COVID-19 breakthrough infection after four doses of the vaccines: a case report

The COVID-19 vaccines provide a high degree of protection against severe disease, hospitalisation, and death. However, no vaccine claimed 100% effectiveness and it is expected that a small proportion of vaccinated individuals may develop a breakthrough infection due to individual differences, virus variants and other factors. We conducted an epidemiological investigation and analysis of an imported case who had finished four doses of vaccination, and in order to provide a relevant reference for regular epidemic prevention and control in the post-pandemic era.

High seroprevalence of anti-SARS-CoV-2 antibodies in the capital of Chad

Background. Since the start of the COVID-19 pandemic, Chad has had 7,417 confirmed cases and 193 deaths, one of the lowest in Africa. Objective. This study assessed SARS-CoV-2 immunity in N'Djamena. Methods. In August-October 2021, eleven N'Djamena hospitals collected outpatient data and samples. IgG antibodies against SARSCoV- 2 nucleocapsid protein were identified using ELISA. "Bambino Gesu" Laboratory, Rome, Italy, performed external quality control with chemiluminescence assay. Results. 25-34-year-old (35.2%) made up the largest age group at 31.9 12.6 years. 56.4% were women, 1.3 women/men. The 7th district had 22.5% and the 1st 22.3%. Housewives and students dominated. Overall seroprevalence was 69.5% (95% CI: 67.7-71.3), females 68.2% (65.8-70.5) and males 71.2% (68.6-73.8). >44-year-old had 73.9% seroprevalence. Under-15s were 57.4% positive. Housewives (70.9%), civil servants (71.5%), and health workers (9.7%) had the highest antibody positivity. N'Djamena's 9th district had 73.1% optimism and the 3rd district had 52.5%. Seroprevalences were highest at Good Samaritan Hospital (75.4%) and National General Referral Hospital (74.7%). Conclusion. Our findings indicate a high circulation of SARS-CoV- 2 in N'Djamena, despite low mortality and morbidity after the first two COVID-19 pandemic waves. This high seroprevalence must be considered in Chad's vaccine policy.

Factors associated with people's satisfaction with their sex life: a survey conducted in Kinshasa (Democratic Republic of Congo) during the COVID-19 pandemic

Background: COVID-19's restrictive measures have significantly affected our health, work and social relationships. As yet, less attention has been given to the changes in sex life. Aim: This study investigates people's satisfaction with sex life in Kinshasa in the Democratic Republic of Congo (DRC). Methods: A cross-sectional survey of the general population (18 years and over) was conducted, from 1st to 18th July 2020, in 17 municipalities in Kinshasa and several measures were used: Quality of life MANSA, EQ-5D-3L, UCLA Loneliness;PHQ-9;GAD-7. Prior to conducting data analysis, diagnostic tests for our data were performed to assess distribution, variance and multicollinearity. Descriptive statistics, bivariate correlation and multiple regression analysis were used. Results: Sex life satisfaction increases from young adults aged 18- 35 to those aged 36-55 and then there is a decrease from ages 56-69. After controlling for socio-demographic factors, sex life satisfaction was positively associated with the number and quality of people's friendships (B=0.30, p=0.01) and people's relationships with their families (B=0.32, p=0.03). People who feel lonely have lower sex life satisfaction (B=-0.15, p=0.01). Conclusion: People's quality of their friendships and family relationships are important for their sexual well-being. Healthcare providers and policymakers should consider people's quality of friendships and family relationships when planning to improve the sexual well-being of people in DRC.

Characterization of varieties biofortified in iron and zinc and local varieties of common bean

Iron and zinc are important minerals in humans in sub Saharan Africa, whose deficiency is known as "hidden hunger" due to the lack of recognised symptoms in the early stages. Although iron deficiency is the most prevalent, zinc is also involved in inhibition of replication of viruses, including the corona virus (COVID-19). In North Kivu and South Kivu provinces where more than 50% of common bean is produced and consumed in Democratic Republic of Congo, 36% and 47% of preschool children are anemic due to iron deficiency. This paradox is mainly due to insufficiency of iron-rich foods. The aim of this study is to characterise 59 iron and zinc biofortified varieties together with six local varieties of common bean for a potential selection programme in Butembo town in the Democratic Republic of Congo. We focused on 15 qualitative and five quantitative parameters. The qualitative parameters were helpful to distinguish the different morphotypes and for cluster analysis. In addition to the descriptive statistics, the quantitative data were used for Pearson correlation and for principal component analysis, PCA. Qualitative parameters enabled grouping of the study genotypes into 14 morphotypes according to the aspect and colour of the seed coat, the colour around the hilum and the size of seeds. Clustering grouped the 65 genotypes into 12 clusters with the most similar genotypes grouped in the same cluster. Quantitative parameters showed that the study genotypes were dissimilar (P=0.00). A positive correlation was obtained between the days to flowering and the days to maturity (P<0.05) and between the number of pods per plant and the days to flowering. A strong correlation was found between the number of pods per plant and seeds per pod (P<0.01). In contrast, a negative correlation was observed between the 100 seed weight and the number of seeds per pod. The PCA represented on two perpendicular axes showed 64.1% of the total variance of which the 42.3% is explained by the first axis and 21.8% by the second axis. Overall, the study genotypes are morphologically and quantitatively different and thus can be used in a selection programme.

