Prevalence, correlates of undernutrition and intestinal parasitic infection among children below 5 years living in the forest community of Ndelele, East Region of Cameroon: A cross-sectional assessment.

In low- and middle-income countries, undernutrition often co-exists with intestinal parasites, especially Soil Transmitted Helminth (STH) infections in children. The collective impact of both conditions result in undernutrition and can exacerbate the general poor health status of children. A cross-sectional survey of 422 mother-child (12-59 months old) pairs from 14 villages in the District of Ndelele, East Region of Cameroon, was carried out to assess the magnitude and correlates of undernutrition and intestinal parasites. Socio-demographic data were collected from mothers and anthropometric data were collected from children. Parasitological assessment was performed using a combination of direct microscopy flotation, sedimentation and centrifugation techniques. Correlates of undernutrition and intestinal parasites were identified using multinomial logistic regression at individual and household levels. 83.77% of the children assessed for undernutrition were undernourished and 66.82% were positive for one or more intestinal parasites. It was not uncommon for the study participants to be concurrently infected with two or more intestinal parasites. The most common intestinal parasitic infections detected in the study were A. lumbricoides, E. histolytica/dispar and Hookworm infection. Multinomial logistic regression using Nutritional status as outcome showed that, children who were not exclusively breastfed were 106% (RR = 2.06; C.I = 1.12-3.80) more likely to be underweight compared to those who were exclusively breastfed. The household size of 4 to 6 persons also significantly impacted wasting (p-value = 0.007) at 7% (RR = 1.07, C.I = 0.49-2.32). Analysis by a logistic regression model with STH infection as outcome revealed that, Fingernail cleanness (p-value = 0.044; AOR = 1.75; CI = 1.09-2.78) and household size (p-value = 0.038; AOR = 0.55; CI = 0.32-0.92) were positively associated with intestinal parasite infection at the 5% significant level. This study reveals that intestinal helminthic parasitic infections (STH) and undernutrition are serious health problems in children below five in the study area. To address this dire situation, concerted efforts are needed to improve sanitation, hygiene education access, community deworming programs, and improve diets.

Prevalence of alcohol among drivers, riders and pedestrians injured in road traffic crashes in Cameroon: a cross-sectional study.

The use of alcohol among road users injured in road traffic crashes and admitted to three major hospitals in Cameroon was studied. Alcohol use was measured using breathalyzers, and data on age, gender, education level, religion, type of road user, time of the crash, crash characteristics, and injury severity were recorded using a questionnaire. Of the 350 participants, 30.9% had blood alcohol concentrations (BACs) above 0.08% (legal limit for drivers); the proportion was highest among motorcycle riders (36.5%), followed by pedestrians (24.8%) and motor vehicle drivers (18.9%). The proportion with BAC above 0.08% was highest on weekend nights and among those who were most seriously injured. Those who reported being Muslims had a lower prevalence of alcohol. Multivariable logistic regression analysis confirmed those associations. Many road traffic injuries could have been avoided if the patient had not consumed alcohol. Actions should therefore be taken to reduce the proportion of alcohol-impaired road users.Supplemental data for this article is available online at https://doi.org/10.1080/17457300.2022.2030365 .

Zoonotic diseases risk perception and infection prevention and control practices among poultry farmers in the Buea Health District, Cameroon: A one health perspective.

