Regional vulnerability for COVID-19 in Cameroon

Introduction: few studies have assessed risk for coronavirus disease 2019 (COVID-19) within African countries. Here we examine differences in vulnerability to COVID-19 among the ten administrative Regions and two major cities of Cameroon based on epidemiological risk factors and access to healthcare resources. Methods: regional epidemiological and healthcare access vulnerability indices were created and compared with cumulative COVID-19 cases, case fatality rates, co-morbidities, and healthcare resources in Cameroon. Results: based on epidemiological risk factors, populations in the East Region, Douala (in the Littoral Region), West Region, and Yaoundé (in the Center Region) are at highest risk for COVID-19. Meanwhile, the North, Far North, East, and Adamawa Regions had the most healthcare access vulnerability. COVID-19 cases per population were highest in the Center, Littoral, and East Regions. Case fatality rates were greatest in the North Region. Potential co-morbidities with greater prevalence among COVID-19 patients included male sex, hypertension, and diabetes. Conclusion: epidemiological risk factors for COVID-19 and access to healthcare varies between the Regions of Cameroon. These discrepancies are potentially reflected in regional differences of COVID-19 cases and case fatality rates. In particular, the East Region has high epidemiological risk factors and low healthcare accessibility compared to other Regions. Understanding the relationships between epidemiological risk factors, access to healthcare resources, and COVID-19 cases in Cameroon could aid decision-making among national policymakers and inform further research

Evaluation of Virologic Methods for Early Detection of HIV-1 in a Resource-limited Setting: Performance and Cost Analysis

Introduction : Rapid testing and detection of acute HIV infection are two important arms in the prevention of HIV infection. Virologic testing for HIV remains the mainstay for early diagnosis of the infection. Nucleic acid-based testing for HIV however; requires expensive laboratory infrastructure and well-trained personnel; thereby making it not easily accessible in Low- Middle- Income Countries (LMIC). HIV DNA polymerase chain reaction is currently used by few laboratories in many LMIC to detect HIV in children born of HIV-positive mothers before 18 months. Challenges relating to timely result notification can be reduced if the Early Infant Diagnosis (EID) Programme is decentralized and with easy access to laboratory facilities using other tests with high performance characteristics. Methods: We evaluated the performance of five assays to identify HIV antibodies; p24 antigen; proviral DNA or viral RNA in 109 infants born to HIV-positive mothers in Yaounde; Cameroon. Results: The test performance (using plasma) of the HIV p24 antigen ELISA by Perkin Elmer; Roche Amplicor HIV-1 DNA PCR and the Abbott Realtime HIV-1 assay was 100 identifying 12 positive cases. A positive and significant correlation between the HIV-1 RNA viral load and HIV p24 antigen level was found (p0.05). Conclusion: Therefore; HIV p24 antigen detection by ELISA can be used for early diagnosis of HIV and thus recommended for a decentralized EID Programme in LMIC