Bacterial vaginosis and risk factors: A cross-sectional study among women at Soa District Hospital, Cameroon

Bacterial vaginosis is the most prevalent genital infection, characterized by malodorous vaginal discharge, and has arisen as a public health concern due to its link to sexually transmitted illnesses. The purpose of this cross-sectional study was to determine the prevalence rate of bacterial vaginosis due to Gardnerella species and the risk factors related to this infection in childbearing women at the Hospital of District of Soa.  A questionnaire was administered before each vaginal swab sample was obtained. Bacterial vaginosis was classified as a Nugent score of 7 to 10, and the presence of clue cells. The findings were as follows: 210 women were enrolled in this study. The average age was 29.42±5.15 years, with extremes ranging from 18 to 48years. The age group with the highest representation (38.67%) was 26-33 years. The prevalence of bacterial vaginosis was 42.85% (90/210), with Gardnerella species present at 90% (81/90) and Mobiluncus species present at 3.33%. The 18-25 age group was more susceptible to bacterial vaginosis due to Gardnerellas pecies (35.80%), although the student group was the most affected (32.09%), and the difference was not statistically significant. With a prevalence of 44.44%, the single group was statistically significantly more exposed to this vaginal infection than the other groups. University-level women had a higher prevalence rate of bacterial vaginosis due to Gardnerella species infection (54.32%), followed by secondary-level women (37.03%). Gardnerella speciesvaginosis was found in both pregnant and non-pregnant women (38.27% and 61.72%, respectively). To avoid future obstetric difficulties, this infection must be effectively managed therapeuticall

Epidémiologie moléculaire du rotavirus du groupe A associé aux gastroentérites chez les enfants de moins de 5 ans dans la ville de Yaoundé (Cameroun)

Le rotavirus est la première cause de gastroentérites grave chez les enfants de moins de 5 ans. La gravité et la mortalité de la maladie sont majorées dans les pays à revenus faibles d’Asie du sud et d’Afrique subsaharienne. Au Cameroun, la forte prévalence des rotaviroses, associées aux spécificités génotypiques locales du virus, soulignent l’importance de disposer de données épidémiologiques sur le virus. Cette étude visait à contribuer à une meilleure connaissance des principales souches de rotavirus responsables des gastroentérites chez les enfants de moins de 5 ans dans la ville de Yaoundé. Il s’agit d’une étude descriptive transversale d’une durée de 4 mois, dans 8 formations sanitaires de la ville de Yaoundé. Les échantillons de selles d’enfants de moins de 5 ans, hospitalisés pour gastroentérite ont été prélevés. La recherche du rotavirus s’est faite avec le kit ELISA Oxoid ProSpec TTM, et la détermination des génotypes du virus s’est faite par RT - PCR. Cent trente échantillons de selles d’enfants souffrant de gastroentérite ont été collectés. 66,1% de ces échantillons provenaient des hôpitaux FCB/CME, du CHE et de HDE. Le rotavirus a été isolé chez 30% des enfants, dont 40% avait entre 6 et 11 mois. Le CHE (6,9%) et l’HGY (0%) avaient respectivement la prévalence la plus élevée et la plus basse de la ville. Un nombre élevé de combinaisons génotypiques a été isolé, parmi lesquels prédominaient G1P[8] (31%) suivit de G3P[6] (28%) et de G4P[6] (13 %). Les génotypes mixtes G1P[6][8], G2P[6][8], et G1G3P[8] représentaient 22% des isolats. Un type G (3%) est resté indéterminé durant cette étude.© 2015 International Formulae Group. All rights reserved.Mots clés: Epidémiologie moléculaire, rotavirus, génotypes, gastroentérite, enfants, YaoundéEnglish Title:  Molecular epidemiology of group A rotavirus associated to gastroenteritis in children less than 5 years in Yaoundé (Cameroon)English AbstractRotavirus is the leading cause of severe gastroenteritis in children less than 5 years. Severity and mortality of this disease are majored in low-income countries of South - Asia and sub - Saharan Africa. In Cameroon, the high prevalence of rotaviruses associated to local genotypic specificities of virus enhances the importance of epidemiological database on the virus. This study aimed at contributing to a better knowledge of the main rotavirus strains responsible for gastroenteritis in children less than 5 years in Yaoundé. We carried out a descriptive and cross sectional study during 4 months, in 8 health centers in Yaoundé. Stool specimens were collected from children less than 5 years old, hospitalized for gastroenteritis. Rotavirus was detected with ELISA kit Oxoid ProSpecTTM, and genotypes determined by RT - PCR. One hundred and twenty seven stool specimens were collected during the study. FCB/CME, CHE, HDE provided 66.1% of specimens collected. Rotavirus was isolated in 30% of children, and 40% of these children were between 6 to 11 months old. The CHE (6. 9%) and the HGY (0%) had respectively the highest and the lowest prevalence of the town. A large number of genotype has been isolated and G1P[8] (31%) were predominant, followed by G3P[6] (28%) and G4P[6] (13%). Mixt genotypes G1P[6][8], G2P[6][8], and G1G3P[8] represented 22% of isolates. One G - type remained untypable.© 2015 International Formulae Group. All rights reserved.Keywords: Molecular epidemiology, rotavirus, genotypes, gastroenteritis, children, Yaound

