Burnout syndrome and associated factors among university teaching staff in Cameroon: Effect of the practice of sport and physical activities and leisures.

OBJECTIVES: This study aimed to evaluate the epidemiology of burnout syndrome among university teaching staff in Cameroon; and to establish if the practice of physical activities and leisures could have preventive effect. METHODS: A cross-sectional study using a self-administered questionnaire on socio-demographic characteristics, socio-professional conditions, Maslach Burnout Inventory-Educator Survey (MBI-ES) to evaluate burnout syndrome, and Ricci-Gagnon metrics to assess level of physical activities practice among grades of teaching staff, in the various faculties of the University of Douala, Cameroon. RESULTS: Three hundreds and three teaching staff members aged 43±7 years were included (69% males). The prevalence of burnout syndrome was 68%, distributed within the three dimensions as follows: emotional exhaustion (15.2%), depersonalization (32.1%) and loss of personal accomplishment (22.1%), with 57% low level, 38% moderate and 6% severe. Burnout affected respectively 55.4% lecturers, 38.3% senior lecturers and 6.3% professors. Burnout was significantly associated with poor working conditions (P=0.0001), unsatisfactory salary (P=0.0001), part time teaching in private university institutions (P=0.027), sensation of strenuous job (P=0.002), conflict with colleagues (P=0.028), sedentariness (P=0.007). Sport and physical activities showed significant protective effect against burnout (P=0.004), the same with leisures (P=0.016). CONCLUSION: The prevalence burnout syndrome is high among university teaching staff in Cameroon. The practice of sport and physical activities and leisures has a protective effect against burnout syndrome.

Aspects cliniques et prise en charge des accidents de travail survenus en milieu industriel à Douala

Introduction : Les statistiques générales des accidents de travail sont en régression dans le monde, mais restent élevées dans les pays émergents et sous-développés. L'absence de données scientifiques locales sur les risques professionnels et la méconnaissance des caractéristiques générales des accidents de travail a motivé la conduite de cette étude dont l'objectif était de décrire les aspects cliniques et la prise en charge des accidents de travail survenus en milieu industriel à Douala au Cameroun entre 2000 et 2009.Méthodologie : L'étude était rétrospective et descriptive. Elle s'est déroulée du 25 mars au 23 mai 2014 dans les cinq centres de la Caisse Nationale de Prévoyance Sociale de Douala. Nous avons colligé tous les dossiers exploitables des victimes d'accidents de travail survenus en milieu industriel pendant la période 2000-2009. Les résultats ont été présentés sous forme univariée et bivariée. Résultats : Mille soixante-quatre (1064) cas ont été retenus sur les 1471 dossiers étudiés (72,33%). L'échantillon était à prédominance masculine et la moyenne d'âge était de 35,7± 7,41 ans. La majorité des victimes était des ouvriers (54,4%). Ils travaillaient dans les industries du secteur du bois (38,3%) ou du secteur du pétrole, gaz et chimie. La majorité des lésions était légère et modérée (53,20%), localisées aux mains (35,8%), aux membres inférieurs (17,6%) et aux yeux (13,2%). Il s'agissait de lésions cutanéo-muqueuses ou ostéo-articulaires. Les victimes avaient reçu des premiers soins, dans 74,10% dans des formations sanitaires situées hors de l'entreprise. La majorité des victimes (51,8%) avait effectué des examens radiographiques exploratoires, 47,2% avaient été consultées par des médecins et 313 victimes avaient été hospitalisées pendant 1 à 2 jours (56,5%), 88 victimes pendant 3-7 jours (28,3%) et 48 victimes pendant plus de 7 jours (15,2%). La quasi-totalité des victimes a eu un arrêt de travail avec ITT supérieure à 7 jours (64,5%). Sept-cent-cinquante-deux victimes ont guéri (70,70%) et 237 (22,30%) ont consolidé. Conclusion : Les victimes d'accidents de travail à Douala pour la période 2000-2009 sont des jeunes ouvriers travaillant dans l'industrie du bois, du pétrole, gaz et chimie et de la métallurgie. La prise en charge a étéeffectuée en dehors de l'entreprise et met en exergue les difficultés fonctionnelles des centres médicaux d'entreprise

Étude des accidents électriques d'origine professionnelle à Yaoundé.

