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PubMed2002

Hepatitis C virus infection and genotypes among human immunodeficiency virus high-risk groups in Cameroon.

Parenteral transmission of HCV is well established but other possible routes such as heterosexual transmission are still questioned. The Central African region is characterised by a high HCV endemicity without any evidence on the route of transmission. The information on HCV genotypes that circulate in this area is also limited and controversial. HIV infection is very frequent in this region and mostly acquired via the heterosexual route. The aim of this work was to investigate the trend of HCV infection and genotypes among HIV high-risk groups from Cameroon. Four hundred eighty-two patients including 229 tuberculosis clinic attendants, 184 sexually transmitted disease clinic attendants, and 69 HIV clinical suspects from another clinic were enrolled. All plasma samples were screened for antibodies to HCV and HCV RNA. Genotypes were assigned by sequencing a 5'UTR amplified fragment. The overall prevalence of HCV markers was 11.6% and a significant increasing trend with respect to age was observed. A proportion of 64.1% (34/53) of HCV antibody positive samples was viraemic. HCV RNA was found in 3 samples that were indeterminate in RIBA 3.0. One was negative in the antibody screening test and the two others were weakly positive. The data on HCV genotypes revealed that genotype 1 was involved in 57% of viraemias, genotype 2 in 24%, while genotypes 4 and 5a accounted for 16 and 3%, respectively. In contrary to the predominance of genotype 4 reported in some African countries and even the neighbouring countries, these data demonstrate clearly that HCV infection in Cameroon is dominated by genotypes 1 and 2. No association was found between the HCV markers and the presence of HIV infection. It is concluded, therefore, that the heterosexual route plays a minor role in HCV transmission in this country.

Adolescent↗
PubMed1982

The secondary importance of primary health care in South Cameroon.

Primary health care in Cameroon meets with serious obstacles. The state gives it a low priority in its budget and over-all policy. The health institutions are rarely active in this field. Institutions which do practice some primary health care are usually foreign. The villagers, finally, are little interested. They insist only on improvement of curative services and material life conditions. The conclusion is that primary health care is regarded as something of secondary importance. First comes a better life. The research for this paper was conducted in 1980 in the South of Cameroon.

Cameroon↗
PubMed1992

A novel sickle cell mutation of yet another origin in Africa: the Cameroon type.

The sickle cell mutation (beta s) arose as at least three independent events in Africa and once in Asia, being termed the Senegal, Benin, Bantu and Indian types respectively. An investigation in Cameroon was carried out to determine whether the atypical sickle genes observed in the neighboring countries are the result of recombination or the presence of a sickle cell mutation of a different genetic origin. It was conducted on 40 homozygous SS patients followed at the Blood Transfusion Center in the capital city of Yaoundé. On 80 beta s chromosomes, 13 exhibited a novel polymorphic pattern that was observed three times in the homozygous state. This chromosome contains an A gamma T gene. The restriction fragment length polymorphism haplotype is different from all the other beta s chromosomes in both the 5' and 3' regions, but has previously been reported in sporadic cases. The (AT)8(T)5 sequence in the -500 region of the beta gene is specific and different from that of the Senegal, Benin, Bantu or Indian beta s genes. All the carriers of this specific chromosome belong to the Eton ethnic group and originate from the Sanaga river valley. This observation strongly argues for yet another independent origin of the sickle cell mutation in Africa, here referred to as the "Cameroon type". The Benin haplotype and a Benin/Bantu recombinant haplotype have been observed in the other studied populations: Ewondo, Bamiléké, Bassa, Yambassa and Boulou.

Anemia, Sickle Cell↗
PubMed1991

Seroepidemiology of pertussis infection in an urban childhood population in Cameroon.

In 1989, the prevalence of IgG antibodies to pertussis toxin (PT) in a sample of 367 unvaccinated apparently healthy children 5-14 years old was estimated by ELISA in Kumba City (Cameroon). Children were recruited using a systematic random sampling from six primary schools located in different districts of the city. The sample was representative of the various socioeconomic classes. The overall prevalence was 75%; it increased from 62% in 5 year old children to 81% in children 12-14 years old (P less than 0.01). IgG antibody prevalence was positively related to the family size. Children belonging to households of nine or more members had a 2.2-fold risk (C.I. 95 per cent = 1.1-4.6) of previous exposure to B. pertussis infection. No association was found with the father's occupation (O.R. = 1). These findings demonstrate a great impact of pertussis infection in Cameroon, with a nearly total exposure by late childhood.

Adolescent↗
PubMed1997

Prevalence of NIDDM and impaired glucose tolerance in a rural and an urban population in Cameroon.