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.

Outbreaks of different viral etiologies amidst COVID-19 pandemic

The COVID-19 pandemic has severely affected public health system and surveillance of other communicable diseases across the globe. The lockdown, travel constraints and COVID phobia turned down the number of people with illness visiting to the clinics or hospitals. Besides this, the heavy workload of SARS-CoV-2 diagnosis has led to the reduction in differential diagnosis of other diseases. Consequently, it added to the underlying burden of many diseases which remained under-diagnosed. Amidst the pandemic, the rise of emerging and re-emerging infectious diseases was observed worldwide and reported to the World Health Organization i.e., Crimean Congo Hemorrhagic Fever (2022, Iraq;2021 India), Nipah virus (2021, India), Zika virus (2021, India), and H5N1 influenza (2021, India), Monkeypox (2022, multicountry outbreak), Ebola virus disease (2022, DRC, Uganda;2021, DRC, Guinea;2020, DRC), Marburg (2022, Ghana;2021, Guinea), Yellow fever (2022, Uganda, Kenya, West and Central Africa;2021, Ghana, Venezuela, Nigeria;2020, Senegal, Guinea, Nigeria, Gabon;2020, Ethiopia, Sudan, Uganda), Dengue (2022, Nepal, Pakistan, Sao Tome, Temor-Leste;2021, Pakistan), Middle east respiratory syndrome coronavirus (2022, Oman, Qatar;2021, Saudi Arabia, UAE;2020, Saudi Arabia, UAE), Rift valley fever (2021, Kenya;2020, Mauritania), wild poliovirus type 1 (2022, Mozambique), Lassa fever (2022, Guinea, Togo, Nigeria;2020, Nigeria), Avian Influenza (H3N8) (2022, China), Avian Influenza (H5N1) (2022, USA), H10N3 influenza (2021, China), Hepatitis E virus (2022, Sudan), Measles (2022, Malawi, Afghanistan;2020, Burundi, Mexico), Mayaro virus disease (2020, French Guiana), Oropouche virus disease (2020, French Guiana). All these diseases were associated with high morbidity and burdened the public health system during the COVID-19 pandemic. During this critical public health menace, majority of the laboratory workforce was mobilized to the SARS-CoV-2 diagnosis. This has limited the surveillance efforts that likely led to under diagnosis and under-detection of many infectious pathogens. Lockdowns and travel limitations also put a hold on human and animal surveillance studies to assess the prevalence of these zoonotic viruses. In addition, lack of supplies and laboratory personnel and an overburdened workforce negatively impacted differential diagnosis of the diseases. This is especially critical given the common symptoms between COVID-19 and other pathogens causing respiratory illnesses. Additionally, the vaccination programs against various vaccine preventable diseases were also hampered which might have added to the disease burden. Despite these challenges, the world is better prepared to detect and respond to emerging/re-emerging pathogens. India now has more than 3000 COVID-19 diagnostic laboratories and an enhanced hospital infrastructure. In addition, mobile BSL-3 facilities are being validated for onsite sampling and testing in remote areas during outbreak situations and surveillance activities. This will undoubtedly be valuable as the COVID-19 pandemic evolves as well as during future outbreaks and epidemics. In conclusion, an increase in the emergence and re-emergence of viruses demonstrates that other infectious diseases have been neglected during the COVID-19 pandemic. Lessons learned from the infrastructure strengthening, collaborations with multiple stakeholders, increased laboratory and manufacturing capacity, large-scale COVID-19 surveillance, extensive network for laboratory diagnosis, and intervention strategies can be implemented to provide quick, concerted responses against the future threats associated with other zoonotic pathogens.

Weekly epidemiological record

Yellow fever transmission in Africa included outbreaks and cases in countries with a history of YF mass vaccination campaigns (Cameroon, Central African Republic, Ghana), escalating the concern raised by the re-emergence of outbreaks in West Africa in 2020. In 2021, those outbreaks affected populations that had not been reached by immunization services, including people living in areas with compromised security and people missed in large-scale campaigns. The resurgence of intense viral transmission highlights the importance of achieving and maintaining equitable, high vaccination coverage of all at-risk populations. COVID-19 continued to impact YF control in 2021. The type of effect changed as countries prioritized vaccination against COVID-19, which led to postponement or de-prioritization of YF vaccination in some countries and affected vaccine acceptance. Despite the challenges, priority countries made good progress in implementing the Eliminate Yellow fever Epidemics (EYE) strategy in 2021, with >48 million people reached through reactive, catch-up and preventive YF vaccination campaigns in Africa.

