Prevalence of soil transmitted helminths and impact of Albendazole on parasitic indices in Kotto Barombi and Marumba II villages (South-West Cameroon)

This study assessed the actual prevalence of geohelminths and the impact of albendazole on parasitic indices in Kotto Barombi and Marumba II. Stools samples were collected from 420 school children and examined using the Kato-katz faecal technique. Participants were treated with 600 mg of albendazole. Baseline prevalence of infections and mean parasite loads were 26.4% and 6226.9e/g (Ascaris lumbricoides), 31.0% and 252.4 e/g (Trichuris trichiura), and 1.4% and 468.0e/g (Necator americanus). Four children (0.9%) were infected with Strongyloides stercoralis. A significant difference of prevalence was observed between the two villages for A. lumbricoides (P = 0.0001) and T. trichiura (P = 0.0005), and parasite loads for T. trichiura (P = 0.0001). Single infection (T. trichiura or A. lumbricoides) and double infection (A. lumbricoides - T. trichiura) were more prevalent. Post treatment control showed a decrease of prevalence and mean parasite load to 24.4% and 2969.5e/g (A. lumbricoides), and 24.0% and 112.8e/g (T. trichiura), and 0.0% for N. americanus and S. stercoralis. Efficacy and egg reduction rates were 84.6% and 55.3% (T. trichiura), 82.0% and 52.2% (A. lumbricoides), and 100.0% for N. americanus and S. stercoralis. These results suggest that geohelminths infections remain a serious health problem in school children in Kotto Barombi focus

Purification and characterization of circulating Onchocerca volvulus antigens from epileptic and non-epileptic onchocerciasis patient sera

Studies conducted during the past 25 years to investigate the possible relationship between onchocerciasis and epilepsy have led to contradictory results. In the present study aimed at contributing to the investigation of a possible relationship between onchocerciasis and epilepsy, we proceeded to purify and characterize circulating O. volvulus antigens from sera of onchocerciasis patients with and without epilepsy. Out of 539 onchocerciasis patients included in the study, sera from 78 epileptics and 20 non epileptics with high antigen titres were separately pooled and subjected to affinity purification using immunosorbent columns prepared using human and rabbit anti-O. volvulus IgG antibodies. Eluates of purified circulating O. volvulus antigens were concentrated, and then the protein contents were determined using the Bradford method. The antigenicity of the purified antigens was evaluated in a direct ELISA using onchocerciasis patient sera. Finally, the molecular composition of the purified proteins was determined by SDS-PAGE. The purified antigens were highly antigenic and there was no significant difference in the reaction profiles of the two groups or categories of patients. SDS-PAGE analysis showed that the purified antigens ranged from 31.63 to 102.40 KDa and there was no difference in the molecular composition of antigens purified from sera of the two classes of patients. Based on this antigen profiling between epileptic and non-epileptic onchocerciasis patients, we cannot conclude with certainty whether onchocerciasis is really a cause of epilepsy in areas where it is hyperendemic as predicted by some epidemiological studies.Keywords: Antigen-detection ELISA, Immunoadsorbent columns, Affinity chromatography, Antigenicity, SDS-PAG

Reference Physiological Ranges for Serum Biochemical Parameters among Healthy Cameroonians to Support HIV Vaccine and Related Clinical Trials

Background: A valid scientific evaluation of the efficacy of HIV vaccines or antiretroviral drugs includes measurement of changes in physiological parameters of subjects from known established baseline reference ranges. This study was designed to establish reference ranges for biochemical parameters among healthy adult Cameroonians to support planned HIV Vaccine clinical trials and scaling up of ARV drugs among AIDS patients.Methods: After informed consent, blood and urine samples were collected from a total of 576 adult Cameroonians and analyzed for the presence of underlying pathologies that may affect biochemical parameters. Samples from 501 of them were found eligible for the determination of reference biochemical parameters. After complete assay, the data were subjected to both parametric and non parametric statistics for analyses with 2.5 and 97.5 percentiles considered as the lower and upper limits of reference ranges.Results: There were 331(66.1%) males and 170(33.9) females, with 359(71.7%) and 142(28.3) of them residing in the urban and rural areas respectively. Statistically significant differences (P<0.05) were observed in the following biochemical parameters between urban and rural participants: AST, ALT, alkaline phosphatase, creatinine, total protein, albumin, triglyceride, total cholesterol, and the bilirubins. When the data were regrouped into sex, there were statistically significant differences (P<0.05) in the following parameters between males and females: AST, ALT, creatinine, albumin, triglyceride, total cholesterol, and direct bilirubin.Conclusion: The present study shows that sex and geographic location have significant impact on reference physiological biochemical parameters of healthy, adult Cameroonians; hence this should be taken into consideration when monitoring participants either during HIV Vaccine clinical trials or on antiretroviral (ARV) drugs treatment.Key Words: Normal Biochemical Ranges, Health Adult Cameroonians

