Low seroprevalence of Zika virus in Cameroonian blood donors

Abstract A Zika virus seroepidemiology study was performed in 1084 blood donors collected from August to October 2015 in six sites of Cameroon representing a large panel of eco-environments. Samples were tested using an anti-NS1 IgG ELISA detection kit and positives were further confirmed by seroneutralization. The observed global seroprevalence was low (around 5%, peaking at 10% and 7.7% in Douala and Bertoua, respectively) with risk factors associated with seropositivity pointing to the existence of a local (peri-)sylvatic cycle of transmission. These results call attention to the potential introduction and subsequent spread in African urban areas of Asian genotype Zika virus currently circulating in the Americas and adapted to transmission by peri-domestic mosquitoes. They should leverage reinforced surveillance efforts in Africa.

Clinical forms and determinants of different locations of extrapulmonary tuberculosis in an African country.

Background: Extra-pulmonary tuberculosis (EPTB) accounts for about 15% to 36% of all cases of TB and its prevalence has significantly increased with the advent of the global pandemic of human immune-deficiency virus (HIV) infection. A few studies are available on the determinants of EPTB. Aims: To determine the distribution and determinants of the main locations of EPTB in the context of high endemicity for HIV infection. Methods: This was a cross-sectional study among patients aged >15 years, receiving care in the pneumology service of the Yaounde Jamot Hospital, between October 2010 and December 2011. Logistic regressions were used to investigate potential determinants of different locations of EPTB. Results: Of the 788 eligible patients admitted during the study period, 100 (12.7%) had isolated EPTB, and 158 (20.1%) had both PTB and EPTB. Among 258 patients definitively included, 162 (62.8%) were men and the median age was 33 (25.75-44) years. Frequent extra-pulmonary locations of tuberculosis were lymph nodes (126 patients, 48.3%), pleura (121 patients, 46.4%) and peritoneum (25 patients, 9.6%). Using isolated pleural TB as a referent, independent determinants of isolated lymph node tuberculosis were HIV infection [odds ratio (95% CI), 2.58 (1.25-5.32)], duration of symptoms >6 weeks [2.41 (1.11-5.22)] and pulmonary involvement [2.39 (1.14-5.05)]. HIV infection [2.23 (1.06- 4.70)] and duration of symptoms >6 weeks [2.31 (1.08-4.96)] were also independent determinants of multifocal/disseminated tuberculosis. Conclusion: EPTB with or without concomitant PTB is frequent in this setting, with HIV infection being the main determinant.

Antimicrobial resistance of bacterial agents of the upper respiratory tract of school children in Buea, Cameroon.

The study was aimed at determining bacterial agents of the upper respiratory tract and the susceptibility patterns of isolates to antibiotics. In total, 200 throat swabs were obtained from students attending different boarding schools within the Buea Municipality and screened to obtain the prevalence of respiratory pathogens and to understand the antibiotic susceptibility patterns of isolates using standard microbiological procedure and the disc-diffusion test. Of the 200 samples screened, 112 (56%) had positive cultures with the dominant bacterial pathogens being Haemophilus influenzae (20%), followed by Streptococcus pneumoniae (15%), Klebsiella pneumoniae (11%), and Staphylococcus aureus (10%). Although 56% of the isolates were recovered from females compared to 44% from males, the difference was not statistically significant (p>0.05). Sixty-seven percent of the pathogens were isolated from the age-group of 10-13 years, 19.6% from the age-group of 14-17 years, and 12.5% from the age-group of 18-21 years. Antibiotic susceptibility testing revealed that gentamicin (92%) and cefuroxime (88.4%) were the most effective antibiotics against the isolates. Generally, susceptibility ranged from 0% to 92% depending on the antibiotic and the species of microorganism. Penicillin had the highest (100%) resistance to all the isolates. The findings revealed that students living in boarding schools in the Buea Municipality were at risk of acquiring upper respiratory tract infections from their peers since the upper respiratory tract of more than 50% of the students was colonized with respiratory pathogens. Although multidrug-resistant strains of organisms were identified, gentamicin and cefuroxime are recommended as the first-line antibiotics of choice against the pathogens. There is, therefore, a need for surveillance of nasopharyngeal carriage of resistant strains of these organisms, especially H. influenzae in unhealthy school children since the vaccine is yet to be introduced in Cameroon. The findings have clinical and epidemiological significance.

Maternal mortality in Maroua Provincial Hospital, Cameroon (2003-2005)

Background: In September 2000, the Heads of States of the 191 countries of the United Nations approved the Millennium Declaration in which reduction of pregnancy-related deaths to a quarter by 2015 was one of its goals. However, before the middle of the first decade of this millennium, there were no reports on the status of maternal mortality in Maroua, Cameroon.Objective: The aim of this study was to establish baseline data on maternal mortality for future evaluation of pregnancy-related mortality trends in this city. Subjects and Methods: Maternal deaths that occurred from 2003 to 2005 in Maroua City, Cameroon,were analyzed. Mortality ratios were determined by comparing the number of the deaths related to pregnancy with that of women with safe deliveries. Mortality risks were determined by comparing the characteristics of women with pregnancy-related deaths to those of women with safe deliveries. Results: The overall maternal mortality ratio was 1266 maternal deaths per 100 000 live births. The leading causes of death were hypertension (17.5%), obstetric infections (14.3%), uterine rupture(14.3%), anaemia (12.7%) and HIV complications (9.5%). Among the women who died, 28.6% were teenagers and 14.3% were at their sixth delivery (or above). Compared with women aged 20 to 24 years, those aged 25 to 29 years were more than twice as likely to die from pregnancy-related causes (HR: 2.34; CI: 1.07,5.08; p = 0.029). A similar trend was also found in those aged 30 to 34 years (HR: 2.26; CI: 1.02,5.00; p = 0.042). Conclusion: The findings suggest that Maternal Mortality Ratio in Maroua, City, Cameroon, is veryhigh. Since most of the causes of death were preventable, we propose that the current maternal and Family Planning strategies be reviewed with the view to reducing the current trend. Such a strategy would enable the Maroua city to meet the Millennium goals by 2015.

