Sciences, University of Douala, Douala, Cameroon
| | - Jerome Fru-Cho
- Department of Microbiology and Parasitology, Faculty of Science, University of Buea, Buea, Cameroon
- Research Foundation in Tropical Diseases and Environment, Buea, Cameroon
- Centre for Infection Biology and Translational Research, Forzi Institute, Buea, Cameroon
| | - Flobert Njiokou
- Centre for Research in Infectious Diseases (CRID), Yaoundé, Cameroon
| | - Samuel Wanji
- Department of Microbiology and Parasitology, Faculty of Science, University of Buea, Buea, Cameroon
- Research Foundation in Tropical Diseases and Environment, Buea, Cameroon
| | - Charles S. Wondji
- Centre for Research in Infectious Diseases (CRID), Yaoundé, Cameroon
- Vector Biology Department, Liverpool School of Tropical Medicine, Liverpool, United Kingdom
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Fokam J, Essomba RG, Njouom R, Okomo MCA, Eyangoh S, Godwe C, Tegomoh B, Otshudiema JO, Nwobegahay J, Ndip L, Akenji B, Takou D, Moctar MMM, Mbah CK, Ndze VN, Maidadi-Foudi M, Kouanfack C, Tonmeu S, Ngono D, Nkengasong J, Ndembi N, Bissek ACZK, Mouangue C, Ndongo CB, Epée E, Mandeng N, Kamso Belinga S, Ayouba A, Fernandez N, Tongo M, Colizzi V, Halle-Ekane GE, Perno CF, Ndjolo A, Ndongmo CB, Shang J, Esso L, de-Tulio O, Diagne MM, Boum Y, Mballa GAE, Njock LR. Genomic surveillance of SARS-CoV-2 reveals highest severity and mortality of delta over other variants: evidence from Cameroon. Sci Rep 2023; 13:21654. [PMID: 38066020 PMCID: PMC10709425 DOI: 10.1038/s41598-023-48773-3] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/22/2022] [Accepted: 11/30/2023] [Indexed: 12/18/2023] Open
Abstract
While the SARS-CoV-2 dynamic has been described globally, there is a lack of data from Sub-Saharan Africa. We herein report the dynamics of SARS-CoV-2 lineages from March 2020 to March 2022 in Cameroon. Of the 760 whole-genome sequences successfully generated by the national genomic surveillance network, 74% were viral sub-lineages of origin and non-variants of concern, 15% Delta, 6% Omicron, 3% Alpha and 2% Beta variants. The pandemic was driven by SARS-CoV-2 lineages of origin in wave 1 (16 weeks, 2.3% CFR), the Alpha and Beta variants in wave 2 (21 weeks, 1.6% CFR), Delta variants in wave 3 (11 weeks, 2.0% CFR), and omicron variants in wave 4 (8 weeks, 0.73% CFR), with a declining trend over time (p = 0.01208). Even though SARS-CoV-2 heterogeneity did not seemingly contribute to the breadth of transmission, the viral lineages of origin and especially the Delta variants appeared as drivers of COVID-19 severity in Cameroon.
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Affiliation(s)
- Joseph Fokam
- National Public Health Emergencies Operations Coordination Centre (NPHEOCC), Ministry of Public Health, Yaoundé, Cameroon.
- COVID-19 Genomic Surveillance Platform (PSG), Ministry of Public Health, Yaoundé, Cameroon.
- Chantal BIYA International Reference Centre for Research on HIV/AIDS Prevention and Management (CIRCB), Yaoundé, Cameroon.
- Faculty of Health Sciences (FHS), University of Buea, Buea, Cameroon.
| | - Rene Ghislain Essomba
- COVID-19 Genomic Surveillance Platform (PSG), Ministry of Public Health, Yaoundé, Cameroon
- National Public Health Laboratory (NPHL), Ministry of Public Health, Yaoundé, Cameroon
- Faculty of Medicine and Biomedical Sciences (FMBS), University of Yaounde I, Yaounde, Cameroon
| | - Richard Njouom
- COVID-19 Genomic Surveillance Platform (PSG), Ministry of Public Health, Yaoundé, Cameroon
- Centre Pasteur du Cameroun (CPC), Yaoundé, Cameroon
| | - Marie-Claire A Okomo
- COVID-19 Genomic Surveillance Platform (PSG), Ministry of Public Health, Yaoundé, Cameroon
- National Public Health Laboratory (NPHL), Ministry of Public Health, Yaoundé, Cameroon
- Faculty of Medicine and Biomedical Sciences (FMBS), University of Yaounde I, Yaounde, Cameroon
| | - Sara Eyangoh
- COVID-19 Genomic Surveillance Platform (PSG), Ministry of Public Health, Yaoundé, Cameroon
- Centre Pasteur du Cameroun (CPC), Yaoundé, Cameroon
| | - Celestin Godwe
- Centre de Recherche en Maladies Emergentes et Re-emergentes (CREMER), Yaounde, Cameroon
| | - Bryan Tegomoh
- School of Public Health, University of California, Berkeley, Berkeley, CA, USA
| | - John O Otshudiema
- World Health Organization (WHO), Cameroon Country Office, Yaounde, Cameroon
| | - Julius Nwobegahay
- COVID-19 Genomic Surveillance Platform (PSG), Ministry of Public Health, Yaoundé, Cameroon
- Centre de Recherche Pour la Santé des Armées (CRESAR), Ministry of Defence, Yaoundé, Cameroon
| | - Lucy Ndip
- Faculty of Health Sciences (FHS), University of Buea, Buea, Cameroon
| | - Blaise Akenji
- National Public Health Laboratory (NPHL), Ministry of Public Health, Yaoundé, Cameroon
| | - Desire Takou
- Chantal BIYA International Reference Centre for Research on HIV/AIDS Prevention and Management (CIRCB), Yaoundé, Cameroon
| | - Mohamed M M Moctar
- USAID's Infectious Diseases Detection and Surveillance, Yaounde, Cameroon
| | | | - Valantine Ngum Ndze
- Faculty of Health Sciences (FHS), University of Buea, Buea, Cameroon
- African Society for Laboratory Medicine (ASLM), Yaounde, Cameroon
| | - Martin Maidadi-Foudi
- Centre de Recherche en Maladies Emergentes et Re-emergentes (CREMER), Yaounde, Cameroon
| | - Charles Kouanfack
- Centre de Recherche en Maladies Emergentes et Re-emergentes (CREMER), Yaounde, Cameroon
| | - Sandrine Tonmeu
- National Public Health Laboratory (NPHL), Ministry of Public Health, Yaoundé, Cameroon
| | - Dorine Ngono
- School of Public Health, University of California, Berkeley, Berkeley, CA, USA
| | - John Nkengasong
- Africa Centres for Disease Control and Prevention (Africa CDC), Addis-Ababa, Ethiopia
| | - Nicaise Ndembi
- Africa Centres for Disease Control and Prevention (Africa CDC), Addis-Ababa, Ethiopia
| | - Anne-Cecile Z K Bissek
- Faculty of Health Sciences (FHS), University of Buea, Buea, Cameroon
- Division for Operational Health Research (DROS), Ministry of Public Health, Yaoundé, Cameroon
| | - Christian Mouangue
- National Public Health Emergencies Operations Coordination Centre (NPHEOCC), Ministry of Public Health, Yaoundé, Cameroon
- Department of Disease, Epidemic and Pandemic Control (DLMEP), Ministry of Public Health, Yaounde, Cameroon
| | - Chanceline B Ndongo
- National Public Health Emergencies Operations Coordination Centre (NPHEOCC), Ministry of Public Health, Yaoundé, Cameroon
- Department of Disease, Epidemic and Pandemic Control (DLMEP), Ministry of Public Health, Yaounde, Cameroon
- Faculty of Medicine and Pharmaceutical Sciences (FMPS), University of Douala, Douala, Cameroon
| | - Emilienne Epée
- National Public Health Emergencies Operations Coordination Centre (NPHEOCC), Ministry of Public Health, Yaoundé, Cameroon
- Faculty of Medicine and Biomedical Sciences (FMBS), University of Yaounde I, Yaounde, Cameroon
- Department of Disease, Epidemic and Pandemic Control (DLMEP), Ministry of Public Health, Yaounde, Cameroon
| | - Nadia Mandeng
- National Public Health Emergencies Operations Coordination Centre (NPHEOCC), Ministry of Public Health, Yaoundé, Cameroon
- Department of Disease, Epidemic and Pandemic Control (DLMEP), Ministry of Public Health, Yaounde, Cameroon
- Faculty of Health Sciences (FHS), University of Bamenda, Bamenda, Cameroon
| | - Sandrine Kamso Belinga
- National Public Health Emergencies Operations Coordination Centre (NPHEOCC), Ministry of Public Health, Yaoundé, Cameroon
- Department of Disease, Epidemic and Pandemic Control (DLMEP), Ministry of Public Health, Yaounde, Cameroon
| | - Ahidjo Ayouba
- Institut de Recherche Pour le Developpement (IRD), Montpellier, France
| | - Nicolas Fernandez
- Institut de Recherche Pour le Developpement (IRD), Montpellier, France
| | - Marcel Tongo
- Centre de Recherche en Maladies Emergentes et Re-emergentes (CREMER), Yaounde, Cameroon
| | - Vittorio Colizzi
- Chantal BIYA International Reference Centre for Research on HIV/AIDS Prevention and Management (CIRCB), Yaoundé, Cameroon
- Chair of UNESCO Biotechnology, University of Rome Tor Vergata, Rome, Italy
| | | | - Carlo-Federico Perno
- Chantal BIYA International Reference Centre for Research on HIV/AIDS Prevention and Management (CIRCB), Yaoundé, Cameroon
- Bambino Gesu Pediatric Hospital, Rome, Italy
| | - Alexis Ndjolo
- Chantal BIYA International Reference Centre for Research on HIV/AIDS Prevention and Management (CIRCB), Yaoundé, Cameroon
- Faculty of Medicine and Biomedical Sciences (FMBS), University of Yaounde I, Yaounde, Cameroon
| | - Clement B Ndongmo
- US Centres for Disease Control and Prevention (CDC), Cameroon Country Office, Yaounde, Cameroon
| | - Judith Shang
- US Centres for Disease Control and Prevention (CDC), Cameroon Country Office, Yaounde, Cameroon.
