Microbiological Profile of Oral Infections in Diabetic Patients and Non-Diabetic Controls in SouthWest, Cameroon

Background: Oral microbial flora is increasingly being incriminated in oral infections. There is paucity of information on the importance of aerobic oral flora in diabetes. The purpose of this study was to compare aerobic oral microbial flora in diabetics and non-diabetics and to relate these microbes with oral infections.Materials and Methods: This study involved 154 diabetics and 111 non-diabetics aged 18 years and above. Oral washes were inoculated unto blood agar, chocolate agar, Mac Conkey agar and Sabouraud’s agar and isolates were identified by standard biochemical tests. Oral exam was conducted by a Dentist to assess oral infections and oral health status of participants.Results: Thirteen different genera of aerobic microbes were identified. The most prevalent microbes were Streptococcus sp (99.6 %), Candida albicans (17.0 %), Serratia Spp (7.2 %), other Candida Spp (6.8 %), Coagulase negative Staphylococci (CNS) (6.4 %) and Klebsiella Spp (5.7 %). Candida sp was more prevalent in diabetic patients than non-diabetics. Gram negative aerobic bacteria were significantly isolated from cases of dental  caries.Conclusion: The oral microbiological profile of diabetic patients was different from those of non-diabetics and aerobic Gram negative bacteria may play an important role in dental diseases in diabetic patients.Keywords: Oral microbiological profile; oral infections; diabetes; Cameroon Contexte: La flore microbienne orale est de plus en plus incriminée dans les infections buccales. Il existe peu d'informations sur l'importance de la flore buccale aérobie chez les diabétiques. Le but de cette étude était de comparer la flore microbienne aérobie orale chez les diabétiques et les non diabétiques et de déterminer le lien que ces germes ont avec les infections buccales.Matériels et méthodes: Cette étude a porté sur 154 diabétiques et 111 non-diabétiques âgés de 18 ans et plus. Le liquide de lavage buccal a été inoculé sur des géloses au sang, au chocolat, de Mac Conkey et de Sabouraud respectivement, et les souches bactériennes ont été identifiées par des tests biochimiques standards. L’examen oral a été mené par un dentiste afin d’évaluer les infections buccales et l'état de santé bucco-dentaire des participants.Résultats: Treize genre différents de microorganismes aérobies ont été identifiés. Les microbes les plus répandus étaient Streptococcus sp (99,6%), Candida albicans (17,0%), Serratia spp (7,2%), les autres espèces de Candida (6,8%), les staphylocoques à coagulase négative (SCN) (6,4%) et Klebsiella spp (5,7%). Candida spp était plus fréquent chez les patients diabétiques que chez les non-diabétiques. Les bactéries Gram négatives aérobies ont été considérablement isolées des cas de caries dentaires.Conclusion: Le profil microbiologique oral des patients diabétiques était différent de ceux des non- diabétiques. Les bactéries Gram négatif aérobies peuvent jouer un rôle important dans les maladies dentaires chez les patients diabétiques.Mots-clés: Profil microbiologique orale; infections buccales; diabète; CamerounArticle in English

An investigation of symptomatic malaria parasitaemia and anaemia in nursery and primary school children in Buea District Cameroon.

A CAJM journal article.Objectives: To investigate the prevalence of asymptomatic malaria parasitaemia and anemia in nursery and primary school children and correlate parasite density with haemoglobin levels. Design: Cross sectional study. Setting: Samples were collected from children attending the Saint Theresa’s bilingual school and the Government Primary school, Buea, South West Province, Cameroon. Subjects: 297 nursery and primary school children two to 11 years old selected based on parental consent. Main Outome Measures: Relationship between asymptomatic malaria and anaemia. Results: The prevalence of asymptomatic malaria in children was 30.3%. Parasite prevalence and density was independent of age and sex (p>0.05). The mean haemoglobin level for parasitaemic children was 11.9g/dl (±SD1.1) compared with 12.1g/dl (±1.2) for non-parasitaemic children. The difference was not significant (t=1.918, p>0.05). Anaemia when present was mild. No correlation was found between malaria parasite density and haemoglobin levels (r=-0.065; p>0.05). Conclusion: Asymptomatic malaria was accompanied by low grade parasitaemia, which did not seem to have a significant effect on haemoglobin levels

Avoiding Consumer Scapegoatism : Towards a Political Economy of Sustainable Living

