Prevalence and risk factors to HIV-infection amongst health care workers within public and private health facilities in Cameroon.

Introduction: This study aimed at assessing the prevalence of Human Immunodeficiency Virus (HIV) among health care workers (HCWs) and to evaluate some risks factors for HCWs. Methods: We conducted a cross sectional study amongst HCWs in public and private healthcare facilities within seven regions amongst the 10 found in Cameroon. We collected data from 446 HCWs within 150 healthcare facilities. We used questionnaires for interviews and biological sampling for HIV test. Results: HIV prevalence was 2.61% (95% CI: 1.32% - 4.61%) regardless of gender and age. HCWs in private health facilities were more infected compared to those in public health facilities 5.00% vs 1.40% (p = 0.028); OR = 3.7 (95% CI: 1.01-12.90). HCWs who had never screened for HIV had a high risk of being infected OR = 7.05 (95% CI: 2.05-24.47). 44.62% of HCWs reported to have been victim of an Accidental Exposure to Blood (AEB). Amongst them, 45.80% in public HF versus 32.1% in private HF reported to have received an HIV screening and Post Exposure Prophylaxis following this incident. 4.20% of HCW victim of AEB were HIV positive, and 36.40% of HCWs had appropriate capacity training for HIV patient care. Conclusion: Though the HIV prevalence in HCWs is lower than in the general population 2.61% vs 4.3%, there is a high risk of infection as we observed a relatively high percentage of AEB amongst HCWs with an HIV prevalence of 4.20%. There is thus, a need in strengthening the capacity and provide psychosocial support to HCWs

Communication pour le développement (C4D) et changement de paradigmes dans la lutte contre le sida au Cameroun : analyse de l’impact bibliométrique en « evidence-based policy-making »

