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Background: Respiratory syncytial virus (RSV) is one of the major pathogens frequently associated with severe respiratory tract infections in younger children and older adults globally. There is an unmet need with a lack of routine country-specific databases and/or RSV surveillance systems on RSV disease burden among adults in most low- and middle-income countries, including Cameroon. We aim to estimate the adult RSV burden needed to develop a framework for establishing an RSV surveillance database in Cameroon. Methods and analysis: A two-phase study approach will be implemented, including a literature review and a review of medical records. First, a systematic review of available literature will provide insights into the current burden of RSV in adults in Cameroon, searching the following databases: Global Health, PubMed, CINAHL, Embase, African Journal Online Library, Scopus, Global Index Medicus, Cochrane databases, and grey literature search. Identified studies will be included if they reported on the RSV burden of disease among Cameroonian adults aged ≥18 years from 1st January 1990 to 31st December 2023. A narrative synthesis of the evidence will be provided. A meta-analysis will be conducted using a random effect model, when feasible. Two co-authors will independently perform data screening, extraction, and synthesis and will be reported according to the PRISMA-P guidelines for writing systematic review protocols. Secondly, a retrospective cohort design will permit data analysis on RSV among adults in the laboratory registers at the National Influenza Center. Medical records will be reviewed to link patients' files from emanating hospitals to capture relevant demographic, laboratory, and clinical data. The International Classification of Diseases and Clinical Modifications 10th revision (ICD-10-CM) codes will be used to classify the different RSV outcomes retrospectively. Results: The primary outcome is quantifying the RSV burden among the adult population, which can help inform policy on establishing an RSV surveillance database in Cameroon. The secondary outcomes include (i) estimates of RSV prevalence among Cameroonian adult age groups, (ii) RSV determinants, and (iii) clinical outcomes, including proportions of RSV-associated morbidity and/or death among age-stratified Cameroonian adults with medically attended acute respiratory tract infections. Conclusions: The evidence generated from the two projects will be used for further engagement with relevant stakeholders, including policymakers, clinicians, and researchers, to develop a framework for systematically establishing an RSV surveillance database in Cameroon. This study proposal has been registered (CRD42023460616) with the University of York Center for Reviews and Dissemination of the International Prospective Register of Systematic Reviews (PROSPERO). [ABSTRACT FROM AUTHOR]

Four new species of freshwater crab are described from material collected in northern and southwestern Cameroon and assigned to Sudanonautes Bott, 1955. Sudanonautes cameroonensis sp. n., S. eyimba sp. n., S. ngaoundere sp. n. and S. nkam sp. n., are distinguished by characters of the carapace, thoracic sternum, chelipeds, mandibles, adult male gonopods, and in addition by genetic analyses using the mitochondrial CO1 and 16S rRNA genes. Diagnoses, illustrations, and a phylogenetic tree based on mtDNA sequences are provided, as well as a discussion of the threats and conservation of all species. [ABSTRACT FROM AUTHOR]

Background: Influenza and severe acute respiratory syndrome coronavirus 2 (SARS‐CoV‐2) are both respiratory viruses with similar clinical manifestations and modes of transmission. This study describes influenza data before and during the coronavirus disease pandemic (COVID‐19) in Cameroon and SARS‐CoV‐2 data during the pandemic period. Methods: The study ran from 2017 to 2022, and data were divided into two periods: before (2017–2019) and during (2020–2022) the COVID‐19 pandemic. Nasopharyngeal samples collected from persons with respiratory illness were tested for influenza using the Centers for Disease Control and Prevention (CDC) typing and subtyping assays. During the COVID‐19 pandemic, the respiratory specimens were simultaneously tested for SARS‐CoV‐2 using the DaAn gene protocol or the Abbott real‐time SARS‐CoV‐2 assay. The WHO average curve method was used to compare influenza virus seasonality before and during the pandemic. Results: A total of 6246 samples were tested. Influenza virus detection rates were significantly higher in the pre‐pandemic period compared to the pandemic period (30.8% vs. 15.5%; p < 0.001). Meanwhile, the SARS‐CoV‐2 detection rate was 2.5%. A change in the seasonality of influenza viruses was observed from a bi‐annual peak before the pandemic to no clear seasonal pattern during the pandemic. The age groups 2–4 and 5–14 years were significantly associated with higher influenza positivity rates in both pre‐pandemic and pandemic periods. For SARS‐CoV‐2, all age groups above 15 years were the most affected population. Conclusion: The COVID‐19 pandemic had a significant impact on the seasonal influenza by changing the seasonality of the virus and reducing its detection rates. [ABSTRACT FROM AUTHOR]