Transitioning to sustainable living is a complex, conflicting, and highly contested issue. As part of this push, governments and businesses have focused on promoting green consumerism - framing people as primarily consumers with “a utility function” and seeking to solve the consumerism problem by paradoxically building consumer capacity to purchase more energy and material efficient products. The now-debunked assumption is that a critical mass of informed, ecologically conscious consumers can, through the market mechanism, apply pressure on producers and thus transform the economic system into a sustainable one. In this thesis I argue that this approach, which is driven by economistic thinking, is consumer scapegoatism, and is both simplistic and flawed. In light of the magnitude and urgency of the unsustainability problem, green consumerism could even be dangerous as it delays deployment of effective solutions. Consumer scapegoatism occurs when ecological imbalance is examined primarily through an economic-growth lens, and the critical role of addressing these systemic flaws is ascribed to the consumer without proper regard for whether he or she has the power to influence other more salient actors in the system. This thesis argues for the need to develop an explicit political economy approach to sustainable living research, policy and practice. Political economy asks questions about power, institutions and agency. For sustainable living, these would be questions such as: who benefits or loses from current patterns of consumption, what are the drivers and structures that propagate unsustainable consumption, where are the meaningful points of intervention that can have desired effects. Critical to finding solutions is in understanding the power dynamics around the issue. I analyse sustainable living as an issue of heterogeneous claims and conflicting interests. The means and practical implications of achieving sustainable living threaten the interests of powerful actors such as national governments, large transnational corporations, and institutions that together shape contemporary politics, policy, and markets. Such actors are also responsible for the systems of provisioning and choice architecture that largely predetermine how individuals and communities pursue and meet their needs. As heterogeneity and conflict of interests are essential to political economy, this approach is well situated as the organizing frame of the field of sustainable living. I discuss the main tensions embodied in the pursuit of sustainable living, and juxtapose these with characteristics of the political economy approach that make it a suitable research framing. Political economy characteristics include: understanding of social transition; interdisciplinarity in research design; use of a moral perspective; and praxis, or practice orientation. I emphasize the element of power as vital in the articulation of social transformation, and highlight the need for sustainable living research to undertake a systemic analysis of power. To apply this, I develop the In-Power framework for analysing power dynamics within a system. The in-power framework has four components: institutions, interests, instruments, and influence. Institutions set the conditions or “rules of the game” for how actors operate in the production-consumption system; Interests identify stakes, showing heterogeneity or homogeneity of those interests in the sustainable living issue; Instruments refer to sources of power and tools available to each stakeholder to support its objectives; and Influence refers to activities stakeholders undertake and reflects agency. I use the framework to analyse the global value chain of consumer goods with a view to understanding drivers of consumption, how power is wielded by stakeholders, and potential points of effective intervention that can enable sustainable living. Dismantling the architecture of unsustainability would invariably call for a questioning of corporate architechture, not only due to the environmental impact resulting from its mode of operation, but also its lock-in effect on institutions and other actors of society. By extension, understanding unsustainable consumption and approaching sustainable living has at its core the need to address the balance – or imbalance – in power dynamics between consumption patterns and corporate power. Using the in-power framework to analyse power flows in a value chain leads to identifying the nexus of influence and the lead actor. The nexus of influece is the concentration of stakeholders who act interdependently and who have a combined decisive influence on the final product and also on the eco-system around it. The lead actor is the main actor in the system with a critical marketing, technological, or financial edge that permits it to set the standards or specifications for other actors in the value chain, and the characteristics that determine its production and use. Thus I argue that consumer scapegoatism, assigning full responsibility to the consumer, is ineffective; a more effective approach to addressing the systemic flaws causing or caused by unsustainable consumption is to target the nexus of influence and the lead actors in order to reform the choice architecture and systems of provision upon which people depend for meeting their needs and wants. Finally, I discuss two points not addressed in this thesis but which are essential to the political economy of sustainable living. They are: the need to define parameters for a sustainable consumption space; and to move research on sustainable living out of the shadows of economics.Siirtymä kohti kestävää elämäntapaa on