Background: In the absence of post exposure prophylaxis, an estimated 327 000 people would die fr... more Background: In the absence of post exposure prophylaxis, an estimated 327 000 people would die from Africa and Asia each year from rabies. In Cameroon, three cases of rabies were confirmed in humans in 2010 with a case fatality rate of 100%. In the same year there were 20 confirmed cases in dogs. We set out to determine the anti-rabies vaccinotherapy completion rate in 2011 and describe the characteristics of users of the newly created anti-rabies unit in of the International Vaccination Centre Douala (IVCD), Cameroon. Method: A retrospective study was conducted in February 2012. Every individual who had received at least a single dose of anti rabies vaccine in 2011 and registered in the anti rabies unit of the IVCD was included. Data was analyzed using Epi Info version 3.5.3 for Windows and Microsoft Office Excel 2007. Results: Eighty-one users received post exposure prophylaxis and 6 pre exposure prophylaxis. Most of the users were males 48(55.2%), pupils and students 31(35.6%), live in the city of Douala 83(95.4%) and aged less than 31 years 48(55.2%). The time interval between animal bite and receiving the first dose of anti rabies vaccine ranged from less than 24 hours to 37days. Most of the victims were bitten by dogs 52(64.2%) and had category II or III exposures. The total vaccinotherapy completion rate was 26(29.9%). The anti-rabies vaccinotherapy completion rate was significantly (P=0.008) lower in students 7(15.9%) compared to non students 19(44.2%). Conclusion: The completion rate of the 5-dose (post exposure) and 3-doses (pre exposure) anti rabies regimen in the first ever created anti rabies centre in the city of Douala was very low. Users should be proposed the 4-dose regimen for post exposure prophylaxis and new strategies put in place to increase usage and therapy completion.
Epidemiology and clinical characteristics of the Measles outbreak in the Nylon Health District, D... more Epidemiology and clinical characteristics of the Measles outbreak in the Nylon Health District, Douala Cameroon: a retrospective descriptive cross sectional study
Background: Access to Human Immunodeficiency Virus (HIV) care has been rolled out in Cameroon in ... more Background: Access to Human Immunodeficiency Virus (HIV) care has been rolled out in Cameroon in the last decade through decentralised delivery of care and timely initiation of free antiretroviral drugs. We sought to describe the evolution of mortality and loss to follow up (LTFU) and their patient-related determinants at an HIV clinic which is facing significant challenges. Methods: A retrospective review of point of care data from HIV patients was conducted in June 2012 at Nkongsamba Regional Hospital in Cameroon to establish mortality and LTFU rates. Univariable and multivariable Cox regression models were used to screen for factors associated with the outcomes. Telephone calls were made to trace patients LTFU. Results: Between June 2005 and December 2010, 2388 HIV infected patients were admitted. Of these, 1858 were aged 15 and above and were included in our analysis. Their median age was 36 years (IQR: 30–44) and they were followed up over a total risk period of 3647.3 person-y...
A weak AFP surveillance system constitutes a major threat to Nigeria’s polio free certification s... more A weak AFP surveillance system constitutes a major threat to Nigeria’s polio free certification status. This study investigates the factors that have affected AFP surveillance, case detection along the international border settlements of Oyo state, Nigeria. A cross-sectional survey was conducted between 26th-31th December 2018 using structured questionnaires uploaded onto Open Data Kit-collect (ODK) mobile software in 4 LGAs in Oyo state. Overall, 427 respondents (community members=420, community informants=7) participated in this study. On the average, 10% and 46% of the community members and informants could identify the various aspects of the AFP case definition. Majority of the community members weren’t aware of AFP surveillance neither were they aware of their AFP focal person/DSNO or where to report AFP cases. Barriers to case reporting include, irregular movements of commercial vehicles, swampy roads during rainy seasons, rocky roads during dry seasons; poor communication net...
