Effect of Some Plant Growth Hormones on the Performance of Artemisia vulgaris L. Cuttings

In the wake of the novel coronavirus (COVID-19), many plant material such as artemisia (Artemisia vulgaris L) have received renewed attention as cheap, easy-to-make treatment for many infections. However, the proliferation of artemisia from seeds is often a lengthy process. Here we investigated the role of commercial (Indol-3-butyric acid - IBA, Natural Rooting Hormone Powder - NRHP, Apple Cider Vinegar - ACV) and cottage-made (coconut water - CW and aloe vera gel - AVG) rooting hormone, and water as control (CONT) on the proliferation of artemisia cuttings in a greenhouse experiment in 2021. The survival of artemisia cuttings did not differ significantly (P > .05) across the treatments. The highest number of stems (19) and plant height (138.0 cm) was observed from CW + AVG, and the differed significantly from the others (P < .05) from the others. AVG produced the highest number of leaves per plant (1466), followed by CW (1317), CW + AVG (1278), and IBA (1241). The leaf dry weight was highest in CW + AVG, followed by those of CW and IBA. A similar pettern was observed for the root dry weight. The findings from this study showed that cottage-made plant based (coconut water and aloe vera gel) growth hormone has comparable effect to commercially available IBA on overall performance of artemisia cuttings. This study has great implications for low-tech proliferation of artemisia.

Community Health Education for Health Crisis Management: The Case of COVID-19 in Cameroon.

The current coronavirus disease 2019 (COVID-19) pandemic has led Cameroon's government to implement public health measures aimed at preventing its spread. This paper investigates how community health education on the virus was being carried out, what gaps exist and what further action could be taken. A survey instrument was used to gather data among a total of 179 Cameroonians recruited via opportunistic and snowball sampling methods. According to our findings, gaps exist. These include the need for adequate community health education on COVID-19, maximising multilingualism and indigenous cultural assets and disbanding misconceptions on the pandemic, as well as stigmatisation. The paper culminates by underlining the significance of an integrated approach to confront the pandemic. This approach captures the need to frame but also firm up community health education architecture on COVID-19 that captures inputs from different stakeholders, including indigenous knowledge holders, for collective wellbeing.

Impacts of the COVID-19 pandemic on livelihoods and wild meat use in communities surrounding the Dja Faunal Reserve, South-East Cameroon.

The COVID-19 outbreak has had considerable negative impacts on the livelihoods and living conditions of communities around the world. Although the source of COVID-19 is still unknown, a widely spread hypothesis is that the virus could be of animal origin. Wild meat is used by rural communities as a source of income and food, and it has been hypothesised that the pandemic might alter their perceptions and use of wild meat. McNamara et al. (2020) developed a causal model hypothesising how the impacts of the pandemic could lead to a change in local incentives for wild meat hunting in sub-Saharan African countries. From February 27 to March 19, 2021, we carried out a survey around the Dja Faunal Reserve, Southeast Cameroon, to test McNamara et al.'s model in practice, using semi-structured questionnaires to investigate the impacts of the COVID-19 outbreak on wild meat hunting and consumption. Our results generally agree with the causal pathways suggested by McNamara et al. However, our study highlights additional impact pathways not identified in the model. We provide revisions to McNamara's model to incorporate these pathways and inform strategies to mitigate the impacts of the pandemic.