kompleksinen, ristiriitainen ja erittäin kiistanalainen asia. Osana tätä liikettä hallitukset ja liike-elämä ovat alkaneet edistämään vihreää kuluttajuutta – jossa ihmiset kehystetään pääasiassa kuluttajina, joilla on ”hyötyfunktio”, ja joka pyrkii ratkaisemaan kuluttajuuden ongelman paradoksaalisella tavalla lisäämällä kuluttajien kapasiteettia energia- ja materiaalitehokkaampien tuotteiden ostamiseen. Jo kumottu oletus on se, että informoitujen ja ekologisesti tiedostavien kuluttajien kriittinen massa voi antaa painetta tuottajia kohtaan markkinamekanismin kautta, ja näin muuttaa talousjärjestelmän kestävämmäksi. Tässä väitöksessä esitän, että kyseinen lähestymistapa, jota ajaa ekonomistinen ajattelu, tarkoittaa kuluttajan syyllistämistä ja on sekä yksinkertaistettu että virheellinen. Kestävyysongelman suuruuden ja kiireellisyyden valossa vihreä kuluttajuus voi olla jopa vaarallista viivyttäessään tehokkaiden ratkaisujen käyttöönottoa. Kuluttajien syyllistämistä ilmenee silloin, kun ekologista epätasapainotilaa tarkastellaan pääasiassa talouskasvun näkökulmasta ja näiden systeemisten vikojen korjaamisen kriittistä roolia tarjotaan kuluttajalle ilman asianmukaisen huomion kiinnittämistä siihen, onko kuluttajilla valtaa vaikuttaa järjestelmän muihin keskeisiin toimijoihin. Tässä väitöksessä puolletaan tarvetta kehittää eksplisiittisesti talouspoliittinen lähestymistapa kestävän elämäntavan tutkimiseen, poliittiseen päätöksentekoon ja käytäntöön. Poliittinen taloustiede kysyy valtaa, instituutioita ja toimijuutta koskevia kysymyksiä. Kestävän elämäntavan tapauksessa näitä kysymyksiä ovat esimerkiksi seuraavat: kuka hyötyy tai häviää nykyisten kulutuskäytäntöjen takia, mitkä tekijät ja rakenteet levittävät kestämätöntä kulutusta, missä sijaitsevat merkitykselliset intervention kohteet, joihin puuttumalla voidaan saavuttaa haluttuja vaikutuksia. Ratkaisujen löytämisessä kriittisen tärkeää on asiaa ympäröivien valtadynaamisten tekijöiden ymmärtäminen. Analysoin kestävää elämäntapaa ilmiönä, johon liittyy heterogeenisiä väitteitä ja ristiriitaisia intressejä. Kestävän elämäntavan saavuttamisen keinot ja käytännön seuraukset uhkaavat sellaisten voimakkaiden toimijoiden kuten kansallisvaltioiden, suurten ylikansallisten korporaatioiden ja instituutioiden intressejä, jotka yhdessä muokkaavat nykyistä politiikkaa, päätöksentekoa ja markkinoita. Nämä toimijat ovat myös vastuussa niistä rahoituksen ja valinta-arkkitehtuurin järjestelmistä, jotka määräävät pitkälti ennalta sen, miten yksilöt ja yhteisöt ajavat etujaan sekä täyttävät tarpeitaan. Koska heterogeenisyys ja eturistiriidat ovat keskeisiä poliittisessa taloustieteessä, tämä suuntaus on omiaan muodostamaan kestävän elämäntavan kenttää järjestävän kehyksen. Painotan valtaelementtiä keskeisenä tekijänä yhteiskunnallisen muutoksen artikuloinnissa ja korostan tarvetta ryhtyä vallan systeemiseen analyysiin kestävän elämäntavan tutkimuksessa. Tämän soveltamiseksi kehitän vallan tutkimuksen kehyksen (In-Power Framework), jolla vallan dynamiikkaa voidaan tutkia järjestelmän sisällä. Tämä kehys sisältää neljää osaa: instituutiot, intressit, instrumentit ja vaikutusvallan. Instituutiot asettavat “pelisääntöjen” reunaehdot sille, miten toimijat toimivat tuotannon ja kulutuksen järjestelmässä; intressit tunnistavat pelin panokset ja näyttävät näiden intressien hetero- tai homogeenisyyden kestävää elämäntapaa koskien; instrumentit viittaavat vallan lähteisiin ja niihin työkaluihin, joita jokaisella eturyhmällä on käytettävissään tavoitteidensa tueksi; ja vaikutusvalta viittaa eturyhmien toimiin, heijastaen toimijuutta. Käytän tätä kehystä analysoimaan kulutushyödykkeiden globaalia arvoketjua, pitäen silmällä kulutuksen muutosajurien, eturyhmien vallankäytön ja kestävää elämäntapaa mahdollistavien tehokkaiden interventiokohteiden ymmärtämistä. Kestämättömyyden arkkitehtuurin purkaminen vaatisi poikkeuksetta suuryritysarkkitehtuurin kyseenalaistamista sekä sen toimintatavan ympäristövaikutusten että sen yhteiskunnan instituutioita ja muita toimijoita sisäänsä sulkevan vaikutuksen takia. Laajemmin ajateltuna kestämättömän kulutuksen ymmärrys ja kestävän elämäntavan saavuttaminen pitävät sisällään tarpeen kiinnittää huomiota kulutuskäytäntöjen ja yritysten vallan välisen valtadynamiikan tasapainoon – tai epätasapainoon. Kehyksen käyttö arvoketjun valtasuhteiden analysointiin johtaa vaikutusvallan keskipisteen ja johtavan toimijan tunnistamiseen. Vaikutusvallan keskipisteessä on se eturyhmien keskittymä, joka toimii keskinäisriippuvaisella tavalla ja jolla on yhdessä ratkaisevaa vaikutusvaltaa lopputuotteeseen sekä sitä ympäröivään ekosysteemiin. Johtava toimija puolestaan on se järjestelmän pääasiallinen toimija, jolla on kriittistä markkinointiin, teknologiaan tai talouteen liittyvää kilpailuetua, joka antaa sen määrittää arvoketjun muiden toimijoiden standardit tai spesifikaatiot sekä tuotannon ja käytön määrittäviä ominaisuuksia. Näin ollen esitän, että kuluttajien syyllistäminen, eli kokonaisvastuun siirtäminen kuluttajien hartioille, on tehotonta; parempi tapa kestämättömän kulutuksen aiheuttamien tai kestämätöntä kulutusta aiheuttavien systeemisten vikojen korjaamiseen on ottaa kohteeksi vaikutusvallan keskipiste sekä johtavat toimijat, jolloin valinta-arkkitehtuuri ja ne järjestelmät, joista ihmiset ovat riippuvaisia tarpeidensa täyttämiseksi, voidaan reformoida. Lopuksi käsittelen kahta seikkaa, joita ei ole käsitelty tässä väitöksessä, mutta jotka ovat kuitenkin oleellisia kestävän elämäntavan talouspolitiikalle. Ne ovat tarve määrittää kestävän kulutuksen tilan parametrit, ja kestävää elämäntapaa koskevan tutkimuksen siirtäminen taloustieteen varjoista kohti keskustaa