Hospital-based Surveillance Provides Insights Into the Etiology of Pediatric Bacterial Meningitis in Yaoundé, Cameroon, in the Post-Vaccine Era.

BACKGROUND:Meningitis is endemic to regions of Cameroon outside the meningitis belt including the capital city, Yaoundé. Through surveillance, we studied the etiology and molecular epidemiology of pediatric bacterial meningitis in Yaoundé from 2010 to 2016. METHODS:Lumbar puncture was performed on 5958 suspected meningitis cases; 765 specimens were further tested by culture, latex agglutination, and/or polymerase chain reaction (PCR). Serotyping/grouping, antimicrobial susceptibility testing, and/or whole genome sequencing were performed where applicable. RESULTS:The leading pathogens detected among the 126 confirmed cases were Streptococcus pneumoniae (93 [73.8%]), Haemophilus influenzae (18 [14.3%]), and Neisseria meningitidis (15 [11.9%]). We identified more vaccine serotypes (19 [61%]) than nonvaccine serotypes (12 [39%]); however, in the latter years non-pneumococcal conjugate vaccine serotypes were more common. Whole genome data on 29 S. pneumoniae isolates identified related strains (<30 single-nucleotide polymorphism difference). All but 1 of the genomes harbored a resistance genotype to at least 1 antibiotic, and vaccine serotypes harbored more resistance genes than nonvaccine serotypes (P < .05). Of 9 cases of H. influenzae, 8 were type b (Hib) and 1 was type f. However, the cases of Hib were either in unvaccinated individuals or children who had not yet received all 3 doses. We were unable to serogroup the N. meningitidis cases by PCR. CONCLUSIONS:Streptococcus pneumoniae remains a leading cause of pediatric bacterial meningitis, and nonvaccine serotypes may play a bigger role in disease etiology in the postvaccine era. There is evidence of Hib disease among children in Cameroon, which warrants further investigation

Phylogeography and resistome of pneumococcal meningitis in West Africa before and after vaccine introduction.

Despite contributing to the large disease burden in West Africa, little is known about the genomic epidemiology of Streptococcus pneumoniae which cause meningitis among children under 5 years old in the region. We analysed whole-genome sequencing data from 185 S. pneumoniae isolates recovered from suspected paediatric meningitis cases as part of the World Health Organization (WHO) invasive bacterial diseases surveillance from 2010 to 2016. The phylogeny was reconstructed, accessory genome similarity was computed and antimicrobial-resistance patterns were inferred from the genome data and compared to phenotypic resistance from disc diffusion. We studied the changes in the distribution of serotypes pre- and post-pneumococcal conjugate vaccine (PCV) introduction in the Central and Western sub-regions separately. The overall distribution of non-vaccine, PCV7 (4, 6B, 9V, 14, 18C, 19F and 23F) and additional PCV13 serotypes (1, 3, 5, 6A, 19A and 7F) did not change significantly before and after PCV introduction in the Central region (Fisher's test P value 0.27) despite an increase in the proportion of non-vaccine serotypes to 40 % (n=6) in the post-PCV introduction period compared to 21.9 % (n=14). In the Western sub-region, PCV13 serotypes were more dominant among isolates from The Gambia following the introduction of PCV7, 81 % (n=17), compared to the pre-PCV period in neighbouring Senegal, 51 % (n=27). The phylogeny illustrated the diversity of strains associated with paediatric meningitis in West Africa and highlighted the existence of phylogeographical clustering, with isolates from the same sub-region clustering and sharing similar accessory genome content. Antibiotic-resistance genotypes known to confer resistance to penicillin, chloramphenicol, co-trimoxazole and tetracycline were detected across all sub-regions. However, there was no discernible trend linking the presence of resistance genotypes with the vaccine introduction period or whether the strain was a vaccine or non-vaccine serotype. Resistance genotypes appeared to be conserved within selected sub-clades of the phylogenetic tree, suggesting clonal inheritance. Our data underscore the need for continued surveillance on the emergence of non-vaccine serotypes as well as chloramphenicol and penicillin resistance, as these antibiotics are likely still being used for empirical treatment in low-resource settings. This article contains data hosted by Microreact

