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PubMed2005

Attitudes of traditional healers towards Western medicine in rural Cameroon.

A range of AIDS prevention programmes suggested that cooperation between traditional healers and the biomedical primary health-care system would benefit patients. To assess the knowledge and attitudes of traditional healers in Cameroon towards Western medicine and evaluate their willingness to cooperate with the district health-care system, a qualitative study was undertaken. In this study, 16 randomly chosen traditional healers in Kumba, Cameroon, were interviewed. Western medicine was well accepted for certain indications and referral of patients to health-care centres was frequently practised. All healers stated that they wished to cooperate more extensively with the district primary health-care system and to obtain more biomedical knowledge. Closer cooperation between traditional healers and the district primary health-care system is possible. The frequent occurrence of illiteracy must be considered when designing health education for traditional healers.

Attitude of Health Personnel↗
PubMed2003

Increased HIV prevalence among individuals attending a sexually transmitted infection clinic in Yaounde, Cameroon.

Monitoring HIV prevalence among selected groups provides important data on infection trends. The present study assessed current HIV prevalence and risk correlates among 255 men and women consecutively attending a sexually transmitted infection clinic in Yaounde, Cameroon. Prevalence of 21.96% and 5.5% were found for HIV and syphilis, respectively, with a significant correlation between the two infections. Although marriage was not a significant predictor for HIV, married men were twice as likely as unmarried men to be infected; no such difference was observed for women. Inconsistent condom use was positively, but not significantly, associated with HIV. Also, age, education, and number of sex partners were not significant correlates of HIV infection. Compared to data collected in 1997, HIV prevalence in this clinic has increased nearly 6%. Our findings highlight the increasing spread of HIV infection in Cameroon and the need for additional control strategies to curb the epidemic.

Adult↗
PubMed1998

Antenatal HIV prevalence in Yaounde, Cameroon.

From June 1994 to July 1996, 4100 pregnant women living in Yaounde, Cameroon, were tested for human immunodeficiency virus type 1 (HIV-1) and syphilis. The HIV seroprevalence was 4.2% (95% confidence interval (CI): 3.6%-4.8%), and that of antibodies to Treponema pallidum was 17.4% (95% CI: 16.3%-18.6%) (HIV infection was twice as common in women with positive syphilis serology) (7.2% vs 3.6%). Over the study period, the antenatal seroprevalence of syphilis remained stable, while there was an increase in the HIV seroprevalence rate. There was an increase in HIV seropositivity in women uninfected with syphilis between 1994/1995 and 1995/1996 from 2.9% to 4.3%. By the end of the study, HIV infection was no commoner in women with negative compared with positive syphilis serology. It is therefore postulated that HIV infection in Yaounde has entered the general, sexually active female population. We suggest that management of pregnant women in Cameroon should include routine screening for both HIV infection and other sexually transmitted diseases (STDs).

Cameroon↗
PubMed1998

Prevalence and prediction of sexually transmitted diseases among sex workers in Cameroon.

The aim of the study was to determine the prevalence of sexually transmitted diseases (STDs), describe the frequency of genitourinary symptoms and signs, and to assess the accuracy of clinical diagnoses of STD in a cohort of Cameroonian sex workers. Physical examinations were conducted on 1233 sex workers in Yaoundé and Douala, Cameroon. Symptoms experienced within the 14 days prior to examination were collected. Women were tested for gonorrhoea, chlamydia infection, and trichomoniasis. Doctors' clinical impressions were compared with laboratory tests. Prevalence of cervical infection and trichomoniasis was 20%. A high percentage of abnormal signs and symptoms was found in this cohort. Clinical diagnosis for cervicitis and trichomoniasis had low sensitivities (<50%) while specificity remained high (>65%). In conclusion STDs are common among sex workers in Cameroon. Clinical diagnosis was not an accurate predictor of infection at the individual level in this population at risk of STD.

Adolescent↗
PubMed2026

Genetic diversity and antifungal susceptibility among ecological niche populations of Aspergillus flavus in Yaound&#xe9;, Cameroon.