The frequency of work-related electrical injuries has dropped but their characteristics remain unknown in our country. This survey aimed to describe the work-related electrical injuries that occurred in Yaounde during the period 2005-2014. The study was carried out in Yaounde-based central level hospitals from February 1st, 2015 to May 10th, 2015. Data from the files of the victims of these accidents were collated and analyzed. Socio-demographic, professional and epidemiological data were described and results were presented in descriptive mode. The sample comprised 25 males (83.3%) and 5 females (16.7%). The mean age was 28±8.3 years. Three out of four victims were working in the informal sector. Accidents were caused by low voltage current (56.7%). The victims were usually electricians and electrical workers (24%). Accidents occurred at various locations, such as in workshops and in the yard and at different times of the day. We recommend that specific training sessions targeting these workers of the informal sector be organized in order to prevent these dangerous accidents.

[Burnout syndrome among generalist medical doctors of Douala region (Cameroon): Can physical activities be a protective factor?] / Syndrome de burnout chez les médecins généralistes de la région de Douala (Cameroun) : les activités physiques peuvent-elles être un facteur protecteur ?

BACKGROUND: This study aimed to evaluate and document the importance of Burnout syndrome among generalist medical doctors (GMD) since no investigation have been carried in Cameroon. METHODS: Cross-sectional study including 85 GMD using a self-administered questionnaire on socio-demographic characteristics, socioprofessional conditions, Maslach Burnout Inventory - Human Services Survey (MBI-HSS) to evaluate burnout, and Ricci-Gagnon physical activities level metrics. RESULTS: 77 GMD (90.6 %) reported having never heard about burnout. Mean age was 29 years (range 24-42 years). The MBI-HSS revealed that 36 GMD (42.4 %) were victims of burnout, with 27 (31.8 %) at a low level, 8 (9.4 %) moderate and one (1.2 %) severe. Burnout was associated with distance from home to job place (p ⟨ 0.05), strenuous job (p = 0.04), number of children in charge (p = 0.007), number of hospital attended (p = 0.003), number of hours of labor per day (p = 0.0001), conflicts with the hierarchy (p = 0.01), number of guards per month (p = 0.01). Physical activities practice did not showed significant preventive effect on burnout (p = 0.3) (Odds-ratio = 1.45, IC 95 % 0.6, 3.45). CONCLUSIONS: Burnout syndrome is not well known among GMD in Douala, though having a high prevalence. Various socio-demographic and socio-professional factors are associated and contribute to increase the level of affect. Burnout seems to be a vicious somato-psycho-somatic disorder. This study did not found a protective or preventive effect of physical activities on burnout.

BUT: Le but de cette étude était d'évaluer et documenter l'importance du syndrome de burnout parmi les médecins généralistes (MG), dans un contexte d'une absence totale de données sur cette affection au Cameroun. METHODES: Etude transversale incluant 85 médecins généralistes, à l'aide d'un questionnaire auto-administré sur les caractéristiques sociodémographiques, les conditions socioprofessionnelles, le Maslach Burnout Inventory - Human Services Survey (MBI-HSS) pour évaluer le burnout et le questionnaire de Ricci-Gagnon pour déterminer le niveau des activités physiques. RESULTATS: 77 MG (90,6 %) ont déclaré n'avoir jamais entendu parler du burnout. L'âge variait de 24 à 42 ans. Le MBI-HSS a révélé que 36 (42,4 %) étaient victimes du burnout, dont 27 (31,8 %) à un niveau faible, 8 (9,4 %) modéré et 1 (1,2 %) sévère. Le burnout était associé à la distance domicile-lieu de travail (p ⟨ 0,05), à la charge du travail (p = 0,04), au nombre d'enfants à charge (p = 0,007), au nombre d'hôpitaux de consultation (p = 0,003), au nombre d'heures de travail par jour (p = 0,0001), aux conflits avec la hiérarchie (p = 0,01), au nombre de gardes par mois (p = 0,01). La pratique des activités physiques n'a pas montré un effet préventif significatif sur le burnout (p = 0,3) (odds-ratio = 1,45, IC 95 % 0,6, 3,45). CONCLUSIONS: Bien qu'ayant une prévalence élevée, le burnout n'est pas bien connu parmi les MG à Douala. Divers facteurs sociodémographiques et socio-professionnels sont associés et contribuent à augmenter le niveau de l'affection. Le burnout semble être un trouble somato-psycho-somatique vicieux.

Experimental investigation and modelling of tritium washout by precipitation in the area of the nuclear power plant of Paks, Hungary.

