Prevalence of bacterial vaginosis and associated risk factors in pregnant women receiving antenatal care at the Kumba Health District (KHD), Cameroon

Abstract Background Bacterial vaginosis (BV) is a common reproductive tract disorder in women of child bearing age, accounting for one third of vaginal infections. It is characterized by an increase in vaginal pH, decreased Lactobacilli, and overgrowth of facultative and anaerobic bacteria. Studies have consistently shown BV to be a risk factor for adverse obstetric and gynecological outcomes. BV is believed to play a critical role in the transmission of sexually transmitted infections. Its aetiology and risk factors are poorly understood. This study determined the prevalence and risk factors for BV among pregnant women in Kumba Health District (KHD) Cameroon to generate findings that could guide the design of interventions for prevention of infection and associated poor pregnancy outcomes. Methods A structured questionnaire was administered to 309 women seeking antenatal care (ANC) in three health facilities in KHD between May to July 2016, to capture data on demographic, gynecological and obstetric characteristics, and hygiene behavior. High vaginal swabs (HVS) collected from these women were gram stained, examined under a microscope and BV evaluated by Nugent scoring. Chi square (χ2) test was used to determine the relationship between BV and factors investigated. Statistical significance was set at p < 0.05. Results The prevalence of BV was 26.2%. Nine point 1 % of participants had a mixed infection with Candida. BV was higher (29.5%) in participants from the rural area (χ2 = 8.609. P = 0.014), those who did not use antibiotics (31.9%) prior to the study (χ2 = 12.893, P = 0.002) and women with no history of a genital tract infection (χ2 = 18.154, P = 0.001). There was a significant difference in prevalence with respect to gestation age (χ2 = 13.959, P = 0.007) with the highest occurring in women in the second trimester (31.7%). Women who practiced douching (χ2 = 23.935, P = 0.000) and those who did not wash pants with disinfectant (χ2 = 7.253, P = 0.027) had a high prevalence. Conclusion BV could be a health concern among pregnant women in study area. BV prevalence was affected by some hygiene behaviors, socio-demographic and clinical factors. Screening and treatment of positive cases during antenatal visits to prevent adverse outcomes, as well as education of women on vaginal hygiene is highly recommended

Prescribing patterns and associated factors of antibiotic prescription in primary health care facilities of Kumbo East and Kumbo West Health Districts, North West Cameroon.

Inappropriate use of antibiotics is a global public health challenge and has been associated with antibiotic resistance. WHO reports show that efforts to promote rational antibiotic use in developing countries are poor. With the growing number of infections with antibiotic resistant bacteria, rational drug use becomes imperative and studies that promote rational drug use are highly necessary. Considering this, we investigated prescribing patterns and predictors of antibiotic prescription in primary health care facilities in Kumbo East (KE) and Kumbo West (KW) health districts in North West Cameroon, to contribute data which could influence policy on antibiotic use.A cross sectional retrospective study was conducted from April 2014 to April 2015 in 26 randomly selected primary care facilities. Questionnaires were administered to 59 antibiotic prescribers to determine factors that predict antibiotic prescribing. Data on antibiotic prescription were collected by review of consultation registers. Prescription rates and demographics, prescriber and institution factors were analyzed using ANOVA. The best predictor of prescription was determined using multiple linear regression analysis.A total of 30,096 prescriptions were reviewed. Overall antibiotic prescription rate was 36.71%, with a mean of 1.14 antibiotics prescribed per patient. Amoxicillin was the most prescribed (29.9%). The most prevalent indications for prescribing were respiratory tract infections (21.27%). All antibiotics prescribed were broad-spectrum. Antibiotics were prescribed for patients with malaria and also in situations where diagnosis was uncertain. Prescribing by generic name was 98.36% while 99.87% was from Essential Drug List. Use of laboratory results, patient turnout and Performance Based Financing (PBF) were significantly associated with antibiotic prescribing rates (p < 0.05). PBF moderated prescribing.There was misuse of antibiotics in primary care facilities in study area. We recommend all primary care health facilities in study area to be included in the PBF scheme and that prescribing should only be done by physicians as the have adequate training

A Community Based Study on the Mode of Transmission, Prevention and Treatment of Buruli Ulcers in Southwest Cameroon: Knowledge, Attitude and Practices

<div><p>Background</p><p>Buruli ulcer (BU) is a neglected tropical disease affecting the skin, tissues and in some cases the bones, caused by the environmental pathogen <i>Mycobacterium ulcerans</i> (<i>M</i>. <i>ulcerans</i>). Its mode of transmission is still elusive. Delayed treatment may cause irreversible disabilities with consequent social and economic impacts on the victim. Socio-cultural beliefs, practices and attitudes in endemic communities have been shown to influence timely treatment causing disease management, prevention and control a great challenge. An assessment of these factors in endemic localities is important in designing successful intervention strategies. Considering this, we assessed the knowledge, attitude and practices regarding BU in three endemic localities in the South West region, Cameroon to highlight existing misconceptions that need to be addressed to enhance prompt treatment and facilitate effective prevention and control.</p><p>Methods and Findings</p><p>A cross-sectional study was executed in three BU endemic health districts. Using qualitative and quantitative approaches we surveyed 320 randomly selected household heads, interviewed BU patients and conducted three focus group discussions (FGDs) to obtain information on awareness, beliefs, treatment, and attitudes towards victims. The influence of socio-demographic factors on these variables was investigated.</p><p>Results</p><p>Respondents (84.4%) had a good knowledge of BU though only 65% considered it a health problem while 49.4% believed it is contagious. Socio-demographic factors significantly (P<0.05) influenced awareness of BU, knowledge and practice on treatment and attitudes towards victims. Although the majority of respondents stated the hospital as the place for appropriate treatment, FGDs and some BU victims preferred witchdoctors/herbalists and prayers, and considered the hospital as the last option. We documented beliefs about the disease which could delay treatment.</p><p>Conclusion</p><p>Though we are reporting a high level of knowledge of BU, there exist fallacies about BU and negative attitudes towards victims in communities studied. Efforts towards disease eradication must first of all target these misconceptions.</p></div

Antibiotic prescription rate in health care facilities in Kumbo East and Kumbo West health districts between April 2014 and April 2015.

<p>Antibiotic prescription rate in health care facilities in Kumbo East and Kumbo West health districts between April 2014 and April 2015.</p

Characteristics of patients prescribed antibiotics.

<p>Characteristics of patients prescribed antibiotics.</p

Understanding of the causes of BU by community members with respect to level of education.

<p>Understanding of the causes of BU by community members with respect to level of education.</p

Number of antibiotics per prescription.

<p>Number of antibiotics per prescription.</p

Demographic characteristics of community members and their understanding of BU.

<p>Demographic characteristics of community members and their understanding of BU.</p

Characteristics of prescribers.

<p>Characteristics of prescribers.</p