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Prior studies have shown that Onchocerca volvulus DNA can be detected in skin snips and in black flies after polymerase chain reaction (PCR) with primers specific for repeated "O-150" DNA sequences. We have adapted a paper chromatography hybridization assay (PCHA) to detect amplified O-150 DNA and compared this method to two established methods, namely agarose gel electrophoresis (AGE) and hybridization enzyme-linked immunosorbent assay (ELISA). The minimum amounts of purified O-150 DNA detected by PCHA, AGE, and ELISA were 5, 10, and 2 ng, respectively. The three methods had similar estimated sensitivities for detecting O. volvulus DNA amplified from skin snips from African subjects with onchocerciasis (88%, 84%, and 91%, respectively). No false positive results were observed with skin snips from uninfected control subjects. The paper chromatography hybridization assay detects PCR products in 30 minutes without electricity or special equipment. This technology brings DNA detection a step closer to widespread use in field settings.

Microfilter absorbed whole blood samples from 223 Tanzanian babies and 189 adults from Cameroon have been examined. Blood specimens are difficult to obtain from African suburban and rural areas, and lack of storage and transportation facilities can prevent the collection of samples. We evaluated some microassays employing whole blood collected on filter paper. This method is a well established technique in neonatal screening for endocrinometabolic diseases. We also developed microassays for whole dried blood spots to type AB0 blood groups and HIV disease using commercial reagents. Phenotype and gene frequencies for AB0 and hemoglobin systems as well as our results concerning the typings of thyroxine (T4), thyroid stimulating hormone (TSH), human immunodeficiency virus (HIV) and hepatitis B virus (HBV) are reported.

Background: Vibrio cholerae is endemic in South Asia and Africa where outbreaks of cholera occur widely and are particularly associated with poverty and poor sanitation. Knowledge of the genetic diversity of toxigenic V. cholerae isolates, particularly in Africa, remains scarce. The constraints in improving this understanding is not only the lack of regular cholera disease surveillance, but also the lack of laboratory capabilities in endemic countries to preserve, store and ship isolates in a timely manner. We evaluated the use of simplified sample preservation methods for molecular characterization using multi-locus variable-number tandem-repeat analysis (MLVA) for differentiation of Vibrio cholerae genotypes., Methods and Findings: Forty-seven V. cholerae isolates and 18 enriched clinical specimens (e.g. stool specimens after enrichment in broth) from cholera outbreaks in Cameroon were preserved on Whatman filter paper for DNA extraction. The samples were collected from two geographically distinct outbreaks in the Far North of Cameroon (FNC) in June 2014 and October 2014. In addition, a convenience sample of 14 isolates from the Philippines and 8 from Mozambique were analyzed. All 87 DNAs were successfully analyzed including 16 paired samples, one a cultured isolate and the other the enriched specimen from which the isolate was collected. Genotypic results were identical between 15 enriched specimens and their culture isolates and the other pair differed at single locus. Two closely related, but distinct clonal complexes were identified among the Cameroonian specimens from 2014., Conclusions: Collecting V. cholerae using simplified laboratory methods in remote and low-resource settings allows for subsequent advanced molecular characterization of V. cholerae O1. These simplified DNA preservation methods identify V. cholerae and make possible timely information regarding the genetic diversity of V. cholerae; our results set the stage for continued molecular epidemiological research to better understand the transmission and dissemination of V. cholerae in Africa and elsewhere worldwide.

Background: Cassava processing is a crucial source of livelihood for rural farmers and processors in Nigeria and Cameroon. This study investigated the varietal effect on the processing productivity of women farmer processors within their working environment and compared this with the food product quality as evaluated by the processors and the field yield. Field trials were established in Nigeria (Benue and Osun state) and Cameroon (Littoral region). Eight cassava genotypes were evaluated. These eight varieties included newly bred genotypes, commercial checks and varieties provided and preferred by the processors. The roots of these genotypes were harvested and processed into gari and eba by processors. The time of each processing step was recorded. Processors assessed the quality of the roots and food products using pairwise ranking., Results: In the field trials in Cameroon and Nigeria (Benue state), the newly bred genotypes showed superior performance in terms of dry matter content and fresh and dry yield. During processing, genotypes showed significant variation for most assessed parameters in both countries. Some newly bred varieties exhibited lower productivity that can make them more prone to drudgery than the local commercial checks and the varieties provided and preferred by the processors. Newly bred varieties were mostly ranked higher or equal to processors' preferred varieties concerning fresh root and food product quality. In the Cameroon location there were significant varietal differences in processing productivity and drudgery index which suggest that the particular processing methods there - such as pressing methods and fermentation time - cause these varietal differences to matter more., Conclusions: The varieties that were tested were observed to differ in yield, product quality, processing productivity, and potential drudgery levels. Some breeders' germplasms displayed a combination of increased yields and good product quality and good processor productivity. Those varieties that showed low processor productivity should be avoided during selection to avoid increased labour burden and associated drudgery of women processors. Further research is recommended to enhance food product color, latent culinary qualities, and processing productivity of newly bred varieties to improve acceptability and reduce processing drudgery for women. © 2023 The Authors. Journal of The Science of Food and Agriculture published by John Wiley & Sons Ltd on behalf of Society of Chemical Industry., (© 2023 The Authors. Journal of The Science of Food and Agriculture published by John Wiley & Sons Ltd on behalf of Society of Chemical Industry.)

HBs-antigen was determined in serum, red cells and whole blood dried onto filter paper. In samples from HBs-antigen carriers readings of the Ausria II-test were higher in whole blood than in serum or red cells. The relevance of this finding was tested and the value of the method was demonstrated in a study on HBs-antigen prevalence in West Africans.

To assess public exposure to radon, thoron, and their progeny, measurements were conducted in 50 dwellings within the bauxite-rich area of Fongo-Tongo in western Cameroon. Passive integrating radon-thoron discriminative detectors (specifically RADUET) were employed for radon and thoron measurements. Additionally, concentrations of short-lived radon and thoron progeny were estimated using Direct Radon Progeny Sensors (DRPSs) and Direct Thoron Progeny Sensors (DTPSs) based on LR-115 detectors. The findings revealed indoor radon concentrations ranging from 31 to 123 Bq m -3 with a geometric mean (GM) of 62 Bq m -3 , and indoor thoron concentrations ranging from 36 to 688 Bq m -3 with a GM of 242 Bq m -3 . The Equilibrium Equivalent Radon Concentration (EERC) ranged from 3 to 86 Bq m -3 with a GM of 25 Bq m -3 , while the Equilibrium Equivalent Thoron Concentration (EETC) ranged from 1.2 to 12.5 Bq m -3 with a GM of 7.6 Bq m -3 . Notably, all dwellings recorded radon concentrations below 100 Bq m -3 . Arithmetic means of radon and thoron equilibrium factors were calculated as 0.47 and 0.04, respectively. To assess annual effective doses from radon and thoron inhalation, equilibrium factors were used along with direct measurements of EERC and EETC. The differences observed in annual effective doses were 4.5% for radon and 42.5% for thoron. Furthermore, the contribution of thoron and its decay products to the annual effective dose from radon, thoron, and their progeny ranged from 12 to 94%, with an average contribution of 58%. Thus, this study found that the effective dose due to thoron inhalation in the study area exceeded that due to radon inhalation. It is concluded that, when evaluating radiation doses and health risks, it is crucial to consider both thoron and its progeny alongside radon and its progeny. This underscores the importance of considering direct measurements for accurately estimating radiation doses., (© 2024. The Author(s), under exclusive licence to Springer-Verlag GmbH Germany, part of Springer Nature.)

Ant-following behavior is a common phenomenon in birds of Neotropical and Afrotropical rainforests but yet little is known from Central Africa. We here report on the phenomenon in lowland rainforest in Cameroon, quantifying the strength of the interaction of different ant-following bird species with driver ants and test the hypothesis that higher levels of specialization in ant-following behavior are associated with dominance or aggression-dependent plumage and other morphological traits. Flock size varied between 1 and 11 individuals with a mean size of 5.34 ± 2.68 (mean ± SD) individuals occurring at the same time. The maximum number of species present during one raid observed was ten, whereas the minimum number was four with an overall species richness of 6.89 ± 2.1 species. The 21 attending bird species strongly varied in the degree of ant-following behavior. In an interspecific comparison, plumage traits such as the presence of a colored crown, eyespots, and bare skin around the eye, in combination with metatarsus length and weight, were significantly correlated with ant-following behavior. These results suggest that-in size and identity of species-ant-following bird assemblages in Central Africa are similar to those reported from East Africa. They also suggest that ant following favors the selection of traits that signal dominance in interactions between individuals struggling for valuable food resources in the forest understory., (© 2024. The Author(s).)

Pesticides, especially the newly developed neonicotinoids, are increasingly used in many countries around the world, including Cameroon, to control pests involved in crop destruction or disease transmission. Unfortunately, the pesticides also pose tremendous environmental problems because a predominant amount of their residues enter environmental matrices to affect other nontargeted species including humans. This therefore calls for continuous biomonitoring of these insecticides in human populations. The present study sought to assess the neonicotinoid insecticide exposures in two agrarian regions of Cameroon, the South-West region and Littoral region. The study involved 188 men, including 125 farmers and 63 nonfarmers. Spot urine samples were obtained from these subjects and subjected to liquid chromatographic-tandem mass spectrometric analysis for concentrations of neonicotinoid compounds, including acetamiprid, clothianidin, dinotefuran, imidacloprid, thiacloprid, nitenpyram, thiamethoxam, and N-dm-acetamiprid. Neonicotinoid compounds were detected in all study participants, and residues of all the screened pesticides were detected among participants. N-dm-Acetamiprid and imidacloprid were the most prevalent among the subjects (100.0% and 93.1%, respectively), whereas nitenpyram was less common (3.2%). The median values of imidacloprid and total urinary neonicotinoid concentrations were elevated among farmers (0.258 vs. 0.126 µg/L and 0.829 vs. 0.312 µg/L, respectively). Altogether the findings showed that both the farmer and nonfarmer study populations of Cameroon were exposed to multiple residues of neonicotinoids, with relatively higher levels of pesticides generally recorded among farmers. Although exposure levels of the neonicotinoids were generally lower than their respective reference doses, these results warrant further research on the health risk evaluation of multiple residues of the pesticides and reinforcement of control measures to minimize the exposure risks, especially among farmers. Environ Toxicol Chem 2024;43:952-964. © 2024 SETAC., (© 2024 SETAC.)

