Evaluation of the patient's willingness to pay for the RTS, S / AS01 (MOSQUIRIX) malaria vaccine in Cameroon

Introduction: In Cameroon, Malaria is the leading cause of death and morbidity in children under 5years of age and in pregnant women. It also represents 40% of household health expenditure in this country. To prevent malaria, the World Health Organisation (WHO) recommends, among other measures, the use of insecticide-treated mosquito nets, indoor insecticide sprays and chemoprevention. However, the effectiveness of these preventive measures remains limited. It is for this reason that, for several years now, research on possible malaria vaccine is being carried out by academics and pharmaceutical companies. An example is the renowned company glaxosmithkline (GSK) who came up with the RTS,S/ASO1 vaccine ("Mosquirix"). To date, the mosquirix vaccine is the only vaccine against malaria to have been validated by the European Medicines Agency. The WHO has authorized the implementation of a pilot study underway in 3 countries of sub-Saharan Africa (Ghana, Kenya and Malawi). Aim: to determine the average maximum price that patients living in Cameroon would be willing to pay for this new vaccine and at the same time determine the factors influencing the prices offered. Materials and methods: We conducted a cross-sectional study, through a semi-open questionnaire in 5 hospitals in Cameroon (Dschang district hospital, protestant hospital of Mbouo in Bandjoun, Efoulan district hospital, CMA of Odza and Yaoundé military hospital). The study included all individuals aged 18 and over, who presented themselves for malaria-related counseling at one of the 5 above mentioned hospitals Results: we were able to obtain data from 1187 respondents aged between18 and 80 years. From these data, we noted that patients are willing to spend on average 1,34% of their income to benefit from this vaccine. This percentage corresponds to a maximum price of 1,850 Fcfa (2,84 euro). This price was significantly associated with respondents' income, having been consulted at least once for malaria within the 12 months preceding the survey and whether the respondent has at least 1 child under 5 years of age or not. Respondents had good knowledge of malaria but very limited knowledge of the vaccine. Conclusion: the maximum price that cameroonian patients would be willing to pay for this RTS,S/ASO1 vaccine ("mosquirix") is 1850 Fcfa.Introduction : Le paludisme représente la première cause de mortalité et de morbidité chez les enfants de moins de 5 ans et chez les femmes enceintes au Cameroun. Il induit 40% des dépenses de santé des ménages dans ce pays. Afin de prévenir les cas de paludisme, l’OMS recommande, entre autres, l’utilisation de moustiquaires imprégnées d’insecticide, la pulvérisation d’insecticide à l’intérieur des habitations et la chimio-prévention. Mais l’efficacité de ces moyens de prévention reste limitée. C’est dans ce contexte que, depuis plusieurs années des recherches sur la vaccination sont menées par des universitaires et des firmes pharmaceutiques. C’est le cas de GlaxoSmithKline (GSK) qui a mis sur pied le vaccin RTS,S/ASO1 (« Mosquirix »). Ce vaccin est le seul à ce jour contre le paludisme à avoir été validé par l’Agence Européenne des Médicaments et l’OMS a autorisé la réalisation d’une phase pilote en cours dans 3 pays d’Afrique subsaharienne (le Ghana, le Kenya et le Malawi). Objectif : Déterminer le prix moyen maximum que les patients vivant au Cameroun seraient prêts à payer pour ce nouveau vaccin et par la même occasion, déterminer les facteurs influençant les prix proposés. Matériels et méthode : Nous avons réalisé une étude transversale, au travers d’un questionnaire semi-ouvert dans 5 hôpitaux du Cameroun (hôpital de district de Dschang, hôpital protestant de Mbouo, Bandjoun, hôpital de district d'Efoulan, CMA d'Odza et hôpital militaire de Yaoundé). Ont été incluses dans l’étude toutes personnes âgées d’au moins 18 ans, venues en consultation pour des raisons liées au paludisme dans un des 5 hôpitaux. Résultats : Nous avons pu obtenir des données de 1187 répondants âgés entre 18 et 80 ans. De ces données, il ressort le constat suivant : en vue de bénéficier d’un vaccin contre le paludisme, les patients sont prêts à dépenser en moyenne 1,34% de leurs revenus. Soit une somme maximale de l’ordre de 1850 Fcfa (2,84 Euro). Ce prix était significativement associé au revenu des patients, au fait d’avoir au moins 1 enfant de moins de 5 ans et au fait d’avoir été au moins 1 fois en consultation pour paludisme les 12 mois précédant l’enquête. Les répondants avaient une bonne connaissance sur le paludisme mais une connaissance très limitée en ce qui concerne le vaccin. Conclusion : le prix maximum que les patients camerounais serait prêt à payer pour ce vaccin RTS,S/ASO1 (« Mosquirix ») s’élève à 1850 FCFA

Connaissance et attitudes de la population vivant dans les zones rurales et semi-rural face à la COVID-19 : Cas du département de la Menoua, Cameroun

