Assessment of Sharp Injuries among Cameroonian Dental Professionals

Objective To assess the prevalence of sharp injury among Cameroonian dental professionals. Materials and Methods A cross-sectional study of 41 dental professionals recruited from 4 out of 10 provinces in Cameroon was conducted in the second half of 2009. A self-administered questionnaire was used to capture information on demography, nature, frequency and causes of sharp injury, post-exposure prophylaxis practice and methods of sharps disposal. Results Thirty-nine dental professionals (95.1%) had experienced sharp injury with 35.9% being once in the preceding 12 months. Needlestick was the most common sharp injury experienced by the respondents. Most of the injuries occurred during recapping of the needle. Activity during which injuries occurred was not significantly associated with type of practice. Twenty three (59.0%) respondents received post-exposure prophylaxis after sustaining sharp injury. Proper disposal of sharps in a special container was observed by 35 (85.4%) of the respondents. Conclusion The prevalence of sharp injuries among Cameroonian dental professionals was high. This justifies an urgent need for concerted effort to reduce sharp injuries in Cameroon dental practices through a comprehensive sharp injury prevention program including work place safety, employee training on guidelines adherence, safe recapping and disposal systems

Cameroonian Dentists’ Opinion On Training And Quality Of Dental Services Rendered By Dental Auxiliaries

Objective To assess Cameroonian dentists’ opinion on training and quality of dental services rendered by dental auxiliaries. Material and Methods: The questionnaire-based cross-sectional survey was conducted amongst randomly selected dentists from six provinces in Cameroon in the first quarter of 2010. Results More than half (51.4%) of the 37 respondents have worked with dental auxiliaries for more than 4 years with higher interaction between the respondents and dental therapists (59.5%). Majority approved scaling and polishing and tooth extraction, few approved root canal therapy and none approved minor surgical procedure like salivary stone removal for the dental auxiliaries. Most respondents (86.5%) agreed that dental auxiliaries work well with 30 (81.1%) opining that the quality of services rendered by the dental auxiliaries were very satisfactory. A total of 15 (41%) of the respondents thought that dental therapists should work in specific areas with 80% recommending rural areas. Majority of the respondents 30 (81.1%) thought that dental auxiliaries are important in oral health care delivery in Cameroon and 33 (89.2%) of the respondents thought that government should continue the training of dental auxiliaries. Conclusion The study revealed high level of interactions between dentists and dental auxiliaries in Cameroon. The respondents’ opinions about dental auxiliaries were mostly positive. There existed variability in opinion of respondents about procedures that dental auxiliaries should perform. The is need for establishment of regulatory agency which would tap and harmonize all the derivable potential from dental auxiliaries

The Impact Of Dental Auxiliaries In Oral Health Delivery In Cameroon

Objective: To assess the impact of dental auxiliaries in oral health delivery in Cameroon.Materials and Methods: A cross-sectional study of 47 dental auxiliaries recruited from six of 10 provinces in Cameroon was conducted in 2010. A self-administered questionnaire elicited information on demography, training received and role in the clinic and opinion about their job.Results: Most of the respondents carry out amalgam fillings, dental prophylaxis, composite fillings, extractions, atraumatic restoration (ART), fabrication of partial and full dentures. Few respondents carry out wound suturing, root canal treatment (RCT), treat minor injuries and mandibular reduction. More than half (52.5%) of the  respondents treat 6-10 patients per day while 13 (29.5%) of respondents work without any direct supervision. Out of the respondents, 80.9% were formally trained and 25.6% were trained in Yaoundé University Teaching Hospital. A total of 61.7% received training for <3 years, 26.1% have not received any additional training after qualifying and 77.8% signified interest in further training. Most respondents (80.9%) considered their work rewarding and interesting, 57.4% think their work is useful to the society and 38.3% find their work, tasking.Conclusion: This study highlighted the importance of dental auxiliaries in the oral healthcare delivery, their responsibilities, strength and limitations. The training and job specification was highly variable necessitating the establishment of regulatory agency to standardize the training and job description of dental auxiliaries in Cameroon

Smokeless tobacco use, tooth loss and oral health issues among adults in Cameroon

Background: Tobacco use in smokeless and smoked forms is preventable cause of mortality and morbidity worldwide.Objective: To determine the prevalence of smokeless tobacco use and the association with tooth loss and oral health problems among adults in Cameroon.Methods: Adults dwelling in the Fokoue area of West Region of Cameroon were studied.Results: Out of the 226 participants studied, 119 of them reported smokeless tobacco use giving a prevalence of 52.7% with majority-74 (62.2%) chewing it. Three-quarters (77.3%) of the respondents use it more than than thrice-daily and more than half of them respondents have been using it for 6-10 years. The smokeless tobacco users were more of those aged 50-59 years, females, farmers, those with less than post-primary education, non alcohol consumers and those that have notreceived previous dental care than smokeless tobacco users. However, it was only age (p=0.006) and educational attainment (p=0.009) that were significantly associated with smokeless tobacco use. Smokeless tobacco user were more likely to have poor oral hygiene, dental caries, gingival recession, leukoplakia, erythroplakia, abnormal growth, tooth wear lesion, experienced tooth loss and edentulousnss than non smokeless tobacco users. However, the significantly associated lesions with smokeless tobacco use were tooth loss (p=0.008), edentulousness (p=0.016), gingival recession (p=0.006) and leukoplakia (p=0.001).Conclusion: The prevalence of smokeless tobacco use was high among adults in Cameroon and it was associated with more likelihood of oral health problems. There is therefore a need for health education on the health consequences of the smokeless tobacco use with demonstrations by the dentist.Key words: Smokeless tobacco, tooth loss, mucosal problems, adult

