| 1. Title: Evaluation of transmitted HIV drug resistance among recently-infected antenatal clinic attendees in four Central African countries. Author: Aghokeng AF; Vergne L; Mpoudi-Ngole E; Mbangue M; Deoudje N; Mokondji E; Nambei WS; Peyou-Ndi MM; Moka JJ; Delaporte E; Peeters M Source: Antiviral therapy. 2009;14(3):401-11. Abstract: BACKGROUND: The rapid expansion of antiretroviral treatment in resource-limited settings is raising concerns regarding the emergence and transmission of HIV drug resistance (HIVDR). We evaluated the extent of transmission of drug-resistant HIV strains in four Central African countries: the Republic of Congo, Central African Republic, Chad and Cameroon. METHODS: The World Health Organization (WHO) HIVDR threshold survey was implemented in major treatment areas in each country. Pregnant women who were aged <25 years, who were at first pregnancy and who were HIV type-1-positive were enrolled at each site in 2006-2007 for genotyping. HIVDR prevalence was categorized using the WHO threshold survey binomial sequential sampling method. RESULTS: The prevalence of HIVDR in Brazzaville and Bangui sites could not be classified because the eligible sample number was not reached. HIVDR prevalence was low (<5%) in N'Djamena for all drug classes. In Yaounde, we found one individual with the D67D/N mutation and two with K103N. HIVDR prevalence was categorized as low (<5%) for protease inhibitors (PIs) and nucleoside reverse transcriptase inhibitors (NRTIs), and moderate (> or =5-< or =15%) for non-NRTIs (NNRTIs). HIVDR prevalence in Douala was low for PIs and NNRTIs, and moderate for NRTIs as we identified one individual with M184V plus K101E plus G190A mutations and a second with D67D/N. CONCLUSIONS: The moderate HIVDR prevalence found in Yaounde and Douala indicate that efforts should be made in Cameroon to prevent HIVDR; however, additional surveys are needed to confirm this trend. This study highlighted challenges presented by the WHO methodology, such as additional costs, workload, difficulties in acquiring even small sample numbers and the necessity for better quality assurance of HIV testing and record keeping at antenatal clinics. Language: English Keywords: CAMEROON | CENTRAL AFRICAN REPUBLIC | CHAD | REPUBLIC OF THE CONGO | RESEARCH REPORT | SAMPLING STUDIES | PREGNANT WOMEN | PERSONS LIVING WITH HIV/AIDS | HIV TRANSMISSION | ANTIRETROVIRAL DRUGS | DRUG RESISTANCE | PREVALENCE | ANTENATAL CARE | Developing Countries | Africa, Western | Africa, Sub Saharan | Africa | Africa, Central | Studies | Research Methodology | Population Characteristics | Demographic Factors | Population | HIV Infections | Viral Diseases | Diseases | Treatment | Medical Procedures | Medicine | Health Services | Delivery of Health Care | Health | Measurement | Maternal Health Services | Maternal-Child Health Services | Primary Health Care Document Number: 342346 |
| 2. Peer Reviewed Title: Financial barriers to HIV treatment in Yaounde, Cameroon: first results of a national cross-sectional survey. Author: Boyer S; Marcellin F; Ongolo-Zogo P; Abega SC; Nantchouang R; Spire B; Moatti JP Source: Bulletin of the World Health Organization. 2009 Apr;87(4):279-87. Abstract: OBJECTIVE: To assess the extent to which user fees for antiretroviral therapy (ART) represent a financial barrier to access to ART among HIV-positive patients in Yaounde, Cameroon. METHODS: Sociodemographic, economic and clinical data were collected from a random sample of 707 HIV-positive patients followed up in six public hospitals of the capital city (Yaounde) and its surroundings through face-to-face interviews carried out by trained interviewers independently from medical staff and medical questionnaires filled out by prescribing physicians. Logistic regression models were used to identify factors associated with self-reported financial difficulties in purchasing ART during the previous 3 months. FINDINGS: Of the 532 patients treated with ART at the time of the survey, 20% reported financial difficulty in purchasing their antiretroviral drugs during the previous 3 months. After adjustment for socioeconomic and clinical factors, reports of financial difficulties were significantly associated with lower adherence to ART (odds ratio, OR: 0.24; 95% confidence interval, CI: 0.15-0.40; P < 0.0001) and with lower CD4+ lymphocyte (CD4) counts after 6 months of treatment (OR: 2.14; 95% CI: 1.15-3.96 for CD4 counts < 200 cells/microl; P = 0.04). CONCLUSION: Removing a financial barrier to treatment with ART by eliminating user fees at the point of care delivery, as recommended by WHO, could lead to increased adherence to ART and to improved clinical results. New health financing mechanisms based on the public resources of national governments and international donors are needed to attain universal access to drugs and treatment for HIV infection. Language: English Keywords: CAMEROON | RESEARCH REPORT | CROSS SECTIONAL ANALYSIS | CLIENTS | PERSONS LIVING WITH HIV/AIDS | FEES | ANTIRETROVIRAL THERAPY | OBSTACLES | TREATMENT | ANTIRETROVIRAL DRUGS | PROGRAM ACCESSIBILITY | Developing Countries | Africa, Western | Africa, Sub Saharan | Africa | Research Methodology | Program Activities | Programs | Organization and Administration | HIV Infections | Viral Diseases | Diseases | Financial Activities | Economic Factors | HIV | Medical Procedures | Medicine | Health Services | Delivery of Health Care | Health | Program Evaluation Document Number: 342978 |
3.  Title: Is the process of diagnosing and treating incidental medical findings a barrier to contraceptive acceptance and use? Author: Ekabua JE; Ekabua KJ; Ekanem EI; Iklaki CU Source: Journal of Obstetrics and Gynaecology. 2009 Apr;29(3):237-9. Abstract: The objective of this study is to determine the impact of diagnosing and treating incidental medical disorders on contraceptive acceptance/use. The setting was the University of Calabar Teaching Hospital, a tertiary referral centre for the South-South zone of Nigeria and South-west Cameroon. Subjects were apparently healthy women seeking contraceptive counselling at the Teaching Hospital, Calabar (2001-2005). A total of 4,990 women's records were studied for the diagnosis of incidental medical findings. Two levels of missed opportunity for contraceptive uptake were identified. Incidental medical findings were seen in 26.9% of women. Contraceptive acceptance in women with incidental medical findings was 24.8%. Defaults from the screening process and treatment of incidental medical findings were significantly associated with high parity and low social status (p < 0.5). Incidental medical disorders, although uncommon in women desiring contraception were associated with low contraceptive uptake in women with high parity and low social status. Language: English Keywords: NIGERIA | CAMEROON | RESEARCH REPORT | KAP SURVEYS | CLINICAL RESEARCH | WOMEN IN DEVELOPMENT | EXAMINATIONS AND DIAGNOSES | SCREENING | PSYCHOSOCIAL FACTORS | CONTRACEPTIVE USAGE | MULTIPARITY | SOCIAL CLASS | Developing Countries | Africa, Western | Africa, Sub Saharan | Africa | Surveys | Sampling Studies | Studies | Research Methodology | Economic Development | Economic Factors | Medical Procedures | Medicine | Health Services | Delivery of Health Care | Health | Behavior | Contraception | Family Planning | Parity | Fertility Measurements | Fertility | Population Dynamics | Demographic Factors | Population | Socioeconomic Status | Socioeconomic Factors Document Number: 330945 |