Background: Major sickle cell syndromes are the most common hemoglobinopathy in the world. The sickle cell patients are subjected to several factors causing inflammation, and the genetic identification of each individual allows to focus the possibility of allelic variations influence of a specific gene and then the polymorphism. This study aims at determining the distribution of HP gene (OMIM#140100) and their involvement on hematological parameters and the iron profile in the sickle cell patients presenting an inflammation condition during major sickle cell syndromes in Cameroun., Methods: A case-control analytical study has been conducted over a period of 6 months. Cases consisting of sickle cell patients in a situation of inflammation and control of non-inflamed sickle cell patients. The patients presenting major sickle cell syndromes, interned and/or followed at the Hematology Department of the Regional Hospital of Bafoussam and the Central Hospital of Yaoundé have been recruited. HP genotyping was carried out at the Laboratory for Public Health Research Biotechnologies (LAPHER-Biotech) in Yaoundé using allele-specific PCR. Also, inflammatory, hematological parameters and martial assessment were explored by standard methods. Statistical analysis of the data was performed using the statistical tool R version 4.1.1. The comparison of proportions of alleles was made with the chi-square test, and the Wilcoxon test was used to compare the median between different groups using the statistical tool R version 4.1.1., Results: We analyzed the samples of 149 patients. The HP polymorphism describes a significant frequency of the "1F" allele (69.8%) followed by the "2" allele (46.31%). In addition, 80 patients (53.69%), 48 (32.21%), and 21 (14.09%) presented the genotype HP 1-1, HP 2-1, and HP 2-2, respectively. And eighty-one percent (81%) patients with genotype HP 2-2 showed a significant higher relative frequency of thrombocytosis compared with the genotype HP 1-1 and HP 2-1, respectively (51.2% and 68.8%, p = 0.087). The proportion of inflammation in the HP 2-2 group was higher (57.1%) compared with the other groups (respectively 42.5% and 35.4% in the HP 1-1 and HP 2-1 groups). Furthermore, the median CRP was significantly higher in the HP 2-2 group compared with the other groups (p = 0.039). Moreover, the entire population of the HP 2-2 group showed an elevation of ferritin and IL6 unlike the HP 1-1 and HP 2-1 groups., Conclusion: This study demonstrates a higher frequency of genotype HP 1-1 followed by the HP 2-2 genotype in patients with major sickle cell syndromes. However, a larger proportion of patients with genotype HP 2-2 are associated with hematological profile disorders, inflammation, and dysregulation of iron metabolism. Then, the haptoglobin polymorphism contributes to the severity of major sickle cell syndromes., (© 2023 The Authors. Molecular Genetics & Genomic Medicine published by Wiley Periodicals LLC.)

The radon-prone area of the Adamawa region in Cameroon is characterized by high natural radiation background resulting from the high concentrations of radium-226, thorium-232, and indoor radon. To produce a radon-risk map, radon measurements in soil were carried out in the city of Ngaoundere. The radon activity concentration in soil gas ranged from 256 to 166 kBq m -3 with a mean of 80 kBq m -3 and a standard deviation of 38 kBq m -3 . The area is mostly classified as high risk (80%) according to the Swedish classification, and 20% as medium risk. A low-risk area was not observed. Granite-like geology sites were characterized by higher radon concentration. A ratio of about 295:1 was obtained for soil radon gas to indoor radon concentrations, with a positive correlation (R = 0.40), and a transfer factor of 3 per mil. These results demonstrate that in situ measurements of radon concentration in soil can provide accurate information on the level of indoor radon concentrations. Geostatistical and deterministic interpolation techniques have been used to obtain a radon map by comparing the suitability of ordinary kriging and inverse-distance-weighted (IDW) interpolation methods. It turned out that there is not much difference in the prediction errors of the two techniques (Root Mean Square Error = 34.4 for ordinary kriging and 34.3 for IDW). It is concluded that both methods give acceptable results. In situ measurements and geostatistical analysis allow assessment of expected indoor radon exposure in a given area at reduced costs and time required. However, for the investigated area, more research is needed to produce reliable radon-risk maps., (© 2023. The Author(s), under exclusive licence to Springer-Verlag GmbH Germany, part of Springer Nature.)

Cameroonian farmers regularly use pesticides in farming to control pests, particularly along the riverbank of the Santchou agricultural area. The aim of this study was to assess the perception of farmers in West Cameroon (Santchou area) regarding the contamination risk in aquatic environments from the use of pesticides. A cross-sectional study via questionnaires was conducted among 150 selected farmers who cultivated fields along the banks of the Menoua River. Almost all the farmers (90%) used pesticides regularly, particularly herbicides, insecticides, and fungicides to combat pests. The main pesticides used were glyphosate, paraquat, dieldrin, chlorpyrifos-ethyl, copper oxide, and mancozeb. Farmers who cultivated larger areas of land or who had mixed culture crops tended to use pesticides more often (p < 0.001). The use of river water by farmers was correlated with pesticide use (p = 0.010). Most of the pesticide users (90%) did not use protective equipment when spraying the crops. The farmers' perceptions of the risk of pesticide contamination of the river water (p = 0.002) or fish (p = 0.008) did not influence their actions. A correlation was found among pesticide users who believed that there was a risk of river contamination (45%) or fish contamination (42%) and intensive pesticide application during the rainy season (61%) or non-respect of the prescribed pesticide application doses (51%; p = 0.002). Farmers who regularly or occasionally consumed fish used pesticides more often than those who did not consume fish from the river. The findings of this study emphasize the need for education of farmers in Santchou to prevent the risk of environmental contamination and health hazards from increased dietary and/or dermal pesticide exposure. Integr Environ Assess Manag 2023;19:1600-1608. © 2023 SETAC., (© 2023 SETAC.)

Background: The COVID-19 pandemic indirectly impacts HIV epidemiology in Central/West Africa. We estimated the potential impact of COVID-19-related disruptions to HIV prevention/treatment services and sexual partnerships on HIV incidence and HIV-related deaths among key populations including female sex workers (FSW), their clients, men who have sex with men, and overall., Setting: Yaoundé (Cameroon) and Cotonou (Benin)., Methods: We used mathematical models of HIV calibrated to city population-specific and risk population-specific demographic/behavioral/epidemic data. We estimated the relative change in 1-year HIV incidence and HIV-related deaths for various disruption scenarios of HIV prevention/treatment services and decreased casual/commercial partnerships, compared with a scenario without COVID-19., Results: A 50% reduction in condom use in all partnerships over 6 months would increase 1-year HIV incidence by 39%, 42%, 31%, and 23% among men who have sex with men, FSW, clients, and overall in Yaoundé, respectively, and 69%, 49%, and 23% among FSW, clients, and overall, respectively, in Cotonou. Combining a 6-month interruption of ART initiation and 50% reduction in HIV prevention/treatment use would increase HIV incidence by 50% and HIV-related deaths by 20%. This increase in HIV infections would be halved by a simultaneous 50% reduction in casual and commercial partnerships., Conclusions: Reductions in condom use after COVID-19 would increase infections among key populations disproportionately, particularly FSW in Cotonou, who need uninterrupted condom provision. Disruptions in HIV prevention/treatment services have the biggest impacts on HIV infections and deaths overall, only partially mitigated by equal reductions in casual/commercial sexual partnerships. Maintaining ART provision must be prioritized to minimize short-term excess HIV-related deaths., Competing Interests: K.M.M. has received an honorarium from Gilead for speaking, outside the submitted work. The remaining authors have conflicts of interest to disclose., (Copyright © 2021 The Author(s). Published by Wolters Kluwer Health, Inc.)

Change in land use and land cover (LULC) contributes in worsening ecological issues. Studying the trends of change in land use is highly significant to deal with global climate change and sustainable development. The aim of this paper is to evaluate the spatial-temporal dynamics of LULC of the Bamenda Mountains (BM) in the North West region of Cameroon, over a period of 34 years (1988-2022) and predict 34 years (2022-2056) future land use scenario of this site using time series satellite imagery (MSS, TM, ETM+, and OLI-TIRS) and ancillary data and to comprehend the driving forces of land use/land cover change (LULCC). The trends of LULCC were quantified; LULC maps were derived by classifying time series satellite images. Six LULC categories were identified during the study period (1988-2022). The research revealed a significant LULCC of the BM which can be justified by increase in the human population observed in the study area and the desire to extend agricultural lands to sustain the growing population. Overall, cultivated area 5684 ha (10.47%), 10680 ha (19.57 %), and 15163 ha (27.78%) and built-up area 449 ha (0.83%), 996 ha (1.83%), and 3242 ha (5.94%) for the study years 1988, 2003, and 2022, respectively, were all on the increase throughout the study period at the expense of other land cover types. The predicted figures of 2056 showed a continuous reduction of montane forest and savanna: 2401.92 ha (4.40%) and 25,862.67 ha (47.39%), respectively. Bare area is expected to drop in 2056 (2905.92 ha (5.32%)). The above decrease, when compared to 2022 figures, represents a loss of 3.97%, 4.53%, and 0.57%, respectively. The losses observed are gained by built-up and cultivated land (5.72% and 3.39%, respectively), covering surfaces areas of 6364.89 ha (11.66%) and 17,008.56 ha (31.17%), respectively. The above findings suggest that population growth is likely the major menace to the natural environment. It is thus safe to say that substantial LULCC was observed throughout the study period and will undoubtedly continue if nothing is done. This necessitates urgent measures such as reforestation and afforestation, encouraging off-farm activities and even improving technologies to combat the rate of forest degradation of the BM. Additionally, rebuilding trust between the French and English Cameroons through dialogue is premodial, to end the curent conflictual civil war and lessen the landscape configuration in Bamenda., (© 2023. The Author(s), under exclusive licence to Springer Nature Switzerland AG.)