Tritium occurs in nature in trace amounts, but its concentration is changing due to natural and artificial sources. Studies focusing on natural tritium have to take into account the effect of artificial sources. Also, the impact of tritium is an important issue in environmental protection, e.g. in connection with the emissions from nuclear power plants. The present work focuses on the rain washout of tritium emitted from the Paks nuclear power plant in Hungary. Rainwater collectors were placed around the plant and after a period of precipitation, rainwater was collected and analysed for tritium content. Samples were analysed using low-level liquid scintillation counting, with some also subject to the more accurate (3)He ingrowth method. The results clearly show the trace of the tritium plume emitted from the plant; however, values are only about one order of magnitude higher than environmental background levels. A washout model was devised to estimate the distribution of tritium around the plant. The model gives slightly higher concentrations than those measured in the field, but in general the agreement is satisfactory. The modelled values demonstrate that the effect of the plant on rainwater tritium levels is negligible over a distance of some kilometres.

[Distribution and ecology of the Savannah human African trypanosomiasis vectors in disturbed forest zone in south Cameroon: about case in the Doumé forest]. / Distribution et écologie des vecteurs de la trypanosomose humaine africaine de type savanicole en zone de forêt dégradée au sud Cameroun: cas du foyer de Doumé.

Vector control through trapping in the foci of humid forest areas is rather difficult because of the wide spreading of tsetse flies and transmission sites of human African trypanosomiasis. In fact, traps should be a priori set up everywhere to stop the transmission. The identification of the disease transmission sites enables efficient trapping through localisation of dangerous tsetse flies habitats needing vector control measures. The study of adult tsetse flies and teneral tsetse flies spatial distribution and human vector contacts was conducted in Doumb to determine the transmission of human African trypanosomiasis for efficient vector control. Glossina fuscipes fuscipes was the only tsetse fly captured with a very low apparent density of 0.13 tsetse flies per trap and per day. Furthermore, the disease transmission in the focus was not found uniform. In fact, human vector contacts are high in two villages (Paki and Mendin) located in the highly disturbed forest zones. These contacts occur in humid shallows where teneral tsetse flies were only captured around streams and forest galleries. The Doumé focus presents therefore characteristics of savannah focus where river banks and nearby biotopes are the main target sites for vector control campaigns.

Distribution of the members of Anopheles gambiae and pyrethroid knock-down resistance gene (kdr) in Guinea-Bissau, West Africa.

An entomological survey conducted in 2002 in Guinea Bissau aimed i) to study the distribution of the members of Anopheles gambiae Giles complex (Diptera: Culicidae) throughout four ecological areas extended from mangrove to savannah ii) to evaluate the insecticide susceptibility status of these malaria vectors exposed to permethrin 0.75% and DDT4%, and finally iii) to investigate the occurrence and the spread of the Leu-Phe knock down resistance (kdr) gene associated with pyrethroid and DDT resistance within these vector populations. Adult female mosquitoes issued from indoor morning collections were tested using WHO procedures, test kits and impregnated papers to assess their insecticide susceptibility status. Tested specimens were identified by PCR assays and characterized for the kdr gene. Malaria vectors were mainly dominated elsewhere by An. gambiae s.s. (both S and M molecular forms) living in sympatry with low proportion of An. melas in the littoral. An. gambiae s.s. tested populations were fully susceptible both to permethrin 0.75% and to DDT 4% irrespective to their location and ecotypes. The Leu-Phe kdr mutation was detected at low frequency only in two sites respectively urban (Bissau) and Guinea-savannah (Gabu) areas. It occurred only in the S molecular form in Gabu (at the frequency of 0.14) and both in the S and M molecular forms in Bissau at the frequency of 0.06 and 0.02 respectively. These results suggested that the populations of An. gambiae s.s., the most frequent malaria vector in Guinea Bissau, still remain cross-susceptible to pyrethroids and DDT This susceptibility status and the frequency of resistance mechanism such as the kdr mutation must be monitored in the future particularly in the urban and savannah areas with continuous and intensive use of insecticides.