| 4. Title: Dried blood spots versus plasma for the quantification of HIV-1 RNA using the manual (PCR-ELISA) amplicor monitor HIV-1 version 1.5 assay in Yaounde, Cameroon. Author: Ikomey GM; Atashili J; Okomo-Assoumou MC; Mesembe M; Ndumbe PM Source: Journal of the International Association of Physicians in AIDS Care. 2009 May-Jun;8(3):181-4. Abstract: OBJECTIVES: Considering the recent accrued need for viral load quantification in resource-limited settings, this study evaluated the use of dried blood spots (DBS) compared to plasma as a means of sample collection and storage for HIV-1 RNA quantification using a non-automated assay. METHODS: Venous blood was collected from 60 consenting HIV-1-positive patients, plasma separated within 4 hours, and stored at -20 degrees C. Venous blood, 50 microL, was blotted on 4 designated areas of Whatman filter paper and air-dried at room temperature for 2 hours. RESULTS: There was a strong statistically significant correlation between HIV-1 RNA viral load using plasma and DBS (r = .955, P < .001). On average plasma viral loads were only slightly higher than DBS viral loads (mean difference: 0.06 log(10) copies/mL). CONCLUSION: Even when using an entirely manual HIV-quantification assay, DBS may provide a reliable, cost-effective method for sample collection and storage for HIV-1 RNA quantification in resource-limited settings. Language: English Keywords: CAMEROON | RESEARCH REPORT | COMPARATIVE STUDIES | PERSONS LIVING WITH HIV/AIDS | CLIENTS | HEMATOLOGIC TESTS | MONITORING | LABORATORY PROCEDURES | COST EFFECTIVENESS | Developing Countries | Africa, Western | Africa, Sub Saharan | Africa | Studies | Research Methodology | HIV Infections | Viral Diseases | Diseases | Program Activities | Programs | Organization and Administration | Laboratory Examinations and Diagnoses | Examinations and Diagnoses | Medical Procedures | Medicine | Health Services | Delivery of Health Care | Health | Evaluation | Evaluation Indexes | Quantitative Evaluation Document Number: 342457 |
| 5. Peer Reviewed Title: Acceptability of intrapartum HIV counselling and testing in Cameroon. Author: Kongnyuy EJ; Mbu ER; Mbopi-Keou FX; Fomulu N; Nana PN; Tebeu PM; Tonye RN; Leke RJ Source: BMC Pregnancy and Childbirth. 2009;9:9. Abstract: BACKGROUND: To assess the acceptability of intrapartum HIV testing and determine the prevalence of HIV among labouring women with unknown HIV status in Cameroon. METHOD: The study was conducted in four hospitals (two referral and two districts hospitals) in Cameroon. Labouring women with unknown HIV status were counselled and those who accepted were tested for HIV. RESULTS: A total of 2413 women were counselled and 2130 (88.3%) accepted to be tested for HIV. Of the 2130 women tested, 214 (10.1%) were HIV positive. Acceptability of HIV testing during labour was negatively associated with maternal age, parity and number of antenatal visits, but positively associated with level of education. HIV sero-status was positively associated with maternal age, parity, number of antenatal visits and level education. CONCLUSION: Acceptability of intrapartum HIV testing is high and the prevalence of HIV is also high among women with unknown HIV sero-status in Cameroon. We recommend an opt-out approach (where women are informed that HIV testing will be routine during labour if HIV status is unknown but each person may decline to be tested) for Cameroon and countries with similar social profiles. Language: English Keywords: CAMEROON | RESEARCH REPORT | EPIDEMIOLOGIC METHODS | PREGNANT WOMEN | WOMEN IN DEVELOPMENT | PERSONS LIVING WITH HIV/AIDS | VOLUNTARY COUNSELING AND TESTING | CHILDBIRTH | PREVENTION OF MOTHER-TO-CHILD TRANSMISSION | MATERNAL AGE | PARITY | ANTENATAL CARE | CLINIC VISITS | EDUCATIONAL STATUS | PREVALENCE | Developing Countries | Africa, Western | Africa, Sub Saharan | Africa | Research Methodology | Population Characteristics | Demographic Factors | Population | Economic Development | Economic Factors | HIV Infections | Viral Diseases | Diseases | HIV Testing | Laboratory Examinations and Diagnoses | Examinations and Diagnoses | Medical Procedures | Medicine | Health Services | Delivery of Health Care | Health | Pregnancy Outcomes | Pregnancy | Reproduction | Disease Transmission Control | Prevention and Control | Parental Age | Age Factors | Fertility Measurements | Fertility | Population Dynamics | Maternal Health Services | Maternal-Child Health Services | Primary Health Care | Service Statistics | Program Activities | Programs | Organization and Administration | Socioeconomic Status | Socioeconomic Factors | Measurement Document Number: 331239 |
| 6. Peer Reviewed Title: Low levels of antiretroviral-resistant HIV infection in a routine clinic in Cameroon that uses the World Health Organization (WHO) public health approach to monitor antiretroviral treatment and adequacy with the WHO recommendation for second-line treatment. Author: Kouanfack C; Montavon C; Laurent C; Aghokeng A; Kenfack A; Bourgeois A; Koulla-Shiro S; Mpoudi-Ngole E; Peeters M; Delaporte E Source: Clinical Infectious Diseases. 2009 May 1;48(9):1318-22. Abstract: A cross-sectional study, performed at a routine human immunodeficiency virus (HIV)/AIDS clinic in Cameroon that uses the World Health Organization public health approach, showed low rates of virological failure and drug resistance at 12 and 24 months after initiation of antiretroviral therapy. Importantly, the cross-sectional study also showed that the World Health Organization recommendation for second-line treatment would be effective in almost all patients with HIV drug resistance mutations. Language: English Keywords: CAMEROON | RESEARCH REPORT | SUMMARY REPORT | EPIDEMIOLOGIC METHODS | CLINICAL RESEARCH | CROSS SECTIONAL ANALYSIS | PERSONS LIVING WITH HIV/AIDS | PREVALENCE | DRUG RESISTANCE | ANTIRETROVIRAL THERAPY | HIV INFECTIONS | WHO | MONITORING | STANDARDIZATION | CHROMOSOME ABNORMALITIES | Developing Countries | Africa, Western | Africa, Sub Saharan | Africa | Research Methodology | Viral Diseases | Diseases | Measurement | Treatment | Medical Procedures | Medicine | Health Services | Delivery of Health Care | Health | HIV | UN | International Agencies | Organizations | Political Factors | Sociocultural Factors | Evaluation | Data Adjustment | Neonatal Diseases and Abnormalities Document Number: 341154 |
| 7. Peer Reviewed Title: Early assessment of the implementation of a national programme for the prevention of mother-to-child transmission of HIV in Cameroon and the effects of staff training: a survey in 70 rural health care facilities. Author: Labhardt ND; Manga E; Ndam M; Balo JR; Bischoff A; Stoll B Source: Tropical Medicine and International Health. 2009 Mar;14(3):288-93. Abstract: OBJECTIVES: To assess the availability of equipment and the staff's knowledge to prevent Mother-To-Child Transmission (PMTCT) in rural healthcare facilities recently covered by the national PMTCT programme in Cameroon. METHODS: In eight districts inventories of antiviral drugs and HIV test kits were made on site, using a standardised check-list. Knowledge of HIV and PMTCT was evaluated with a multiple-choice (MC) questionnaire based on typical clinical PMTCT cases. Staff participated subsequently in a 2-day training on HIV/AIDS and the Cameroon PMTCT guidelines. Immediately after training and after 7 months, retention of knowledge was tested with the same questions but in different order and layout. RESULTS: Sixty two peripheral nurse-led clinics and the eight district hospitals were assessed. Whereas all district hospitals presented complete equipment, only six of the peripheral clinics (10%) were equipped with both complete testing materials and a full set of drugs to provide PMTCT. Thirty six peripheral facilities (58%) possessed full equipment for HIV-testing and 8 (13%) stocked all PMTCT drugs. Of 137 nurses, 102 (74%) agreed to the two knowledge tests. Fewer than 66% knew that HIV-diagnosis requires positive results in two different types of rapid tests and only 19% chose the right recommendation on infant-feeding for HIV-positive mothers. Correct answers on drug regimens in different PMTCT settings varied from 25% to 56%. All percentages of correct answers improved greatly with training (P < 0.001) and retention remained high 7 months after training (P < 0.001). CONCLUSIONS: Prevent Mother-To-Child Transmission programmes in settings such as rural Cameroon need to be adapted to the special needs of peripheral nurse-led clinics. Appropriate short training may considerably improve nurses' competence in PMTCT. Other important components are regular supervision and measures to guarantee supply of equipment in rural areas. Language: English Keywords: CAMEROON | EVALUATION REPORT | KAP SURVEYS | HEALTH PERSONNEL | INFANT | GOVERNMENT PROGRAMS | PREVENTION OF MOTHER-TO-CHILD TRANSMISSION | HIV PREVENTION | TRAINING PROGRAMS | RURAL HEALTH SERVICES | KNOWLEDGE | HIV TESTING | ANTIRETROVIRAL DRUGS | EQUIPMENT AND SUPPLIES | PROGRAM EVALUATION | Developing Countries | Africa, Western | Africa, Sub Saharan | Africa | Evaluation | Surveys | Sampling Studies | Studies | Research Methodology | Delivery of Health Care | Health | Youth | Age Factors | Population Characteristics | Demographic Factors | Population | Programs | Organization and Administration | Disease Transmission Control | Prevention and Control | Diseases | HIV Infections | Viral Diseases | Education | Health Services | Sociocultural Factors | Laboratory Examinations and Diagnoses | Examinations and Diagnoses | Medical Procedures | Medicine | Treatment Document Number: 330960 |