| | - Linda Esso
- National Public Health Emergencies Operations Coordination Centre (NPHEOCC), Ministry of Public Health, Yaoundé, Cameroon
- Department of Disease, Epidemic and Pandemic Control (DLMEP), Ministry of Public Health, Yaounde, Cameroon
| | - Oliviera de-Tulio
- University of KwaZulu-Natal and Stellenbosch University, Stellenbosch, South Africa
| | | | - Yap Boum
- National Public Health Emergencies Operations Coordination Centre (NPHEOCC), Ministry of Public Health, Yaoundé, Cameroon
- Faculty of Medicine and Biomedical Sciences (FMBS), University of Yaounde I, Yaounde, Cameroon
- Epicentre, Medecins Sans Frontières (MSF), Yaounde, Cameroon
| | - Georges A E Mballa
- National Public Health Emergencies Operations Coordination Centre (NPHEOCC), Ministry of Public Health, Yaoundé, Cameroon
- Faculty of Medicine and Biomedical Sciences (FMBS), University of Yaounde I, Yaounde, Cameroon
- Department of Disease, Epidemic and Pandemic Control (DLMEP), Ministry of Public Health, Yaounde, Cameroon
| | - Louis R Njock
- COVID-19 Genomic Surveillance Platform (PSG), Ministry of Public Health, Yaoundé, Cameroon
- Faculty of Medicine and Biomedical Sciences (FMBS), University of Yaounde I, Yaounde, Cameroon
- Faculty of Medicine and Pharmaceutical Sciences (FMPS), University of Douala, Douala, Cameroon
- General Secretariat, Ministry of Public Health, Yaounde, Cameroon
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Agbodzi B, Sado Yousseu FB, Nemg Simo FB, Kumordjie S, Yeboah C, Mosore MT, Bentil RE, Coatsworth HG, Attram N, Nimo-Paintsil S, Fox AT, Bonney JHK, Ampofo W, Dinglasan RR, Sanders T, Wiley MR, Demanou M, Letizia AG. Whole genome sequencing of outbreak strains from 2017 to 2018 reveals an endemic clade of dengue 1 virus in Cameroon. Emerg Microbes Infect 2023; 12:2281352. [PMID: 37933502 PMCID: PMC10732222 DOI: 10.1080/22221751.2023.2281352] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/23/2023] [Accepted: 11/04/2023] [Indexed: 11/08/2023]
Abstract
Dengue fever is expanding as a global public health threat including countries within Africa. For the past few decades, Cameroon has experienced sporadic cases of arboviral infections including dengue fever. Here, we conducted genomic analyses to investigate the origin and phylogenetic profile of Cameroon DENV-1 outbreak strains and predict the impact of emerging therapeutics on these strains. Bayesian and maximum-likelihood phylogenetic inference approaches were employed in virus evolutionary analyses. An in silico analysis was performed to assess the divergence in immunotherapeutic and vaccine targets in the new genomes. Six complete DENV-1 genomes were generated from 50 samples that met a clinical definition for DENV infection. Phylogenetic analyses revealed that the strains from the current study belong to a sub-lineage of DENV-1 genotype V and form a monophyletic taxon with a 2012 strain from Gabon. The most recent common ancestor (TMRCA) of the Cameroon and Gabon strains was estimated to have existed around 2008. Comparing our sequences to the vaccine strains, 19 and 15 amino acid (aa) substitutions were observed in the immuno-protective prM-E protein segments of the Dengvaxia® and TetraVax-DV-TV003 vaccines, respectively. Epitope mapping revealed mismatches in aa residues at positions E155 and E161 located in the epitope of the human anti-DENV-1 monoclonal antibody HMAb 1F4. The new DENV strains constitute a conserved genomic pool of viruses endemic to the Central African region that needs prospective monitoring to track local viral evolution. Further work is needed to ascertain the performance of emerging therapeutics in DENV strains from the African region.
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Affiliation(s)
- Bright Agbodzi
- U.S. Naval Medical Research Unit EURAFCENT, Accra, Ghana
| | | | | | | | - Clara Yeboah
- U.S. Naval Medical Research Unit EURAFCENT, Accra, Ghana
| | | | | | - Heather G. Coatsworth
- Department of Infectious Diseases & Immunology and Emerging Pathogens Institute, College of Veterinary Medicine, University of Florida, Gainesville, Florida, USA
| | - Naiki Attram
- U.S. Naval Medical Research Unit EURAFCENT, Accra, Ghana
| | | | - Anne T. Fox
- U.S. Naval Medical Research Unit EURAFCENT, Accra, Ghana
| | - Joseph H. K. Bonney
- Virology Department, Noguchi Memorial Institute for Medical Research, University of Ghana, Accra, Ghana
| | - William Ampofo
- Virology Department, Noguchi Memorial Institute for Medical Research, University of Ghana, Accra, Ghana
| | - Rhoel R. Dinglasan
- Department of Infectious Diseases & Immunology and Emerging Pathogens Institute, College of Veterinary Medicine, University of Florida, Gainesville, Florida, USA
| | - Terrel Sanders
- U.S. Naval Medical Research Unit EURAFCENT, Accra, Ghana
| | - Michael R. Wiley
- Department of Pathology and Microbiology, University of Nebraska Medical Center, Omaha, NE, USA
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Bonnet M, Vasiliu A, Tchounga BK, Cuer B, Fielding K, Ssekyanzi B, Tchakounte Youngui B, Cohn J, Dodd PJ, Tiendrebeogo G, Tchendjou P, Simo L, Okello RF, Kuate Kuate A, Turyahabwe S, Atwine D, Graham SM, Casenghi M. Effectiveness of a community-based approach for the investigation and management of children with household tuberculosis contact in Cameroon and Uganda: a cluster-randomised trial. Lancet Glob Health 2023; 11:e1911-e1921. [PMID: 37918417 DOI: 10.1016/s2214-109x(23)00430-8] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/13/2023] [Revised: 08/22/2023] [Accepted: 09/01/2023] [Indexed: 11/04/2023]
Abstract
BACKGROUND Globally, the uptake of tuberculosis-preventive treatment (TPT) among children with household tuberculosis contact remains low, partly due to the necessity of bringing children to health facilities for investigations. This study aimed to evaluate the effect on TPT initiation and completion of community-based approaches to tuberculosis contact investigations in Cameroon and Uganda. METHODS We did a parallel, cluster-randomised, controlled trial across 20 clusters (consisting of 25 district hospitals and primary health centres) in Cameroon and Uganda, which were randomised (1:1) to receive a community-based approach (intervention group) or standard-of-care facility-based approach to contact screening and management (control group). The community-based approach consisted of symptom-based tuberculosis screening of all household contacts by community health workers at the household, with referral of symptomatic contacts to local facilities for investigations. Initiation of TPT (3-month course of rifampicin-isoniazid) was done by a nurse in the household, and home visits for TPT follow-up were done by community health workers. Index patients were people aged 15 years or older with bacteriologically confirmed, drug-susceptible, pulmonary tuberculosis diagnosed less than 1 month before inclusion and who declared at least one child or young adolescent (aged 0-14 years) household contact. The primary endpoint was the proportion of declared child contacts in the TPT target group (those aged <5 years irrespective of HIV status, and children aged 5-14 years living with HIV) who commenced and completed TPT, assessed in the modified intention-to-treat population (excluding enrolled index patients and their contacts who did not fit the eligibility criteria). Descriptive cascade of care assessment and generalised linear mixed modelling were used for comparison. This study is registered with ClinicalTrials.gov (NCT03832023). FINDINGS The study included nine clusters in the intervention group (after excluding one cluster that did not enrol any index patients for >2 months) and ten in the control group. Between Oct 14, 2019 and Jan 13, 2022, 2894 child contacts were declared by 899 index patients with bacteriologically confirmed tuberculosis. Among all child contacts declared, 1548 (81·9%) of 1889 in the intervention group and 475 (47·3%) of 1005 in the control group were screened for tuberculosis. 1400 (48·4%) child contacts were considered to be in the TPT target group: 941 (49·8%) of 1889 in the intervention group and 459 (45·7%) of 1005 in the control group. In the TPT target group, TPT was commenced and completed in 752 (79·9%) of 941 child contacts in the intervention group and 283 (61·7%) of 459 in the control group (odds ratio 3·06 [95% CI 1·24-7·53]). INTERPRETATION A community-based approach using community health workers can significantly increase contact investigation coverage and TPT completion among eligible child contacts in a tuberculosis-endemic setting. FUNDING Unitaid. TRANSLATION For the French translation of the abstract see Supplementary Materials section.
