Impact of short-term discontinuation of ivermectin-based chemoprevention on onchocerciasis transmission in endemic settings with long history of mass drug administration.

BACKGROUND: The control of onchocerciasis currently relies on annual distribution of single dose ivermectin. Because ivermectin has minimal effects on the adult parasite, mass drug administration (MDA) campaigns against onchocerciasis require at least 15 years of annual uninterrupted ivermectin distribution. Mathematical models have predicted that short-term disruption of MDA (as was seen during COVID-19) could impacted the microfilaridermia prevalence depending on the pre-control endemicity and the histories of treatment, requiring corrective measures (such as biannual MDA) to mitigate the effect on onchocerciasis elimination. Field evidence supporting this prediction, however, has yet to be gathered. This study aimed to assess the impact of ~2 years disruption of MDA on onchocerciasis transmission indicators. METHODOLOGY: A cross-sectional survey was carried out in 2021 in seven villages of Bafia and Ndikinimeki, two health districts located in the Centre Region, Cameroon, where MDA has been ongoing for two decades, but interrupted in 2020 as a response to the COVID-19 pandemic. Volunteers aged 5 years and above were enrolled for clinical and parasitological examinations for onchocerciasis. Data were compared with pre-COVID-19 prevalence and intensity of infection from the same communities to measure changes over time. PRINCIPAL FINDINGS: A total of 504 volunteers (50.3% males), aged 5-99 years (Median: 38; IQR: 15-54) was enrolled in the two health districts. The overall prevalence of microfilaridermia in 2021 was similar in Ndikinimeki health district (12.4%; 95% CI: 9.7-15.6) and Bafia health district (15.1%; 95% CI: 11.1-19.8) (p-value = 0.16). Microfilaridermia prevalences were either similar between 2018 and 2021 in the communities of Ndikinimeki health district (19.3% vs 12.8% (p = 0.057) for Kiboum 1; and 23.7% vs 21.4% (p = 0.814) for Kiboum 2), or higher in 2019 compared to 2021 in the communities of Bafia health district (33.3% vs 20.0% (p = 0.035) for Biatsota). The mean microfilarial densities in these communities dropped from 5.89 (95% CI: 4.77-7.28) mf/ss to 2.4 (95% CI: 1.68-3.45) mf/ss (p-value < 0.0001), and from 4.81 (95% CI: 2.77-8.31) mf/ss to 4.13 (95% CI: 2.49-6.86) mf/ss (p-value < 0.02) in Bafia and Ndikinimeki health districts, respectively. Community Microfilarial Load (CMFL) dropped from 1.08-1.33 mf/ss in 2019 to 0.052-0.288 mf/ss in 2021 in Bafia health district while remaining stable in the Ndikinimeki health district. CONCLUSION/SIGNIFICANCE: The continued decline in prevalence and CMFL observed ~2 years after MDA disruption is consistent with mathematical predictions (ONCHOSIM) and shows that additional efforts and resources are not needed to mitigate the effects of short-term MDA disruption in highly endemic settings prior to intervention with long treatment histories.

COVID-19: Comparison of Vaccination Coverage between Oral Health Care Practitioners and Other Health Care Personnel in Yaounde

Introduction: COVID-19 is a global pandemic for which vaccination coverage is still low in our environment. Health care workers and particularly those in the oral sphere are at high risk of contracting it. General objective: To evaluate the COVID-19 vaccination coverage among oral health care workers in comparison with other health care workers in Yaounde. Materials and methods: We conducted a cross-sectional study on 360 individuals in three hospitals in Yaounde, from February to April 2022, i.e., 3 months. All health personnel who gave their free consent consecutively were included. Statistical analysis was performed using SPSS 26.0 software with a statistical significance level of p<0.05. Results: The coverage rate of the COVID-19 vaccine was 34.2%. The rates of vaccination against COVID-19 were 43.3% and 32.2% in oral sphere practitioners and others respectively (p=0.135). There was no statistically significant difference in the distribution of vaccine received, adverse events and post-vaccination infection rate against SARS-CoV-2 between our two groups (p≥0.05). Conclusion: A similar distribution was found between oral health professionals and other health personnel in terms of vaccination rate, type of vaccine received, and post-vaccination adverse events against SARS-CoV-2. Education seems to be a priority action to target the most at-risk populations.

Anti-COVID-19 Vaccination: Perception and Attitudes among Oral Health Practitioners and Other Health Personnel in Yaoundé

Introduction: Vaccination against COVID-19 promoted among high-risk populations such as an oral health care worker is one of the most rapidly and massively deployed interventions in history. Objective: The overall objective of our study was to assess the perception and attitudes regarding COVID-19 vaccination among oral health care workers in comparison to other health care workers in Yaoundé. Materials and methods: A cross-sectional study was conducted from February to April 2022 (3 months) on 360 health personnel in three hospitals in Yaoundé. All health personnel who gave informed consent were included in the study. Statistical analysis was performed using SPSS 26.0 software with a significance level of p<0.05. Results: In more than half of the cases, doubt about the efficacy of the COVID-19 vaccines was found without any difference between the oral practitioners (53.3%) and the others (58.7%) (p=0.476). Fear of harm was mainly found among oral practitioners (75.0% vs 46.4%;p=0.006). There was no statistically significant difference in terms of vaccination coverage and motivations for vaccination between our two socio-professional groups (p ≥0.05). Conclusion: the fear of the harmfulness of the COVID-19 vaccine was preponderant among healthcare personnel working in the oral sphere. De-structuring the representation of this vaccine among this population could improve the response to this disease.

