Facteurs associés à la mortalité des urgences chirurgicales néonatales à Douala / Determinants of mortality of neonatal surgical emergencies in Douala

Introduction. Les urgences chirurgicales néonatales (UCN) se manifestent de la naissance au 28e jour de vieet nécéssitent un traitement chirurgical dans un délai court. L'objectif de ce travail est d'identifier les facteurs associés à la mortalité des UCN dans quatre hôpitaux de la ville de Douala.Méthodologie. Nous avons mené une étude transversale analytique avec collecte de données rétrospective sur une période de 10 ans, allant du 1er Janvier 2013 au 31 Décembre 2022 dans 4 hôpitaux de la ville de Douala à savoir: l'Hôpital Général, l'Hôpital Laquintinie, l'Hôpital Gynéco-obstétrique et pédiatrique de Yassa, et l'Hôpital Protestant de Ndogbati. Résultats.Laprévalence hospitalièredes urgences chirurgicales néonatalesétait de6,1%. La tranche d'âge la plus représentée était celle de 2 à 7 jours avec un sex-ratio de 1,7. La mortalité était de 48%avec une majorité de décès en post-opératoire (64,4%).Les déterminants de mortalité sur le plan sociodémographique étaient : l'âge à l'admission inférieur à 8 jours (OR= 1,95 ; P<0,001), le sexe masculin (OR=1,51 ; P=0,002); la moyenne prématurité (OR=0,91 ; P<0,001), le poids de naissance < 2500g (OR= 5,15 ; P=0,009), et le délai d'admission > 2 jours (OR=0,73 ; P<0,001). Sur le plan évolutif, les facteurs de mauvais pronostic étaient : les malformations anorectales (OR=2,23; P< 0,001), l'atrésie de l'œsophage (OR=3,63 ; P=0,001), la présence de complications post opératoires (OR= 3,45 ; P<0,001) et le sepsis (OR= 7,87; P=0,037).ConclusionLa mortalité post opératoire est très élevée. Les facteurs associés sont le long délai diagnostic, la prématurité, les pathologies malformatives digestives et le seps

Introduction.Neonatal surgical emergencies (NSE) occur from birth to the 28th day of life and require surgical treatment within a short timeframe. The objective of this study is to identify factors associated with mortality in NSE in four hospitals in the city of Douala. Methodology.We conducted a cross-sectional analytical study with retrospective data collection over a period of 10 years, from January 1st, 2013 to December 31st, 2022, in 4 hospitals in the city of Douala, namely: General Hospital, Laquintinie Hospital, Gynecological-Obstetric and Pediatric Hospital of Yassa, and Protestant Hospital of Ndogbati. Results.The hospital prevalence of neonatal surgical emergencies was 6.1%. The most represented age group was 2 to 7 days with a sex ratio of 1.7. The mortality rate was 48%, with a majority of deaths occurring in the post-operative period (64.4%). Sociodemographic determinants of mortality were: age at admission less than 8 days (OR=1.95; P<0.001), male sex (OR=1.51; P=0.002); moderate prematurity (OR=0.91; P<0.001), birth weight < 2500g (OR=5.15; P=0.009), and admission delay > 2 days (OR=0.73; P<0.001). In terms of progression, factors associated with poor prognosis were: anorectal malformations (OR=2.23; P<0.001), esophageal atresia (OR=3.63; P=0.001), presence of post-operative complications (OR=3.45; P<0.001), and sepsis (OR=7.87; P=0.037). Conclusion Post-operative mortality is very high. Associated factors include delayed diagnosis, prematurity, digestive malformative pathologies, and sepsis.

Type 1 diabetes care delivery in Yaoundé, Cameroon: Social and political representations

Background: Increasing chronic diseases challenges the health systems of low- and middleincome countries, including Cameroon. Type 1 diabetes (T1D), among the most common chronic diseases in children, poses particular care delivery challenges. Aim: We examined social representations of patients' roles and implementation of T1D care among political decision-makers, healthcare providers and patients within families. Setting: The study was conducted in Yaoundé, Cameroon. Methods: Eighty-two individuals were included in the study. The authors conducted semistructured interviews with policy makers (n = 5), healthcare professionals (n = 7) and patients 'parents (n = 20). Questionnaires were administered to paediatric patients with T1D (n = 50). The authors also observed care delivery at a referral hospital and at a T1D-focused nongovernmental organisation over 15 days. Data were analysed using thematic content analysis and descriptive statistics. Results: Cameroonian health policy portrays patients with T1D as passive recipients of care. While many practitioners recognised the complex social and economic determinants of adherence to T1D care, in practice interactions focused on specific biomedical issues and offered brief guidance. Cultural barriers and policy implementation challenges prevent patients and their families from being fully active participants in care. Parents and children prefer an ongoing relationship with a single clinician and interactions with other patients and families. Conclusion: Patients and families mobilise experience and lay knowledge to complement biomedical knowledge, but top-down policy and clinical practice limit their active engagement in T1D care. Contribution: Children with T1D and their families, policy makers, healthcare professionals, and civil society have new opportunities to contribute to person-centred care, as advocated by the Sustainable Development Goals.