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Affiliation(s)
- Maryline Bonnet
- TransVIHMI, University Montpellier, Institut de Recherche pour le Développement, INSERM, Montpellier, France.
| | - Anca Vasiliu
- TransVIHMI, University Montpellier, Institut de Recherche pour le Développement, INSERM, Montpellier, France; Department of Pediatrics, Baylor College of Medicine, Houston, TX, USA
| | | | - Benjamin Cuer
- TransVIHMI, University Montpellier, Institut de Recherche pour le Développement, INSERM, Montpellier, France
| | | | | | | | - Jennifer Cohn
- Department of Innovation and New Technology, Elizabeth Glaser Pediatric AIDS Foundation, Geneva, Switzerland
| | - Peter J Dodd
- School of Health and Related Research, University of Sheffield, Sheffield, UK
| | - Georges Tiendrebeogo
- University Montpellier, Institut de Recherche pour le Développement, INSERM, Montpellier, France
| | | | - Leonie Simo
- Elizabeth Glaser Pediatric AIDS Foundation, Yaoundé, Cameroon
| | | | | | | | - Daniel Atwine
- Clinical Research Department, Epicentre Mbarara Research Centre, Mbarara, Uganda
| | - Stephen M Graham
- Royal Children's Hospital, University of Melbourne Department of Paediatrics and Murdoch Children's Research Institute, Melbourne, Australia; International Union Against Tuberculosis and Lung Disease, Paris, France
| | - Martina Casenghi
- Department of Innovation and New Technology, Elizabeth Glaser Pediatric AIDS Foundation, Geneva, Switzerland
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Siewe N, Yakubu AA. Unequal effects of SARS-CoV-2 infections: model of SARS-CoV-2 dynamics in Cameroon (Sub-Saharan Africa) versus New York State (United States). J Biol Dyn 2023; 17:2246496. [PMID: 37598351 DOI: 10.1080/17513758.2023.2246496] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 06/27/2022] [Accepted: 08/05/2023] [Indexed: 08/22/2023]
Abstract
Worldwide, the recent SARS-CoV-2 virus disease outbreak has infected more than 691,000,000 people and killed more than 6,900,000. Surprisingly, Sub-Saharan Africa has suffered the least from the SARS-CoV-2 pandemic. Factors that are inherent to developing countries and that contrast with their counterparts in developed countries have been associated with these disease burden differences. In this paper, we developed data-driven COVID-19 mathematical models of two 'extreme': Cameroon, a developing country, and New York State (NYS) located in a developed country. We then identified critical parameters that could be used to explain the lower-than-expected COVID-19 disease burden in Cameroon versus NYS and to help mitigate future major disease outbreaks. Through the introduction of a 'disease burden' function, we found that COVID-19 could have been much more severe in Cameroon than in NYS if the vaccination rate had remained very low in Cameroon and the pandemic had not ended.
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Affiliation(s)
- Nourridine Siewe
- School of Mathematical Sciences, College of Science, Rochester Institute of Technology, Rochester, NY, USA
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Tanih NF, Belinga KI, Nyasa R, Tanih GN, Cho JF, Samie A, Njunda AL. CO-INFECTION WITH MALARIA AND INTESTINAL PARASITES AND ITS ASSOCIATION WITH ANEMIA IN CHILDREN (ZERO TO TEN YEARS OLD) IN TIKO SUBDIVISION, CAMEROON. J Parasitol 2023; 109:615-621. [PMID: 38151048 DOI: 10.1645/23-48] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/29/2023] Open
Abstract
Concomitant infections with malaria and intestinal parasitic infections may be associated with anemia in children (0-10 yr). This study determined the prevalence of co-infection with malaria and intestinal parasitic infections and determined its association with anemia in children (0-10 yr) in Tiko, Cameroon. A hospital-based cross-sectional study was carried out whereby venous blood and stool samples were collected from 377 febrile children. Blood was used to perform a full blood count. Thick and thin blood films were prepared and stained with Giemsa for malaria parasite diagnosis. The formol ether concentration technique was used to analyze the stools. Pearson's chi-square test, Student's t-test, and other statistical analyses were performed. Of the 377 participants, 139 (36.9%) were positive for malaria, 21 (5.6%) had intestinal helminths, 8 (2%) had co-infection, and 79 (21.0%) were anemic. Malaria and anemia were prevalent among the children and were significantly associated (P = 0.025). There was no statistically significant difference (P > 0.05) among age groups. Girls were more often infected with malaria (69, 37.3%), and boys were more often infected with intestinal parasites (13, 7.0%), but there was no statistical association for both malaria and intestinal parasitic infections (IPIs) for both sexes (P > 0.05). Hookworms, Ascaris lumbricoides, and Trichuris trichiura were the intestinal parasites found in this study. There was a significant association between anemia and parasitic co-infection in children (P = 0.003). Malaria and IPIs are prevalent in the Tiko municipality. They play a great role in anemia especially when there is a co-infection. Public education and awareness campaigns are necessary in this municipality.
