RESUMO
BACKGROUND: Malaria has a negative impact on the activities of companies in endemic countries especially in Cameroon. In this regard, an increasingly growing number of companies have started to include management of malarious patients in their health policies. In the present study, we will evaluate the diagnostic performances of a fluorescence microscopy (FM), Cyscope® microscope, in the detection of malaria parasites. METHODS: A cross-sectional study was conducted among employees of two companies of the town of Douala on 21 and 22 March 2017. Sociodemographic information of employees was collected using a questionnaire form. Blood samples of ~ 10 µL were collected by venipuncture for the diagnosis of malaria using FM and light microscopy (LM). Performances of FM with respect to sensitivity (Se), specificity (Sp), positive and negative predictive values (PPV and NPV), positive and negative likelihood rates (PLR and NLR), accuracy, reliability, and Kappa index were calculated using LM as gold standard. RESULTS: In total, 442 employees, aged 37.8 ± 9.7 years old on average, were included in the study. Prevalence of malaria using FM and LM was 39.2% and 17%, respectively (p < 0.01). Plasmodium falciparum and P. vivax were the two species involved in malaria infection cases. In terms of developmental stages, 68%, 45.3%, and 1.3% of employees carried gametocytes, trophozoites, and schizonts, respectively. Findings on diagnostic performances of FM were as follows: Se = 84%, Sp = 69.95%, PPV = 63.58%, NPV = 95.5%, accuracy = 89.36%, and reliability = 53.95%. Sensitivity of Cyscope® microscope increased as a function of parasitemia with values ranging from 76.92% at parasitemia between 1 and 500 parasites/µL to 91.11% at parasitemia between 501 and 5000 parasites/µL. The geometric mean parasite density was1850 parasites per µL of blood (range 1600-40,000), and most of employees (60.8%) had moderate parasitemia. The performances of FM were similar between febrile and afebrile patients. CONCLUSIONS: This study showed good performances of Cyscope® microscope and outlines that this diagnostic tool could be used in management of malaria at workplace.
RESUMO
BACKGROUND: Malaria remains a public health issue in the world especially in resource-limited countries, where it has a negative impact on their economy. There is a body of recent reports outlining the crucial role of enterprises in control of malaria. The present study aimed at determining the knowledge, attitudes, and practices (KAP) towards malaria among employees from enterprises in the town of Douala, Cameroon. METHODS: A cross-sectional descriptive study took place between February 2015 and June 2017 in 14 enterprises of Douala. A pretested structured questionnaire was used to document sociodemographic parameters and KAP of employees. RESULTS: A total of 2705 employees, mainly consisted of males (83.1%), were included in the study. The mean age of respondents was 37.33 ± 9.78 years (range 19-87). Over 90% of respondents knew at least one sign/symptom (94.1%) and associated malaria transmission with mosquito bites (91%). Artemether-Lumefantrine (36.2%), under commercial name "Coartem," was the most cited antimalarial drug. Nearly 98.2% considered malaria as a dangerous disease. Misconceptions on malaria transmission, causative agent, prevention, and treatment were recorded. More than 77% of employees declared to use mosquito bed nets to prevent malaria. About 63% employees declared going to the hospital when they were feel having malaria while 12.9% were seeking care through street drugs. Educational level, socioprofessional category, area of residence, and enterprise were significantly associated with the level of knowledge on malaria transmission, causative agent, and preventive and treatment practices. CONCLUSION: This study showed a good level of knowledge, attitudes, and practices of employees even though some misconceptions and bad behaviors are still present especially in people with a low level of education. Hence, there is a need to develop strategies for sensitization especially in this fraction of employees. In addition, enterprises could be an interesting approach in order to control malaria in Cameroon.