Background: The pandemic situation the world is facing caused by the new SARS-Cov-2 continues to evolve and still represent a real problem. With more than eight thousand reported cases infection, Cameroon stands as the seventh most affected country in Africa. Prevention remains the best way to fight against this zoonosis. However, the limited information available about this infection is a great barrier to stopping the propagation of the virus within the population, especially in rural and semi-rural areas, where the lack of financial and material resources is a reality. This study aimed to assessing Awareness and attitudes of the population of the Menoua Division on COVIL-19 infection. Methods:A cross-sectional study was conducted from March 9 to April 15 2020 amongst the populations of rural and semi-rural areas of the Menoua Division. Data were collected using a questionnaire administered face to face to each participant. The analysis was carried out using the Statistical Analysis System software (SAS version 9.4). The significance threshold was set at a P value of less than 0.05. Results: A total of 434 participants of which male majority(sex ratio 1.07) were included in this study. The most represented age group was [21F 40] years old representing 40.29% of the participants. Approximately all participants (98.57%) were aware of the world emergency state due to Coronavirus. 75.56%, 91% and 90.93% of the participants knew respectively that having close contacts, kissing and touching the face with the hands could favor the transmission of the virus. However, nearly 91.14% were not aware of the clinical symptoms of the disease. Moreover, 85.02% responded that they would not be able to comply with the confinement measures if they were applied at national level. The level of awareness varied significantly according to the occupation(p=0.038) and the educational level (p<0.001) of the participants. Conclusion: The average level of awareness of the population of the Menoua Division on COVID-19 infection was relatively low. Overcoming this pandemic disease means ensuring the flow of the correct information towards the population. Community outreach activities focus on clinical manifestations and what to do in case of COVID-19 infection as well as material and financial support should be help the population to protect themselves effectively against pandemic, particularly in rural areas and surrounding

Malaria in West Cameroon: An Assessment of the Populations’ Knowledge, Attitudes and Practices

peer reviewedMalaria remains one of the main causes of morbidity and mortality in Cameroon. Children under 5 years old and pregnant women are most burdened. A few studies have been carried out on the knowledge, attitudes and practices (KAP) of patients towards malaria in this country. We aimed at evaluating the level of knowledge, attitudes and practice towards malaria in Western Cameroon. We conducted a cross-sectional survey, using a semi-opened questionnaire in two Cameroonian’s hospitals in April 2018. We analyzed our collected data with Chi square test through SAS software (version 9.4). P-values lower than 0.05 were considered statistically significant. Of 691 participants, 55.14% (381/691) defined malaria as a parasitic disease, 100% mentioned the mosquito as the transmission vector and 89.15% 616/691) mentioned blood stream as transmission route. The most preventive method used by the participants was mosquito nets. The use of malaria treatment was associated with the level of income and the fact of consultation of a health care practitioner the month preceding the survey. About 72.4% (501/691) of respondents took antimalarial treatment without consultation or medical prescription. Among patients who spent less than 8000XAF (12Euro) for treatment during their last episode of malaria, 70.1% (101/144) used a plant-based treatment. Participants had good knowledge and attitudes towards malaria. However, practices were not the best. These results highlight the problem of self-medication, which might lead to some resistance against antimalarial treatment in the future

POWER RCT dataset

This dataset contains the survey responses and biomarker data for 3 waves of the POWER RCT titled: "Protecting Women from Economic shocks to fight HIV in Africa (POWER)". It contains 2,909 observations from 1,147 respondents stratified almost equally between women engaged in commercial and transactional sex.The main research hypothesis is that women who engage in transactional and commercial sex in Africa use risky sex as a way to cope for economic shocks. Providing health insurance to themselves and their economic dependents is effective to reduce risky sexual behaviours, and prevent STIs and HIV infection among women and girls who engage in commercial and transactional sex. The general objective of this research is to understand explore the role of economic shocks (e.g.,illness, COVID-19) as a driver of heightened vulnerability of women to HIV in order to inform the design of novel public heath interventions to tackle STIs and HIV. The RCT aims to estimate the effectiveness of health insurance for high-risk women and their economic dependents as a strategy to prevent STI and HIV. The POWER project addresses important gaps in the current literature by answering to the following research questions:- What is the role of economic shocks on STIs and HIV?- How do economic shocks affect STIs and HIV?- What is the effect of health insurance as a risk-coping strategy to reduce risky sexual behaviours, STIs and HIV?</p

Determinants of adherence to ARVs in HIV+ women enrolled in the PMTCT program in the West and North Regions of Cameroon

