Effect of Hepatitis B Vaccination on HBV-infection among school children in Yaounde ten years after its introduction of the HBV vaccine into routine Immunization Program in Cameroon

Introduction: since the introduction of the anti-HBV vaccine into the Expanded Program on Immunization (EPI) in 2005 in Cameroon, vaccination coverage has reached 99.0%. This coverage would indicate an increase the number of children immune to Hepatitis B Virus (HBV) and a decrease in susceptibility to HBV-infection. This study was conducted to evaluate the effect of the HBV vaccine on pediatric HBV-infection in Yaounde, Cameroon. Methods: this school based cross-sectional study was conducted from February to May 2016 among 180 children from Nkomo public school. The study population was stratified into two groups: vaccinated (n=95) versus (vs) unvaccinated (n=85). Screening for HBV biomarkers was done using a rapid panel test for detection (HBsAg, HBeAg and anti-HBc) and anti-HBs titer using enzyme linked immunosorbent assay (ELISA). Statistical analyses were done using SPSS v. 22 with p ≥0.05 considered significant. Results: the mean age was 9.65 years. HBsAg (p=0.019) and anti-HBc (p=0.001) rates were detected in children aged ≥10 years and children aged < 10 years (95.95% [71/74]) were vaccinated vs 22.64% (24/106) for those aged ≥10 years (OR: 80.86; 95% CI: 23.36%-279.87%, p < 0.0001). According to anti-HBV vaccination status, HBsAg rate varied from [9.41% (8/85) to 1.05% (1/95), p=0.025], HBeAg rate varied from [2.35% (2/85) to 0% (0/95), p= 0.42] and anti-HBc rate ranged from [12.94% (11/85) to 2.10% (2/95), p= 0.011]. Conclusion: despite the variability of the anti-HBs titer, vaccination against HBV has a positive effect on the reduction of HBV infection in children in tropical settings such as Cameroon.

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.

Hepatitis B Virus and Behavioural Risk among Blood Donors, Gabon

Background: In resource-limited setting, co-infection between HIV and hepatitis B virus (HBV) poses important public health considerations. This cross-sectional study was undertaken with the aim of determining HBV seroprevalence patterns in urban blood banks.Methods: A cross-sectional study was conducted at an urban blood bank setting. A total of 1610 blood donors were enrolled, and 283 consecutive plasma samples with unknown HBsAg status were selected for risks factors. HBV seroprevalence was based on the Chemiluminescence method (Cobas® e601, Roche). Potential risk factors associated with overt HBV infection were assessed by calculating the crude and adjusted odds ratio, 95% confidence intervalley (95% CI) and p values.Results: Of 1610 participants, overall rate seroprevalence of HBsAg was 5.5% (95% CI: 4.36%–6.58%) ranging from 0.06% (95% CI: 0-0.18) (HCV) to 0.12% (95% CI: 0-0.30)(Syphilis). Seroprevalence of infection increased in older age groups (20-39 years) but men had a statistically significant higher prevalence of overt HBV infection than women (P=0.0001). The multivariate model showed the following to be predictors of HBV infection: male gender (OR=2.5 (95% CI 1.14-5.58), P= 0.02), first-time donor status (OR = 11.06, (95% CI 5.34-22.9), P= 0.01) andresidence outside of Libreville (OR = 2.52, 95% CI 1.09-5.83), P=0.03).Conclusion: HB and co-infection are n o t common in Gabon. Intermediate seroprevalence was associated with male gender, first-time donor status and residence outside of Libreville. HCV andHBV infection among the younger age groups are becoming an alarming issue. Prevention and control of HBV infection are needed to reduce HBV transmission

Prevalence and pattern of lower extremity injuries due to road traffic crashes in Fako Division, Cameroon

