Malaria prevention in the Buea health district in Cameroon: factors influencing Mosquito bed net use in households

Background: Insecticide treated bed nets (ITNs), though proven to be effective in preventing malaria will have little impact unless people sleep under them. Several studies have shown that owned ITNs are usually not used and that ITN use is influenced by several factors that vary between communities.Objective: To investigate the factors influencing the use of mosquito bed nets in households in the Buea Health District (BHD) in Cameroon.Material and Methods: A cross-sectional study with two-stage cluster sampling included 420 households from 35 sites. Questionnaires adapted from the Malaria Indicator Survey were used. CSPro 4.1 and Epi info 3.5.3 were used to create database and analyze respectively.Results: ITN ownership in the BHD was high (92.6%; 95% CI: 89.6%-94.9%) but ITN use was less than average (41.2%; 95% CI: 39.2%-43.3%). ITN use was least likely in the age group 5-15 years (P<0.01), in educated individuals (P<0.01) and in households with less than one ITN for two persons (P<0.01). White ITNs were less likely to be used (P<0.01). Conclusion: There is a gap between ITN ownership and use in the malaria holoendemic BHD and ITN use is associated with age of individual, level of education, colour of ITNs and household net density. Use of the highly owned ITNs could be increased by targeting the least protected 5-15 years age group and schooling individuals; by promoting school-based education on ITN use.Keywords: Insecticide-treated nets, malaria, Buea Health Distric

Gravid Uterus in an Umbilical Hernia

Umbilical hernias large enough to contain a gravid uterus are rare. We report a case of a woman with prolapse of a gravid uterus through a previously repaired umbilical hernia. Our plans for elective surgery with caesarean section and hernia repair were foiled by poor compliance. The hernia was repaired during an emergency caesarean section. We provide details of her management and briefly review the literature on umbilical hernias and pregnancy. Surgical management offers an opportunity for hernia repair and can ensure a safe delivery for the mother and child

Nuchal Cord and Perinatal Outcome at the Yaounde General Hospital, Cameroon

The aim of this study was to determine the incidence of nuchal cord at delivery and perinatal outcome. We conducted a retrospective descriptive study from 1992–2008 at the Yaounde General Hospital. Obstetrical and neonatal variables were compared in the loose and tight nuchal cord groups and a control group (no nuchal cord). Of 9275 deliveries recorded, 16.2% had a nuchal cord. Of these nuchal cords, 75.81% were loose and 24.18% were tight. Cesarean delivery rate was lower in the loose and tight nuchal cord groups when compared with control group (P <.001;P < .05). Low Apgar scores < 7 at the 1st and 5th minutes were less in the loose nuchal cord group when compared with control group (P = .06, P = .7). In tight nuchal cord group, low Apgar score < 7 at the 1st minute was significantly higher, when low Apgar score < 7 at the 5th minute was non significantly higher when compared with control group (P < .001, P = .14). Transfer rate to neonatology unit was lower in the loose and tight nuchal cord than in the control group. Loose nuchal cord may not be associated with adverse perinatal outcome. However, tight nuchal cord may be associated with increased risk of low Apgar score < 7 at the 1st minute. Consequently, the ultrasound diagnosis of a nuchal cord at the end of pregnancy should not be the indication of elective cesarean delivery.Keywords nuchal cord; perinatal outcome; Apgar scor