Prévalence de l’hypertension artérielle en milieu du travail : Cas du groupe Alucam au Cameroun: Prevalence of hypertension among workers : A case of the Alucam group in Cameroon

Context and objective. Hypertension (HTN), a silent killer, is a major global public health problem. Its magnitude remains however unknown in a professional environment. The objective of this study was to evaluate the frequency and risk factors associated with HTN among workers from the Alucam group in Cameroon. Method. A descriptive and analytical cross-sectional study of an exhaustive sample of workers from the Alucam Socatral industrial plant in Cameroon was conducted between January and September 2015. Parameters of interest included data on the determinants of the individual, the company, and Karasek’s psychosocial risk assessment as well as clinical data (measurement of blood pressure, height and weight). The Chi-square tests of Pearson and De Snedecor were used to compare the proportions. Odds ratio (OR) was used to assess risk factors associated to HTN. The statistical significance level was set at 5% (p < 0.05). Results. 637 employees were enrolled. Their average age was 52 years old and all were male. The prevalence of HTN was 14.3%. We noted a very significant hypertension prevalence among older workers compared to younger (OR = 16.95, p< 0.0001). HTA was significantly related to obesity (OR = 4.7, p < 0.0001). Almost all of the workers (90%) had not changed their service since being hired with a seniority of more than 30 years in 54% of the cases. Active workers accounted for 91% of all HTNs. According to psychosocial risk, the majority of workers (63%) was in the dial “job strain”, of which 70% were operators. Social support and decision latitude decreased as psychological demand increased. Conclusion. One in seven workers in this company is hypertensive. Age, obesity and shift work are associated with hypertension in the present study population. Contexte & objectif. L’hypertension (HTA), tueur silencieux, est un problème majeur de santé publique à travers le monde. Son ampleur reste cependant inconnue en milieu professionnel. L’objectif de la présente étude était d’évaluer la fréquence et les facteurs associés à l’HTA chez les travailleurs du groupe Alucam, au Cameroun. Méthodes. Nous avons conduit une étude transversale descriptive et analytique auprès d’un échantillon exhaustif des travailleurs de l’établissement industriel Alucam Socatral, entre janvier et septembre 2015, au Cameroun. Les paramètres d’intérêt englobaient les données relatives aux déterminants de l’individu, de l’entreprise et l’évaluation du risque psychosocial par le modèle de Karasek ainsi que les données cliniques (mesure de la pression artérielle, taille et poids). Les tests Khi² de Pearson et de De Snedecor ont été utilisés pour comparer les proportions. Odds ratio (OR) a permis d’évaluer les facteurs associés à l’HTA. Le seuil de signification statistique a été fixé à 5% (p < 0,05). Résultats. 637 employés ont été enrôlés. Leur âge moyen était de 52 ans et tous étaient du sexe masculin La prévalence de l’HTA était de 14,3 %. On notait une prévalence d’HTA très significative chez les travailleurs âgés par rapport aux plus jeunes (OR = 16,95, p < 0,0001). L’HTA était significativement liée avec l’obésité (OR 4,7, p = 0,0001). La quasi-totalité des travailleurs (90 %) n’avait pas changé de service depuis l’embauche avec une ancienneté de plus de 30 ans dans 54% des cas. Les travailleurs actifs constituaient 91 % des HTA. Selon le risque psychosocial, la majorité des travailleurs (63%) était dans le cadran « job strain », parmi lesquels 70 % étaient opérateurs. Le soutien social et la latitude décisionnelle diminuaient alors que la demande psychologique augmentait. Conclusion. Un travailleur sur sept de cette entreprise est hypertendu. L’âge, l’obésité et le travail posté sont associés à l’HTA dans notre population d’étude

Quantifying the value of viral genomics when inferring who infected whom in the 2014–16 Ebola virus outbreak in Guinea

Transmission trees can be established through detailed contact histories, statistical or phylogenetic inference, or a combination of methods. Each approach has its limitations, and the extent to which they succeed in revealing a 'true' transmission history remains unclear. In this study, we compared the transmission trees obtained through contact tracing investigations and various inference methods to identify the contribution and value of each approach. We studied eighty-six sequenced cases reported in Guinea between March and November 2015. Contact tracing investigations classified these cases into eight independent transmission chains. We inferred the transmission history from the genetic sequences of the cases (phylogenetic approach), their onset date (epidemiological approach), and a combination of both (combined approach). The inferred transmission trees were then compared to those from the contact tracing investigations. Inference methods using individual data sources (i.e. the phylogenetic analysis and the epidemiological approach) were insufficiently informative to accurately reconstruct the transmission trees and the direction of transmission. The combined approach was able to identify a reduced pool of infectors for each case and highlight likely connections among chains classified as independent by the contact tracing investigations. Overall, the transmissions identified by the contact tracing investigations agreed with the evolutionary history of the viral genomes, even though some cases appeared to be misclassified. Therefore, collecting genetic sequences during outbreak is key to supplement the information contained in contact tracing investigations. Although none of the methods we used could identify one unique infector per case, the combined approach highlighted the added value of mixing epidemiological and genetic information to reconstruct who infected whom

Determinants of Transmission Risk During the Late Stage of the West African Ebola Epidemic.

Understanding risk factors for Ebola transmission is key for effective prediction and design of interventions. We used data on 860 cases in 129 chains of transmission from the latter half of the 2013-2016 Ebola epidemic in Guinea. Using negative binomial regression, we determined characteristics associated with the number of secondary cases resulting from each infected individual. We found that attending an Ebola treatment unit was associated with a 38% decrease in secondary cases (incidence rate ratio (IRR) = 0.62, 95% confidence interval (CI): 0.38, 0.99) among individuals that did not survive. Unsafe burial was associated with a higher number of secondary cases (IRR = 1.82, 95% CI: 1.10, 3.02). The average number of secondary cases was higher for the first generation of a transmission chain (mean = 1.77) compared with subsequent generations (mean = 0.70). Children were least likely to transmit (IRR = 0.35, 95% CI: 0.21, 0.57) compared with adults, whereas older adults were associated with higher numbers of secondary cases. Men were less likely to transmit than women (IRR = 0.71, 95% CI: 0.55, 0.93). This detailed surveillance data set provided an invaluable insight into transmission routes and risks. Our analysis highlights the key role that age, receiving treatment, and safe burial played in the spread of EVD