Aspergillus flavus is a ubiquitous fungus commonly found in a variety of ecological niches including soil, crops, the air, and humans. In humans, it is the second leading cause of invasive aspergillosis (IA) and is linked to other illnesses through contamination of agricultural products with aflatoxins. As such, A. flavus threatens food safety, economic wellbeing, and human health, particularly in less developed regions and countries such as Cameroon. To mitigate these effects, farmers and clinicians rely on triazoles to reduce aflatoxin contamination and treat IA. However, a consequence of increasing triazole use is the emergence and spread of triazole resistance in both agriculture and clinics. To identify the prevalence of triazole resistance and the potential genetic relationships among triazole resistant and susceptible strains, this study investigated antifungal susceptibility to both clinical and agricultural triazoles and analyzed genetic variation among various ecological niche populations of A. flavus in Cameroon. Strain genotypes were obtained through analysis of six polymorphic microsatellite markers. Our analyses revealed that 30.3% (17/56) of the strains were resistant to at least one of the four triazoles, with increased minimum inhibitory concentrations found among crop-isolated strains. A Permutational Multivariate Analysis of Variance suggested limited ecological niche-based clustering of genotypes, consistent with frequent gene flow and dispersal among ecological niches. A multilocus linkage disequilibrium analysis revealed evidence of non-random recombination in A. flavus. Overall, this study elucidates the interplay between ecological pressures, antifungal resistance, and genetic differentiation, and invites alternative methods to control aflatoxin contamination in foods without the use of agricultural fungicides.

Aspergillus flavus↗
PubMed1992

Mefloquine resistant malaria in Cameroon and correlation with resistance to quinine.

Based on the results of in vitro sensitivity of Plasmodium falciparum to chloroquine, quinine and mefloquine, and evaluation of drug consumption conducted in 1987-1988 in four areas in the north and south-west of Cameroon, two opposite situations were encountered in this country. In northern Cameroon where mefloquine resistance is prevalent a close correlation was found between the responses of P. falciparum to mefloquine and to quinine, but not between mefloquine and chloroquine. In the south, where chloroquine resistance is highly prevalent, no correlation was found neither between mefloquine and chloroquine nor mefloquine and quinine, but the responses to quinine and chloroquine appear partly correlated. These results lead to formulate the hypothesis of a "southern" type of P. falciparum submitted to a high chloroquine drug pressure inducing a secondary cross resistance, whilst a "northern" type submitted to a relatively high and abortive quinine drug pressure inducing a primary quinine resistance and a secondary cross resistance with mefloquine.

Animals↗
PubMed2003

Insecticide susceptibility status of Anopheles gambiae s.l. (Diptera: Culicidae) in the Republic of Cameroon.

A large-scale survey of Anopheles gambiae Giles, 1902 susceptibility to DDT, dieldrin, permethrin, and deltamethrin was conducted in the Republic of Cameroon. 15 field populations from various geographical areas were tested using World Health Organization test kits for adult mosquitoes. The laboratory Kisumu susceptible reference strain was tested as a control. Results showed that dieldrin and DDT resistance was still present in some populations, and indicated permethrin or deltamethrin resistance. Within the Anopheles gambiae complex, resistant individuals belonged to An. gambiae s.s. and An. arabiensis species. Both M and S molecular forms of An. gambiae s.s. were found resistant. In most of resistant populations, the knockdown times were 2-5-folds increased. However, none of the surviving mosquitoes was positive to the kdr "Leu-Phe" mutation using polymerase chain reaction (PCR) diagnostic test. These results likely suggested involvement of other resistance mechanism(s), such as enzyme detoxification or kdr "Leu-Ser" mutation. Researches on An. gambiae s.l. resistance should be promoted in Cameroon, to improve malaria vector control programs and to implement resistance management strategies.

Animals↗
PubMed1990

Oculocutaneous albinism in Cameroon. A 15-year follow-up study.

