[Mycological profile of onychomycosis in Yaoundé, Cameroon]. / Profil mycologique des onychomycoses vues en consultation de dermatologie à Yaoundé, Cameroun.

BACKGROUND: The lack of data concerning the mycological spectrum of onychomycosis in Cameroon prompted us to conduct the present study, which aimed to determine the mycological profile of onychomycosis diagnosed during dermatologic consultations in Yaoundé, Cameroon. METHODS: This was a cross-sectional study held from October 2014 to March 2015 in six hospitals of Yaoundé. Patients suspected of onychomycosis were consecutively recruited during dermatologic consultations; anamnestic and clinical data were recorded and one or several nail fragments sampled for mycological examination (direct examination or culture). RESULTS: A total of 3457 patients were examined during the study period, 117 of whom were suspected of onychomycosis; 133 samplings were performed. The distolateral subungual form was the dominating one: 72/110; 65.5%. The diagnosis was confirmed with 110 of the 133 samples (82.7%), these collected among 96 patients, hence a prevalence of 2.8% (96/3457). We isolated 99 germs, among which two-co-infestations. Dermatophytes (52/99; 52.5%), especially Trichophyton rubrum (23/52; 44.2%) and Trichophyton verrucosum (11/52; 21.2%) were the main pathogens causing onychomycois of the toes whereas yeasts (43/99; 43.4%), Candida albicans (31/43; 72.1%) in majority, were the prevailing germs incriminated in onychomycosis of the fingers. There were few cases of molds infestation (4/99; 4%). CONCLUSION: Onychomycosis are common in dermatology consultations in Yaoundé. Candida albicans, Trichophyton rubrum and Trichophyton verrucosum are the main pathogens in cause.

Epidemiology of tinea capitis among school-age children in Meiganga, Cameroon.

Tinea capitis (TC) commonly called scalp ringworm is a worldwide concern and a public health problem in Africa. This study aimed at determining the epidemiologic profile of TC among school-aged children in the savanna zone of Cameroon. All children present at school during this study period, August 2011-July 2012, were examined for signs suggestive of TC. Children not registered at school were excluded from the study. Pathologic specimens were taken from suspected head lesions and cultured. Amongst the 4601 children, average age 10.7±0.16 years, 377 presented with suggestive TC lesions giving a prevalence of 8.1%. The proportion of boys with TC was (63.7%) higher than in girls (36.3%) (P≤0.05). TC manifestations varied; small plaques of alopecia 59.26% were the most frequent. Communal living was the most incriminated risk factor. Three hundred and thirty six isolates were obtained in culture. The prevalence was significantly higher (P<0.05) in age range between 8 and 12 years, followed by that between 13 and 15. The most prevalent isolate was T. soudannense 56.8%, followed by T. rubrum 29.2%. Only 6.0% of the isolates belonged to the genus Microsporum.

Prevalence of cryptococcosis among HIV-infected patients in Yaounde, Cameroon.

BACKGROUND: Cryptococcus neoformans is encapsulated yeast which causes life-threatening infections in up to 40% of AIDS patients in Africa. OBJECTIVE: To investigate the prevalence of cryptococcosis among HIV infected patients in Yaounde. METHODS: In a hospital-based surveillance study of cryptococcosis, the colonization of Cerebrospinal Fluid (CSF), urine and blood sample by C. neoformans was evaluated by direct microscopic examination and culture techniques. Data obtained were then analyzed based on the medical records of the patients. RESULTS: Among the 105 patients sampled for the study, the CD4 counts varied between 31 and 304 lymphocytes/mm(3). Direct specimens examination (n= 294) in India ink preparations revealed polysaccharide capsule in 25 (8.5%) of the samples. Upon culture, 29 (9.86 %) samples were positive of C. neoformans (23 from the CSFs and 6 from the urine). All the positive samples were obtained from patients who were not on Antiretroviral Therapy (ART). Meningo-encephalitis symptoms were observed in 13 patients with C. neoformans in CSFs. CONCLUSION: This study reveals that cryptococcosis is rife in AIDS patients in Yaounde. Therefore, to minimize the death toll, we recommend that its routine check should be integrated in the management of HIV/AIDS patients.

