Targeted deep amplicon sequencing of antimalarial resistance markers in Plasmodium falciparum isolates from Cameroon.

BACKGROUND: Recent studies showed the first emergence of the R561H artemisinin-associated resistance marker in Africa, which highlights the importance of continued molecular surveillance to assess the selection and spread of this and other drug resistance markers in the region. METHOD: In this study, we used targeted amplicon deep sequencing of 116 isolates collected in two areas of Cameroon to genotype the major drug resistance genes, k13, crt, mdr1, dhfr, and dhps, and the cytochrome b gene (cytb) in Plasmodium falciparum. RESULTS: No confirmed or associated artemisinin resistance markers were observed in Pfk13. In comparison, both major and minor alleles associated with drug resistance were found in Pfcrt, Pfmdr1, Pfdhfr, and Pfdhps. Notably, a high frequency of other nonsynonymous mutations was observed across all the genes, except for Pfcytb, suggesting continued selection pressure. CONCLUSIONS: The results from this study supported the continued use of artemisinin-based combination therapy and administration of sulfadoxine-pyrimethamine for intermittent preventive therapy in pregnant women, and for seasonal chemoprevention in these study sites in Cameroon.

Nutrition Habits and Health Outcomes of Breastfeeding HIV-positive mothers in the Dschang Health District, West Region Cameroon.

BACKGROUND: Amongst the different at-risk periods for mother-to-child HIV transmission that is, during pregnancy, labor and delivery and breastfeeding, much care and attention needs to be given, not only to the child as concerns its feeding options, but also to the mother. The aim of this study was to determine the nutritional habits and health outcomes of HIV-positive breastfeeding mothers in the Dschang Health District, in the context of prevention of mother-to-child transmission (PMTCT) activities. METHODS: A cross-sectional study was carried out from September 2014 to February 2015, at the Dschang District Day Care Hospital. A standard questionnaire was administered by face-to-face interview to 56 breastfeeding HIV-positive mothers. Anthropometric parameters of the mothers were measured (weight and height), and a physical check-up performed, with examination of the mothers' conjunctiva and palms. Clinical status was determined by anemia test using the Tallquist hemoglobin test. Data collected were analyzed using Epi Info version 7.1.3.3 and Excel 2013. RESULTS: The mean age of participants was 33 years. Most women ate three meals per day (53.6%, n=30/56), while 26,8% (15/56) ate two. Staples (27.27%) and fruits (33.68%) were found to be the most consumed foods per week and green leafy and yellow vegetables the least consumed (13.74%). Body mass index was used to evaluate the nutritional status of participating women: 26.9% (n=14/52) were in the normal range of weight, slightly more than half were overweight (51.9%, n=27/52) and 21.2% (n=11/52) were obese. All mothers were on antiretroviral therapy (ART). Recent CD4 count results were available for about half of the women and the mean was 293 cells/mmc (range 97-798). Physical checkup showed that 64.3% (n=36/56) and 67.9% (n=38/56) of women respectively had moderately colored conjunctiva and palms, while 10.7% (n=6/56) and 12.5% (n=7/56) respectively had pale conjunctiva and palms, considered to be clinical signs of anemia. About 74.1% (n=40/54) of the women were borderline anemic, 24.1% (n=13/54) had frank anemia and only 1.9% (n=1/54) had normal blood counts. CONCLUSION: Nutrition habits amongst HIV-positive breastfeeding women of the Dschang Health District were not optimal and contributed a great deal to the poor health outcomes observed in the PMTCT study. Nutritional education should be offered in addition to ART, to help women make better nutrition choices to meet body needs and improve health.

Condom perception and prevention of HIV/AIDS infection in Cameroon: appraisal of knowledge, attitudes and practices among level one students of the University of Dschang.

BACKGROUND: With the decreasing HIV epidemiology in Cameroon (5.5% in 2004 to 4.3% in 2011), HIV/AIDS remains a major public health concern, affecting mostly the sexually active population, among which the young University students represent an important target. Since sexual intercourses represent about 90% of HIV transmission, understanding the sexual behaviors of youth could relevantly optimize the design of HIV prevention strategies, through updated and adapted communication strategies for healthy sexual behavioral changes. METHODOLOGY: A qualitative, descriptive and cross-sectional study was conducted in November 2010, among 518 newly registered students in the various faculties of the University of Dschang, Cameroon. In order to evaluate Knowledge, Attitudes and Practices (KAP) toward HIV/AIDS prevention among the study participants, a structured questionnaire was administered to each participant, on the basic knowledge about HIV/AIDS and condoms. Data analysis was performed using Epi Info version 3.5.0 software. RESULTS: The mean age of participants was 20 years, with a slight female predominance (52%). 98.6% of students voted familiar with the theme "condom", with 88.9% giving a satisfactory definition. However, 41.1% do not know the appropriate transmission route of HIV, while 5.4% do not master the correct use of condom; with up to 75.7% being aware of the female condom existence. Although 97.8% of students consider the proper use of condoms as an effective HIV preventive tool, up to 34.5% of them fail to use condoms during sexual intercourses and 69% were not in favor of the use of female condom, mainly due to a decreasing sexual pleasure. CONCLUSION: Despite the existing sensitization campaigns, the perception of condoms is still very poor among young Cameroonian academics; with the non-systematic use of condoms being the major setback. The lack of familiarity to female condom, both among female and male, would also be a contributing drawback. These major sexual behavioral risk factors to HIV infection appear as key points to address during the campaigns to ensure owning of healthy sexual habits, a leading component to reduce HIV incidence among young Cameroonian/Africans.