Malaria vectors and transmission dynamics in coastal south-western Cameroon

Background: Malaria is a major public health problem in Cameroon. Unlike in the southern forested areas where the epidemiology of malaria has been better studied prior to the implementation of control activities; little is known about the distribution and role of anophelines in malaria transmission in the coastal areas. Methods: A 12-month longitudinal entomological survey was conducted in Tiko; Limbe and Idenau from August 2001 to July 2002. Mosquitoes captured indoors on human volunteers were identified morphologically. Species of the Anopheles gambiae complex were identified using the polymerase chain reaction (PCR). Mosquito infectivity was detected by the enzyme-linked immunosorbent assay and PCR. Malariometric indices (plasmodic index; gametocytic index; parasite species prevalence) were determined in three age groups (5yrs; 5-15yrs; 15yrs) and followed-up once every three months. Results: In all; 2;773 malaria vectors comprising Anopheles gambiae (78.2); Anopheles funestus (17.4) and Anopheles nili (7.4) were captured. Anopheles melas was not anthropophagic. Anopheles gambiae had the highest infection rates. There were 287; 160 and 149 infective bites/person/year in Tiko; Limbe and Idenau; respectively. Anopheles gambiae accounted for 72.7; An. funestus for 23and An. nili for 4.3of the transmission. The prevalence of malaria parasitaemia was 41.5in children 5 years of age; 31.5in those 5-15years and 10.5in those 15years; and Plasmodium falciparum was the predominant parasite species.Conclusions: Malaria transmission is perennial; rainfall dependent and An. melas does not contribute to transmission. These findings are important in the planning and implementation of malaria control activities in coastal Cameroon and West Africa

Rupture prématurée des membranes: devenir maternel et foetal en l'absence de la prophylaxie antibiotique

La prophylaxie antibiotique dans la prise en charge des Ruptures prématurées des Membranes (RPM) avant le terme est jusqu'à nos jours controversés. Cent dix femmes enceintes avec Rupture Prématurée des Membranes avant terme ont été distribuées dans l'un des deux groupes suivants: groupe A (groupe sans traitement) ou groupe B (groupe sous traitement). Les taux d'accouchements prématurés étaient similaires 71 pour cent contre 77 pour cent (p=0;56). Le faible poids à la naissance; le score d'Apgar; la détresse fœtale; l'ictère néonatal et l'infection néonatale ont été observées dans les proportions similaires entre les deux groupes 6.5 pour cent des sujets du groupe A ont développé une endométrite contre 5.7 pour cent dans les groupes A et B (p=0;13). La prophylaxie antibiotique n'a pas semblé influencer le pronostic materno-foetal chez les patients présentant une Rupture Prématurée des Membranes dans notre environnement

Diagnostic de la situation

L'infertilite etant une situation qui concerne l'homme et la femme; son investigation implique le couple et il est souhaitable de voir les deux conjoints en consultation. Car leur interrogatoire faciliterait le diagnostic. A cela s'ajoute les tests simples et de routine de l'infertilite pouvant etre effectues au premier niveau des soins

Maternal serum alpha fetoprotein screening test in routine antenatal care : Is it cost effective in Cameroon?

Screening test for maternal serum alpha feoto-protein (MS-AFP) in routine antenatal care is compulsory in most developed countries to detect neural tube defect (NTD). With the cost of suck a programme; there was a need to evaluate its need in our environment. A high risk clinic was choosen for the recruitment of the subjects to maximize the risk. Incidence of NTD could be considered to be low in Cameroon compared to countries where screening for MS-AFP is compulsory. Coupled with the low socio-economic status of our population and the lack of infrastructures; we could conclude that this screening test on a routine basis is not cost-effective