Monitoring and impact evaluation of iodized salt intervention in Cameroon.

This study was carried out to monitor current iodization and its impact on iodine excess. The results show medians values increasing gradually from 62 ug/L to 283 µg/L then dropping to 169 µg/L for acceptable significance to above toxicity significant values of 300 µg/L as from 2006, exaggerated in 2018 at 1145 µg/L. Salt iodine contents, compared to the 20 - 40 ppm range recommended by WHO, show coarse grain as lowest with average 26.9 ppm while fine grain for human consumption average was 57.3 ppm. The extra fine grain variety has the highest iodine content at 248.8 ppm. Imported cerebos salt from France contained iodine at an average of 45.5 ppm while the Senegal salt contained iodine at an average of 182.2 ppm. The F-ratio (62.9) indicates great variation in iodine content of the salt involved while the p-value (p = 0.0002) indicates significant differences in iodine content of the salt of different refineries. By implication, there are still lapses on iodization.

The urgent need for environmental sanitation and a safe drinking water supply in Mbandjock, Cameroon.

Studies were conducted to assess the physical, chemical, and bacteriological qualities of drinking water in Mbandjock, Cameroon. Study results indicated that the vast majority of drinking water sources possessed acceptable physical and chemical qualities, according to the World Health Organization standards. However, microbiological analyses revealed that only the waters treated by the Cameroon National Water Company (SNEC) and the Sugar Processing Company (SOSUCAM) were acceptable for human consumption. All spring and well waters presented evidences of fecal contamination from human and/or animal origin. Water from these sources should, therefore, be treated before use for drinking. Since the majority of the population gets its water from wells and springs, there is an urgent need to develop a health education program, within the framework of primary health care, with respect to environmental sanitation and safe drinking water supply in this community.

[Child victims of sexual abuse in Cameroon]. / Les enfants victimes de sévices sexuels au Cameroun.

Reports of sexual abuse in children are infrequent in the French-speaking nations of black Africa. This study was undertaken to determine the incidence of sexual abuse in children in Yaounde, describe the profile of victims, and identify factors associated with sexual abuse. Seventeen female rape or attempted rape victims were enrolled over an 8-month period. Most (57.05%) were 7 to 15 years of age and lived in underprivileged neighborhoods. Genital bleeding (12 cases), hymenal tears (14 cases) and/or perineal tears were the main lesions found. Most of the rapists were young adults (19-45 years old in 70.5% of cases) who were neighbors, relatives or friends of the family, and single (58.82%). The motivations of the rapists were unclear. This medicosocial reality which is new in Cameroon needs attention.

Seroprevalence of anti-HCV in an urban child population: a pilot survey in a developing area, Cameroon.

Hepatitis C Virus (HCV) is the principal agent of non-A, non-B hepatitis and its spread in the community is not well defined. We evaluated the prevalence of anti-HCV (ortho ELISA System) in 696 children (4-14 years) in Kumba, Cameroon. Children were selected by systematic random sampling in six primary schools. A seroprevalence of 14.5% (101 children) was found which increased steadily with age. No significant differences were observed with respect to sex or to family size. There was a highly significant association both with parents' social class, the lowest class presenting a 2.2-fold risk factor, and with area of residence, suburban children showing a significantly higher prevalence (P less than 0.01). These results suggest that Cameroon is endemic for HCV infection, that children are infected at an early age and that infection increases with age. We can therefore hypothesize that transmission of HCV infection in this population is from child to child. Furthermore, the infection seems to be influenced by social factors but not by demographic ones.

PIP: The seroprevalence of anti-hepatitis C virus antibodies in a randomly selected group of 696 urban and suburban children from Kumba City, South West Province, Cameroon, was estimated with ELISA kits (Ortho Diagnostic Systems). The children, aged 4-14 years, were selected from 6 primary schools. Sera were frozen and shipped in a thermocooled container within 15 hours to Rome for analysis at the laboratory of Virology, National Institute of Health. The overall seroprevalence was 14.5%, increasing from 6.6% in children aged 4-6, to 17.5% in those aged 11 (p0.001). There was no difference between sexes or among those with different family sizes. Those among lower classes, based on parents' occupation, had a 2.2-fold greater risk for positive anti-HCV antibodies. Children of single parents were not at increased risk. Suburban children had higher seroprevalence, 21.0%, compared to urban children, 11.5%. Since hepatitis C is transmitted parenterally, and ritual scarification and tattooing now are rare, it was hypothesized that transmission may have occurred from contact sports or play, or by an insect vector.

A high degree of exposure to hepatitis A virus infection in urban children in Cameroon.

In January 1989, the prevalence of antibodies to hepatitis A virus (anti-HAV) was determined by ELISA in 702 apparently healthy children 5-14 years old in Kumba City, Cameroon. Children were recruited from those attending six different primary schools, representative of the socio-demographic characteristics of the inhabitants, using a systematic random sampling. The overall IgG anti-HAV prevalence was 96.9%, reaching 100% by the age of 11 years. In primary school beginners the prevalence was very high, 94.0%, contrary to what has been observed in developed countries. The anti-HAV prevalence was not associated with family size, but was related to parent's occupation, children from the lower class having a 5.9 fold risk (C.I. = 1.9-18.3) of past exposure to HAV. These results suggest a persistently high prevalence of anti-HAV in children despite improving hygienic conditions. The spread of HAV in this population may be the result of domestic water and/or food contamination.

