Practices Regarding the Use of Antimalarial Medications among Inhabitants of the Buea Health District, Southwestern Cameroon: Implications for Malaria Treatment Policy

Background: Malaria treatment policy recommends continuous monitoring and reporting of therapeutic efficacy of antimalarial medications for early detection of resistant strains. Patient adherence to policies regarding the use of antimalarial medications is critical to success of global malaria elimination. This study assessed the practices regarding the use of antimalarial medications in the Buea Health District, Southwest Cameroon. Methods: A descriptive cross-sectional survey of a random sample of 495 people living in the district with episodes of malaria in the last one year prior to the study was conducted between February and August, 2015. Questionnaire was designed to obtain information from participants on the general knowledge of malaria and practices regarding to the use of antimalarial medications. Results: Knowledge on malaria symptoms, transmission and prevention was reasonable among 80.6% (399) of the respondents (p < 0.07). Only 31.3% (155) of the respondent could attribute cause of malaria to protozoan of genus Plasmodium species. Majority of the respondents 56.9% (283) frequently treat malaria with ACT, 32.4% (161) with monotherapy, < 15% with other non-ACTs. Presumptive diagnosis was commonly practiced by 67.3% (333) of the respondents. The prevalence of self-medication in the study population was 18.4%. Only 57.2% (283) of respondents took prescribed antimalarials. Majority of self-medicated respondents (63%) obtained antimalarials from drugstores and friends. About 50.9% (252) of the respondents took medications regularly and 57.6% (258) completed the treatment regimen. Respondents whose treatments were based on laboratory diagnosis adhered better than those on self-medication or recommended at the pharmacy (p < 0.02). Conclusion: The findings revealed a high knowledge of malaria with poor practices regarding the use of antimalarials. Efforts are needed to educate inhabitants of the district on practices regarding the use of antimalarials to prevent early emergence of drug resistance. Keywords: Antimalarials, Drug resistance, Presumptive diagnosis, Self-medication, Adherenc

Caractérisation physico-chimique et dendrométrie dans les traitements de régénération de mangrove de l’Estuaire du Cameroun

Malgré l’échec des initiatives de régénération à restaurer les écosystèmes de mangroves diversifiés et fonctionnels, les études sur le rôle joué par le milieu physicochimique sont rares. Cette étude a été menée pour déterminer les paramètres dendrométriques, les propriétés physicochimiques de l’eau et du sol et comment elles influencent le processus de régénération des mangroves. Pour cela, deux transects de 40 m de long et 10 m de large ont été établis par site, subdivisés ensuite en placettes de 100 m2 dans lesquelles les plantules ont été mesurées, des échantillons d’eau et de sol prélevés et analysés. Les tests statistiques ANOVA à un facteur et de corrélation de Pearson, au seuil de 5%, ont été utilisés pour, respectivement, comparer les deux sites et croiser les catégories de paramètres. Les meilleurs paramètres dendrométriques ont été enregistrés dans la parcelle de régénération naturelle de Tiko. Les valeurs des propriétés physicochimiques de l’eau montraient que ce site, proche du milieu urbain, est plus pollué que la plantation de Mbiako, situé en milieu rural. Par ailleurs, les sols étaient organiques et hyper acides mais soumis à une faible minéralisation. La matrice de corrélation montrait une forte influence des propriétés physicochimiques de l’eau en particulier la turbidité, salinité, conductivité et résistivité électriques et les solides totaux dissouts mais aussi de certaines propriétés chimiques du sol comme le potassium, sodium, phosphore et potentiel hydrogène sur le diamètre, hauteur et densité des plantules. De ces résultats, il faudrait prendre en compte ces facteurs déterminants lors des opérations sylvicoles pour garantir le succès des initiatives de régénération des mangroves.   English title: Characterization of physicochemical and dendrometric parameters in mangrove regeneration treatments of the Cameroon Estuary Despite the failure of regeneration initiatives to restore diversified and functional mangrove ecosystems, the studies on the role of physicochemical environment are rare. This study was conducted to determine dendrometric parameters, physicochemical properties of water and soil and how the latter could influence the mangrove regeneration processes. So two transects of 40 m long and 10 m wide were established per study area. Those transects were then divided into plots of 100 m2 inside which seedlings were measured, soil and water samples were taken and analyzed. The one way ANOVA and correlation tests, at 5% threshold, were used, respectively, to compare the two study areas and correlate the parameter categories. The best dendrometric parameters were observed in the Tiko natural regeneration parcel. The values of physicochemical properties of water showed that this site, close to the urban zone, is more polluted than the one of Mbiako plantation, situated in rural zone. Moreover, the soils of the two sites were hyper acidic and organic but submitted to low mineralization processes. The Pearson correlation table showed a high influence of physicochemical parameters of water particularly the turbidity, salinity, electric conductivity and resistivity and the total dissolved solids in water but also some chemical properties of soil such as potassium, sodium, phosphorous and hydrogen potential on diameter, height and density of seedlings. According to these results, it is necessary to take into account those determinant factors during forestry operations for guarantee the success of mangrove regeneration initiatives

