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[Theater nurse and midwife in Cameroon. Impressions and experiences in the grasslands (Northwest Cameroon) during a six-and-a-half month stay in a hospital situated at a height of 1800 m].

The author describes the circumstances of the hospital and out-of-hospital situation in the region she worked in, in focussing on the relevant practical features of the daily life of patients and staff. She deals among other things with the maternity ward (including the separate "camp" devoted to prenatal stays) and the operating theatre. As regards health activities outside the hospital, she mentions those of the existing health centres and of auxiliary personnel called first-aiders (whose job description is close to the one of the village health workers advocated by WHO and others). A health team, usually led by a physician, makes periodic visits to bush villages. The importance of the contacts thus created, for health work itself (including collaboration with traditional health practitioners) as well as for community development, is underlined.

Cameroon

Genetic diversity and antifungal susceptibility among ecological niche populations of Aspergillus flavus in Yaoundé, 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

Genomic epidemiology of extended-spectrum beta-lactamase-producing Escherichia coli across humans, poultry and wastewater sectors in Douala, Cameroon.

BACKGROUND: The global health threat of antimicrobial resistance involves the human, animal and environmental sectors. Data from Cameroon are scarce. OBJECTIVES: This study aimed to define extended-spectrum beta-lactamase-producing Escherichia coli (ESBL-Ec) rates and associated risk factors across the three sectors in Douala, Cameroon, and to define molecular characteristics of isolates. METHODS: From June 2022 to May 2023, we collected blood cultures from hospitalized patients, rectal swabs from healthy pregnant women, caeca from broiler chickens and environmental wastewater. Samples were screened for ESBL-Ec using CHROMAgar™ ESBL and cefotaxime-supplemented Tryptone Bile X-glucuronide agar. Antimicrobial susceptibility testing was performed by disk diffusion following EUCAST guidelines. Whole-genome sequencing was carried out using Illumina technology. RESULTS: Of 628 samples, 374 yielded ESBL-Ec. Prevalence was 54.6% (131/240) in pregnant women, 70.4% (169/240) in chickens and 93.1% (67/72) in wastewater. The proportion of ESBL-Ec among E. coli-positive-blood cultures was 9.2% (7/76). Multi-family household living was independently associated with ESBL-Ec carriage among pregnant women (adjusted odds ratio = 1.7, 95% CI 1.0-3.1, P = 0.03). High co-resistance (>70%) was observed for tetracycline, ciprofloxacin and trimethoprim/sulfamethoxazole. Sequencing of 32 isolates revealed 45 distinct resistance genes, including blaCTX-M-15 (n = 13, 40.6%), blaCTX-M-55 (n = 11, 34.4%) and last-resort antibiotic resistance genes mcr-1 and bla OXA-181. High-risk sequence types included ST131 (pregnant women) and ST10 (chickens). Notably, ST48 was shared between pregnant women and chickens, and ST155 between pregnant women and wastewater. CONCLUSION: Cross-sectoral ESBL-Ec in Douala exhibits high genomic diversity and alarming resistance. The occurrence of last-resort genes requires immediate One Health surveillance and coordinated interventions.

Journal Article

A new potential mosquito-borne virus: detection of Human-derived Jingmenvirus in several-species of mosquitoes from Yaoundé, Cameroon.

BACKGROUND: Tick-borne Jingmenviruses are becoming an increasing arbovirus concern due to the rising number of reported infections in humans and animals, as well as their wide geographic distribution. The involvement of other hematophagous arthropods as vectors of Jingmenviruses is still unknown. METHODS: Mosquitoes were sampled in two different biotopes in Cameroon (Yaoundé and Garoua) during the rainy and the dry seasons in 2022 and 2023. Metatranscriptomics Next Generation Sequencing was conducted using Illumina technology. Viral sequences detection revealed the presence of several contigs with high sequence identity to a human-derived Jingmenvirus (HdJV) previously discovered in plasma from an individual from Yaoundé, Cameroon. A draft viral genome was constituted for each Jingmenvirus-positive samples. Maximum likelihood phylogenetic reconstructions were used to position mosquito-associated viruses within the diversity of Jingmenviruses. Statistical analyses were conducted to estimate the prevalence of infected mosquitoes and the effect of different variables (region, season, year, mosquito species) on Jingmenvirus detection. RESULTS: HdJV was identified during the dry and the rainy seasons in 4 species of mosquitoes: Aedes albopictus, Culex quinquefasciatus and Culex wansoni from Yaoundé, and Anopheles gambiae s.l. from Garoua. The overall prevalence of HdJV-infected mosquitoes was estimated to 0.90% [0.41-1.69]; and the unique variable significantly associated with HdJV detection was the sampling area: Yaoundé showed the highest prevalence (2.29% [0.95-4.68]) compared to Garoua (0.18% [0.01-0.79]). Mosquito-associated Jingmenviruses shared a high nucleotide identity (between 98.64-100% according to the segment) and clustered in the same clade in the phylogenetic analysis, that they belong to the same viral species circulating in different mosquito species. The viral genome shared between 96.4% and 98.9% nucleotide identity with a HdJV detected in the plasma of a patient suffering from febrile illness originating from the same area, suggesting the possible involvement of mosquitoes as vectors of arboviral Jingmenviruses in human infections. CONCLUSIONS: This finding provides new insights into the ecology and transmission dynamics of Jingmenviruses, highlighting mosquitoes as potential vectors, alongside ticks, in the zoonotic transmission of this virus group.