Background: With the success of antiretroviral therapy (ART), children born with HIV are more likely to reach adolescence. However, frequent non-adherence to ART in adolescents living with HIV (ALHIV) leads to viral replication. Notably, a viraemic infection might lead to archived drug resistance mutations (ADRMs). Hence, within the context of the COVID-19 pandemic, we aimed to compare the patterns of ADRMs in viraemic and non-viraemic vertically infected ALHIV and to assess their immunity to and diagnosis of SARS-CoV-2., Methods: A comparative study was conducted among COVID-19-unvaccinated ALHIV receiving ART in Yaoundé-Cameroon over the period October 2021 to March 2022. Plasma HIV-RNA was measured using Abbott® m2000rt; HIV-1 genotyping was performed on buffy-coat (HIV-1 DNA) and ADRMs were interpreted using HIVdb.v9.0.1. Patterns of HIV-1 ADRMs were compared between viraemic (≥ 1.60 log 10 HIV-1 RNA copies/ml) and non-viraemic (< 1.60 log 10 copies/ml) individuals. SARS-CoV-2 antibodies were assessed on whole blood using Abbott Panbio COVID-19 immunoglobulin G/M (IgG/IgM) rapid test and COVID-19 polymerase chain reaction test was performed using nasopharyngeal swab samples., Results: Of the 60 ALHIV [aged 17 (16-19) years, 51.6% female], median ART duration was 14 (12-16) years; 31/55 (56.3%) were exposed to nonnucleoside reverse transcriptase inhibitor (NNRTI)-based first-line ART (of whom 19/31 transitioned to dolutegravir-based ART in 2020) and 24/55 (43.6%) were on second-line ART. Forty-two out of 60 (70.0%) ALHIV were non-viraemic; 43/60 (71.6%) were successfully sequenced. Overall the ADRM rate was 62.7% (27/43), with 69.2% (9/13) viraemic and 60.0% (18/30) non-viraemic (p = 0.56). NNRTI-ADRMs were significantly higher among viraemic ALHIV (69.2% vs. 46.7%, p = 0.030). Regarding immunity, those with CD4 nadir < 350 cells/μl had significantly higher rates of ADRMs [adjusted odds ratio (aOR) = 3.20 (1.36-95.53), p = 0.03]. In relation to COVID-19 immunity, overall SARS-CoV-2 IgG seropositivity was 28.3% (17/60), whereas 0% (0/60) were seropositive to IgM; in particular, those with CD4 count nadir ≥ 350 cells/μl had higher odds of SARS-CoV-2 IgG seropositivity [OR =7.85 (2.03-30.28), p < 0.01]. No significant association was found between SARS-CoV-2 IgG seropositivity and HIV-RNA (non-viraemic, 33.3%; viraemic, 16.7%; p = 0.18). SARS-CoV-2 RNA prevalence was 4.5% (2/44). The two positive participants were with low-levels of viral load (Ct > 30) and seropositive to IgG., Conclusion: In the context of virological success, the majority of ALHIV harbour ADRMs, essentially driven by NNRTI mutations and low CD4 nadir. During the current pandemic, about one-third of ALHIV were previously exposed to SARS-CoV-2. However, some children might have been exposed and uninfected and others might have been infected but showed no serological response at sampling. These findings support the use of NNRTI-sparing regimens and the implementation of COVID-19 barrier measures targeting ALHIV during such a pandemic., (© 2023 British HIV Association.)

Policymakers are committed to improving nutritional status and to saving lives. Some micronutrient intervention programs (MIPs) can do both, but not to the same degrees. We apply the Micronutrient Intervention Modeling tool to compare sets of MIPs for (1) achieving dietary adequacy separately for zinc, vitamin A (VA), and folate for children and women of reproductive age (WRA), and (2) saving children's lives via combinations of MIPs. We used 24-h dietary recall data from Cameroon to estimate usual intake distributions of zinc and VA for children 6-59 months and of folate for WRA. We simulated the effects on dietary inadequacy and lives saved of four fortified foods and two VA supplementation (VAS) platforms. We estimated program costs over 10 years. To promote micronutrient-specific dietary adequacy, the economic optimization model (EOM) selected zinc- and folic acid-fortified wheat flour, VA-fortified edible oils, and bouillon cubes, and VAS via Child Health Days in the North macroregion. A different set of cost-effective MIPs emerged for reducing child mortality, shifting away from VA and toward more zinc for children and more folic acid for WRA. The EOM identified more efficient sets of MIPs than the business-as-usual MIPs, especially among programs aiming to save lives., (© 2022 New York Academy of Sciences.)

The availability of water for agricultural use in the savannah plateau of Adamawa, Cameroon, is addressed in this paper. Specific field tests coupled with climatic data analysis have helped to characterize the hydrological and hydrogeological conditions of water resources in a small catchment. An agricultural suitability map, based on the water availability during the dry season, is produced. Measured saturated hydraulic conductivities indicated an acceptable disposition of the soils for agriculture. The transmissivity values indicated moderate groundwater potential with mean annual recharge of 96 mm. The agricultural suitability map shows that only 8.8% of the basin area is very favorable for agriculture and that 51% of the basin is not suitable for agriculture, due to water scarcity during the dry season. Due to the considerable depth to the water table, pumping for irrigation purposes is not affordable for the local low-income farmers. Therefore, there is a need to implement adapted solutions for irrigation to support farmers' endeavors, such as the development of water retention basins or the construction of boreholes equipped with electric pumps supplied by solar energy for irrigation., (© 2022. The Author(s), under exclusive licence to Springer Nature Switzerland AG.)

Introduction: Pre-exposure prophylaxis (PrEP) is proven to be a highly effective HIV prevention method for key populations. However, its scale-up in resource-limited settings remains suboptimal. This paper seeks to describe PrEP initiation and continuation among key populations in Cameroon., Methodology: From June 2019 through October 2020, we collected routine program data on PrEP uptake and continuation among female sex workers (FSWs) and men who have sex with men (MSM) in the Continuum of prevention, care and treatment of HIV/AIDS with Most-at-risk Populations (CHAMP) program in Cameroon. PrEP was offered to clients who tested negative for HIV and were assessed to potentially benefit from PrEP. Using survival analysis, we identified factors associated with PrEP discontinuation over time with significance set at 5%., Results: Overall, 27,750 clients were sensitized for PrEP of whom 3,138 persons were eligible to start PrEP and 1,409 (45%; FSW: 691 and MSM: 718) initiated PrEP. The PrEP continuation rate was 37% at 3 months, 28% at 6 months and 19% at 12 months. PrEP discontinuation was significantly higher among FSW than MSM [adjusted hazard ratio (aHR) 1.5 (95% CI: 1.2 to 1.9)] in Yaounde [aHR 1.5 (95% CI: 1.2 to 1.9)] and Bafoussam/Bertoua [aHR 3.1 (2.2-4.5)] relative to Douala. Discontinuation was lower among those with moderate [aHR 0.3 (0.3-0.4)] or good adherence [aHR 0.4 (0.3-0.6)] compared with poor adherence (all P < 0.001)., Conclusion: Differentiated approaches to deliver PrEP, create demand, and provide more intensive support for adherence and continuation may support scale-up of PrEP in Cameroon for equitable and prolonged impact on HIV prevention., Competing Interests: A.L.B., W.P., D.C. and S.B. disclose that they received payments through their institutions for their efforts in this study. The other authors have no conflict of interest to disclose., (Copyright © 2022 The Author(s). Published by Wolters Kluwer Health, Inc.)

Objectives: Rising antimicrobial resistance is a major threat worldwide. WHO has developed a Global Action Plan and has urged all countries to develop and implement a National Action Plan. We analysed the implementation of the Cameroon National Action Plan by identifying the prioritised activities and assessing possible challenges which could limit implementation., Methods: We conducted a review of national documents on the control of antimicrobial resistance, including regulations, policies and guidelines and assessed the health system structure. Publications and other supporting documents were obtained by a systematic literature search. We applied the policy analysis triangle framework and the theory of change to analyse the National Action Plan, actors involved and the process of implementation., Results: The National Action Plan consisted of six strategic objectives, with the first five being a direct translation of the five pillars of the Global Action Plan. The related activities were to be implemented using a phased approach with allocated targets for each year. Several gaps were identified. There was no timeline of activities set per year, the chronology of activities was not consistent, there were no activities or objectives to ensure the sustainability of the National Action Plan like creating awareness on antimicrobial resistance and the indicators for impact evaluation were not included. Among the actors involved, the Ministry of Public Health had the highest interest in the implementation as the lead stakeholder to oversee the overall implementation. However, there was no clear source of funding, and stakeholders at the primary level of the various sectors responsible for implementation were not clearly defined., Conclusion: Despite adequate multisectoral collaboration within the prioritised activities relevant to Cameroon, more is needed for effective implementation of the National Action Plan. The timeline of the different activities, as well as the involvement of key stakeholders at the primary level, needs to be improved. The government's overall commitment to healthcare should be increased and implementation of an action plan should commence at the district or regional level, while challenges in mobilising the necessary funds need to be overcome., (© 2021 John Wiley & Sons Ltd.)