Effects of vegetation's degradation on carbon stock, morphological, physical and chemical characteristics of soils within the mangrove forest of the Rio del Rey Estuary: Case study – Bamusso (South-West Cameroon)

This study was conducted to assess the capacity of mangroves soils to stock carbon and how degradation can influence its various properties. Transect method was performed. So, two transects of 100 m length and 10 m wide were established according to the degradation level. Total of 18 Soil samples were taken to be described and analysed. The degraded transect (T1) shows a mean carbon stock value of 2102.06 ± 405 Mg.ha-1 while natural (T2) accumulate 2476.6 ± 409 Mg.ha-1. Colour are more light inside the degraded transect (Brown to grayish) than the natural transect (brown to blackish) while spots are more colored in natural transect (gray and yellow) than degraded one (yellow). pH mean value showed that soils of degraded transect was more acidic than those of natural one. Organic matter amount was very high and proves that these soils can be valorized to agricultural activities without previous enrichment. Total Nitrogen was low in the two transects while the available phosphorus values showed that natural transect has more available phosphorus that can be used by the plants than degraded transect. So, degradation would take along reduction of available phosphorus rate in the soils. According to this result showing important different values of carbon stock and soils properties between natural and degraded transect, it is necessary to implement conservation methods in order to stop degradation and enhance capacity of mangroves soils properties.Keywords: Bamusso, degraded transect, natural transect, soils, value

Comparing Smoked Fish Quality of Traditional and Improved Modern Ovens Using Dendro-Energy from Mangrove and Tropical Forest Woods and Implications for Conservation in Central African Atlantic Coast, Cameroon

Smoked fish qualitative organoleptic parameters (color, smell, texture and taste) and quantitative proximate parameters (protein and ash content and salt mineral: Ca, Iron, Mg, Zn content in ash) of two species (Ethmalosa fimbriata and Pseudotolithus elongatus) smoked in traditional and modern ovens with wood from mangrove (Rhizophora racemosa) and two tropical forest (Sacoglottis gabonensis and Albizia glaberrina) species in Douala-Edea Atlantic coast, Cameroon are presented. Women processors significantly spend more time, consume more wood and consequently release significant amount of carbon dioxide (CO2) to the environment with traditional smoking system. Organoleptic characteristics were significantly different with ovens types but not with different wood species except color (black and marron from inland forest wood species and preferred brownish and golden brown colored smoked fish from mangrove wood). Fish food constituents yielded for improved smoked oven:  Protein content (65.52%; 69.45%), ash content (6.21%; 5.57%) and traditional oven: Protein content (70.65%; 75.00%), ash content (5.73%; 6.33%) for Ethmalosa fimbriata and Pseudotolithus elongatus respectively. Results also confirmed good dietary quality of fish samples (source of calcium, iron and magnesium). Some energy efficient management techniques and conservation implications were proposed regarding qualitative and quantitative improvement of smoked fish

Revenus économiques et pollution écosystémique liés au transport des personnes et des biens traversant les mangroves de l’estuaire du Wouri (Douala, Cameroun)