The adoption of Western lifestyles is known to lead to increasing prevalence of non-insulin-dependent diabetes mellitus in Africa, yet epidemiological studies using standardised methods are rare. The prevalence of diabetes and impaired glucose tolerance was determined in a rural and an urban community in Cameroon using the 75-g oral glucose tolerance test and the World Health Organization diagnostic criteria in 719 rural (292 men, 427 women) and 1048 urban (458 men, 590 women) subjects aged 24-74 years. The response rate was 95 and 91% for the rural and urban population, respectively. The age-standardized prevalence of diabetes in the rural and urban population was respectively 0.9% (95% confidence interval (0.2-2.7)) and 0.8% (0.2-1.8) for men and 0.5% (0.1-1.6) and 1.6% (0.7-3.1) for women, and that of impaired glucose tolerance was 5.8% (3.3-9.4) and 1.8% (0.9-3.2) for men, and for women, 2.2% (1.0-4.0) and 2.0% (0.6-4.5). Although for both men and women the body mass index was higher at all ages in the urban than in the rural area, the 2-h plasma glucose, even after adjustment for age and body mass index, was significantly higher in the rural than in the urban area (p < 0.005, p < 0.002 for men and women, respectively). There was a female excess of diabetes in the urban area and an equal sex distribution in the rural area. In the rural area 67% (4 of 6) of diabetic subjects were unknown before the survey, compared with 57% (8 of 14) in the urban area. These data indicate a low prevalence of diabetes in Cameroon; however, the prevalence of impaired glucose tolerance suggests an early stage of a diabetes epidemic.

Adult↗
PubMed2003

Bone tumours in Cameroon: incidence, demography and histopathology.

A multicentre analysis was carried out on bone tumours in Cameroon during a 10-year period. Registers and patient records of five pathology laboratories were consulted, and all patients with a histological report of a bone tumour were included in the study. A total of 268 bone tumours were studied and the average incidence was 27 tumours a year, or two per one million inhabitants. Of these tumours 48% were benign, 45% were primary bone cancers and only 6% were metastatic disease. Among the primary malignant bone tumours, osteosarcoma was the most frequent (39%), followed by non-Hodgkin's primary bone lymphoma, fibrosarcoma, chondrosarcoma, and Ewing's sarcoma. Primary site of the metastatic bone tumours was prostatic adenocarcinoma, breast cancer, hepatocarcinoma and thyroid cancer. In Cameroon many bone tumours are not diagnosed due to lack of medical facilities and little awareness among our medical staff. It is likely that the real incidence is at least ten times higher than that shown in our report.

Adolescent↗
PubMed1999

Genetic diversity of HIV-1 group M from Cameroon and Republic of Congo.

We analyzed 57 HIV-1 isolates from Cameroon and the Republic of Congo, with respect to the env C2V3 and/or the pol integrase regions. The results indicated that the topology of the pol tree correlated well with that of the env tree for four clusters of subtype D, F G and H, suggesting that these trees reflect the true evolution of the overall genome structures of these subtypes. However, of 22 Cameroonian isolates that were classified as subtype A based on env, 20 of them diverged in their pol sequence into two lineages that were completely different from the prototypical subtype A, tentatively designated as subtypes A1 and A2. The subtype A1 isolates (6 out of 22) were related in their env C2V3 regions with prototypical subtype A strain, but in their pol regions, they formed an independent cluster that diverged from known HIV-1 subtypes so far reported (except for subtypes I and J). The subtype A2 isolates (14 out of 22), which represent the major epidemic type of HIV-1 in Cameroon, clustered distinctly in both the env and pol trees with the recently described A/G mosaic strains from Nigeria and Djibouti. These two lineages were not spreading in the neighboring Republic of Congo.

Amino Acid Sequence↗
PubMed1988

Sera from Cameroon induce crisis forms during Plasmodium falciparum growth inhibition studies in vitro.

Sera collected from 176 children and adults from 3 different regions of Cameroon were used in inhibition assays against Plasmodium falciparum in vitro. The individuals had been classified clinically as malarious or non-malarious. Of the 58 non-malarious persons questioned, 39 claimed never to have had symptoms of the disease. Sera were tested for inhibitory effects on either merozoite entry and retardation of growth or inhibition of intraerythrocytic growth. The sera from malarious individuals showed only 9% and 29% mean inhibition values at 24 and 48 h, respectively, while those from the non-malarious persons showed 59% and 73% inhibition for the same periods. Of the 58 sera from non-malarious persons, 34 produced typical crisis forms by 24-36 h. Some sera also inhibited merozoite entry into erythrocytes. Our data suggest an important relationship between acquired immunity to P. falciparum in Cameroon and the types of inhibition described here.

Adult↗
PubMedDate not supplied

A short term projection of HIV infection and AIDS cases in Cameroon.