Malaria vectors and transmission dynamics in coastal south-western Cameroon

Background: Malaria is a major public health problem in Cameroon. Unlike in the southern forested areas where the epidemiology of malaria has been better studied prior to the implementation of control activities; little is known about the distribution and role of anophelines in malaria transmission in the coastal areas. Methods: A 12-month longitudinal entomological survey was conducted in Tiko; Limbe and Idenau from August 2001 to July 2002. Mosquitoes captured indoors on human volunteers were identified morphologically. Species of the Anopheles gambiae complex were identified using the polymerase chain reaction (PCR). Mosquito infectivity was detected by the enzyme-linked immunosorbent assay and PCR. Malariometric indices (plasmodic index; gametocytic index; parasite species prevalence) were determined in three age groups (5yrs; 5-15yrs; 15yrs) and followed-up once every three months. Results: In all; 2;773 malaria vectors comprising Anopheles gambiae (78.2); Anopheles funestus (17.4) and Anopheles nili (7.4) were captured. Anopheles melas was not anthropophagic. Anopheles gambiae had the highest infection rates. There were 287; 160 and 149 infective bites/person/year in Tiko; Limbe and Idenau; respectively. Anopheles gambiae accounted for 72.7; An. funestus for 23and An. nili for 4.3of the transmission. The prevalence of malaria parasitaemia was 41.5in children 5 years of age; 31.5in those 5-15years and 10.5in those 15years; and Plasmodium falciparum was the predominant parasite species.Conclusions: Malaria transmission is perennial; rainfall dependent and An. melas does not contribute to transmission. These findings are important in the planning and implementation of malaria control activities in coastal Cameroon and West Africa

Exploiting the potential of vector control for disease prevention.

Although vector control has proven highly effective in preventing disease transmission, it is not being used to its full potential, thereby depriving disadvantaged populations of the benefits of well tried and tested methods. Following the discovery of synthetic residual insecticides in the 1940s, large-scale programmes succeeded in bringing many of the important vector-borne diseases under control. By the late 1960s, most vector-borne diseases--with the exception of malaria in Africa--were no longer considered to be of primary public health importance. The result was that control programmes lapsed, resources dwindled, and specialists in vector control disappeared from public health units. Within two decades, many important vector-borne diseases had re-emerged or spread to new areas. The time has come to restore vector control to its key role in the prevention of disease transmission, albeit with an increased emphasis on multiple measures, whether pesticide-based or involving environmental modification, and with a strengthened managerial and operational capacity. Integrated vector management provides a sound conceptual framework for deployment of cost-effective and sustainable methods of vector control. This approach allows for full consideration of the complex determinants of disease transmission, including local disease ecology, the role of human activity in increasing risks of disease transmission, and the socioeconomic conditions of affected communities.

Vector-control synergies, between 'roll back malaria' and the Global Programme to Eliminate Lymphatic Filariasis, in the African region.

The perspectives and opportunities for controlling the mosquito vectors of Wuchereria bancrofti in tropical Africa are summarized and discussed. The countries covered by the World Health Organization's African Region have about one third of the world's burden of lymphatic filariasis (LF) as well as large shares of the planet's malaria and of many other vector-borne diseases. African LF is entirely caused by nocturnally periodic W. bancrofti, filarial nematode that is transmitted in urban East Africa by Culex quinquefasciatus, and in rural areas across tropical Africa by the same anopheline species that transmit the Plasmodium spp. causing human malaria. The standard practices for controlling the vectors of malarial parasites - house-spraying with residual insecticides and the use of bednets (preferably pre-treated with insecticide) for personal and community protection - can be simultaneously effective against both LF and malaria. Although mass drug administrations remain the main stay of the current strategy for LF elimination, the vector-control activities of the 'Roll Back Malaria' campaign can be expected to reduce the transmission of W. bancrofti in co-endemic areas. The relevant issues of programme management and integrated vector control are briefly reviewed.

The epidemiology of Plasmodium falciparum malaria in two Cameroonian villages: Simbok and Etoa.

In support of ongoing immunologic studies on immunity to Plasmodium falciparum, demographic, entomologic, parasitologic, and clinical studies were conducted in two Cameroonian villages located 3 km apart. Simbok (population = 907) has pools of water present year round that provide breeding sites for Anopheles gambiae, whereas Etoa (population = 485) has swampy areas that dry up annually in which A. funestus breed. Results showed that individuals in Simbok receive an estimated 1.9 and 1.2 infectious bites per night in the wet and dry season, respectively, whereas individuals in Etoa receive 2.4 and 0.4 infectious bites per night, respectively. Although transmission patterns differ, the rate of acquisition of immunity to malaria appears to be similar in both villages. A prevalence of 50-75% was found in children < 10 years old, variable levels in children 11-15 years old, and 31% in adults. Thus, as reported in other parts of Africa, individuals exposed to continuous transmission of P. falciparum slowly acquired significant, but not complete, immunity.

Status of pyrethroid resistance in Anopheles gambiae sensu lato.