Context: Communication for development (C4D) has become an essential tool for health promotion, by making quality information available to decision-makers, to combat the factors that hinder development and social progress. Among these factors are diseases, one of which is AIDS, for which effective control strategies depend on the use of evidence to inform decision-making. Research ranks high among the sources of evidence. But, in order to effectively contribute to decision-making, research must be contextualized and the knowledge produced must present a high level of evidence. The other challenge when looking at the increase of knowledge resulting from research would be to ensure effective communication through efficient transfer processes. Thus, after three decades of research on AIDS, it seemed opportune to examine the use of research results in decision-making in the fight against AIDS in Cameroon.Objectives: The objective was to conduct a situational analysis of the evolution of AIDS policies in the light of research evidence. Specifically, it involved: (i) conducting a situational analysis of the production of research data; (ii) describe the mechanism for transferring research knowledge; and (iii) analyze the use of research results in developing AIDS control strategies.Methodology: We conducted primary research through in-depth interviews for key informants from the National AIDS Control Committee (CNLS), and through the analysis of institutional documents developed by the CNLS between 2000 and 2015 We conducted secondary research on the bibliometric analysis of scientific articles relating to studies on AIDS in Cameroon, published between 1985 and 2014 (number of publications, number of Cameroonian authors, fields of study, research entities involved, accessibility of the publication, level of evidence, level of knowledge synthesis, etc.). The use of available knowledge was assessed through a cross-analysis of control strategies and research recommendations, and on the basis of the calculation of an index (Strategic Impact Factor), designed within the framework of this study.Results: A total of 708 publications were analyzed, mainly from universities and research centers. Analyzes revealed up to 85.97% cross-sectional studies among the publications, reflecting a low-level evidence. Research areas did not always align with the priorities set by decision makers; who also noted the fact that the publications were not always accessible (language, paid journals, etc.) or therefore not sufficiently summarized. Thus, the development of control strategies remained largely based on expert opinion (eminence-based) rather than evidence-based data. However, we observed an increase in the use of research recommendations in the development of control strategies, from 52.5% during the period 2000-2005 to 61.36% during the period 2011-2015. .Conclusion: Despite the wealth of knowledge produced by research on AIDS in Cameroon, it is noted that it remains underutilized when developing control strategies. As an explanation, it was noted that these data did not always present a high level of evidence, and that they were only very poorly synthesized through systematic reviews and meta-analyzes. To this could be added insufficient coordination of research at the national level, insufficient collaboration between researchers and decision-makers and constraints (administrative, financial, human and infrastructural) to the implementation of the recommendations resulting from the research. The role played by universities in research should be better capitalized, research themes should be better oriented to fit in with national priorities, researchers should be better equipped to share knowledge, and an effective exchange platform between researchers and decision-makers should be in place.Contexte : La communication pour le développement (C4D) est devenue un outil indispensable de promotion de la santé, en mettant une information de qualité à la disposition des décideurs, pour lutter contre les facteurs qui entravent le développement et le progrès social. Au rang de ces facteurs figurent les maladies, parmi lesquelles le sida, dont l’efficacité des stratégies de lutte repose sur le recours aux données probantes pour éclairer la prise de décision. La recherche figure en bonne place parmi les sources de données probantes. Mais, afin de contribuer efficacement à la prise de décision, la recherche doit être contextualisée et les connaissances produites doivent présenter un niveau de preuve élevé. L’autre défi face au nombre grandissant de connaissances disponibles serait d’assurer une communication efficace à travers des processus de transfert efficients. Ainsi, après trois décennies de recherche sur le sida, il nous a semblé opportun de nous pencher sur le recours aux résultats de la recherche dans la prise de décision en matière de lutte contre le sida au Cameroun.Objectifs : L’objectif était de mener une analyse situationnelle de l’évolution des politiques de lutte contre le sida à la lumière des données de la recherche. De manière spécifique, il s’agissait de : (i) mener une analyse situationnelle de la production des données de recherche ; (ii) décrire le mécanisme de transfert des connaissances issues de la recherche ; et (iii) analyser l’utilisation des résultats de recherche dans l’élaboration des stratégies de lutte contre le sida.Méthodologie : Nous avons conduit une recherche primaire à travers des entretiens approfondis à l’attention d’informateurs clés du Comité National de Lutte contre le Sida (CNLS), et à travers l’analyse de documents institutionnels élaborés par le CNLS entre 2000 et 2015. Nous avons conduit une recherche secondaire portant sur l’analyse bibliométrique des articles scientifiques relatifs à des études sur le sida au Cameroun, publiés entre 1985 et 2014 (nombre de publications, nombre d’auteurs camerounais, domaines d’étude, entités de recherche impliquées, accessibilité de la publication, niveau de preuve, niveau de synthèse des connaissances, etc.). L’utilisation des connaissances disponibles a été évaluée grâce à une analyse croisée des stratégies de lutte et des recommandations issues de la recherche, et sur la base du calcul d’un indice (Facteur d’Impact Stratégique), conçu dans le cadre de l’étude.Résultats : Au total, 708 publications ont été analysées, issues principalement des universités et des centres de recherche. Les analyses ont révélé jusqu’à 85,97% d’études transversales parmi les publications, traduisant des données de faible niveau de preuve. Les domaines de recherche ne cadraient pas toujours avec les priorités définies par les décideurs. Ces derniers ont de plus noté le fait que les publications n’étaient pas toujours accessibles (langue, revues payantes, etc.) ou alors pas suffisamment synthétisées. Ainsi, l’élaboration des stratégies de lutte restait en grande partie fondée sur les avis d’experts (eminence-based) plutôt que sur les données probantes (evidence-based). Toutefois, nous avons observé une progression du recours aux recommandations de la recherche dans l’élaboration des stratégies de lutte, passant de 52,5% au cours de la période 2000-2005 à 61,36% au cours de la période 2011-2015.Conclusion : Malgré les nombreuses connaissances produites par la recherche sur le sida au Cameroun, on note que celles-ci restent sous utilisées lors de l’élaboration des stratégies de lutte. En guise d’explication, on a relevé que ces données ne présentaient pas toujours un niveau de preuve élevé, et qu’elles n’étaient que très faiblement synthétisées à travers des revues systématiques et des méta-analyses. A cela pourrait s’ajouter une coordination insuffisante de la recherche à l’échelle nationale, une collaboration insuffisante entre chercheurs et décideurs et des contraintes (administratives, financières, humaines et infrastructurelles) à l’implémentation des recommandations issues de la recherche. Le rôle joué par les universités dans la recherche devrait être mieux capitalisé, les thématiques de recherche devraient être mieux orientées pour cadrer avec les priorités nationales, les chercheurs devraient être mieux outillés au partage des connaissances, et une plateforme d’échanges effective entre chercheurs et décideurs devrait être mise en place

A small-scale 'Development Impact Bond' for hepatitis C diagnosis and treatment financing in Cameroon: the way to elimination?