By September 1991 Cameroon had reported 650 cases of the acquired immune deficiency syndrome (AIDS). The results from the sentinnel surveillance system showed a seroprevalence of human immunodeficiency virus (HIV)1 of 1.3% among pregnant women, 2.5% in people attending sexually transmitted disease clinics and 3.5% in tuberculosis patients in 1990. The estimated number of persons infected with HIV varies between 10,000 and 30,000. The World Health Organization projection model was used to make a short-term projection of HIV infection and AIDS cases; it indicated that the number of persons infected with HIV will double by the year 1995, with an estimated 8500 AIDS cases. Even in a low prevalence country such as Cameroon, the impact of the HIV epidemic is important and will result in a burden for the health care system.

Acquired Immunodeficiency Syndrome↗
PubMedDate not supplied

Chloroquine sensitivity of Plasmodium falciparum in vivo in a savanna town in Cameroon.

Chloroquine-resistant Plasmodium falciparum has been reported in the Sahel and forest regions of Cameroon since 1985. In vivo response to chloroquine treatment (25 mg/kg) was assessed in 19 patients with malaria in the savanna North-West province. 58% of the cases showed RII resistance to chloroquine. RIII resistance was suspected in one patient. Only 35% of cases showed complete parasite clearance by day 5 of treatment. Chloroquine reduced parasite counts by at least 87% in all patients. Chloroquine resistance now seems to be well established and widespread in Cameroon. Its rapid spread and the prevalence of resistance suggest the existence of sustained drug pressure resulting in rapid selection of less sensitive strains. Unfortunately, similar pressure is also being exerted with quinine.

Adolescent↗
PubMedDate not supplied

Estimation of the number of cases of schistosomiasis in a country: the example of Cameroon.

An estimate of the number of schistosomiasis infections in Cameroon was based on a statistically representative national prevalence survey carried out in the entire country. The number of cases of infection by Schistosoma haematobium was estimated to be 393,900, and 419,600 for S. mansoni, a total of 813,500. Taking into account the dual infections the total number of cases was 719,100 (95% confidence interval: 392 900-1 027,800). A current World Health Organization estimate extrapolating from the results of limited epidemiological surveys showed 2,239 591 cases for Cameroon, an estimate 3.1 times higher than the more accurate estimate based on the national survey. Schistosomiasis being a focal disease, prevalences observed in limited foci are not representative of regional prevalences. Prevalence survey data in the literature are biased toward reporting only positive results. Therefore extrapolations made on limited surveys may lead to an overestimation of the number of cases of schistosomiasis.

Cameroon↗
PubMedDate not supplied

Prevalence of hepatitis C virus and other blood-borne viruses in Pygmies and neighbouring Bantus in southern Cameroon.

The prevalences of antibodies to hepatitis C virus (anti-HCV), human immunodeficiency virus (anti-HIV), human T lymphotrophic virus (anti-HTLV) and of hepatitis B surface antigen (HbsAg) were determined in 168 subjects aged 12 years and over (108 Pygmies, 60 Bantus) living in south Cameroon. In 167 subjects, we found an estimated minimal anti-HCV prevalence of 13%. The prevalence was significantly higher in Bantus (31.7%) than in Pygmies (11.1%) and increased with age in both groups, albeit more rapidly in Bantus. The overall prevalence of HBsAg was 7.2% and correlated with neither sex nor ethnic group. No association was found between anti-HCV and HbsAg prevalence rates. No subject was confirmed to be positive for HTLV or HIV. These findings confirm the high prevalence of HCV infection in south Cameroon and indicate that even secluded population groups are affected.

Adolescent↗
PubMed1987

Self-care and the informal sale of drugs in south Cameroon.

Self-care, though the most common of all forms of therapeutic action, has been little studied. This paper describes the context of self-medication with western pharmaceuticals in an area of South Cameroon (in 1980). The identity and appropriateness of these pharmaceuticals are briefly discussed. The paradoxical character of self-medication is emphasised: improvement in the quality of self-medication implies both growth and loss of self reliance, increase and decrease of medicalisation. People in Cameroon, or indeed anywhere in the Third World, find themselves in a 'double-bind'.

Cameroon↗
PubMed2004

Infection rate of Trypanosoma brucei s.l., T. vivax, T. congolense "forest type", and T. simiae in small wild vertebrates in south Cameroon.