Comparison of immuno-fluorescence microscopy and optical microscopy after Giemsa staining in the diagnosis of malaria during pregnancy in Buea, Cameroon

Malaria in pregnancy remains a significant threat in sub-Saharan Africa as it is associated with suboptimal pregnancy outcomes. Due to the fact that the current standard diagnostic method is cumbersome, we assessed the diagnostic performance of an alternate method-fluorescent microscopy, compared to optical microscopy after Giemsa staining- the current standard.Venous blood samples were collected from 407 consenting pregnant women and tested by optical microscopy (OM) after Giemsa staining and by fluorescent microscopy (FM) using the Partec-Cyscope (Partec GmbH, Munster, Germany). All participants were asymptomatic at the time of enrollment. Of the 407 samples tested by OM, 255 (62.5%) were plasmodiumpositive. Of the 255 OM positive samples, 207 were also plasmodium-positive by FM, thus a sensitivity of 81.1% (95% confidence interval (CI): 75.8, 85.8%). Of the 152 samples negative by OM, 75 were also negative by FM, thus a specificity of 49.3% (95%CI: 41.1, 57.6%). The positive and negative predictive values of FM were respectively 72.9% (95%CI: 67.3, 78.0%) and 61.0% (95%CI: 51.8, 69.6%). The percentage agreement between both methods was 69.3% (Kappa=0.32,  p-value<0.01). There was moderate agreement between FM and OM results. The low specificity and negative predictive value of FM suggest a high likelihood of false negative results if FM is used in place of OM. OM after Giemsa staining remains the gold standard. Keywords: Diagnostic performance, sensitivity, specificity, positive predictive value, negative predictive value, Cameroon

1.5-Degree Lifestyles: Towards A Fair Consumption Space for All

This report uses a science-based approach to link concrete changes in lifestyles to measurable impacts on climate change in order to achieve the 1.5-degree aspirational target of the Paris Agreement on climate change. The report also fills the knowledge gap arising from most prevailing climate scenarios that underplay the potential contributions of lifestyle changes to climate change mitigation and focus on developing new technologies as well as on changes in production.A summary for policy makers and individual sections of the report can be dowloaded here: https://hotorcool.org/1-5-degree-lifestyles-report/A recording of the report launch is available here:  https://www.youtube.com/playlist?list=PLncecPWTUt9l_I0hQzg3BpGkkTz-h2uh