Background: Key populations (KP) including men who have sex with men (MSM), female sex workers (FSW), and their clients are disproportionately affected by HIV in Sub-Saharan Africa. We estimated the evolving impact of past interventions and contribution of unmet HIV prevention/treatment needs of key populations and lower-risk groups to HIV transmission., Setting: Yaoundé, Cameroon., Methods: We parametrized and fitted a deterministic HIV transmission model to Yaoundé-specific demographic, behavioral, HIV, and intervention coverage data in a Bayesian framework. We estimated the fraction of incident HIV infections averted by condoms and antiretroviral therapy (ART) and the fraction of all infections over 10-year periods directly and indirectly attributable to sex within and between each risk group., Results: Condom use and ART together may have averted 43% (95% uncertainty interval: 31-54) of incident infections over 1980-2018 and 72% (66-79) over 2009-2018. Most onward transmissions over 2009-2018 stemmed from sex between lower-risk individuals [47% (32-61)], clients [37% (23-51)], and MSM [35% (20-54)] with all their partners. The contribution of commercial sex decreased from 25% (8-49) over 1989-1998 to 8% (3-22) over 2009-2018, due to higher intervention coverage among FSW., Conclusion: Condom use and recent ART scale-up mitigated the HIV epidemic in Yaoundé and changed the contribution of different partnerships to onward transmission over time. Findings highlight the importance of prioritizing HIV prevention and treatment for MSM and clients of FSW whose unmet needs now contribute most to onward transmission, while maintaining services that successfully reduced transmissions in the context of commercial sex., Competing Interests: The authors have no conflicts of interest to disclose., (Copyright © 2020 Wolters Kluwer Health, Inc. All rights reserved.)

Background: Rapid reporting of surveillance data is essential to better inform national prevention and control strategies., Objectives: We compare the newly implemented smartphone-based system to the former paper-based and short message service (SMS) for collecting influenza epidemiological data in Cameroon., Methods: Of the 13 sites which collect data from persons with influenza-like illness (ILI), six sites send data through the EWS, while seven sites make use of the paper-based system and SMS. We used four criteria for the comparison of the data collection tools: completeness, timeliness, conformity and cost., Results: Regarding the different collection tools, data sent by the EWS were significantly more complete (97.6% vs 81.6% vs 44.8%), prompt (74.4% vs n/a vs 60.7%) and of better quality (93.7% vs 76.1% vs 84.0%) than data sent by the paper-based system and SMS, respectively. The average cost of sending a datum by a sentinel site per week was higher for the forms (5.0 USD) than for the EWS (0.9 USD) and SMS (0.1 USD). The number of outpatient visits and subsequently all surveillance data decreased across the years 2017-2019 together with the influenza positivity rate from 30.7% to 28.3%. Contrarily, the proportion of influenza-associated ILI to outpatient load was highest in the year 2019 (0.37 per 100 persons vs 0.28 and 0.26 in the other 2 years)., Conclusion: All sentinel sites and even other disease surveillance systems are expected to use this tool in the near term future due to its satisfactory performance and cost., (© 2020 The Authors. Influenza and Other Respiratory Viruses Published by John Wiley & Sons Ltd.)

Dog demographics are considered as one of the main factors in the control of rabies. Having reliable data on dog population and husbandry practices on how they are managed is a key point in the elaboration of any control program to fight against human deaths due to rabies which are mainly due to dogs. However, the lack of data regarding dog population is one of the main hindrances to elaborate effective fighting projects in developing countries, particularly in Africa. In order to contribute for reliable data on dog demographics and husbandry practices related to rabies, this study was carried out in the cities of Ngaoundéré, Garoua and Yaoundé, respectively located in Adamaoua, North and Centre regions of Cameroon from October 2013 to April 2014. A survey was conducted within 2500 households selected randomly to which 45 questions were addressed, while the vaccine status of dogs was checked in the houses by verifying the vaccination booklet and in public and private veterinary clinics. Various aspects of dogs such as dog population, husbandry practices, ownership and age distribution were assessed. Out of these households, 45% of them (1118) had exploitable data. From these, 46% of them owned at least 1 dog for a total of 707 dogs, with a dog per household ratio of 6.3:10 for a dog per human ratio of 1.16:10. The age distribution of these dogs showed that the mean age of male and female was around 2 years with a male per female ratio of 29:10. The estimation of roaming dogs gave a ratio of 2.3:10 per human. Concerning the reasons for having a dog, the main motivation was guarding (76%) and company (17%). Husbandry practices applied to these dogs were a complete restrained (52%), semi-restrained (29%) and a complete roaming (18%). In relation to rabies, only 34% of dog owners were able to prove the effective vaccination of their dogs and no reason was given to explain the non-vaccination by the majority (78%) of the owners. So this study provides for the first time a baseline on dog population for an objective fighting program but also shows that the husbandry practices applied by the owners can be a hindrance to a fighting program against rabies.

Objective: Prices of antiretroviral (ARV) drugs in lower income countries have decreased substantially over the past two decades, helping to facilitate greatly expanded access to antiretroviral therapy (ART). However, ART coverage in many parts of the world remains low. We investigate the extent of epidemiological benefits that might be expected if ARV drug prices decline further., Design: A modeling study using data from seven countries in West and Central Africa (Cameroon, Democratic Republic of the Congo, Côte d'Ivoire, Niger, Nigeria, Senegal, and Togo)., Methods: We investigated how the timing of ARV cost reductions could affect the impact and compared three different possible investment strategies: reinvesting in ART, reinvesting in the HIV response according to historical allocations, and reinvesting with the aim of minimizing HIV incidence and mortality., Results: If ARV drug prices fell by 37% relative to 2018 levels (i.e. following continued trend declines), we calculate ART unit costs could decrease by ∼20% (holding other cost components constant). If this could be achieved by 2020 and the savings were reinvested into ART, we estimate that an additional 8% of HIV infections and 11% of HIV-related deaths could be averted over 2020-2030 across the seven countries. Slightly greater gains could be attained if funds were reinvested in ART in combination with primary prevention. Delays in the year of introduction of ARV price reductions would reduce the impact by about 1% per year., Conclusion: ARV price reductions could free up funds that - if strategically invested - would help countries move closer toward the elimination of HIV.

To effectively combat global warming, an enormous reduction in CO 2 emissions is required. Cameroon, which is currently the largest emitter of CO 2 in the CEMAC subregion, has committed to reducing its greenhouse gas emissions by 32% by 2035. However, previous studies in Cameroon have only addressed the relationship between economic growth, energy consumption, and CO 2 emissions without estimating all causal relationships at the same time. Moreover, no study has yet decomposed this country's CO 2 emissions to date. To fill these research gaps and further assess the determinants of these CO 2 emissions, an extended Kaya identity and the Logarithm Mean Divisia Index (LMDI I) have been applied in this paper to identify, quantify, and explain the main drivers of Cameroon's CO 2 emissions from 2007 to 2014. Seven effects were measured and the main findings show that carbon intensity and the emission factor increased by 0.57% and 107.50% respectively. Regarding contributions to the increase of CO 2 emissions, the population effect was the most positive followed by the activity effect, whereas the energy intensity, the substitution of fossil fuels and the penetration of renewable energies have contributed to reduce the CO 2 emission. To enable Cameroon to not only achieve the goals of its vision but also develop a low-carbon economy, this paper provides some proposed avenues that should be considered by policymakers.

The dynamics of knowledge transmission and acquisition, or how different aspects of culture are passed from one individual to another and how they are acquired and embodied by individuals, are central to understanding cultural evolution. In small-scale societies, cultural knowledge is largely acquired early in life through observation, imitation, and other forms of social learning embedded in daily experiences. However, little is known about the pathways through which such knowledge is transmitted, especially during middle childhood and adolescence. This study presents new empirical data on cultural knowledge transmission during childhood. Data were collected among the Baka, a forager-farmer society in southeastern Cameroon. We conducted structured interviews with children between 5 and 16 years of age (n = 58 children; 177 interviews, with children being interviewed 1-6 times) about group composition during subsistence activities. Children's groups were generally diverse, although children tended to perform subsistence activities primarily without adults and with same-sex companions. Group composition varied from one subsistence activity to another, which suggests that the flow of knowledge might also vary according to the activity performed. Analysis of the social composition of children's subsistence groups shows that vertical and oblique transmission of subsistence-related knowledge might not be predominant during middle childhood and adolescence. Rather, horizontal transmission appears to be the most common knowledge transmission strategy used by Baka children during middle childhood and adolescence, highlighting the importance of other children in the transmission of knowledge.

Health care is provided in many developing countries free of any charge at the point of delivery. This is attributed to the fact that health care is one of the basic human rights. While modern health care in public health units is free, patients in rural areas continue to use either self-care, traditional healers or both. In Cameroon, the idea of integrating traditional and modern medical practices is discussed by both traditional and medical practitioners. However, it is not very clear what influences the household's choice of one or the other. Within a health district, where there are many providers, the question as to whether or not there is a possibility of choice open to all is posed. This article reports on a study undertaken in a rural health district that shows that there are many factors that influence the choice of health care. Among these factors is quality of care which is the most important factor influencing the choice of health care provider. As quality of care increases in governmental health centres, their choice probability also increases. Other factors include: the time spent seeking treatment; household income and size; distance; and, cost of health care. Those with higher incomes tend to choose private health units and those with larger families tend to choose government health units. Other socio-cultural factors, difficult to model, appear to also influence the choice of providers. It is concluded that since household income influences the choice of private health units, policies targeting poverty alleviation should be instituted in the rural areas to provide households with income. This will enable them widened access to private health care and enable government to redeploy its scarce resources to maintain and extend services to needy areas.

Background: Infant mortality rates have been widely used as indicators of health status and the availability, utilization and effectiveness of health services. Two principal sources of data for infant mortality rates are vital registers and censuses. This study was designed to evaluate the accuracy of vital registers as sources of data for infant mortality rates in Cameroon., Methods: A household census of births and infant deaths that occurred in Buea Subdivision between 1 November 1991 and 31 October 1992 was conducted to determine the proportion that were registered and the reasons why the remainder were not registered., Results: The registration coverage was found to be 62% for births and 4% for infant deaths. The most frequently reported reasons for not registering births were lack of money, lack of time and a complicated registration procedure. For infant deaths the reasons were lack of knowledge and no perceived benefits., Conclusions: Vital registers of birth and death are not an accurate source of data for infant mortality rates in Cameroon. Motivation for birth and death registration appear to be dependent on the perceived benefits. A mechanism of registration that uses medical institutions may substantially increase registration coverage for births and infant deaths.