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Affiliation(s)
- Nicoline Fri Tanih
- Department of Medical Laboratory Sciences, Faculty of Health Sciences, University of Buea, Box 63, Cameroon
| | - Kemba Iya Belinga
- Department of Medical Laboratory Sciences, Faculty of Health Sciences, University of Buea, Box 63, Cameroon
| | - Raymond Nyasa
- Department of Microbiology and Parasitology, Faculty of Science, University of Buea, Box 63, Cameroon
| | - Godfred Ngu Tanih
- Department of Biotechnology and Food Technology, Faculty of Science, University of Johannesburg, Private Bag 2028, Johannesburg, South Africa
| | - Jerome Fru Cho
- Department of Microbiology and Parasitology, Faculty of Science, University of Buea, Box 63, Cameroon
| | - Amidou Samie
- Department of Biochemistry and Microbiology, University of Venda, Private Bag X5050 Thohoyandou, South Africa
| | - Anna Longdoh Njunda
- Department of Medical Laboratory Sciences, Faculty of Health Sciences, University of Buea, Box 63, Cameroon
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Dimani BD, Founou RC, Zemtsa JR, Mbossi A, Koudoum PL, Founou LL, Kouanfack C, Sone LHE. Faecal carriage of multidrug-resistant and extended-spectrum β-lactamase-producing Enterobacterales in people living with HIV in Yaoundé, Cameroon. J Glob Antimicrob Resist 2023; 35:26-34. [PMID: 37553020 DOI: 10.1016/j.jgar.2023.07.021] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/04/2022] [Revised: 06/22/2023] [Accepted: 07/27/2023] [Indexed: 08/10/2023] Open
Abstract
OBJECTIVES Antibiotic resistance (AR) is a global health issue with multidimensional repercussions. There is a paucity of data regarding the molecular epidemiology of multidrug-resistant Enterobacterales (MDR-E) and extended-spectrum ß-lactamase-producing Enterobacterales (ESBL-PE) in Africa, especially among people living with HIV (PLHIV). This study aimed at determining the prevalence, risk factors, phenotypic and genotypic profiles of MDR-E and ESBL-PE isolated from PLHIV in Yaoundé, Cameroon. METHODS In total, samples were collected from 185 PLHIV during a three-month period (April-June 2021) at the Yaoundé Central Hospital. Stool samples and rectal swabs were collected and cultured on MacConkey agar. The API 20E kit was used for the phenotypic identification of the isolates, whereas antibiotic susceptibility testing was performed using the Kirby-Bauer disk diffusion method. The ß-lactamase genes and genotypic relatedness were studied by PCR and ERIC-PCR, respectively. RESULTS The prevalence of MDR-E among PLHIV was 81%, of which 39% were ESBL-PE. A high level of resistance to fosfomycin (89%), chloramphenicol (63%), and gentamicin (56%) was observed. Escherichia coli was the predominant MDR non-ESBL-PE (80.8%) and MDR ESBL-PE (73.77%). The principal ß-lactamases genes in MDR non-ESBL and MDR ESBL-PE were blaTEM (62.90%) and blaCTX-M (40.86%), respectively. Genetic fingerprinting revealed high genetic relatedness among E. coli isolates. CONCLUSION This study shows a high prevalence of MDR-E and ESBL-PE in the gut of PLHIV in Yaoundé, with blaTEM and blaCTX-M being the most prevalent. It demonstrates the need to strengthen real-time surveillance of these resistant bacteria in order to improve management of infection among PLHIV.
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Affiliation(s)
- Brice Davy Dimani
- Department of Biomedical Sciences, Higher Institute of Medical Technology, Yaoundé, Cameroon; Antimicrobial Resistance and Infectious Diseases (ARID) Research Unit, Research Institute of Centre of Expertise and Biological Diagnostic of Cameroon (CEDBCAM-RI), Yaoundé, Cameroon.
| | - Raspail Carrel Founou
- Antimicrobial Resistance and Infectious Diseases (ARID) Research Unit, Research Institute of Centre of Expertise and Biological Diagnostic of Cameroon (CEDBCAM-RI), Yaoundé, Cameroon; Department of Microbiology-Haematology and Immunology, Faculty of Medicine and Pharmaceutical Sciences, University of Dschang, Dschang, Cameroon; Antimicrobial Research Unit, College of Health Sciences, University of Kwazulu-Natal, Durban, South Africa
| | - Jessica Ravalona Zemtsa
- Reproductive, Maternal, Newborn, and Child Health (ReMARCH) Research Unit, Research Institute of Centre of Expertise and Biological Diagnostic of Cameroon (CEDBCAM-RI), Yaoundé, Cameroon
| | - Aurélia Mbossi
- Reproductive, Maternal, Newborn, and Child Health (ReMARCH) Research Unit, Research Institute of Centre of Expertise and Biological Diagnostic of Cameroon (CEDBCAM-RI), Yaoundé, Cameroon
| | - Patrice Landry Koudoum
- Antimicrobial Resistance and Infectious Diseases (ARID) Research Unit, Research Institute of Centre of Expertise and Biological Diagnostic of Cameroon (CEDBCAM-RI), Yaoundé, Cameroon
| | - Luria Leslie Founou
- Department of Biomedical Sciences, Higher Institute of Medical Technology, Yaoundé, Cameroon; Antimicrobial Research Unit, College of Health Sciences, University of Kwazulu-Natal, Durban, South Africa; Reproductive, Maternal, Newborn, and Child Health (ReMARCH) Research Unit, Research Institute of Centre of Expertise and Biological Diagnostic of Cameroon (CEDBCAM-RI), Yaoundé, Cameroon; Bioinformatics and Applied Machine Learning Research Unit, EDEN Biosciences Research Institute (EBRI), EDEN Foundation, Yaoundé, Cameroon
| | - Charles Kouanfack
- Faculty of Medicine and Pharmaceutical Sciences, Department of Public Health, University of Dschang, Dschang, Cameroon; Yaoundé Central Hospital, Yaoundé, Cameroon
| | - Lucien Honoré Etame Sone
- Department of Biomedical Sciences, Higher Institute of Medical Technology, Yaoundé, Cameroon; Institute of Medical Research and Medicinal Plant Studies, Ministry of Scientific Research and Innovation, Yaoundé, Cameroon
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Djiyou ABD, Penda CI, Madec Y, Ngondi GD, Moukoko A, Eboumbou CE, Aghokeng AF. Prevalence of HIV drug resistance among adolescents receiving ART in Cameroon with low- or high-level viraemia. J Antimicrob Chemother 2023; 78:2938-2942. [PMID: 37921335 DOI: 10.1093/jac/dkad334] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/03/2023] [Accepted: 10/11/2023] [Indexed: 11/04/2023] Open
Abstract
OBJECTIVES To characterize HIV drug resistance (HIVDR) below and above the WHO threshold of 1000 copies/mL, considered for the definition of HIV ART failure in resource-limited settings. METHODS From a cohort of 280 adolescents (aged 10-19 years) receiving ART for at least 6 months, genotypic resistance testing (GRT) was attempted for two groups of participants: participants with low-level viraemia [LLV; viral load (VL) 200-999 copies/mL] and those in virological failure (VF; confirmed VL ≥1000 copies/mL) using an in-house method. The Stanford HIValg Program was used to identify relevant HIVDR mutations and predict the efficacy of the newly introduced tenofovir-lamivudine-dolutegravir combination. RESULTS GRT was successfully performed in 54/58 (93.1%) eligible participants, of which 28/31 (90.3%) were in VF and 26/27 (96.3%) had LLV. A high level of resistance was found both in adolescents with LLV and those in VF, with respectively 84.6% (22/26) and 75.0% (21/28) of participants harbouring at least one HIVDR mutation. NRTIs and NNRTIs were the most affected drug classes in both population groups. In contrast, PIs were not significantly affected and dolutegravir was expected to be active for all participants tested. However, for the newly introduced dolutegravir-based combination, functional monotherapy (dolutegravir only) was potentially possible for 22.7% (5/22) of the participants with LLV. CONCLUSIONS Our findings show that the 1000 copies/mL threshold is not an indicator of virological success and we call for a revision of the current WHO definition of VF in resource-limited countries.