L'épidémie de COVID­19 a eu des répercussions négatives considérables sur les moyens de subsistance et les conditions de vie des communautés du monde entier. Bien que l'origine de la COVID­19 soit encore inconnue, une hypothèse largement répandue est que le virus pourrait être d'origine animale. La viande de gibier est utilisée par les communautés rurales comme source de revenus et de nourriture et une hypothèse avance que la pandémie pourrait modifier la perception et l'utilisation de ces dernières à l'égard de cette même viande McNamara et al. (2020) ont élaboré un modèle de causalité en émettant l'hypothèse que les répercussions de la pandémie pourraient entraîner une modification des incitations liées à la chasse de gibier au niveau local dans les pays d'Afrique subsaharienne. Entre le 27 février et le 19 mars 2021, nous avons effectué une étude aux alentours de la réserve de faune du Dja, au sud­est du Cameroun, afin de tester le modèle de McNamara et al. dans la pratique, en nous appuyant sur des questionnaires semi­structurés afin d'étudier les répercussions de l'épidémie de COVID­19 sur la chasse de gibier et la consommation de viande de gibier. Nos résultats correspondent globalement au modèle causal suggéré par McNamara et al. Cependant, notre étude met en évidence d'autres schémas de répercussions non identifiés dans ce modèle. Nous souhaitons apporter des modifications au modèle de McNamara afin d'intégrer ces schémas, ainsi que des stratégies visant à atténuer les impacts de la pandémie.

"This is most likely not the correct vaccine": Analyzing COVID-19's viral spread and vaccine anxieties in Ghana, Cameroon, and Malawi.

Following the successful development of vaccines for COVID-19, attention turned to the problem of vaccine access. However, in contexts where vaccines are available, hesitancy remains a major problem. Informed theoretically by the scholarship on vaccine anxiety, this paper uses a qualitative research approach that included 144 semi-structured interviews to investigate how social and political dynamics shaped people's perspectives in particular environments in Ghana, Cameroon, and Malawi about COVID-19's viral spread and COVID-19 vaccines. Vaccines and the viral spread of COVID-19 are related to political tensions and class-related fractures in particular contexts, and how the public interprets COVID-19's viral spread and engages with vaccination is based on people's social and political environment and their experience. Subjectivities are also rooted in coloniality. Vaccine confidence goes beyond clinical and regulatory authority approvals, and encompasses forces that are economic, social, and political in nature. Thus, an exclusive focus on technical prescriptions for enhancing vaccine uptake will not achieve significant positive results.

COVID-19: prevention and control measures in Cameroon

On January 30, 2020, the WHO declared the COVID-19 outbreak a public health emergency of international concern and, in March 2020, began to characterize it as a pandemic in order to emphasize the gravity of the situation and urge all countries to take action in detecting infection and preventing spread. Unfortunately, there is no medication that has been approved by the FDA, gone through controlled studies and demonstrated an effect on the virus for this global pandemic. Although there are cures for illnesses and developments made by leaps and bounds in our day, the strongest and most effective weapon that society has against this virus is the prevention of its spread. The main points in preventing the spread in society are hand hygiene, social distancing, and quarantine. With increased testing capacity, detecting more COVID-19 positive patients in the community will also enable the reduction of secondary cases with stricter quarantine rules. Treatment with the use of plant extracts and vaccination are also control measures that are implemented in Cameroon. This review will focus on the prevention and control measures applied in Cameroon to combat the spread of the pandemic.

Two years of Cameroon's resilient response to the COVID-19 pandemic

In the last two years, Cameroon has faced five waves of COVID-19, with its fourth wave of the B.1.1.529 Omicron variant in December 2021 and subsequently hosted the African Cup of Nation of Football Men's competition that gathered thousands of people from across the world in January 2022 with no increase in the number of cases/deaths. A fifth wave of BA.4, and BA.5 Omicron variants was seen in August 2022. The country as claimed 123 785 cases, 121 633 recovered and 1960 death by 30th September 2022. Despite a low vaccination coverage of 8.7% the country has seen a limited impact of COVID-19 as compared to the international prediction. The response of Cameroon focused in limiting the spread of the SARS-CoV-2 in the population, reducing the morbidity and mortality due to COVID-19 and limiting the socio economic impact of the COVID-19 in Cameroon. The contextualized Cameroonian response was based on an important epidemiologic surveillance relying on mass testing strategy and adaptative measure that ensure the continuity of the of planned mass gathering activities including hosting the African Cup of Nations of Football in the COVID-19 context and the continuity of education. While the COVID-19 has shown some weakness in the health system it has been an opportunity to show its resilience and the opportunity for strengthening the health system including the implementation of a genomic surveillance platform. The lessons learnt from COVID-19 including the importance of coordination through the Public Health Emergency Operating Centre will help the country to address the future public health emergencies and move toward cholera elimination by 2030.