| 8. Peer Reviewed Title: Measure of viral load by using the Abbott Real-Time HIV-1 assay on dried blood and plasma spot specimens collected in 2 rural dispensaries in Cameroon. Author: Mbida AD; Sosso S; Flori P; Saoudin H; Lawrence P; Monny-Lobe M; Oyono Y; Ndzi E; Cappelli G; Lucht F; Pozzetto B; Oukem-Boyer OO; Bourlet T Source: Journal of Acquired Immune Deficiency Syndromes. 2009 Sep 1;52(1):9-16. Abstract: BACKGROUND: This study aimed to evaluate the use of dried blood spots (DBSs) and dried plasma spots (DPSs) locally collected in 2 rural dispensaries in Cameroon for the quantification of HIV-1 RNA. METHODS: Forty-one subjects were sampled and spots of whole blood and plasma were deposited onto Whatman 903 cards and dried at ambient temperature under local conditions. Two sets of DBS and DPS cards were done per patient. The rest of the liquid plasma (LP) was frozen until use. LPs were tested at the "Chantal Biya" International Reference Centre (Yaounde, Cameroon) by the Abbott Real-Time HIV-1 assay (Abbott Molecular Diagnostics, Wiesbaden, Germany). One series of DBS and DPS was transported and tested between 2 and 6 weeks later at the Virology Laboratory of Saint-Etienne (France). The second series was routed by mail and tested after up to 3 months of storage at ambient temperature. RESULTS: From the first series, the correlation rate between viral loads obtained from LP and DBS, and from LP and DPS, was 0.98 and 0.99, respectively; specificity of DBS and DPS results was 100%. The results obtained from the second series indicate a great stability of DBS after long-term storage. CONCLUSION: This study demonstrates that DBSs collected under local conditions in resource-limited settings are suitable for the differed quantification of HIV-1 RNA. Language: English Keywords: CAMEROON | RESEARCH REPORT | LABORATORY PROCEDURES | PERSONS LIVING WITH HIV/AIDS | BLOOD | HIV | HIV TESTING | HEMATOLOGIC TESTS | Developing Countries | Africa, Western | Africa, Sub Saharan | Africa | Laboratory Examinations and Diagnoses | Examinations and Diagnoses | Medical Procedures | Medicine | Health Services | Delivery of Health Care | Health | HIV Infections | Viral Diseases | Diseases | Hemic System | Physiology | Biology Document Number: 342882 |
| 9. Peer Reviewed Title: Human immunodeficiency virus infection and associated factors among specific population subgroups in Cameroon. Author: Mosoko JJ; Macauley IB; Zoungkanyi AC; Bella A; Koulla-Shiro S Source: AIDS and Behavior. 2009 Apr;13(2):277-287. Abstract: The objective of this study was to identify factors associated with HIV infection among specific population subgroups and complement the HIV surveillance system in Cameroon. Five subgroups (truck drivers, femalesex- workers, university students, health service providers, and residents along Chad-Cameroon petroleum pipeline) were targeted in 2004. Potential participants were approached at their geographically diverse areas and consented to participate in the study. Anonymous blood samples were collected. 4,011 participants were surveyed (35% students, 25% sex-workers, 20% pipeline residents, 12.5% health service providers, 7.5% truck drivers). HIV prevalence was highest among sex-workers [26.4%, (95% CI, 23.6-29.2)], pipeline residents [19.9% (95% CI, 17.1-22.7)] and truck drivers [16.3% (95% CI, 12.3-20.9))] and lowest among health service providers [5.2% (95% CI, 3.4-7.5)] and university students [3.8% (95% CI, 2.9-5.0)]. Risky sexual behaviours were practiced in all subpopulations. Multivariable analysis shows in female-sex-workers that; older age, residing in the grassland region (Northwest and West Provinces) and inconstant condom use were significantly associated with HIV infection. Despite a moderate HIV prevalence in the general Cameroonian population, some subgroups are at much higher risk for HIV transmission and practicing risky sexual behaviours. There is need for expanded prevention and care programs with emphasis on truck drivers, sex-workers and pipeline residents. Language: English Keywords: CAMEROON | RESEARCH REPORT | EPIDEMIOLOGIC METHODS | CLINICAL RESEARCH | PERSONS LIVING WITH HIV/AIDS | SEX WORKERS | WOMEN IN DEVELOPMENT | TRUCK DRIVERS | STUDENTS | HEALTH PERSONNEL | PREVALENCE | HIV INFECTIONS | SEX BEHAVIOR | RISK BEHAVIOR | AGE FACTORS | Developing Countries | Africa, Western | Africa, Sub Saharan | Africa | Research Methodology | Viral Diseases | Diseases | Behavior | Economic Development | Economic Factors | Labor Force | Human Resources | Education | Delivery of Health Care | Health | Measurement | Population Characteristics | Demographic Factors | Population Document Number: 340125 |
| 10. Title: Sex differentials in the use of centres for voluntary counselling and testing for HIV in Cameroon. Author: Ngwakongnwi E; Quan H Source: African Journal of AIDS Research. 2009 Apr;8(1):43-49. Abstract: Part of the strategic response to HIV in Cameroon, West Africa, has been the institutionalisation of voluntary testing and counselling (VCT) for HIV services across the country. The study addresses the general level of awareness and use of VCT centres in Cameroon. The data were extracted from the national, cross-sectional, 2004 Cameroon Demographic and Health Survey (DHS). The survey collected information on respondents' demographic characteristics and awareness and utilisation of VCT services, through a standard behavioural surveillance survey, administered in face-to-face interviews with males aged 15 years or older and females aged 15 to 49 years. Chi-square and logistic regression were employed for data analysis. A total of 5 280 males and 10 656 females responded to the 2004 Cameroon DHS. More of the male than female respondents had a secondary or higher education (51.8% versus 39%), slightly more of the males than females resided in urban areas (57.3% versus 54.8%), and males were more likely than females to have heard of VCT centres (37.8% versus 26.8%) and were also much more likely to have had an HIV test at a VCT centre (5.9% males versus 1.3% females). The findings indicate that awareness and use of centres offering VCT for HIV is very low in Cameroon. Further research in Cameroon is needed to assess individuals' reasons for not using VCT, as well as studies to identify patterns of information flow regarding the dissemination of knowledge about HIV and AIDS and about VCT centres. Language: English Keywords: CAMEROON | RESEARCH REPORT | DEMOGRAPHIC AND HEALTH SURVEYS | HOUSEHOLDS | VOLUNTARY COUNSELING AND TESTING | HIV PREVENTION | UTILIZATION OF HEALTH CARE | AWARENESS | KNOWLEDGE | SEX FACTORS | Developing Countries | Africa, Western | Africa, Sub Saharan | Africa | Demographic Surveys | Population Dynamics | Demographic Factors | Population | Family and Household | Sociocultural Factors | HIV Testing | Laboratory Examinations and Diagnoses | Examinations and Diagnoses | Medical Procedures | Medicine | Health Services | Delivery of Health Care | Health | HIV Infections | Viral Diseases | Diseases | Population Characteristics Document Number: 341286 |
| 11. Peer Reviewed Title: Adolescent pregnancies and deliveries: problems encountered. Author: Nkwabong E; Fomulu JN Source: Tropical Doctor. 2009 Jan;39(1):9-11. Abstract: Teenage pregnancies are increasing and need special attention. The aim of this retrospective study, conducted from 1 January 2004 to 31 December 2004 at the maternity department of the Yaounde University Teaching Hospital, Cameroon, was to analyze the evolution of pregnancy and delivery in primiparous teenagers. The medical files of 190 teenagers and 403 patients aged between 20 and 25 years were analyzed and compared. Mean gestational age, the rate of pregnancy-induced hypertensive disease and the caesarean section rate were similar in both groups. However, there were a greater number of low Apgar scores, vaginal tears and instrumental deliveries in teenagers. Those aged 15 years or less had the additional risk of an increased rate of preterm labour, low birth weight and early neonatal death. Therefore, pregnancies and deliveries among teenagers, especially those aged 15 years or less, should be monitored regularly. Language: English Keywords: CAMEROON | RESEARCH REPORT | CLINICAL RESEARCH | RETROSPECTIVE STUDIES | COMPARATIVE STUDIES | PREGNANT WOMEN | ADOLESCENTS, FEMALE | YOUTH | CHILDBIRTH | ADOLESCENT PREGNANCY | PRIMIPARITY | AGE FACTORS | PREGNANCY COMPLICATIONS | CESAREAN SECTION | PREMATURE BIRTH | Developing Countries | Africa, Western | Africa, Sub Saharan | Africa | Research Methodology | Studies | Population Characteristics | Demographic Factors | Population | Adolescents | Pregnancy Outcomes | Pregnancy | Reproduction | Reproductive Behavior | Fertility | Population Dynamics | Parity | Fertility Measurements | Diseases | Obstetrical Surgery | Surgery | Treatment | Medical Procedures | Medicine | Health Services | Delivery of Health Care | Health Document Number: 331070 |