Although several primers targeted to the internal transcribed-spacer 1 (ITS1) of the ribosomal DNA (rDNA) have been designed to improve the detection of African trypanosomes, no study tried to compare their agreement level and ability to amplify different trypanosome species in tsetse flies and mammals in various epidemiological settings. This study was designed to fill this gap, by targeting tsetse-infested areas of Cameroon. For this, archived DNA samples reporting at-least one trypanosome species with species-specific PCR primers were reviewed. Ten sets of primers targeting different ITS1 rDNA sequences of trypanosomes were selected for assessment using single-round and nested-PCR method. Amplification rates (sensitivity) and agreement level of different ITS1 assays were compared using Cohen's-Kappa and McNemar's x 2 statistic. Little agreement level (k = 0.05-0.52) were observed between different ITS1-primers PCRs detection of African trypanosome species despite significant (X 2 =54.3, p = 0.0001) high amplification rate 91.6 % (339/370). This sensitivity varied from quite low for T. simiae (11.9 %) and T. vivax (27.3 %) to fairly good for T. congolence (51.9 %), Trypanozoon (32.4 %) and T. theileri (40.3 %). Primers set targeting ITS1-A sequence of trypanosome species recorded the highest sensitivity (50.5 %) with fairly good agreement compared to 39.2 % for ITS1-C (k = 0.52), 32.4 % for ITS1-R (k = 0.47), 29.7 % for ITS1-N (k = 0.48) and 23.0 % for ITS1-KIN (k = 0.43) respectively. This study revealed a diversity in the sensitivity of different trypanosome species with different sets of ITS-primers enhancing the need to use the same sets of primers in different bio-ecological settings. The use of nested-PCR instead of single-round PCR enabled improvement of trypanosome infections detection in both tsetse and mammals. Among the sets of ITS1-primers tested, those designed by to amplify ITS1-A can be considered as the most appropriate for the detection of trypanosome infections in mammals and tsetse flies., Competing Interests: Declaration of competing interest The authors declare that they have no known competing personal relationships or financial interests that could have appeared to influence the work reported in this paper. Authors also confirm that the manuscript has been read and approved by all named authors. Also that there are no other person who satisfied the criteria for authorship but are no listed. We further confirm that the order of authors listed in the manuscript has been approved by all of us., (Copyright © 2024 Elsevier B.V. All rights reserved.)

Background: Global surgery research efforts have been criticized for failure to transition from problem identification to intervention implementation. We developed a context-appropriate trauma quality improvement (TQI) bundle to ameliorate care gaps at a regional referral hospital in Cameroon. We determined associations between bundle implementation and improvement in trauma resuscitation practices., Methods: We implemented a TQI bundle consisting of a hospital-specific trauma protocol, staff training, a trauma checklist, provision of essential emergency trauma supplies in the resuscitation area, and monthly quality improvement meetings. We compared trends in target process measures (e.g., frequency and timing of vital sign collection and primary survey interventions) in the six-month period pre- and post-bundle implementation using Wilcoxon rank-sum and Fisher's exact tests., Results: We compared 246 pre-bundle patients with 203 post-bundle patients. Post-bundle patients experienced a greater proportion of all vital signs collected compared to the pre-intervention cohort (0 % pre-bundle vs. 69 % post-bundle, p < 0.001); specifically, the proportion of respiratory rate (0.8 % pre-bundle vs. 76 % post-bundle, p < 0.001) and temperature (7 % pre-bundle vs. 91 % post-bundle, p < 0.001) vital sign collection significantly increased. The post-bundle cohort had vital signs measured sooner (74 % vital signs measured within 15 min of arrival pre-bundle vs. 90 % post-bundle, p < 0.001) and more frequently per patient (7 % repeated vitals pre-bundle vs 52 % post-bundle, p < 0.001). Key primary survey interventions such as respiratory interventions (1 % pre-bundle vs. 8 % post-bundle, p < 0.001) and cervical collar placement (0 % pre-bundle vs. 7 % post-bundle, p < 0.001) also increased in the post-bundle cohort., Conclusions: The implementation of a context-appropriate TQI bundle was associated with significant improvements in previously identified trauma care deficits at a single regional hospital. Data-derived interventions targeting frontline capacity at the local level can bridge the gap between identifying care limitations and improvement in resource-limited settings., Competing Interests: Declaration of competing interest The authors declare the following financial interests/personal relationships which may be considered as potential competing interests: Mark T. Yost and Dennis J. Zheng report financial support was provided by National Institutes of Health Fogarty International Center (award number D43TW009343) and the University of California Global Health Institute. Mark T. Yost reports financial support was provided by the H & H Lee Research Program and LB Research and Education Foundation. Catherine Juillard, Alain Chichom-Mefire, and S. Ariane Christie report financial support was provided by National Institutes of Health (award number U54TW012087). If there are other authors, they declare that they have no known competing financial interests or personal relationships that could have appeared to influence the work reported in this paper. The content is solely the responsibility of the authors and does not necessarily represent the official views of the NIH., (Copyright © 2024. Published by Elsevier Ltd.)

The decision to adopt environmental protection policies within companies is faced with the fear of negative repercussions on performance. The aim of this paper is to analyse the effect of adopting environmental protection measures on the performance of VSEs in the tertiary sector in Cameroon. The use of linear models and matching methods such as Propensity Score Matching (PSM) and Multivariate Distance Matching (MDM) reveals a positive influence on performance. However, not all environmental protection measures produce such an effect. When the channel of influence is checked, structural equation models of the path analysis type show that costs are a non-negligible transmission channel. However, a difference in the mechanism of action depending on the device adopted is found. An analysis of the heterogeneity of the effect of adopting environmental protection measures shows that the effect is not identical according to the number of years in business and the size of the company. The results of building a region-sectoral instrument applied to the IV method attest to the robustness of our results. The study encourages companies to behave in an environmentally friendly way and confirms the need for public authorities to support them without forcing them to do so., Competing Interests: Declaration of competing interest There is no conflict of interest between the authors., (Copyright © 2024 Elsevier Ltd. All rights reserved.)

Ethnopharmacological Relevance: Schumanniophyton magnificum is a medicinal plant used to manage many ailments including malaria, skin diseases, parasitic infections, male sexual dysfunctions, female infertility and typhoid fever. However, no scientific investigation has been made for its folkloric use by the "Baka" Pygmies of Cameroon as an aphrodisiac., Aim of the Study: To investigate the aphrodisiac and androgenic activities of the aqueous extract of the roots of Schumanniophyton magnificum in male rats and analyze the phytoconstituents by UHPLC/MS., Materials and Methods: Twenty-five male rats of 16-weeks old were divided into 5 groups and orally treated for 30 days with distilled water (10 ml/kg), or sildenafil citrate (5 mg/kg), or the aqueous extract of Schumanniophyton magnificum (43 mg/kg, 86 mg/kg and 172 mg/kg). The sexual behaviour parameters were monitored on day 1 and 30 by pairing male rats to receptive females. At the end of the experiment, rats were killed and the blood and reproductive organs were collected for histological sectioning, sperm analysis and biochemical analysis. The presence of phytoconstituents and their structures were revealed by UHPLC/MS., Results: The plant extract significantly increased the mount, ejaculation and intromission frequencies in comparison to those in the normal control group; and significantly doubled the serum testosterone levels (2.15 ± 0.70 ng/ml) compared to the normal control group. UHPLC/MS of the aqueous extract of Schumanniophyton magnificum identified 7 major compounds such as Schumanniofioside A, Noreugenin and Rohitukine, with antioxidant and antibacterial activities. The plant extracts significantly increased the penile nitric oxide levels (P <0.05). These results were similar to those obtained after administration of sildenafil citrate., Conclusions: The aqueous extract of Schumanniophyton magnificum could be an alternative for erectile dysfunction management., Competing Interests: Declaration of competing interest The authors declare that they have no known competing financial interests or personal relationships that could have appeared to influence the work reported in this paper., (Copyright © 2024 Elsevier B.V. All rights reserved.)

Current understanding of genetic polymorphisms and natural selection in Plasmodium falciparum circumsporozoite (PfCSP), the leading malaria vaccine, is crucial for the development of next-generation vaccines, and such data is lacking in Africa. Blood samples were collected among Plasmodium-infected individuals living in four Cameroonian areas (Douala, Maroua, Mayo-Oulo, Pette). DNA samples were amplified using nested PCR protocols, sequenced, and BLASTed. Single nucleotide polymorphisms (SNPs) were analysed in each PfCSP region, and their impact on PfCSP function/structure was predicted in silico. The N-terminal region showed a limited polymorphism with four haplotypes, and three novel SNPs (N68Y, R87W, K93E) were found. Thirty-five haplotypes were identified in the central region, with several variants (e.g., NVNP and KANP). The C-terminal region was also highly diverse, with 25 haplotypes and eight novel SNPs (N290D, N308I, S312G, K317A, V344I, D356E, E357L, D359Y). Most polymorphic codon sites were mainly observed in the Th2R subregion in isolates from Douala and Pette. The codon site 321 was under episodic positive selection. One novel (E357L) and three known (K322I, G349D, D359Y) SNPs show an impact on function/structure. This study showed extensive genetic diversity with geographical patterns and evidence of the selection of Cameroonian PfCSP central and C-terminal regions., Competing Interests: Declaration of competing interest The authors declare that they have no known competing financial interests or personal relationships that could have appeared to influence the work reported in this paper., (Copyright © 2024 Elsevier B.V. All rights reserved.)

