Strengthening Foodborne Diseases Surveillance In The Who African Region: An Essential Need For Disease Control And Food Safety Assurance

Several devastating outbreaks of foodborne diseases have been reported in the African region including acute aflatoxicosis in Kenya in 2004 and bromide poisoning in Angola in 2007. There are concerns about transmission of multiple antibiotic resistant bacteria and pesticide residues in foods. The globalization of the food trade which could increase the spread of food contaminants internationally is an emerging issue. The new International Health Regulations (IHR) (2005) cover events of international importance including contaminated food and outbreaks of foodborne disease. The IHR (2005) and other international as well as regional agreements require Member States to strengthen surveillance systems including surveillance for foodborne diseases. WHO has been supporting countries to strengthen foodborne disease surveillance since 2003. This paper reports on the work of WHO and partners in the area of foodborne disease surveillance, the challenges and opportunities and provides perspectives for the area of its work. The paper shows that laboratory-based surveillance is the preferred system for foodborne disease surveillance since it allows early detection of outbreak strains and identification of risk factors with laboratory services as the cornerstone. Foodborne disease surveillance has been included in the revised Integrated Disease Surveillance and Response (IDSR) Strategy and there are guidelines for use by countries. WHO in collaboration with partners, especially the Global Food Infections Network (GFN), has been supporting countries to strengthen national analytical capacity for foodborne disease surveillance and research. Training for countries to detect, control and prevent foodborne and other enteric infections from farm to table has been conducted. The training for microbiologists and epidemiologists from public health, veterinary and food sectors involved in isolation, identification and typing of Salmonella sp, Campylobacter sp., Vibrio cholerae , Vibrio sp. and Shigella from human and food samples have been carried out. Research into specific topics in microbiology and chemical contaminants has been conducted. Three institutions in Cameroun, Mali and Nigeria have been designated as centres of excellence for chemical contaminants. Despite these significant achievements, a number of challenges remain. Most food safety programmes and food safety systems remain fragmented resulting in duplication of efforts and inefficient use of resources; and most laboratories in the African Region are poorly resourced. In countries where facilities exist, there is underutilization and lack of synergy among laboratories. Countries should, therefore, conduct audits of existing laboratories to determine their strengths and weaknesses and strategize as appropriate. It is also imperative to continue to strengthen partnerships and forge new ones and increase resources for food safety, in general, and for foodborne disease surveillance, in particular, and continue capacity building, both human and institutional

L\'antibiotherapie de premiere intention dans le traitement de l\'empyeme pleural de l\'enfant en milieu Africain (Yaoundé-Cameroun).

We examined 125 pleural fluids collected, 67 cultures that represented 53.6% were positive. The three main germs isolated in order of decreasing frequency were Streptococcus pneumoniae (41.7%), Staphylococcus aureus (35.3%) and Haemophilus influenzae (7.5%). The most active antibiotics against each of these bacteria were : for S. pneumoniae, second and third generation cephalosporins with 100% sensitivity, amoxicilline + clavulinic acid (96.4% sensitivity), first generation cephalosporins (95% sensitivity) and 46.4% resistance to penicilline G; for S. aureus, céfuroxime, vancomycine and pristinamycine with 100% sensitivity, whereas gentamicin and tobramycin had only 91.3% sensitivity, and there was 13.8% resistance to oxacilline ; for H. influenzae, amoxicillin + clavulinic acid, first, second and third generation cephalosporins, and quinolones all showed 100% sensitivity with 100% and 60% resistance to cotrimoxazole and chloramphenicol respectively. To cover all these three germs in our environment, we recommend as first line antibiotherapy for empyema thoracis in children either of the following antibiotic combinations: amoxicillin/clavulinic acid with gentamicin or cefuroxime with gentamicin or vancomycin alone if available, against S. aureus infection.Nous avons prélevé et mis en culture 125 liquides pleuraux dont 67 soit 53,6% ont poussé. Les trois principaux germes isolés étaient dans l'ordre de fréquence décroissante : Streptococcus pneumoniae (41,7%) Staphylococcus aureus (35,3%) et Haemophilus influenzae (7,5% ). Les principaux antibiotiques actifs sur ces différents germes étaient : vis à vis de S. pneumoniae les céphalosporines de 2è et 3è génération (100%), amoxicilline+acide clavulanique (96,4%) les céphalosporines de 1ère génération (95%). La résistance à la pénicilline G était de 46,4% ; vis à vis de S. aureus, le céfuroxime, la vancomycine et la pristinamycine étaient actives à 100% contre 91,3% pour la gentamicine et la tobramycine, alors que l'oxacilline avait une résistance de 13,8% et enfin vis à vis de H. influenzae l'amoxicilline+acide clavulanique, les céphalosporines des trois générations et les quinolones avait une activité de 100% et le cotrimoxazole une résistance de 100% contre 60% pour le choramphénicol. Pour couvrir ces trois germes dans notre environnement nous proposons de prescrire en première intention dans l'empyème pleural de l'enfant l'une des deux associations suivantes : soit amoxicilline + acide clavulanique et gentamicine soit céfuroxime et gentamicine ou alors vancomycine seule en cas de S. aureus si ce dernier antibiotique est disponible. Keywords: Antibiotherapy - Child - Empyema thoracis -Yaounde - Cameroon.Clinics in Mother and Child Health Vol. 4 (1) 2007: pp. 641-64

High Prevalence of astA-positive Escherichia coli among children in Yaounde, Cameroon

No Abstract.Cameroon Journal of Experimental Biology Vol. 2 (2) 2006: pp. 95-10