The challenge of vaccine hesitancy and rejection, with a focus on Cameroon and Africa: a mini review

Background: The proportion of COVID-19 vaccination in Africa countries remains lower than other low and middle-income countries around the world. This rate is much lower in sub-Saharan Africa especially Cameroon. The low rate among these countries is attributed to vaccine hesitancy, mainly due to misinformation about vaccine origin, efficacy, and safety and the use of local herbs. Methods: From January to April 2022, we gathered latest experiences and opinions on four vaccine hesitancy-related areas, namely policies, perceived low risk, religious factors and use of local herbs in Cameroon in particular and some selected African countries in general;from published information in the literature. Results and recommended local solutions: The report mentions that political influences, religious beliefs and low perceived risk exists, vaccine safety and effectiveness and consumption of local herbs do contribute to COVID-19 vaccine hesitancy, collectively. Systematically monitoring the drivers of COVID-19 vaccine hesitancy, implementing tailored interventions promoting vaccine acceptance, and evaluating the impact of these interventions reduce vaccine hesitancy drastically.

Comparative impact of COVID-19 and common diseases on poverty in Cameroon and sustainable response strategies

In the context of a developing country like Cameroon characterized by the scarcity of financial resources and the appearance of Covid-19, this article shows that this pandemic was not more important than the pre-existing health problems to the point of giving it more importance in funding compared to strengthening the health system. The theoretical elasticity model of the poverty rate to growth is used to estimate the impact of Covid-19 and the incidence of impoverishing health expenditure is used for the impact of common diseases. It is estimated through direct health payments that common diseases push about 340,865 people into extreme poverty annually. The Covid-19, through the loss of growth generated between 4.8 and 6.6 points according to the optimistic or pessimistic scenarios, would impoverish between 224,193 and 398,565 people: impact on the number of poor ranging from 0.7 to 1.2 times that of all common diseases, i.e., equivalent on average, but sensitive to the speed of spread of the virus and the duration of the crisis while the impact of common diseases is structural and linked to the poorly performing health system. The solutions proposed are endogenous and linked to the impact mechanisms.

Biology and molecular basis of the pathogenesis and control of corona viruses with a focus of the COVID-19: mini review

This brief review, which was presented as an introduction to the CAS/IAP/NASCA Workshop on scientific evidence response to the COVID-19 in Cameroon and Africa, covers the classification of viruses based on the coding nucleic acid type, the structure of the genomes of corona viruses that have infected humans in the 21st century ie SARS-CoV, MERS-CoV and SARS-CoV-2. It is recalled that SARS-CoV-2 has a genome size of 29.8 kb very similar to those of SARS-CoV (29.10 kb) and MERS-CoV (30.1kb). The functions of main proteins featuring on surface the SARS-COV-2, namely, spike (S), membrane (M) and the envelope (E) protein as well as the nucleocapsid (N) protein that is expressed in the core of the viral particle were described. An overview of the pathogenesis showed that the three viruses cause similar symptoms, the most severe of them being the severe respiratory syndrome that could lead to death. A deep understanding of the roles of the viral proteins has facilitated the development of diagnostic tests, vaccines and drugs to combat the COVID-19 pandemic. The review also cites COVID-19 vaccines currently approved by the WHO as well as patent drugs in current usage and points out that none of these were developed in Africa, which is why local capacity has to be built to better combat the current and future pandemics.