The present study confirms the presence of pyrethroid resistance among Anopheles gambiae s.l mosquitos in Côte d'Ivoire and reports the observation of such resistance in two other countries in West Africa (Benin and Burkina Faso). Malaria vector populations from Cameroon (Central Africa), Senegal (West Africa) and Botswana (southern Africa) were found to be susceptible to pyrethroids. In the most resistant mosquito populations, resistance to permethrin was associated with reduced mortality, not only with respect to this compound but also towards deltamethrin. Moreover, a significant increase in knockdown time was observed in some mosquito populations before any decrease in mortality, suggesting that knockdown time could be a good indicator for the early detection of pyrethroid resistance. In view of the current extension of such resistance, there is an urgent need to set up a network in Africa to evaluate its development. It is also vital that the impact of this resistance on pyrethroid-impregnated bednets be assessed.

Origin and prevention of airport malaria in France.

Since 1969, 63 cases of airport malaria have been reported in Western Europe, 24 of which occurred in France. Most were due to Plasmodium falciparum. In 1994, 7 cases occurred in and around Roissy Charles de Gaulle airport (CDG), showing 4 types of contamination: among employees working on airstrips or opening containers, among residents living near the airport, among people living at some distance from the airport after a secondary transport of vectors, and by vectors transported in luggage. In-flight or stop-over infection is not considered as airport malaria. The infective anophelines originated from airports where malaria transmission occurs, mostly in subsaharan Africa. A tentative list is given taking into account aerial traffic with France. Surveys in the airports of Dakar (Senegal), Cotonou (Benin), Abidjan (Cote d'Ivoire) and Yaoundé (Cameroun) found potential vectors in all of these from July to September. After 1994, the Contrôle Sanitaire aux Frontières (CSF) in charge at CDG concentrated its efforts on the flights at risk, as well as information and sensitization of airline companies, which resulted in 73% and 87% of the flights at risk being properly disinsected in 1995 and 1996. Despite pyrethroid resistance in Anopheles gambiae s.s. in West Africa, the efficacy of aircraft spraying with permethrin aerosols is still acceptable. However, surveillance of resistance should be improved and search for nonpyrethroid insecticides suitable for aircraft strongly encouraged.

[Levels of malaria transmission: methods and parameters]. / L'évaluation des niveaux de transmission palustre: méthodologies et paramètres.

Evaluation of malaria transmission levels is necessary to compare ecologically diverse areas and to assess the effectiveness of efforts to control the disease. The purpose of this report is to describe useful techniques for descriptive epidemiology and potentially pertinent indicators regarding the three links in the epidemiological chain: transmission from mosquito to man, transmission from man to mosquito, and sporogonic cycle. Standards for evaluation of transmission from mosquito to man are now well established. Techniques and resulting data, mostly entomological, have been validated in numerous multicenter and multidiscipline studies before and after implementation of control measurements. Evaluation of transmission from man to mosquito has not yet been extensively studied. Gametocyte index does not appear to be a good indicator of infectivity in mosquitoes. Two other parameters that have been proposed in the literature are rate of human infectivity to mosquitoes and probability that a bloodmeal will be infectious. However these evaluation techniques have been neither subjected to comparative study nor validated in epidemiological surveys. The third factor for evaluation of malaria transmission levels involves sexual development of the gametocytes (sporogonic cycle) in the vector. Two indicators that might be useful in this regard are quantification of early-stage parasites in the stomach of the mosquito and study of blood factors in subjects in whom inhibition transmission has been documented. Since these methods have been used only sporadically, further study will be needed to validate this approach to evaluate transmission level.

[Anopheles species and the transmission of malaria in the forest/savannah transition zone in central Cameroon]. / La faune anophélienne et la transmission du paludisme dans une zone de transition forêt/savane au centre du Cameroun.

A longitudinal study on malaria vectors and transmission was carried out in a forest-savannah transitional area in Cameroon. Indoor all night mosquito collections on human bait were performed during one year in two villages: Nditam and Ngoume. Nditam was located in a secondary forest block surrounded by savannah, while Ngoume was situated in an ancient forest block. The results showed that at Nditam, only one anopheline species was collected, that was Anopheles gambiae s.l.. The average daily biting rate was 2.4 bites per man per night. The sporozoitic index of An. gambiae was 9.4%. The entomological inoculation rate was therefore estimated at 0.225 infective bite per man per night that is to say 82 infective bites per man per year. Malaria transmission was low during the year, but an important increase was observed in September, when the rainfall was at its peak. At Ngoume, no Anopheles mosquito was collected. Therefore, malaria transmission was not observed in that village.