Seasonal variation and prevalence of tuberculosis among health seekers in the South Western Cameroon.

OBJECTIVES: To determine the prevalence of tuberculosis (TB) in Fako health District, to assess the effects of seasonal variation on the incidence of TB in the study area and to use sentinel analysis to predict areas of greatest infection. DESIGN: A prospective cross sectional study based on laboratory investigations. SETTING: Fako health District, South Western Cameroon. RESULTS: The prevalence of TB was 23.3%. Tuberculosis was significantly more prevalent in males (12.6%) as compared with females (10.7%) (P = 0.034). TB prevalence was significantly different between age groups, with the highest number of cases recorded in the age group 21-30 (P = 0.002). When the health areas were compared, TB prevalence varied significantly (P = 0.001), with Limbe Town recording the highest number of TB cases. We recorded more TB cases in the wet season compared with the dry season and the difference was statistically significant (P = 0.000). There was a significant drop in the prevalence of TB over the study period (P = 0.000). CONCLUSION: This study is the first to report on the effects of season on the prevalence of TB in Cameroon. These findings will therefore provide additional useful base line data for setting up TB control strategies in Cameroon.

Antibiogram of Klebsiella pneumoniae isolates from Buea, Cameroon.

OBJECTIVE: To determine the antibiotic susceptibility of K. pneumoniae isolates from Buea, Cameroon. DESIGN: A prospective study of K. pneumoniae isolates from clinical samples of nosocomial origin. SETTING: A laboratory based investigative study at the Biotechnology Centres of the Universities of Buea and Yaounde 1, Cameroon, and three Buea based hospitals. K. pneumoniae isolates were obtained from sputum, wound swabs and urine and screened for their antibiogram using standard procedures. RESULTS: Results on the antibiogram showed seven distinct antibiotypes distinguished by different susceptibilities to aminoglycosides (Spectinomycin and Gentamicin), Chloramphenicol and Augmentin. All the isolates shared multi-resistance to Amoxicillin and Trimethoprim. However, the isolates showed marked susceptibilities to Norfloxacin (90.01%), Cefuroxime (95.45%) and Ciprofloxacin (86.36%). CONCLUSION: The study has revealed that K. pneumoniae isolates in the environment of Buea, Cameroon are multi-drug resistant. This finding is of clinical and epidemiological significance.

Prevalence and intensity of urinary schistosomiasis in primary school children of the Kotto Barombi Health Area, Cameroon.

OBJECTIVE: To assess the prevalence and intensity of urinary schistosomiasis in school pupils aged five to sixteen years. SETTING: Barombi Kotto Health Area, southwest Cameroon. DESIGN: A cross-sectional study. SUBJECTS: Three hundred and forty seven primary school children. INTERVENTION: All children found to be infected were treated with praziquantel (biltricide). MAIN OUTCOME MEASURES: The study would be able to provide baseline information on the epidemiology of schistosomiasis which is vital for control strategies. RESULTS: The overall prevalence of Schistosoma haematobium in the study areas was 53.6%, with the highest prevalence of 73.9% recorded in Barombi Kotto village. Children resident on Barombi Kotto island were more significantly infected than those on the peripheral mainland (93.3% versus 46.2%, p < 0.01). Prevalence rate and intensity of infection did not vary significantly (p > 0.05) with sex, class or age of the pupils. The mean egg count varied significantly between schools (p < 0.001). CONCLUSION: Barombi Kotto village was identified as the focus of urinary schistosomiasis, with the highest recorded in children dwelling on the island, the surrounding lake being the main focus of transmission. Focal snail control as an adjunct of chemotherapy and intensive health education for the local population are strongly recommended as a means of reducing the high infection rate in the area.

The pattern of soil-transmitted nematode infections in primary school children of the Kumba Health District, South-West Cameroon.

