Skin Diseases Among Sub-Saharan African Prisoners: The Cameroonian Profile

Background: Overcrowding and promiscuity observed in our prisons are a spreading source of several diseases including infections transmitted by interhuman contact. It has been argued that skin diseases are the most frequent reasons for consultations in prisons. In Cameroon, no study has been done to assess the magnitude of this issue. Our study aimed at determining the profile of dermatological pathologies among Cameroonian prison inmates. Methods: This was a cross-sectional study at the Mfou Principal Prison from February to April 2014. Were included all prisoners who consulted the research team at the prison infirmary during the period of recruitment and who accepted to take part in the study. Prisoners were consulted and a structured questionnaire was used for data collection. Diagnosis was based on the anamnestic and clinical findings. Participants with uncertain diagnosis were excluded from the study. Data were entered into Microsoft excel 2010 spreadsheets and analyzed using SPSS version 17.0. Results: A total of 217 prisoners were retained for our study out of the 369 present in the prison during the study period. Among these 217 prisoners, 201 (92.6%) were males, 189 (87.1%) were Christians, 123 (56.7%) did not attend the secondary school, and 137 (63.1%) were single. Age ranged from 14 to 60 years with a mean of 32 ± 4.7 years and, age groups 21-30 and 31-40 being the most represented ones. More than half (57.1%) of our population exhibited skin diseases with scabies being present in 41% of cases. The dominating presentations of skin diseases were: scabies (71.8%), eczema (9.7%), dermatophytosis (specifically tinea corporis: 5.6%), pityriasis versicolor (4.8%), and acne (3.2%). Six point five percent of participants presented with more than one skin disease, and eczema was the most frequent disease associated with scabies in 8 cases (6.4%). Pityriasis versicolor was the most common skin disease among females (25% of women infected). Conclusion: There is a high prevalence of skin diseases among prisoners at the Mfou Principal Prison. of which scabies (71.6%), eczema (9.7%), dermatophytosis (5.6%) and pityriasis versicolor (4.8%) were the prevailing skin diseases encountered .There is thereby an urgent need to implement strong and efficient interventions in order to solve the problems of over population, poor hygiene, precarious quality of life and lack of health care in our prisons

Rev Epidemiol Sante Publique

Position du problème Au Cameroun, la couverture des enfants éligibles au traitement antirétroviral (TARV) (15 %) était l’une des plus faibles des 21 pays prioritaires du Fonds Mondial en 2012. Le but de cette étude était de faire une analyse situationnelle de l’offre des soins pour améliorer la prise en charge du VIH pédiatrique (PECP) au Cameroun. Méthodes Une étude transversale descriptive a été menée pendant quatre mois (avril à août 2014) dans 12 formations sanitaires de sept régions du Cameroun sélectionnées par un sondage systématique. Les données ont été recueillies à l’aide d’un auto-questionnaire administré aux personnels soignants et aux responsables administratifs inclus dans l’étude. Résultats Au total 142 personnels en charge du VIH pédiatrique ont été inclus dans cette étude : 115 du niveau opérationnel parmi lesquels 59 (51,2 %) personnels de santé, 44 (38,3 %) agents communautaires, 12 (10,4 %) chefs de services, 19 responsables du niveau régional et 8 du niveau central. La grande majorité des personnels soignants impliqués dans la PECP étaient des infirmiers, nécessitant ainsi la délégation effective des tâches médicales institutionnalisée au Cameroun. Très peu de documents normatifs nationaux prenaient en compte la PECP. La faible vulgarisation de ces documents normatifs à tous les niveaux de la pyramide sanitaire pourrait justifier le non-respect des protocoles de prise en charge observé dans les formations sanitaires offrant la PECP. Conclusion La mise à jour et la diffusion à large échelle des documents nationaux normatifs, prenant en compte des spécificités de l’enfant infecté par le VIH, sont nécessaires pour améliorer l’application des directives de la PECP au niveau opérationnel.Background In Cameroon in 2012, the proportion (15%) of children eligible for antiretroviral treatment (ART) was one of the lowest among the 21 Global Fund priority countries. The objective of this study was to carry out a situational analysis of the existing care offer for pediatric HIV in Cameroon. Methods A descriptive cross-sectional study was conducted over a 4-month period (April to August 2014) in 12 healthcare facilities in 7 regions of Cameroon selected by systematic sampling. The data were collected in a self-administered questionnaire filled out by the caregiving and administrative personnel included in the study. Results All in all, 142 persons in charge of pediatric HIV treatment were included in the study, of whom 115 were working at the operational level: 59 (51.2%) health personnel, 44 (38.3%) community agents and 12 (10.4%) department heads; the other 27 exercised responsibilities at the regional (19) and the local (8) levels. An overwhelming majority of the caregivers involved in pediatric VIH treatment were nurses, a factor necessitating the delegation of medical tasks institutionalized in Cameroon. Few standardized nationwide documents take into account these treatment modalities. Inadequate dissemination of the documents at all levels of the healthcare pyramid may justify the non-compliance with the care protocols that has been observed in the training programs dedicated to the subject. Conclusion The updating and large-scale dissemination of standardized nationwide documents taking into account the specificities of HIV-infected children are required to improve implementation at the operational level of the Cameroonian healthcare system of the existing guidelines for pediatric HIV treatment

Population-based monitoring of emerging HIV-1 drug resistance on antiretroviral therapy and associated factors in a sentinel site in Cameroon : low levels of resistance but poor programmatic performance

Background: Scale-up of antiretroviral therapy (ART) in resource-limited settings has drastically reduced HIV-related morbidity and mortality. However, challenges in long-term ART, adherence and HIV drug resistance (HIVDR) itself, require monitoring to limit HIVDR emergence among ART-experienced populations, in order to ensure regimen efficacy. Methods: A longitudinal study was conducted from 2009-2011 in a cohort of 141 HIV-infected adult patients (aged >21) at the national social insurance centre hospital in Yaounde, Cameroon. As per-WHO HIVDR protocol, HIV-1 protease-reverse transcriptase genotyping was performed at baseline and at endpoint (12 months) on first-line ART using ViroSeq (TM) Genotyping kit. Results: At baseline, a prevalence of 3.6% (5/139) HIVDR was observed &#91;protease inhibitors M46I (1/5), G73A (1/5), L90LM (1/5); nucleoside reverse transcriptase inhibitors: M184V (1/5), T215F (1/5); non-nucleoside reverse transcriptase inhibitors: K103N (1/5), Y181Y/C (2/5), M230ML (1/5)&#93;. At endpoint, 54.0% (76) patients were followed-up, 9.2% (13) died, and 3.5% (5) transferred, 38.5% (47) lost to follow-up (LTFU). 69.7% (53/76) of those followed-up had viremia <40 copies/ml and 90.8% (69/76) <1000 copies/ml. 4/7 patients with viremia >= 1000 copies/ml harbored HIVDR (prevalence: 5.3%; 4/76), with M184V/I (4/4) and K103K/N (3/4) being the most prevalent mutations. LTFU was favored by costs for consultation/laboratory tests, drug shortages, workload (physician/patient ratio: 1/180) and community disengagement. Conclusions: Low levels of HIVDR at baseline and at endpoint suggest a probable effectiveness of ART regimens used in Cameroon. However the possible high rate of HIVDR among LTFUs limited the strengths of our findings. Evaluating HIVDR among LTFU, improving adherence, task shifting, subsidizing/harmonizing costs for routine follow-up, are urgent measures to ensure an improved success of the country ART performance