# Background Many governments in low- and middle-income countries (LMICs) have difficulties paying healthcare costs upfront leading to high out-of-pocket payments for patients. A Development Impact Bond (DIB) is an innovative financing mechanism in which pr ivate investors provide pre-payment of development program expenses. At the same time, public agencies or donors repay the investor's investment with a reasonable interest rate if the program succeeds in delivering independently measurable results that are contractually agreed upon. This study assessed quantitatively and qualitatively the feasibility of a DIB for hepatitis C Virus (HCV) diagnosis and treatment in Cameroon. # Methods A revolving fund of up to €230,000 was made available by the investor. The outcome payor reimbursed the investor only in case of good performance, defined as cured patients (HCV-RNA negative). HCV carriers who were identified were referred for treatment and tested for cure 12 weeks after completion of treatment, the outcome being validated by an independent assessor. The evaluation was guided by the six-agents model, involving interviews with relevant stakeholders (N= 22). # Results In total, 253 (98%) patients completed treatment, of which 244 (96%) are cured at week 24. We estimated that the average per-patient *outcome payment* for HCV diagnosis and treatment is €1,542, and the *average costs per treated patient* is €1,858. The investor was fully repaid, including the agreed interest and bonus. Themes or findings from the interviews confirmed the feasibility of a DIB in a low-resource setting. # Conclusions This study demonstrates that a DIB can be a suitable financing mechanism for HCV services, supporting the path towards elimination. When governments in LMICs do not have sufficient resources to fund such elimination programs upfront, such public-private partnerships can offer a solution

CARDIOVASCULAR RISK AND HIV INFECTION IN PATIENTS AGED 50 YEARS AND OLDER AT THE AHALA DISTRICT MEDICAL CENTER, CAMEROON

Aim and objectives: Older people living with HIV (P50+) are living longer and longer and are therefore prone to age-related comorbidities. The objective of this study was to investigate the cardiovascular risk of P50+ followed in an HIV care unit in Cameroon. Methods: Cardiovascular risk factors (CVRF) were assessed through clinical examination and the following paraclinical exams fasting blood glucose, lipid profile, creatinine level with calculation of glomerular filtration rate according to the Cockcroft and Gault formula and resting electrocardiogram. Results: The proportion of P50+ was 13.9% and 80 patients were included in the study. The following prevalence of CVRF were found sedentary lifestyle (77.5%), chronic smoking (5%). Fifteen percent reported having hypertension and 25% of the P50+ had high blood pressure during physical examination. Similarly, 2.5% of the patients reported diabetes and 7.5% of the P50+ had high blood sugar levels. The examinations performed revealed 2.5% of LDL-cholesterol dyslipidemia, 23.1% of glomerular filtration rate abnormalities, 5.7% of left ventricular hypertrophy (LVH), and 22.9% of electrocardiographic signs of myocardial ischemia. The study of the interdependence between CVRF and the characteristics of the population revealed a relationship of dependence between physical activity and age (p=0.002), diabetes and age (p=0.004), diabetes and duration of HIV (p=0.007), LVH and duration of HIV (p=0.001). Conclusion: Cardiovascular risk is high in P50+ which could make them vulnerable to cardiovascular events. It is therefore necessary or even essential that cardiovascular risk assessment be integrated into the continuum of care of PLWH in general and P50+ particularly in HIV care units.                    Peer Review History: Received: 29 April 2022; Revised: 8 June; Accepted: 28 June, Available online: 15 July 2022 Academic Editor:  Dr. A.A. Mgbahurike, University of Port Harcourt, Nigeria, [email protected] UJPR follows the most transparent and toughest ‘Advanced OPEN peer review’ system. The identity of the authors and, reviewers will be known to each other. This transparent process will help to eradicate any possible malicious/purposeful interference by any person (publishing staff, reviewer, editor, author, etc) during peer review. As a result of this unique system, all reviewers will get their due recognition and respect, once their names are published in the papers. We expect that, by publishing peer review reports with published papers, will be helpful to many authors for drafting their article according to the specifications. Auhors will remove any error of their article and they will improve their article(s) according to the previous reports displayed with published article(s). The main purpose of it is ‘to improve the quality of a candidate manuscript’. Our reviewers check the ‘strength and weakness of a manuscript honestly’. There will increase in the perfection, and transparency.  Received file:                                Reviewer's Comments: Average Peer review marks at initial stage: 6.0/10 Average Peer review marks at publication stage: 7.0/10 Reviewers: Dr. Peter Juma Ochieng, Biotech Research Center (BRC), Obuda University, Hungary, [email protected] Dr. Esther Marguerite Chase DJANGA, Faculty of Medicine and Biomedical Sciences. Department of Public Health. University of Yaoundé I, Cameroon. [email protected] Similar Articles:   SERO-EPIDEMIOLOGICAL STUDY OF HEPATITIS B, C, HIV AND TREPONEMA PALLIDUM AMONG BLOOD DONORS IN HODEIDA CITY- YEME