Frequency and determinants of phytotherapy use in patients with type 2 diabetes in the Dschang Health District, Cameroon: a cross-sectional study

Introduction: phytotherapy is widely used in Africa for the management of many diseases. Data on the use of phytotherapy in people with type 2 diabetes are scarce. We aimed to determine the frequency and factors associated with the consumption/use of phytotherapy products among patients with type 2 diabetes in the Dschang Health District. Methods: we conducted a cross-sectional study from January to May 2022, including community-dwelling or hospitalized patients with type 2 diabetes who had lived in the Dschang Health District for at least one year. Informed consent was obtained from all patients. Data were collected using a pre-designed questionnaire. Variables collected included socio-demographic characteristics, diabetes knowledge and practices, and perceptions of care. Results: we included 403 (249 women) patients with type 2 diabetes with a mean (SD) age of 63 (± 14.86) years). Among them, 240 (59.55%) used phytotherapy, either in combination with conventional treatment (168 (41.69%) participants) or not (72 (17.86%) participants), to treat diabetes. The most common reasons for using phytotherapy were easy accessibility and belief in its efficacy. Most patients used both treatments because they thought the combination was more effective. In univariable analysis, we observed a statistically significant association between level of education (p=0.003), socioeconomic level (p<0.001), place of residence (p=0.003), duration of diabetes (p=0.007), and use of phytotherapy. In multivariable analysis, only age between 51 and 60 years (OR: 0.50, 95% CI 0.298 - 0.8521; p=0.01) was associated with the use of phytotherapy. Conclusion: people living with T2D in the Dschang Health District frequently use phytotherapy as an antidiabetic remedy, especially those aged between 51 and 60 years, those with low education level, low socioeconomic level and medium duration of diabetes. There is a need to evaluate its effectiveness in treating diabetes and its adverse effects.

Challenges faced by the HIV testing system in low- and middle-income countries

Introduction: Determining the HIV status of some individuals remains challenging due to multidimensional factors such as flaws in diagnostic systems, technological challenges, and viral diversity. This report pinpoints challenges faced by the HIV testing system in Cameroon. Case presentation: A 53-year-old male received a positive HIV result by a rapid testing algorithm in July 2016. Not convinced of his HIV status, he requested additional tests. In February 2017, he received a positive result using ImmunoComb® II HIV 1 & 2 BiSpot and Roche cobas electrochemiluminescence assays. A sample sent to France in April 2017 was positive on the Bio-Rad GenScreen™ HIV 1/2, but serotyping was indeterminate, and viral load was < 20 copies/mL. The Roche electrochemiluminescence immunoassay and INNO-LIA HIV I/II Score were negative for samples collected in 2018. A sample collected in July 2019 and tested with VIDAS® HIV Duo Ultra enzyme-linked fluorescent assay and Geenius™ HIV 1/2 Confirmatory Assay was positive, but negative with Western blot; CD4 count was 1380 cells/mm3 and HIV proviral DNA tested in France was 'target-not-detected'. Some rapid tests were still positive in 2020 and 2021. Serotyping remained indeterminate, and viral load was 'target-not-detected'. There were no self-reported exposure to HIV risk factors, and his wife was HIV-seronegative.Management and outcome: Given that the patient remained asymptomatic with no evidence of viral replication, no antiretroviral therapy was initiated. Conclusion: This case highlights the struggles faced by some individuals in confirming their HIV status and the need to update existing technologies and develop an algorithm for managing exceptional cases.

Quality of life group of cameroonian patients aged over 65 years in an urban setting: A cross-sectional study

Background. The quality of life of the elderly can be compromised by several chronic diseases. This has a considerable impact on their physical and mental capacities.This study aimed to evaluate the quality of life of the elderly at the Yaoundé Central Hospital. Methods.We carried out a cross-sectional study of elderly patients who consulted at the Yaounde Central Hospital forfive months. Sociodemographic characteristics were taken, and we also took data concerning their chronic conditions and depressive symptoms. The presence of any cognitive impairment was evaluated using the Mini-mental state Examination (MMSE). Their functional capacity was assessed with the six-minute walk test. Quality of life was evaluated using the older people's quality of life questionnaire (OPQOL). The multivariate analysis was done on the logistic regression model, and the p values < 0.05 were considered statistically significant. Results.66 participants were included (35 women) with a median age of 70 (IQR: 67 -75) years. About 87.8% had at least one chronic condition, and 47% had two or more. The most prevalent chronic condition was hypertension (71.2%), followed by abdominal obesity (40.9%) and heart failure (24.2%). Mild depressive symptoms were present in 1.5% of our study population. Fourteen participants (21.2%) had a poor quality of life. The factors associated with a poor quality of life was a distance covered in the 6 MWT less than 350m (OR: 3.7, p < 0.05). Conclusion.There is a high prevalence of poor quality of life among elderly patients consulting at the Yaoundé Central Hospital. A distance covered in the 6MWT less than 350m is associated with poor quality of life.

