Map of biomedical research in Cameroon; a documentary review of approved protocols from 1997 to 2012

Abstract Background Over the last decade, there has been a rapid increase in biomedical research in Cameroon. However, the question of whether these research projects target major health priorities, vulnerable populations and geographic locations at risk remains to be answered. The aim of this paper is to describe the state of biomedical research in Cameroon which is a key determinant that would guide future health care policies and promote equitable access to healthcare. Methods A documentary review of all approved protocols (proposals) of biomedical research projects, from 1997 through 2012, at the Cameroon National Ethics Committee. Protocols were reviewed systematically by independent reviewers and data were extracted on a grid. Data were analyzed by calculating proportions at 95% confidence interval, chi-square test (chi2) and p-values. Results Two thousand one hundred seventy two protocols were reviewed for data extraction. One thousand three hundred ninety-five (64.7%) were student projects, 369 (17.0%) projects had international sponsors, and 1528 (72.4%) were hospital-based studies. The most targeted domain was the fight against diseases 1323 (61.3%); mostly HIV 342 (25.8%) and Malaria 136 (10.3%). Over half of the studies were concentrated in the Centre region 1242 (57.2%), with the least projects conducted in the Northern region 15 (0.7%). There was strong evidence that international and local sponsors would influence the research site (p-value = 0.01) and population targets (p-value = 0.00). Conclusion Although biomedical research targets some important diseases that pose a great burden to Cameroonians, the most vulnerable populations are excluded from research. Biomedical research scarcely addresses other components of the health system and emerging diseases of vital public health importance. We recommend that the government should play a central role, between researchers from academic institutions, sponsors, NGOs and research institutions, to ensure that biomedical research addresses the health priorities of Cameroonians. It should include vulnerable populations, and address other components of the health system for a balance. These recommendations are critical to ensuring that future research informed health policies reflect the health needs of the populations and promote equity in healthcare access

Importance of biochemical analysis of the liver function in the management of disease progression in people living with HIV/AIDS and co-infected by HIV and hepatitis B virus in Cameroon

Liver diseases in HIV infected persons can occur due to hepatitis B virus (HBV) and hepatitis C virus (HCV) co-infections, chronic alcoholism, and hepatic tuberculosis as well as antiretroviral drugs. Coinfection by HIV and HBV is frequently encountered with negative impact on HIV progression. The aim of this study was to evaluate the importance of biochemical analysis of the liver function in the management of disease progression in people living with HIV/AIDS and co-infected by hepatitis B virus in Cameroon. Serum of 75 patients positive for HIV was screened for HBsAg by immunochromatographic test in Yaoundé central hospital, from November 2015 to February 2016. Liver enzymes (AST, ALT, CB, TB and γ-GT), as well as CD4 T cell level determination were assessed following the standard procedures. A second blood sample was taken from HIV mono-infected and HIV/HBV co-infected after three months. The socio-demographic data was also collected. The data was entered and analyzed using SPSS version 22.1 statistical software and p<0.05 was considered as statistically significant. Hepatitis B virus surface antigen (HBsAg) was identified in 12 patients out of 75 HIV-positive patients for a HIV/HBV co-infection prevalence of 16%. Study participants with HIV/HBV co-infection have a high ALT mean level (p<0.05), than HIV mono-infected participants and the difference was statistically significant. Analysis using the second blood sample carried out 3 months later, showed significant elevation of AST, ALT, ALP, conjugated bilirubin and total bilirubin, (46.66±33.42 IU; 148.48±40.65 IU; 153.68±65.82 IU; 0.149±0.028 mg/dl; 0.75±0.089 mg/dl), while the γ-GT remained stable over time. No statistically significant CD4 count mean difference was observed between HIV mono-infected and HIV/HBV co-infected participants. The first blood sample showed significant elevation of ALT in HIV/HBV co-infected patients in the Yaoundé Central hospital. High levels of liver enzymes were seen in co-infection during the second blood sampling, hence there is a necessity of careful monitoring of these patients for better care.Keywords: co-infection, HBV, HIV, CD4 T cells, liver enzyme

Importance of biochemical exploration of the liver in the control of disease progression in people living with HIV/AIDS and coinfected by HIV and Hepatitis C virus in Cameroon.

Viral infection continues to be a major cause of morbidity and mortality in the world in particular those caused by the Hepatitis C virus (HCV) and the Human Immunodeficiency virus (HIV). The aim of this study was to evaluate the importance of the biochemical exploration of the liver function in the control of disease progression in people living with HIV/AIDS and co-infected by HIV and hepatitis C virus. Sera from 75 patients positive for HIV were screened for HCV antibody by immuno-chromatographic test in Yaoundé central hospital, from November 2015 to February 2016. The biochemical parameters (AST, ALT, CB, TB, γ-GT, ALP and creatinin), as well as CD4 T cell level determination were assessed following standard procedures. A second blood sample was taken from HIV mono-infected and HIV/ HCV co-infected after three months. Socio-demographic data were also collected. The data were entered and analyzed using SPSS version 22.1 statistical software and p<0.05 was considered as statistically significant. Amongst 75 study patients, 10 (13.3%) were HIV/HCV co-infected. The results obtained showed that, the activity of γ-GT was significantly higher (P <0.0001) in HIV/HCV co-infected patients compared to HIV mono-infected patients. The concentration of total bilirubin was also significantly higher in HIV/HCV co-infected patients (P = 0.015). Biochemical analysis using the second blood sample carried out 3 months later, after first sample, showed a significant increase of creatinin observed in HIV monoinfected patients, but no significant increase of some biochemical parameters (ALT, Creatinin, total Bilirubin, conjugated Bilirubin) was observed in HIV/HCV co-infected patients. In HIV / HCV co-infected patients, the first blood sample showed a significant increase of γ-GT (118.36±75.95 IU) compared to HIV mono-infected patients, in the Yaoundé Central Hospital. From this observation, hepatic damage should be evaluated by analyzing biochemical parameters.Key words: Liver enzyme, Co-infection, HIV, HCV, contro