Hepatitis B virus infection in Cameroon: a seroepidemiological survey in city school children.

A pilot survey conducted in Cameroon comprising 702 children of primary school age revealed that 58.5% of the children were positive for at least one HBV marker. An overall HBsAg prevalence of 19.9% was observed. Both any HBV marker and HBsAg prevalences increased with age (P less than 0.01). Of the HBsAg-positive subjects, 28.4% were positive for HBV-DNA; none was positive for anti-HDV. There was no significant difference among sexes for either any HBV marker or for HBsAg prevalence. However, a significant difference by sex was found in the percentage ratio HBsAg+/and any marker + (41.0% in males against 28.2% in females; P less than 0.05). No significant difference with respect to the father's occupation and family size was observed. When the zone of location of school was taken into consideration it was observed that suburban school children had a higher prevalence of any HBV marker as compared to central town school children (73.9% vs. 56.6%; P less than 0.001). These results place Cameroon among countries of high endemicity for HBV. The results also indicate an early acquisition of infection, a high infectivity, and probably continuous infection even in the primary school ages.

Seroepidemiology of pertussis infection in an urban childhood population in Cameroon.

In 1989, the prevalence of IgG antibodies to pertussis toxin (PT) in a sample of 367 unvaccinated apparently healthy children 5-14 years old was estimated by ELISA in Kumba City (Cameroon). Children were recruited using a systematic random sampling from six primary schools located in different districts of the city. The sample was representative of the various socioeconomic classes. The overall prevalence was 75%; it increased from 62% in 5 year old children to 81% in children 12-14 years old (P less than 0.01). IgG antibody prevalence was positively related to the family size. Children belonging to households of nine or more members had a 2.2-fold risk (C.I. 95 per cent = 1.1-4.6) of previous exposure to B. pertussis infection. No association was found with the father's occupation (O.R. = 1). These findings demonstrate a great impact of pertussis infection in Cameroon, with a nearly total exposure by late childhood.

Culture, biomedicine and child mortality in Cameroon.

This article is based on a field study conducted by the authors in East Cameroon in 1987-1988 and on written sources available, including U.N. and Cameroon government statistics. It focuses on two major issues, namely, the relationship between biomedical assumptions and programs and traditional cultural tenets and the impact of both on child mortality in Cameroon's East Province. It contrasts the problems of disease and mortality in the area as reflected in official statistics with the actual health situation in the Province in light of resilient beliefs, attitudes, and practices that hinder rather than facilitate the effectiveness of immunization campaigns undertaken by the government to save the child. The study concludes by discussing policy choices and steps that both the government and the affected people might consider to remedy the region's disappointing health conditions.

Age- and sex-related study of HBV-DNA in HBsAg asymptomatic children from an endemic area (Cameroon).

A sero-epidemiological survey was carried out in Cameroon in January 1989 on a sample of 702 children of primary school age. A high HBV endemicity level was observed: 60.3% of the sera were positive to any HBV marker, 23.2% (163 sera) were HBsAg-positive. HBV-DNA positivity was observed in 38/163 (23.3%), thus showing a high level of infectivity among these carriers. Seventy-seven HBsAg-positive sera were tested for HBeAg/anti-HBe: 20 (26%) were HBeAg-positive 31 (40%) anti-HBe-positive, and 26 (34%) were negative for both. All sera were anti-HD-negative. Twenty-five per cent of HBeAg-positive sera were HBV-DNA-negative. This finding could be explained by a delayed HBeAg/anti-HBe seroconversion phase with fluctuant HBV-DNA. Only one case of HBV-DNA-positive anti-HBe-positive serum was observed. This study showed that HBV-DNA prevalence was significantly higher in boys (31.8%) than in girls (14.1%) (p less than 0.02). This difference was not observed for any HBV marker. We therefore conclude that in boys a prolonged HBV replicative phase might explain the observed high chronicity rate.

The knowledge of medicinal plants in Africa today.

The oral tradition for communication in Africa is stressed as well as the secrecy of the treatments with plants by traditional medicine-men. This makes it difficult to obtain more exact information on all the different aspects of traditional medicine. Nevertheless, some data have been collected in the Francophone countries. In English-speaking Africa efforts to gather information have also been made and a number of valuable reports and books published. A number of books report our present knowledge in the African regions south of the equator, mainly in Zambia.

[Knowledge, attitudes, and practice survey in the Cameroons in 1973]. / Enquete des connaissances attitudes et pratiques sur les Camerounaises en 1973.

PIP: A KAP survey taken in 1972/3 by the national organization of women's unions of Cameroon, (OFUNC) in old Western Cameroon revealed that women wanted an ideal family of 6 children and that the age of a woman at 1st marriage should be 18 years, which coincides with the normal age of legal majority. They have also voiced concern about the rapid population growth which is capable of reaching 7 million in 1982. The women have likewise preferred polygamy to monogamy, despite the fact the the majority are Christians. Their greatest desire was to see sex education taught in secondary schools. A certain number of them recommended teaching it at the end of primary education. These women reflected the general pronatalist attitudes and practices which coincided with the official attitude. It is evident that Cameroon remains sensible at this time to a world population problem and has proper characteristics of its national territory. (author's modified)^ieng