Oculocutaneous albinism in Cameroon was studied from 1972 to 1987. Two hundred and seventy-three albinos (160 males and 113 females) were registered. The sex ratio of 1.42 (male/female) was significantly different from unity but this apparent discrepancy may be explained by social and geographical reasons. The highest prevalence occurred in the Bamileke group (190/273 albinos, i.e., 70%) for which the rate was 1 in 7,900, using an estimate of 1,500,000 Bamileke people. The high frequency of the albino gene was thought to result from a greater inbreeding tendency, to the special organization of the Bamileke society in mini-states or kingdoms and to a founder effect in the case of Balengou kingdom. The death of albinos was mainly due to skin cancer induced by solar radiation during the second, third or fourth decade. Cameroon, located from 2 degrees to 12 degrees above the equator, is sunny throughout the year. Registering all albinos early in life, educating them to prevent the damaging effect of the sun (protective clothing, sun-screening agents and indoor occupations), detecting and treating premalignant and malignant lesions are of great importance in this country.

Adolescent↗
PubMedDate not supplied

An epidemic of bloody diarrhea: Escherichia coli O157 emerging in Cameroon?

Between November 1997 and April 20, 1998, bloody diarrhea sickened 298 persons in Cameroon. Laboratory investigation of the epidemic (case-fatality rate, 16.4%) documented amoebiasis in one of three patients and three types of pathogens: multidrug-resistant Shigella dysenteriae type 1, S. boydii, and enterohemorrhagic Escherichia coli. We report the first isolation of E. coli O157:H7 in Cameroon and the second series of cases in the Central African region.

Adolescent↗
PubMedDate not supplied

HIV-1 group O infection in Cameroon, 1986 to 1998.

We report a survey of HIV-1 group O infection in Cameroon during 1986 to 1998. The prevalence of HIV-1/O decreased from 0.6% to 0.4%, while HIV-1/M increased from 19.2% to 31.5% from 1994 to 1998. We concluded that HIV-1/O infection is stable in Cameroon and may be declining slightly.

Acquired Immunodeficiency Syndrome↗
PubMed2004

Acute spotted fever rickettsiosis among febrile patients, Cameroon.

Although potential arthropod vectors are abundant in Cameroon, acute febrile illnesses are rarely evaluated for arboviral or rickettsial infections. Serum samples from 234 acutely febrile patients at clinics in Tiko and Buea, Cameroon, were examined for antibodies to Rickettsia africae and African alphaviruses and flaviviruses. These serum samples did not contain antibodies against typhoid, and blood malarial parasites were not detected. Serum samples of 32% contained immunoglobulin M antibodies reactive with R. africae by immunofluorescence assay and were reactive with outer membrane proteins A and B of R. africae by immunoblotting. These findings established a diagnosis of acute rickettsiosis, most likely African tick-bite fever. Hemagglutination inhibition testing of the serum samples also detected antibodies to Chikungunya virus (47%) and flaviviruses (47%). High prevalence of antibodies to arboviruses may represent a major, previously unrecognized public health problem in an area where endemic malaria and typhoid fever have been the principal diagnostic considerations.

Adolescent↗
PubMed1986

High level of sensitivity to chloroquine of 72 Plasmodium falciparum isolates from southern Cameroon in January 1985.

The sensitivity to chloroquine, quinine and mefloquine of Plasmodium falciparum isolates from 3 areas of southwest Cameroon was evaluated using an in vitro microtest with estimation of parasite growth by 3H-hypoxanthine incorporation. Among 2,429 children examined, P. falciparum was found on thin smears in 124 of them, 76 isolates were submitted to in vitro tests and 72 were successful. In the locations studied, some of which are close to the area of Limbe where in vivo resistance has been reported, all 72 isolates were found fully sensitive to low concentrations of chloroquine (mean EC50 5.9 ng/ml or 18.5 nmol/l of medium). In 47 of these isolates simultaneously tested using WHO microtest predosed plates, the sensitivity was identical. Out of 39 tests performed with quinine, 35 were successful. While most strains responded to low concentrations, some showed a decreased sensitivity to the drug, the EC50 of 4 of them being in the range 230-300 nmol/l. Each of the 17 isolates tested with mefloquine was susceptible to very low concentrations of freshly prepared drug solution. While chloroquine-resistant strains may already exist in Cameroon, the present study suggests that they would be restricted to a limited area and are not widespread. Data also suggest that monitoring of the sensitivity of P. falciparum to quinine might soon be necessary.

