Antenatal HIV prevalence in Yaounde, Cameroon.

From June 1994 to July 1996, 4100 pregnant women living in Yaounde, Cameroon, were tested for human immunodeficiency virus type 1 (HIV-1) and syphilis. The HIV seroprevalence was 4.2% (95% confidence interval (CI): 3.6%-4.8%), and that of antibodies to Treponema pallidum was 17.4% (95% CI: 16.3%-18.6%) (HIV infection was twice as common in women with positive syphilis serology) (7.2% vs 3.6%). Over the study period, the antenatal seroprevalence of syphilis remained stable, while there was an increase in the HIV seroprevalence rate. There was an increase in HIV seropositivity in women uninfected with syphilis between 1994/1995 and 1995/1996 from 2.9% to 4.3%. By the end of the study, HIV infection was no commoner in women with negative compared with positive syphilis serology. It is therefore postulated that HIV infection in Yaounde has entered the general, sexually active female population. We suggest that management of pregnant women in Cameroon should include routine screening for both HIV infection and other sexually transmitted diseases (STDs).

Prevalence of infections affecting the child among pregnant women in Yaounde, Cameroon.

The prevalence of infections which have deleterious effects to either the mother or the fetus during pregnancy are unknown in Cameroon. To formulate appropriate antenatal screening policies for the Central Mother and Child Clinic in Yaounde, we tested random sera obtained from 1,014 stored samples previously obtained from pregnant women. One hundred and fifty sera were tested for the presence of the hepatitis B surface antigen (HBsAg), 544 for syphilis antibodies, 192 for antibodies to rubella and 192 for antibodies to Toxoplasma gondii. We found the HBsAg in 25.3% (38/150) of the subjects, antibodies against syphilis in 15.9% (87/544), antibodies to the rubella virus in 83.9% (161/192) and evidence of toxoplasma infection in 77.1% (148/192). Of the 38 HBsAg-positive subjects, 5.2% and 55.3% were positive for the HBe antigen and HBe antibody, respectively. We found a high prevalence for these infections in the antenatal clinical attendants. The data will be used to develop an appropriate control strategy for them.

[Malaria morbidity at the Center for Maternal and Child Prevention of the Central Hospital, Yaounde, Cameroon. Observations of a sample of 903 infants]. / Etude de la morbidité palustre au Centre de Prévention Maternelle et Infantile de l'Hôpital Central, Yaoundé, Cameroun. Observations d'un échantillon de 903 enfants.

From April 1988 to March 1989, 903 randomly chosen children were examined in the Maternal and Child Health Department of the Central Hospital of Yaounde (Cameroon) to determine the importance of malaria in general morbidity, the relation between clinical symptoms and parasite densities and to have some idea of the population's self-medication behaviour. We adopted the criteria formerly worked out in West Africa, i.e. a fever (t degree higher than 37.9 degrees C) without any obvious febrile disease and a parasitaemia higher than 10,000 red blood cells parasitized by Plasmodium falciparum/mm3. In the sample under investigation, the average plasmodic index was 32.5%, mainly P. falciparum (98% of all infections), while 120 children had a parasitaemia higher than the critical level of 10,000 par./mm3 (i.e. 13.3% of the whole sample and 40.1% of Plasmodium carriers. 559 of the 903 children were actually febrile and among them 94 had a so-called malaria crisis (i.e. 16.8% of fevers and 10.4% of all consultations). It was confirmed that not one single clinical symptom is pathognomic for malaria crisis but fever, splenomegaly and anaemia seemed to occur more frequently among sick children. It also appeared that the proportion of children with fever increased as their parasitaemia exceeded the critical threshold of 10,000 par./mm3, while splenomegaly tends to drop with very high parasitaemia. Faced with fever as a clinical symptom, self-medication is a common behaviour (65% of people interviewed admitted such practice); it is mainly based upon chloroquine tablet ingestion but at a subcurative dosage. Such self-medication could induce an underestimation of malaria morbidity from clinical statistics and, on the other hand, a growing drug pressure, which could play a role in the current spread of P. falciparum chloroquine resistant strains in Central Africa and elsewhere in sub-saharan regions.