Background and Aim: Livestock are associated with pathogenic microbes and farm workers play a significant role in the transmission of zoonotic diseases (ZDs). Lack of awareness of exposure risk among farmers may influence their farm practices, thereby enhancing the spread of diseases on farms and to the community. This study was aimed at evaluating the knowledge, risk perception, and prevention and control practices of ZDs among poultry farmers to provide baseline data for establishing a "One Health" practical approach to reducing ZD transmission in poultry farms. Materials and Methods: Using the exponential discriminative snowball technique, a community-based cross-sectional study involving poultry farmers was carried out in the Buea Health District from April to July 2021. Six feed-producing mills were used as focal points to identify and recruit farmers who were also referred to other farmers. Questionnaires were used to collect data related to participants' knowledge, risk perception, and prevention and control practices of ZDs. Descriptive analyses were performed for all variables while the chi-square test and logistic regression analysis were used to determine associations at 95% confidence level. Results: In all, 183 poultry farms and 207 workers were enrolled in the study. Despite being aware that animal diseases can be transmitted to humans, most participants showed poor knowledge (54.6%), low-risk perception (51.7%), and poor prevention/control practices (54.1%) on ZDs. The majority did not consider coming in contact with birds' body fluid (blood) or apparently healthy birds to be a risk of infection. More participants with small farms (<500 birds) had low-risk perception of ZDs than those with larger farms (>1000 birds) (p = 0.03). Furthermore, most participants reported practicing hand washing but they neither used protective devices such as gloves and face masks, and >50% would not invite veterinary professionals to their farms. There was a significant association between risk perception and knowledge (p = 0.007; CI = 1.257-4.200) as well as between risk perception and prevention/control practice (p = 0.002; CI = 1.451-4.867). Conclusion: Poultry farm workers in Buea had poor knowledge and perception of ZD risk and this might have contributed to their poor prevention/control practices on the farms. Enhanced informal education of poultry farmers through training workshops and seminars will improve their knowledge and skills on ZD transmission risk and prevention.

Roadside surveys of drinking and driving in Cameroon.

OBJECTIVE: This study aimed to assess the prevalence of drinking and driving on roadways in urban areas and highways in Cameroon, and to determine the associations between drinking and driving and socio-demographic factors. METHODS: A cross-sectional study of motor vehicle drivers was performed on Fridays, Saturdays, and Sundays between May and September 2020 with three driver groups: (1) random motor vehicle drivers (including riders) on major highways, (2) drivers recruited at car stations in Yaoundé, and (3) at fuel stations in Douala. Alcohol was measured using breathalyzers, and a questionnaire collected socio-demographic data. RESULTS: In total, 2402 motor vehicle drivers were asked to participate in the study and 1701 (70.8%) gave informed consent. The vast majority (98.6%) were men. Drivers aged 30-39 years constituted the largest age group on highways and in Yaoundé, whereas 18-29 years was the largest age group in Douala. The highest prevalence of alcohol was observed among drivers in Yaoundé, which included mainly clandestine taxi car drivers and motorcycle taxi riders, where about 30% had blood alcohol concentrations (BAC) above the legal limit of 0.08%. The proportion with BACs above the legal limit was about 6% among the drivers in Douala, which included mainly motorcycle taxi riders, and about 4% among drivers on highways. CONCLUSIONS: The findings indicate that drinking and driving is a major traffic safety problem on Cameroonian public roads, especially among motorcycle taxi riders and clandestine taxi drivers in towns, which represent the major mass transportation means in the country. Drinking and driving education and legislation should be better developed and enforced in order to reduce the number road traffic crashes.

Correction to: Ficus sycomorus extract reversed behavioral impairment and brain oxidative stress induced by unpredictable chronic mild stress in rats.

CORRECTION: After the publication of this article [1] it came to our attention that Harquin Simplice Foyet was incorrectly included as Harquin Simplice Harquin Foyet. The corrected name is included in the author list. The original article was updated.

The impact of mass distribution of long lasting insecticide-treated bed-nets on the malaria parasite burden in the Buea Health District in South-West Cameroon: a hospital based chart review of patient's laboratory records.