Malaria vaccine: the tale of terror, triumph, tyranny, and trust

Malaria is an endemic disease in a true sense. It is an acute febrile disease caused due to the parasite Plasmodium. However, unlike COVID-19, it failed to raise an international concern or gain the scientific limelight. Most of the 200 million globally affected by malaria, half of them are from Africa. Four of the nations, Nigeria (25%), the Democratic Republic of the Congo (11%), Mozambique (5%), and Uganda (4%), account for half of the world's malaria burden and is the leading cause of illness and death. In 2019, an estimated 5-6 million people died of malaria - most of them are young children in sub-Saharan Africa. Many of the countries affected by malaria have the lowest economic status. In the malaria-endemic region, the most vulnerable groups are young children and pregnant women. The costs of malaria are enormous to individuals, families, communities, societies, and nations. After a struggle for three decades, the much-awaited malaria vaccine, RTS, S (brand name Mosquirix), was finally launched;but it came with its controversies and allegations. This review explored the different angles of this disease, the vaccine development, and the emerging debates.

Mean Temperature and Drought Projections in Central Africa: A Population-Based Study of Food Insecurity, Childhood Malnutrition and Mortality, and Infectious Disease.

The Central African Region is an agricultural and fishing-based economy, with 40% of the population living in rural communities. The negative impacts of climate change have caused economic/health-related adverse impacts and food insecurity. This original article aims to research four key themes: (i) acute food insecurity (AFI); (ii) childhood malnutrition and mortality; (iii) infectious disease burden; and (iv) drought and mean temperature projections throughout the twenty-first century. Food insecurity was mapped in Central Africa based on the Integrated Food Security Phase Classification (IPC) for AFI. The global hunger index (GHI) was presented along with the proportion of children with undernourishment, stunting, wasting, and mortality. Data for infectious disease burden was computed by assessing the adjusted rate of change (AROC) of mortality due to diarrhea among children and the burden of death rates due to pneumonia across all age groups. Finally, the mean drought index was computed through the year 2100. This population-based study identifies high levels of hunger across a majority of the countries, with the mean drought index suggesting extreme ends of wet and dry days and an overall rise of 1-3 °C. This study is a source of evidence for stakeholders, policymakers, and the population residing in Central Africa.

The Weight Women Carry: Research on the Visible and Invisible Baggage in Suitcase Trade between China and Africa

Grounded in ethnographic observations, this article offers a commentary on the visible and invisible dynamics of mobility between China and West and Central Africa. It follows the transnational trajectories of African trader women and takes stock of some of the weight that these women shoulder during trips where goods and money are set in motion. The materiality of the transported consumer items shapes traders' experiences of mobility and immobility. Trader women also must carry immaterial baggage relating to what their mobile, racialized female bodies represent to various people they encounter. Specifically, the Chinese state and general public view their bodies as threats to social order and, in the context of Ebola and COVID-19, as threats to public health. Our analysis also attends to the weight that female scholars metaphorically carry while conducting research. We devote space to addressing our presence as White researchers, thus attending to methodological opaqueness alongside issues of hidden geographies in transnational trade and migration. © 2021 The Author(s). Published with license by Taylor & Francis Group, LLC.

COVID-19 Vaccine Hesitancy among Adults Who Rely on Social Media for Health Care Information in Cameroon, Africa

Background. In Africa, uptake of effective COVID-19 vaccines has been limited by accessibility and vaccine hesitancy (VH). VH is multifactorial but influences include disinformation through social media with Whats App being the most popular form in Cameroon. The aim of this study was to test our hypothesis that frequent users of social media would have higher vaccine hesitancy due to exposure to disinformation in Cameroon in Central Africa. Methods. A survey study was conducted at urban and suburban hospital facilities in four of the ten regions of Cameroon. Participants were asked to self-report sociodemographics, perceptions of COVID-19 infection, and interest in vaccination. They were also asked to rank their top two sources of health care information, including social media. Bivariate analysis was used to explore the perceptions of infection and vaccination stratified by social media preference with statistical significance set at p< 0.05. Results. We found that 18% (151/835) of participants cited social media (SM) as a top source of health care information. Health care professionals were cited by 82% as the most trusted source for health information (n=681). Fewer than one-third of survey participants were interested in receiving the COVID-19 vaccine (31%, 257/835) and rates did not differ by SM preferences. More people in the social media group, 53% vs 38% (p=0.046) stated that more information about vaccine safety may help reduce hesitancy. Perceived risks of COVID-19 vaccination ranged from death (33%) to fetal harm (31%) to supernatural reactions (1.4%). The SM group was not more likely to site perceived risks of the vaccine (p=0.244). Participant Characteristics. Conclusion. Although vaccine hesitancy in Cameroon was high at the time of the survey, adults who prefer to get health information from social media were not more likely to express vaccine hesitancy. Public education campaigns led by healthcare professionals may have the greatest impact on vaccine acceptability based on trusted information sources cited by participants.

Investigation of a cluster of COVID-19 cases imported through inbound air flight

Objective: To understand the epidemiological characteristics and explore source of infection of coronavirus disease 2019 (COVID-19) cases imported through an inbound air flight from Kenya to Guangzhou, China.