Introduction : le cholera est en mode endemo-epidemique dans la ville de Douala, comme dans de no... more Introduction : le cholera est en mode endemo-epidemique dans la ville de Douala, comme dans de nombreuses grandes villes d’Asie et d’Afrique. Notre objectif etait de decrire les aspects epidemiologiques, cliniques et bacteriologiques de l’epidemie de cholera survenue en 2011 a Douala, afin de mieux riposter lors des nouvelles flambees epidemiques. Materiels et methodes : l’etude etait transversale et retrospective. L’echantillonnage etait systematique. Resultats : Parmi les 5292 nouveaux cas suspects notifies durant toute l’annee, les jeunes âges de 16 a 34 ans etaient les plus atteints (52,8%, p=0,000), il en etait de meme des hommes contrairement aux femmes (56,2% vs 43,8%, P=0,000). Deux pics de frequence de 429 cas chacun, ont ete observes aux 41e et 45e semaines epidemiologiques. Le taux d’attaque etait de 0,23‰ pour une population de 2 271722 habitants. Le nombre de cas variait significativement selon les districts de sante, Deido avait notifie le plus grand nombre de cas (159...
Background Environmental surveillance (ES) for poliovirus is increasingly important for polio era... more Background Environmental surveillance (ES) for poliovirus is increasingly important for polio eradication, often detecting circulating virus before paralytic cases are reported. The sensitivity of ES depends on appropriate selection of sampling sites, which is difficult in low-income countries with informal sewage networks. Methods We measured ES site and sample characteristics in Nigeria during June 2018–May 2019, including sewage physicochemical properties, using a water-quality probe, flow volume, catchment population, and local facilities such as hospitals, schools, and transit hubs. We used mixed-effects logistic regression and machine learning (random forests) to investigate their association with enterovirus isolation (poliovirus and nonpolio enteroviruses) as an indicator of surveillance sensitivity. Results Four quarterly visits were made to 78 ES sites in 21 states of Nigeria, and ES site characteristic data were matched to 1345 samples with an average enterovirus prevalen...
* Coverage with the third dose of diphtheria-tetanus-pertussis vaccine is used as a surrogate for... more * Coverage with the third dose of diphtheria-tetanus-pertussis vaccine is used as a surrogate for routine immunization coverage because reported OPV coverage can include doses given during SIAs. † Polio high-risk states in northern Nigeria:
Background: Despite being certified guinea worm free in 2007, Cameroon continues surveillance eff... more Background: Despite being certified guinea worm free in 2007, Cameroon continues surveillance efforts to ensure rapid verification of any suspected reoccurrence. This includes the investigation of every rumor and confirmation of each suspicious expulsed worm. This paper presents fieldwork carried out to investigate a guinea worm rumor in Cameroon which turned out to be an Onchocerca volvulus mimicking Dracunculus medinensis. Methods: The investigation included a field visit to the subsistence farming community where the rumor was reported. During the visit, interviews were conducted with health staff who managed the case and the elderly farmer from whom the worm was retrieved. An investigation of any potential missed guinea worm cases was also conducted through interviews with community residents and reviews of the health facility's medical records. This was combined with laboratory analyses of water samples from the community's water sources and the retrieved worm which was removed from the patient via wrapping it around a stick. Results: Microscopy and molecular analyses of the retrieved worm revealed a female Onchocerca volvulus whose expulsion strongly mimicked guinea worm. In addition to presenting findings of our investigation, this paper discusses distinguishing elements between the two parasites and gives an overview of guinea worm eradication efforts in Cameroon as well as current challenges to the worm's eradication globally. Conclusions: The investigation findings suggest the evolving Onchocerca volvulus worm tropisms' adaptive survival behavior worth further investigation. Strategies used to successfully control guinea worm in Cameroon could be adapted for Onchocerca volvulus control.
ABSTRACT Background: In the absence of post exposure prophylaxis, an esti-mated 327 000 people wo... more ABSTRACT Background: In the absence of post exposure prophylaxis, an esti-mated 327 000 people would die from Africa and Asia each year from rabies. In Cameroon, three cases of rabies were confirmed in humans in 2010 with a case fatality rate of 100%. In the same year there were 20 confirmed cases in dogs. We set out to determine the anti-rabies vaccinotherapy completion rate in 2011 and describe the characteris-tics of users of the newly created anti-rabies unit in of the International Vaccination Centre Douala (IVCD), Cameroon. Method: A retrospective study was conducted in February 2012. Every individual who had received at least a single dose of anti rabies vaccine in 2011 and registered in the anti rabies unit of the IVCD was included. Data was analyzed using Epi Info version 3.5.3 for Windows and Microsoft Office Excel 2007. Results: Eighty-one users received post exposure prophylaxis and 6 pre exposure prophylaxis. Most of the users were males 48(55.2%), pupils and students 3...