Phytotoxic, antifungal activities and acute toxicity studies of the crude extract and compounds from Diospyros canaliculata.

In vitro biological activities including phytotoxic, antifungal activities as well as acute toxicity of the methanol extract, fractions and/or isolated compounds from the stem bark of Diospyros canaliculata were investigated. Well agar diffusion and macrodilution assays were used for investigating the antifungal activity. A phytotoxicity assay was performed against Lemna minor while an acute toxicity assay was performed in mice via oral administration. As a result, plumbagin (5-hydroxy-2-methyl-1,4-naphtoquinone) and two known pentacyclic triterpenes (lupeol and lupenone) were isolated from the extract. With regards the antifungal activities, the inhibition zones varied from 16.51 to 24.86 mm and from 20.50 to 25.10 mm for the extract and plumbagin, respectively. The minimum inhibitory concentrations of the extract and plumbagin ranged between 12.5-25 and 0.78-1.56 µg mL(-1), respectively. At 50 µg mL(-1), the hexane fraction showed phytotoxic activities similar to paraquat, the standard phytotoxic inhibitor. The extract was found to be non-toxic to mice after administration per os. Based on the current findings, we can conclude that this extract is non toxic, with significant phytotoxic and antifungal properties due to the presence of plumbagin.

Traditional medicine: past, present and future research and development prospects and integration in the National Health System of Cameroon.

Traditional medicine refers to health practices, approaches, knowledge and beliefs incorporating plant, animal and mineral based medicines, spiritual therapies, manual techniques and exercises, applied singularly or in combination to treat, diagnose and prevent illnesses or maintain well-being. In the last decade traditional medicine has become very popular in Cameroon, partly due to the long unsustainable economic situation in the country. The high cost of drugs and increase in drug resistance to common diseases like malaria, bacteria infections and other sexually transmitted diseases has caused the therapeutic approach to alternative traditional medicine as an option for concerted search for new chemical entities (NCE). The World Health Organisation (WHO) in collaboration with the Cameroon Government has put in place a strategic platform for the practice and development of TM in Cameroon. This platform aims at harmonizing the traditional medicine practice in the country, create a synergy between TM and modern medicine and to institutionalize a more harmonized integrated TM practices by the year 2012 in Cameroon. An overview of the practice of TM past, present and future perspectives that underpins the role in sustainable poverty alleviation has been discussed. This study gives an insight into the strategic plan and road map set up by the Government of Cameroon for the organisational framework and research platform for the practice and development of TM, and the global partnership involving the management of TM in the country.

Candiduria in HIV Infected Patients in Yaounde; Cameroon

Objective: To detect Candida species in the urine of patients living with human immuno-deficiency virus (HIV); and correlate the presence of candiduria and CD4 counts. Patients and Methods: The study population consisted of 105 hospitalized patients from the Military and Central Hospitals of Yaounde; who either were HIV positive or already suffering from AIDS. The patients consisted of 63 females (60) and 42 males (40) giving a male to female ratio of 1:1.5. Midstream urine samples were collected from all patients and mycological examination of the centrifuged sediments was done. Patients with CD4 counts 499 lymphocytes/mm3 were a proxy control group. Results: 38 of 105 (36.2) subjects had candiduria. 71of the cases were asympto-matic. The percentage of patients positive versus negative for candiduria increased progressively from stage-A (5) to B (32) to C (63) HIV infection. There was thus a correlation between candiduria and the CDC disease stage. Its presence heralded an advanced immuno-suppressed state of the AIDS patient. Conclusion: In resource-poor communities; where viral copy and CD4 count determination are expensive; candiduria may serve as one of the indicators for anti-retroviral therapy. We recommend routine detection of candiduria in this high-risk group of HIV/AIDS patients