Population genetics of Glossina palpalis palpalis from central African sleeping sickness foci

<p>Abstract</p> <p>Background</p> <p><it>Glossina palpalis palpalis </it>(Diptera: Glossinidae) is widespread in west Africa, and is the main vector of sleeping sickness in Cameroon as well as in the Bas Congo Province of the Democratic Republic of Congo. However, little is known on the structure of its populations. We investigated <it>G. p. palpalis </it>population genetic structure in five sleeping sickness foci (four in Cameroon, one in Democratic Republic of Congo) using eight microsatellite DNA markers.</p> <p>Results</p> <p>A strong isolation by distance explains most of the population structure observed in our sampling sites of Cameroon and DRC. The populations here are composed of panmictic subpopulations occupying fairly wide zones with a very strong isolation by distance. Effective population sizes are probably between 20 and 300 individuals and if we assume densities between 120 and 2000 individuals per km², dispersal distance between reproducing adults and their parents extends between 60 and 300 meters.</p> <p>Conclusions</p> <p>This first investigation of population genetic structure of <it>G. p. palpalis </it>in Central Africa has evidenced random mating subpopulations over fairly large areas and is thus at variance with that found in West African populations of <it>G. p. palpalis</it>. This study brings new information on the isolation by distance at a macrogeographic scale which in turn brings useful information on how to organise regional tsetse control. Future investigations should be directed at temporal sampling to have more accurate measures of demographic parameters in order to help vector control decision.</p

A new initiative for the development of new diagnostic tests for human African trypanosomiasis

Human African trypanosomiasis is a threat to millions of people living in sub-Saharan countries and is fatal unless treated. At present, the serological and parasitological tests used in the field for diagnosis of sleeping sickness have low specificity and sensitivity. There is clearly an urgent need for accurate tools for both diagnosis and staging of the disease. The Foundation for Innovative New Diagnostics and the World Health Organization have announced that they will collaborate to develop and evaluate new diagnostic tests for human African trypanosomiasis

The WOMAN trial: clinical and contextual factors surrounding the deaths of 483 women following post-partum haemorrhage in developing countries.

BACKGROUND: Post-partum haemorrhage (PPH) is a leading cause of maternal death worldwide. The WOMAN trial assessed the effects of tranexamic acid (TXA) on death and surgical morbidity in women with PPH. The trial recorded 483 maternal deaths. We report the circumstances of the women who died. METHODS: The WOMAN trial recruited 20,060 women with a clinical diagnosis of PPH after a vaginal birth or caesarean section. We randomly allocated women to receive TXA or placebo. When a woman died, we asked participating clinicians to report the cause of death and to provide a short narrative of the events surrounding the death. We collated and edited for clarity the narrative data. RESULTS: Case fatality rates were 3.0% in Africa and 1.7% in Asia. Nearly three quarters of deaths were within 3 h of delivery and 91% of these deaths were from bleeding. Women who delivered outside a participating hospital (12%) were three times more likely to die (OR = 3.12, 95%CI 2.55-3.81) than those who delivered in hospital. Blood was often unavailable due to shortages or because relatives could not afford to buy it. Clinicians highlighted late presentation, maternal anaemia and poor infrastructure as key contributory factors. CONCLUSIONS: Although TXA use reduces bleeding deaths by almost one third, mortality rates similar to those in high income countries will not be achieved without tackling late presentation, maternal anaemia, availability of blood for transfusion and poor infrastructure