Introduction: low and middle income countries are disproportionately affected with road traffic injuries and the lower extremity is one of the most affected anatomical body parts. There exist very limited data on the pattern of lower extremity injuries in the Cameroon especially in the South West Region. We therefore, hypothesized that lower limb injuries are common in road traffic crashes and motorized two wheelers are the commonest cause.Methods: this was a hospital based prospective, cross sectional study. It involved four hospitals (Limbe and Buea Regional Hospitals, Baptist hospital Mutengene and Tiko District Hospital) in the Fako Division. It was carried out for three months. Victims of road traffic crashes received at emergency department of these hospitals during this period were assessed. Crash characteristics and injury characteristics were assessed and recorded.Results: we analyzed 411 crash victims, 197(47.93%) had lower extremity injuries. The male to female ratio was 1.4:1. Majority of crash victims were in their 3rd and 4th decades of life. The mean age of patients who had lower limb injuries was 33.30(±16.04). The most vulnerable road users were pedestrians (26.52%) and passengers on motor bikes (38.44%) and the commonest mechanism by which crash victims sustained injuries were: bike-car collisions (22.84%), and bike-pedestrian collisions (19.29%). Commercial motor bikes (62.77%) and taxis (22.38%) were the road users most involved in road traffic collisions. The leg 98(49.75%), thigh 23(11.68%), and knee 20(10.15%) were the most injured anatomical parts of the lower extremity. Fractures 68 (34.52%), lacerations 53(26.90%), and bruises 49(24.87%) were the most recurrent pattern of lower extremity injuries.Conclusion: in view of our findings we conclude therefore as follows: The prevalence of lower extremity injuries from Road Traffic Crashes in our study area was 47.93%. Associated risk factors to the road traffic crashes as identified by the victims were bad roads (10.15%) and bad weather (5.05%). The safety gargets were not adequately utilized by our victims, with 87.72% confirming that they did not wear the helmet and 87.50% affirming that they did not wear the seat belt at the time of the crash. The occupations mostly affected in our series were pupils and students (20.3%) and business people (19.2%), then the bike riders (15.23%). We thus recommend that the laws on the use of road safety gargets, especially helmets and seatbelts, be enforced, with riding and driving speeds reduced to below 60km/hour. Road usage should be avoided in bad weather and pedestrians lanes and zebra crossings be provided to minimize pedestrian-car or -bike collision

Antioxidant activity of dichloromethane fraction of Dichrocephala integrifolia in Salmonella typhi-infected rats / 中西医结合学报

OBJECTIVE@#Infectious diseases such as typhoid fever lead to the formation of free radicals which can damage the body. Many medicinal plants have antioxidant molecules that neutralize free radicals. The present work evaluated the antioxidant activity and histopathological effects of the dichloromethane fraction of Dichrocephala integrifolia in Salmonella typhi-infected rats.@*METHODS@#The S. typhi-infected rats concurrently received daily doses of D. integrifolia extract at doses of 25, 50 and 100 mg/kg body weight or ciprofloxacin (5 mg/kg body weight) for 15 days. Body temperature was measured daily during infection and treatment periods. At the end of treatment period, the animals were sacrificed and biological responses including hematological parameters, superoxide dismutase and catalase activities, and glutathione, malondialdehyde and nitric oxide concentrations were evaluated.@*RESULTS@#The elevated body temperature induced by infection was significantly decreased in animals treated with 25, 50 or 100 mg/kg of the extract. Platelet levels decreased slightly in infected rats, while treatment with the dichloromethane fraction of D. integrifolia significantly increased platelet levels; this response was greater than that elicited by ciprofloxacin. The doses of 50 and 100 mg/kg of the dichloromethane fraction of D. integrifolia notably decreased monocyte and neutrophil values. Activity of superoxide dismutase and catalase and levels of glutathione in the tissues of treated animals were increased significantly (P < 0.01), while malondialdehyde and nitric oxide levels were significantly decreased (P < 0.01), following treatment with the dichloromethane fraction of D. integrifolia.@*CONCLUSION@#The results of this study show that the dichloromethane fraction of D. integrifolia has protective effects against a series of pathological conditions initiated by oxidation and tissue damage in the course of a S. typhi infection.

Antibacterial Activities of some Medicinal Plants Used for Treatment of Infectious Diseases in the Vina and Mayo-Louti Divisions of Cameroon

Background: In Cameroon, most peoples use traditional medicine treating infectious diseases. To verify the scientific bases of these locally used medicinal plants, an ethnobotanical survey was carried out in some villages of Vina and Mayo-Louti Divisions. Materials and Methods: Interviews were conducted through structured questionnaires among 31 traditional healers living in these divisions. With the medicinal plants revealed, a literature investigation on their therapeutic effects, as well as in vitro antimicrobial activity of these plants were conducted. The agar diffusion method was used to determine the antibacterial activities of the methanol extracts against the pathogens while the Minimum Inhibitory Concentration (MIC) was determined using the Broth dilution method. Result: A total of 15 medicinal plants species belonging to 12 families are being used in the treatment of numerous infectious diseases in the Vina and Mayo-Louti Divisions. Khaya senegalensis (Meliaceae), Terminalia glaucescens (Combretaceae), Flacourtia flavescens wild (Salicaceae), Pterocarpus erinaceus (Fabaceae) and Boswellia dalzielii (Burseraceae) were the mostly used plants for the treatment of infectious diseases in the study areas. Maceration (43.75%) was the common mode of preparation, followed by infusion (31.25%) and decoction (25.00%). Bioassay showed that crude methanol extract of Pterocarpus erinaceus and Flacourtia flavescens were the most active plant extract with a MIC of 0.8 mg/ml on many tested bacteria. The antibacterial activity of Boswellia dalzeilii from Cameroon are reported here for the first time. Conclusion: Many herbals remedies are used in these divisions for the treatment infectious diseases. The plants can be used as source of antibacterial drugs to treat infections caused by susceptible bacteria

pros and cons of the QuantiFERON test for the diagnosis of tuberculosis, prediction of disease progression, and treatment monitoring