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Affiliation(s)
- Armando B D Djiyou
- Department of Biological Sciences, Faculty of Medicine and Pharmaceutical Sciences, University of Douala, Douala, Cameroon
- MIVEGEC, Université de Montpellier, CNRS, IRD, Montpellier, France
| | - Calixte I Penda
- Department of Clinical Sciences, Faculty of Medicine and Pharmaceutical Sciences, University of Douala, Douala, Cameroon
- Department of Pediatrics and Child Health, General Hospital of Douala, Douala, Cameroon
| | - Yoann Madec
- Institut Pasteur, Université de Paris, Epidemiology of Emerging Diseases, F-75015 Paris, France
| | - Grace D Ngondi
- Department of Virology, Hôpital Laquintinie, Douala, Cameroon
| | - Astrid Moukoko
- Department of Virology, Hôpital Laquintinie, Douala, Cameroon
| | - Carole E Eboumbou
- Department of Biological Sciences, Faculty of Medicine and Pharmaceutical Sciences, University of Douala, Douala, Cameroon
- Department of Parasitology, Centre Pasteur du Cameroun, Yaoundé, Cameroon
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Mafirakureva N, Tchounga BK, Mukherjee S, Youngui BT, Ssekyanzi B, Simo L, Okello RF, Turyahabwe S, Kuate Kuate A, Cohn J, Vasiliu A, Casenghi M, Atwine D, Bonnet M, Dodd PJ. Cost-effectiveness of community-based household tuberculosis contact management for children in Cameroon and Uganda: a modelling analysis of a cluster-randomised trial. Lancet Glob Health 2023; 11:e1922-e1930. [PMID: 37918416 DOI: 10.1016/s2214-109x(23)00451-5] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/14/2023] [Revised: 08/22/2023] [Accepted: 09/12/2023] [Indexed: 11/04/2023]
Abstract
BACKGROUND WHO recommends household contact management (HCM) including contact screening and tuberculosis-preventive treatment (TPT) for eligible children. The CONTACT trial found increased TPT initiation and completion rates when community health workers were used for HCM in Cameroon and Uganda. METHODS We did a cost-utility analysis of the CONTACT trial using a health-system perspective to estimate the health impact, health-system costs, and cost-effectiveness of community-based versus facility-based HCM models of care. A decision-analytical modelling approach was used to evaluate the cost-effectiveness of the intervention compared with the standard of care using trial data on cascade of care, intervention effects, and resource use. Health outcomes were based on modelled progression to tuberculosis, mortality, and discounted disability-adjusted life-years (DALYs) averted. Health-care resource use, outcomes, costs (2021 US$), and cost-effectiveness are presented. FINDINGS For every 1000 index patients diagnosed with tuberculosis, the intervention increased the number of TPT courses by 1110 (95% uncertainty interval 894 to 1227) in Cameroon and by 1078 (796 to 1220) in Uganda compared with the control model. The intervention prevented 15 (-3 to 49) tuberculosis deaths in Cameroon and 10 (-20 to 33) in Uganda. The incremental cost-effectiveness ratio was $620 per DALY averted in Cameroon and $970 per DALY averted in Uganda. INTERPRETATION Community-based HCM approaches can substantially reduce child tuberculosis deaths and in our case would be considered cost-effective at willingness-to-pay thresholds of $1000 per DALY averted. Their impact and cost-effectiveness are likely to be greatest where baseline HCM coverage is lowest. FUNDING Unitaid and UK Medical Research Council.
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Affiliation(s)
| | | | | | | | | | - Leonie Simo
- Elizabeth Glaser Pediatric AIDS Foundation, Yaounde, Cameroon
| | | | - Stavia Turyahabwe
- National Tuberculosis and Leprosy Program, Ministry of Health, Kampala, Uganda
| | - Albert Kuate Kuate
- National Tuberculosis Control Program, Ministry of Health, Yaounde, Cameroon
| | - Jennifer Cohn
- Perelman School of Medicine at the University of Pennsylvania, Philadelphia, PA, USA
| | - Anca Vasiliu
- Baylor College of Medicine, Department of Pediatrics, Global TB Program, Houston, TX, USA; University Montpellier, TransVIHMI, IRD, Inserm, Montpellier, France
| | | | - Daniel Atwine
- Epicentre, Mbarara, Uganda; Mbarara University of Science and Technology, Mbarara, Uganda
| | - Maryline Bonnet
- University Montpellier, TransVIHMI, IRD, Inserm, Montpellier, France
| | - Peter J Dodd
- Health Economics and Decision Science, University of Sheffield, Sheffield, UK
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Sephton-Clark P, Temfack E, Tenor JL, Toffaletti DL, Loyse A, Molloy SF, Perfect JR, Bicanic T, Harrison TS, Lortholary O, Kouanfack C, Cuomo CA. Genetic diversity and microevolution in clinical Cryptococcus isolates from Cameroon. Med Mycol 2023; 61:myad116. [PMID: 37952096 PMCID: PMC10709296 DOI: 10.1093/mmy/myad116] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/22/2023] [Revised: 11/03/2023] [Accepted: 11/09/2023] [Indexed: 11/14/2023] Open
Abstract
Cryptococcal meningitis is the second most common cause of death in people living with HIV/AIDS, yet we have a limited understanding of how cryptococcal isolates change over the course of infection. Cryptococcal infections are environmentally acquired, and the genetic diversity of these infecting isolates can also be geographically linked. Here, we employ whole genome sequences for 372 clinical Cryptococcus isolates from 341 patients with HIV-associated cryptococcal meningitis obtained via a large clinical trial, across both Malawi and Cameroon, to enable population genetic comparisons of isolates between countries. We see that isolates from Cameroon are highly clonal, when compared to those from Malawi, with differential rates of disruptive variants in genes with roles in DNA binding and energy use. For a subset of patients (22) from Cameroon, we leverage longitudinal sampling, with samples taken at days 7 and 14 post-enrollment, to interrogate the genetic changes that arise over the course of infection, and the genetic diversity of isolates within patients. We see disruptive variants arising over the course of infection in several genes, including the phagocytosis-regulating transcription factor GAT204. In addition, in 13% of patients sampled longitudinally, we see evidence for mixed infections. This approach identifies geographically linked genetic variation, signatures of microevolution, and evidence for mixed infections across a clinical cohort of patients affected by cryptococcal meningitis in Central Africa.
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Affiliation(s)
- Poppy Sephton-Clark
- Infectious Disease and Microbiome Program, Broad Institute of MIT and Harvard, Cambridge, Massachusetts, USA
| | - Elvis Temfack
- Internal Medicine Unit, Douala General Hospital, Douala, Cameroon
- Institut Pasteur, Molecular Mycology Unit, CNRS UMR 2000, Paris, France
| | - Jennifer L Tenor
- Division of Infectious Diseases, Department of Medicine, Duke University School of Medicine, Durham, North Carolina, USA
| | - Dena L Toffaletti
- Division of Infectious Diseases, Department of Medicine, Duke University School of Medicine, Durham, North Carolina, USA
| | - Angela Loyse
- Institute of Infection and Immunity, St George's University of London, London, UK
- Clinical Academic Group in Infection, St George's University Hospital, London, UK
| | - Síle F Molloy
- Institute of Infection and Immunity, St George's University of London, London, UK
| | - John R Perfect
- Division of Infectious Diseases, Department of Medicine, Duke University School of Medicine, Durham, North Carolina, USA
| | - Tihana Bicanic
- Institute of Infection and Immunity, St George's University of London, London, UK
- Clinical Academic Group in Infection, St George's University Hospital, London, UK
| | - Thomas S Harrison
- Institute of Infection and Immunity, St George's University of London, London, UK
- MRC Centre for Medical Mycology, University of Exeter, Exeter, UK
| | - Olivier Lortholary
- Department of Infectious Diseases and Tropical Medicine, Paris Cité University, Necker-Enfants Malades Hospital, AP-HP, IHU Imagine, Paris, France
- Mycology Department and National Reference Center for Invasive Mycoses and Antifungals, Institut Pasteur, Paris, France
| | - Charles Kouanfack
- Department of Public Health, Faculty of Medicine and Pharmaceutical Sciences, University of Dschang, Dschang, Cameroon
- Day Hospital, Hospital Central Yaoundé, Yaoundé, Cameroon
- Research Center for Emerging and Re-emerging Diseases, Cameroon Baptist Convention Health Services (CBCHS), Yaoundé, Cameroon
| | - Christina A Cuomo
- Infectious Disease and Microbiome Program, Broad Institute of MIT and Harvard, Cambridge, Massachusetts, USA
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Ndzomo P, Tchatchouang S, Njih Tabah E, Njamnshi T, Tsanga MVN, Bondi JA, Handley R, González Beiras C, Tchatchueng J, Müller C, Lüert S, Knauf S, Boyomo O, Harding-Esch E, Mitja O, Crucitti T, Marks M, Eyangoh S. Prevalence and risk factors associated with Haemophilus ducreyi cutaneous ulcers in Cameroon. PLoS Negl Trop Dis 2023; 17:e0011553. [PMID: 38150487 PMCID: PMC10791135 DOI: 10.1371/journal.pntd.0011553] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/27/2023] [Revised: 01/09/2024] [Accepted: 12/15/2023] [Indexed: 12/29/2023] Open
Abstract
Epidemics of yaws-like cutaneous ulcers are regularly documented in children in the tropics. They occur mainly in poor and remote communities without access to health facilities. The integration of molecular tools into yaws control efforts has made it possible to describe Haemophilus ducreyi (HD) as a major cause of cutaneous ulcers. The objective of this study was to determine the prevalence of HD as cause of cutaneous ulcers, investigate its presence in asymptomatic individuals and identify associated risk factors. A cross-sectional study was conducted in yaws endemic districts of Cameroon. Participants included people presenting yaws-like ulcers and asymptomatic individuals. Swab samples were collected from each participant and tested for HD and Treponema pallidum (TP) using an established qPCR method. Additionally, demographic, habitat, proximity, and hygiene characteristics were collected using a structured questionnaire. A total of 443 individuals participated in the study, including 271 ulcer cases and 172 asymptomatic contacts. The prevalence of HD in ulcers was 30.3% (Confidence Interval (CI) 95% [24.8-35.7]) and the prevalence of asymptomatic HD carriage was 8.6% (CI95% [4.5-12.9]). TP was also detected in our sample among ulcer cases but in lower proportion (5.2% CI95% [2.5-7.8]) compared to HD. The adjusted logistic regression model showed that women were as much at risk of having HD cutaneous ulcer as men regardless of age. Physical proximity to a confirmed ulcer case was the major factor identified favouring HD transmission. HD ulcers were more likely to be present on Bantu individuals compared to Baka as well as HD colonization. These findings highlight HD as the most common cause of cutaneous ulcers in yaws-endemic communities in Cameroon. The exact implications of detecting HD on intact skin are not yet clear. Further studies are needed to understand the significance of this carriage in the spread dynamics of the disease.