Background: The prevalence of contraception among married women, evaluated at 23%, is low in Cameroon. Maternal death rates, estimated at 782 deaths per 100,000 live births, are very worrying. The National Strategic Plan for Reproductive, Maternal, Newborn and Child Health (2015-2020) and the Health Sector Strategy (2016-2027) focuses on increasing modern contraceptive prevalence as a means to reduce maternal death. This paper identifies women's bargaining power as a factor that may stimulate contraceptive use. The objective of this study is to analyze the association between women's bargaining power within couples and modern contraceptive use., Methods: The data used come from the fifth Demographic and Health Survey (DHS) conducted in 2018. Women's bargaining power within couple is measured by a Woman Bargaining Power Composite Index (WBPCI) built through a multiple correspondence analysis. The logistic regression model was used to analyze the relationship between WBPCI and modern contraceptive use., Results: The results of the descriptive statistics show that women's bargaining power is higher among women who use contraception than for those who do not. The results of the logistic regression model show that an increase of WBPCI was significantly associated with higher chances of using a modern contraceptive method (OR = 1.352; 95% CI: 1.257, 1.454; p <0.01). The education of women is also a key determinant since educated women were at least two times more likely to use a modern contraceptive method than uneducated women., Conclusions: To reduce high maternal death rates in Cameroon, public health policies should not only focus on the health system itself, but should also focus on social policies to empower women in the household., Competing Interests: No competing interests were disclosed., (Copyright: © 2024 Tchakounté Tchuimi D and Kamga BF.)

The widespread of chlorhexidine and antibiotics in the water bodies, which grew during the global COVID-19 pandemic, can increase the dispersion of antibiotic resistance. We assessed the occurrence of these pharmaceutical compounds as well as SARS-CoV-2 and analysed the bacterial community structure of hospital and urban wastewaters from Brazil, Cameroon, and Madagascar. Water and wastewater samples (n = 59) were collected between January-June 2022. Chlorhexidine, azithromycin, levofloxacin, ceftriaxone, gentamicin and meropenem were screened by Ultra-High-Performance Liquid Chromatography coupled with mass spectrometer. SARS-CoV-2 was detected based on the nucleocapsid gene (in Cameroon and Madagascar), and envelope and spike protein-encoding genes (in Brazil). The total community-DNA was extracted and used for bacterial community analysis based on the 16S rRNA gene. To unravel likely interaction between pharmaceutical compounds and/or SARS-CoV-2 with the water bacterial community, multivariate statistics were performed. Chlorhexidine was found in hospital wastewater effluent from Brazil with a maximum concentration value of 89.28 μg/L. Additionally, antibiotic residues such as azithromycin and levofloxacin were also present at concentrations between 0.32-7.37 μg/L and 0.11-118.91 μg/L, respectively. In Cameroon, azithromycin was the most found antibiotic present at concentrations from 1.14 to 1.21 μg/L. In Madagascar instead, ceftriaxone (0.68-11.53 μg/L) and levofloxacin (0.15-0.30 μg/L) were commonly found. The bacterial phyla statistically significant different (P < 0,05) among participating countries were Proteobacteria, Patescibacteria and Dependentiae which were mainly abundant in waters sampled in Africa and, other phyla such as Firmicutes, Campylobacterota and Fusobacteriota were more abundant in Brazil. The phylum Caldisericota was only found in raw hospital wastewater samples from Madagascar. The canonical correspondence analysis results suggest significant correlation of azithromycin, meropenem and levofloxacin with bacteria families such as Enterococcaceae, Flavobacteriaceae, Deinococcaceae, Thermacetogeniaceae and Desulfomonilaceae, Spirochaetaceae, Methanosaetaceae, Synergistaceae, respectively. Water samples were also positive for SARS-CoV-2 with the lowest number of hospitalized COVID-19 patients in Madagascar (n = 7) and Brazil (n = 30). Our work provides new data about the bacterial community profile and the presence of pharmaceutical compounds in the hospital effluents from Brazil, Cameroon, and Madagascar, whose limited information is available. These compounds can exacerbate the spreading of antibiotic resistance and therefore pose a risk to public health., Competing Interests: Declaration of competing interest The authors declare that they have no known competing financial interests or personal relationships that could have appeared to influence the work reported in this paper., (Copyright © 2024 Elsevier B.V. All rights reserved.)

This paper is aimed at developing an air quality monitoring system using machine learning (ML), Internet of Things (IoT), and other elements to predict the level of particulate matter and gases in the air based on the air quality index (AQI). It is an air quality assessor and therefore a means of achieving the Sustainable Development Goals (SDGs), in particular, SDG 3.9 (substantial reduction of the health impacts of hazardous substances) and SDG 11.6 (reduction of negative impacts on cities and populations). AQI quantifies and informs the public about air pollutants and their adverse effects on public health. The proposed air quality monitoring device is low-cost and operates in real-time. It consists of a hardware unit that detects various pollutants to assess air quality as well as other airborne particles such as carbon dioxide (CO 2 ), methane (CH 4 ), volatile organic compounds (VOCs), nitrogen dioxide (NO 2 ), carbon monoxide (CO), and particulate matter with an aerodynamic diameter of 2.5 microns or less (PM 2.5 ). To predict air quality, the device was deployed from November 1, 2022, to February 4, 2023, in certain bauxite-rich areas of Adamawa and certain volcanic sites in western Cameroon. Therefore, machine learning algorithm models, namely, multiple linear regression (MLR), support vector regression (SVR), random forest regression (RFR), XGBoost (XGB), and K-nearest neighbors (KNN) were applied to analyze the collected concentrations and predict the future state of air quality. The performance of these models was evaluated using mean absolute error (MAE), coefficient of determination (R-square), and root mean square error (RMSE). The obtained data in this study show that these pollutants are present in selected localities albeit to different extents. Moreover, the AQI values obtained range from 10 to 530, with a mean of 132.380 ± 63.705, corresponding to moderate air quality state but may induce an adverse effect on sensitive members of the population. This study revealed that XGB regression performed better in air quality forecasting with the highest R-squared (test score of 0.9991 and train score of 0.9999) and lowest RMSE (test score of 1.5748 and train score of 0. 0073) and MAE (test score of 0.0872 and train score of 0.0020), while the KNN model had the worst prediction (lowest R-squared and highest RMSE and MAE). This embryonic work is a prototype for projects in Cameroon as measurements are underway for a national spread over a longer period of time., (© 2024. The Author(s), under exclusive licence to Springer Nature Switzerland AG.)

Objectives: The implementation of pediatric oncology advanced practice nurse (s) roles in low- and middle-income countries (LMICs) presents opportunities and challenges. The authors explore the implications of pediatric oncology advanced practice nursing roles in Pakistan, Cameroon, Turkey, and Mexico. Potential benefits and drawbacks of advanced practice nursing roles, impacts on nursing care, and strategies for advanced practice nursing role development in LMIC settings are considered., Methods: Information from scholarly articles, policy documents, and four LMIC pediatric oncology nurse expert perspectives on existing and imagined advanced practice nursing roles in pediatric oncology in LMIC were synthesized., Results: Current literature and policies point to efforts across LMICs to establish a wide variety of advanced nursing practices, not necessarily aligned with internationally accepted advanced practice nursing standards of practice or education. The LMIC nurses describe a wide range of national general nurse education and government advanced practice nurse recognition/licensing. Challenges to achieving or strengthening advanced practice nursing roles include, for example, healthcare professional resistance, government unwillingness to recognize/license advanced practice nurses, and lack of advanced practice nursing faculty. To promote a pediatric oncology advanced practice nursing role in LMICs requires navigating the national nursing scope of practice and nursing culture., Conclusion: The strategic introduction of pediatric oncology advanced practice nursing roles in LMICs has the potential to significantly enhance patient care by, for example, addressing healthcare workforce shortages and facilitating timely care delivery. However, challenges related to role complexity, resistance from traditional healthcare structures, and role overlap must be considered. Tailoring these roles to local contexts and fostering stakeholder collaboration are essential for successful implementation., Implications for Nursing Practice: The adoption of advanced practice nursing roles can lead to improved quality of care for pediatric oncology patients and their families in LMICs, where cancer care is challenging. The positive impact of pediatric oncology advanced practice nurses on patient outcomes and healthcare delivery cannot be discounted but must align with local nursing and healthcare culture and expectations., Competing Interests: Declaration of competing interest The authors declare that they have no known competing financial interests or personal relationships that could have appeared to influence the work reported in this paper., (Copyright © 2024 Elsevier Inc. All rights reserved.)

Background: Cassava is an important crop for the survival of smallholder farmers in Cameroon. However, the cassava sector has a low production per unit area compared to the technological potential in this country. In this context, breeders have developed varieties based mainly on their potential in terms of yield and disease resistance. These varieties have been widely disseminated in Cameroon within the framework of development projects. However, these releases have not achieved the expected adoption and yield levels at the national level. Therefore, it appears important to rethink the determinants of dissemination with a broader examination of the cassava production system., Results: This paper analyses varietal complementarity as a key strategy in support of optimizing the experimental and continuous use of cassava varieties by farmers in the Central and Eastern regions of Cameroon. These two regions account for 50% of the country's production. A total of 111 semi-structured interviews were conducted with farmers selected through purposive sampling in four villages in Central and Eastern Cameroon where improved varieties have been disseminated. The research revealed four types of complementarity, related to use, crop management, risk management and cultural complementarity., Conclusion: Our results argue for considering varietal complementarities practiced by farmers, within research and development programs to develop more effective breeding and dissemination approaches. © 2023 The Authors. Journal of The Science of Food and Agriculture published by John Wiley & Sons Ltd on behalf of Society of Chemical Industry., (© 2023 The Authors. Journal of The Science of Food and Agriculture published by John Wiley & Sons Ltd on behalf of Society of Chemical Industry.)

Among the problems encountered today in Expanded Programmes on Immunization (EPI) is the failure to reach an acceptable level of immunization coverage in rapidly growing urban areas. This paper describes a checklist to identify the reasons for such low coverage. The checklist was first used in Yaounde, United Republic of Cameroon. There the low coverage is found to be associated with certain neighborhoods, one ethnic group, low socio-economic status, and newly-arrived families. Publicity about immunizations is not reaching Yaounde residents in those categories. Furthermore, health lessons (given only in French) seem to be confusing the parents rather than educating them. Finally, previous ineffective immunization programmes have made Yaounde residents mistrustful of the current programme. The authors recommend solutions to each of these Yaounde problems. The checklist, and the methods used for answering it in Yaounde, should prove useful to other immunization programmes.