Jingmenvirus

[Epidemiologic study of dracunculosis in the Podokwos of the Mandara mountains (northern Cameroon)].

The purpose of the present work is the study of the epidemiological aspects of dracontiasis in an endemic area in Cameroon. The study was undertaken in the central Podokwo settlement in Mora subdivision. It is a mountainous area with a climate characterized by a long dry season, from October to mid-May, and a short rainy season. Two seasonal, streams run across the settlement. The water supply of the community is ensured throughout the year by two well built wells. During the rainy season, shallow unprotected wells are the water sources of about 80% of the inhabitants. Among the 944 subjects studied in our sample, 251 had the disease, corresponding to a prevalence of 26 6%. There is no significant difference between both sexes in the prevalence of the disease in our study. The age group 13-26 years is most affected. The worm load varies from 1 to 5, averagely 1.5. As to the localization of the worms in the body, in 92.7% of cases the worms is located in the lower limbs, the feet alone representing up to 46.8%. Less common sites of localization are the head, the breast, the external genitalia. The maximum rate of infestation is observed between August and September. Desinfection of wells with chemicals would be recommended during this period of time.

Adolescent

[Epidemiologic study of the focus of cutaneous leishmaniasis in Mokolo (North Cameroon)].

Fifty-eight patients with cutaneous leishmaniasis are studied in the North of Cameroon. All of them are living in an area located not further than 30 miles away from Mokolo. Both sexes are equally concerned. Young adults are representing the age group the most frequently infected. The greatest number of cases is observed in August and September during the rainy season. Uncovered parts of the body, the face and the limbs, are mostly concerned. They are only one, or more often many different lesions, which are separated one from the next, and which are evoluting naturally towards cicatrization, leaving usually a cicatricial mark. Diagnosis is achieved by discovering the Leishman-bodies in the smears or in the skin sections.

Adolescent

[Cameroon swelling; infection by the filaria Loa loa].

Recurrent skin edemata due to an infestation with the filaria Loa loa are called Cameroon or Calabar swellings. These are tense elastic, circumscribed, indolent swellings, which are just slightly red coloured and disappear within 24 to 48 hours. Intervals of several weeks or months may occur. One should think of Loa loa disease seeing travellers return from Loa endemic areas (West Africa) with recurrent, transitory edema and eosinophilia. The stay in these areas may have been several years before! Treatment and prophylaxis: Diethylcarbamazine.

Cameroon

[Epidemiological study of onchocercosis in 5 villages of the valley of the Sanaga (Cameroon)].

The study carried out in five villages in the Sanaga Valley of Cameroon was concerned with the prevalence of the disease, the level of infection and an evaluation of the effect of the parasites on the health of the people. Entomological data were also collected. The study was concerned with the onchocerciasis found in the forest area where the disease is hyperendemic. The males are infected moreoften than the females. Among the adults the skin and lymphatic lesions are extremly important. It was found that as the visual acuity diminishes with age, from age forty many for the people are blind. The villages most affected are those situated near the Sanaga rapids where there is a concentration of the breeding sites of the vectors.

Adolescent

Vascular lesions in testes associated with male infertility in Cameroon. Possible relationship to parasitic disease.

Testicular biopsies in 40 of 41 infertile males with severe oligospermia in Cameroon presented massive subendothelial "fibrinoid" deposits in the small and medium sized vessels. Fibrinogen, complement and IgM were demonstrated in these deposits by immunofluorescence. Evidence strongly suggestive of parasitic testicular involvement was also observed in 2 cases. It is postulated that the "fibrinoid" deposits are the result of repeated formation and deposition of circulating immune complexes by reaction of antibodies with antigens. These antigens could be of various origins and in the cases described here they could be derived from living or dying parasites in the region. The accumulation and incorporation of the "fibrinoid" deposits may lead to vascular stenosis resulting in chronic ischaemia, tubular atrophy and fibrosis, and finally oligospermia.

Adult