Measles is a public health problem especially in South Asia and Africa. Nylon Health District has... more Measles is a public health problem especially in South Asia and Africa. Nylon Health District has experienced two measles outbreaks over a period of three years. We hereby describe the epidemiology and clinical characteristics of the outbreak of February 2011. A retrospective descriptive cross sectional study was conducted in November 2011. All suspected measles cases according to the World Health Organization case definition line listed in the district service were included. Data was analyzed using Epi Info version 3.5.3 for Windows and Microsoft Office Excel 2010. An epidemic curve was drawn and proportions per variable category were estimated and presented in frequency tables. The outbreak started from the 4(th) to the 25(th) epidemiological week of 2011 with a peak on the 10(th) week after onset. The attack and case fatality rates were 34/100000 inhabitants and zero respectively. Females and infants aged 9-59 months represented 97(63.4%) and 75(49%) of cases respectively. Bonadi...
Introduction: L'objectif principal de notre étude était d'identifier les bactéries associées à l'... more Introduction: L'objectif principal de notre étude était d'identifier les bactéries associées à l'infection nosocomiale, dans le service de réanimation, de l'hôpital Laquintinie de Douala en vue d'améliorer la prise en charge et diminuer la létalité. Méthodes: Il s'agissait d'une étude transversale et descriptive, menée du 1 er mars au 31 mai 2011.Tous les patients hospitalisés depuis au moins 48 h étaient inclus dans l'étude et ceux présentant une infection documentée à l'admission étaient exclus. L'analyse des donnés a été faite par le logiciel SPSS 16.Les tests de Khi deux pour la signification. Résultats: la prévalence de l'infection nosocomiale était de 12%, elle concernait des personnes âgées de plus de 60 ans et présentant une infection urinaire dans 79% des cas. La létalité était de 72% pour une durée moyenne de séjour de 11,7 ± 12,1 jours. Les bactéries responsables étaient en majorité des bactéries gram positifs (BGN), dont E coli dans 23,1% et les cocci gram positifs(CGP), dans 15,4% des cas. Conclusion: L'étude de la résistance aux antibiotiques, montre une multi résistance, dont il faut tenir compte en mettant en place une stratégie de prévention active.
The Littoral region of Cameroon met most of its routine immunization and surveillance objectives ... more The Littoral region of Cameroon met most of its routine immunization and surveillance objectives in 2010 but has not reiterated such a performance since then. We describe the casebased measles surveillance performance of 2010 by person, place, time and determine measles surveillance system delays. Descriptive statistics were performed using Epi Info 3.5.3. There were 130 suspected measles cases investigated by 17 (89.5%) health districts, 83 (64%) males and 99 (76%) ≤5 years. At least 4 cases were investigated per month with a peak of 23 cases in June. About 67 (51.5%) patients visited a hospital more than 48 h after disease onset, 34 (26.2%) health facilities informed the district service late after receiving a suspected case and 65 (50%) samples got to the reference laboratory more than 24 h after reception by the specimen collection centre. More than 2 discarded measles/100,000 population were investigated but with health facilities, specimen collection centre and patients' ability to seek healthcare delays. All specimens got to the reference laboratory within 72 h. Patients' health seeking behavior need to be improved and personnel involved in surveillance sensitized on timeliness. Study population and design It was a retrospective cross sectional study
