[Drug sensitivity study of Plasmodium falciparum in the city of Yaounde (Cameroon)]. / Etude de la chimiosensibilité de Plasmodium falciparum aux antimalariques dans la ville de Yaoundé (Cameroun).

In July 1990, the in vitro chemosensitivity of 22 isolates of Plasmodium falciparum was assessed by an isotopic semi-microtest in Yaounde, Cameroon. Out of them, 54.5% were resistant to chloroquine, 28.6% to amodiaquine, 4.8% to quinine and 4.5% had a decrease of sensitivity to mefloquine. A strong positive correlation between the IC50 of the antimalarial drugs compared by pairs was detected.

Gestion du personnel de sante de district au Cameroun : cas du Departement de la Mefou

Afin de determiner si les methodes et procedes de gestion du personnel de sante peripherique sont de nature a favoriser le developpement d'un systeme de sante de district auto-responsable et operationnel; les auteurs ont realise une enquete transversale a passage unique avec renseignement de questionnaires aupres du personnel medico-sanitaire des formations sanitaires publiques dans les huit Arrondissements de la Mefou. Il ressort de cette etude que la gestion du personnel de sante peripherique est caracterisee par une mauvaise utilisation des effectifs disponibles; un encadrement inadequat et une insuffisance de motivation materielle et psychologique du personnel

[Evaluation of practice and costs of vector control on a family level in Central Africa. II. Douala City (Cameroon), July 1988]. / Evaluation des pratiques et des coûts de lutte antivectorielle à l'échelon familial en Afrique centrale. II. Ville de Douala (Cameroun), juillet 1988.

A Knowledge, Attitude, Practice survey was carried out in July 1988 in Douala city, by cluster sampling and household visits. 98% of these households declared being disturbed by mosquitoes (bites, diseases, noise); 91% of families are using a vector control method; the main methods are: bed-nets (48%), insecticide sprays (39.5%) and mosquito coils (36.7%). The average cumulated expense by households for vector control (116.6 ECU/year) and care for diseases attributed to mosquitoes (147.4 ECU/year) was evaluated at the equivalent of about 3 months of "minimum monthly wages". More than 90% of people interviewed would accept buying and using an insecticide impregnated bed-net provided that the price of such a product be lower than the current habitual price for ordinary bed-nets. The distribution of the impregnation technique must be made at the level of impregnation centres, which should start impregnating the existing bed-nets and take care of informing the public.

[Uncomplicated malaria attack in an area with high chloroquine resistance. 2. Evaluation of first-choice therapeutic scheme]. / Accès palustres simples en zone de haut niveau de résistance à la chloroquine. 2. Evaluation de schémas thérapeutiques de première intention.

The authors evaluate the comparative efficiency of chloroquine and amodiaquine (35 mg/kg during 3 days) for uncomplicated malaria treatment in an area with high chemoresistance level. 236 patients with malaria were examined and treated. 38% of them previously used antimalarials. The increase dosage in comparison with the WHO recommendations (25 mg/kg), lead to no advantages for chloroquine treatment (50% failure), in contrast with amodiaquine (4% failure). Therefore amodiaquine might be preferred in the health field unit for uncomplicated malaria.

[Uncomplicated malaria attack in an area with high resistance to chloroquine. 3. The use of second-choice oral drug treatment]. / Accès palustres simples en zone de haut niveau de résistance à la chloroquine. 3. Emploi de traitements de deuxième intention, par voie orale.

This study appreciated the efficiency of uncomplicated malaria second line treatment (P. falciparum) in an area with high level of chemoresistance. No therapeutic failure was found with sulfadoxine-pyrimethamine (Fansidar), and mefloquine-sulfadoxine-pyrimethamine (Fansimef), in contrast with a rate of 8% with quinine. The authors discuss the place of these therapeutic, in the treatment of malaria.

[Surveillance of Plasmodium falciparum drug sensitivity in Yaounde and its surroundings (Cameroon). In vivo and in vitro study]. / Surveillance de la chimiosensibilité de Plasmodium falciparum à Yaoundé et ses environs (Cameroun). Etude in vivo, in vitro.

