Implementation of a customised antimicrobial resistance laboratory scorecard in Cameroon, Ethiopia and Keny

Background: In low-resource settings, antimicrobial resistance (AMR) is detected by traditional culture-based methods and ensuring the quality of such services is a challenge. The AMR Scorecard provides laboratories with a technical assessment tool for strengthening the quality of bacterial culture, identification, and antimicrobial testing procedures. Objective: To evaluate the performance of the AMR Scorecard in 11 pilot laboratory evaluations in three countries also assessed with the Stepwise Laboratory Quality Improvement Process Towards Accreditation (SLIPTA) checklist.Methods: Pilot laboratory evaluations were conducted in Cameroon, Ethiopia and Kenya between February 2019 and March 2019. Assessors with previous SLIPTA and microbiology experience were trained. Assessors performed the laboratory assessments using the SLIPTA and AMR Scorecard tools.Results: Weaknesses in technical procedures and the quality management systems were identified in all areas and all laboratories. Safety had the highest mean performance score (SLIPTA: 68%; AMR Scorecard: 73%) while management review had the lowest (SLIPTA: 32%; AMR Scorecard: 8%) across all laboratories. The AMR Scorecard scores were generally consistent with SLIPTA scores. The AMR Scorecard identified technical weaknesses in AMR testing, and SLIPTA identified weaknesses in the quality management systems in the laboratories.Conclusion: Since the AMR Scorecard identified important gaps in AMR testing not detected by SLIPTA, it is recommended that microbiology laboratories use SLIPTA and the AMR Scorecard in parallel when preparing for accreditation. Expanding the use of the AMR Scorecard is a priority to address the need for quality clinical microbiology laboratory services in support of optimal patient care and AMR surveillance.

Evaluation of corrective actions of feedback from clinicians on Clinical Laboratory Services at Bamenda Regional Hospital Laboratory, Cameroon

Background: Customers' satisfaction is imperative for success. Clinical laboratories continuously strive to attain very high levels of customer satisfaction to serve their clients and maintain accreditation. The concept of customer satisfaction has not yet been asserted in most clinical laboratories in Cameroon. Objectives: Our objectives were to assess the satisfaction of clinicians with the laboratory services at the Bamenda Regional Hospital Laboratory, identify important challenges, corrective actions implemented and changes in satisfaction. Methods: This retrospective study reviewed secondary data from clinician satisfaction survey records from March 2017 and November 2017. Challenges and implemented corrective actions were identified for assessed statements of dissatisfaction (dissatisfaction rates ≥ 20%) on the March 2017 survey. Satisfaction rates in March 2017 and November 2017 were compared. Results: High levels of dissatisfaction were observed for general satisfaction, waiting time, communication, duty consciousness, specimen collection and approach on the March 2017 survey. The main challenges identified were: lack of respect for the expected length of the waiting time, poor attitude, inadequate information, staff shortage and inadequate supervision. Statistically significant reductions in rates of dissatisfaction were observed for general satisfaction, waiting time, communication, response to emergencies, issuing of results, specimen collection, approach and duty consciousness. Conclusion: Waiting time is a major cause of clinician dissatisfaction with laboratory services. The identification of clinicians' challenges and the effective implementation of corrective actions contribute to improvements in clinician satisfaction

The Susceptibility Pattern of Salmonella Species to Commonly Used Antibiotics in the Bamenda District Health Area; Cameroon

The susceptibility of Salmonella bacteria to commonly used antibiotics such as ampicillin; chloramphenicol and trimethoprim/sulphamethoxazole is threatened by the emergence of resistance strains of Salmonella. A cross-sectional study was carried out from September 2014 to November 2014 in the Regional Hospital Bamenda on individuals presenting with symptoms of salmonellosis. The Salmonellae were isolated from stool by culturing in Salmonella-Shigella Agar and Kliger Iron Agar; the later in which the isolates produced specific biochemical characteristics which were conclusive. They were assessed for antimicrobial susceptibility by the disc diffusion method using Mueller-Hinton Agar following both CLSI and EUCAST manual instructions. A total of 253 samples were collected and 22 cases were positive for Salmonella species with a prevalence of 8.70%. The susceptibility of the isolated Salmonellae to seven antibiotics was noted with ciprofloxacin having an overall sensitivity of 52.38%; ofloxacin; 47.62%; ceftriaxone; 47.62%; and gentamicin; 38.10%. Chloramphenicol had a low sensitivity percentage of 28.57%; while co-trimoxazole and amoxicilin had a high resistance level of 100.00% (0% sensitivity). The fluoroquinolones were found to be the best drugs for the treatment of typhoid; but there was also a noticeable re-emergence of chloramphenicol susceptible Salmonella

HIV Infection among Individuals at the University of Dschang: Prevalence; Awareness; and Sexual Practices

Between September 2009 and October 2010 we conducted a study to determine the HIV prevalence; level of awareness; and sexual practices among students of the University of Dschang; so as to recommend a practical approach to prevention at the institution. HIV testing was carried out using the Determine and Oraquick Diagnostic tests Kits; (Method: As described by the manufacturer) and each respondent completed a questionnaire. Of the 659 respondents; 389 (59) were males and 270 (41) females; of these; 7 (1.1) were confirmed positive by the two tests. All who responded to the questionnaire were aware of the different modes of acquiring HIV-infection; and 137 (56.6) respondents reported heterosexual practice. Compared with the general population; HIV prevalence in this student population is still low and offers an opportunity to develop targeted intervention strategies

Prevention of Mother-to-Child Transmission of the Human Immunodeficiency Virus: Investigating the Uptake and Utilization of Maternal and Child Health Services in Tiko Health District; Cameroon

Introduction: despite evi dence that interventions to prevent mother-to-chil d transmission (PMTCT) of HIV are effective in ensuring a healthy child and keeping mothers alive; there are many challenges to achieving successful interventions in Cameroon. The stu dy was con ducted to investigate factors that affect access to and utilization of maternal and chil d health (MCH) and PMTCT services among women in Tiko health district in Cameroon. Methods: we conducted a cross-sectional; descriptive study on women of reproductive age who had experienced a pregnancy using a self-a dministered; structured questionnaire; in health facilities offering PMTCT services and in communities within the district. Results: four hun dred and thirteen women were interviewed. The majority; 98.4%; of them atten ded antenatal care (ANC) during their most recent pregnancy. Of these women; 87.4% of them made at least four ANC visits. HIV testing during the first visit among the ANC atten dees was 85.5%. Approximately; 92.1% of women who tested for HIV received their results on the same day. All participants reported to have given birth in a health facility during their most recent pregnancy. No education (Odds Ratio [OR] 0.11; 95% CI 0.01-0.83) and acquisition of primary education (OR 0.25; 95% CI 0.06-0.88) was associated with better male partner involvement in PMTCT. Conclusion: the uptake of MCH1PMTCT services was high in this study. Further exploration of these levels is warranted so that this model of care and engagement can be replicated in other parts of the country where uptake is low