Objective/Background: Tuberculosis [TB] is a re-emerging disease with the advent of human immunodeficiency virus/AIDS infections. Discovered in 1959, diagnosed by various approaches and treated with antibiotics, the treatment of TB infection still poses public health concerns. Many cases of resistance and cross-resistance are observed. Diagnosis by culture, which is considered as the standard method, takes too long [20-30 days] and is not suitable for extrapulmonary TB. QuantiFERON test, which is an indirect immunoassay based on blood, was developed. Much hope was placed in this new approach because it is based on blood, and many research teams have used it. We discuss the results of these different research groups who have used QuantiFERON for diagnosis, prediction of disease progression, or monitoring patients during the treatment of TB

Methods: articles published in PubMed and documents published on Google were searched with the keywords: diagnosis and TB and QuantiFERON; TB and QuantiFERON and therapeutic monitoring; interferon-y release assay; disease progression. These articles were read and analyzed

Results: the results were controversial with regards to using the QuantiFERON test for the diagnosis of TB according to the study population [ethnic group, bacillus Calmette-Guerin vaccine use] and according to the state of the immune system of the people studied [human immunodeficiency virus immunosuppression in cancer medication, hypertension]. Also, research findings were controversial with regards to using QuantiFERON for monitoring TB patients on anti-TB medications. Also, the predictive positive value for the progression to TB among immigrant close contacts of both interferon-y release assays was not better than that of the tuberculin skin test

Conclusion: the QuantiFERON has advantages and limitations depending on the type of population studied. Recommendations are made to improve the sensitivity and specificity and to differentiate between latent and active TB by adding other specific proteins in the Mycobacterium tuberculosis antigen cocktail

Activity of Oxalis barrelieri aqueous extract on rat secretory diarrhea and intestine transit.

Oxalis barrelieri is used in the folk medicine for diarrhea treatment. The effects of the aqueous extract of Oxalis barrelieri on castor oil-induced diarrhea and intestine transit were investigated in rats. To induce the diarrhea and enteropooling, animals orally received castor oil (1 mL/100 g bw). Each rat received 30 minutes after, one of the single oral doses of O. barrelieri aqueous extract: 0, 25, 50, 100, 200 and 250 mg/kg bw or loperamide (5 mg/kg bw). The frequency and the total diarrheal weight for diarrhea and the intestine content for enteropooling were measured. To value the extract effect on intestine transit, normal rats received or not acetylcholine 0.1 mg/kg bw i.p. and then different dose of plant extract 50 and 100 mg/kg bw. The extract produced significant (p<0.01) decrease: respectively 95 %, 96.36 %, 99 % and 100 % in the severity of diarrhea. The 50 and 100 mg/kg bw extract produced remarkable (p<0.01) decrease in castor oil-induced enteropooling (59 % and 71.43%), intestine transit (42.12 % and 46.50 %), and reduced acetylcholine action (-65.90 % and -53.73 %) respectively. The results provide evidence that the aqueous extract of O. barrelieri could act on secretory diarrhea and intestinal motility, and thus could justify its traditional use.

Evaluation of the diuretic effects of crude stem bark extraction of Zanthoxylum heitzii (Rutaceae) in Wistar rats / 中西医结合学报