Biomedical studies accompanied by a questionnaire survey were carried out on 803 pupils of classes 3, 5 an 7 attending 17 primary schools in the Kumba Health District to determine the prevalence of soil - transmitted nematodes and infection-associated morbidity. The prevalence rate of worms in the sample population from the questionnaire survey was 42.3% which correlates closely with 44.2% recorded for abdominal pains. The biomedical studies gave a worm infection rate of 67.1%. Ascaris lumbricoides, Trichuris trichiura and hookworm had prevalence rates of 54.9%, 33.8% and 20.3% respectively. Mixed infections were recorded in 34.4 % of the sample population compared to 32.8% for single infections. Hookworm infection rate was significantly higher in the rural areas than in the urban areas (27.5 % versus 14.8%, P < 0.001). A similar trend was observed for T. trichiura (38.4% versus 30.3 %, P < 0.02). Prevalence of A. lumbricoides was similar in the urban and rural areas (56.5% versus 52.6%). Males carried heavier burdens of Ascaris and Trichuris than females. The worm burden for all 3 species decreased as children moved to higher classes and with age after the first decade of life. There was a significant correlation between the intensities of infection of A. lumbricoides and T. trichiura.

Infection pattern of Schistosoma haematobium in primary school children of the Kumba Health District, South-West Cameroon.

Studies were carried out on 855 pupils of classes 3, 5 and 7 (age range 5-16 years) attending 17 primary schools in the Kumba Health District, Cameroon, to determine the infection pattern of Schistosoma haematobium in its different communities. The results reveal prevalence rates of 9.7 % for urinary schistosomiasis and 11.6 % for haemuturia. The focal area for Schistosomiasis was Barombi kotto with a prevalence rate of 75.9 %, a finding not significantly different from 78.2 % for haematuria. Low prevalence rates were recorded in the villages at the periphery of Barombi Kotto and also in the vicinity of Kumba town. Lake Barombi Kotto and "Kumba Water" were the main sources of infection in these areas. No significant differences in prevalence were observed between males and females or between children in the different classes surveyed. Age-specific evaluation revealed that peak infection was attained at

The Pattern of Soil Transmitted Nematode Infections in Primary School Children of the Kumba Health District; South-West Cameroon

Biomedical studies accompanied by a questionnaire survey were carried out on 803 pupils of classes 3; 5 an 7 attending 17 primary schools in the Kumba Health District to determine the prevalence of soil - transmitted nematodes and infection-associated morbidity. The prevalence rate of worms in the sample population from the questionnaire survey was 42.3which correlates closely with 44.2recorded for abdominal pains. The biomedical studies gave a worm infection rate of 67.1. Ascaris lumbricoides; Trichuris trichiura and hookworm had prevalence rates of 54.9; 33.8and 20.3respectively. Mixed infections were recorded in 34.4of the sample population compared to 32.8for single infections. Hookworm infection rate was significantly higher in the rural areas than in the urban areas (27.5versus 14.8; P 0.001). A similar trend was observed for T. trichiura (38.4versus 30.3; P 0.02). Prevalence of A. lumbricoides was similar in the urban and rural areas (56.5versus 52.6). Males carried heavier burdens of Ascaris and Trichuris than females. The worm burden for all 3 species decreased as children moved to higher classes and with age after the first decade of life. There was a significant correlation between the intensities of infection of A. lumbricoides and T. trichiura

Definition of populations at risk for Plasmodium falciparum infection in three endemic areas of Cameroon.

Blood samples were collected from 285 individuals attending hospitals in 1 of 3 different regions of Cameroon. Of these, 89 had Plasmodium falciparum parasitemia. Prevalence in the Douala region was drastically reduced above the age of 19. In the Njinikom and Bamenda regions, on the other hand, an appreciable decline in prevalence was not observed until over the age of 49. Enzyme-linked immunosorbent assay (ELISA) values indicate that in Douala, high antibody titers to P. falciparum were present in all age groups tested. In Njinikom and Bamenda, an age dependence was seen in the response, with sera from individuals above 20 having significantly higher ELISA values compared with those below age 20. Generally, individuals with high antibody titers had low or no parasitemia. Results suggest that future malaria control and treatment measures might target high risk populations such as those defined in this study.