BACKGROUND: Malaria remains a leading cause of illness and deaths in Cameroon. The use of long lasting insecticide treated bed nets (LLITN) is the most effective method to reduce the burden of malaria. The aim of this study was to determine the impact of the mass distribution of LLITN on the hospital prevalence of malaria (prevalence of malaria in patients with a presumptive diagnosis of malaria), in the Buea Health District in the South-West Region of Cameroon. METHODS: A hospital-based chart review of records of malaria confirmatory test results in health facilities of the Buea Health District from January 2011 through December 2013. Data were extracted with the help of a grid, then analyzed with EPIinfo version 6 and Microsoft Excel 2010. Chi square test was used to compare prevalence and ANOVA was used to compare mean parasitaemia. RESULTS: A total of 17,268 records were reviewed, 3545[20.5% (19.9-21.1)] confirmed malaria positive with mean trophozoite count of 2735.3 ± 23,323.5 trophozoite/µl of blood. Prevalence was higher in males 1497 [23.5% (22.4-24.5)] than females 2047 [18.8% (18.1-19.6)], p < 0.01. Significant evidence of a reduction in the prevalence of malaria was found in under-fives in 2012 (p = 0.03). CONCLUSIONS: Universal coverage with LLITN failed to guarantee effective control of malaria in the Buea Health District, as expected. Continuous and appropriate use of LLITN is indispensable, in addition to periodic sensitization, booster campaigns of LLITN distribution and evaluation research for effective prevention and control of malaria.

Ficus sycomorus extract reversed behavioral impairment and brain oxidative stress induced by unpredictable chronic mild stress in rats.

BACKGROUND: Stress, regardless of its nature is nowadays recognized as one of the major risk factors for neuropsychiatric diseases, such as mood and anxiety disorders. The brain compared with other organs is more vulnerable to oxidative damage mainly due to its high rate of oxygen consumption, abundant lipid content, and relative insufficiency of antioxidant enzymes. Thus, the identification of neural mechanisms underlying resistance and vulnerability to stress is of crucial importance in understanding the pathophysiology of neuropsychiatric disorders and in developing new treatments, since the existing ones are for several reasons subject to increasing limitations. This study was aimed to assess the effects of hydromethanolic extract of Ficus sycomorus stem bark on depression, anxiety and memory impairment induced by unpredictable chronic mild stress (UCMS) in rats. METHODS: These effects were studied using anxiety-related behavior, depression-related behavior, anhedonia-like behavior and the Y maze task. Sucrose test was performed twice (before and after UCMS) to assess anhedonia in rats. Liquid chromatography-mass spectrometry analysis of the extract were performed. The antioxidant activities of the extract were assessed using total glutathione (GSH) content and malondialdehyde (MDA) level (lipid peroxidation) in the rat temporal lobe homogenates. RESULTS: The extract of F. sycomorus in a dose of 100 mg/kg significantly increased the sucrose consumption and the swimming time which had been reduced by the unpredictable chronic mild stress (p < 0.001). The extract also significantly reduced (p < 0.01) the latency time in the novelty-suppressed feeding test. In the elevated plus-maze, the extract (100 and 200 mg/kg) significantly reduced (p < 0.01) the time and the number of entries into the closed arms. The treatment with the extracts also significantly increased alternation in the Y-maze (p < 0.01 for 100 mg/kg). The extract significantly increased the total GSH content and reduced MDA level in rat temporal lobe. For the LC-MS analysis, the major compound in the extract was a flavonoid with formula C22H28O14. CONCLUSIONS: F. sycomorus reversed the harmful effects of UCMS on mood and behaviors in rats and it possesses an antidepressant property that is at least in part mediated through the oxidative pathway.

Cross-sectional assessment of three commonly used measures of adherence to combination antiviral therapy in a resource limited setting.

Nowadays, global coverage of combination antiretroviral therapy (cART) has increased due to a continuous process to scale up access. This increase has potentially transformed HIV-infection from a fatal to a chronic disease: a transformation only possible if the prescribed medications are taken accordingly. We therefore evaluated optimal adherence to cART by three commonly used methods: visual analogue scale (VAS), four days recall (FDR) and clinic attendance (CA) for the last six months in 301 HIV-infected patients on cART for at least six months at the Douala General Hospital, Cameroon. Optimal adherence was defined to be greater than or equal to the 95th percentile estimate of each method. We found that 70.8% of our study population was female. The mean age was 40.8 years (SD 10.5) and 85% were on first line cART. Median CD4 count was 397 cells/ml (252-559). Optimal adherence by VAS, FDR and CA, was 68.1%, 83.4%, and 73.4%, respectively. VAS and FDR inter-correlated strongly (Pearson's Chi square coefficient, r = 0.58, p < 0.001). Higher CD4 count above 200 cells/ml was associated with optimal adherence by CA (Adjusted Odds Ratio [AOR]:2.6 (95% CI: 1.2-5.3, p < 0.001)). As high optimal adherence to cART is associated with good clinical outcome in HIV patients, simple methods such as the VAS for evaluating adherence, should be integrated to the HIV clinic of the Douala General Hospital.

