Vaccination against Hepatitis B among health care workers in the Bamenda Health District: influence of knowledge and attitudes, Cameroon.

INTRODUCTION: Hepatitis B virus (HBV) infection is one of the most serious occupational hazards faced by healthcare workers (HCW). This study aimed at assessing the influence of knowledge and attitudes of HCWs in the Bamenda Health District (BHD) on their vaccination status. METHODS: this was a cross-sectional analytic study carried out in Bamenda health district, Cameroon. Random sampling method was used to select 10 private, 10 public, and 4 confessional health facilities, from which 280 HCW were included in the study by convenience sampling. Data were analysed using Epi Info 7 and presented using tables, figures, and percentages. RESULTS: the vaccination coverage among HCW in the BHD was found to be 13.9%. Healthcare workers who had no knowledge of the minimum number of doses for complete primary HBV vaccination were less likely to be vaccinated than those who had knowledge (p = 0.00). Healthcare workers who had been tested for HBsAg were more likely to be vaccinated than those who had not done the test (p = 0.00). Among HCW (90.7%) who knew they were more at risk of contracting HBV, 98.6% knew it can be prevented out of which 72.6% reported that vaccination is the most effective means of prevention; only 13.9% of HCW were vaccinated. Other factors could have influenced the vaccination status of HCW; high cost of the vaccine, lack of time for vaccination, negligence, and the non-availability of the vaccine. CONCLUSION: awareness should be created among HCW and they should be encouraged to go for HBsAg screening and those who are negative should receive a full dose of HBV vaccine. Also, the vaccine should be subsidized and made available to all HCW in the BHD.

Residual or Recurrent Precancerous Lesions After Treatment of Cervical Lesions in Human Immunodeficiency Virus-infected Women: A Systematic Review and Meta-analysis of Treatment Failure.

BACKGROUND: Screening and treating premalignant cervical lesions (cervical intraepithelial neoplasia 2+ [CIN2+]) is an effective way to prevent cervical cancer, and recommendations exist for the monitoring of treatment success. Yet, there is no specific recommendation for human immunodeficiency virus (HIV)-infected women, who are at a known, increased risk of cervical cancer. METHODS: A systematic review was performed by searching MEDLINE, EMBASE, and Web of Science for studies published from January 1980 through May 2018. Eligible studies described the prevalence of histologically- and/or cytologically-defined lesions in HIV-infected women at least 6 months post-treatment. The primary endpoint was treatment failure, defined as the presence of residual and/or recurrent high-grade CIN2+/high-grade squamous intraepithelial lesions post-treatment. The pooled prevalence in HIV-infected women and the odds ratios (ORs) for HIV-infected compared to HIV-uninfected women were estimated using random-effects models. RESULTS: Among 40 eligible studies, the pooled prevalence of treatment failure in HIV-infected women was 21.4% (95% confidence interval [CI] 15.8-27.0). There was no significant difference in the treatment failure prevalence for cryotherapy (13.9%, 95% CI 6.1-21.6) versus loop electrosurgical excision procedure (13.8%, 95% CI 8.9-18.7; P = .9), but the treatment failure prevalence was significantly higher in women with positive (47.2%, 95% CI 22.0-74.0) than with negative (19.4%, 95% CI 11.8-30.2) excision margin (OR 3.4, 95% CI 1.5-7.7). Treatment failure was significantly increased in HIV-infected versus HIV-uninfected women, both overall (OR 2.7, 95% CI 2.0-3.5) and in all sub-group analyses. CONCLUSIONS: There is strong evidence for an increased risk of treatment failure in HIV-infected women, in comparison to their HIV-negative counterparts. The only significant predictor of treatment failure in HIV-infected women was a positive margin status, but further data is needed on long-term outcomes after ablative treatment in HIV-infected women.

Assessment of adverse drug reactions in the home management of malaria cases of children under 5 years using artemisinin-based combination therapy in Mfou health district, Center region of Cameroon.

Malaria remains one of the major public health concerns in Cameroon. Its treatment is frequently initiated at home, most often with street drugs. The home management of malaria cases entails the prescription of Artemisinin-based combination (ACTs) as first-line therapy for treatment of uncomplicated malaria after having confirmed the malaria case using rapid diagnostic tests. But induced adverse reactions of this therapy are not well known in Cameroon. Thus, a prospective, observational, cohort study of adverse events associated with ACTs was conducted from January 2013 to November 2013 in the health district of Mfou. Children under 5 years receiving ACTs for malaria treatment at home were enrolled. Suspected ADRs and other clinical events were recorded. Data were managed and analysed using Epi Info version 3.5.3 and Statistical Package for Social Sciences, statistical software version 20. Of the 479 children investigated, 56.8% (n=272/479) were males, the age group 25-59 months (49.5%; n=237/479) was most represented, 27.1% (n=130/479) had experienced one form of ADRs, male children (56.2%; n=73/130) and the age group 25-59 months (50.8%; n=66/130) were most affected. No significant association was found between age, sex and incidence of adverse ACTs reactions. The main experienced ACTs reactions were tiredness (43.1%; n=56/130) followed by lack of appetite (24.6%; n=32/130). The incidence ACTs ARDs was found to be relatively low and tolerable. Home management of malaria cases using ACTs should be encouraged and community members should be trained to improve the recognizing and reporting of adverse effects.