Primary health care in Cameroon meets with serious obstacles. The state gives it a low priority in its budget and over-all policy. The health institutions are rarely active in this field. Institutions which do practice some primary health care are usually foreign. The villagers, finally, are little interested. They insist only on improvement of curative services and material life conditions. The conclusion is that primary health care is regarded as something of secondary importance. First comes a better life. The research for this paper was conducted in 1980 in the South of Cameroon.

Ethnopharmacological Relevance: Shigella infection is a public health problem responsible for approximately 700,000 deaths annually. The management of this disease is impaired by the emergence of multidrug-resistant Shigella species, highlighting the urgent need to search for alternative treatment options. In this regard, investigating medicinal plants traditionally used for the treatment of dysentery, diarrheal infections, and/or associated symptoms in endemic regions might provide an opportunity to identify phytochemicals that could be further used as a basis for the development of future anti-shigella drug candidates., Aim of the Study: This study was designed to investigate the anti-shigella and antioxidant-based ethnopharmacological potency of some Cameroonian medicinal plants with an emphasis on pharmacokinetic properties of the identified chemical pharmacophore., Materials and Methods: Briefly, plant species were selected and collected based on their ethnopharmacological uses and information reported in the literature. Crude aqueous, ethanolic, methanolic, and hydroethanolic (30:70, v/v) extracts from these plants were prepared and then screened for their anti-Shigella activity against four Shigella strains and cytotoxicity against Vero and Raw cell lines using microdilution and resazurin-based methods, respectively. The antioxidant activities of potent extracts were evaluated using DPPH, ABTS, NO, and FRAP scavenging assays. The chemical profile of potent extracts was performed using the UHPLC-LIT-MS/MS and the pharmacokinetic properties, druglikeness, and likely molecular targets of the chemical scaffolds identified were predicted using SwissADME and SwissTargetPredictor., Results: Thirty-nine (39) plants belonging to 26 plant families were harvested. Out of the 228 extracts tested, 18 extracts originating from 6 plants (15.38 %) were active (MICs 250-1000 μg/mL) and nontoxic toward Vero (CC 50 129.25-684.55 μg/mL) and Raw cell lines (CC 50 336.20 to >1000 μg/mL). Six potent extracts from the two plants exhibited moderate to potent DPPH (SC 50 8.870-54.410 μg/mL), ABTS (SC 50 12.020-27.36 μg/mL), and NO (SC 50 0.02-195.85 μg/mL) scavenging activities. Later, these extracts showed interesting ferric iron-reducing power (1.28-12.14 μg equivalent NH 2 OH/g of extract). The shortest onset of action time (4 and 6 h) observed following inhibition kinetics studies was observed with extracts BFSHE, PMSE, and PMSM. The UHPLC-LIT-MS/MS and some databases (Mass Spectral Library (NIST 14), Human Metabolome Database (HMD), MassBank, SuperNatural 3.0, The Food Database (FooDB), and Chemical Entities of Biological Interest (ChEBI)) allowed the annotation of 18 and 17 metabolites in the extracts from stem bark of P. macrophylla and B. ferruginea respectively. Pharmacokinetic prediction of these chemicals showed that compound 6 (4,6a-bis(Hydroxymethyl)-9a-methyl-3-oxo-1a,1b,3,5,6,6a,7a,9a-octahydrobis (oxireno)[2',3':5,6; 2″,3'':9,10]cyclodeca[1,2-b]furan-5-yl methacrylate), compound 8 (Corynoxeine), and compounds 35 (Stachybotrydial acetate) demonstrated acceptable druglike and pharmacokinetic properties and might act through inhibition of kinase, transferase, protease, oxidoreductase, and family AG protein-linked receptors., Conclusion: The findings from this investigation demonstrated that Cameroonian medicinal plants are suitable reservoirs of anti-Shigella and antioxidant agents with good drug candidate properties., Competing Interests: Declaration of competing interest The authors declare that they have no known competing financial interests or personal relationships that could have influenced the work reported in this paper., (Copyright © 2024. Published by Elsevier B.V.)

The use of antibiotics in food animals and the nonobservance of the withdrawal period might result in the accumulation and persistence of residues in foods. The contamination of foods by antibiotic residues might induce health risks including allergy, gastrointestinal dysbiosis, antimicrobial resistance, and cancer to consumers. Therefore, this study was initiated to investigate the presence of antibiotic residues in raw eggs, raw milk, and beef collected at the wholesale and retail points in the three major cities of Cameroon and consumers' perceptions of the risk of antibiotic residues in foods. Qualitative antibiotic residue kits (PremiTest® and Delvotest®) were used to screen 407 samples of foods collected in markets of three towns (Ngaoundéré, Yaoundé, and Douala) in Cameroon. A structured questionnaire was used to evaluate the knowledge and attitudes of 1462 consumers toward microbial drug residues in foods of animal origin. Prevalence of residues of 70.55%, 17.39%, and 69.63% for beef, eggs, and milk, respectively, was observed. More than 1/3 of the respondents believed that the consumption of contaminated foods with antibiotic residues is a risk to their health and thought that allergies and intoxication they often experience are related to the consumption of contaminated foods. Most of them showed their willingness to pay more to acquire quality foods, free from antibiotic residues., Competing Interests: Declaration of competing interest The authors declare that they have no known competing financial interests or personal relationships that could have appeared to influence the work reported in this paper., (Copyright © 2024 The Author(s). Published by Elsevier Inc. All rights reserved.)

Background: This paper highlights the role of cultural and structural gaps that shape illness experiences of women with manifestations of female genital schistosomiasis (FGS) and their impacts upon mental well-being., Methods: Using ethnography, case study narrative accounts of women manifesting symptoms of FGS, as well as interviews with health workers within FGS-endemic rural fishing communities in Cameroon, we present experiences of women affected by FGS, alongside information on FGS health service provision., Results: Our results show how gendered power dynamics in decision making, gendered experiences around menstrual health and structural gaps in service provision, combine and lead to poor mental well-being. Subfertility brings a heavy psychosocial toll from external blame and rejection, exacerbated by internalised stigma and the challenge of not being able to fulfil cultural and gendered social norms., Conclusions: Gender analysis is key to developing context-embedded understanding and addressing FGS-related challenges. With context-specific experiences demonstrating FGS comorbidity with mental ill health, there is a need to prioritise mental health integration at policy level through a person-centred approach. Furthermore, to address stigma and discrimination, campaigns to raise awareness in Cameroon, and beyond, are needed., Contexte: Cet article met en évidence le rôle des lacunes culturelles et structurelles qui façonnent les expériences des femmes atteintes de schistosomiase génitale féminine (SGF) et leur impact sur le bien-être mental., La Méthode: À l'aide de l'ethnographie, de récits d'études de cas de femmes présentant des symptômes de schistosomiase génitale féminine, et d'entretiens avec des agents de santé au sein de communautés de pêcheurs ruraux endémiques de la schistosomiase génitale féminine au Cameroun, nous présentons les expériences des femmes touchées par le SGF, ainsi que des informations sur les services de santé liés au SGF., Résultats: Nos résultats montrent comment la dynamique du pouvoir dans la prise de décision, les expériences de la santé menstruelle et les lacunes structurelles dans la fourniture de services, interagissent et conduisent à un manque de bien-être psychologique. La sous-fécondité entraîne un lourd fardeau psychosocial du fait du blâme et de rejet externes auxquelles sont assujetties les personnes souffrant de la maladie, ce qui est exacerbé par la stigmatisation intériorisée et le défi que représente leur incapacité à respecter les normes sociales culturelles et sexospécifiques., Conclusion: L'analyse de genre est essentielle pour développer une compréhension intégrée au contexte et pour relever les défis liés aux SGF. les défis liés à l'ESF. Avec des expériences spécifiques au contexte démontrant la comorbidité de la FGS avec la mauvaise santé mentale, il est nécessaire de donner la priorité à l'intégration de la santé mentale au niveau politique par le biais d'une approche centrée sur la personne. l'intégration de la santé mentale au niveau politique par une approche centrée sur la personne. En outre, pour lutter contre la stigmatisation et la stigmatisation et la discrimination, des campagnes de sensibilisation sont nécessaires au Cameroun et au-delà., Antecedentes: En este documento se pone de relieve el papel de las brechas culturales y estructurales que dan forma a las experiencias de enfermedad de las mujeres con manifestaciones de Esquistosomiasis Genital Femenina (EGF), y sus impactos en el bienestar mental., Método: Utilizando la etnografía, estudios de caso mediante relatos narrativos de mujeres que manifiestan síntomas de EGF y entrevistas con trabajadores sanitarios de comunidades pesqueras rurales endémicas en Camerún, presentamos las experiencias de las mujeres afectadas por la EGF, junto con información sobre la prestación de servicios sanitarios para la EGF., Resultados: Nuestros resultados muestran cómo la dinámica de poder de género en la toma de decisiones, las experiencias de género en torno a la salud menstrual y las deficiencias estructurales en la prestación de servicios se combinan y conducen a un bienestar mental deficiente. La subfertilidad conlleva un alto coste psicosocial debido a la culpa y el rechazo externos, exacerbados por el estigma interiorizado y el reto de no poder cumplir las normas culturales y de género., Conclusión: El análisis de género es clave para desarrollar una comprensión integrada en el contexto y abordarlos retos relacionados con la EGF. Dado que las experiencias específicas de cada contexto demuestran la comorbilidad de las EGF con la enfermedad mental, es necesario priorizar la integración de la salud mental en las políticas a través de un enfoque centrado en la persona. Además, para hacer frente al estigma y la discriminación, son necesarias campañas de sensibilización en Camerún y en otros lugares., (© The Author(s) 2024. Published by Oxford University Press on behalf of Royal Society of Tropical Medicine and Hygiene.)