Background: Access to Human Immunodeficiency Virus (HIV) care has been rolled out in Cameroon in ... more Background: Access to Human Immunodeficiency Virus (HIV) care has been rolled out in Cameroon in the last decade through decentralised delivery of care and timely initiation of free antiretroviral drugs. We sought to describe the evolution of mortality and loss to follow up (LTFU) and their patient-related determinants at an HIV clinic which is facing significant challenges. Methods: A retrospective review of point of care data from HIV patients was conducted in June 2012 at Nkongsamba Regional Hospital in Cameroon to establish mortality and LTFU rates. Univariable and multivariable Cox regression models were used to screen for factors associated with the outcomes. Telephone calls were made to trace patients LTFU. Results: Between June 2005 and December 2010, 2388 HIV infected patients were admitted. Of these, 1858 were aged 15 and above and were included in our analysis. Their median age was 36 years (IQR: 30-44) and they were followed up over a total risk period of 3647.3 person-years (pyrs). The overall mortality rate was 34.6 deaths per 1000 pyrs (95% CI: 29.0-41.1) while the overall LTFU rate was 94.6 per 1000 pyrs (95%CI: 85.1-105.1).The mortality rates steadily rose to a peak of 69.6 deaths per 1000 pyrs in 2009 and then fell drastically to 20.6 per 1000 pyrs in 2010. The LTFU rate increased sharply from 29.7 in 2006 to 138.2 in 2007 and remained virtually stable until 2010. The factors associated with mortality were: being male (aHR = 2.25, 95% CI: 1.58-3.19), clinical disease progression (aHR = 2.0, 95% CI: 1.58-2.53), CD4 count <200 cells/μl (aHR = 3.14, 95% CI: 1.27-7.73), haemoglobin level <10 g/dl (aHR = 2.50, 95% CI: 1.69-3.69). Major factors associated with high LTFU rate were: distance to clinic of over 5 km (aHR = 1.25, 95% CI: 1.00-1.55), being single, having partners with unknown HIV status or taking no treatment and with CD4 count >500 cells/μl. Two-thirds (66.7%) of traced LTFU patients were dead. Conclusion: Mortality and LTFU rates in our cohort were high but there is evidence that patients' outcomes are improving. Interventions to address factors associated with high mortality and LTFU should be implemented for optimal results in patient care.
The Cameroon health system is divided into central, intermediate and peripheral levels. Of the 43... more The Cameroon health system is divided into central, intermediate and peripheral levels. Of the 43 health districts with a measles outbreak in Cameroon in 2011, only the Nylon Health District organized a documented outbreak response immunization. We present the methods and results of the response campaign solely shouldered by the district and intermediate level. The risk group, targets and neighborhoods to be vaccinated were identified after a detailed analysis of initial cases. The intermediate level defined strategies, provided logistics, capacity building and 41% of the operational budget while 59% was completed by the peripheral level. Microsoft Office Excel 2007 was used to estimate coverage rates and to draw an epidemic curve. The response immunization campaign was organized on the 14 th epidemiological week, 10 weeks after the onset of the outbreak which ended 11 weeks thereafter. A total of 15867 (108.5%) children aged 9-59 months were vaccinated in five health areas at a direct cost (vaccines excluded) of 71.34FCFA ($0.143) per vaccinated child. An additional 824 children aged 9-59 months were vaccinated around the residence of notified cases in neighborhoods which were not involved in the response campaign. The number of cases after the response campaign was lower than before. Once vaccines are available, prompt outbreak response campaigns can be organized at operational level to obtain commendable results instead of depending solely on international organizations or central levels. Decision makers at the intermediate and operational levels should redeploy available funds during emergencies to prevent the development of extreme public health conditions.
, the Ministry of Public Health's Expanded Program on Immunization requested technical support to... more , the Ministry of Public Health's Expanded Program on Immunization requested technical support to improve mapping of health district boundaries and health facility locations for more effective planning and analysis of polio program data. In December 2015, teams collected data on settlements, health facilities, and other features using smartphones. These data, combined with high-resolution satellite imagery, were used to create new health area and health district boundaries, providing the most accurate health sector administrative boundaries to date for Cameroon. The new maps are useful to and used by the polio program as well as other public health programs within Cameroon such as the District Health Information System and the Emergency Operations Center, demonstrating the value of the Global Polio Eradication Initiative's legacy.
