Fertility Desire and Reproductive Health Education Needs of Women Living with HIV Receiving Care at Regional Hospital Limbe HIV Treatment Centre.

Aims: Fertility desires among persons living with HIV (PLHIV) could have important HIV prevention and demographic implications particularly in high prevalence settings such as Cameroon. There is a paucity of data on fertility desires and associated factors among PLHIV in Cameroon. The aim of the study was to determine whether HIV positive women desire having children so as to improve on the sexual and reproductive health messages and services provided to them. Study Design: This was a facility based cross-sectional study. Place and Duration of Study: Regional Hospital Limbe (RHL) HIV treatment centre between May and June 2014. Methodology: Systematic sampling was used to select 250 women between the ages of 15–49 years as they consulted at the clinic. Participants were recruited and data collected using an interviewer administered questionnaire. Results: Mean age was 32 years and 75.9% were sexually active. In this study, 51.4% were not married while 48.6% were married. Fertility desires was high (83.3%) and child bearing after HIV diagnosis was common (48%) with 71.2% of them not going in for preconception counseling. In multivariate analysis, older age (OR: 20.895, 95%CI: 5.3-83.5), not using condom (OR: 30.021, 95% CI: 3.4-262.6) and not being married (OR: 4.87, 95%CI: 1.4-17.6) were having a significantly higher chance of desiring children in future. Majority of WLWHIV (86.9%) indicated a need for RH education. Fertility desire (OR: 11.013, P=.001), previous RH discussions (OR: 7.49, P=.001) and knowledge of PMTCT (OR: 3.647, P=0.021) were the best predictors of RHE need. Conclusion: A substantial number of WLWHIV attending RHL HIV treatment centre desire having children and there is unmet Reproductive Health Education needs for these women. There is need to sought new strategies to address reproductive health care services so as to satisfy reproductive health care needs of HIV positive woman in Cameroon.

Co-infection of Malaria and Typhoid Fever in Feverish Patients in the Kumba Health District, Southwest Cameroon: Public Health Implications.

Aims: This study was aimed at generating updated baseline data on co-infection of malaria and typhoid fever and finding out the implications of these co-infections in disease severity. Study Design: The study was cross-sectional. Place and Duration of Study: The study was carried out in Kumba, Southwest Cameroon from May to July, 2010. Methodology: Venous blood was collected from 206 febrile patients of both sexes aged 4-80 years old at the Kumba District Hospital. Malaria parasite density and speciation were determined using Giemsa-stained thick and thin blood films respectively. Typhoid fever was diagnosed by isolation and characterisation of the aetiologic agent from stool samples in 178/206 patients. Antimicrobial susceptibility of recovered isolates was determined by the disc diffusion method. Anaemia status, Alanine aminotransferase (ALT) and Aspatate aminotransferase (AST) values were determined. Results: Overall malaria prevalence was 90.3% (186/206) while geometric mean parasite density (GMPD) was 866 (range: 40 – 64880) parasites/μL of blood. Plasmodium falciparum was the most prevalent Plasmodium species. Overall prevalence of typhoid fever was 7.9% (14/178) while malaria/typhoid fever co-infection rate was 6.74% (12). Of the 14 typhoidal Salmonella isolates recovered, 6 were identified as Salmonella typhi and 8 as S. paratyphi. The Salmonella isolates were all susceptible to ciprofloxacin and gentamycin. Patients co-infected with malaria/typhoid fever had a significantly higher (P = .007) GMPD (1203, range: 100-64880 parasites/μL) when compared to patients with mono-infections of malaria (774, range: 40-18660 parasites/μL). Abnormal ALT and anorexia prevalence values were significantly higher (P=.01 and P =.045 respectively) in patients with only typhoid fever than their counterparts. The values of anaemia and AST were comparable in all groups of patients. Conclusion: This study confirms that co-infections of malaria and typhoid fever are common and may exacerbate malaria intensity.

IS6110 Restriction Fragment Length Polymorphism Typing of Drug-resistant Mycobacterium tuberculosis Strains from Northeast South Africa.