La mangrove est une formation forestière caractéristique des littoraux tropicaux vaseux,  essentiellement constituée de palétuviers. Au Cameroun, les mangroves couvrent une   superficie de 2700 km2, soit 1,5% de la superficie des forêts, répartie telle que 1600 km2 occupent le Rio Del Rey et  1100 km2 l’Estuaire du Cameroun. Une étude sur les paiements écosystèmiques a été conduite dans l’écosystème mangrove de l’estuaire du Wouri pour évaluer les enjeux financiers et les risques de pollution liés au transport des personnes et des marchandises. La méthode d’échantillonnage s’est faite aléatoirement sur 27 pirogues dans deux débarcadères principaux de mangroves dans la localité, dont 20 à Youpwè et 07 à  Akwa-Nord, avec les observations basées sur l’utilisation des fiches d’enquêtes socio-économiques. Les résultats obtenus montrent que les services écosystèmiques constituent un moyen de subsistence pour les populations riveraines. Le flux des personnes et des marchandises est important et équivaut à un chiffre d’affaires de 12 252 600 F CFA (24 505 USD)/pirogue/an à Youpwè et 3 896 286 F CFA (7 792 USD)/pirogue/an à Akwa-Nord. Toutefois, les activités anthropiques liées à ce transport constituent des menaces pour sa pérennisation.© 2015 International Formulae Group. All rights reserved.Mots clés: Mangrove, transport, services écosystemiques, enjeux financiers, menacesEnglish AbstractThe mangrove is a forest formation characteristic of muddy tropical coastlines, mostly  constituted of mangroves. In Cameroon, mangroves covers a superficial area of 2700 km2, about 1.5% of the superficial area, divided into 1600 km2 occupied by Rio Del Rey and 1100 km2 by Cameroon estuary. A study on the ecosystem services was carried out in the mangrove ecosystem of the Wouri estuary to estimate the financial stakes and pollution risks connected to the transport of persons and goods. A random sample of 27 canoes were taken in two main mangrove landing areas in the locality with 20 and 07 in Youpwè and Akwa-Nord respectively with observations using socio-economic data sheets. The results obtained show  that the ecosystemic services constitute a means of livelihood for the riverine populations. The flux of persons and goods were important and amounts to a turnover of 12 252 600 F CFA (24 505 USD)/canoe/year for Youpwè and 3 896 286 F CFA (7 792 USD)/canoe/year for Akwa-Nord respectively. However, the anthropogenic activities linked to this transport constitute threats to its perpetuity.© 2015 International Formulae Group. All rights reserved.Keywords: Mangrove, transport, ecosystemic services, financial stakes, threat

PREVALENCE OF BACTERIAL VAGINOSIS AMONG SEXUALLY ACTIVE WOMEN ATTENDING THE CDC CENTRAL CLINIC TIKO, SOUTH WEST REGION, CAMEROON

Background: Bacterial vaginosis (BV) is a polymicrobial, superficial vaginal infection involving a reduction in the amount of hydrogen peroxide-producing Lactobacillus and overgrowth of anaerobic bacteria. Common symptoms include increased fishy smelling vaginal discharge which is usually white or gray in color. Burning with urination may occur and itching is uncommon. Risk factors include douching, new or multiple sex partners, antibiotics, and use of intrauterine device among others. Materials and Methods: This cross-sectional study assessed the prevalence of bacterial vaginosis among sexually active women aged 15-45 years. Vaginal swabs were obtained with the use of sterile swab sticks which were later smeared on clean glass slides and then Gram stained. The stained smears were observed for bacterial morphotypes with the X100 oil immersion objective and the Nugent scoring system was used to determine BV. Data were analyzed using the Statistical Package for Social Scientists (SPSS) version 17.0 and were considered significant at p ≤ 0.05. Results: A total of 100 women participated in the study with the overall prevalence of BV rated 38%. The prevalence of BV with respect to associated factors was also investigated and it was observed that BV was more prevalent in the age groups 20-25 (48.1%) and 25-29 (44.4%), those who had attained only primary education (60.5%), married women, (68.4%), pregnant women (71.0%), and women who practiced vaginal douching, (97.4%). However, no statistical significant difference was observed in the prevalence between these parameters (P > 0.05). Conclusions: Conclusively, the prevalence of bacterial vaginosis in our study population is 38% and highest among women aged between 25 and 34 years, pregnant women, married women, less educated women and women who practiced poor vaginal hygiene

Malaria Perceptions among Medicine Vendors in Buea Community: An Assessment of Knowledge of Malaria and Conditions of Antimalarial Drug Dispensing

Background: Lack of knowledge of rational use of antimalarial drugs among medicine vendors is a serious problem, notably in areas of intense transmission. These misunderstandings increase the risks of resistance and adverse drug reactions. This study aimed to assess knowledge of malaria and environments wherein medicine vendors dispense antimalarials in the Buea community. Methods: Administration of a community-based cross-sectional survey of a random sample of 140 medicine vendors living within the Buea community occurred between March and June 2017. The survey sought to obtain information from medicine vendors on their general knowledge of malaria as well as their dispensing practices. Statistically significant findings were associated with p ≤ .05. Results: The majority of participants were aware that use of insecticide – treated bed nets (ITNs) and maintenance of a clean environment equate to effective malaria prevention efforts.  Alternatively, only one-third of participants correctly attributed the causative organism of malaria to being protozoan. Participants employed within drugstore settings had less knowledge of malaria than their hospital/community counterparts did. A directly proportional relationship existed between the amount of experience that participants had in their respective disciplines with an increased knowledge of malaria overall.  Conclusion: These findings reveal fluctuating knowledge of malaria among study participants. Reported antimalarial dispensing practices also warrants room for improvement. Routine monitoring and evaluation to prevent emergence of resistant strains to current efficacious antimalarials remains paramount.   Article Type: Original Researc