In Nigeria and tropical Africa, the bias towards the protection of natural sites on account of terrestrial biodiversity or their resultant ecosystem services has led to a considerably low number of freshwater conservation studies in the region. To close this gap, six lotic freshwater systems in three different natural sites (Obudu Mountains, Agbokim Waterfalls, and Cross River National Park) along the Cameroon border of Nigeria were evaluated for the biodiversity of macroinvertebrates and some aspects of water quality in December 2021 and March 2022. Among other macroinvertebrate-related indices, the community conservation index (CCI), which considers the presence of threatened, rare, and notable species, was used for the conservation evaluation of the freshwater systems. The Ephemeroptera-Plecoptera-Trichoptera (EPT) species were notably rich at the sites, with over 12 species each at the Afundu Stream, Kwa River, Cataract Stream, and Agbokim River. All of the sites had a very high conservation value, according to the CCI, which was greater than 20. Some Obudu sites (Grotto and Becheve streams), despite having fewer EPT taxa, had higher CCI than the Kwa or Agbokim River. This was due to the presence of the endangered damselflies (Africocypha centripunctata and Allocnemis vicki) at the Obudu sites and a rare mayfly species in Nigeria (Tricorythus tinctus), which was reported at Agbokim and Kwa Rivers. The presence of a notable damselfly genus (Pentaphlebia) at the Afundu stream of the Obudu Mountains also raises some hope that the critically endangered damselfly (Pentaphlebia gamblesi), whose adult was last seen in 1973, could still be alive at the site. Canonical Correspondence Analysis revealed that the proportion of scrapers had a strong association with high BOD and EC in Agbokim River, while the Becheve and Grotto streams which had high vegetal cover was positively associated with shredders. Also, increasing DO in Afundu Stream, Kwa River and Cataract Stream was positively associated with EPT richness. This study revealed that more freshwater ecological studies need to be conducted at isolated natural sites and protected areas in Africa. Findings from such studies have implications for preserving freshwater ecosystems of high conservation value from the various threats that characterize the Anthropocene., Competing Interests: Declaration of competing interest The authors declare that they have no known competing financial interests or personal relationships that could have appeared to influence the work reported in this paper., (Copyright © 2024 Elsevier Ltd. All rights reserved.)

Introduction: rare diseases (RD) are extremely complex health conditions. Persons affected by these conditions in Cameroon are often neglected in society and health systems through the inexistence of policies and programs. In Cameroon, there exists no program or policy conceived to address their needs in terms of access to quality health care, timely and reliable diagnosis, treatments, education, etc. The consequence is that persons living with a RD (PLWRD) and their families do not participate in social life. The unique fate of PLWRD reveals that the principle of social justice and equity is flawed in Cameroon. However, patients, in order to survive in society, rely on patients' organizations (PO) to improve their quality of life (QoL) and advocate for a better consideration in the society. The aim of this paper is to highlight how initiatives from a grassroot perspective like POs can inform decision-makers to address the needs of PLWRD and their families., Methods: the study associated a systematic literature review and semi-structured interviews with parents of children suffering from a RD and who are members of a PO. Through the systematic literature review we highlighted the impact POs have in the development of research on RDs, patient literacy, patient empowerment and advocacy while semi-structured interviews brought out the needs of patients and their families., Results: findings, on the one hand show that, in Cameroon PLWRD face a number of challenges like the incurability of their condition, catastrophic medical expenses, stigmatization and marginalization, etc. and though in POs their QoL still remains poor. On the other hand, where POs are empowered they are key actors in research on RDs and help decision-makers on having a better insight into the type of RD that exists across a geographical area, the sociodemographic profile of patients, etc. for a better management of PLWRD., Conclusion: the study suggests that the ministry of public health should create a network with existing RD POs to adequately meet the needs of PLWRD., Competing Interests: The authors declare no competing interests., (Copyright: Rose-Danielle Ngoumou et al.)

Antigenic variation associated with genetic diversity in global Plasmodium falciparum apical membrane antigen-1 (PfAMA-1) is a major impediment to designing an effective malaria vaccine. Here, we report the first study on genetic diversity and natural selection of the Pfama-1 gene in P. falciparum isolates from Cameroon. A total of 328 P. falciparum positive samples collected during 2016 and 2019 from five localities of Cameroon were analysed. The ectodomain coding fragment of Pfama-1 gene was amplified for polymorphism profiling and natural selection analysis. A total of 108 distinct haplotypes were found in 203 P. falciparum isolates with considerable nucleotide diversity (π = 0.016) and haplotype diversity (Hd = 0.976). Most amino acid substitutions detected were scattered in ectodomain-I and few specific mutations viz P145L, K148Q, K462I, L463F, N471K, S482L, E537G, K546R and I547F were seen only in Cameroonian isolates. A tendency of natural selection towards positive diversifying selection was observed (Taj-D = 2.058). Five positively selected codon sites (P145L, S283L, Q308E/K, P330S and I547F) were identified, which overlapped with predicted B-cell epitopes and red blood cell (RBC) binding sites, suggesting their potential implication in host immune pressure and parasite-RBC binding complex modulation. The Cameroonian P. falciparum populations indicated a moderate level of genetic differentiation when compared with global sequences, with few exceptions from Vietnam and Venezuela. Our findings provide baseline data on existing Pfama-1 gene polymorphisms in Cameroonian field isolates, which will be useful information for malaria vaccine design., Competing Interests: Declaration of Competing Interest The authors declare the following financial interests/personal relationships which may be considered as potential competing interests: Chhabi Govind reports financial support was provided by National Institutes of Health. If there are other authors, they declare that they have no known competing financial interests or personal relationships that could have appeared to influence the work reported in this paper., (Copyright © 2023 Elsevier B.V. All rights reserved.)

Objective: To develop a predictive model for peripartum infection among high risk laboring patients in Cameroon, Africa., Study Design: We conducted a secondary analysis of the Cameroon Antibiotic Prophylaxis Trial (NCT03248297), a multicenter 3-arm double-blind randomized controlled trial of oral azithromycin ± amoxicillin among term pregnancies with prolonged labor or rupture of membranes in Cameroon 1/2018-5/2020. Patients with chorioamnionitis prior to randomization, study drug contraindications, or planned cesarean were excluded. The outcome of interest was a composite of maternal peripartum infection (chorioamnionitis, endometritis, sepsis by World Health Organization criteria, wound infection/abscess) diagnosed up to 6 weeks postpartum. Potential predictors were compared between patients with and without the composite outcome, and evaluated at a 0.05 alpha level. Statistically significant exposures were analyzed using multivariable regression (to generate adjusted odds ratios and 95 % confidence intervals) with backwards selection to generate a parsimonious model. Receiver operating characteristic curves with associated area under the curve assessed the model's predictive ability. A nomogram based on the final best fit multivariable model was constructed., Results: Of 756 patients in the parent trial, 652 were analyzed: 45 (7 %) had peripartum infection. Those with infection were more likely to be nulliparous, lower education level, higher gestational age, receive antibiotics per hospital protocols, and undergo cesarean. In our best-fit multivariable model, none/primary education (vs university), cesarean birth, and antibiotic receipt per physician discretion (vs for cesarean prophylaxis) were significantly associated with increased infection risk. This model was moderately predictive (AUC = 0.75, 95 % CI 0.67-0.82). When using this 3 factor model, for a patient with a cesarean birth, receipt of antibiotics per physician discretion, and university education, the probability of peripartum infection was 35 % (95 % CI 0.11-0.73)., Conclusions: While several variables such as parity are associated with infectious morbidity within 6 weeks among high risk laboring patients in Cameroon, only education level, antibiotic indication, and cesarean birth were independently associated, and a model including these 3 factors was moderately predictive. Validation of our findings in a larger population is warranted., Competing Interests: Declaration of competing interest The authors declare that they have no known competing financial interests or personal relationships that could have appeared to influence the work reported in this paper., (Copyright © 2023. Published by Elsevier B.V.)

The transport of non-indigenous species in ship's ballast water represents a threat to marine biodiversity. This study is the first on marine bioinvasion in Sub-Saharan Africa. The Port of Douala (PoD), located in the Gulf of Guinea, is experiencing increasing maritime traffic, hence the importance of preventing biological invasions. PoD received ballast water from 41 ports and 20 ecoregions during the study period (2018-2021). We used a biological invasion model and showed that ships from the ports of Antwerp, Durban, Dar es Salaam, Pointe-Noire (Southern Gulf of Guinea) and Dakar (Sahelian Upwelling), with their associated ecoregions present a major invasion risk. Treating ballast water from these ships to IMO D-2 standards could reduce their probability of biological invasion by 97.18, 98.43, 98.80, 98.77 and 98.84 %, respectively. Climate change may also mitigate the risk of biological invasion, particularly for ships in the North Sea ecoregion from the port of Antwerp., Competing Interests: Declaration of competing interest The authors declare that they have no known competing financial interests or personal relationships that could have appeared to influence the work reported in this paper., (Copyright © 2023 Elsevier Ltd. All rights reserved.)

After vanishing from the public eye for more than 50 years, bed bugs have resurged to become one of the most widely discussed and heavily researched insect pests in the world. This study presents the basic information of infestations of tropical bed bugs, Cimex hemipterus (Hemiptera: Cimicidae), in Cameroon. A total of 248 immature stage and adult bed bug specimens were collected from households and a travel agency in Yaoundé and Douala, Cameroon. The ability of MALDI-TOF MS to identify bed bugs was tested using heads for adults and cephalothoraxes for immature stages. Microorganism screening was performed by qPCR and confirmed by regular PCR and sequencing. Based on morphometrical criteria, four stages of immature bed bugs are represented. Of the 248 bed bug specimens morphologically identified as Cimex hemipterus, 246 (77 males, 65 females and 104 immature specimens) were submitted to MALDI-TOF MS analysis. Of the 222 adults and immature specimens tested, 122 (59.9 %) produced good quality MALDI-TOF MS spectra (35 adults and 87 immature specimens). Blind testing allowed species level identification of 98.21 % of adult and immature C. hemipterus. Among the bacteria tested, only Wolbachia DNA was found in 12/246 (4.8 %) bed bugs. More surveys in the country are warranted to assess the true level of bed bug infestations, in order to take appropriate action for their control., Competing Interests: Declaration of Competing Interest The authors declare that they have no known competing financial interests or personal relationships that could have appeared to influence the work reported in this paper., (Copyright © 2023. Published by Elsevier B.V.)