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Affiliation(s)
- Philippe Ndzomo
- Centre Pasteur du Cameroun, Yaounde, Cameroon
- Department of Microbiology, Faculty of Science, University of Yaounde 1, Yaounde, Cameroon
| | | | - Earnest Njih Tabah
- National Yaws, Leishmaniasis, Leprosy and Buruli ulcer Control Programme, Ministry of Public Health, Yaounde, Cameroon
- Department of Public Health, Faculty of Medicine and Pharmaceutical Sciences, University of Dschang, Dschang, West Cameroon
| | - Theophilus Njamnshi
- National Yaws, Leishmaniasis, Leprosy and Buruli ulcer Control Programme, Ministry of Public Health, Yaounde, Cameroon
- Department of Medical Laboratory Sciences, Faculty of Health Sciences, University of Buea, Buea, Cameroon
| | | | | | - Rebecca Handley
- Clinical Research Department, Faculty of Infectious and Tropical Diseases, London School of Hygiene and Tropical Medicine, London, United Kingdom
| | - Camila González Beiras
- Department of Infectious Diseases, Hospital Universitari Germans Trias i Pujol, Badalona, Spain
| | | | - Claudia Müller
- Institute of International Animal Health/One Health, Friedrich-Loeffler-Institut, Federal Research Institute for Animal Health, Greifswald—Insel Riems, Germany
| | - Simone Lüert
- Institute of International Animal Health/One Health, Friedrich-Loeffler-Institut, Federal Research Institute for Animal Health, Greifswald—Insel Riems, Germany
| | - Sascha Knauf
- Institute of International Animal Health/One Health, Friedrich-Loeffler-Institut, Federal Research Institute for Animal Health, Greifswald—Insel Riems, Germany
| | - Onana Boyomo
- Department of Microbiology, Faculty of Science, University of Yaounde 1, Yaounde, Cameroon
| | - Emma Harding-Esch
- Clinical Research Department, Faculty of Infectious and Tropical Diseases, London School of Hygiene and Tropical Medicine, London, United Kingdom
| | - Oriol Mitja
- Department of Infectious Diseases, Hospital Universitari Germans Trias i Pujol, Badalona, Spain
| | - Tania Crucitti
- Experimental Bacteriology Unit, Institut Pasteur de Madagascar, Antananarivo, Madagascar
| | - Michael Marks
- Clinical Research Department, Faculty of Infectious and Tropical Diseases, London School of Hygiene and Tropical Medicine, London, United Kingdom
- Hospital for Tropical Diseases, University College London Hospital, London, United Kingdom
- Division of Infection and Immunity, University College London, London, United Kingdom
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46
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Ajong AB, Yakum MN, Aljerf L, Ali IM, Mangala FN, Onydinma UP, Liwo BM, Bekolo CE, Tameh TY, Kenfack B, Telefo PB. Association of hypertension in pregnancy with serum electrolyte disorders in late pregnancy among Cameroonian women. Sci Rep 2023; 13:20940. [PMID: 38017060 PMCID: PMC10684507 DOI: 10.1038/s41598-023-47623-6] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/12/2023] [Accepted: 11/16/2023] [Indexed: 11/30/2023] Open
Abstract
Multiple electrolyte disorders, including sodium, potassium and calcium disorders, have been associated with hypertension in pregnancy. Most of these studies failed to evaluate the combined effect of low and high sodium, potassium, calcium and chloride ion concentrations on hypertension in pregnancy. This study evaluates the combined effect of these ion categories (low, normal, high) on hypertension in pregnancy. Biochemical ion assays and blood pressure measurements were carried out on 1074 apparently healthy pregnant women in late third trimester. Serum potassium, sodium, chloride, and ionised calcium were measured by ion-selective electrode potentiometry, while total plasma calcium was measured by absorption spectrophotometry. Hypertension in pregnancy was defined as systolic blood pressure ≥ 140 mmHg and/or diastolic blood pressure ≥ 90 mmHg. The prevalence of hyponatraemia, hypokalaemia, hypochloraemia, ionised hypocalcaemia and total hypocalcaemia in late pregnancy was 1.30 [0.78-2.18]%, 3.55 [2.60-4.84]%, 1.96 [1.28-2.97]%, 1.49 [0.92-2.21]% and 43.58 [40.64-46.56]%, respectively. Hypernatraemia, hyperkalaemia, hyperchloraemia, ionised hypercalcaemia and total hypercalcaemia were found in 1.49 [0.92-2.41]%, 2.34 [1.59-3.43]%, 4.38 [3.31-5.77]%, 39.94 [37.06-42.90]%, 2.79 [1.96-3.96]% of the participants, respectively. The prevalence of hypertension in pregnancy was 7.17 [5.77-8.87]%. When ion categories were considered in multiple logistic regression, only ionised and total calcium had significant associations with hypertension in pregnancy. Women with ionised hypercalcaemia had lower odds of hypertension in pregnancy (AOR = 0.50 [0.29-0.87], p-value = 0.015), and women with total hypocalcaemia had higher odds of hypertension in pregnancy (AOR = 1.99 [1.21-3.29], p-value = 0.007), compared to women with ionised and total normocalcaemia, respectively. Increasing kalaemia was associated significantly with higher odds of hypertension in pregnancy; however, kalaemia below and above the normal concentrations had no significant association with hypertension. Nonetheless, participants with kalaemia ≤ 3.98 mmol/L, had lower odds of hypertension in pregnancy compared with those with higher kalaemia (OR = 0.40 [0.24-0.66], p-value = 0.0003). Calcium disorders remain the most frequent electrolyte disorders in pregnancy. When normal cut-offs are considered for calcium and other ions, only ionised and total calcium influence the occurrence of hypertension in pregnancy. Kalaemia seems to affect hypertension in pregnancy but primarily within its normal concentrations. Serum electrolyte follow-up is indispensable for a proper pregnancy follow-up.
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Affiliation(s)
- Atem Bethel Ajong
- Kekem District Hospital, Kekem, West Region, Cameroon.
- Department of Biochemistry, University of Dschang, Dschang, West Region, Cameroon.