Assessment of adverse drug reactions in the home management of malaria cases of children under 5 years using artemisinin-based combination therapy in Mfou health district, Center region of Cameroon

health concerns in Cameroon. Its treatment is frequently initiated at home, most often with street drugs. The home management of malaria cases entails the prescription of Artemisinin-based combination (ACTs) as first-line therapy for treatment of uncomplicated malaria after having confirmed the malaria case using rapid diagnostic tests. But induced adverse reactions of this therapy are not well known in Cameroon. Thus, a prospective, observational, cohort study of adverse events associated with ACTs was conducted from January 2013 to November 2013 in the health district of Mfou. Children under 5 years receiving ACTs for malaria treatment at home were enrolled. Suspected ADRs and other clinical events were recorded. Data were managed and analysed using Epi Info version 3.5.3 and Statistical Package for Social Sciences, statistical software version 20. Of the 479 children investigated, 56.8% (n=272/479) were males, the age group 25-59 months (49.5%; n=237/479) was most represented, 27.1% (n=130/479) had experienced one form of ADRs, male children (56.2%; n=73/130) and the age group 25-59 months (50.8%; n=66/130) were most affected. No significant association was found between age, sex and incidence of adverse ACTs reactions. The main experienced ACTs reactions were tiredness (43.1%; n=56/130) followed by lack of appetite (24.6%; n=32/130). The incidence ACTs ARDs was found to be relatively low and tolerable. Home management of malaria cases using ACTs should be encouraged and community members should be trained to improve the recognizing and reporting of adverse effects

Succeeding in New Vaccine Introduction: Lessons Learned From the Introduction of Inactivated Poliovirus Vaccine in Cameroon, Kenya, and Nigeria.

Introducing a new vaccine is a large-scale endeavor that can face many challenges, resulting in introduction delays and inefficiencies. The development of national task teams and tools, such as prelaunch trackers, for the introduction of new vaccines (hereafter, "new vaccine introductions" [NVIs]) can help countries implement robust project management systems, front-load critical preparatory activities, and ensure continuous communication around vaccine supply and financing. In addition, implementing postlaunch assessments to take rapid corrective action accelerates the uptake of the new vaccines. NVIs can provide an opportunity to strengthen routine immunization, through strengthening program management systems or by reinforcing local immunization managers' abilities, among others. This article highlights key lessons learned during the introduction of inactivated poliovirus vaccine in 3 countries that would make future NVIs more successful. The article concludes by considering how the Immunization Systems Management Group of the Global Polio Eradication Initiative has been useful to the NVI process and how such global structures could be further enhanced.

Predictors of depression among patients on art in a rural health district in North West Cameroon.

Depression in people living with HIV/AIDS (acquired immune-deficiency syndrome) (PLWHA) increases risky HIV transmission behaviour, disease progression to AIDS, negatively affects drug adherence and is thus a risk for the development of drug-resistant strains. This study sought to identify predictors of depression in rural Cameroon. A cross-sectional analytic study was carried out from September 2013 to November 2013 in the Mbengwi district hospital of the North West region. We measured depression (PHQ-9 (nine-item Patient Health Questionnaire)), clinical and demographic characteristics of patients on antiretroviral therapy (ART). Means, proportions and a stepwise logistic regression model were fit to describe participants' characteristics and predictors of depression in the study population. Of the 202 recruited patients, 58(28.7%) had a positive depression screen. Independent predictors of depression included monthly income less than 20,000 FCFA (US$40), (adjusted odds ratio (aOR) = 2.47; 95% CI = 1.18-5.18), CD4 count <200 cls/µl (aOR = 7.56; 95% CI = 2.46-23.30) and presence of AIDS symptoms (aOR = 4.29; 95% CI = 2.09-8.81). There was no significant correlation between duration on ART, marital status, age, gender and depression. Early diagnosis and treatment of depressed patients need to be incorporated into intervention programmes, which might improve patient outcomes. More research is needed to investigate the impact of antidepressant therapy in PLWHA on the evolution of treatment.