Background: In the absence of post exposure prophylaxis, an estimated 327 000 people would die fr... more Background: In the absence of post exposure prophylaxis, an estimated 327 000 people would die from Africa and Asia each year from rabies. In Cameroon, three cases of rabies were confirmed in humans in 2010 with a case fatality rate of 100%. In the same year there were 20 confirmed cases in dogs. We set out to determine the anti-rabies vaccinotherapy completion rate in 2011 and describe the characteristics of users of the newly created anti-rabies unit in of the International Vaccination Centre Douala (IVCD), Cameroon. Method: A retrospective study was conducted in February 2012. Every individual who had received at least a single dose of anti rabies vaccine in 2011 and registered in the anti rabies unit of the IVCD was included. Data was analyzed using Epi Info version 3.5.3 for Windows and Microsoft Office Excel 2007. Results: Eighty-one users received post exposure prophylaxis and 6 pre exposure prophylaxis. Most of the users were males 48(55.2%), pupils and students 31(35.6%), live in the city of Douala 83(95.4%) and aged less than 31 years 48(55.2%). The time interval between animal bite and receiving the first dose of anti rabies vaccine ranged from less than 24 hours to 37days. Most of the victims were bitten by dogs 52(64.2%) and had category II or III exposures. The total vaccinotherapy completion rate was 26(29.9%). The anti-rabies vaccinotherapy completion rate was significantly (P=0.008) lower in students 7(15.9%) compared to non students 19(44.2%). Conclusion: The completion rate of the 5-dose (post exposure) and 3-doses (pre exposure) anti rabies regimen in the first ever created anti rabies centre in the city of Douala was very low. Users should be proposed the 4-dose regimen for post exposure prophylaxis and new strategies put in place to increase usage and therapy completion.
Epidemiology and clinical characteristics of the Measles outbreak in the Nylon Health District, D... more Epidemiology and clinical characteristics of the Measles outbreak in the Nylon Health District, Douala Cameroon: a retrospective descriptive cross sectional study
Background: Access to Human Immunodeficiency Virus (HIV) care has been rolled out in Cameroon in ... more Background: Access to Human Immunodeficiency Virus (HIV) care has been rolled out in Cameroon in the last decade through decentralised delivery of care and timely initiation of free antiretroviral drugs. We sought to describe the evolution of mortality and loss to follow up (LTFU) and their patient-related determinants at an HIV clinic which is facing significant challenges. Methods: A retrospective review of point of care data from HIV patients was conducted in June 2012 at Nkongsamba Regional Hospital in Cameroon to establish mortality and LTFU rates. Univariable and multivariable Cox regression models were used to screen for factors associated with the outcomes. Telephone calls were made to trace patients LTFU. Results: Between June 2005 and December 2010, 2388 HIV infected patients were admitted. Of these, 1858 were aged 15 and above and were included in our analysis. Their median age was 36 years (IQR: 30–44) and they were followed up over a total risk period of 3647.3 person-y...
A weak AFP surveillance system constitutes a major threat to Nigeria’s polio free certification s... more A weak AFP surveillance system constitutes a major threat to Nigeria’s polio free certification status. This study investigates the factors that have affected AFP surveillance, case detection along the international border settlements of Oyo state, Nigeria. A cross-sectional survey was conducted between 26th-31th December 2018 using structured questionnaires uploaded onto Open Data Kit-collect (ODK) mobile software in 4 LGAs in Oyo state. Overall, 427 respondents (community members=420, community informants=7) participated in this study. On the average, 10% and 46% of the community members and informants could identify the various aspects of the AFP case definition. Majority of the community members weren’t aware of AFP surveillance neither were they aware of their AFP focal person/DSNO or where to report AFP cases. Barriers to case reporting include, irregular movements of commercial vehicles, swampy roads during rainy seasons, rocky roads during dry seasons; poor communication net...