Whole blood pathogen reduction technology and blood safety in sub-Saharan Africa: A systematic review with regional discussion.

BACKGROUND: Despite vast improvements in transfusion services in sub-Saharan Africa over the last decade, there remain serious concerns on the safety and adequacy of the blood supply across the region. OBJECTIVE: This review paper ascertains the role of pathogen reduction technology (PRT) in improving blood safety and supply adequacy in the region. METHOD: The state of blood safety in sub-Saharan Africa was reviewed. Meetings, seminars and correspondence were undertaken with key clinicians, scientists and professional bodies in the region, including the World Health Organization's Regional Office for Africa, to examine the suitability of PRT for improving the safety of whole blood transfusion, a prevalent transfusion format in the region. RESULTS: Existing literature suggests that combining PRT with current blood safety measures (such as serology) would improve the safety and adequacy of the blood supply for transfusions in sub-Saharan Africa. This was echoed by the findings of the stakeholder meetings. CONCLUSION: Following a detailed appraisal of two leading PRT systems, the Mirasol® PRT System and the Cerus S-303 System, we suggest that companies conduct comprehensive toxicological evaluation of the agents used for PRT and publish this in the scientific literature. We also recommend that the safety and efficacy of these technologies should be established in a randomised clinical trial conducted in sub-Saharan Africa.

Whole blood pathogen reduction technology and blood safety in sub-saharan Africa: a systematic review with regional discussion

Background: Despite vast improvements in transfusion services in sub-Saharan Africa over the last decade, there remain serious concerns on the safety and adequacy of the blood supply across the region. Objective: This review paper ascertains the role of pathogen reduction technology (PRT) in improving blood safety and supply adequacy in the region. Method: The state of blood safety in sub-Saharan Africa was reviewed. Meetings, seminars and correspondence were undertaken with key clinicians, scientists and professional bodies in the region, including the World Health Organization's Regional Office for Africa, to examine the suitability of PRT for improving the safety of whole blood transfusion, a prevalent transfusion format in the region. Results: Existing literature suggests that combining PRT with current blood safety measures(such as serology) would improve the safety and adequacy of the blood supply for transfusions in sub-Saharan Africa. This was echoed by the findings of the stakeholder meetings. Conclusion: Following a detailed appraisal of two leading PRT systems, the Mirasol® PRT System and the Cerus S-303 System, we suggest that companies conduct comprehensive toxicological evaluation of the agents used for PRT and publish this in the scientific literature. We also recommend that the safety and efficacy of these technologies should be established in a randomised clinical trial conducted in sub-Saharan Africa

Antimicrobial and toxicological activities of five medicinal plant species from Cameroon traditional medicine.

