Formative Research: A Necessary Step for the Implementation of a Home Fortification Program in Cameroon.

Objectives: To understand caregivers' knowledge on anemia, barriers to optimal infant and young child feeding (IYCF) practices, and the acceptability and appropriate use of micronutrient powders (MNP) in households of children 6-23 months, in order to inform an implementation of MNP in Cameroon. Methods: The study was conducted in health districts of the North and South regions, areas with high prevalence of anaemia among young children. There were two steps: 1) situation analysis including focus group discussions and key informant interviews, 2) 30 day study to assess MNP acceptability and utilization. Caregivers (N=101) were interviewed at baseline, day 10, and day 30. Data were both qualitative and quantitative. Results: The situation analysis demonstrated that knowledge on anaemia and IYCF practices were not appropriate. Potential MNP food vehicles were identified. The 30 day study showed high rates of acceptability (100%). Adherence was challenging for the group on a rigid schedule (30 MNP sachets for 30 days) mainly due to child illness related interruption, which is why a flexible schedule (15 MNP sachets for 30 days) was found more feasible. Opposition to and rumours regarding MNP were observed in some cases. The main motivation factors for giving MNP cited by caregivers were: make child healthy, improve immune system and stimulate appetite. Conclusions: The formative research demonstrated the importance of a strong community sensitisation. A comprehensive communication strategy and community-based capacity building are essential to maximise acceptability, appropriate MNP utilization, adherence, and prevent rumour generation. Further, implementing MNP provides a great opportunity to strengthen IYCF.

Efficacite de la polyvidone Iodee a 2;5 dans la prevention de l' ophtalmie neonatale a Yaounde; Cameroun

Objectif: Determiner l'efficacite de la polyvidone a 2;5 comparativement aux collyres usuels dans la prevention de l'ophtalmie neonatale a Yaounde. Materiels et methodes : Il s'agissait d'un essai clinique randomise realise dans deux formations sanitaires a Yaounde d'Octobre 2009 a Mars 2010. Cinq cent nouveau-nes dont les meres avaient donne leur consentement verbal etaient recrutes. Les donnees portaient sur les caracteristiques sociodemographiques; l'histoire obstetricale et les parametres anthropometriques du nouveau-ne. L'intervention consistait en une application oculaire a la naissance de polyvidone iodee a 2;5 ou de collyres usuels. Les nouveau-nes etaient suivis pendant trois jours a l'hopital puis par relance telephonique pour la survenue de conjonctivite. La clairance ethique etait obtenue du Comite National d'Ethique. L'analyse des donnees s'etait faite a l'aide du logiciel Epi-Info 3.5.1. Le seuil de significativite etait de 0;05. Resultats : Sur les 245 nouveau-nes du groupe polyvidone iodee a 2;5 et les 244 du groupe collyres usuels; le nombre d'ophtalmie neonatale etait identique soit 3 (1;2) respectivement (p=0;65). Le Klebsiella pneumoniae; l'Acinetobacter calcoaceticus et le Streptococcus pneumoniae etaient les germes isoles. Conclusion : L'efficacite de la polyvidone iodee a 2;5 a ete comparable a celle des collyres usuels dans la prevention de l'ophtalmie neonatale. Elle serait a recommander vu son faible prix

La gale humaine : profil sociodemographique; distribution lesionnelle et types de lesions

Introduction : La gale humaine est une ectoparasitose due a Sarcoptes scabiei; parasite humain obligatoire. Son diagnostic est essentiellement clinique. Plusieurs auteurs ont recemment decrit sa recrudescence. Ainsi avons-nous voulu etablir un profil socio-demographique; ressortir la distribution lesionnelle et le type de lesions de la scabiose rencontree au cours de nos consultations de Dermatologie a Yaounde (Cameroun). Methodologie : Nous avons mene une etude descriptive et analytique a Yaounde pendant 12 mois (Octobre 2011 a Septembre 2012). Les patients avec un diagnostic de gale humaine pose durant la consultation initiale etaient inclus dans cette etude ouverte au tout venant. Les donnees recoltees prospectivement etaient saisies et analysees sous le logiciel Epi infos version 3.5.3. Resultats : 255 patients etaient retenus dont 158 (62) de sexe masculin et 97 (38) de sexe feminin. L'age variait de 0 a 80 ans avec une mediane de 18; 151 (59.2) etaient contamines par un proche ; 176 (69) signalaient une notion de contage et on notait 42 cas (16;5) de recidive. Une a huit personnes dans l'entourage avait un prurit. Les lesions siegeaient aux plis sous fessiers (71;8); aux poignets (70;2); aux plis inter fessiers (56;5). Les points crouteux (82;4); les papules (69;8) et les papulo-vesicules (68;6) etaient observes. Conclusion : La scabiose reste d'actualite et sa tendance a la propension necessite une sensibilisation aussi bien des populations que des praticiens au diagnostic precoce et a la prise en charge dans un bref delai

Social Stigma as an Epidemiological Determinant for Leprosy Elimination in Cameroon

Leprosy has been eliminated as a public health problem in most countries of the world according to the WHO; but the social stigma to the disease is still very high. The present study was performed to investigate the role of social stigma as a determinant for leprosy elimination in a leprosy endemic region of Cameroon. Focus group discussions; in-depth interviews and structured questionnaires were used to investigate leprosy social stigma among lepers; their contacts and a control group consisting of patients attending a health facility for reasons other than leprosy. Informed consent was sought and gained prior to starting the study. Focus group discussions and in-depth interviews identified three types of stigma: lack of self-esteem; tribal stigma and complete rejection by society. From the 480 structured questionnaires administered; there were overall positive attitudes to lepers among the study population and within the divisions (P=0.0). The proportion of participants that felt sympathetic with deformed lepers was 78.1[95confidence interval (CI): 74.4-81.8] from a total of 480. Three hundred and ninety nine (83.1) respondents indicated that they could share a meal or drink at the same table with a deformed leper (95CI: 79.7-86.5). Four hundred and three (83.9) participants indicated that they could have a handshake and embrace a deformed leper (95CI: 80.7-87.3). A total of 85.2(95.0CI: 81.9-88.4) participants affirmed that they could move with a deformed leper to the market or church. A high proportion of 71.5(95.0CI: 67.5-75.5) participants stated that they could offer a job to a deformed leper. The results indicate that Menchum division had the lowest mean score of 3.3 on positive attitudes to leprosy compared with Mezam (4.1) and Boyo (4.8) divisions. The high proportion of positive attitudes among the participants and in different divisions is a positive indicator that the elimination of leprosy social stigma is progressing in the right direction. Quantification of stigma to assess the elimination struggle is a new research area in public health