Static Analysis of Technical and Economic Energy-Saving Potential in the Residential Sector of Xiamen City

Technical potential Economic potential Energy savings Household energy consumption Levelised cost of conserved energy Residential buildingsBased on a household energy use survey, this paper explores the technical and economic potential of residential energy savings in a Chinese city, Xiamen. The survey adopted a similar questionnaire used by the U.S. EIA's Residential Energy Consumption Survey (RECS), covering the end-uses of cooking, water heating, plug-in appliances, lighting and space cooling. The analysis shows that the technical potential of energy savings in Xiamen's residential buildings is significant, around 20%. Of the technical potential, about two-thirds to four-fifths are cost-effective from a whole society perspective. The cost-effectiveness was evaluated by comparing the Levelised Cost of Conserved Energy (LCOCE) of advanced technical measures with the actual cost of conserved energy. The actual cost of energy is defined by adding the carbon emission cost and hidden government subsidies over the retail prices of energy. About threequarters of the technical energy-saving potential in Xiamen come from adopting efficient household appliances, therefore, further tightening the energy efficiency standards for key household appliances and promoting wide diffusion of efficient models of appliances by various effective financial incentives are essential for achieving residential energy savings in China's “Hot Summer and Warm Winter” region where Xiamen locates

Reduced levels of chloroquine resistant Plasmodium falciparum in selected foci of the South West Province, Cameroon

A CAJM article on malaria parasites.The objectives of this study were firstly to evaluate the state of chloroquine resistant malaria in the South West Province 13 years after it was first reported and secondly, to obtain accurate information on the prevalence of the different species of Plasmodium in the area using the more sensitive PCR amplification technique

Household time use, carbon footprints, and urban form : a review of the potential contributions of everyday living to the 1.5 degrees C climate target

The 1.5 °C mitigation challenge for urban areas goes far beyond decarbonizing the cities’ energy supply and needs to enable and incentivize carbon-free everyday living. Reviewing recent literature, we find that dense and mixed urban form enables lower direct emissions from mobility and housing, while income is the major driver of total household carbon footprints; importantly, these effects are not linear. The available urban infrastructure, services and societal arrangements, for example on work, all influence how households use their time, which goods and services they consume in everyday life and their subsequent carbon footprints and potential rebound effects. We conclude that changes in household consumption, time use and urban form are crucial for a 1.5 °C future. We further identify a range of issues for which a time use perspective could open up new avenues for research and policy.Peer reviewe

Antibiogram of Klebsiella Pneumoniae Isolates from Buea, Cameroon.

A CAJM article on Antibiogram of Klebsiella pneumoniae pathogen in Buea, Cameroon.Klebsiella pneumoniae is an important human pathogen that has been associated in recent decades with nosocomial outbreaks.They are important opportunistic pathogens, commonly isolated from urinary tract infections, surgical wounds, nosocomial pneumonia and bloodstream infections. These organisms are also an important source of transferable antibiotic resistance, and several outbreaks caused by multiple resistant K. pneumoniae, especially the extended-spectrum B-lactamase-producing(ESBL) strains of the types TEM and SHV have been reported

Reference Values of CD4-Lymphocyte Counts in HIV Seronegative Pregnant Women in Buea, Cameroon

Pregnancy is a physiologically immunocompromised state, during which alterations in T-lymphocyte subsets may occur. Reference values for CD4 counts in pregnancy have not been established particularly in sub-Saharan populations. This study aimed at describing expected (‘normal’) values of CD4 counts in healthy HIV-negative pregnant women so these could serve as reference for assessing the progress of HIV disease in HIV-infected pregnant women. The study was conducted in antenatal clinics in the Buea Health District, Cameroon. All eligible women were interviewed using a standardized questionnaire. Whole blood samples collected were tested for HIV using Determine 1/2 and SD Bioline HIV-1/2 3.0 rapid tests. The CD4+ absolute counts were assessed using the Partec Cyflow Counter and the CD4 easy count kit. A total of 279 women were analysed. Their ages ranged from 15 to 47 years. A vast majority (95%) of participants were in the second or third trimester of gestation. Slightly less than half (43%) were primiparous. The CD4 cell count ranged from 321 to 1808 cells/μl . This distribution was approximately normal with a mean of 851cells/μl, a median of 831cells/μl , and a standard deviation of 254cells/μl . The expected (‘normal’) range, covering 95% of the sample was 438-1532 cells/μl. Participants with malaria parasitaemia tended to have a lower CD4 count (lower on average by 115 cells/μl,