Gender and COVID-19 Vaccine Disparities in Cameroon

Six months following the national launch of COVID-19 vaccinations in Cameroon, only 1.1% of the target population was fully vaccinated, with women representing less than one-third of the vaccinated population regardless of age, profession, or comorbidities. Hence, the aim of this study was to understand the low COVID-19 vaccination rate of women in order to enhance vaccine uptake. A cross-sectional study was conducted between July and October 2021 through an online survey. Additionally, a retrospective analysis of the Cameroon Ministry of Public Health (MINSANTE) database of the pandemic (COVID-19) for the period of March 2020 to October 2021 was simultaneously carried out. Our sample consisted of 249 responders aged between 18 and 50 years enrolled in the 10 regions of Cameroon, with 142 (57%) who were female. We assessed factors related to having been vaccinated against COVID-19 and predictors of COVID-19 vaccination among non-vaccinated people. Concerning COVID-19 vaccination, 39.2% were not vaccinated. Non-vaccination was statistically associated with being female, being a healthcare worker, fear of adverse effects, and not believing in the vaccine. In the qualitative analysis, women identified themselves as being anti-COVID-19-vaccine for several reasons, including doubts about the quality or safety of the vaccine;the perception that COVID-19 vaccines are presented as being an obligation;and regarding the multitude of vaccines on the market, the belief that there are 'more local';effective alternatives to the vaccine. The implementation of the gender approach to COVID-19 vaccination is one factor influencing its effectiveness and sustainability.

Challenges, best practices, and lessons learned from oral cholera mass vaccination campaign in urban Cameroon during the COVID-19 era.

BACKGROUND: Since 1971, Cameroon has been facing an ever-growing series of cholera epidemics; despite all the efforts made by the government to address this substantial public health problem. In 2020, in addition to the COVID-19 pandemic, Cameroon recorded a high cholera case fatality rate of 5.3% following epidemics noted in the South, Littoral, and South-West regions which is far higher than the 1% World Health Organization acceptable rate. METHODOLOGY/PRINCIPAL FINDINGS: The Ministry of Public Health organized a reactive vaccination campaign against cholera to address the high mortality rate in the affected health districts. The first round was in August 2020 and the second in March 2021. We conducted a cross-sectional study and reviewed this vaccination campaign's challenges, best practices, and lessons. The vaccination coverage for the two doses of the oral cholera vaccine was 80.4%, with a refusal rate as high as 67%. People 20 years and above recorded the lowest vaccination coverage. The main challenge was misinformation about the cholera vaccine. The best practice was thorough population sensitization through community actors. CONCLUSION: Proper communication will always brave the odds of hesitancy and favor mass population vaccination to thwart hesitancy and consolidate herd immunity.

The first 30 days of COVID-19 vaccination in Cameroon: achievements, challenges, and lessons learned.

Introduction: Cameroon's national vaccination campaign was launched on April 12, 2021, amid a nationwide outbreak of COVID-19 with two types of vaccines. This study provides preliminary evidence to assess early outputs of the COVID-19 vaccination response strategy implementation. Methods: a cross-sectional study was conducted from April 12, 2021, to May 11, 2021, and data on COVID-19 vaccination were reviewed from the Ministry of Public Health database. Descriptive statistical analyses were conducted. Results: thirty days after the introduction of COVID-19 vaccines, just about five percent of the target population was vaccinated. Women represented one-third of the people vaccinated regardless of age and health conditions. Although AEFI reported were minor and scanty with both vaccines, most of the vaccinated did not come back for their second dose. There was a need to build confidence among eligible beneficiaries to expand the benefits of vaccination to control the current pandemic. Conclusion: the country was still far below the target, which was worrisome given that vaccine uptake was slow. Also, 391 200 doses of the Covishield were at risk of expiration in August 2021. This study offers insights into those early efforts contributing to significant discussions about the approaches to improve service delivery and vaccine uptake.

Unexpected low burden of coronavirus disease 2019 (COVID-19) in sub-Saharan Africa region despite disastrous predictions: reasons and perspectives.

The severe acute respiratory syndrome coronavirus-2 (SARS-CoV-2) is responsible for the development of a highly contagious disease called coronavirus disease (COVID-19). Ten months after the onset of the pandemic, America and Europe remain the most affected regions. Initially, experts predicted that Africa, the poorest continent with the most vulnerable population and health system, would be greatly affected by the ongoing outbreak. However, 240days after the first confirmed case, Africa is among the least affected region, with lower than expected incident cases and mortality. In this review, we discuss possible explanations and reasons for this unexpected low burden of COVID-19 in Africa. We focus on the characteristics of the virus, specificities of the sub-Saharan African population and local environment.

Support for families of isolated or deceased COVID-19 patients in sub-Saharan Africa.

Aside the direct effect of the COVID-19 on infected patients, this infectious disease outbreak has various psychological consequences. These mental health repercussions pertain to the general population of uninfected individuals, and particularly families of isolated or deceased COVID-19 patients. This aspect is of substantial interest amid sub-Saharan African communities, considering the key place and cultural significance of mourning and funerals in these settings. In this commentary, we discuss on the issue of psychological and social support of COVID-19 patients' families, by taking into account some sub-Saharan African cultural considerations.