Viral etiology of severe acute respiratory infections in hospitalized children in Cameroon, 2011–2013

BACKGROUND: Severe acute respiratory illness (SARI) is recognized as an important cause of morbidity, mortality, and hospitalization among children in developing countries. Little is known, however, in tropical countries like Cameroon about the cause and seasonality of respiratory infections, especially in hospitalized settings. Objectives: Our study investigates the viral etiology and seasonality of SARI in hospitalized children in Yaounde, Cameroon. METHODS: Prospective clinic surveillance was conducted to identify hospitalized children aged ≤15 years presenting with respiratory symptoms ≤5‐day duration. Demographic and clinical data, and respiratory specimens were collected. Nasopharyngeal samples were tested for 17 respiratory viruses using a multiplex polymerase chain reaction. The viral distribution and demographic data were statistically analyzed. RESULTS: From September 2011 through September 2013, 347 children aged ≤15 years were enrolled. At least one virus was identified in each of 65·4% children, of which 29·5% were coinfections; 27·3% were positive for human adenovirus (hAdV), 13·2% for human respiratory syncytial virus (hRSV), 11·5% for rhinovirus/enterovirus (RV/EV), 10·6% for human bocavirus (hBoV), 9·8% for influenza virus (Inf), 6·6% for human parainfluenza virus (hPIV), 5·7% for human coronavirus (hCoV), and 2·3% for human metapneumovirus (hMPV). While hRSV showed seasonal patterns, hAdV and RV/EV were detected throughout the year and no evident temporal patterns were observed for the remaining viruses. CONCLUSION: Respiratory viruses were associated with a high burden of hospitalizations among children in Cameroon. Nevertheless, additional studies evaluating asymptomatic Cameroonian children will be important in understanding the relationship between viral carriage and disease

Viral etiology of severe acute respiratory infections in hospitalized children in Cameroon, 2011-2013

International audienceBACKGROUND: Severe acute respiratory illness (SARI) is recognized as an important cause of morbidity, mortality, and hospitalization among children in developing countries. Little is known, however, in tropical countries like Cameroon about the cause and seasonality of respiratory infections, especially in hospitalized settings.OBJECTIVES: Our study investigates the viral etiology and seasonality of SARI in hospitalized children in Yaounde, Cameroon.METHODS: Prospective clinic surveillance was conducted to identify hospitalized children aged ≤15 years presenting with respiratory symptoms ≤5-day duration. Demographic and clinical data, and respiratory specimens were collected. Nasopharyngeal samples were tested for 17 respiratory viruses using a multiplex polymerase chain reaction. The viral distribution and demographic data were statistically analyzed.RESULTS: From September 2011 through September 2013, 347 children aged ≤15 years were enrolled. At least one virus was identified in each of 65·4% children, of which 29·5% were coinfections; 27·3% were positive for human adenovirus (hAdV), 13·2% for human respiratory syncytial virus (hRSV), 11·5% for rhinovirus/enterovirus (RV/EV), 10·6% for human bocavirus (hBoV), 9·8% for influenza virus (Inf), 6·6% for human parainfluenza virus (hPIV), 5·7% for human coronavirus (hCoV), and 2·3% for human metapneumovirus (hMPV). While hRSV showed seasonal patterns, hAdV and RV/EV were detected throughout the year and no evident temporal patterns were observed for the remaining viruses.CONCLUSION: Respiratory viruses were associated with a high burden of hospitalizations among children in Cameroon. Nevertheless, additional studies evaluating asymptomatic Cameroonian children will be important in understanding the relationship between viral carriage and disease