Introduction. La qualité de vie des personnes âgées peut être compromise par la survenue de plusieurs pathologies chroniques. Cela a un impact considérable sur leurs capacités physiques mais aussi sur leurs capacités mentales. Le but de cette étude était d'évaluer la qualité de vie des personnes âgées suivies à l'Hôpital Central de Yaoundé. Méthodologie. Nous avons réalisé une étude transversale analytique sur des patients âgés ayant consulté à l'hôpital central de Yaoundé pendant une période de cinq mois. Les caractéristiques sociodémographiques ont été prises, ainsi que leurs différentes comorbidités. La présence d'un déficit cognitif a été évaluée à l'aide du Mini Mental State Examination(MMSE). Leur capacité fonctionnelle a été évaluée à l'aide du test de marche de six minutes. La qualité de vie a été évaluée à l'aide du score OPQOL.. L'analyse multivariée a été effectuée sur le modèle de régression logistique et les valeurs de p < 0,05 ont été considérées comme statistiquement significatives. Résultats. 66 participants ont été inclus (35 femmes) avec un âge médian de 70 (IQR : 67 -75) ans. Parmi eux, environ 87,8 % avaient au moins une maladie chronique et 47 % en avaient deux ou plus. L'affection chronique la plus répandue était l'hypertension artérielle (71,2 %), suivie de l'insuffisance cardiaque (24,2 %) et de l'arthrose (12,1 %). Des symptômes dépressifs légers étaient présents chez 1,5 % de la population de notre étude. 14 participants (21,2 %) avaient une mauvaise qualité de vie. Les facteurs associés à unemauvaise qualité de vie étaient une distance parcourue dans le 6MWT inférieure à 350m (OR : 3,7, p < 0,05). Conclusion. Il existe une forte prévalence de la mauvaise qualité de vie chez ce groupe de patients âgés camerounais dont le facteur associé retrouvéest une distance parcourue durant le 6MWT inférieure à 350m.Ceci confirme le bénéfice de l'activité physique sur le plan physique et mental, indispensable pour une meilleure qualité de vie.

Frequency and pattern of intrauterine hysteroscopic lesions among women coming for IVF in the city of Yaoundé

Background: Hysteroscopy is an essential tool to make intrauterine assessment in infertile patients. Diagnosis and appropriate correction of intrauterine anomalies are considered essential in order to increase chances of conception. Ourobjective was to determine the frequency and pattern of intra uterine anomalies identified among women attending hysteroscopy at the Gynaecological Endoscopic Surgery and Human Reproduction Teaching Hospital Paul et Chantal Biya ­Yaoundé (GESHRTH). Methodsand results.Thiswas a cross sectional retrospective study of 96 women attending diagnostic or operative hysteroscopy at the GESHRTH between January 2020 and December 2021.The mean age was 38.7 ±7.6 years. Fifty-nine (61.5%) of the patients were nulliparous. Primary and secondary infertility were found respectively in fifty-two patients (54.2%) and forty-four patients (45.4%). Eleven patients (11.5%) were post-menopausal. Concerning previous surgery, 29 patients (30.2%) have had a myomectomy, 28 patients (29.1%) curettage,16 patients (16.6%) laparoscopy, eight (8.3%) hysteroscopy and one (1%) caesarean section. In all, 92 patients (95.8%) had abnormal intra uterine findings consisting of endometrial polyps (43.7%), sub-mucosal fibroids (42.7%), uterine cavity adhesions (20.8%), endometrial atrophy (4.1%), foetal bone (2%), uterine septum (1%) and non-absorbable suture thread (1%).Conclusion: Abnormal uterine findings were identified in 95.8% of patients attending hysteroscopy at GESHRTH. Most frequent findings were polypsin 43.7%, sub-mucosal fibroids in 42.7% and synechiae in 20.8%. The overall per operatory complication rate was 6.2%.

