Investigation of an Outbreak of Dengue Virus Serotype 1 in a Rural Area of Kribi, South Cameroon: A Cross-Sectional Study.

BACKGROUND: On May 2017, a case of dengue serotype 1 was detected and confirmed through routine surveillance in a traveler returning from Kribi, a seaside town of Southern Cameroon. This study aimed at confirming the circulation of dengue virus (DENV) in Southern Cameroon. METHODS: A cross sectional study was carried out in Londji near Kribi from June 21-25, 2017, by a joint team of Centre Pasteur of Cameroon and the Department of Diseases, Epidemics and Pandemics Control. Blood samples of consented participants were collected and tested for anti-D ENV IgM using an IgM antibody capture enzyme-linked immunosorbent assay (MAC-ELISA), and for the detection of Zika, dengue, or chikungunya viruses using Trioplex real-time reverse transcription-polymerase chain reaction (RT-PCR). DENV RNA-positive samples were serotyped using an end-point nested RT-PCR. RESULTS: Ninety-one participants were enrolled, 50.55% (46/91) of them males. The mean age of the population was 30.71 years (±18.89). In total, 14.28% (13/91) of the participants had DENV infection (3 anti-DENV IgM positive and 10 DENV serotype 1 RT-PCR positive). CONCLUSION: The detection of DENV serotype 1 in an autochthonous population during this survey is a confirmation that the seaside city of Kribi is a risk area for contracting dengue infection in Cameroon.

Verbal autopsy and therapeutic itinerary of children who die before arrival in a paediatric centre in Yaoundé, Cameroon.

BACKGROUND: In Cameroon the rate of infant-juvenile mortality remains high and most death occur in the community. Mortality statistics is usually based on hospital data which are generally insufficient and less reliable. In a context where legislation on death registration is not applied, and where conventional autopsy is not often done, verbal autopsy (VA) provides information on mortality. This study tried to experiment this method and also analyses the therapeutic pathway of a group of children who died before arrival at the emergency department of a pediatric hospital. METHODS: A cross sectional descriptive study was carried out on children who died before arrival, at the Mother and Child Centre of the Chantal Biya Foundation in Yaounde, between October 2013 and April 2014. The addresses of parents or relatives of the deceased children were registered at the start of the study. Each respondent was interviewed 5 to 6 weeks later at the residence of the deceased child, with the aid of a VA questionnaire. Information obtained was on the socio-demographic characteristics of the families, past history of deceased, clinical presentation and the different health care services sought before the death. RESULTS: In all, 40 children who died were included in the study. The majority of the deceased children were less than 5 years (82.5%) with 50.0% being less than 1 year of age. Almost half of them (47.5%) had been ill for more than 24 hours, 40% for more than 3 days. Up to 50.0% had not been taken to a health facility. Most of them had visited 2 or 3 other health facilities before dying on the way to our hospital. Auto medication was frequent (42.5%); parents initially recourse to drugs which were either bought or obtained from home. Some parents (25.0%) brought their children only after they had been to a private dispensary, or a traditional healer (15.0%). Only 7.5% benefited from consultation in a public health facility and 2.5% resorted to prayers and incantations. Whatever the kind of care sought, the choice was mostly guided by its proximity (32.5%), advice from a relative (27.5%) or its affordability. CONCLUSIONS: It is of crucial importance that the government reinforces the measures to avoid the existence of clandestine health centres and check the competence of health care professionals. Improving referral/counter referral system will permit the limitation of fatal medical errors.