BACKGROUND: Infectious diseases caused by multiresistant microbial strains are on the increase. Fighting these diseases with natural products may be more efficacious. The aim of this study was to investigate the in vitro antimicrobial activity of methanolic, ethylacetate (EtOAc) and hexanic fractions of five Cameroonian medicinal plants (Piptadeniastum africana, Cissus aralioides, Hileria latifolia, Phyllanthus muellerianus and Gladiolus gregasius) against 10 pathogenic microorganisms of the urogenital and gastrointestinal tracts. METHODS: The fractions were screened for their chemical composition and in vivo acute toxicity was carried out on the most active extracts in order to assess their inhibitory selectivity. The agar well-diffusion and the micro dilution methods were used for the determination of the inhibition diameters (ID) and Minimum inhibitory concentrations (MIC) respectively on 8 bacterial species including two Gram positive species (Staphylococcus aureus, Enterococcus faecalis), and six Gram negative (Escherichia coli, Klebsiella pneumoniae, Pseudomonas aeruginosa, Proteus mirabilis, Shigella flexneri, Salmonella typhi) and two fungal isolates (Candida albicans, Candida krusei). The chemical composition was done according to Harbone (1976), the acute toxicity evaluation according to WHO protocol and the hepatic as well as serum parameters measured to assess liver and kidney functions. RESULTS: The chemical components of each plant's extract varied according to the solvent used, and they were found to contain alkaloids, flavonoids, polyphenols, triterpens, sterols, tannins, coumarins, glycosides, cardiac glycosides and reducing sugars. The methanolic and ethylacetate extracts of Phyllanthus muellerianus and Piptadeniastum africana presented the highest antimicrobial activities against all tested microorganisms with ID varying from 8 to 26 mm and MIC from 2.5 to 0.31 mg/ml. The in vivo acute toxicity study carried out on the methanolic extracts of Phyllanthus muellerianus and Piptadeniastrum africana indicated that these two plants were not toxic. At the dose of 4 g/kg body weight, kidney and liver function tests indicated that these two medicinal plants induced no adverse effect on these organs. CONCLUSION: These results showed that, all these plant's extracts can be used as antimicrobial phytomedicines which can be therapeutically used against infections caused by multiresistant agents. Phyllanthus muellerianus, Piptadeniastum africana, antimicrobial, acute toxicity, kidney and liver function tests, Cameroon Traditional Medicine.

Antifertility and fetotoxic activities of Acanthus montanus aqueous extract in Wistar rats.

Acanthus montanus T. Anderson (Acanthaceae) possesses several medicinal properties; it is used in Cameroon as a folk medicine to treat pain, inflammation and threatened abortion. The aim of this study was to determine the effect of A. montanus aqueous extract on the estrous cycle pre- and postimplantation in rats and its mechanism of action. The estrous cycles of Wistar rats were monitored before, during and after oral administration of distilled water (control) or aqueous extract (62.5, 125, 250, 500, 1000 mg/kg/day). Furthermore, pregnant rats received the above doses of aqueous extract on days 1-6 (preimplantation) or 6-15 (postimplantation) of gestation and were sacrificed on day 8 or 20 of pregnancy, respectively. Moreover, aqueous extract (500 and 1000 mg/kg/day) was given to ovariectomized rats in the presence or absence of exogenously administered estrogen and/or progesterone and uterine weight and deciduoma count were evaluated. The extract, irrespective of dose, reversibly prolonged the metestrous and occasionally the diestrous stages of the estrous cycle. The extract did not alter the uterine wet weight or deciduoma count, suggesting a lack of estrogenic and progestational effects. At 1000 mg/kg/day, the extract caused appreciable preimplantation losses of 36.8 +/- 6.5% (P < 0.05), while none of the doses caused postimplantation losses. The extract also caused delayed fetal growth.

Anti-inflammatory and anti-nociceptive activities of the stem bark extracts from Allanblackia monticola STANER L.C. (Guttiferae).