Introduction : le cholera est en mode endemo-epidemique dans la ville de Douala, comme dans de no... more Introduction : le cholera est en mode endemo-epidemique dans la ville de Douala, comme dans de nombreuses grandes villes d’Asie et d’Afrique. Notre objectif etait de decrire les aspects epidemiologiques, cliniques et bacteriologiques de l’epidemie de cholera survenue en 2011 a Douala, afin de mieux riposter lors des nouvelles flambees epidemiques. Materiels et methodes : l’etude etait transversale et retrospective. L’echantillonnage etait systematique. Resultats : Parmi les 5292 nouveaux cas suspects notifies durant toute l’annee, les jeunes âges de 16 a 34 ans etaient les plus atteints (52,8%, p=0,000), il en etait de meme des hommes contrairement aux femmes (56,2% vs 43,8%, P=0,000). Deux pics de frequence de 429 cas chacun, ont ete observes aux 41e et 45e semaines epidemiologiques. Le taux d’attaque etait de 0,23‰ pour une population de 2 271722 habitants. Le nombre de cas variait significativement selon les districts de sante, Deido avait notifie le plus grand nombre de cas (159...
Background Environmental surveillance (ES) for poliovirus is increasingly important for polio era... more Background Environmental surveillance (ES) for poliovirus is increasingly important for polio eradication, often detecting circulating virus before paralytic cases are reported. The sensitivity of ES depends on appropriate selection of sampling sites, which is difficult in low-income countries with informal sewage networks. Methods We measured ES site and sample characteristics in Nigeria during June 2018–May 2019, including sewage physicochemical properties, using a water-quality probe, flow volume, catchment population, and local facilities such as hospitals, schools, and transit hubs. We used mixed-effects logistic regression and machine learning (random forests) to investigate their association with enterovirus isolation (poliovirus and nonpolio enteroviruses) as an indicator of surveillance sensitivity. Results Four quarterly visits were made to 78 ES sites in 21 states of Nigeria, and ES site characteristic data were matched to 1345 samples with an average enterovirus prevalen...
* Coverage with the third dose of diphtheria-tetanus-pertussis vaccine is used as a surrogate for... more * Coverage with the third dose of diphtheria-tetanus-pertussis vaccine is used as a surrogate for routine immunization coverage because reported OPV coverage can include doses given during SIAs. † Polio high-risk states in northern Nigeria:
Background: Despite being certified guinea worm free in 2007, Cameroon continues surveillance eff... more Background: Despite being certified guinea worm free in 2007, Cameroon continues surveillance efforts to ensure rapid verification of any suspected reoccurrence. This includes the investigation of every rumor and confirmation of each suspicious expulsed worm. This paper presents fieldwork carried out to investigate a guinea worm rumor in Cameroon which turned out to be an Onchocerca volvulus mimicking Dracunculus medinensis. Methods: The investigation included a field visit to the subsistence farming community where the rumor was reported. During the visit, interviews were conducted with health staff who managed the case and the elderly farmer from whom the worm was retrieved. An investigation of any potential missed guinea worm cases was also conducted through interviews with community residents and reviews of the health facility's medical records. This was combined with laboratory analyses of water samples from the community's water sources and the retrieved worm which was removed from the patient via wrapping it around a stick. Results: Microscopy and molecular analyses of the retrieved worm revealed a female Onchocerca volvulus whose expulsion strongly mimicked guinea worm. In addition to presenting findings of our investigation, this paper discusses distinguishing elements between the two parasites and gives an overview of guinea worm eradication efforts in Cameroon as well as current challenges to the worm's eradication globally. Conclusions: The investigation findings suggest the evolving Onchocerca volvulus worm tropisms' adaptive survival behavior worth further investigation. Strategies used to successfully control guinea worm in Cameroon could be adapted for Onchocerca volvulus control.
ABSTRACT Background: In the absence of post exposure prophylaxis, an esti-mated 327 000 people wo... more ABSTRACT Background: In the absence of post exposure prophylaxis, an esti-mated 327 000 people would die from Africa and Asia each year from rabies. In Cameroon, three cases of rabies were confirmed in humans in 2010 with a case fatality rate of 100%. In the same year there were 20 confirmed cases in dogs. We set out to determine the anti-rabies vaccinotherapy completion rate in 2011 and describe the characteris-tics of users of the newly created anti-rabies unit in of the International Vaccination Centre Douala (IVCD), Cameroon. Method: A retrospective study was conducted in February 2012. Every individual who had received at least a single dose of anti rabies vaccine in 2011 and registered in the anti rabies unit of the IVCD was included. Data was analyzed using Epi Info version 3.5.3 for Windows and Microsoft Office Excel 2007. Results: Eighty-one users received post exposure prophylaxis and 6 pre exposure prophylaxis. Most of the users were males 48(55.2%), pupils and students 3...
