Rev Epidemiol Sante Publique

Position du problème Au Cameroun, la couverture des enfants éligibles au traitement antirétroviral (TARV) (15 %) était l’une des plus faibles des 21 pays prioritaires du Fonds Mondial en 2012. Le but de cette étude était de faire une analyse situationnelle de l’offre des soins pour améliorer la prise en charge du VIH pédiatrique (PECP) au Cameroun. Méthodes Une étude transversale descriptive a été menée pendant quatre mois (avril à août 2014) dans 12 formations sanitaires de sept régions du Cameroun sélectionnées par un sondage systématique. Les données ont été recueillies à l’aide d’un auto-questionnaire administré aux personnels soignants et aux responsables administratifs inclus dans l’étude. Résultats Au total 142 personnels en charge du VIH pédiatrique ont été inclus dans cette étude : 115 du niveau opérationnel parmi lesquels 59 (51,2 %) personnels de santé, 44 (38,3 %) agents communautaires, 12 (10,4 %) chefs de services, 19 responsables du niveau régional et 8 du niveau central. La grande majorité des personnels soignants impliqués dans la PECP étaient des infirmiers, nécessitant ainsi la délégation effective des tâches médicales institutionnalisée au Cameroun. Très peu de documents normatifs nationaux prenaient en compte la PECP. La faible vulgarisation de ces documents normatifs à tous les niveaux de la pyramide sanitaire pourrait justifier le non-respect des protocoles de prise en charge observé dans les formations sanitaires offrant la PECP. Conclusion La mise à jour et la diffusion à large échelle des documents nationaux normatifs, prenant en compte des spécificités de l’enfant infecté par le VIH, sont nécessaires pour améliorer l’application des directives de la PECP au niveau opérationnel.Background In Cameroon in 2012, the proportion (15%) of children eligible for antiretroviral treatment (ART) was one of the lowest among the 21 Global Fund priority countries. The objective of this study was to carry out a situational analysis of the existing care offer for pediatric HIV in Cameroon. Methods A descriptive cross-sectional study was conducted over a 4-month period (April to August 2014) in 12 healthcare facilities in 7 regions of Cameroon selected by systematic sampling. The data were collected in a self-administered questionnaire filled out by the caregiving and administrative personnel included in the study. Results All in all, 142 persons in charge of pediatric HIV treatment were included in the study, of whom 115 were working at the operational level: 59 (51.2%) health personnel, 44 (38.3%) community agents and 12 (10.4%) department heads; the other 27 exercised responsibilities at the regional (19) and the local (8) levels. An overwhelming majority of the caregivers involved in pediatric VIH treatment were nurses, a factor necessitating the delegation of medical tasks institutionalized in Cameroon. Few standardized nationwide documents take into account these treatment modalities. Inadequate dissemination of the documents at all levels of the healthcare pyramid may justify the non-compliance with the care protocols that has been observed in the training programs dedicated to the subject. Conclusion The updating and large-scale dissemination of standardized nationwide documents taking into account the specificities of HIV-infected children are required to improve implementation at the operational level of the Cameroonian healthcare system of the existing guidelines for pediatric HIV treatment

Co-infection by hepatitis C but not hepatitis B virus aggravates hepatic periportal fibrosis and its clinical outcomes in subjects infected by Schistosoma mansoni

International audienceno abstrac

Practices of Care to HIV-Infected Children: Current Situation in Cameroon

Background: To accelerate access to pediatric HIV care in Cameroon, operational challenges in implementing HIV pediatric care need to be identified. The aim of this study was to assess the knowledge, attitudes, and practices of health care workers regarding pediatric HIV infection in Cameroon. Methods: A descriptive cross-sectional study was conducted over a 4-month period (April to August 2014) in 12 health facilities in 7 regions of Cameroon selected using systematic random sampling. Data were collected from interviews with health care providers and managers using standardized self-administered questionnaires and stored in the ACCESS software. Results: In total, 103 health care providers were included in this study, of which 59 (57.3%) were health workers and 44 (42.7%) community agents. Most of the health workers in charge of HIV pediatric care were nurses, requiring effective medical task shifting that was institutionalized in Cameroon. The knowledge of health care providers in relation to pediatric HIV care was acceptable. Indications for prescription of test for early infant diagnosis were known (96.1%), but their attitudes and practices regarding initiating antiretroviral therapy (ART) in infants less than 2 years (5.2%) and first-line ART protocols (25.4%) were insufficient, due to little information about standard procedures. Conclusion: Capacity building of health care providers and large-scale dissemination of normative national documents are imperative to improve HIV pediatric care in the health care facilities