Cryptosporidium and Giardia safety margin increase in leafy green vegetables irrigated with treated wastewater

[EN] The presence of Cryptosporidium and Giardia in waste water is a main concern because water reuse for irrigation can jeopardize human health. Spanish Legislation for water reuse does not oblige to analyze the presence of both pathogens Cryptosporidium and Giardia in reused water for irrigation. Therefore, the objective of this paper is to determine the influence of wastewater treatment in the increase of the consumer safety margin in relation to the presence of Cryptosporidium and Giardia in leafy green vegetables. With this aim in mind, a total of 108 samples from raw (influent) and treated wastewater (effluent) from three wastewater treatment plants in Spain were analysed according to USEPA Method 1623. Effluent results show that Cryptosporidium oocysts average counts ranged from 1.38 to 2.6/L oocysts and Giardia cysts ranged from 0.6 to 1.7/L cysts, which means a removal values of 2.7 log, 2.5 log and 1.8 log for Cryptosporidium oocysts and 1 log, 2 log and 2.2 log for Giardia cysts in the three wastewater treatment plants analysed. In relation to safety margin the highest probability that exposure exceed the dose response was observed for Giardia. In addition, the sensitivity analysis showed that (oo) cysts concentration present in the leafy green vegetables and the human dose-response were the most influential inputs in the safety margin obtained.We thank EPSAR for authorizing us sampling of WWTP and the personnel of WWTP for providing with WWTP samples. We also thank members of GAMASER for concentrating the secondary and tertiary WWTP samples with the Envirocheck capsules. This study has been supported by the Spanish Ministry of Economy and Competitiveness (MINECO), in the frame of the collaborative international consortium WATERJPI2013-095-C03-02-METAWATER of the Water Challenges for a Changing World Joint Programming Initiative (Water JPI) Pilot Call.Doménech Antich, EM.; Amoros, I.; Moreno Trigos, MY.; Alonso Molina, JL. (2018). Cryptosporidium and Giardia safety margin increase in leafy green vegetables irrigated with treated wastewater. International Journal of Hygiene and Environmental Health. 221(1):112-119. https://doi.org/10.1016/j.ijheh.2017.10.009S112119221

Political Economy of Climate Compatible Development: Artisanal Fisheries and Climate Change in Ghana

Interest in prospects for policy processes that contribute to development, climate change adaptation and mitigation, known as ‘climate compatible development’, has been growing in response to increasing awareness of the impacts of climate change. This paper provides insight into the complex political economy of climate compatible development in Ghana's artisanal fisheries, a sector that has received comparatively little attention in climate change literature and policy processes. It focuses on two contentious policy areas where there is potential for climate compatible development, namely the subsidized premix fuel provided to artisanal fishermen, and mangrove protection. Regarding the premix subsidy, while there is theoretical scope for a ‘triple win’ outcome by removing the subsidy to reduce incentives to unsustainable fishing and supporting alternative policies, in practice this is highly problematic. Artisanal fishermen strongly oppose removing the subsidy on the grounds that it would damage their livelihoods, and do not have the confidence that they would be appropriately compensated for any hypothetical reform. Moreover, it is argued that removing it could have negative unintended consequences if fishermen are forced into alternative livelihoods that are themselves unsustainable. There is, however, a need to make considerable improvements to the distribution of the premix fuel so that it reaches the intended beneficiaries and is not siphoned off for contraband. Meanwhile, although improved mangrove protection could have significant ‘triple‐win’ benefits, this area suffers from a lack of funding and administrative coordination across ministries and agencies, leading it to be neglected. The case studies reveal, therefore, that the major constraint to climate compatible development is institutional failing, rather than a lack of policies per se. The paper emphasizes the need to conceptualize climate compatible development as a process which is dynamic across space and time, such that potential for triple win outcomes is fluctuate to vary according to changing circumstances. It is necessary to recognize, furthermore, that pressures from a number of actors, including those at the grass roots, may demand short term improvements to current problems rather than aspiring to triple win outcomes in the long term, creating a major challenge for climate compatible development