Among 172 strains collected in Yaoundé 60% are chloroquine-resistant, 37% are amodiaquine-resistant, instead of quinine and mefloquine which are completely efficient. Among 30 strains collected at a rural health center (where self treatment decreases), 27% are chloroquine-resistant. New therapeutic schemes for first and second line treatment in endemic areas must be evaluated.

[Evaluation of practices and costs of antivectorial control at the family level in central Africa, I. Yaoundé City (March 1988)]. / Evaluation des pratiques et des couts de lutte antivectorielle a l'échelon familial en Afrique centrale. I. Ville de Yaoundé (mars 1988).

Within the framework of the preparation (acceptability and feasibility) of an integrated malaria control including insecticide impregnated bednets notably, a Knowledge Attitude Practice survey (home cluster sample) was carried through in March, 1988 in Yaoundé City to identify the current major mosquito behaviour control methods: insecticide sprays, mosquito coils and bednets and the motivations in the use of these control methods. The cost of vector control and cares for diseases attributed to mosquitoes have been evaluated. The survey shows that insecticide impregnated bednets represent an accessible and suitable control method subject to regular supply with reasonable prices and implementation of demonstration stations for the impregnation.

[Epidemiologic surveillance of the acquired immunodeficiency syndrome in 6 states of Central Africa]. / Surveillance épidémiologique du syndrome d'immunodépression acquise dans six états d'Afrique Centrale.

Since 1985, OCEAC, the organization for control of widespread endemic disease in Central Africa, has managed an epidemiological surveillance programme concerning HIV infection and AIDS in six countries of the Sub-Region: Cameroon, Tchad, Central African Republic, Congo, Equatorial Guinea and Gabon. This programme consists in evaluating longitudinally incidence rates of infection and clinical cases, and mortality rates. It is based on a selective strategy using a network of sentinels (hospitals and maternity care consultation centers), completed by cross sectional epidemiological studies. Thanks to this programme high risk groups of population, high risk places and high risk activities have been identified. These observations will be used to plan national prevention programmes on AIDS.

[Impact of the African year of vaccination on vaccine coverage in Cameroon]. / Impact des journées africaines de vaccination sur la couverture vaccinale au Cameroun.

The efficiency of the African Year of Immunization has been studied in Cameroon by the evaluation of the nationwide coverage thanks to two cluster sample surveys carried out in rural and urban areas. The results are compared to those of previous surveys.

[Infant and child morbidity and mortality due to diarrheal disease in central Africa]. / Morbidite et mortalite infantiles par maladies diarrheiques en Afrique Centrale.

PIP: Diarrheal diseases in Central African countries have often been identified as the 2nd leading cause of death after measles and the 2nd leading cause of morbidity after malaria. These diseases are responsible for death rates in children under 5 that range from 58/1000 in urban centers to 150 in rural areas, and they impose heavy costs on the health services for both pediatric beds and intravenous rehydration. Diarrhea contributes to malnutrition and to high fertility rates among parents who believe they must have many children to insure survival of a few. To study patterns of diarrheal disease in the region, 10 sites with different characteristics were selected for survey. 9 surveys of locations with widely varying climatic, ecologic, demographic, and socioeconomic conditions have been completed, 3 in Cameroon, 1 in the Central African Republic, 2 in Congo, 1 in Gabon, and 2 in Chad. All but 1 of the surveys were conducted between October 1983 and March 1985. The methodology was based on the cluster sampling recommended by the World Health Organization, which has the advantages of relative speed, moderate cost, and low personnel requirements. The clusters were either a village in rural areas or a section of an urban area. Interviewers obtained information about the number of children under 5 in the household, the number who had diarrhea in the previous 15 days and the treatment given, the number dying in the 12 months preceding the survey and the cause of death, whether diarrhea was a factor, and the age of the child at the time of death. A total of 63,107 children under 5 belonging to 33,051 households were surveyed. 12,732 episodes of diarrhea in the preceding 15 days were reported. It was estimated that each child in the region had an average of 4.8 episodes of diarrhea per year. The rate of diarrheal morbidity varied significantly by climatic zone. A follow-up survey of diarrheal morbidity figures from sentinel health centers is underway to determine the significance of climatic and seasonal variations. Only 7.1% of the reported diarrheal episodes were treated by oral rehydration therapy. 50.7% received some other form of medical treatment, 27.4% received traditional treatment, and 14.7% were not treated. Oral rehydration was not used at all in 2 survey locations and use exceeded 13% in only 3 locations. Diarrhea was a factor in 53% of reported deaths in infants and small children. Deaths due to diarrhea without any associated cause were in 2nd place following measles. Mortality rates due to diarrhea varied from under 65/1000 in survey sites with tropical or equatorial climates to 119.31 and 263.9.1000 in sites with Sahelian climates. Rural diarrheal mortality rates were higher than urban rates except in N'djamena, Chad.^ieng

