Pathogenesis of cancrum oris (noma): confounding interactions of malnutrition with infection.

This study showed that impoverished Nigerian children at risk for cancrum oris (noma) had significantly reduced plasma concentrations of zinc (< 10.8 micromol/L), retinol (< 1.05 micromol/L), ascorbate (< 11 micromol/L), and the essential amino acids, with prominently increased plasma and saliva levels of free cortisol, compared with their healthy counterparts. The nutrient deficiencies, in concert with previously reported widespread viral infections (measles, herpesviruses) in the children, would impair oral mucosal immunity. We postulate, subject to additional studies, that evolution of the oral mucosal ulcers including acute necrotizing gingivitis to noma is triggered by a consortium of microorganisms of which Fusobacterium necrophorum is a key component. Fusobacterium necrophorum elaborates several dermonecrotic toxic metabolites and is acquired by the impoverished children via fecal contamination resulting from shared residential facilities with animals and very poor environmental sanitation.

Artificial donor insemination in Yaounde: some socio-cultural considerations.

Infertility affects about 14% of the population in Cameroon. The majority of those affected are between 26-30 years old. Between 40-50% of all cases of infertility are associated with male failure, and azoospermia is implicated in 14.4% of the cases. There is thus an indication for assisted reproduction among this category of infertile couples particularly artificial insemination by donor (A.I.D.). A comparative study on fertile and infertile couples' perception of A.I.D. revealed that knowledge of A.I.D. is low, 35.30% of infertile respondents were aware of the procedure via à vis 30.6% of their fertile counterparts. Nonetheless 49% of infertile respondents accepted A.I.D. in principle compared to 37.75% of their fertile counterparts. Despite the high value respondents placed on having children and the strong desire by infertile couples to have their reproductive potentials fulfilled, only 19.6% of infertile respondents and 42.87% of their fertile counterparts respectively, would actually practice A.I.D. if the need arose. There are indications that respondents did not perceive A.I.D. as an acceptable solution to infertility. Evidently, the possible influence of socio-cultural barriers to A.I.D. as well as perceived socio-cultural alternatives which may be more acceptable to infertile couples than a technically assisted form of reproduction, have been overlooked.