EVALUATION AND SUPPLY OF ORAL CARE SERVICES IN THE HEALTH DISTRICT OF MBANGA, CAMEROON

Background: Access to oral care is a real public health challenge because dental pathologies affect all social strata, even the most disadvantaged. Knowing that the peripheral level in the health pyramid of Cameroon does not always benefit from oral services, this work proposed to present the offer of oral services in conventional medicine and traditional medicine in the Health District of Mbanga. Materials and methods: A mixed descriptive cross-sectional study was carried out in the Mbanga health district taking place from April 2021 to January 2022. All dentists and traditional therapists providing oral care were included in the study and having given their consent. To do this, a reading grid and an interview guide made it possible to obtain two types of variables. The qualitative variables were analyzed manually with the color code. While the quantitative variables were analyzed using SPSS version 26.0 software. Results: Total 13 traditional healers were found and two dental surgeons working in the community of Mbanga were interacted for this study. The dentists were only women with less than a year of experience. The technical platform consisted of a portable dental chair and a dental case. The benefits were essentially curative. The traditional therapists worked in counters or in their vehicles. The majority of the products were decoctions. They treated oral ailments and would refer to the hospital in case of complications. Only a few used products to perform dental extractions. Conclusion: The offer of services must be within the reach of every individual. However, this offer must be in line with the need.                            Peer Review History: Received: 1 March 2022; Revised: 9 April; Accepted: 26 April, Available online: 15 May 2022 Academic Editor: Dr. Asia Selman Abdullah, Pharmacy institute, University of Basrah, Iraq, [email protected] UJPR follows the most transparent and toughest ‘Advanced OPEN peer review’ system. The identity of the authors and, reviewers will be known to each other. This transparent process will help to eradicate any possible malicious/purposeful interference by any person (publishing staff, reviewer, editor, author, etc) during peer review. As a result of this unique system, all reviewers will get their due recognition and respect, once their names are published in the papers. We expect that, by publishing peer review reports with published papers, will be helpful to many authors for drafting their article according to the specifications. Auhors will remove any error of their article and they will improve their article(s) according to the previous reports displayed with published article(s). The main purpose of it is ‘to improve the quality of a candidate manuscript’. Our reviewers check the ‘strength and weakness of a manuscript honestly’. There will increase in the perfection, and transparency.  Received file:                                Reviewer's Comments: Average Peer review marks at initial stage: 5.5/10 Average Peer review marks at publication stage: 7.0/10 Reviewers: Dr. A.A. Mgbahurike, University of Port Harcourt, Nigeria, [email protected] Dr. Bilge Ahsen KARA, Ankara Gazi Mustafa Kemal Hospital, Turkey, [email protected] Dr. Peter Juma Ochieng, Biotech Research Center (BRC), Obuda University, Hungary, [email protected] Similar Articles:  KNOWLEDGE AND ATTITUDE TOWARD CONE BEAM COMPUTED TOMOGRAPHY: A QUESTIONNAIRE STUDY AMONG YEMENI DENTAL PRACTITIONERS KNOWLEDGE AND PERCEPTION OF MOLAR INCISOR HYPOMINERALIZATION AMONG DENTAL PRACTITIONERS IN SANA’A CITY- YEME

Achieving a high cure rate with direct-acting antivirals for chronic Hepatitis C virus infection in Cameroon: a multi-clinic demonstration project

Objectives: Highly effective direct-acting antivirals (DAAs) for Hepatitis C treatment are largely inaccessible in sub-Saharan Africa. Data on treatment feasibility and outcomes in clinical settings are limited. We assessed the feasibility of achieving a high (≥90%) cure rate with DAAs in six gastroenterology clinics in Cameroon. Methods: Patients with chronic Hepatitis C virus (HCV) infection were treated for 12 or 24 weeks with ledipasvir/sofosbuvir, ledipasvir/sofosbuvir/ribavirin or sofosbuvir/ribavirin, depending on the stage of liver disease and HCV genotype. The cure rate was defined as the proportion of patients with a sustained virological response 12 weeks after treatment completion (SVR12) among all treatment completers. Results: We identified 190 HCV RNA positive patients between September-2017 and August-2018, 161 (84.7%) of whom started treatment. 105 (65.2%) were female, median age was 61.3 years [IQR = 55.9–66.9] and 11 (6.8%) were HIV-positive. Median plasma HCV RNA was 6.0 log10IU/mL [IQR = 5.6–6.4]. HCV genotypes identified were 1 (34.8%), 2 (13.7%), 4 (50.9%), 1 and 4 (0.6%); 46 (28.6%) strains of 160 single-genotype infections were non-subtypeable. Of 158 treatment completers, 152 (96.2%, 95%CI = 91.9–98.6%) achieved SVR12. Six patients did not achieve SVR12: five carried HCV with NS5A resistance mutations and one with NS5B resistance mutations. Three patients died before and two after treatment completion. The most common adverse events were asthenia (12.0%), headache (11.4%) and dizziness (18.9%). Conclusion: High cure rates of Hepatitis C with DAAs are achievable in clinical settings of Cameroon. However, the accessibility and provision of HCV screening, diagnosis, treatment, monitoring and care should be addressed for large-scale implementation