Persistent anthrax as a major driver of wildlife mortality in a tropical rainforest

Anthrax is a globally important animal disease and zoonosis. Despite this, our current knowledge of anthrax ecology is largely limited to arid ecosystems, where outbreaks are most commonly reported. Here we show that the dynamics of an anthrax-causing agent, Bacillus cereus biovar anthracis, in a tropical rainforest have severe consequences for local wildlife communities. Using data and samples collected over three decades, we show that rainforest anthrax is a persistent and widespread cause of death for a broad range of mammalian hosts. We predict that this pathogen will accelerate the decline and possibly result in the extirpation of local chimpanzee (Pan troglodytes verus) populations. We present the epidemiology of a cryptic pathogen and show that its presence has important implications for conservation

Tixagevimab–cilgavimab for treatment of patients hospitalised with COVID-19: a randomised, double-blind, phase 3 trial

Background: Tixagevimab–cilgavimab is a neutralising monoclonal antibody combination hypothesised to improve outcomes for patients hospitalised with COVID-19. We aimed to compare tixagevimab–cilgavimab versus placebo, in patients receiving remdesivir and other standard care. Methods: In a randomised, double-blind, phase 3, placebo-controlled trial, adults with symptoms for up to 12 days and hospitalised for COVID-19 at 81 sites in the USA, Europe, Uganda, and Singapore were randomly assigned in a 1:1 ratio to receive intravenous tixagevimab 300 mg–cilgavimab 300 mg or placebo, in addition to remdesivir and other standard care. Patients were excluded if they had acute organ failure including receipt of invasive mechanical ventilation, extracorporeal membrane oxygenation, vasopressor therapy, mechanical circulatory support, or new renal replacement therapy. The study drug was prepared by an unmasked pharmacist; study participants, site study staff, investigators, and clinical providers were masked to study assignment. The primary outcome was time to sustained recovery up to day 90, defined as 14 consecutive days at home after hospital discharge, with co-primary analyses for the full cohort and for participants who were neutralising antibody-negative at baseline. Efficacy and safety analyses were done in the modified intention-to-treat population, defined as participants who received a complete or partial infusion of tixagevimab–cilgavimab or placebo. This study is registered with ClinicalTrials.gov, NCT04501978 and the participant follow-up is ongoing. Findings: From Feb 10 to Sept 30, 2021, 1455 patients were randomly assigned and 1417 in the primary modified intention-to-treat population were infused with tixagevimab–cilgavimab (n=710) or placebo (n=707). The estimated cumulative incidence of sustained recovery was 89% for tixagevimab–cilgavimab and 86% for placebo group participants at day 90 in the full cohort (recovery rate ratio [RRR] 1·08 [95% CI 0·97–1·20]; p=0·21). Results were similar in the seronegative subgroup (RRR 1·14 [0·97–1·34]; p=0·13). Mortality was lower in the tixagevimab–cilgavimab group (61 [9%]) versus placebo group (86 [12%]; hazard ratio [HR] 0·70 [95% CI 0·50–0·97]; p=0·032). The composite safety outcome occurred in 178 (25%) tixagevimab–cilgavimab and 212 (30%) placebo group participants (HR 0·83 [0·68–1·01]; p=0·059). Serious adverse events occurred in 34 (5%) participants in the tixagevimab–cilgavimab group and 38 (5%) in the placebo group. Interpretation: Among patients hospitalised with COVID-19 receiving remdesivir and other standard care, tixagevimab–cilgavimab did not improve the primary outcome of time to sustained recovery but was safe and mortality was lower. Funding: US National Institutes of Health (NIH) and Operation Warp Speed

Points to consider in cardiovascular disease risk management among patients with rheumatoid arthritis living in South Africa, an unequal middle income country

ABSTRACT: Background: It is plausible that optimal cardiovascular disease (CVD) risk management differs in patients with rheumatoid arthritis (RA) from low or middle income compared to high income populations. This study aimed at producing evidence-based points to consider for CVD prevention in South African RA patients. Methods: Five rheumatologists, one cardiologist and one epidemiologist with experience in CVD risk management in RA patients, as well as two patient representatives, two health professionals and one radiologist, one rheumatology fellow and 11 rheumatologists that treat RA patients regularly contributed. Systematic literature searches were performed and the level of evidence was determined according to standard guidelines. Results: Eighteen points to consider were formulated. These were grouped into 6 categories that comprised overall CVD risk assessment and management (n=4), and specific interventions aimed at reducing CVD risk including RA control with disease modifying anti-rheumatic drugs, glucocorticoids and non-steroidal anti-inflammatory drugs (n=3), lipid lowering agents (n=8), antihypertensive drugs (n=1), low dose aspirin (n=1) and lifestyle modification (n=1). Each point to consider differs partially or completely from recommendations previously reported for CVD risk management in RA patients from high income populations. Currently recommended CVD risk calculators do not reliably identify South African black RA patients with very high-risk atherosclerosis as represented by carotid artery plaque presence on ultrasound. Conclusions: Our findings indicate that optimal cardiovascular risk management likely differs substantially in RA patients from low or middle income compared to high income populations. There is an urgent need for future multicentre longitudinal studies on CVD risk in black African patients with RA.The first meeting held amongst local Rheumatologists was funded by the South African Arthritis and Rheumatology Association. The studies by Professor González-Gay have been supported by grants from “Fondo de Investigaciones Sanitarias” PI06/0024, PS09/00748, PI12/00060, PI15/00525, PI18/00043, and RD12/0009/0013 and RD16/0012 (RIER) from “Instituto de Salud Carlos III” (ISCIII) (Spain), co-funded by FEDER funds