[Evaluation of morbidity, mortality and therapeutic procedures in diarrheal diseases of young children in Cameroon]. / Evaluation de la morbidité, de la mortalité et des conduites thérapeutiques relatives aux maladies diarrhéiques chez les jeunes enfants au Cameroun.

The authors report the results of 3 sample surveys carried out in Cameroon and designed to determine the diarrhoeal morbidity, mortality and treatment rates in children under five years of age living in urban and rural areas, under different types of climate.

[The expanded vaccination program in Cameroon: status of the intermediate objectives and future prospects]. / Le programme élargi de vaccination au Cameroun: état de réalisation des objectifs intermédiaires et perspectives d'avenir.

The authors report the results of nine sample surveys for the evaluation of the immunization coverage program carried out in urban and rural areas in Cameroon. The halfway target of 30% is reached in urban areas and approached in rural areas. The achievement of the target (85%) will need the solution of more and more intricate problems and the participation of the whole national community.

[Prevalence of bilharzia antibodies in the pediatric population of the village of Pointe-Noire (Republic of the Congo)]. / Prévalence des anticorps antibilharziens dans la population infantile de la ville de Pointe-Noire (R. P. Congo).

Thirty clusters of children have been tested for schistosomiasis serology in the town of Pointe-Noire (Popular Republic of Congo). Out of 360 patients, 3 presented antibodies against schistosomiasis. The antibodies prevalence of this parasitosis is 0.83% +/- 0.008% which is very low as compared to other areas of the country.

[Evaluation of immunological and entomotological indices of yellow fever in Pointe-Noire, People's Republic of Congo]. / Evaluation des indices immunologiques et entomologiques de la fièvre jaune à Pointe-Noire, en République populaire du Congo.

The authors report the results of a serological sample survey managed to evaluate the prevalence of two types of yellow fever antibodies, connected with an entomological survey, in the town of Pointe-Noire in the People's Republic of Congo. According to the high rate of non protected people, the high level of entomological indices and the characteristics of local environment, this densely populated town may be considered as an area exposed to a potential hazard of a yellow fever outbreak. A vaccinal strategy ought to be planned according to this situation.

[Mass treatment of Schistomsoma haematobium bilharziasis in the member states of the Organization for Coordination of the Campaign against Endemic Diseases in Central Africa]. / Réflexions sur le traitement de masse des bilharzioses à Schistosoma haematobium dans les états membres de l'Organisation de Coordination pour la lutte contre les Endémies en Afrique Centrale (OCEAC).

The authors analysed the results of the control of Schistosoma haematobium bilharziasis in two central African countries, the Congo and the Cameroun . These results demonstrated: --The feasibility of mass screening by filtering urine; --The acceptability and efficacy of new antibilharzian drugs, praziquantel and oltipraz . With the aim of improving the cost/effectiveness ratio of these campagnes and taking into account the health requirements which exist and/or are desired by the population, the authors propose four modifications of the strategy of mass control: --The integration of Schistosoma haematobium bilharziasis control with the other regional health priorities; --Screening target groups;