COVID 19 and nutrition: coronavirus and 5 immune boosting nutrients

The COVID-19 outbreak which started in 2019 in China, turned out to be a deadly, infectious worldwide pandemic, caused by the SARS-CoV-2. COVID-19 affects the respiratory system, symptoms including cough, fever and shortness of breath. Upon infection, there is an uncontrolled release of pro-inflammatory cytokines, leading to acute respiratory distress syndrome, and even death. The shutdown of economies during the outbreak made acquisition of nutritious foods difficult, exposing the world to malnutrition. This was worse in underdeveloped countries where there is poor hygiene and poor healthcare systems. A good and balanced nutrition strengthens the immune system, with fruits and vegetables enhancing the anti-inflammatory responses and regulating chronic diseases which are risk factors for COVID-19. In Cameroon, decoctions against COVID-19 made from medicinal plants and foods were widely used. This included 'star yellow', a sauce formulated and used for its role in the control of the transmission of SARSCOV-2. Star yellow contains a combination of palm oil and limestone, which exposes viral RNA to zinc attacks. It also possesses anti-viral and antioxidant properties which inactivates the viral particles in the gut thus stopping the possible transmission of the SARSCOV-2 virus via faeces.

Fostering home-grown response to COVID-19: development of improved traditional herbal medicines to WHO standards

Facing the unprecedented burden and rapid spread of the Covid-19 pandemic across the globe, responses from various regions have been exceptionally quick. Drug discovery has been essentially based on repurposing, particularly at the onset of the scourge. Several experimental models have been designed ranging from in vitro cell culture systems to nonhuman primates;however, each with advantages and limitations. It was revealed beside its detrimental consequences on health, economy and the society, Covid-19 has also provided opportunity to highlight the immense potential of traditional medicine as a valid alternative for addressing major health threat. The African traditional medicine has been instrumental for the control of the COVID-19 pandemic in the continent, in situation of extremely low vaccination coverage. For optimal and sustainable use of traditional medicine, we strongly recommend products be developed following the WHO standards, while taking into consideration sustainability, environmental protection and copyright issues surrounding the natural product-based drug research and development.

INTEGRATION OF SARS-CoV-2 RAPID ANTIGEN TEST IN HEALTH SERVICES IN KENYA AND CAMEROON

Background: Early diagnosis of COVID-19 is key to prevent severe cases and poor outcomes in vulnerable populations, including pregnant women and people living with HIV or infected with tuberculosis (TB). The feasibility of integration of SARS-CoV-2 antigen rapid diagnostic testing (Ag-RDT) into maternal neonatal, and child Health (MNCH);HIV;and TB clinics is unknown. Method(s): We analyzed data from a SARS-CoV-2 screen and test program implemented in 50 health facilities (25 in Kenya and 25 in Cameroon), integrating SARS-CoV-2 Ag-RDT in MNCH, HIV, and TB clinics between May and October 2022. Clients aged two and older attending MNCH, HIV, and TB clinics were offered SARS-CoV-2 screening, and those eligible were tested using SARS-CoV-2 Ag-RDT. Routine SARS-CoV-2 program data were captured through dedicated paper forms in Cameroon or an electronic medical record (EMR) interface in Kenya and transferred to a database for analysis. We estimated the proportion of clients screened and tested and the SARS-CoV-2 positivity rates. Result(s): Overall, 527,184 attendee visits were reported in Cameroon (282,404) and Kenya (244,780), with screening for COVID-19 symptoms and exposure performed in 256,033 (48.5%) with substantive variations between countries (62.6% in Cameroon and 32.4% in Kenya). Among the 256,033 screened, 19,058 (7.4%) were eligible for testing (9.0% in Cameroon and 3.9% in Kenya), of whom 12,925 (67.8%) were tested for SARS-CoV-2 with substantial variation in testing rates between countries (61.9% in Cameroon and 97.9% in Kenya) and clinics (59.9% in MNCH, 68.7% in HIV, and 92.8% in TB clinics). A total of 390 (3.0%) positive tests were identified (329 (3.3%) in Cameroon and 61 (2.0%) in Kenya). The estimated case detection rate was 1.26 (95% CI=0.76-1.75) per 1,000 attendee visits in Cameroon and 0.49 (95% CI=0.12-0.86) per 1,000 attendee visits in Kenya. Country integration strategy, facility level, setting, and clinic were independently associated with screening (Table 1) and testing. Conclusion(s): Integration of SARS-CoV-2 Ag-RDT in HIV, TB, and MNCH clinics was feasible in both countries despite challenges with low screening rates in Kenya and low testing rates in Cameroon. Decentralization of SARS-CoV-2 testing at different facility clinics allowed detection of SARS-CoV-2 cases among vulnerable populations. Integration strategies should consider facility settings (rural compared to urban) and additional human resources in high volume facilities to improve screening and testing rates.