In order to identify the infection rate of trypanosome species infecting wild animals in four localities (Bipindi, Campo, Fontem and Nditam) of southern Cameroon, 1,141 wild animals were sampled. These animals belonged to 36 species grouped in 8 orders including 407 primates, 347 artiodactyls, 264 rodents, 54 pangolins, 53 small carnivores, 11 saurians and crocodilians and 5 hyraxes. PCR using specific primers for Trypanosoma vivax, T. brucei s.l., T. congolense "forest type", and T. simiae showed that 18.7% of the animals were infected by at least one of these trypanosome species. A positive PCR result may not indicate absolutely an active infection because PCR can detect also transient infections. T. vivax (Duttonella) had the highest infection rate (9.5%) and was found in almost all the host orders studied. T. brucei s.l. mostly infected primates, rodents and some duikers (Cephalophus dorsalis and C. monticola). Trypanosomes of the subgenus Nannomonas had a lower infection rate of 5.5% (2.4% for T. simiae and 3.1% for T. congolense "forest type"). They were harboured mainly by primates, ungulates and rodents. Trypanosome infection rates were highest in Nditam (24.5%) and Bipindi (21%). T. brucei s.l. (Trypanozoon) had its maximum infection rate of 10.4% in Bipindi. The "Quantitative Buffy Coat" (QBC) and Kit for in vitro isolation techniques were used to identify 48 (6.1%) infected animals. 13 were positive using QBC, and 42 were positive by KIVI. However, PCR was negative on 16 of these infected animals, probably due to infections with other trypanosome species. This study showed that trypanosomes of the subgenera Duttonella, Nannomonas and Trypanozoon could infect small wild vertebrates as has been shown for large ungulates and carnivores. The presence of T. brucei s.l. in a large range of wild animals strengthens the hypothesis of the existence of a wild animal reservoir of T. b. gambiense in Cameroon.

Animals↗
PubMed2006

Population genetic structure of the malaria vector Anopheles moucheti in south Cameroon forest region.

We used recently developed microsatellite DNA markers to explore the population genetic structure of the malaria vector, Anopheles moucheti. Polymorphism at 10 loci was examined to assess level of genetic differentiation between four A. moucheti populations from South Cameroon situated 65-400 km apart. All microsatellite loci were highly polymorphic with a number of distinct alleles per locus ranging from 9 to 17. Fst estimates ranging from 0.0094 to 0.0275 (P < 0.001) were recorded. These results suggest a very low level of genetic differentiation between A. moucheti populations. The recently available microsatellite loci revealed useful markers to assess genetic differentiation between geographical populations of A. moucheti in Cameroon.

Alleles↗
PubMedDate not supplied

Co-endemicity of loiasis and onchocerciasis in the South West Province of Cameroon: implications for mass treatment with ivermectin.

Encephalopathy has been reported in Cameroon in individuals heavily infected with Loa loa microfilariae who were treated with ivermectin against onchocerciasis. Prior to the initiation of the community-directed treatment of onchocerciasis with ivermectin (CDTI) in the South West Province of Cameroon, an epidemiological survey of loiasis was conducted (in July 1998-July 1999) to ascertain the intensity of the disease. Thick blood films were made from 1228 blood samples collected during the day. Rapid epidemiological assessment (REA) of onchocerciasis was conducted among 614 individuals in the Upper Bayang area. Sixteen percent of the population examined were carriers of L. loa microfilariae. More males (20.1%) than females (12.4%) were infected. The community mean microfilaraemias of the different villages were low (< 1100 mf/mL). However, 1 person was found harbouring 174,000 mf/mL of blood and 1% of the study population (12) had microfilaraemia > 8100 mf/mL. Results of the REA of onchocerciasis show that 31.3% of the population investigated in the Upper Bayang area have this disease. These findings show that loiasis and onchocerciasis are co-endemic in the area, but the risk of developing encephalopathy after taking ivermectin is small.

Adolescent↗
PubMedDate not supplied

The increase in occurrence of typhoid fever in Cameroon: overdiagnosis due to misuse of the Widal test?

This study investigates the cause of an apparent increase in occurrence of typhoid fever in Cameroon. The reasons explored include an overdiagnosis of the illness related to poor performance of the Widal test in laboratories and interpretation by prescribers. Questionnaires were used in 1996 to evaluate the use and interpretation of the Widal test, and checklists were used to assess its laboratory performance in 2 of the 10 provinces in Cameroon. The majority of prescribers from 20 health facilities (an average of 76% of the doctors and 61% of the nurses) could detect patients who truly had positive Widal tests and needed treatment. However, an average of 48% of the doctors and 84% of the nurses would treat patients who did not require treatment based on the Widal test result. Patients may therefore be treated unnecessarily. Most (88%) of the visited laboratories performed the Widal rapid slide agglutination test as opposed to the conventional tube agglutination test. About 14% of the laboratories that performed the rapid slide agglutination test had a score above average for each criterion evaluated. Misdiagnosis of typhoid fever leads to unnecessary expenditure and exposure of patients to the side-effects of antibiotics. In addition, misdiagnosis may result in delayed diagnosis and treatment of malaria, and other acute febrile illness.

Agglutination Tests↗