Introduction. Le recours à l'hystéroscopie constitue une étape indispensable au bilan cavitaire des patientes infertiles. Le diagnostic et la prise en charge adéquate des lésions intra cavitaires permettent d'améliorer les chances de conception.L'objectif de cette étude était de déterminer la fréquence et les caractéristiques des anomalies intra cavitaires chez les patientes opérées d'une hystéroscopie au Centre Hospitalier de Recherche et d'Application en Chirurgie Endoscopique et Reproduction Humaine Paul et Chantal Biya ­Yaoundé (CHRACERH).Méthodes et résultats. Nous avons mené une étude descriptive transversale de Janvier 2020 à Décembre 2021 et recruté 96 patientes. L'âge moyen était de38,7 ±7,6 ans. Soixante-neuf patientes (61,5%) étaient nullipares. Cinquante-deux (54,2%) et quarante-quatre (45,5%) présentaient une infertilité primaire et secondaire respectivement. Onze patientes (11,5%) étaient ménopausées. Concernant les antécédents chirurgicaux,nous avons identifié une myomectomie chez 29 patientes (30,2%), un curetage utérin chez 28 (29,1%), une cœlioscopie chez 16 (16,6%), une hystéroscopie chez huit (8,3%) et une césarienne chez une (1%). Au total, 92 (95,8%) des patientes avaient des anomalies cavitaires objectivées. Il s'agissait de polypes endométriaux (43,7%), fibromes sous-muqueux (42,7%), synéchies utérines (20,8%), atrophie de l'endomètre (4,1%), métaplasie osseuse (2%), cloison utérine (1%) et corps étranger à type de fil de suture nonrésorbable (1%).Conclusion.Les anomalies intra-cavitaires étaient retrouvées chez 95,8% des patientes réalisant une hystéroscopie au CHRACERH. Les anomalies les plus représentées étaient les polypes endométriaux (43,7%), les fibromes sous-muqueux (42,7%) et les synéchies utérines (20,8%). Le taux global de complications opératoires était de 6,2%.

Prevalence and seroprevalence of COVID-19 in suspected malaria during the second wave in Yaounde, Cameroon

Background. The COVID-19 pandemic has added an additional burden in countries with already fragile health systems. Our objective was to determine the prevalence and seroprevalence of COVID-19 in suspected malaria during the second wave in Yaounde. Methods. A descriptive cross-sectional study was conducted at the Jordan Medical Services for 8 weeks from April 19 to June 13, 2021, i.e., during the second wave in Cameroon. For the 86 patients with suspected malaria, nasopharyngeal and blood samples were taken for SARS-CoV-2 antigen and anti-SARS-CoV-2 IgG and IgM using the STANDARD TM Q COVID-19 Ag kit from SD BIOSENSOR, Korea, 2020 and Standard TM Q COVID 19 Ac IgG/IgM kit from SD BIOSENSOR, Korea, 2020 respectively. Confirmation of malaria was done by microscopic examination of stained blood smears. Results. Malaria was confirmed in 20.9% (18) of cases. The prevalences of COVID-19 and COVID-19/malaria co-infection were 8.1% and 0.9% respectively. Of the 25.6% (54) of patients with anti-COVID-19 IgM, no positive microscopic cases were found. On the other hand, a little more than half of the patients had IgG antibodies against COVID-19 whether they had a positive thick drop or not (56.0% (42/75) and 52.2% (71/136) respectively). Conclusion. In case of suspicion of malaria in a malaria area, it seems important to consider COVID-19 as a differential diagnosis.

Introduction. La pandémie de la COVID-19 a ajouté un fardeau supplémentaire dans les pays aux systèmes de santé déjà fragiles. Objectif : déterminer la prévalence et la séroprévalence de la COVID-19 en cas de suspicion du paludisme au cours de la deuxième vagueà Yaoundé. Méthodologie. Une étude transversale descriptive a été menée au Centre Médical le Jourdain pendant 8 semaines du 19 Avril au 13 Juin 2021 soit durant la deuxième vague au Cameroun. Pour les 86 patients avec suspicion de paludisme, des prélèvements nasopharyngé et sanguins ont été réalisés pour la recherche d'antigène du SRAS- CoV 2 et des IgG et IgM anti-SARS-CoV-2 grâce aux kits STANDARDTM Q COVID-19 Ag de SD BIOSENSOR, Corée, 2020 et StandardTM Q COVID 19 Ac IgG/IgM de SD BIOSENSOR, Corée, 2020 respectivement. La confirmation du paludisme a été faite grâce à l'examen microscopique des étalements de sang colorés. Résultats. Le paludisme était confirmé dans 20,9% (18) des cas. Les prévalences de la COVID-19 et de la coïnfection COVID19/Paludisme étaient de 8,1% et de 0,9% respectivement. Sur les 25,6% (54) des patients avec des IgM anti-COVID-19, aucun cas de microscopie positive n'a été retrouvé. Par ailleurs un peu plus de la moitié des patients avaient des anticorps IgG anti-COVID-19 qu'ils aient une goutte épaisse positive ou pas soit 56,0% (42/75) et 52,2% (71/136) respectivement. Conclusion. En cas de suspicion du paludisme en zone impaludée, il parait non négligeable de considérer la COVID-19 comme un diagnostic différentiel.