| 12. Peer Reviewed Title: How long could we wait for the delivery of the second twin? Author: Nkwabong E; Kamgaing Noubi N; Dadje C; Mbu R Source: Tropical Doctor. 2009 Aug 11; Abstract: There is no consensus about the safe time interval between the deliveries of twins. This retrospective study, conducted from 1 January 2000 to 31 December 2004 at the University Teaching Hospital of Yaounde, Cameroon, was designed to evaluate the safe time interval between deliveries of twins. We analysed 268 twin deliveries. The mean time interval between twin deliveries was 10.0 +/- 7.9 minutes. The mean fetal weight of the first twin was 2416 +/- 565 g and that of the second was 2395 +/- 558 g. However, in 47.7% cases, the second twin was bigger than the first. When the second twin was delivered more than 30 minutes after the first, the mean 5 minute Apgar score was low. Therefore, efforts should be made to deliver the second twin within 30 minutes after the delivery of the first baby. Language: English Keywords: CAMEROON | RESEARCH REPORT | RETROSPECTIVE STUDIES | CHILDBIRTH | PREGNANCY | MULTIPLE BIRTH | TIME FACTORS | Developing Countries | Africa, Western | Africa, Sub Saharan | Africa | Studies | Research Methodology | Pregnancy Outcomes | Reproduction | Population Dynamics | Demographic Factors | Population Document Number: 342543 |
| 13. Title: Two vs. three sputum samples for microscopic detection of tuberculosis in a high HIV prevalence population. Author: Noeske J; Dopico E; Torrea G; Wang H; Van Deun A Source: International Journal of Tuberculosis and Lung Disease. 2009 Jul;13(7):842-7. Abstract: SETTING: A busy urban hospital in Cameroon. OBJECTIVES: To compare the yield in bacteriologically proven tuberculosis (TB) cases examining two morning vs. three spot-morning-spot sputum specimens (MM vs. SMS) by direct microscopy for acid-fast bacilli (AFB). DESIGN: Repeated temporal cross-over between MM and SMS sampling for successive TB suspects, using culture as gold standard. RESULTS: A total of 799 suspects were screened using the MM strategy, identifying 223 smear-positives, and 808 suspects with the SMS strategy, yielding 236 smear-positives. Of the MM, 256 were culture-positive, of whom 195 (76%) were smear-positive. For SMS, these figures were respectively 281 and 206 (73%), a non-significant difference. The MM and SMS strategies also detected respectively 28 and 30 smear-positive cases not confirmed by culture. No cases were lost to treatment with either strategy. CONCLUSIONS: In this population with a high prevalence of human immunodeficiency virus (HIV) with late case presentation, smear microscopy of two morning specimens detected at least as many positive cases as the classical strategy, and no cases were lost before treatment. Two specimens for initial TB suspect screening can thus be recommended, also without excessive workload. Comparative studies in populations presenting with paucibacillary sputum are needed to determine the equivalent quality and yield of an alternative strategy with two spot specimens at consultation. Language: English Keywords: CAMEROON | RESEARCH REPORT | COMPARATIVE STUDIES | CLIENTS | TUBERCULOSIS | LABORATORY EXAMINATIONS AND DIAGNOSES | HIV INFECTIONS | PREVALENCE | SCREENING | WHO | STANDARDS | Developing Countries | Africa, Western | Africa, Sub Saharan | Africa | Studies | Research Methodology | Program Activities | Programs | Organization and Administration | Infections | Diseases | Examinations and Diagnoses | Medical Procedures | Medicine | Health Services | Delivery of Health Care | Health | Viral Diseases | Measurement | UN | International Agencies | Organizations | Political Factors | Sociocultural Factors Document Number: 342823 |
| 14. Peer Reviewed Title: Spousal violence and spontaneous fetal loss [letter] Author: Shelton JD; Adetunji J Source: Lancet. 2009 May 2;373(9674):1520; author reply 1520-1. Abstract: Amina Alio and colleagues (Jan 24, p 318) make an admirable effort to unravel a myriad of confounders to explain their finding of a statistical relation between spousal violence and spontaneous fetal loss. Spousal violence is clearly deplorable. But, as Alio and colleagues note, it included a wide range of behaviours, including "saying something to humiliate" and pushing and twisting the arm, as well as more violent acts. A biological explanation for such spousal violence "ever" to account for a 50% increase in fetal loss "ever" does not seem obvious. Another explanation is major misclassification with induced abortion. Although the 2004 Demographic and Health Survey instrument for Cameroon attempted to distinguish between the two, responses on numbers of induced abortions, spontaneous abortions, and still births were contained within the same question. It would be easy for respondents to report induced abortions as spontaneous. Induced abortion is notoriously underreported, especially in countries such as Cameroon where it is illegal. On the other hand, both induced abortion and spousal violence might be common markers of other factors such as relationship stress or other dysfunction and thus lead to a spurious finding. There is a response from Amina Alio included. Language: English Keywords: CAMEROON | CRITIQUE | RESEARCH REPORT | METHODOLOGICAL STUDIES | CLASSIFICATION | DEMOGRAPHIC AND HEALTH SURVEYS | SPOUSE | WOMEN IN DEVELOPMENT | PREGNANT WOMEN | DOMESTIC VIOLENCE | ABORTION, SPONTANEOUS | ABORTION | FETAL DEATH | Developing Countries | Africa, Western | Africa, Sub Saharan | Africa | Studies | Research Methodology | Demographic Surveys | Population Dynamics | Demographic Factors | Population | Family Relationships | Family Characteristics | Family and Household | Sociocultural Factors | Economic Development | Economic Factors | Population Characteristics | Crime | Social Problems | Pregnancy Complications | Diseases | Fertility Control, Postconception | Family Planning | Mortality Document Number: 341098 |
| 15. Peer Reviewed Title: Determinants of survival in AIDS patients on antiretroviral therapy in a rural centre in the Far-North Province, Cameroon. Author: Sieleunou I; Souleymanou M; Schonenberger AM; Menten J; Boelaert M Source: Tropical Medicine and International Health. 2009 Jan;14(1):36-43. Abstract: OBJECTIVE: To analyse the outcomes of antiretroviral therapy (ART) in routine conditions in a rural hospital in the Far-North province of Cameroon. METHOD: Retrospective cohort study of 1187 patients >15 years who started ART between July 2001 and December 2006. The survival time was estimated by Kaplan-Meier analysis and Cox proportional hazard models were fitted to explain survival. RESULTS: Upon enrollment, 90.4% patients were in WHO stage III or IV and 56.1% had a BMI <18.5. Median CD4 count was 105 cells/mm(3) (IQR 40-173). At the end of the study period, 338/1187 had died and 59/1187 were lost to follow-up. The survival probability was 77% at 1 year [95% CI: 75-80] and 47% at 5 years [95% CI: 40-55]. The median survival time was 58 months. CD4 count, haemoglobin, BMI, sex and clinical stage at enrollment were independent predictors of mortality. CONCLUSION: This study confirms the clinical benefit of ART programs in a remote and resource-constrained setting operating in routine conditions. The challenge ahead is to secure earlier access to ART and to maintain its longer-term benefit. Language: English Keywords: CAMEROON | RESEARCH REPORT | CLINICAL RESEARCH | LONGITUDINAL STUDIES | RETROSPECTIVE STUDIES | COHORT ANALYSIS | RURAL POPULATION | HIV INFECTIONS | ANTIRETROVIRAL THERAPY | TIME FACTORS | SURVIVORSHIP | Africa, Western | Africa, Sub Saharan | Africa | Developing Countries | Research Methodology | Studies | Population Characteristics | Demographic Factors | Population | Viral Diseases | Diseases | HIV | Population Dynamics | Length of Life | Mortality Document Number: 330263 |