Economic Evaluations of Health Financing Programs

For several decades Cameroon's healthcare system has faced a multitude of challenges. These challenges are associated with observed shifts in the country's demographic profile, epidemiology, lifestyle, technological advances, and environment change. Health outcomes are among the poorest in the world. Cameroon's medical infrastructure and available human resources fail to meet the demand for care. Public financing accounts for only 3% of the national budget, thus Cameroonians spend large shares of their household budget on healthcare. Cameroon has benefited from national and international financial support for healthcare. This has helped establish 31 healthcare financing programmes (HFP) in Cameroon. This chapter reviews the practice of economic and efficiency evaluations of HFP in Cameroon. It also presents the main challenges faced when conducting these assessments. The chapter stresses the need for continuous monitoring and evaluation of Cameroon's healthcare sector financing, both in the current COVID-19 pandemic as well as in the post-pandemic period. Such critical appraisal of current HFP is necessary to achieve optimal, effective, efficient and sustainable investment that can promote healthcare for the Cameroonian population over the long term. © Oxford University Press 2022. All rights reserved.

Viral Dynamics and Factors Favouring the Duration of Covid-19 Positivity in Cameroon

Background: Evolution evidence of Coronavirus disease 2019 (COVID-19) and viral clearance time remains limited in tropical settings. Understanding this is crucial for public health control measures at community-level. We evaluated the viral dynamics of SARS-CoV-2 infection and factors associated with positivity duration in COVID-19 cases in Cameroon. Method(s): We conducted a prospective cohort-study of SARS-CoV-2 positive cases from the first to third wave (March 2020-October 2021) in Yaounde- Cameroon. RT-PCR was performed on nasopharyngeal swabs. SARS-CoV-2 positivity duration was evaluated from the first to last positive test before a negative result. Epi-info V.7.0 was used for data analyses with p< 0.05 considered statistically significant Results: A total of 282 participants were enrolled. The mean age was 41+/-14 years, with male predominant (62.1%). We had 15.6% symptomatic cases and cough most common (59.09%). The overall median positivity duration was 15[IQR: 9-23] days with 15[ IQR: 13-16] in the first, 17[ IQR: 11-26] in the second and 8[ IQR: 4-12] in the third wave (p= 0.007). Positivity duration was significantly higher in males (16 versus 14 days, p=0.03) and people aged >40 years (15 versus 14 days, p=0.02). Positivity duration was not affected by presence or absence of symptoms (p=0.80). No significant correlation was found with viral load (r=0.03;p=0.61). Considering baseline (24.7+/-7.2Ct) and last viral load (29.3+/-5.9 Ct), the DELTACt (4.6+/-1.3) and positivity duration (15 days) revealed a kinetic in viral decay of 0.3+/-0.087 Ct/day. Conclusion(s): A median positivity duration of 15 days is in accordance with viral clearance around 2 weeks for optimal confinement at community-level. Men and/or the elderly stand at higher risk of prolonged infection. Given the viral decay (0.3 Ct daily), we suggest personalized confinement periods. The variability of positivity duration according to phases could be function of strains which could be a factor of positivity duration.

