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

Infection Pattern of Schistoma 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 9.7for urinary schistosomiasis and 11.6for haemuturia. The focal area for Schistosomiasis was Barombi kotto with a prevalence rate of 75.9; a finding not significantly different from 78.2for 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 /and 83.8respectively."

A study of onchocerciasis with severe skin and eye lesions in a hyperendemic zone in the forest of southwestern Cameroon: clinical, parasitologic, and entomologic findings.

Prior to the initiation of an onchocerciasis control program based on the mass administration of ivermectin in the rain forest of southwestern Cameroon, a preliminary baseline study of the area was conducted. The results of this study showed that onchocerciasis was hyperendemic in the area. Skin symptoms and signs were observed including pruritus (67.4% of the population examined), onchocerca nodules (51.6%), skin depigmentation (18.5%), and hanging groins (5.7%). Except for pruritus, the prevalence of these symptoms increased with age. Of the eyes examined, 44.9% had microfilariae in the anterior chamber, 33.5% had choroidoretinitis, 28.0% had punctate keratitis, 8.3% had papillary abnormalities, and 3.6% had sclerosing keratitis. Vision in 10.5% of the eyes examined was classified as blind or very poor (visual acuity = 0-0.10), in 15.7% as poor (visual acuity = 0.11-0.39), and in 73.8% as good (visual acuity = 0.4-1.00). Unlike previous reports that have linked serious ocular damage mainly to savanna onchocerciasis, the present study showed that forest onchocerciasis also caused significant ocular pathology, including blindness. Parasitologically, positive skin snips were recorded for 92.7% of the persons examined, with both sexes being equally infected. The parasite load, expressed as the geometric mean number of microfilariae per skin snip, was 53.6, and was much higher in males than in females. The flv vector, Simulium squamosum, had a high infection rate of 7.5% infective females in Bakumba and 6.8% infective females in Ngbandi, the two fly-catching points. The transmission potential was 266 infective larvae per person per month in Bakumba and 189 in Ngbandi.

A community-based trial of ivermectin for onchocerciasis control in the forest of southwestern Cameroon: clinical and parasitologic findings after three treatments.

In the onchocerciasis-endemic rain forest area of the Rumpi Hills in southwestern Cameroon, a community-based trial of ivermectin, given either once or twice a year over a three-year period (1988-1991), confirmed that the drug is a potent microfilaricide. The side effects recorded following the first treatment were edema, fever, pruritus, generalized body pains and lymphadenitis. Following subsequent treatments, the same adverse reactions were recorded, but these were generally milder when compared with those of the first treatment. The prevalence of skin microfilaria (mf) was more reduced in zone two, in which treatment was given every six months (76.9% reduction at the end of one year) than in the zone one, in which treatment was given once a year (7.4% reduction). In both zones, the impact of the drug in reducing the intensity of infection was more significant than that for prevalence. Besides pruritus, other skin symptoms were not significantly modified by ivermectin treatment. Ivermectin reduced the prevalence of ocular mf as well as the mf load of the anterior chamber of the eye, resulting in improvement of certain eye lesions such as punctate keratitis, anterior uveitis, and papillary anomalies. There was also some improvement in visual acuity. The level of participation of the village populations was somewhat low, ranging from 52% to 66%, despite excitement over the drug's additional benefit of expelling intestinal round worms.

Pediculosis among urban and rural school children in Kumba, Meme division, south-west Cameroon.

Pediculosis is an important and common health problem in both urban and rural areas of Kumba. Out of a total of 2,312 children examined (1,462 urban and 850 rural), there was a rather disquieting overall infestation rate of 31.6% in the urban and 32.6% in the rural schools, respectively, and there was a much higher incidence of infestation among girls (36.3% urban, 35.1% rural) than boys (26.9% urban, 30.0% rural). Pubic infestation was more rampant among girls aged 13-15 years (0.3%) than boys (0.1%) of the same age-group, an age which coincides with the characteristic pubertal development of pubic hair. There was a higher incidence of lice infestation in the 9-12 year age-group (33.6% urban, 33.3% rural) than in both the 5-8 year age-group (29.3% urban, 31.6% rural) and the 13-18 year age-group (31.1% urban, and 31.7% rural). Given the nature of Cameroonian society with its African extended family system and its peculiar hospitality traits, it was not possible to correlate socioeconomic status of the children with their infestation rates. Additionally, the schools studied were not class-oriented thus social mixing occurred. Body hygiene has become a mere theoretical exercise in today's schools. Children are neither closely monitored for body cleanliness nor expelled for scandalously poor and unkempt hair and clothing. Inspection of children must be stepped up in order to improve these declining health standards.