| 16. Title: Involving new actors to achieve ART scaling-up: difficulties in an HIV/AIDS counselling and testing centre in Cameroon. Author: Yakam JC; Gruenais ME Source: International Nursing Review. 2009 Mar;56(1):50-7. Abstract: BACKGROUND: The high HIV/AIDS-related mortality among young adults is devastating countries in sub-Saharan Africa. The implementing capacity of the health systems is the main limiting factor of antiretroviral treatment (ART) scaling-up;(1) this capacity depends mainly on the health workforce. Tackling the issue of human resources for health is thus of paramount importance to achieve universal access to ART and for the survival of health systems in time of AIDS. To support such a process, the World Health Organization stresses the importance of task shifting(2) from medical doctors to nurses and from nurses to community health workers. Such task shifting is not easy to achieve but undoubtedly needed. STUDY OBJECTIVE: This paper raises issues about the involvement of new actors(3) without precise redefinitions of roles and task-shifting procedures. We take the example of a 'Centre de Prevention et de Depistage Volontaire du VIH/sida'(4) in one major town of the Far-North province of Cameroon (Central Africa). METHODOLOGY: The study was qualitative. Observations were carried out in the service and in-depth interviews conducted with health workers and actors of Cameroon's National AIDS Control Committee. These interviews were recorded and transcribed. The material was analysed using keywords. KEY RESULT: The involvement of new actors in a context of human resources for health shortage and health system crisis creates confusion and role conflicts, which lead to frustration. It favours the appearance of chinks within which these new actors slip and 'find their way' in the system; it finally raises problems related to their legitimacy and position within the existing hierarchy. KEY POLICY MESSAGE: It is necessary, when involving new staff members (particularly when they do not belong to internationally recognized health professionals such as nurses, doctors and pharmacists), to redefine roles and build precise task-shifting procedures so that everyone may still have a place in the whole system and feel useful. Language: English Keywords: CAMEROON | RESEARCH REPORT | KAP SURVEYS | HEALTH PERSONNEL | ANTIRETROVIRAL THERAPY | CAPACITY BUILDING | VOLUNTARY COUNSELING AND TESTING | HIV TESTING | HUMAN RESOURCES | PROGRAM ACCESSIBILITY | PARTICIPATION | Developing Countries | Africa, Western | Africa, Sub Saharan | Africa | Surveys | Sampling Studies | Studies | Research Methodology | Delivery of Health Care | Health | HIV | HIV Infections | Viral Diseases | Diseases | Program Sustainability | Programs | Organization and Administration | Laboratory Examinations and Diagnoses | Examinations and Diagnoses | Medical Procedures | Medicine | Health Services | Economic Factors | Program Evaluation | Social Behavior | Behavior Document Number: 330984 |
| 17. Peer Reviewed Title: Febrile status, malarial parasitaemia and gastro-intestinal helminthiases in schoolchildren resident at different altitudes, in south-western Cameroon. Author: Achidi EA; Apinjoh TO; Mbunwe E; Besingi R; Yafi C Source: Annals of Tropical Medicine and Parasitology. 2008;102(2):103-118. Abstract: In the many areas where human malaria and helminthiases are co-endemic, schoolchildren often harbour the heaviest infections and suffer much of the associated morbidity, especially when co-infected. In one such area, the Buea district, in south-western Cameroon, two cross-sectional surveys, together covering 263 apparently healthy schoolchildren aged 4-12 years, were recently conducted. The prevalences of fever, malarial parasitaemia and intestinal helminth infections, the seroprevalences of anti-Plasmodium falciparum IgG and IgE and antiglycosylphosphatidylinositol (anti-GPI) IgG, plasma concentrations of total IgE, and the incidence of anaemia were all investigated. The mean (S.D.) age of the study children was 7.56 (1.82) years. Overall, 156 (59.3%) of the children were found parasitaemic, with a geometric mean parasitaemia of 565 parasites/ml. Parasitaemia and fever were significantly associated (P = 0.042). The children who lived at low altitude, attending schools that lay 400-650 m above sealevel, had significantly higher parasitaemias than their high-altitude counterparts (P less than 0.01). At low altitude, the children attending government schools had significantly higher parasitaemias than their mission-school counterparts (P = 0.010). Of the 31 children (11.9%) found anaemic, 22 (70.4%) had mild anaemia and none had severe anaemia. A significant negative correlation (r = -0.224; P = 0.005) was observed between haemoglobin concentration and level of parasitaemia. Infection with Plasmodium appeared to reduce erythrocyte counts (P = 0.045), a condition that was exacerbated by co-infection with helminths (P = 0.035). Plasma concentrations of total IgE were higher in the children found to be excreting helminth eggs than in those who appeared helminth-free, while levels of anti-P. falciparum IgE were higher in the children with low-grade parasitaemias than in those with more intense parasitaemias. Levels of anti-GPI IgG increased with age and were relatively high in the children who lived at lowaltitude and in those who were aparasitaemic. The survey results confirm that asymptomatic malarial parasitaemia frequently co-exists with helminth infections in schoolchildren and indicate links with fever, altitude and school type. Immunoglobulin E may play a role in immune protection against helminthiasis whereas anti-GPI antibodies may be important in the development of antimalarial immunity in such children. In Cameroon, as in other areas with endemic malaria, control programmes to reduce the prevalences of infections with intestinal helminths and malarial parasites in schoolchildren, which may effectively reduce the incidence of anaemia, are clearly needed. (author's) Language: English Keywords: CAMEROON | RESEARCH REPORT | CROSS SECTIONAL ANALYSIS | CHILD | ALTITUDE | INFECTIONS | MORBIDITY | FEVER | MALARIA | SIGNS AND SYMPTOMS | ANEMIA | LABORATORY EXAMINATIONS AND DIAGNOSES | IMMUNOLOGIC FACTORS | Developing Countries | Africa, Western | Africa, Sub Saharan | Africa | Research Methodology | Youth | Age Factors | Population Characteristics | Demographic Factors | Population | Environment | Diseases | Body Temperature | Physiology | Biology | Parasitic Diseases | Examinations and Diagnoses | Medical Procedures | Medicine | Health Services | Delivery of Health Care | Health | Immunity | Immune System Document Number: 325068 |
| 18. Peer Reviewed Title: HIV status and age at first marriage among women in Cameroon. Author: Adair T Source: Journal of Biosocial Science. 2008 Sep;40(5):743-760. Abstract: Recent research has highlighted the risk of HIV infection for married teenage women compared with their unmarried counterparts. This study assesses whether a relationship exists, for women who have completed their adolescence (age 20-29 years), between HIV status with age at first marriage and the length of time between first sex and first marriage. Multivariate analysis utilizing the nationally representative 2004 Cameroon Demographic and Health Survey shows that late-marrying women and those with a longer period of pre-marital sex have the highest risk of HIV. Although women in urban areas overall marry later than their rural counterparts, the positive relationship between age at marriage and HIV risk is stronger in rural areas. The higher wealth status and greater number of lifetime sexual partners of late-marrying women contribute to their higher HIV risk. Given that the age at first marriage and the gap between first marriage and first sex have increased in recent years, focusing preventive efforts on late-marrying women will be of much importance in reducing HIV prevalence among females. (author's) Language: English Keywords: CAMEROON | RESEARCH REPORT | EPIDEMIOLOGIC METHODS | DEMOGRAPHIC AND HEALTH SURVEYS | WOMEN IN DEVELOPMENT | ADOLESCENTS, FEMALE | MARRIAGE AGE | HIV INFECTIONS | CHILD MARRIAGE | FIRST INTERCOURSE | PREVALENCE | PREMARITAL SEX BEHAVIOR | RISK FACTORS | SOCIOECONOMIC FACTORS | DEMOGRAPHIC FACTORS | Developing Countries | Africa, Western | Africa, Sub Saharan | Africa | Research Methodology | Demographic Surveys | Population Dynamics | Population | Economic Development | Economic Factors | Adolescents | Youth | Age Factors | Population Characteristics | Marriage Patterns | Marriage | Nuptiality | Viral Diseases | Diseases | Sex Behavior | Behavior | Measurement | Biology Document Number: 313960 |