Assessing the causes of under-five mortality and proportion associated with pneumococcal diseases in Cameroon. A case-finding retrospective observational study: 2006-2012

<div><p>Background</p><p>Vital registration data outlining causes of deaths (CoD) are important for a sustainable health system, targeted interventions and other relevant policies. There is data paucity on vital registration systems in developing countries. We assessed the leading causes and proportions of under-five deaths, and particularly those related to pneumococcal infections in Yaoundé, Cameroon, using hospital registration data.</p><p>Methods</p><p>A retrospective case-finding observational study design was used to access and identify data on 817 death cases in children under-five years of age recorded in health facilities in Yaoundé, within the period January 1, 2006 and December 31, 2012. Patients’ files were randomly selected and needed information including demographic data, date of admission, clinical and laboratory diagnosis, principal and/or underlying causes of death were abstracted into structured case report forms. The International Classification of Diseases and Clinical Modifications 10^th revision (ICD-10-CM) codes (ICD10Data.com 2017 edition) were used to classify the different CoD, retrospectively. Ascertainment of CoD was based on medical report and estimates were done using the Kaplan-Meier procedure and descriptive statistics.</p><p>Results</p><p>Of the 817 death records assessed, malaria was the leading CoD and was responsible for 17.5% of cases. Meningitis was the second largest CoD with 11.0%; followed by sepsis (10.0%), <i>Streptococcus pneumoniae</i> infections (8.3%), malnutrition (8.3%), gastro-enteritis / diarrhoea (6.2%), anaemia (6.1%) and HIV (3.5%), respectively.</p><p>Conclusion</p><p>The main CoD in this population are either treatable or vaccine-preventable; a trend consistent with previous reports across developing countries. Besides, the health effects from non-communicable infections should not be neglected. Therefore, scaling-up measures to reduce causes of under-five deaths will demand sustainable efforts to enhance both treatment and disease prevention strategies, to avoid a decline in the progress towards reducing under-five deaths by 2/3 from the 1990 baseline.</p></div

Impact of 13-valent pneumococcal conjugate vaccine on laboratory-confirmed pneumococcal meningitis and purulent meningitis among children <5 years in Cameroon, 2011–2018

Background The 13-valent pneumococcal conjugate vaccine (PCV13) entered Cameroon’s childhood national immunization programme (NIP) in July 2011 under a 3-dose schedule (6, 10, 14 weeks of age) without any catch-up. We described the impact of PCV13 onserotype distribution among pneumococcal meningitis cases over time. Methods We used laboratory-based sentinel surveillance data to identify meningitis cases among 2-to 59-month-old children with clinically-suspected bacterial meningitis (CSBM) admitted to hospitals in Yaoundé (August 2011-December 2018). Purulent meningitis cases had a cerebrospinal fluid (CSF) white blood cell (WBC) count 20 per mm3. Pneumococcal meningitis cases had S. pneumoniae identified from CSF, with serotyping by polymerase chain reaction. Years 2011-2014 were described as early PCV13 era (EPE) and years 2015-2018 as late PCV13 era (LPE) impact periods. Results Among children hospitalized with CSBM who had a lumbar puncture obtained, there was no significant change from the EPE versus the LPE in the percentage identified with purulent meningitis: 7.5% (112/1486) versus 9.4% (154/1645), p = 0.0846. The percentage of pneumococcal meningitis cases due to PCV13 vaccine-serotype (VST) decreased from 62.0% (31/50) during the EPE to 35.8% (19/53) in the LPE, p = 0.0081. The most frequent pneumococcal meningitis VSTs during the EPE were 6A/6B (30%) and 5 (6%), and during the LPE were 14 (13.2%), 3 (7.6%), 4 (5.6%) and 18C (5.6%). Conclusion Four to seven years after PCV13 introduction, the proportion of pneumococcal meningitis due to vaccine serotypes has declined, mainly due to reductions of serotypes 6A/6B, 1, 19A, and 23F; nevertheless, PCV13 VSTs remain common. Because the analyzed surveillance system was not consistent or population based, we could not estimate incidence or overall impact; this emphasizes the need for improved surveillance to document further the utility of PCV13 immunization in Cameroon.publishedVersionPeer reviewe