Prevalence and Clinical Aspects of Hemophiliain the Western Region of Cameroon

Introduction: Hemophilia is a constitutional defect in blood clotting related to a clotting factor deficiency. Its remains a major public health problem, mainly due to ignorance of the disease, limited screening capacities and access to treatment in sub-Saharan Africa and particularly in Cameroon. It causes heavy bleeding in the absence of adequate management. Few reports are available about the disease in countries with limited resources. This study assess the occurrence of hemophilia in the Western region of Cameroon and clinical aspects with the aim of raising public awareness of the disease. Methods: A cross-sectional and descriptive study was carried out over a period of 04 months in 5 departments of the Western region of Cameroon, in particular Mifi, Ndé, Bamboutos, Haut Nkam and Menoua. The individuals were selected in their houses on the basis of clinical arguments, i.e. bleeding from the gums, traumatic wounds, hematomas. The blood samples taken from the latter were analyzed in the hemostasis laboratory of the Regional Hospital of Bafoussam. The epidemiological characteristics of hemophiliacs identified and suspects hemophiliacs were analyzed. The results obtained were analysed using statistical software R version 4.1.1.Results: Out of 5995 people selected, 13 (0.22%) cases of hemophilia were identified, 09 confirmed cases and 04 new cases. The mean age of the patients was 14.85 years old (1.5-49). The disease was discovered mainly during circumcision in the months following birth (9/13, 69.23%), and by bleeding of the gums (9/13, 69.23%). Clinical signs were pain of the joints (46%), hematoma and swelling of the joints (38%). Platelets counts and prothrombin rate were normal in all. However, a prolonged Cephalin + Activator Time was found; it was corrected by supplying normal control plasma. Conclusion: Hemophilia is a pathology little known for the general public. For this, with the help of public authorithies, continuing education sessions must be set up to raise awareness among the population in order to limit the transmission of the disease and to eradicate this scourge which constitutes a real public health problem.

Influence of Socioeconomic Factors on the Nutritional Status of Pupils of 5 to 11 in Rural Areas in Cameroon: Case of the Nyambaka Municipality in the Adamawa Region

Malnutrition greatly increases the risk of infant mortality and vulnerability to various diseases later in the long run. It has been shown that children’s malnutrition is the result of low household income. Rural areas in Cameroon are mainly made up of poor families. This guided the present research to analyze some socioeconomic factors and their impact on the nutritional status of pupils. Using a simple random sampling technique, 300 pupils were recruited. About 66.33% of pupils were from poor families. Obesity was more prevalent in the category of rich pupils (09.52%) compared to poor (06.53%). The height and weight of pupils studied were lower than the reference (P < 0.001). This study carried out in a single council is proven to be limited for a better understanding of the epidemiology of malnutrition among students, and large-scale studies would be adequate to better prevent and control malnutrition in rural areas.

Anthelmintic Resistance of Gastrointestinal Strongyles Infecting Sheep in Nziih, West Cameroon

Aims: This study aimed to investigate the levels of efficacy of anthelmintics that were most commonly used in sheep farms in Nziih locality. Study Design: Longitudinal prospective study. Place and Duration of Study: The study was carried out in Nziih locality in August 2019 and September 2020. Methodology: Resistance against Albendazole (12.5 mg/kg) and Ivermectin (0.2 mg/kg) was evaluated using faecal egg count reduction test in naturally occurring gastrointestinal strongyles of sheep in Nziih. A total of 300 young animals were randomly selected from 5 farms in 2019 and in 2020. Faecal samples were collected from each animal on the first day of treatment (D0) and collected again 14 days later (D14). Faecal Egg Counts were performed using the Willis and Mac Master techniques and resistance was declared when faecal egg count reduction (FECR) was less than 95 % and the lower limit of confidence interval (LCI) less than 90%. Pooled faecal samples for each treatment group were set for D0 and D14 to identify resistant strongyles genera by calculating persistent larval rate (PLR). Results: Resistance against Ivermectin was detected while there was none against Albendazole. Moreover, it was declared only in 2 farms out of the 5 selected. From 2019 to 2020, the status of resistance has shifted from suspicion to resistance for ivermectin and from absence of resistance to suspicion to Albendazole. Resistance was recorded in 2 sites: Pastorale1 (FECR= 85 %, LCI= 42.61 %) and Pastorale 3 (FECR=90.5 %, LCI= 72.26 %) in large flock herds and in farms where sheep were dewormed at least 4 times per year. Trichostrongylus were more persistent than Haemonchus and Oesophagostomum/Chabertia with PLR of 21.22 %, 13.71 %, and 7.40 % respectively. Conclusion: Anthelmintics must be used correctly in conjunction with farmer education in Nziih.

