Non-classical reproductive tract infections on the rise in women in Dschang, Cameroon

Health promotion and education, wide coverage and pinpointing impediments to the realization of prevailing measures are among primary interventions for sexually transmitted infections (STIs). This work sought to establish STIs burden and related risk factors in women consulting gynecologists and general practitioners in some health centres in Dschang, Cameroon. For seven consecutive months, in a cross-sectional study, 1009 heterosexual women were examined; 353 (35%) symptomatic patients aged 15-46 years (mean 31±3.3years) consented and were interviewed using a questionnaire. Vaginitis was diagnosed by symptoms, positive cultures, and testing of blood and cervical specimens for antibodies to Treponema pallidum and Chlamydia trachomatis respectively. Infections recorded 45% under gynecological care and 14% for general consultations (p< 0.001), with an alarming 84% of general consultation cases without any intention of STIs screens or having future gynecologic appointments. Multiple sexual partners, early sexual debut, poverty, poor sanitation, recurrent infections, tight underwear, no barrier protection or irregular condom use and using chemicals in the vagina were recorded risks. Infectious vaginitis was identified in 300 (30%) patients, 53(5%)cases were non –infectious and 60% had multiple infections. Bacterial vaginosis (28%) and vaginal candidiasis (21%) predominated. Rates for C. trachomatis, Neisseria gonorrhoeae, Trichomonas vaginalis, Phthirus pubis,infectious syphilis, genital warts and genital herpes were < 2%. The present findings portrayed: STIs not given prime consideration under general practice, and a rising trend for non-traditional genital diseases due to poor hygiene and reproductive health knowledge deficiency. Health and sanitary campaigns, and mandatory gynecological exams for individuals of reproductive age were inevitable.Keywords: reproductive tract infections, women, pathogens, risk factors, prevention, Cameroon

Knowledge and Practice of Family Planning in Dschang Municipality, Cameroon

This study was conducted to examine factors which influence contraception in order to ameliorate services. For 12 consecutive months, 706 consenting women on fertility control presenting at the Dschang District Hospital, Cameroon were interviewed and cervical/blood samples collected for analysis. Study respondents were aged 15-50 years (mean 33.61±6.29 years). Levonorgestrel implants (46.7%) and medroxyprogesterone injections (27.6%) were cost effective over the intrauterine copper device (9.5%), Norgestrel (7.8%), Norethisterone enanthate (6.7%), male condoms (6.4%), Progestin only pills (1.4%) and spermicides (1.1%). Lack of expertise precluded tubal ligation or implants and vasectomy. Stigmatization, male rejection, giving or taking methods without adequate laboratory services or regular health checks and failure to recognize or report adverse reproductive health changes impacted on contraception. Genital infections were identified in 33.7% respondents, vaginal candidiasis 20%, bacterial vaginosis 19%, HIV/AIDS 9%, chlamydia 6% and <2% other traditional venereal diseases. Sensitization, education, improved diagnostics and attitude change were adopted.RésuméCette étude a été menée pour examiner les facteurs qui influent sur la contraception dans le but d'améliorer les services. Pendant 12 mois consécutifs, 706 femmes consentantes sur le contrôle de la fertilité qui fréquentent l'hôpital de district de Dschang, au Cameroun ont été interviewées et des échantillons des cols de l’utérus /du sang ont été prélevés pour analyse. Les participantes à l'étude étaient âgées de 15-50 ans (moyenne ± 33,61 6,29 années). Les implants au lévonorgestrel (46,7%) et les injections de médroxyprogestérone (27,6%) étaient rentables sur le dispositif intra-utérin (9,5%), Norgestrel (7,8%), Norethisterone énanthate (6,7%), les préservatifs masculins (6,4%), les pilules progestatives seulement (1,4%) et les spermicides (1,1%). Le manque d'expertise a empêché la ligature des trompes ou des implants et la vasectomie. La stigmatisation, le rejet du mâle, le don ou la prise des méthodes sans des services de laboratoire adéquats ou des bilans de santé réguliers et l'incapacité à reconnaître ou à déclarer des changements défavorables de santé de la reproduction a eu une influence sur la contraception. Les infections génitales ont été identifiées chez 33,7% des personnes interrogées, la candidose vaginale 20%, la vaginose bactérienne 19%, le VIH / sida 9%, 6% et chlamydia <2% d'autres maladies vénériennes classiques. La sensibilisation, l’éducation, ont amélioré les diagnostics et l’on a adopté les changements d'attitude.Keywords: contraception, women, socio-demographics, barriers, genital healt

Antibiotic resistance in Candida albicans and Staphylococcus aureus involved in vaginitis: Case study of Dschang town, Cameroon

Nowadays, vaginal candidiasis and bacterial vaginosis are frequently encountered in medical practice and antibiotic resistance in implicated pathogens has not been reported in Dschang. This study sought to determine the antimicrobial susceptibility patterns of 198 isolates of Candida albicans and 300 strains of Staphylococcus aureus which caused vaginal candidiasis and bacterial vaginosis in Dschang in 2003 and 2005 respectively, using a standardized disc diffusion technique. Results showed a significant high resistance (p<0.05) to ketoconazole (61.0%), fluconazole (74.7%), amphotericin B (79.3%) and griseofulvin (100%) by C. albicans. Sensitivity rates to commonly used antimycotics such as nystatin (100%), clotrimazole (82.3%) and miconazole (73.2%) are still very high, thus, in life threatening infections, treatment with these agents is advocated for empirical therapy. The profile of S. aureus heavily favours gentamycin (91.7%), amoxycillin - clavulanic acid (87.7%) and ciprofloxacin (81.3%) (p<0.05) which are commonly used. The extent of resistance to erythromycin (70.3%), cloxacillin, (76.6%) and penicillin (81.0%) favours their retirement consideration unless in vitro studies depict otherwise. Vancomycin exhibited 100% efficacy. The present findings highlight the need for a regular review of the antimicrobial susceptibility profiles of commonly isolated organisms in any environment, with a view to ensuring a rational choice for both empirical and definitive antimicrobial chemotherapy.Keywords: Vaginitis, Candida albicans, Staphylococcus aureus, antibiotic resistanc