Malaria prevalence and treatment of febrile patients at health facilities and medicine retailers in Cameroon.

OBJECTIVE: To investigate the quality of malaria case management in Cameroon 5 years after the adoption of artemisinin-based combination therapy (ACT). Treatment patterns were examined in different types of facility, and the factors associated with being prescribed or receiving an ACT were investigated. METHODS: A cross-sectional cluster survey was conducted among individuals of all ages who left public and private health facilities and medicine retailers in Cameroon and who reported seeking treatment for a fever. Prevalence of malaria was determined by rapid diagnostic tests (RDTs) in consenting patients attending the facilities and medicine retailers. RESULTS: Among the patients, 73% were prescribed or received an antimalarial, and 51% were prescribed or received an ACT. Treatment provided to patients significantly differed by type of facility: 65% of patients at public facilities, 55% of patients at private facilities and 45% of patients at medicine retailers were prescribed or received an ACT (P = 0.023). The odds of a febrile patient being prescribed or receiving an ACT were significantly higher for patients who asked for an ACT (OR = 24.1, P < 0.001), were examined by the health worker (OR = 1.88, P = 0.021), had not previously sought an antimalarial for the illness (OR = 2.29, P = 0.001) and sought treatment at a public (OR = 3.55) or private facility (OR = 1.99, P = 0.003). Malaria was confirmed in 29% of patients and 70% of patients with a negative result were prescribed or received an antimalarial. CONCLUSIONS: Malaria case management could be improved. Symptomatic diagnosis is inefficient because two-thirds of febrile patients do not have malaria. Government plans to extend malaria testing should promote rational use of ACT; though, the introduction of rapid diagnostic testing needs to be accompanied by updated clinical guidelines that provide clear guidance for the treatment of patients with negative test results

Modernist Urban Planning as a Tool of Acculturation: Implications for Sustainable Human Settlement Development in Cameroon

Modernist urban planning, the version of planning that originated in Western Europe during the post-1850 industrial period, is interrogated as a tool of Western acculturation. Previous studies have focused narrowly on the strategies that have been employed to impose Western spatial structures on non-Western societies. The present study is broader in its focus as it examines implications of supplanting indigenous planning principles and practices with Western varieties. Qualitative techniques employing data culled mainly from secondary sources are employed. Cameroon constitutes the empirical referent of study. It is shown that by supplanting indigenous African practices in the built environment, modernist urban planning has effectively complicated sustainable development efforts in the country. To succeed, the paper concludes, planning initiatives must be contextualized to account for local conditions in Cameroon