19.  Title: Men's condom use in higher-risk sex: Trends and determinants in five Sub-Saharan countries. Author: Adair T Source: Calverton, Maryland, Macro International, MEASURE DHS, 2008 Apr. 29 p. (DHS Working Papers No. 34USAID Contract No. GPO-C-00-03-00002-00) Abstract: This paper examines men's condom use at last higher-risk sex (i.e., nonmarital, noncohabiting partner) in five sub-Saharan countries: Burkina Faso, Cameroon, Kenya, Tanzania, and Zambia. The two most recent Demographic and Health Surveys (DHS) in each country are analyzed to show trends in various indicators. Condom use is an important way to prevent the transmission of HIV, the virus that causes AIDS. Encouragingly, use of condoms has increased substantially in Burkina Faso, Cameroon, and Tanzania, with smaller increases in Kenya and Zambia. At the same time, levels of higher-risk sex have declined in four of the five countries, although use of a condom at last higher-risk sex remains below 50 percent in Kenya and Zambia. Multivariate analysis shows that higher education is a consistently strong, positive predictor of condom use at last higher-risk sex, whereas higher wealth status is not significant in most surveys. Knowledge that use of condoms can reduce the risk of HIV transmission is a consistently strong, positive predictor of condom use, but urban-rural residence and region are significant only in some surveys. Comparing the two most recent DHS surveys in each of the five countries, there are no clear patterns of change in the predictive strength of explanatory variables. However, there is evidence of widening gaps in condom use by level of education in Cameroon and by urban-rural residence in Kenya. One important policy finding that emerged from this study is that low wealth status is not a barrier to condom use in most countries, but lack of education is. (author's) Language: English Keywords: BURKINA FASO | CAMEROON | KENYA | TANZANIA | ZAMBIA | RESEARCH REPORT | DEMOGRAPHIC AND HEALTH SURVEYS | MULTIVARIATE ANALYSIS | MEN | CONDOM USE | RISK BEHAVIOR | EDUCATIONAL STATUS | Developing Countries | Africa, Western | Africa, Sub Saharan | Africa | Africa, Eastern | Africa, Southern | Demographic Surveys | Population Dynamics | Demographic Factors | Population | Data Analysis | Research Methodology | Risk Reduction Behavior | Behavior | Socioeconomic Status | Socioeconomic Factors | Economic Factors Document Number: 326392 |
| 20. Peer Reviewed Title: Malaria transmission and rice cultivation in Lagdo, northern Cameroon. Author: Antonio-Nkondjio C; Atangana J; Ndo C; Awono-Ambene P; Fondjo E Source: Transactions of the Royal Society of Tropical Medicine and Hygiene. 2008 Apr;102(4):352-359. Abstract: Cross-sectional entomological surveys were carried out during the 2006 dry and rainy seasons in Lagdo, Cameroon to measure the impact of rice cultivation on malaria transmission and to monitor vector susceptibility to insecticides. Adult anopheline mosquitoes were captured on human volunteers and by pyrethrum spray collections. A total of 4740 mosquitoes was collected during the study. Anopheles arabiensis was the major species and the main malaria vector in all study sites, followed by A. funestus. Malaria transmission was high in the non-irrigated zone of Mayo Mbocki, whereas in the irrigated area of Gounougou it was below detection level during the dry season and high during the rainy season. Insecticide susceptibility tests performed on A. gambiae s.l. populations detected resistance to lambdacyhalothrin and to a lower extent to deltamethrin. All survivors were A. arabiensis. None of the surviving mosquitoes carried the kdr mutation, suggesting an alternative resistance mechanism. (author's) Language: English Keywords: CAMEROON | RESEARCH REPORT | CROSS SECTIONAL ANALYSIS | AGRICULTURAL WORKERS | MALARIA | TRANSMISSION | AGRICULTURE | INSECTS | PESTICIDES | DRUG RESISTANCE | VECTOR CONTROL | IRRIGATION | Developing Countries | Africa, Western | Africa, Sub Saharan | Africa | Research Methodology | Labor Force | Human Resources | Economic Factors | Parasitic Diseases | Diseases | Infections | Macroeconomic Factors | Disease Transmission Control | Prevention and Control | Ingredients and Chemicals | Treatment | Medical Procedures | Medicine | Health Services | Delivery of Health Care | Health Document Number: 325274 |
| 21. Title: Analyzing the origin of armed conflicts and their impact on women: the case of western Cameroon. Author: Bechon CR Source: Women's World. 2008;43:19-23. Abstract: Language: English Keywords: CAMEROON | HISTORICAL REVIEW | EVALUATION | WOMEN IN DEVELOPMENT | ORPHANS AND VULNERABLE CHILDREN | WAR | COLONIALISM | HUMAN RIGHTS | SOCIOECONOMIC FACTORS | POLITICAL FACTORS | LAND TENURE | AGRICULTURE | VIOLENCE AGAINST WOMEN | WOMEN'S RIGHTS | Developing Countries | Africa, Western | Africa, Sub Saharan | Africa | Economic Development | Economic Factors | Family and Household | Sociocultural Factors | Political Systems | Macroeconomic Factors | Domestic Violence | Crime | Social Problems Document Number: 331340 |
| 22. Title: Anthropometric measurements of children attending a vaccination clinic in Yaounde, Cameroon. Author: Chiabi A; Tchokoteu PF; Takou V; Fru F; Tchouine F Source: African Health Sciences. 2008 Sep;8(3):174-179. Abstract: Growth faltering is a frequent public health problem in children and anthropometric measurements are useful tools for follow-up and early diagnosis. This problem has not been studied in the Cameroonian setting, that's why we undertook this study. To have a synopsis of the nutritional status in apparently healthy children attending a vaccination clinic and show the importance of anthropometric measurements in routine child health care. 1351 children aged (6-24 months), who attended the vaccination clinic of the Yaounde Gynaeco-Obstetric and Pediatric Hospital over a 6 month period, were enrolled in the study. The registers of the vaccination clinic of the above hospital were retrospectively reviewed from 1st March to 31st August 2005. The following parameters were noted: age, height, weight, mid-upper arm circumference (MUAC), and Z scores calculated for the following indicators: weight for age (WAZ), weight for height (WHZ), and height for age (HAZ). Our results show that 12 children (1.1 percent) in the 0-6 months age group and 4 (1.6 percent) in the 6-12 months age group had WAZ less than -2 indicating underweight. Also 10 children (0.9 percent) and 2 (0.8 percent) in the 0-6 and 6-12 months age groups respectively had WHZ less than -2, indicating wasting. HAZ was less than -2 in 70 children (6.4 percent) and in 8 (3.2 percent) in the 0-6 and 6-12 months age groups respectively indicating stunting. The MUAC was less than 12.5 cm in 6 children (2.4 percent). From our results, we conclude that growth faltering is common in supposedly healthy children attending our vaccination clinic. Anthropometric measurements are thus recommended and should be encouraged in routine child care settings for early diagnosis of growth retardation and to provide useful interventions. Language: English Keywords: CAMEROON | RESEARCH REPORT | CLINICAL RESEARCH | RETROSPECTIVE STUDIES | CHILDREN | ANTHROPOMETRY | GROWTH | PHYSICAL EXAMINATIONS AND DIAGNOSES | CHILD NUTRITION | BODY WEIGHT | AGE FACTORS | BODY HEIGHT | Africa, Western | Africa, Sub Saharan | Africa | Developing Countries | Research Methodology | Studies | Youth | Population Characteristics | Demographic Factors | Population | Measurement | Child Development | Biology | Examinations and Diagnoses | Medical Procedures | Medicine | Health Services | Delivery of Health Care | Health | Nutrition | Physiology Document Number: 323087 |