In silico and in vitro screening of licensed antimalarial drugs for repurposing as inhibitors of hepatitis E virus

International audienceHepatitis E virus (HEV) infection is emerging in Cameroon and represents one of the most common causes of acute hepatitis and jaundice. Moreover, earlier reports showed evidence of falciparum malaria/HEVcoexistence. Although the Sofosbuvir/Ribavirin combination was recently proposed in the treatment of HEV-infected patients, no specific antiviral drug has been approved so far, thereby urging the search for new therapies. Fortunately, drug repurposing offers a good alternative to this end. In this study, we report the in silico and in vitro activities of 8 licensed antimalarial drugs and two anti-hepatitis C virus agents used as references (Sofosbuvir, and Ribavirin), for repurposing as antiviral inhibitors against HEV. Compounds were docked against five HEV-specific targets including the Zinc-binding non-structural protein (6NU9), RNA-dependent RNA polymerase (RdRp), cryoEM structure of HEV VLP, genotype 1 (6LAT), capsid protein ORF-2, genotype 3 (2ZTN), and the E2s domain of genotype 1 (3GGQ) using the iGEMDOCK software and their pharmacokinetic profiles and toxicities were predicted using ADMETlab2.0. Their in vitro effects were also assessed on a gt 3 p6Gluc replicon system using the luciferase reporter assay. The docking results showed that Sofosbuvir had the best binding affinities with 6NU9 (− 98.22 kcal/mol), RdRp (− 113.86 kcal/mol), 2ZTN (− 106.96 kcal/mol), while Ribavirin better collided with 6LAT (− 99.33 kcal/mol). Interestingly, Lumefantrine showed the best affinity with 3GGQ (-106.05 kcal/mol). N-desethylamodiaquine and Amodiaquine presented higher binding scores with 6NU9 (− 93.5 and − 89.9 kcal/mol respectively vs − 80.83 kcal/mol), while Lumefantrine had the greatest energies with RdRp (− 102 vs − 84.58), and Pyrimethamine and N-desethylamodiaquine had stronger affinities with 2ZTN compared to Ribavirin (− 105.17 and − 102.65 kcal/mol vs − 96.04 kcal/mol). The biological screening demonstrated a significant (P < 0.001) antiviral effect on replication with 1 µM N-desethylamodiaquine, the major metabolite of Amodiaquine. However, Lumefantrine showed no effect at the tested concentrations (1, 5, and 10 µM). The biocomputational analysis of the pharmacokinetic profile of both drugs revealed a low permeability of Lumefantrine and a specific inactivation by CYP3A2 which might partly contribute to the short half-time of this drug. In conclusion, Amodiaquine and Lumefantrine may be good antimalarial drug candidates for repurposing against HEV. Further in vitro and in vivo experiments are necessary to validate these predictions

Global epidemiology of hepatitis C virus in dialysis patients: A systematic review and meta-analysis.

Dialysis is a replacement therapy for patients with End-Stage Renal Disease (ESRD). Patients on dialysis are at high risk of acquiring hepatitis C virus (HCV), which has become a leading cause of morbidity and mortality in this population. There is a wide range of prevalence of HCV in dialysis populations around the world. It is still unknown how prevalent HCV infection is among worldwide dialysis patients (including those undergoing hemodialysis and peritoneal dialysis). A review was conducted to estimate the global epidemiology of hepatitis C in dialysis patients. We searched PubMed, Excerpta Medica Database (Embase), Global Index Medicus and Web of Science until October 2022. A manual search of references from relevant articles was also conducted. Heterogeneity was evaluated by the χ2 test on Cochrane's Q statistic, and the sources of heterogeneity were investigated using subgroup analysis. In order to assess publication bias, funnel plots and Egger tests were conducted, and pooled HCV prevalence estimates were generated using a DerSimonian and Laird meta-analysis model. The study is registered with PROSPERO under CRD42022237789. We included 634 papers involving 392160 participants. The overall HCV case fatality rate was 38.7% (95% CI = 28.9-49). The global prevalence of HCV infection in dialysis population group were 24.3% [95% CI = 22.6-25.9]. As indicated by UNSD region, country, dialysis type, and HCV diagnostic targeted; Eastern Europe had the highest prevalence of 48.6% [95% CI = 35.2-62], Indonesia had 63.6% [95% CI = 42.9-82], hemodialysis patients had 25.5% [95% CI = 23.8-27.3], and anti-HCV were detected in 24.5% [95% CI = 22.8-26.2]. Dialysis patients, particularly those on hemodialysis, have a high prevalence and case fatality rate of HCV infection. Hemodialysis units need to implement strict infection control measures