GENOMIC SURVEILLANCE OF SARS-CoV-2 REVEALS SEVERITY OF DELTA VARIANT IN CAMEROON

Background: At the global level, the dynamics of the COVID-19 pandemic have been driven by several epidemiological waves, determined by the emergence of new SARS-CoV-2 variants from the original viral lineage from Wuhan, China. While the SARS-CoV-2 dynamic has been described globally, there is a lack of data from Sub-Saharan African. Method(s): A laboratory-based survey was conducted in Cameroon, from March 1, 2020 to March 30, 2022, through an assessment of the evolutionary patterns of SARS-CoV-2 lineages across the four COVID-19 waves in the country. Data on full-length sequencing from all four sequencing laboratories were consecutively entered into the GISAID platform. These data were downloaded, and the molecular phylogeny of the SARS-CoV-2 sequences was performed using Nexstrain. The Mann-Whitney U test was used to calculate the correlation between the duration of each outbreak and the number of confirmed cases and between hospitalised cases and CFR, with a p value < 0.05 considered statistically significant. Result(s): A total of 3,881 samples were successfully processed, of which 38.9% (n=1,509) using PCR mutation assay, 41.5% (n=1,612) using targeted sequencing, and 19.6% (n=760) using whole-genome sequencing. The mean age of the study population was 36 years (min-max: 2-86), and 45% were within the age range 26-45. Regarding gender distribution, 50.9% were male, and 49.1% were female. Phylogenetic analysis of the 760 whole-genome sequences generated from March 2020 to March 2022 revealed that the greater proportion of SARS-CoV-2 circulating in Cameroon belonged to the viral sub-lineages of the original strain from Wuhan (74%), 15% Delta variant, 6% Omicron variant, 3% Alpha variant and 2% Beta variant.The pandemic was driven by SARS-CoV-2 lineages of origin in Wave 1 (16 weeks, 2.3% CFR), the Alpha and Beta variants in Wave 2 (21 weeks, 1.6% CFR), Delta variants in Wave 3 (11 weeks, 2.0% CFR), and Omicron variants in Wave 4 (8 weeks, 0.73% CFR), with a declining trend over time (p=0.01208). Conclusion(s): In a nutshell, the SARS-CoV-2 epidemic in Cameroon appears to have been driven by the SARS-CoV-2 lineage of origin in Wave 1, the cointroduction of the Alpha and Beta variants in Wave 2, the Delta variant in Wave 3, and the Omicron variant in Wave 4, with an overall declining trend in the wave duration, confirmed cases and hospitalisations over time.The SARS-CoV-2 lineage of origin and the Delta variant appeared to be the drivers of COVID-19 severity in Cameroon.

CLUSTER-RANDOMIZED TRIAL COMPARING TWO SARS-CoV-2 TESTING MODELS IN AFRICA

Background: Most programs use a screen and test strategy to identify SARS-CoV-2 infection, but this strategy does not identify individuals with asymptomatic infection. We determined the SARS-CoV-2 case detection rates in a test-all model compared to the standard screen-and-test model in Kenya and Cameroon. Method(s): A cluster-randomized trial was conducted in 20 health facilities between May-October 2022. In each country, 5 facilities were randomized to test all (testing offered regardless of screening outcome) or screen and test (testing offered if screened positive) arms. Additional staff were hired to support implementation of the two models in Kenya (K) and the test all model in Cameroon (C). Clients age>2 years attending HIV, TB and MNCH clinics were tested using SARS-CoV-2 rapid antigen tests. We estimated case detection rates (CDR) with facility level weighted averages and used a weighted t-test with robust standard errors for between arm comparison. Result(s): Overall, 80,828 attendee visits were reported in the test-all arm (63,492 C and 17,336 K) and 71,254 attendee visits were reported in the screenand- test arm (56,589 C and 14,665 K). In the test-all arm, 42,325 (52.4%) were screened for COVID-19 symptoms (46.7% C and 73.2% K) and 21,536 (26.6%) were tested (29.2% C and 17.4% in Kenya) with a positivity rate of 1.4% (2.0% C and 1.1% K). In the screen-and-test arm, 48,314 (67.8%) were screened (72.8% C and 48.6% K), and 3,629 (7.5%) were eligible for testing (8.2% C and 3.7% K) - of those, 2,139 (58.9%) were tested (57.1% C and 82.4% K) with a positivity rate of 4.1% (3.4% C and 10% K). The estimated CDR was 3.59 (95% CI:1.55-5.64) per 1,000 attendee visits in the test-all arm and 1.46 (95% CI:0.60-2.32) per 1,000 attendee visits in the screen-and-test arm. Compared to the screen-and-test arm, the test-all arm had significantly higher COVID-19 CDR in MNCH clinics (3.57 vs.1.29, p=0.034). There were no significant differences in COVID-19 CDR between the two arms in HIV (4.20 vs.1.98, p=0.174) and TB (10.33 vs. 5.03, p=0.283) clinics, though the number of SARS-CoV-2 infections was small. Conclusion(s): The test-all arm identified more SARS-CoV-2 cases than the routine screen-and-test model, despite overall low testing coverage. The test-all model should be considered in future epidemics to improve early detection of SARS-CoV-2 infection among vulnerable populations, but effective implementation requires additional human resources to manage the clinic volumes. COVID-19 Case Detection Rates Per 1,000 Attendees: Comparison of Screen-and- Test and Test-All Arms.