Measles is a public health problem especially in South Asia and Africa. Nylon Health District has... more Measles is a public health problem especially in South Asia and Africa. Nylon Health District has experienced two measles outbreaks over a period of three years. We hereby describe the epidemiology and clinical characteristics of the outbreak of February 2011. A retrospective descriptive cross sectional study was conducted in November 2011. All suspected measles cases according to the World Health Organization case definition line listed in the district service were included. Data was analyzed using Epi Info version 3.5.3 for Windows and Microsoft Office Excel 2010. An epidemic curve was drawn and proportions per variable category were estimated and presented in frequency tables. The outbreak started from the 4(th) to the 25(th) epidemiological week of 2011 with a peak on the 10(th) week after onset. The attack and case fatality rates were 34/100000 inhabitants and zero respectively. Females and infants aged 9-59 months represented 97(63.4%) and 75(49%) of cases respectively. Bonadi...
Introduction: L'objectif principal de notre étude était d'identifier les bactéries associées à l'... more Introduction: L'objectif principal de notre étude était d'identifier les bactéries associées à l'infection nosocomiale, dans le service de réanimation, de l'hôpital Laquintinie de Douala en vue d'améliorer la prise en charge et diminuer la létalité. Méthodes: Il s'agissait d'une étude transversale et descriptive, menée du 1 er mars au 31 mai 2011.Tous les patients hospitalisés depuis au moins 48 h étaient inclus dans l'étude et ceux présentant une infection documentée à l'admission étaient exclus. L'analyse des donnés a été faite par le logiciel SPSS 16.Les tests de Khi deux pour la signification. Résultats: la prévalence de l'infection nosocomiale était de 12%, elle concernait des personnes âgées de plus de 60 ans et présentant une infection urinaire dans 79% des cas. La létalité était de 72% pour une durée moyenne de séjour de 11,7 ± 12,1 jours. Les bactéries responsables étaient en majorité des bactéries gram positifs (BGN), dont E coli dans 23,1% et les cocci gram positifs(CGP), dans 15,4% des cas. Conclusion: L'étude de la résistance aux antibiotiques, montre une multi résistance, dont il faut tenir compte en mettant en place une stratégie de prévention active.
The Littoral region of Cameroon met most of its routine immunization and surveillance objectives ... more The Littoral region of Cameroon met most of its routine immunization and surveillance objectives in 2010 but has not reiterated such a performance since then. We describe the casebased measles surveillance performance of 2010 by person, place, time and determine measles surveillance system delays. Descriptive statistics were performed using Epi Info 3.5.3. There were 130 suspected measles cases investigated by 17 (89.5%) health districts, 83 (64%) males and 99 (76%) ≤5 years. At least 4 cases were investigated per month with a peak of 23 cases in June. About 67 (51.5%) patients visited a hospital more than 48 h after disease onset, 34 (26.2%) health facilities informed the district service late after receiving a suspected case and 65 (50%) samples got to the reference laboratory more than 24 h after reception by the specimen collection centre. More than 2 discarded measles/100,000 population were investigated but with health facilities, specimen collection centre and patients' ability to seek healthcare delays. All specimens got to the reference laboratory within 72 h. Patients' health seeking behavior need to be improved and personnel involved in surveillance sensitized on timeliness. Study population and design It was a retrospective cross sectional study
Background: Access to Human Immunodeficiency Virus (HIV) care has been rolled out in Cameroon in ... more Background: Access to Human Immunodeficiency Virus (HIV) care has been rolled out in Cameroon in the last decade through decentralised delivery of care and timely initiation of free antiretroviral drugs. We sought to describe the evolution of mortality and loss to follow up (LTFU) and their patient-related determinants at an HIV clinic which is facing significant challenges. Methods: A retrospective review of point of care data from HIV patients was conducted in June 2012 at Nkongsamba Regional Hospital in Cameroon to establish mortality and LTFU rates. Univariable