Vaccination coverage and safety in Cameroon: descriptive assessment of COVID-19 infection in vaccinated individuals

Objective. Toassess national vaccination coverage, adverse events following immunization (AEFI) and evaluate the vaccination status in COVID infected patients. Methods. Sociodemographic data on vaccination and clinical characteristics of Covid-19 cases were extracted from the national COVID-19databases of the Public Health Emergency Center and the Expanded Program on Immunization. Result. A total number of 808229 out of 27 869965 (2.9%) were fully immunized on 13 February 2022 in the Cameroon. The most requested vaccine was Janssen with 48.24% of total doses administered. Women were less vaccinated than men and with a remarkable disparity in northern regions of the country. The Adamawa region presented the best performance 11.3% of adults fully immunized. Despite vaccinal coverage still insufficient among health care worker, they were the most vaccinated among priority groups (43.4%). Only 8% COVID-19 cases were vaccinated and 0.22 % of all vaccinated still developed COVID-19. Tolerability assessment identified 1.83 non-serious AEFI and 0.1 serious AEFI per 1000 doses administered. Only 7% of vaccinated individual still developed laboratory-confirmed COVID-19. Conclusion. COVID-19vaccination coverage is still low in Cameroon compared to the target of 60%. Although data completeness is still an issue, the protection against severe forms of the disease provided by the vaccines currently used is quite satisfactory. There is however a need to intensify all strategies to make people adhere to vaccination in order to protectthem against severe form of the disease.

Incidence and Predictors of Poor Outcome amongChildhood Tuberculosis in the North of Cameroon

Background. Childhood tuberculosis (TB) has been neglected by TB programs in Sub-Saharan Africa. The aim of this study was to determine the incidence and predictors of poor outcome in children with TB in the North region of Cameroon. Methods.It was a retrospective cohort study based on hospital TB registers and treatment TB forms, in all of the 18 functional diagnosis and therapeutic centers (DTC) in the North region. All children aged 0-15years, on anti-TB treatment between 2010-2016 were enrolled. Logistic regression was used to find independent factors associated to poor outcome. Results. Of the 668 children included [321 (48.1%) boys], the median (25th-75thpercentile) age was 11(6-14) years, with 75.9% children aged >5 years. Pulmonary TB was the most common (62.9%) with 34.3% smear-negative pulmonary TB. Extrapulmonary TB (62.1%) was mostly found in children aged 0-5years. HIV/TB coinfection was 10.3%. Incidence (95%CI) of poor outcome was 4.0 %( 2.5-5.5%). Predictors [OR (95%CI)] of poor outcome were: HIV positivechildren [3.995(1.131-14.112), p=0.031], management in peripheral DTC [32.451(4.211-250.099), p=0.001], and transferred in patients from a peripheral zone toward a 3rdor 4thDTC category [4.602(1.092-19.386), p=0.037]. Conclusion.Incidence of poor outcome of childhood TB was quite low in the North region of Cameroon. HIV, peripheral TDC and transferred in patients were predictors of poor outcome. A better management of HIV, retraining DTC personnel and early reference from peripheral DTC would reduce poor outcome among childhood TB.

Problématique duDiagnostic du VIH en Afrique Subsaharienne: Résultats Erronés dans une Etude Pilote (NAMSAL) au Cameroun

Introduction.The NAMSAL therapeutic trial evaluated the non-inferiority of a first line treatment comprising Dolutegravir to another line comprising Efavirenz 400. The criteria for not taking part to the trial included infection with non-M HIV-1, untreated patients with HIV viral load <1000 copies/mL. The objective of this study was to explain why some treatment naïve patients had undetectable viral loads. Materials and methods. Out of 817 patients pre-included with HIV-1 infection and untreated, 204 were not included and the present study focused on 114 of these 204 patients not included in NAMSAL. HIV plasma viral load, serological status and the serotype were confirmed by RT-qPCR (Abbott), INNOLIA HIVI/II Score (Fujirebio), and by ELISA with synthetic peptides of thedifferent HIV-1&2 groups. Universal or specific PCR (M and O) were performed on the samples for molecular confirmation and characterization. Results. Amongthe 114 patients studied, 49 (43%) had a viral load < 1000 copies/mL and 65 (57%) had a viral load > 1000 copies/mL. When reported to the whole cohort of pre-included patients (n=817), 4/817 (0.5%) were group-O confirmed by molecular biology. Based on the PCR results, 14 out of 817 patients (1.7%) deemed to be HIV-1 positive were most likely uninfected. Conclusion. 1.7% of HIV-1 patients referred for inclusion in NAMSAL were not actually infected. Ongoing staff training and quality control of laboratories must be strengthened in Cameroon in view of the social and economic consequences of misdiagnosis.