Large Diffusion of Severe Acute Respiratory Syndrome Coronavirus 2 After the Successive Epidemiological Waves, Including Omicron, in Guinea and Cameroon: Implications for Vaccine Strategies.

Background: We aimed to estimate the severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) seroprevalence among the general population in Conakry, Guinea and Yaounde, Cameroon after the coronavirus disease 2019 Omicron wave. Methods: We conducted population-based, age-stratified seroprevalence surveys in Conakry and Yaounde (May and June 2022). We collected demographic and epidemiologic information and dried blood spot samples that were tested for SARS-CoV-2 immunoglobulin G (IgG) antibodies using recombinant nucleocapsid and spike proteins with Luminex technology. Results: Samples were obtained from 1386 and 1425 participants in Guinea and Cameroon, respectively. The overall age-standardized SARS-CoV-2 IgG seroprevalence against spike and nucleocapsid proteins was 71.57% (95% confidence interval [CI], 67.48%-75.33%) in Guinea and 74.71% (95% CI, 71.99%-77.25%) in Cameroon. Seroprevalence increased significantly with age categories. Female participants were more likely than male participants to be seropositive. The seroprevalence in unvaccinated participants was 69.6% (95% CI, 65.5%-73.41%) in Guinea and 74.8% (95% CI, 72.04%-77.38%) in Cameroon. In multivariate analysis, only age, sex, and education were independently associated with seropositivity. Conclusions: These findings show a high community transmission after the different epidemiological waves including Omicron, especially among people aged >40 years. In addition, our results suggest that the spread of SARS-CoV-2 has been underestimated as a significant proportion of the population has already contracted the virus and that vaccine strategies should focus on vulnerable populations.

Spread of SARS-CoV-2 Infection in Adult Populations in Cameroon: A Repeated Cross-Sectional Study Among Blood Donors in the Cities of Yaoundé and Douala.

Over a period of about 9 months, we conducted three serosurveys in the two major cities of Cameroon to determine the prevalence of SARS-COV-2 antibodies and to identify factors associated with seropositivity in each survey. We conducted three independent cross-sectional serosurveys of adult blood donors at the Central Hospital in Yaoundé (CHY), the Jamot Hospital in Yaoundé (JHY) and at the Laquintinie Hospital in Douala (LHD) who consented in writing to participate. Before blood sampling, a short questionnaire was administered to participants to collect their sociodemographic and clinical characteristics. We included a total of 743, 1202, and 1501 participants in the first (January 25-February 15, 2021), second (May 03-28, 2021), and third (November 29-December 31, 2021) surveys, respectively. The adjusted seroprevalence increased from 66.3% (95% CrI 61.1-71.3) in the first survey to 87.2% (95% CrI 84.0-90.0) in the second survey, and 98.4% (95% CrI 96.8-99.7) in the third survey. In the first survey, study site, participant occupation, and comorbid conditions were associated with SARS-CoV-2 seropositivity, whereas only study site remained associated in the second survey. None of the factors studied was significantly associated with seropositivity in the third survey. Together, the data suggest a rapid initial spread of SARS-CoV-2 in the study population, independent of the sociodemographic parameters assessed.