| | - Martin Ndinakie Yakum
- Department of Epidemiology and Biostatistics, School of Medical and Health Sciences, Kesmonds International University, Mile 3 Nkwen, Bamenda, Cameroon
| | - Loai Aljerf
- Department of Basic Sciences, Faculty of Dentistry, Damascus University, Damascus, Syria
- Key Laboratory of Organic Industries, Department of Chemistry, Faculty of Sciences, Damascus University, Damascus, Syria
| | - Innocent Mbulli Ali
- Department of Biochemistry, University of Dschang, Dschang, West Region, Cameroon
| | | | | | - Blaise Mbuomboh Liwo
- Department of Biochemistry, University of Dschang, Dschang, West Region, Cameroon
| | - Cavin Epie Bekolo
- Department of Public Health, Faculty of Medicine and Pharmaceutical Sciences, University of Dschang, Dschang, West Region, Cameroon
| | - Theodore Yangsi Tameh
- Faculty of Health Sciences, University of Bamenda, Bamenda, North West Region, Cameroon
| | - Bruno Kenfack
- Department of Obstetrics/Gynaecology and Maternal Health, Faculty of Medicine and Pharmaceutical Sciences, University of Dschang, Dschang, West Region, Cameroon
| | - Phelix Bruno Telefo
- Department of Biochemistry, University of Dschang, Dschang, West Region, Cameroon
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Sama LF, Sadjeu S, Tchouangueu TF, Dabou S, Kuh GF, Ngouateu OB, Noubom M. Diabetes Mellitus and HIV Infection among Newly Diagnosed Pulmonary Tuberculosis Patients in the North West Region of Cameroon: A Cross-Sectional Study. Int J Clin Pract 2023; 2023:5998727. [PMID: 38045656 PMCID: PMC10691891 DOI: 10.1155/2023/5998727] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/23/2023] [Revised: 07/21/2023] [Accepted: 09/07/2023] [Indexed: 12/05/2023] Open
Abstract
Objective To determine the prevalence rate of HIV and diabetes among tuberculosis (TB) patients and also the comorbidity rate. Design Cross-sectional study. Setting. This study was carried out at the Tuberculosis Reference Laboratory, Regional Hospital Bamenda, North West Region of Cameroon, from January 2017 to December 2019. Participants. 1115 cases of pulmonary tuberculosis aged ≥14 years (mean 42.5 ± 15.28 years). Methods Sputum samples collected were acid-fast stained and examined macroscopically as well as inoculated for culture. A chest X-ray was performed for further confirmation of TB diagnosis. After the TB diagnosis was done, fasting blood glucose, 2 h-PG test, HbA1c, and biochemical enzymatic tests were performed for the diagnosis of diabetes. Rapid strip test and enzyme-linked immunosorbent assay were used to diagnose HIV infection. Interventions. No intervention was done during the period of study. Outcome Measures. The prevalence of TB/HIV and TB/HIV/DM, signs and symptoms, imaging results, and bacteriology status among TB/HIV, TB/HIV/DM coinfected, and comorbidity cases. Results Of 1115 participants, 38.57% had TB/HIV, and 5.83% had TB/HIV/DM. Among TB/HIV/DM cases, 20.39% had a cough for more than 2 weeks [p < 0.0001; OR (95%CI): 4.866 (3.170-7.404)], and 35.71% had a fever for at least 2 weeks [p < 0.0001; OR (95%CI): 7.824 (5.336-11.36)]. The majority of TB/HIV/DM patients (77.42%) had chest pain for at least 2 weeks [p < 0.0001; OR (95%CI): 114.3 (59.78-207.1)]. 7.41%, 14.18%, and 9.09% of TB/HIV/DM, respectively, had chest abnormality, positive smear, and positive culture (p = 0.018). Significant differences were observed between signs and symptoms, imaging results, bacteriology, treatment history for TB cases and those with HIV and/or DM, and those without HIV and/or DM coinfection and comorbidity. Conclusion This study reports a high prevalence of DM comorbidity and HIV coinfection among active TB patients in the North West Region of Cameroon as well as TB/HIV/DM comorbidity.
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Affiliation(s)
- Leonard Fonkeng Sama
- Department of Biochemistry, University of Dschang, P.O. Box 67, Dschang, Cameroon
| | - Sidoine Sadjeu
- Gulf of Guinea University Institute, Institute of Applied Science, Douala, Cameroon
| | - Thibau Flaurant Tchouangueu
- Department of Microbiology, Haematology and Immunology, Faculty of Health and Pharmaceutical Science, P.O. Box 96, University of Dschang, Dschang, Cameroon
| | - Solange Dabou
- Department of Biochemistry, University of Dschang, P.O. Box 67, Dschang, Cameroon
| | - Georges Ful Kuh
- Department of Biochemistry, University of Dschang, P.O. Box 67, Dschang, Cameroon
| | - Omer Bebe Ngouateu
- University of Yaoundé I, Faculty of Science, Department of Animal Biology and Physiology, P.O. Box 812, Yaoundé, Cameroon
| | - Michel Noubom
- Department of Microbiology, Haematology and Immunology, Faculty of Health and Pharmaceutical Science, P.O. Box 96, University of Dschang, Dschang, Cameroon
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Nkengkana OA, Founou RC, Founou LL, Dimani BD, Koudoum PL, Zemtsa JR, Mbossi A, Mawout CS, Tegang LT, Noubom M. Phenotypic and genotypic characterization of multidrug resistant and extended-spectrum β-lactamase-producing Enterobacterales isolated from clinical samples in the western region in Cameroon. BMC Infect Dis 2023; 23:819. [PMID: 37993766 PMCID: PMC10666389 DOI: 10.1186/s12879-023-08742-7] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/07/2023] [Accepted: 10/24/2023] [Indexed: 11/24/2023] Open
Abstract
BACKGROUND The 2017 World Health Organization (WHO) report has listed extended-spectrum β-lactamase-producing Enterobacterales (ESBL-E) as critical pathogens for public health and requiring urgently new antibiotics. The aim of this study was to characterize phenotypically and genotypically ESBL-E isolated among clinical samples in Dschang, Cameroon. METHODS A cross-sectional study was conducted during a four-month periods from February to May 2022 in the two biggest hospitals of Dschang. Clinical samples were collected and cultured on Eosin Methylene Blue agar. Suspected growing colonies were biochemically identified using the Enterosystem Kit 18R. Antimicrobial susceptibility testing (AST) was done using the Kirby Bauer disc diffusion method and interpretated according to the CA-SFM recommendations. ESBL phenotypes were double screened using CHROMagar™ ESBL and double disk synergy test (DDST). The detection of resistance genes was performed using conventional and multiplex PCR methods. Results were analyzed with SPSS (version 21) and a p-value < 0.05 was considered statistically significant. RESULTS A total of 152 Enterobacterales were isolated among 597 clinical samples including urine, blood, cervico-vaginal, urethral swabs and wound samples. The overall prevalence of ESBL-Enterobacterales was 29.61% (45/152). The most represented ESBL species were Escherichia coli (n = 23; 51.11%), Klebsiella pneumoniae (n = 8; 17.78%) and Citrobacter freundii (n = 6; 13.33%). CONCLUSION This study reveals the high burden of ESBL-E among clinical samples in the regional hospital in Dschang with the most common species being E. coli and K. pneumoniae. It confirmed the high occurrence of blaCTX-M and blaTEM among ESBL-E. The study suggests that implementing antimicrobial stewardship program and real-time surveillance of antimicrobial resistance are needed in the Western region of Cameroon. Moreover, the implementation of infection prevention and control measures (IPC) is essential to curb the dissemination of these bacteria from community to hospital settings. Implementation of national action plan to fight against antimicrobial resistance at the local levels is urgently needed.
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Affiliation(s)
- Omer Aurelle Nkengkana
- Department of Microbiology- Hematology and Immunology, Faculty of Medicine and Pharmaceutical Sciences, University of Dschang, Dschang, Cameroon
| | - Raspail Carrel Founou
- Department of Microbiology- Hematology and Immunology, Faculty of Medicine and Pharmaceutical Sciences, University of Dschang, Dschang, Cameroon.
- Antimicrobial Research Unit, School of Health Sciences, College of Health Sciences, University of KwaZulu-Natal, Durban, 4000, South Africa.
- Antimicrobial Resistance and Infectious Disease (ARID) Research Unit, Research Institute of Centre of Expertise and Biological Diagnostic of Cameroon (CEDBCAM-RI), Yaoundé, Cameroon.
