Sero-epidemiology of human immunodeficiency virus, hepatitis B and C viruses, and syphilis infections among first-time blood donors in Edéa, Cameroon.

BACKGROUND: Blood safety remains an issue of major concern in transfusion medicine in sub-Saharan Africa. Blood-borne agents such as the human immunodeficiency virus (HIV), hepatitis B virus (HBV), hepatitis C virus (HCV), and Treponema pallidum are among the greatest threats to blood safety for the recipient. This study aimed to determine the seroprevalence and risk factors of HIV, HCV, HBV, and syphilis infections among first-time blood donors at the new hospital-based blood bank in Edéa, Cameroon. METHODS: We carried out a retrospective analysis of blood donor data recorded between December 2011 and May 2012 at the blood bank of the Edéa Regional Hospital. Antibodies to HIV types 1 and 2 were screened with the Determine and ImmunoComb tests. Hepatitis B surface antigen and antibodies to HCV were detected using DIASpot test strips. Syphilis was diagnosed using the Venereal Disease Research Laboratory (VDRL) test and the Treponema pallidum hemagglutination assay (TPHA). RESULTS: A total of 543 blood donors were included, among whom 349 (64.3%) were family replacement donors. One hundred and fifteen donors (21.2%) were infected with at least one pathogen. The overall seroprevalence rates of HIV, HBV, HCV, and syphilis were 4.1%, 10.1%, 4.8%, and 5.7%, respectively. We found a total of 26 dual infections. The most common combinations were HBV-HCV and HBV-HIV. There was a significant association between HIV and HBV infections (adjusted odds ratio (aOR) 3.46, 95% CI 1.29-9.39; p=0.014), and between HBV and HCV infections (aOR 2.81, 95% CI 1.02-10.12; p=0.036). Compared to voluntary donors, family replacement donors were significantly more infected by at least one screened pathogen (aOR 1.81, 95% CI 1.14-2.88; p=0.013), and more infected specifically by HIV (aOR 3.66, 95% CI 1.07-12.55; p=0.039) and syphilis (aOR 2.81, 95% CI 1.05-7.46; p=0.039). CONCLUSIONS: Our findings indicate that blood safety remains a major problem in Cameroon where hospital-based blood banks and family replacement donors are predominant. There is an urgent need for a national blood transfusion program in Cameroon that will establish a nationally coordinated blood transfusion service based on the principles of voluntary regular non-remunerated blood donation.

Community-based health insurance knowledge, concern, preferences, and financial planning for health care among informal sector workers in a health district of Douala, Cameroon.

INTRODUCTION: For the last two decades, promoted by many governments and international number in sub-Saharan Africa. In 2005 in Cameroon, there were only 60 Community-based health insurance (CBHI) schemes nationwide, covering less than 1% of the population. In 2006, the Cameroon government adopted a national strategy aimed at creating at least one CBHI scheme in each health district and covering at least 40% of the population with CBHI schemes by 2015. Unfortunately, there is almost no published data on the awareness and the implementation of CBHI schemes in Cameroon. METHODS: Structured interviews were conducted in January 2010 with 160 informal sectors workers in the Bonassama health district (BHD) of Douala, aiming at evaluating their knowledge, concern and preferences on CBHI schemes and their financial plan to cover health costs. RESULTS: The awareness on the existence of CHBI schemes was poor awareness schemes among these informal workers. Awareness of CBHI schemes was significantly associated with a high level of education (p = 0.0001). Only 4.4% of respondents had health insurance, and specifically 1.2% were involved in a CBHI scheme. However, 128 (86.2%) respondents thought that belonging to a CBHI scheme could facilitate their access to adequate health care, and were thus willing to be involved in CBHI schemes. Our respondents would have preferred CBHI schemes run by missionaries to CBHI schemes run by the government or people of the same ethnic group (p). CONCLUSION: There is a very low participation in CBHI schemes among the informal sector workers of the BHD. This is mainly due to the lack of awareness and limited knowledge on the basic concepts of a CBHI by this target population. Solidarity based community associations to which the vast majority of this target population belong are prime areas for sensitization on CBHI schemes. Hence these associations could possibly federalize to create CBHI schemes.