<p><b>OBJECTIVE</b>Zanthoxylum heitzii is a medicinal plant widely used in central Africa for the treatment of many diseases, especially cardiovascular diseases and hypertension. The diuretic effects of crude stem bark extraction were determined and its safety in rats was evaluated.</p><p><b>METHODS</b>The diuretic effects of crude stem bark extraction of Z. heitzii 250 g ± 10 g) of both sexes. The crude stem bark extraction of Z. heitzii at the doses of 225, 300 and 375 mg/kg was administered to rats at 5 mL/kg body weight. Urine volume was determined 1, 2, 3, 4, 5, 6 and 24 h after administration of the extract. Kinetics of electrolyte elimination in response to a single oral administration dose of acute treatment was measured. The experiments were performed under the same conditions with two synthetic pharmacological diuretics considered as reference (furosemide and hydrochlorothiazide). Urinary and plasma concentrations of sodium and potassium ions were determined using flame photometry. Concentrations of creatinine, urea, glucose, albumin and electrolytes in the plasma and urine samples were evaluated using a two-way digital bidirectional spectrophotometer. The osmolarity of plasma and urine samples was measured by cytometry using an osmometer. Aldosterone was measured by radioimmunoassay.</p><p><b>RESULTS</b>The plant extract accelerated the elimination of overloaded fluid and increased urine volume and the excretion of Na+, K+ and Cl- 24 h after administration (P<0.05). The increase in elimination of Na+, K+, and Cl- induced by caused alkalinization of the urine, and showed a strong inhibitory effect on carbonic anhydrase and saluretic. These effects were mainly observed at the dose of 375 mg/kg. At the maximum diuretic response, urinary osmolarity decreased significantly (P<0.05) when compared to controls. The stability of aldosterone level, the absence of correlation with the plasma levels of Na+, and increased clearance of free water in the animals treated with indicated that increased diuresis and natriuresis were tubular in origin. No significant (P>0.05) changes were observed in the body temperature of the animals.</p><p><b>CONCLUSION</b>The significant increase in urine volume 24 h after treatment followed a dose-response pattern. The excretion of Na+, K+ and Cl- caused a decrease in urine osmolarity. The stability of aldosterone, the absence of correlation with the plasma levels of sodium, and increased clearance of free water in animals treated with aqueous extract suggest that increased diuresis and moderate natriuresis elevation were of tubular origin.</p>

Co-Infection of Hepatitis B Virus and Hepatitis Delta Virus in Yaounde-Cameroon.

Aims: To determine the seroprevalence of HDV as well as the virological and clinical characteristics of HBV mono-infected and HBV/HDV co-infected patients. Study Design: The few studies on HDV in Cameroon have reported a high prevalence of this viral infection. This is a first step in describing the virological and clinical profile of HBV mono-infected and of HBV/HDV co-infected patients. Place and Duration of Study: Blood collection was carried out in the Gastroenterology Unit of the Yaounde University Hospital Centre, Yaounde General Hospital and “Centre Médical la Cathédrale”, from August 2012 to May 2013. Methodology: We included into this study treatment-naïve HBV-infected patients from Yaounde irrespective of age and gender free of HIV and HCV infection. Blood samples were collected from each patient for laboratory analysis. Detection of HDV antibodies (Diasorin, Germany) was performed by ELISA and viral load for HBV and HDV was determined using real-time PCR (Abbott Molecular Diagnostics). Patients were classified clinically into low replicative hepatitis, immune tolerance and chronic active hepatitis. Moreover, ultrasound and liver histological data were collected. Results: The population comprised 128 chronic HBV-infected patients of which 77 (60.16%) were male and 51 (39.84%) were female. We found 29 HDV-positive patients representing 22.66% of the population. In the HBV/HDV co-infected group, the mean viral load for HBV was significantly low compared to patients with HBV mono-infection (P = .01). These patients also presented with higher liver cytolysis compared to HBV monoinfected patients (P<.001). Chronic active hepatitis was significantly more prevalent in HBV/HDV co-infected patients (68.96%) compared to HBV mono-infected patients (20.20%). Conclusion: We found that HBV/HDV co-infection results in suppression of HBV replication and such patients show broader sequelae of liver disease. The prevalence of HBV and HDV co-infection is high in this population. Routine screening of HBV-positive individuals for HDV should be implemented in the health services nationwide.

Breastfeeding practices in infants in the west region of Cameroon

The study was conducted to evaluate the knowledge, attitudes and practices of breast-feeding in the West region of Cameroon. A cross sectional descriptive study was conducted in two health facilities on 195 mother-infant pairs, seen at the out patient and vaccination units of the Bafoussam Regional Hospital over a period of one month from 1[st] to 30[th] September 2008. The socio-demographic characteristics of mothers, knowledge on breastfeeding and the practice of breastfeeding were studied. Data was analyzed using the SPSS software. The chi square and student t- test were used for comparison and results considered significant for P< 0.05. Breastfeeding was practised by 99.48% of the mothers. Only 33.8% of the mothers knew that they had to exclusively breastfeed up to 6 months, and 20% effectively breastfed up to 6 months. The mean duration of breastfeeding was 5.06 months and negatively correlated with the number of children and the profession of the mother. In 69.74% of the women, nothing was given to the baby before the first breastfeed. Discontinuation of breastfeeding was done averagely around 15.24 months and earlier in married women and in those with a higher educational level. Although the majority of parents practised breast feeding, only a minority understood its benefits, so more should be done to educate the community on the benefits of exclusive breast-feeding for up to six months