IN THE UNITED STATES COURT OF FEDERAL CLAIMS

Democracy Worldwide v. United States No. 20-782C Filed: September 30, 2020· OPINION BLAKE, J. This case arises out of a grant awarded by the United States Agency for International Development (USAID) to Democracy Worldwide (DW), as authorized by the Further Consolidated Appropriations Act of 2020, Pub. USAID sought applications for programs to increase protection for human rights defenders through various methods, including, but not limited to, strengthening civil society capacity to conduct civic education and activism, bolstering protections for journalists and human rights advocates, and conducting strategic civil and human rights-based litigation. [...]DW's Program Manager, Amanda McDowell, contacted Justin Baird, the Agreements Officer Representative (AOR) at USAID, to alert him that the training would need to make certain adjustments. The cheapest option per mask was a manufacturer that required a 500-mask minimum. Because the COVID-19 pandemic appeared that it would last beyond the first training, DW decided to order 500 masks.

BRIEF OF CONTRACTOR-APPELLANT, DEMOCRACY WORLDWIDE

Dep'ts and Agencies (Jan. 05, 2021), https://www.whitehouse.gov/wp-content/uploads/2021/01 /M-21-11.pdf 226 Novel Coronavirus (COVID-19), USAID (Mar. 21, 2020), https:/ www.usaid.gov/coronavirus [http://web.archive.org /web/20200321032153] 217 U.S. Gov't Accountability Off., GAO-12-331G, Government Auditing Standards (2018) 218 OTHER AUTHORITIES Advice on the Use of Masks in the Community, During Home Care, and in Health Care Settings in the Context of COVID-19, WHO (Mar. 19, 2020), https://apps.who.int/iris/bitstream/handle/10665/331493 /WHO-2019-nCoV-IPC_Masks-2020.2-eng.pdf?sequence= 14&isAllowed=y 218 Amindeh Blaise Atabong, In Cameroon, Face Masks Are Compulsory-But Unaffordable for Many, Mail & Guardian (Apr. 18, 2020), https:// mg.co.za/article/2020-04-18-in-cameroon-face-masks-are -compulsory-but-unaffordable-for-many 217, 218 Cost of Living in Yaounde, Numbeo, https://www.numbeo.com/cost -of-living/in/Yaounde-Cameroon (last visited Mar. 5, 2021) 218 Fadela Chaib, Shortage of Personal Protective Equipment Endangering Health Workers Worldwide, WHO (Mar. 02, 2020), https://www .who.int/news/item/03-03-2020-shortage-of-personal-protective -equipment-endangering-health-workers-worldwide 217 How COVID-19 Spreads, CDC (last updated Oct. 28, 2020), https:// www.cdc.gov/coronavirus/2019-ncov/prevent-getting-sick/how -COVID-spreads.html. 216 How Much Water Do You Use at Home?, U.S. Geological Surv. (last visited Mar. 5, 2021), https://water.usgs.gov/edu/activity -percapita.php 218 Scott S. Sheffler, A Reasoned Case for a "Grant Disputes Act," 47 Pub. L.J. 209 (2018) 207 STATEMENT OF RELATED CASES Pursuant to Rule 47.5 of the Federal Circuit Rules of Practice, Democracy Worldwide is unaware of another appeal in or from the same civil action or proceeding in the lower court or body that was previously before this Court or another appellate court. In November 2019, the Center of Excellence on Democracy, Human Rights, and Governance, which is part of the United States Agency for International Development (USAID), published a Notice of Funding Opportunity (NOFO), announcing that USAID had $8,000,000 for human rights programming awards to increase protection for human rights defenders in Central Africa. Democracy Worldwide proposed a program to support human rights defenders in Cameroon by strengthening the normative frameworks and institutional architecture that would help Cameroon respect its human rights obligations and by building the capacity of civil society actors to promote those rights, monitor compliance, and demand accountability.