| 23. Title: Anthropometric measurements of children attending a vaccination clinic in Yaounde, Cameroon. Author: Chiabi A; Tchokoteu PF; Takou V; Fru F; Tchouine F Source: African Health Sciences. 2008 Sep;8(3):174-9. Abstract: BACKGROUND: Growth faltering is a frequent public health problem in children and anthropometric measurements are useful tools for follow-up and early diagnosis. This problem has not been studied in the Cameroonian setting, that's why we undertook this study. OBJECTIVES: To have a synopsis of the nutritional status in apparently healthy children attending a vaccination clinic and show the importance of anthropometric measurements in routine child health care. DESIGN: A retrospective study. PATIENTS AND PARTICIPANTS: 1351 children aged (6-24 months), who attended the vaccination clinic of the Yaounde Gynaeco-Obstetric and Pediatric Hospital over a 6 month period, were enrolled in the study. METHOD: The registers of the vaccination clinic of the above hospital were retrospectively reviewed from 1st March to 31st August 2005. The following parameters were noted: age, height, weight, mid-upper arm circumference (MUAC), and Z scores calculated for the following indicators: weight for age (WAZ), weight for height (WHZ), and height for age (HAZ). RESULTS: Our results show that 12 children (1.1 percent) in the 0-6 months age group and 4 (1.6 percent) in the 6-12 months age group had WAZ less than -2 indicating underweight. Also 10 children (0.9 percent) and 2 (0.8 percent) in the 0-6 and 6-12 months age groups respectively had WHZ less than -2, indicating wasting. HAZ was less than -2 in 70 children (6.4 percent) and in 8 (3.2 percent) in the 0-6 and 6-12 months age groups respectively indicating stunting. The MUAC was less than 12.5 cm in 6 children (2.4 percent). CONCLUSIONS: From our results, we conclude that growth faltering is common in supposedly healthy children attending our vaccination clinic. Anthropometric measurements are thus recommended and should be encouraged in routine child care settings for early diagnosis of growth retardation and to provide useful interventions. Language: English Keywords: CAMEROON | RESEARCH REPORT | CLINICAL RESEARCH | RETROSPECTIVE STUDIES | CHILDREN | ANTHROPOMETRY | IMMUNIZATION | GROWTH | CHILD NUTRITION | DEFICIENCY DISEASES | MALNUTRITION | AGE FACTORS | BODY HEIGHT | BODY WEIGHT | Developing Countries | Africa, Western | Africa, Sub Saharan | Africa | Research Methodology | Studies | Youth | Population Characteristics | Demographic Factors | Population | Measurement | Primary Health Care | Health Services | Delivery of Health Care | Health | Child Development | Biology | Nutrition | Nutrition Disorders | Diseases | Physiology Document Number: 331275 |
| 24. Peer Reviewed Title: Dynamics of insecticide resistance in the malaria vector Anopheles gambiae s.l. from an area of extensive cotton cultivation in Northern Cameroon. Author: Chouaibou M; Etang J; Brevault T; Nwane P; Hinzoumbe CK Source: Tropical Medicine and International Health. 2008 Apr;13(4):476-486. Abstract: The objective was to explore temporal variation in insecticide susceptibility of Anopheles gambiae s.l. populations to the four chemical groups of insecticides used in public health and agriculture, in close match with the large-scale cotton spraying programme implemented in the cotton-growing area of North Cameroon. Mosquito larvae were collected in 2005 before (mid June), during (mid August) and at the end (early October) of the cotton spraying programme. Larvae were sampled in breeding sites located within the cotton fields in Gaschiga and Pitoa, and in Garoua, an urban cotton-free area that served as a control. Insecticide susceptibility tests were carried out with 4% DDT (organochlorine), 0.4% chlorpyrifos methyl (organophosphate), 0.1% propoxur (carbamate), 0.05% deltamethrin and 0.75% permethrin (pyrethroids). Throughout the survey, An. gambiae s.l. populations were completely susceptible to carbamate and organophosphate, whereas a significant decrease of susceptibility to organochlorine and pyrethroids was observed during spraying in cotton-growing areas. Tolerance to these insecticides was associated with a slight increase of knockdown times compared to the reference strain. Among survivor mosquitoes, the East and West African Kdr mutations were detected only in two specimens of An. gambiae s.s. (n = 45) and not in Anopheles arabiensis (n = 150), suggesting metabolic-based resistance mechanisms. Environmental disturbance due to the use of insecticides in agriculture may provide local mosquito populations with the enzymatic arsenal selecting tolerance to insecticides. (author's) Language: English Keywords: CAMEROON | RESEARCH REPORT | INSECTS | MALARIA | PARASITE CONTROL | INGREDIENTS AND CHEMICALS | DRUG RESISTANCE | METABOLIC EFFECTS | PUBLIC HEALTH | AGRICULTURE | ENVIRONMENT | Developing Countries | Africa, Western | Africa, Sub Saharan | Africa | Disease Transmission Control | Prevention and Control | Diseases | Parasitic Diseases | Health | Treatment | Medical Procedures | Medicine | Health Services | Delivery of Health Care | Physiology | Biology | Macroeconomic Factors | Economic Factors Document Number: 325994 |
| 25. Peer Reviewed Title: Young women's perceived ability to refuse sex in urban Cameroon. Author: Hattori MK; DeRose L Source: Studies in Family Planning. 2008 Dec;39(4):309-320. Abstract: In many sub-Saharan African countries, young women face decreasing educational opportunities, age asymmetries between sexual partners, and high prevalence of HIV infection. This study draws upon data from the 2002 Cameroon Adolescent Reproductive Health Survey to analyze the determinants of young women's perceived ability to refuse sex in urban Cameroon. Our findings are consistent with predictions of social exchange theory: young women's status characteristics predict their vulnerability differently under different circumstances, and, overall, young women report having a lower ability to refuse sex in their relationships with men who offer to pay their school fees than in their relationships with men in positions of power over them. The costs and benefits of sexual exchanges made in order to continue one's education increase simultaneously in a context of declining enrollments and spreading HIV infection. When educational aspirations exceed opportunities, policy supporting access to education could reduce young women's need to employ their sexual resources in order to invest in their future. Language: English Keywords: CAMEROON | RESEARCH REPORT | KAP SURVEYS | HEALTH SURVEYS | COST BENEFIT ANALYSIS | WOMEN IN DEVELOPMENT | URBAN POPULATION | ADOLESCENTS | PERCEPTION | SEXUAL INTERCOURSE | DECISION MAKING | WOMEN'S STATUS | MICROECONOMIC FACTORS | SCHOOL ENROLLMENT | HIV TRANSMISSION | Africa, Western | Africa, Sub Saharan | Africa | Developing Countries | Surveys | Sampling Studies | Studies | Research Methodology | Health | Quantitative Evaluation | Evaluation | Economic Development | Economic Factors | Population Characteristics | Demographic Factors | Population | Youth | Age Factors | Psychological Factors | Behavior | Reproduction | Socioeconomic Factors | Educational Status | Socioeconomic Status | HIV Infections | Viral Diseases | Diseases Document Number: 328193 |
| 26. Title: Indicators of anaemia in under-fives with malaria at a hospital in northern Cameroon. Author: Jourdan PM; Laoussou P; Lybie A; Kjetland EF Source: West African Journal of Medicine. 2008 Jan;27(1):7-12. Abstract: BACKGROUND: Severe malarial anaemia accounts for nearly one million deaths annually in under-fives in Africa. OBJECTIVE: To describe the clinical and social indicators of anaemia in under-fives with malaria seeking healthcare at a hospital in northern Cameroon. METHODS: This cross-sectional study included 91 consecutive patients below the age of 60 months in whom malaria was diagnosed by symptomatic fever and microscopic examination. Patients were clinically investigated and mothers questioned on related clinical and social aspects. RESULTS: Anaemia (haemoglobin less than 110 g/L) was detected in 69 (82%), and a high parasite load (more than 100 Plasmodia per 100 high-power fields) in 24 (26%) of the patients. Clinical findings were associated with the levels of haemoglobin, rather than the parasite load in a single blood slide. Anaemia was found significantly more often in children between the ages of 12 and 23 months and in patients born at home (p = 0.035 and p = 0.048 respectively). Severe anaemia (haemoglobin less than 50 g/L) was found significantly more often in patients who had not been vaccinated (p = 0.008). CONCLUSION: Anaemia is an important health issue in this population. Clinical signs appear to be associated with the haemoglobin status of the patient rather than the parasite load determined in a single blood slide. Recently weaned children and children of mothers with low socio-economic status and who do not usually use the hospital services, may need particular attention in prevention of anaemia. Further studies are required in order to establish cost-effective interventions against anaemia in under-fives in northern Cameroon. Language: English Keywords: CAMEROON | RESEARCH REPORT | CROSS SECTIONAL ANALYSIS | CHILDREN | ANEMIA | MALARIA | EXAMINATIONS AND DIAGNOSES | Developing Countries | Africa, Western | Africa, Sub Saharan | Africa | Research Methodology | Youth | Age Factors | Population Characteristics | Demographic Factors | Population | Diseases | Parasitic Diseases | Medical Procedures | Medicine | Health Services | Delivery of Health Care | Health Document Number: 328719 |