| | - Luria Leslie Founou
- Antimicrobial Research Unit, School of Health Sciences, College of Health Sciences, University of KwaZulu-Natal, Durban, 4000, South Africa
- Reproductive, Maternal, Newborn and Child Health (ReMARCH) Research Unit, Research Institute of the Centre of Expertise and Biological Diagnostic of Cameroon (CEDBCAM-RI), Yaoundé, Cameroon
- Bioinformatics & Applied Machine Learning Research Unit, EDEN Biosciences Research Institute (EBRI), EDEN Foundation, Yaoundé, Cameroon
| | - Brice Davy Dimani
- Antimicrobial Resistance and Infectious Disease (ARID) Research Unit, Research Institute of Centre of Expertise and Biological Diagnostic of Cameroon (CEDBCAM-RI), Yaoundé, Cameroon
| | - Patrice Landry Koudoum
- Antimicrobial Resistance and Infectious Disease (ARID) Research Unit, Research Institute of Centre of Expertise and Biological Diagnostic of Cameroon (CEDBCAM-RI), Yaoundé, Cameroon
| | - Jessica Ravalona Zemtsa
- Reproductive, Maternal, Newborn and Child Health (ReMARCH) Research Unit, Research Institute of the Centre of Expertise and Biological Diagnostic of Cameroon (CEDBCAM-RI), Yaoundé, Cameroon
| | - Aurelia Mbossi
- Reproductive, Maternal, Newborn and Child Health (ReMARCH) Research Unit, Research Institute of the Centre of Expertise and Biological Diagnostic of Cameroon (CEDBCAM-RI), Yaoundé, Cameroon
| | - Cyrielle Signe Mawout
- Department of Microbiology- Hematology and Immunology, Faculty of Medicine and Pharmaceutical Sciences, University of Dschang, Dschang, Cameroon
| | | | - Michel Noubom
- Department of Microbiology- Hematology and Immunology, Faculty of Medicine and Pharmaceutical Sciences, University of Dschang, Dschang, Cameroon
- Annex Regional Hospital of Dschang (ARHD), Dschang, Cameroon
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49
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Saidu Y, Agbor VN, Di Mattei P, Nchinjoh SC, Edwidge NN, Njoh AA, Muteh NJ, Prescott M, Wiwa O, Diack D, Flegere J, Montomoli E, Costa Clemens SA, Clemens R. Development of a composite scoring system to rank communities at high risk of zero-dose children in Cameroon: A geospatial analysis. J Glob Health 2023; 13:04136. [PMID: 37971948 PMCID: PMC10653342 DOI: 10.7189/jogh.13.04136] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/19/2023] Open
Abstract
Background Despite growing efforts to improve access to vaccination, millions of children, especially in developing countries, have not received a single dose of diphtheria, tetanus, and pertussis (DTP) vaccine. Consequently, they are often called zero-dose children (ZDC). With limited health resources, prioritising communities for rapid and mass zero-dose catch-up vaccination in missed communities to avert epidemic outbreaks is complicated by unreliable denominators used to compute vaccination coverages. Incorporating other indicators of access and utilisation of vaccination services can help with identifying and ranking missed communities based on the likelihood of finding ZDC. We described the process of generating a scoring method to rank health areas in Cameroon based on their likelihood of containing ZDC. Methods We used geospatial analysis to compute and aggregate health area characteristics, including hard-to-reach (HTR) areas (defined as areas of settlement above a one- (for urban areas) or 15-kilometre radius (for rural areas) beyond a vaccinating health facility), amount of area covered by slums and new area settlement, and percentage of children unvaccinated for DTP-1. We attributed a weight based on the ability to limit accessibility or utilisation of vaccination services to each characteristic and computed the score as a weighted average of health area characteristics. The health area score ranged from 0 to 1, with higher scores representing a higher likelihood of containing ZDC. We stratified the analysis by rural and urban health areas. Results We observed substantial district and regional variations in health area scores, with hotspots health areas (administrative level 4) observed in the Far North (0.83), North (0.81), Adamawa (0.80), East (0.75), and South West (0.67) regions. The Adamawa region had the highest percentage of health areas with the highest score (78%), followed by the East (50%), West (48%), and North (46%) regions. For most regions (Far North, South, South West, Littoral, West, and North West), DTP-1 contributed the most to the score. However, HTR settlement areas within a health area contributed substantially to the overall score in the East, North, and Adamawa regions. Conclusions We found substantial variations in health area scores with hotspots in the Far North, North, Adamawa, East, and South West regions. Although DTP-1 could be used as an indicator to identify health areas with ZDC for most communities, HTR settlement area was a valuable indicator in ranking priority health areas in the East, North, and Adamawa regions, further emphasising the need to consider other indicators before prioritisation.
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Affiliation(s)
- Yauba Saidu
- Clinton Health Access Initiative Inc., Yaoundé, Cameroon
- Institute for Global Health, Department of Molecular and Developmental Medicine, University of Siena, Siena, Italy
| | - Valirie N Agbor
- Clinical Trial Service Unit and Epidemiological Studies Unit (CTSU), Nuffield Department of Population Health, University of Oxford, Oxford, UK
| | | | | | | | - Andreas A Njoh
- Expanded Program on Immunization, Cameroon Ministry of Public Health, Yaoundé, Cameroon
- School of Global Health and Bioethics, Euclid University, Bangui, Central African Republic
| | | | - Marta Prescott
- Global Analytics and Implementation Research Team, Clinton Health Access Initiative Inc., Boston, USA
| | - Owens Wiwa
- Clinton Health Access Initiative Inc., Yaoundé, Cameroon
| | - Demba Diack
- Gavi, the Vaccine Alliance, Geneva, Switzerland
| | | | - Emanuele Montomoli
- Institute for Global Health, Department of Molecular and Developmental Medicine, University of Siena, Siena, Italy
- VisMederi srl, Siena, Italy
| | - Sue A Costa Clemens
- Institute for Global Health, Department of Molecular and Developmental Medicine, University of Siena, Siena, Italy
- Department of Pediatrics, University of Oxford, Oxford, UK
| | - Ralf Clemens
- Institute for Global Health, Department of Molecular and Developmental Medicine, University of Siena, Siena, Italy
- International Vaccine Institute, IVI, Seoul, Republic of Korea
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50
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Fottsoh Fokam A, Rouamba T, Samadoulougou S, Ye Y, Kirakoya-Samadoulougou F. A Bayesian spatio-temporal framework to assess the effect of seasonal malaria chemoprevention on children under 5 years in Cameroon from 2016 to 2021 using routine data. Malar J 2023; 22:347. [PMID: 37951942 PMCID: PMC10640753 DOI: 10.1186/s12936-023-04677-1] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/22/2023] [Accepted: 08/16/2023] [Indexed: 11/14/2023] Open
Abstract
BACKGROUND Malaria affects millions of Cameroonian children under 5 years of age living in the North and Far North regions. These regions bear the greatest burden, particularly for children under 5 years of age. To reduce the burden of disease in these regions, Cameroon adopted the Seasonal Malaria Chemoprevention (SMC) in 2016 and has implemented it each year since its adoption. However, no previous studies have systematically assessed the effects of this intervention in Cameroon. It is important to understand its effect and whether its implementation could be improved. This study aimed to assess the effect of SMC in Cameroon during the period 2016-2021 on malaria morbidity in children under 5 years of age using routine data. METHODS Data on malaria cases were extracted from the Cameroon Health Monitoring Information System (HMIS) from January 1, 2011, to December 31, 2021. Health facilities report these data monthly on a single platform, the District Health Information System version 2 (DHIS2). Thus, a controlled interrupted time-series model in a Bayesian framework was used to evaluate the effects of the SMC on malaria morbidity. RESULTS SMC implementation was associated with a reduction in the incidence of uncomplicated malaria cases during the high-transmission periods from 2016 to 2021. Regarding the incidence of severe malaria during the high-transmission period, a reduction was found over the period 2016-2019. The highest reduction was registered during the second year of implementation in 2017:15% (95% Credible Interval, 10-19) of uncomplicated malaria cases and 51% (47-54) of confirmed severe malaria cases. CONCLUSION The addition of SMC to the malaria intervention package in Cameroon decreased the incidence of uncomplicated and severe malaria among children under 5 years of age. Based on these findings, this study supports the wide implementation of SMC to reduce the malaria burden in Cameroon as well as the use of routine malaria data to monitor the efficiency of the strategy in a timely manner.
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Affiliation(s)
- Arnold Fottsoh Fokam
- Innovations for Poverty Action, Cocody, Quartier Val Doyen, Abidjan, Côte d'Ivoire.
- ICF, Maroua, Cameroon.
| | - Toussaint Rouamba
- Clinical Research Unit of Nanoro, Institute for Research in Health Sciences, National Center for Scientific and Technological Research, 42, Avenue Kumda‑Yoore, BP 218 Ouagadougou CMS 11, Ouagadougou, Burkina Faso
- Centre de Recherche en Epidémiologie, Biostatistique et Recherche Clinique, Ecole de Santé Publique, Université Libre de Bruxelles, Route de Lennik, 808, Bruxelles, Brussels, 1070, Belgium
| | - Sekou Samadoulougou
- Evaluation Platform on Obesity Prevention, Quebec Heart and Lung Institute Research Center, Quebec City, QC, G1V 4G5, Canada
- Centre for Research on Planning and Development, Laval University, Quebec, G1V 0A6, Canada
| | - Yazoume Ye
- ICF, 530 Gaither Road, Rockville, MD, 20850, USA
| | - Fati Kirakoya-Samadoulougou
- Centre de Recherche en Epidémiologie, Biostatistique et Recherche Clinique, Ecole de Santé Publique, Université Libre de Bruxelles, Route de Lennik, 808, Bruxelles, Brussels, 1070, Belgium
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