Background: According to UNAIDS 2019, 52% of people worldwide living with HIV is on antiretrovirals (ARVs), HIV positive women representing 80% of them. This study aimed at highlighting the determinants of adherence to ARVs for HIV positive women enrolled in PMTCT programs in the West and North Regions of Cameroon. Methods: A descriptive and analytical cross-sectional study was carried out from February to September 2019 in three treatment centres in the West (Bafoussam Regional Hospital and Dschang District Hospital) and North (Garoua Regional Hospital) regions in Cameroon. Data were collected using a questionnaire administered face to face and encoded in Excel 2013, then analyzed using SAS version 7.8. P-values &lt; 0.05 were considered statistically significant Results: One thousand (1000) women were interviewed. The mean age was 17 ±2 years (Range: 12 – 67 years); 231 (23.1%) were single. Overall, the prevalence of ART-adherence was 68.6%. After multivariate analysis using multiple logistic regression; having one HIV-infected children (aOR=60.9; 95%CI=[7.6; 489.1]; P=0.001), non-disclosure of serological status with the spouse/boyfriend (aOR=25.2; 95%CI=[9.2; 68.9]; P&lt;0.001), not being educated (aOR=7.7; 95%CI=[4.4; 13.3]; P&lt;0.001); and taking ARVs once or less daily (aOR=50; 95%CI=[20.0; 100.0]; P&lt;0.001) were four risk factors for non-adherence. Conclusion: ART-adherence among Cameroonian pregnant women is still very far below UNAIDS target (95%), with four potential key determinants identified. As we are progressively moving towards the elimination of HIV vertical transmission in 2030 as advocated by UNAIDS, local policies should be reinforced in order to consolidate the strides made so far. Keywords: HIV, PMTCT, Pregnancy, Adherence, option B+, Cameroon

Knowledge on STIs / HIV / AIDS, Stigma-Discrimination and sexual behaviors AMONG students of the University of Dschang, in Cameroon

This study reports the results of a survey conducted among students of the University of Dschang, on STI/HIV/AIDS, the Stigma-Discrimination pair and sexual behaviors. This was a descriptive cross-sectional study conducted during the months of January and February 2017. We collected data by a face to face questionnaire administered to students of the University of Dschang. The codification, process and analysis have been done using the software EPI-Info 7.3.1.1, with the threshold of significance set at 0.05. A total of 520 individuals participated in this survey, with more than half (62.7%, n = 326/520) aged between 20-30 years, with a male/female sex ratio of 1,031. The vast majority (83%, n = 418/520) of them were in the undergraduate cycle. The main modes of transmission cited included: the combination of items such as blood transfusion / soiled objects / Mother-to-child transmission/ unprotected sex for 36.3% of respondents (n = 186/516) although 21.9 % (n = 112/516) of them admitted not knowing any modes of transmission of STIs / HIV. Also, 74.2% (n = 386/520) of respondents were sexually active, with the estimated age of sex debut being over 18 years (53.9%; 208/386) for half of them. Of the 36.2% (n = 186/514) respondents who reported knowing someone with STI / HIV and AIDS, the first feeling they had with regards to them was pity (86.6%; n = 386/446), followed by fear in 11.7% (n = 52/446) of respondents but yet 40.2% (n = 208/518) admitted they have never heard of discrimination. Stigma and discrimination in the student milieu remains a major barrier to students' development who, becoming sexually active at a very early age, are more exposed to the risk of contracting STI / HIV. Sensitization actions should be implemented within university campuses and reproductive health courses for young adults, included in the academic curriculum for a significant reduction in the number of new infections

Knowledge on STIs / HIV / AIDS, Stigma-Discrimination and sexual behaviors AMONG students of the University of Dschang, in Cameroon

This study reports the results of a survey conducted among students of the University of Dschang, on STI/HIV/AIDS, the Stigma-Discrimination pair and sexual behaviors. Methods: This was a descriptive cross-sectional study conducted during the months of January and February 2017. We collected data by a face to face questionnaire administered to students of the University of Dschang. The codification, process and analysis have been done using the software EPI-Info 7.3.1.1, with the threshold of significance set at 0.05. Results: A total of 520 individuals participated in this survey, with more than half (62.7%, n = 326/520) aged between 20-30 years, with a male/female sex ratio of 1,031. The vast majority (83%, n = 418/520) of them were in the undergraduate cycle. The main modes of transmission cited included: the combination of items such as blood transfusion / soiled objects / Mother-to-child transmission/ unprotected sex for 36.3% of respondents (n = 186/516) although 21.9 % (n = 112/516) of them admitted not knowing any modes of transmission of STIs / HIV. Also, 74.2% (n = 386/520) of respondents were sexually active, with the estimated age of sex debut being over 18 years (53.9%; 208/386) for half of them. Of the 36.2% (n = 186/514) respondents who reported knowing someone with STI / HIV and AIDS, the first feeling they had with regards to them was pity (86.6%; n = 386/446), followed by fear in 11.7% (n = 52/446) of respondents but yet 40.2% (n = 208/518) admitted they have never heard of discrimination. Conclusion: Stigma and discrimination in the student milieu remains a major barrier to students’ development who, becoming sexually active at a very early age, are more exposed to the risk of contracting STI / HIV. Sensitization actions should be implemented within university campuses and reproductive health courses for young adults, included in the academic curriculum for a significant reduction in the number of new infection