Health policy and systems research capacity development to support maternal, newborn, child and adolescent health in West and Central Africa

Objectives: To examine how and why a South-South capacity development and networking program for leadership, research, practice and advocacy on maternal new-born, child and adolescent health and health policy and systems strengthening in West Africa and Cameroon worked and identify lessons for low- and middle-income countries. Design: Single qualitative case study drawing on data from document review, observations, key informant interviews and a deliberative workshop. Ethics approval for primary data collection was obtained from the Ghana Health Service Ethical Review Committee (GHS-ERC 012/10/18). Setting: West Africa and Cameroon Participants: Researchers, policy and programme managers and frontline health workers Interventions: Networking and capacity development Results: The programme made good progress in implementing many but not all planned capacity development and networking activities. The opportunity to network with other organisations and individuals and across countries, disciplines, and languages as well as to learn, to develop skills, and obtain mentorship support, were considered valuable benefits of the partnership. Human and financial resource constraints meant that not all planned interventions could be implemented. Conclusions: Lessons for health policy and systems research capacity building in LMIC include the potential of South-South partnerships, the need for dedicated resources, the potential of Sub-regional health organizations to support capacity building and recognition that each effort builds on preceding efforts of others, and that it is important to explore and understand where the energy and momentum for change lies.

Perception on cervical cancer and enhancing strategies to screening uptake among women in Bamenda, Cameroon: A qualitative method

The treatment of cervical cancer has a good prognosis if diagnosed early. Hence, screening is very vital. The aim of this study was to evaluate the perception of women on cervical cancer and strategies to enhance its screening uptake in the city of Bamenda, Cameroon. Qualitative study was carried out from July, 2019 to August, 2019. Eight focus group discussions were organized in five different quarters in the city of Bamenda. These quarters and participants were purposively selected and each group constituted 6 to 8 Participants. Ethical clearance and administrative authorization for the study were obtained prior to the study. Data was analyzed using thematic analysis with the help of QDA Miner. A total of 53 study participants took part in this study. Their ages ranged between 21 to 45 years. Most participants did not know about cervical cancer. Their perceived barriers to cervical cancer screening included: inadequate sensitization; financial challenges and embarrassing testing strategies; lack of awareness on the availability of screening centers; poor attitude of health personnel. Proposed strategies to enhance cervical cancer screening were: sensitization of the population, recruitment of more competent staff, testing centers should be located closed to the target population, less embarrassing screening methods should be used, health care workers should demonstrate positive attitudes during care, female staff should manage the screening units, screening cost should be subsidized. Due to the Small purposive sample size and qualitative nature of this study, the findings are not generalizable

First delivery of a COVID-19 positive patient in Cameroon

Since its appearance in China in December 2019, COVID-19 which is caused by the SARS-CoV-2 virus has become a real global health problem. Pregnant women are not immune to this novel infection, which makes it difficult for proper management of pregnancy and childbirth. Authors present here the first case of childbirth in Cameroon of a 19-year-old adolescent tested positive for COVID-19.

Prevalence, Infection Intensity and Risk Factors of Schistosomiasis and Soil Transmitted Helminthiasis among School Aged Children in Tiko Health District, Southwest Cameroon: A Community-Based Cross-Sectional Study

Aims:This study aimed at determining the prevalence, infection intensities and risk factors associated with Schistosomiasis (SCH) and Soil transmitted helminthiasis (STH) among school aged children (SAC) in Tiko Health District (THD). Study Design: A community-based cross-sectional study was conducted in three health areas (Likomba, Holforth and Tiko town) in Tiko Health District.Place and Duration of Study: The study was carried out in THD from July to October, 2018.Methodology:The study included 464 children of both sexes aged between 4 –15 years. Stool and urine samples were collected from 464 children and processed using the Kato Katz and Urine filtration techniques respectively. Information on socio-demographic characteristics and risk factors were collected using structured questionnaires. Data was analyzed using SPSS version 25 with statistical significance set at p< 0.05.Results:Of the 464 SAC examined, the overall prevalence of Schistosomiasis, STH and Schistosomiasis/STH co-infection rate in THD was 16.16%, 14.44% and 0.43% respectively. Females (18.98%; 14.81%) were more infected with Schistosomiasis when compared to STH than males (13.71%; 14.11%). The order of STH prevalence observed was Ascariasis (9.27%) > Hookworm disease (3.88%) > Trichuriasis (1.29%). The mean infection intensity for Urinary Schistosomiasis and STH was 4.36 eggs per 10ml and 11.74 eggs per gram (EPG) respectively. SAC residing in Likomba HA were significantly at higher risk of Schistosomiasis (aOR: 4.40, P=0.008) and STH (aOR: 2.14, P= 0.031). Use of tap water was associated with STH.Conclusion: Tiko Health District can be considered as a moderate-risk zone for Schistosomiasis and a low risk zone for STH infection according to WHO classification

Soil-Transmitted Helminths: Prevalence and Intensity of Some Soil Transmitted Nematodes among Pupils in Selected Primary Schools in Penka-Michel Sub-division, West-Cameroon