Antecedentes: En septiembre del 2000, los Jefes de Estado de 191 países de la Naciones Unidas, aprobaron la Declaración del Milenio, una de cuyas metas es la reducción hasta una cuarta parte, de las muertes relacionadas con el embarazo, para el año 2015. Sin embargo, antes de mediados de la primera década de este milenio, no habia reportes sobre el estado de la mortalidad materna en Maroua, Camerún. Objetivo: El objetivo de este estudio fue establecer los datos preliminares comparativos de referenciasobre la mortalidad materna para la evaluación futura de las tendencias de la mortalidad en relación con el embarazo en esta ciudad. Sujetos y Métodos: Se analizaron las muertes maternas ocurridas del 2003 al 2005 en la ciudad de Maroua, Camerún. Las tasas de mortalidad fueron determinadas comparando el número de muertesrelacionadas con el embarazo, con el número de mujeres que tuvieron partos seguros. Los riesgos de mortalidad fueron determinados comparando las características de mujeres que murieron por causas asociadas al embarazo, con mujeres que tuvieron partos seguros. Resultados: La tasa general de mortalidad materna fue de 1266 muertes maternas por cada 100 000nacidos vivos. Las causas principales de muerte fueron: hipertensión (17.5%), infecciones obstétricas (14.3%), ruptura uterina (14.3%), anemia (12.7%) y complicaciones por VIH (9.5%). De las mujeres que murieron, 28.6% eran adolescentes y 14.3% estaban en su sexto parto (o por encima). En comparación con las mujeres de 20 a 24 años de edad, las de 25 a 29 años presentaban una probabilidad dos veces mayor de morir por causas relacionadas con el embarazo (HR: 2.34; CI: 1.07, 5.08; p =0.029). Una tendencia similar se halló también en las mujeres de 30 a 34 años de edad (HR: 2.26; CI: 1.02, 5.00; p = 0.042). Conclusión: Los hallazgos sugieren que la tasa de mortalidad maternal en la ciudad de Maroua,Camerún, es muy alta...

Rural bancroftian filariasis in north-western Cameroon: parasitological and clinical studies.

A cross-sectional epidemiological, parasitological and clinical survey of bancroftian filarieasis was conducted in the rural north-western Republic of Cameroon. Of the 1020 respondents (622 males and 398 females) randomly drawn from 4 ethnically homogeneous communities, 148 were microfilaraemic giving an overall prevalence of 14.5%. Association between the ages of individuals and the prevalence of microfilaria (mf) in peripheral circulation was statistically significant (chi 2(6) = 12.59, P < 0.05). More males (7.8%) than females (6.7%) of all ages exhibited mf and was significant statistically (chi 2 = 0.98, P < 0.01). Community-specific prevalence of mf ranged from 11.9% in Bambui to 17.0% in Bambeli. At the community level the overall geometric mean intensity (GMI) of infection was 192 mf per 10 ml of blood (range 165 mf p ml to 248 mf p ml). Overt clinical manifestations of chyluria, elephantiasis and hydrocele were detected among the mf-positive respondents. Thirty one cases (20.9%) involving 15 (18.6%) males and 16 (23.15%) females exhibited chyluria which was absent in children aged 1 < or = 10 years but appeared to be associated with advancing age. Elephantiasis especially of lower extremities and breast was observed in 8 (10.0%) males and 15 (22.0%) females. Highest cases of elephantiasis were recorded for female adults aged 41-60 years (34.6%) of total cases. Hydrocele affected 20.0% of mf-positive males ages > or = 11 years with cases increasing with advancing age. A positive association seems to exist between hydrocele prevalence and the prevalence of microfilaraemia. A total of 1440 female mosquitoes belonging to 3 species were dissected for the presence of microfilariae. Anopheles gambiae complex s.l. was the dominant species and the only one found to be naturally infected with mf. The apparently low mf. intensity in the population, pattern of microfilaraemia, distribution of clinical syndromes and vector species are discussed.

Stroke in children in Yaounde, Cameroon.

Thirty five children aged 5 months to 15 years suffering from stroke were studied from August 1984 to July 1990 from two hospitals in order to determine the incidence, the etiological factors and the short term outcome of the stroke. The average annual incidence was 1.85 per 1000 pediatric hospitalizations. There was a progressive rise in the number of cases from 1985, with a peak in 1990. Motor impairment of one half of the body was the commonest clinical feature seen in 97.1% of the cases. Other clinical signs were: facial paralysis (62.9%) and aphasia (28.6%). The main etiological factors were: homozygous sickle cell disease (31.4%), heart disease (17.1%), cerebral malaria (14.3%) and meningitis (14.3%). No causative factor was identified in 7 patients (20%). The mortality rate was low (2.9%) and all the children had neurological deficit after a mean hospital stay of 15 days. Laboratory investigations including lipid analysis, platelet count, and skull X-rays proved to be of no diagnostic value. However, computed tomography (CT) scan confirmed the diagnosis of ischemic stroke whenever it could be done.