| 27. Peer Reviewed Title: After a decade of annual dose mass ivermectin treatment in Cameroon and Uganda, onchocerciasis transmission continues. Author: Katabarwa M; Eyamba A; Habomugisha P; Lakwo T; Ekobo S; Kamgno J; Kuete T; Ndyomugyenyi R; Onapa A; Salifou M; Ntep M; Richards FO Source: Tropical Medicine and International Health. 2008 Sep;13(9):1196-203. Abstract: OBJECTIVE: To evaluate the effectiveness of 10 years' annual single dose ivermectin treatment on onchocerciasis transmission in hyperendemic areas of Cameroon and Uganda. METHODS: Baseline nodule and microfilaria ('skin snip') prevalence data were available from 10 hyperendemic sentinel communities in Cameroon (from 1996) and hyperendemic 20 sentinel communities in Uganda (from 1993). We returned to these villages in 2005, 10 months after the last annual ivermectin distribution, to repeat the cross-sectional surveys. Each sentinel community reported a mean interval treatment coverage of eligible persons of >88% (range 37-100%). Data were analyzed for more than 6200 person examinations. In Cameroon, 719 people >or=10 years were examined at the baseline survey in 1996 and 838 at the follow-up survey in 2005. In Uganda, 1590 people >or=10 years were examined at the baseline survey in 1993 and 2122 people at the follow-up survey in 2005. We also examined children under 10 in Cameroon (1996, n = 185; 2005, n = 448) and Uganda (1993, n = 177; 2005, n = 130). In Uganda, the vitality of worms was judged using standard histological criteria in 80 nodules excised in 2005. RESULTS: The prevalence of microfilaria carriers among older children and adults (>or=10 years) in Cameroon sentinel communities dropped from 70.1% to 7.04% (P < 0.0001) over the 10-year treatment period; that of nodule carriers from 58% to 9.55% (P < 0.0001). Similarly, in Uganda, the prevalence of microfilaria carriers fell from 71.9% to 7.49% (P < 0.0001) over the 13-year treatment period, and that of nodule carriers from 53.21% to 9.66% (P < 0.0001). The number of microfilaria carriers among children <10 years in Cameroon decreased from 29.73% to 3.8% (P < 0.0001), and in Uganda from 33.89% to 3.1% (P < 0.0001). In 2005, worms excised from nodules in Uganda, 81.4% of males remained alive, and 64% of females, with 24% of them inseminated. CONCLUSION: A decade or more of annual single dose ivermectin treatment in hyperendemic areas has reduced onchocerciasis to 'hypoendemicity', but onchocerciasis transmission persists. For now, annual treatment with ivermectin should be continued in formerly mesoendemic and hyperendemic zones. Language: English Keywords: CAMEROON | UGANDA | RESEARCH REPORT | EVALUATION | PREVALENCE | ONCHOCERCIASIS | TRANSMISSION | TREATMENT | ADMINISTRATION AND DOSAGE | DRUGS | PROGRAM EFFECTIVENESS | Africa, Western | Africa, Sub Saharan | Africa | Developing Countries | Africa, Eastern | Measurement | Research Methodology | Parasitic Diseases | Diseases | Infections | Medical Procedures | Medicine | Health Services | Delivery of Health Care | Health | Program Evaluation | Programs | Organization and Administration Document Number: 328629 |
| 28. Peer Reviewed Title: Adverse perinatal outcomes of adolescent pregnancies in Cameroon. Author: Kongnyuy EJ; Nana PN; Fomulu N; Wiysonge SC; Kouam L Source: Maternal and Child Health Journal. 2008 Mar;12(2):149-154. Abstract: There are geographic variations in fetal outcomes of adolescent pregnancies because of socioeconomic differences between regions and countries. The aim of our study was to determine adverse fetal outcomes associated with adolescent pregnancies in Cameroon. A cross-sectional study to compare the outcomes of 268 singleton, adolescent pregnancies with 832 controls, delivered in four referral hospitals in Yaounde (Cameroon), between November 2004 and April 2005. The adverse fetal outcomes related to adolescent pregnancies were low birth weight (less than 2,500 g) (odds ratios [OR], 1.71; confidence interval [CI], 1.15-2.50), premature babies (less than 37 weeks) (OR, 1.77; CI, 1.24-2.52) and early neonatal death (OR, 2.18; CI, 1.04-4.48). The rates of stillbirth and intrauterine growth retardation were not significantly higher among adolescents. Adverse maternal outcome associated with adolescent pregnancies were eclampsia (OR, 3.18; CI, 1.21-8.32), preeclampsia (OR, 1.99; CI, 1.24-3.15), perineal tear (OR, 1.45; CI, 1.06-1.99) and episiotomy (OR, 1.82; CI, 1.20-2.73). Caesarean delivery, instrumental delivery and premature rupture of membranes were not significantly associated with adolescent pregnancy. Maternal factors associated with adverse fetal outcome in adolescents were maternal age, number of prenatal visits less than 4, and the state of being unemployed. Adolescent pregnancies are associated with both adverse fetal and maternal outcomes in Cameroon. Improving compliance with prenatal care could significantly reduce the frequency of adverse fetal outcomes in adolescent populations in Cameroon. (author's) Language: English Keywords: CAMEROON | RESEARCH REPORT | CROSS SECTIONAL ANALYSIS | ADOLESCENT PREGNANCY | PREGNANCY OUTCOMES | SOCIOECONOMIC FACTORS | LOW BIRTH WEIGHT | PREMATURE BIRTH | NEONATAL MORTALITY | Developing Countries | Africa, Western | Africa, Sub Saharan | Africa | Research Methodology | Reproductive Behavior | Fertility | Population Dynamics | Demographic Factors | Population | Pregnancy | Reproduction | Economic Factors | Birth Weight | Body Weight | Physiology | Biology | Infant Mortality | Mortality Document Number: 324356 |
| 29. Peer Reviewed Title: Association between fertility and HIV status: what implications for HIV estimates? Author: Kongnyuy EJ; Wiysonge CS Source: BMC Public Health. 2008;8:309. Abstract: BACKGROUND: Most estimates of HIV prevalence have been based on sentinel surveillance of pregnant women which may either under-estimate or over-estimate the actual prevalence in adult female population. One situation which can lead to either an underestimate or an overestimate of the actual HIV prevalence is where there is a significant difference in fertility rates between HIV-positive and HIV-negative women. Our aim was to compare the fertility rates of HIV-infected and HIV-uninfected women in Cameroon in order to make recommendations on the appropriate adjustments when using antenatal sentinel data to estimate HIV prevalence. METHODS: Cross-sectional, population-based study using data from 4493 sexually active women aged 15 to 49 years who participated in the 2004 Cameroon Demographic and Health Survey. RESULTS: In the rural area, the age-specific fertility rates in both HIV positive and HIV negative women increased from 15-19 years age bracket to a maximum at 20-24 years and then decreased monotonically till 35-49 years. Similar trends were observed in the urban area. The overall fertility rate for HIV positive women was 118.7 births per 1000 woman-years (95% Confidence Interval [CI] 98.4 to 142.0) compared to 171.3 births per 1000 woman-years (95% CI 164.5 to 178.2) for HIV negative women. The ratio of the fertility rate in HIV positive women to the fertility rate of HIV negative women (called the relative inclusion ratio) was 0.69 (95% CI 0.62 to 0.75). CONCLUSION: Fertility rates are lower in HIV-positive than HIV-negative women in Cameroon. The findings of this study support the use of summary RIR for the adjustment of HIV prevalence (among adult female population) obtained from sentinel surveillance in antenatal clinics. Language: English Keywords: CAMEROON | RESEARCH REPORT | METHODOLOGICAL STUDIES | INDIRECT ESTIMATION TECHNIQUES | ESTIMATION TECHNIQUES | EPIDEMIOLOGIC METHODS | COMPARATIVE STUDIES | CROSS SECTIONAL ANALYSIS | WOMEN IN DEVELOPMENT | RURAL POPULATION | FERTILITY RATE | HIV INFECTIONS | PREVALENCE | BIAS | AGE FACTORS | Africa, Western | Africa, Sub Saharan | Africa | Developing Countries | Research Methodology | Studies | Economic Development | Economic Factors | Population Characteristics | Demographic Factors | Population | |