Animals↗
PubMed1988

Patterns of in vitro resistance to chloroquine, quinine, and mefloquine of Plasmodium falciparum in Cameroon, 1985-1986.

The drug sensitivity of 246 Plasmodium falciparum isolates was studied in vitro in five areas of Cameroon at the end of 1985. Results demonstrate that parasites resistant either to chloroquine, quinine, or mefloquine, or to two of these drugs, were prevalent in four of the areas investigated, but the drug response pattern varies widely from one area to another. The recent explosive emergence of chloroquine resistance in the south of the country, where both prevalences and levels are very high (up to 86%), contrasts with only moderate levels of resistance in the north. This may be related to differences in transmission by mosquitoes between Sahel and forest areas. Quinine resistance was observed in 24% of the isolates studied in vitro and was frequently associated with chloroquine resistance. The presence of isolates responding poorly to mefloquine, observed mainly in northern Cameroon, suggests that resistance may occur in areas where the drug has never been used.

Adolescent↗
PubMed1995

A pilot study of the prevalence of hepatitis C virus antibodies and hepatitis C virus RNA in southern Cameroon.

Information is lacking on the prevalence of hepatitis C virus (HCV) infection in most African countries. An algorithm based on a combination of enzyme immunoassays (EIAs) with different formats (a commercial test, an HCV antibody [Ab] III test, and an HCV core Ab EIA) was used to estimate the prevalence of HCV infection in different population groups from southern Cameroon. An overall high prevalence was observed, with a significant increasing trend for both sexes with respect to age. A high proportion (67.4%) of HCV-positive sera were viremic as demonstrated by the reverse transcription-polymerase chain reaction. We conclude that the prevalence of HCV is high in southern Cameroon and increases linearly with age.

Adolescent↗
PubMed1995

Increase of birth weight following chloroquine chemoprophylaxis during the first pregnancy: results of a randomized trial in Cameroon.

A randomized trial was carried out from 1991 to 1993 among women attending an antenatal clinic in Ebolowa, Cameroon where malaria is hyperendemic and transmission occurs at a high level all year round. All pregnant women attending the clinic for their first prenatal visit between October 1991 and November 1992 were alternately assigned to chloroquine (CQ) or control (CT) groups. Chloroquine was given under observation at a weekly oral dose of 300 mg. At delivery, smears from maternal, cord, and placental blood were made and stained with Giemsa for parasites. An in vivo chloroquine sensitivity investigation was carried out on women attending the postnatal consultation to evaluate the level of chloroquine resistance in the target population. The efficacy of chloroquine was moderate in placental infection (39.2% infected in the CQ group versus 57.8% in the CT group: P = 0.05), probably because of a resistance to chloroquine estimated to be 10.9%. In the CQ group, the mean birth weight was significantly higher (P = 0.02) and the proportion of low birth weight newborns was lower (10.5% versus 27.7%; P = 0.02). A strong correlation between placental infection and birth weight was observed: the mean birth weight difference between infected and noninfected placentae was 359 g (P < 0.0001) and the proportion of low birth weight new born babies was 35.6% versus 5.9% (P = 0.0001). In Cameroon, in spite of a moderate resistance to chloroquine, this drug proved to be highly effective in increasing birth weight when administered to primigravidae. We therefore think such a prophylaxis should be recommended only to primigravidae in high transmission areas.

Adolescent↗
PubMed1998

Molecular epidemiology of malaria in Yaounde, Cameroon I. Analysis of point mutations in the dihydrofolate reductase-thymidylate synthase gene of Plasmodium falciparum.