THE AIM OF THIS STUDY: was to assess the anti-inflammatory and mechanism of action of Allanblackia monticola (Guttiferae). The anti-inflammatory activity "in vivo" of the methylene chloride/methanol extract, methanol and methylene chloride fractions of stem barks of Allanblackia monticola, administered orally at doses of 37.5; 75; 150 and 300 mg/kg, was evaluated on carrageenan-induced oedema in rats to determine the most active fraction. Indomethacin, inhibitor of cyclo-oxygenase was used as reference drug. The effects of the most active fraction were then examined on the rat paw oedema caused by histamine, serotonin, arachidonic acid and dextran followed by its ulcerogenic effect. The results showed that the methylene chloride fraction of Allanblackia monticola was more effective on the oedema caused by the carrageenan. The anti-nociceptive activity of the methylene chloride fraction was assessed using the acetic acid-induced abdominal constriction model, formalin test and hot plate test. At 150 mg/kg, Allanblackia monticola caused maximum inhibitions of inflammation induced by carrageenan (83.33%), by histamine (42.10%), by dextran (40.29%) and by arachidonic acid (64.28%). Allanblackia monticola (75-300 mg/kg) did not cause significant modification of the oedema induced by serotonin. Concerning the anti-nociceptive properties of the plant, the methylene chloride fraction (75-300 mg/kg) caused a dose-dependent inhibition on abdominal contractions induced by acetic acid (32.34-77.37%) and significantly inhibited the inflammatory pain caused by formalin (40.71-64.78%). Allanblackia monticola did not increase the latency time in the hot plate test. Like indomethacin (10mg/kg), the fraction at the dose of 150 mg/kg caused ulceration of the gastric mucous membrane in treated rats. These results show that Allanblackia monticola has an anti-inflammatory and analgesic activities with gastric ulcerative side effects.

Antidiabetic effect of Ceiba pentandra extract on streptozotocin-induced non-insulin-dependent diabetic (NIDDM) rats.

The aim of this work was to investigate the effect of daily oral administration of root bark methylene chloride/methanol extract of Ceiba pentandra (Linn) in streptozotocin-induced type-2 diabetic rats, and the effect of this treatment on the physiological and metabolic parameters that are related in diabetic animals. The diabetic rats were separated into four groups and each given the following samples by gavage, daily for 28 days: vehicle (diabetic control), Ceiba pentandra extract at the dose of 40 mg/kg, Ceiba pentandra extract at the dose of 75 mg/kg and glibenclamide (5 mg/kg). All the parameters were also determined in healthy (non diabetic) rats for comparison. The methylene chloride/methanol extract of Ceiba pentandra treatment significantly reduced the intake of both food and water as well as the levels of blood glucose, serum cholesterol, triglyceride, creatinine and urea, in comparison with diabetic controls. The treatment also improves impaired glucose tolerance but no effect was observed in the level of hepatic glycogen. The effect of Ceiba pentandra (40 mg/kg) was more prominent when compared to glibenclamide in lowering blood glucose, with the added benefit of considerably reducing serum cholesterol and triglyceride concentrations. The results of this experimental animal study indicated that Ceiba pentandra possesses antidiabetic activity; and thus is capable of ameliorating hyperglycaemia in streptozotocin-induced type-2 diabetic rats and is a potential source for isolation of new orally active agent(s) for anti-diabetic therapy.

Acute and subchronic toxicity of Anacardium occidentale Linn (Anacardiaceae) leaves hexane extract in mice.

These studies focus on the toxicity leaf hexane extract of A. occidentale L (Anacardiaceae) used in Cameroon traditional medicine for the treatment of diabetes and hypertension. Previous findings on antidiabetic and anti-inflammatory have given support to the ethnopharmacological applications of the plant. After acute oral administration, it was found that doses of the extract less than 6 g/kg are not toxic. Signs of toxicity at high doses were asthenia, anorexia, diarrhoea, and syncope. The LD(50) of the extract, determined in mice of both sexes after oral administration was 16 g/kg. In the subchronic study, mice received A. occidentale at doses of 6, 10 and 14 g/kg (by oral route) for 56 days. At doses of 2, 6 and 10 g/kg of extract, repeated oral administration to mice produced a reduction in food intake, weight gain, and behavioural effects. Liver or the kidney function tests were assessed by determining serum parameters like, creatinine, transaminases, and urea. All these parameters were significantly (p<0.01) abnormal. Histopathological studies revealed evidence of microscopic lesions either in the liver or in the kidney which may be correlated with biochemical disturbances. We conclude that toxic effects of A. occidentale L hexane leaf extract occurred at higher doses than those used in Cameroon folk medicine.