and multivariable Cox regression models were used to screen for factors associated with the outcomes. Telephone calls were made to trace patients LTFU. Results: Between June 2005 and December 2010, 2388 HIV infected patients were admitted. Of these, 1858 were aged 15 and above and were included in our analysis. Their median age was 36 years (IQR: 30-44) and they were followed up over a total risk period of 3647.3 person-years (pyrs). The overall mortality rate was 34.6 deaths per 1000 pyrs (95% CI: 29.0-41.1) while the overall LTFU rate was 94.6 per 1000 pyrs (95%CI: 85.1-105.1).The mortality rates steadily rose to a peak of 69.6 deaths per 1000 pyrs in 2009 and then fell drastically to 20.6 per 1000 pyrs in 2010. The LTFU rate increased sharply from 29.7 in 2006 to 138.2 in 2007 and remained virtually stable until 2010. The factors associated with mortality were: being male (aHR = 2.25, 95% CI: 1.58-3.19), clinical disease progression (aHR = 2.0, 95% CI: 1.58-2.53), CD4 count <200 cells/μl (aHR = 3.14, 95% CI: 1.27-7.73), haemoglobin level <10 g/dl (aHR = 2.50, 95% CI: 1.69-3.69). Major factors associated with high LTFU rate were: distance to clinic of over 5 km (aHR = 1.25, 95% CI: 1.00-1.55), being single, having partners with unknown HIV status or taking no treatment and with CD4 count >500 cells/μl. Two-thirds (66.7%) of traced LTFU patients were dead. Conclusion: Mortality and LTFU rates in our cohort were high but there is evidence that patients' outcomes are improving. Interventions to address factors associated with high mortality and LTFU should be implemented for optimal results in patient care.
The Cameroon health system is divided into central, intermediate and peripheral levels. Of the 43... more The Cameroon health system is divided into central, intermediate and peripheral levels. Of the 43 health districts with a measles outbreak in Cameroon in 2011, only the Nylon Health District organized a documented outbreak response immunization. We present the methods and results of the response campaign solely shouldered by the district and intermediate level. The risk group, targets and neighborhoods to be vaccinated were identified after a detailed analysis of initial cases. The intermediate level defined strategies, provided logistics, capacity building and 41% of the operational budget while 59% was completed by the peripheral level. Microsoft Office Excel 2007 was used to estimate coverage rates and to draw an epidemic curve. The response immunization campaign was organized on the 14 th epidemiological week, 10 weeks after the onset of the outbreak which ended 11 weeks thereafter. A total of 15867 (108.5%) children aged 9-59 months were vaccinated in five health areas at a direct cost (vaccines excluded) of 71.34FCFA ($0.143) per vaccinated child. An additional 824 children aged 9-59 months were vaccinated around the residence of notified cases in neighborhoods which were not involved in the response campaign. The number of cases after the response campaign was lower than before. Once vaccines are available, prompt outbreak response campaigns can be organized at operational level to obtain commendable results instead of depending solely on international organizations or central levels. Decision makers at the intermediate and operational levels should redeploy available funds during emergencies to prevent the development of extreme public health conditions.
, the Ministry of Public Health's Expanded Program on Immunization requested technical support to... more , the Ministry of Public Health's Expanded Program on Immunization requested technical support to improve mapping of health district boundaries and health facility locations for more effective planning and analysis of polio program data. In December 2015, teams collected data on settlements, health facilities, and other features using smartphones. These data, combined with high-resolution satellite imagery, were used to create new health area and health district boundaries, providing the most accurate health sector administrative boundaries to date for Cameroon. The new maps are useful to and used by the polio program as well as other public health programs within Cameroon such as the District Health Information System and the Emergency Operations Center, demonstrating the value of the Global Polio Eradication Initiative's legacy.
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Papers by Gerald Sume