Resistance to antifolate antimalarial drugs (cycloguanil, a biologically active metabolite of proguanil, and pyrimethamine) is associated with a Ser- to Asn-108 point mutation in the dihydrofolate reductase-thymidylate synthase gene of Plasmodium falciparum. The frequency of this mutation was studied in 127 clinical isolates obtained in Yaounde, Cameroon using a simple and rapid molecular technique based on the polymerase chain reaction and restriction fragment length polymorphism. Of the 127 isolates, pure wild-type Ser-108 codon, pure mutant-type Asn-108 codon, and mixed codons were observed in 66, 55, and six parasites, respectively. The proportion of antifolate-resistant, pure mutant-type codon, with respect to pure wild-type or mixed alleles, was 43% (55 of 127). The results of the molecular assay were compared with those of semimicro isotopic in vitro assay in 34 isolates. All 17 pure Ser-108 isolates and two isolates with mixed alleles were sensitive to both pyrimethamine (50% inhibitory concentration [IC50] < 100 nM) and cycloguanil (IC50 < 50 nM). Fourteen of 15 isolates with the mutant-type Asn-108 codon were resistant to pyrimethamine and cycloguanil. One isolate with Asn-108 showed a slightly elevated pyrimethamine IC50 (78 nM), which was within the sensitive range. This study provides further evidence that antifolate-resistant P. falciparum isolates are already present in Yaounde, Cameroon.

Alleles↗
PubMed1998

Prevalence of and risk factors for anemia in young children in southern Cameroon.

Anemia during childhood remains a major public health challenge in sub-Saharan Africa. To determine the prevalence of and the main risk factors for anemia in young children, we conducted a longitudinal survey in Ebolowa in southern Cameroon. Children were enrolled in two cohorts and followed during a three-year period: the first cohort was composed of 122 children from 0 to 36 months of age and the second cohort was composed of 84 children from 24 to 60 months of age. The two cohorts were followed weekly for symptomatic malaria, monthly for both symptomatic and asymptomatic malaria, and every six months for hematologic data; the children were grouped into six-month age groups. The prevalence of anemia (hemoglobin [Hb] level < 11 g/dl) was the highest in the six-month-old age group (47%) and the age-related evolution clearly showed a decrease in the prevalence from three years of age. Thus, 42% of the children less than three years of age were anemic, while 21% of the children between three and five years of age were anemic. The lowest mean +/- SD Hb content (10.7 +/- 2.1 g/dl) was observed in the six-month-old children and a regular improvement in the Hb level occurred from six months to three years of age. A stabilization was observed at a level of approximately 12 g/dl. At any age, there was no difference in mean Hb levels between children with AS and AA Hb genotypes. Hookworm infection was diagnosed in two children in the study population. Results of a multivariate analysis showed that placental malaria infection was the strongest risk factor for anemia in the six-month-old children (odds ratio [OR] = 3.6; 95% confidence interval [CI] = 1.1-12.3) and was independent of the frequency of parasitemia, parasitemia at the time of Hb measurement, or microcytosis. In the one-year-old age group, microcytosis was a significant factor related to anemia (OR = 2.8, 95% CI = 1-7.8) pointing out the role of iron deficiency at this age. Parasitemia at the time of Hb measurement was significantly associated with anemia in all age groups (except in 54- and 60-month-old groups). Strategies to decrease the prevalence of anemia in young children in southern Cameroon should include chemoprophylaxis for pregnant women, prevention of acquired malaria infection in both pregnancy and infancy, and prevention of nutritional iron deficiency.

Anemia↗
PubMedDate not supplied

[10 new clinical cases of mycoses caused by Entomophorales in Cameroon].

Authors describe ten new cases of Entomophthoromycosis in Cameroon. In four cases of subcutaneous phycomycosis, Basidiobolus meristoporus was isolated in one case. In six cases of rhino-entomophthoromycosis, we have obtained by culture two Basidiobolus meristoporus and one Entomophthora coronata. In Cameroon, rhino-entomophthoromycosis may be caused by the two species Basidiobolus meristoporus and Entomophthora coronata.

Adult↗