Background: Soil transmitted helminth infections are Neglected Tropical Diseases (NTD) affecting mostly pupils in developing countries. They seem to lose more and more interest due to the fact that resources and research are being justifiably diverted to more recent priorities such as HIV/AIDS, cancers, tuberculosis and malaria. As a result, specific data on STH infections is often lacking. Aims:To evaluate the prevalence and intensities of STH parasites among pupils in Penka-Michel Sub-division, West-Cameroon in order to refresh information for a better management of these parasitic diseases.Original Research Article Settings and Design:A cross-sectional analytic study was conducted from October to December 2018 in Penka-Michel Sub-division.Methods and Materials:To evaluate the prevalence and intensities of STH parasites among pupils, seven hundred and twenty nine (729) stool samples were collected from pupilsaged 4 to 14 years old in 23 randomly selected primary schools.The samples were analysed using the concentration method of Willis and the Mc Master technic.Results:Out of 729 pupils enrolled, 107(14.7%) were infected with one or more STH parasite species. The nematodes species identified were Ascaris lumbricoides(9.9%), Trichuris trichiura(5.3%) and hookworms (2.2%). Pupils aged from 8 to 11 years were the most infected (17.3%). Statistically females were more infected with hookworms (2.2%). These parasites occurred as monospecific (84.11%), bi-specific (13.0%) and tri-specific (2.80%) infections. The mean fecal eggs count was 3652.78±8715.93, 266.67±273.81 and 118.75±72.74 for A. lumbricoides,T. trichiuraand hookwormrespectively.According to faecal concentration of eggs, 88.18% of infections were light.Conclusion:These results show the necessity of sustainable application of regular deworming, health education and improvements in sanitation among pupils in Penka-Michel Sub-division

An Update on Schistosomiasis: Prevalence, Intensity of Infection and Risk Factors among School-Aged Children in Njombe, Littoral Region, Cameroon

Aims: The study aimed to assess an update of the burden of schistosomiasis among primary school children.Study Design:The study was a school-based cross-sectional study carried out among children aged between 4 to 15 years old.Place and Duration of Study:The study took place in Njombé, Littoral Region, Cameroon from March to April 2017.Methodology:Urine and stool samples were collected were collected from 412 school-aged children and examined using the urine filtration method and the Kato-Katz technique respectively. A questionnaire was administered to assess their water related activities. The data were analyzed using SPSS version 2.0. Logistic regression and odds ratio was used to measure association and strength between variables respectively. P-value < .05 at 95% CI was considered as statistically significant.Results:The overall prevalence of schistosomiasis was 9.7%, with 7,8% and 1,9% of school children infected with S.mansoniand S. haematobium,respectively and 0.7% co-infection with both species. The intensities of S. haematobiumand S. mansoniinfection were 2.1 eggs per 10 mL of urine, 94 eggs per gram of stool respectively. The multiple regression analysis revealed that itching after bathing in backwater (Odds ratio (OR)= 2.427, confidence interval (CI): 1.080 -5454, P=.03). And school children attending EPB Alpha (OR= 2.024), CI: 1.203 –4.804, P=.011). were predictors of schistosomiasis infection. However, significantassociation was found between schistosomiasis and playing in the stream and the presence of the river and back water in thevicinity of schools.Conclusion:There was a drastic decline in the prevalence of schistosomiasis infection in school children in Njombé compared to previous reports. The decrease is attributed to the bi-annual deworming campaign by the Public Health Authorities.

In vitro Anthelmintic Activity of Aqueous and Ethanolic Extract of Senna italica (Caesalpiniaceae) on Three-stages of Haemonchus contortus

A phytochemical screening and in vitroanthelminthic activity of aqueous and ethanolic extract of Senna italicaon Haemonchus contortuswere conducted. Polyphenol, tannin and flavonoid contents were determinedby using gallic acid and rutin. egg hatching inhibition test was carried out on fresh eggs; larval mortality test was conducted on infective larvae (L3) and adult worm mortality test was conducted. Eggs, larvae and adults worms were incubated in aqueous and ethanolic extract of S. italicaat different concentrations (0.1; 0.3; 0.5; 0.7 and 1 mg/mL). All extracts of plants showed an effect on all stages of H. contortuswith high efficiency variations depending on the dose used. The inhibition of eggs hatching rate increased from 8.67±1.53% to 65.67±1.15% and from 24.67±1.53% to 80±1.73% respectively for aqueous and ethanolic extract of S. italic.The larval mortality rate increased from 12.22±2.34% to 56.67±4.9% after 24 h and from 45.28±4.11% to 91.25±3.73% after 48 h for aqueous extract and from 30.07±2.84% to 70.83±6.31% after 24 h and from 48.79±3.73% to 96.25±4.79% after 48 h for ethanolic extract. After 24 h of exposure to aqueous and ethanolic extract of S. italica, the adult mortality rate varies from 55.56±9.62% to 83.33±9.62% for aqueous extract and from 61.11±9.62% to 88.89±9.62%.These in vitroresults confirm the use of S. italicain traditional medicine