Tuberculosis (TB) remains a deadly infectious disease affecting millions of people worldwide; 95% of TB cases, with 98% of death occur in developing countries. The situation in South Africa merits special attention. A total of 21,913 sputum specimens of suspected TB patients from three provinces of South Africa routinely submitted to the TB laboratory of Dr. George Mukhari (DGM) Hospital were assayed for Mycobacterium tuberculosis (MTB) growth and antibiotic susceptibility. The genetic diversity of 338 resistant strains were also studied. DNA isolated from the strains were restricted with Pvu II, transferred on to a nylon membrane and hybridized with a PCR-amplified horseradish peroxidase 245 bp IS6110 probe. Of the 338 resistant strains, 2.09% had less than 5 bands of IS6110, and 98% had 5 or more bands. Unique restriction fragment length polymorphism (RFLP) patterns were observed in 84.3% of the strains, showing their epidemiological independence, and 15.7% were grouped into 22 clusters. Thirty-two strains (61.5%) from the 52 that clustered were from Mpumalanga, 16/52 (30.8%) from Gauteng, and 4/52 (9.6%) from Limpopo province. Clustering was not associated with age. However, strains from male patients in Mpumalanga were more likely to be clustered than strains from male patients in Limpopo and/or Gauteng province. The minimum estimate for the proportion of resistant TB that was due to transmission is 9.06% (52-22=30/331). Our results indicate that transmission of drug-resistant strains may contribute substantially to the emergence of drug-resistant tuberculosis in South Africa.

Inhibitory and Bactericidal Potential of Crude Acetone Extracts of Combretum molle (Combretaceae) on Drug-resistant Strains of Helicobacter pylori.

Infection with Helicobacter pylori is strongly associated with a number of gastroduodenal pathologies. Antimicrobial resistance to commonly-used drugs has generated a considerable interest in the search for novel therapeutic compounds from medicinal plants. As an ongoing effort of this search, the susceptibility of 32 clinical strains of H. pylori and a reference strain—NCTC 11638—was evaluated against five solvent extracts of Combretum molle, a plant widely used for the treatment of gastric ulcers and other stomach-related morbidities in South Africa. The extracts were screened for activity by the agar-well diffusion method, and the most active one of them was tested against the same strains by micro-broth dilution and time kill assays. Metronidazole and amoxicillin were included in these experiments as positive control antibiotics. The solvent extracts all demonstrated anti-H. pylori activity with zone diameters of inhibition between 0 and 38 mm. The most potent anti-H. pylori activity was demonstrated by the acetone extract, to which 87.5% of the clinical strains were susceptible. The minimum inhibitory concentration (MIC90) values for this extract ranged from 1.25 to 5.0 mg/mL while those for amoxicillin and metronidazole ranged from 0.001 to 0.94 mg/mL and from 0.004 to 5.0 mg/mL respectively. The acetone extract was highly bactericidal at a concentration of 2.5 and 5.0 mg/mL, with complete elimination of the test organisms in 24 hours. Its inhibitory activity was better than that of metronidazole (p<0.05) as opposed to amoxicillin (p<0.05). The results demonstrate that C. molle may contain therapeutically-useful compounds against H. pylori, which are mostly concentrated in the acetone extract.

Phenotypic Characterization of Salmonella Typhimurium Isolates from Food-animals and Abattoir Drains in Buea, Cameroon.

Salmonella spp. have been extensively incriminated worldwide as common causes of bacterial gastroenteritis in humans, with food-animals serving as important reservoirs. The study was aimed at investigating cattle and pigs slaughtered in Buea as reservoirs of Salmonella Typhimurium and the susceptibility of isolates to antibiotics. In total, 230 specimens (comprising 50 each from the rectum, ileum, and gall bladder of cattle; and 10 each from same anatomical sites of pigs and 50 from abattoir drains) were analyzed for Salmonella using the standard microbiological, biochemical and serological techniques. Antibiotic susceptibility of the isolates was determined by the Kirby-Bauer disc-diffusion test. The isolates were characterized into biotypes using the API 20E kit, and results were analyzed using the chi-square test. Seventy-five (32.6%) of the 230 specimens were positive for S. Typhimurium, with pigs and abattoir drains presenting the highest level of isolation (40%). Biochemical typing grouped the isolates into five biotypes. Biotype I was the most prevalent (30.6%) while biotype IV was the least prevalent (9.3%) and was absent in samples from pigs. Antibiotic susceptibility studies revealed 14 antibiotypes based on antibiotics used in the study. The predominant antibiotype AMXR DOXRCEFR was recorded in 13 (17.3%) of the isolates. Multidrug resistance (to four or more antibiotics) was recorded in 50.7% (38/75) of the isolates. The most active drugs were ciprofloxacin (98.6%), ofloxacin (93.3%), amikacin (90.6%), and gentamicin (84%). All the isolates (100%) were resistant to tetracycline and ampicillin. Cattle and pigs were found to be reservoirs of S. Typhimurium in the environment of Buea, Cameroon, implying that foods from these sources, if not properly handled, could serve as vehicles for its transmission to humans.