Assessing core capacities for addressing public health emergencies of international concern at designated points of entry in cameroon during the COVID-19 Pandemic.

BACKGROUND: Points of Entry (POEs) are at the frontline for prevention, detection and response to international spread of diseases. The objective of this assessment was to ascertain the current level of existing International Health Regulations (IHR) core capacities of designated airports, ports and ground crossings in Cameroon and identify critical gaps for capacity building for prevention, early warning and response to public health threats including COVID-19. METHODS: Data were collected from April to May 2020 in 5 designated POEs: Yaounde Nsimalen International Airport (YIA), Douala international Airport (DIA), Douala Autonomous Port (DAP), Garoua-Boulai ground crossing, Kye-Ossi ground crossing which were all selected for their high volume of passenger and goods traffic. The World Health Organization (WHO) assessment tool for core capacity requirements at designated airports, ports and ground crossings was used to collect data on three technical capacities: (i) communication and coordination, (ii) Capacities at all times and (iii) capacities to respond to Public Health Emergencies of International Concern (PHEIC). RESULTS: All the investigated POEs scored below 50% of capacities in place. YIA recorded the highest percentage for all groups of capacities, coordination and communication and for core capacity at all times with a percentage of 42%, 58% and 32% respectively. For core capacity to respond to PHEIC, all the POEs recorded below 50%. The DAP and all ground crossings lacked trained personnel for inspection of conveyances. Only DIA had a public health emergency plan. There is no isolation/quarantine and transport capacity at the POEs. CONCLUSION: All POEs assessed did not meet IHR standards and need significant improvement to fulfill the IHR requirements. Unstructured communication channels between stakeholders make the implementation of IHR challenging. A coordination mechanism, with clear functions and structure, is necessary for well-coordinated response efforts to health emergencies at POEs. This assessment will serve as a baseline to inform planning and IHR implementation at designated POEs in Cameroon.

Epidemiological Features of Highly Pathogenic Avian Influenza in Cameroon.

The epidemiology of avian influenza is unknown in Cameroon despite the two outbreaks that occurred in 2006 and 2016-2017, respectively. In order to fill the gap, an attempt was made to provide some basic information on the epidemiology of highly pathogenic avian influenza in Cameroon. Thus, data were collected from follow-up reports of the second HPAI outbreaks prepared by the veterinary health officials of Cameroon and sent to the World Organisation for Animal Health (OIE). Two HPAI virus strains (H5N1 and H5N8) turned out to occur, with H5N1 virus involved in the Center, South, West, and Adamawa regions outbreaks and H5N8 involved in the Far North outbreak only. The affected hosts were the laying hens, backyard chickens, turkeys, guinea fowls, ducks, broiler and layer breeders, and geese for the H5N1 virus and the Indian peafowl (Pavo cristatus), pigeon, ducks, backyard chickens, and guinea fowls for the H5N8 virus. The first outbreak took place in Mvog-Betsi poultry complex in the Center region on the 20th May 2016 and spread to other regions. The mortality rate varied from 8% to 72% for H5N1 virus and was 96.26% for the H5N8 strain in Indian peafowl. No human case was recorded. The potential supporting factors for disease dissemination identified on the field were the following: poultry and eggs dealers moving from one farm, market, or town to another without any preventive care; poor biosecurity measures on farms and live poultry markets. After the first HPAI H5N1 virus outbreak in 2006, the second HPAI outbreak ten years later (2016-2017) involving two virus strains is a cause of concern for the poultry industry. The Cameroon Epidemio-Surveillance Network needs to be more watchful.