Reference Physiological Ranges for Serum Biochemical Parameters among Healthy Cameroonians to Support HIV Vaccine and Related Clinical Trials

Background: A valid scienti\ufb01c evaluation of the e\ufb03cacy of HIV vaccines or antiretroviral drugs includes measurement of changes in physiological parameters of subjects from known established baseline reference ranges. This study was designed to establish reference ranges for biochemical parameters among healthy adult Cameroonians to support planned HIV Vaccine clinical trials and scaling up of ARV drugs among AIDS patients. Methods: After informed consent, blood and urine samples were collected from a total of 576 adult Cameroonians and analyzed for the presence of underlying pathologies that may a\ufb00ect biochemical parameters. Samples from 501 of them were found eligible for the determination of reference biochemical parameters. After complete assay, the data were subjected to both parametric and non parametric statistics for analyses with 2.5 and 97.5 percentiles considered as the lower and upper limits of reference ranges. Results: There were 331 (66.1%) males and 170 (33.9) females, with 359 (71.7%) and 142 (28.3%) of them residing in the urban and rural areas respectively. Statistically signi\ufb01cant di\ufb00erences (P&lt;0.05) were observed in the following biochemical parameters between urban and rural participants: AST, ALT, alkaline phosphatase, creatinine, total protein, albumin, triglyceride, total cholesterol, and the bilirubins. When the data were regrouped into sex, there were statistically signi\ufb01cant di\ufb00erences (P&lt;0.05) in the following parameters between males and females: AST, ALT, creatinine, albumin, triglyceride, total cholesterol, and direct bilirubin. Conclusion: The present study shows that sex and geographic location have signi\ufb01cant impact on reference physiological biochemical parameters of healthy, adult Cameroonians; hence this should be taken into consideration when monitoring participants either during HIV Vaccine clinical trials or on antiretroviral (ARV) drugs treatment

Traditional Medicine: Past, present and future research and development prospects and integration in the National Health System of Cameroon

Traditional medicine refers to health practices, approaches, knowledge and beliefs incorporating plant, animal and mineral based medicines, spiritual therapies, manual techniques and exercises, applied singularly or in combination to treat, diagnose and prevent illnesses or maintain well-being. In the last decade traditional medicine has become very popular in Cameroon, partly due to the long unsustainable economic situation in the country. The high cost of drugs and increase in drug resistance to common diseases like malaria, bacteria infections and other sexually transmitted diseases has caused the therapeutic approach to alternative traditional medicine as an option for concerted search for new chemical entities (NCE). The World Health Organisation (WHO) in collaboration with the Cameroon Government has put in place a strategic platform for the practice and development of TM in Cameroon. This platform aims at harmonizing the traditional medicine practice in the country, create a synergy between TM and modern medicine and to institutionalize a more harmonized integrated TM practices by the year 2012 in Cameroon. An overview of the practice of TM past, present and future perspectives that underpins the role in sustainable poverty alleviation has been discussed. This study gives an insight into the  strategic plan and road map set up by the Government of Cameroon for the organisational framework and research platform for the practice and development of TM, and the global partnership involving the management of TM in the country.Key words: Tradttional medicine, Cameroon

Should I Get Screened for Sleeping Sickness? A Qualitative Study in Kasai Province, Democratic Republic of Congo

Active screening strategies are common disease control interventions in the context of poor and remote rural communities with no direct access to healthcare facilities. For such activities to be as effective as possible, it is necessary that they are well adapted to local socio-economic and cultural settings. Our aim was to gain insight into the barriers communities in the Kasai-Oriental province of the Democratic Republic of Congo experience in relation to their participation in active screening activities for African sleeping sickness. Participation rates seem to be especially low in this province compared to other endemic regions in the country. We found several important factors to be in play, a number of which could be addressed by adapting the operational procedures of the mobile teams that perform the active screening activities (e.g., improved confidentiality during the screening procedure). However, more profound considerations were found in the form of regional beliefs related to the treatment of the disease. Although not based on rational grounds, these prohibitions seem to pose a significant barrier in a person's decision to seek diagnosis and treatment. A better understanding of these prohibitions and their origin could lead to improved participation rates for sleeping sickness screening in Kasai-Oriental