Background: Health-related quality of life (HRQoL) assessment is necessary for the management of patients with congenital heart diseases (CHD). No study has yet been reported on Cameroonian adolescents. The aim of this study was to evaluate the profile of and look for determinants of HRQoL in adolescents with CHD in Cameroon. Methods: This was a cross-sectional study with prospective recruitment carried out on 71 adolescents diagnosed with CHD aged 12 to 18 years and recruited at the Douala General Hospital. Sociodemographic and clinical data were collected using a structured questionnaire. HRQoL was assessed using the pediatric quality of life inventory (PedsQL4.0) for child and parent reports. Multivariate linear regression was used to assess the determinants of HRQoL. Differences were considered significant for p < 0.05. Results: Mean age of participants was 15 ± 2 years with 54.9% women. Mean physical and psychosocial functioning scores were 50.7 ± 13.9 and 60.5 ± 9.6 for parent report and 49.5 ± 13.4 and 59.1 ± 9.1 for child report respectively; with no significant difference according to gender. Distribution of functioning scores according to anatomical complexity showed no significant difference while it was lower in patients with a greater physiological severity and to those with no surgical intervention compared to the others. After multivariate adjustments, physiological stage 3 or 4 was negatively associated while cardiac intervention was positively associated with HRQoL. Conclusion: CHD adolescents exhibit a low level of quality of life. Cardiac intervention positively affects HRQoL and should be targeted in the reduction of HRQoL burden from CHD in Cameroon. [ABSTRACT FROM AUTHOR]

While the burden of metabolic syndrome (MetS) is still increasing in sub-Saharan Africa, there is a lack of data among young Cameroonian population. The aim of this study was to evaluate the prevalence of MetS and its components among secondary school students in Douala. This was a cross-sectional prospective study carried out on 803 students recruited from February to May 2021 in public and private secondary schools in Douala city, Cameroon. MetS was assessed according to the IDF/AHA/NHLBI 2009 consensus definition. The data collection consisted of a questionnaire on sociodemographic characteristics, measurement of anthropometric parameters (height, weight, body mass index (BMI), waist circumference) and overnight fasting blood sample. Blood pressure (BP), fasting blood glucose, HDL cholesterol and triglycerides were measured using standard methods. The mean age was 18±3 years, 73.3% female. The prevalence of MetS was 27.4%, common among participants aged ≥16 years, and higher in females compare to males (33.7% vs. 11.1%, P<0.0001). The prevalence of MetS components i.e abdominal obesity, high BP, fasting hyperglycemia, low-level HDL cholesterol and hypertriglyceridemia were 14.1, 18.1, 42.8, 51.4 and 38.6% respectively. All MetS components were significantly higher in females compared to males except for high BP which was similar among the genders. In our study population, the prevalence of MetS is high and this calls for improved monitoring to limit the evolution of associated cardiometabolic complications among young Cameroonians. [ABSTRACT FROM AUTHOR]

Aim: Cardiovascular diseases are the leading cause of death worldwide and physical activity (PA) practice is recommended as the most efficient preventive measure to curse their burden in sub-Saharan Africa. Our study aimed to compare cardiovascular risk factors (CVRFs) in adolescents in public and private schools in Cameroon and assess the impact of PA practice. Methods: We conducted a cross-sectional study on students from private and public secondary schools in the city of Douala. Anthropometric parameters, blood glucose, and blood pressure (BP) were collected. PA was assessed using the short form of the International Physical Activity Questionnaire. Multivariate logistic regression was used to assess the influence of PA levels on different CVRFs. The differences were considered significant for p <.05. Results: We recruited 771 participants, aged 16 ± 1years, 51.4% female, and 48.6% private school students. Prevalence of CVRFs was 38.4%; 11.5%; 5.6%; 5.4%, and 3% for overweight/obesity, abdominal obesity, smoking, glucose homeostasis abnormalities, and high BP (HBP) respectively. Around 41% of participants had low PA level (LPA). Abdominal obesity and LPA were more common among girls (p <.0001 both) and 1.3% of participants had more than four CVRF. In multivariate analysis, LPA was significantly associated with a higher odd of HBP (OR = 7.69; p <.0001). Conclusion: The prevalence of various CVRF is high among Cameroonian adolescent schoolers. Public policies should focus on prevention programs through physical exercise and the reduction of smoking. [ABSTRACT FROM AUTHOR]

Objectives: Burnout syndrome (BOS) is an affection mostly resulting from chronic job-related stress. Many studies have identified job-related and non-job-related factors associated with BOS. Our aim of this study was to assess the level of BOS in private and public hospital healthcare providers in Fako division, Cameroon and evaluate the impact of physical activity and sleep quality (SQ). Methods: The study was carried out in five randomly selected hospitals in Fako Division over a three-month period. Consenting doctors, nurses and laboratory technicians were recruited using consecutive sampling methods. Sociodemographic and professional characteristics were collected using a structured questionnaire. BOS was assessed using the Maslach Burnout Inventory Human Services Survey (MBI-HSS). Sleep quality (SQ) and physical activity (PA) were assessed using the Pittsburgh Sleep Quality Index (PSQI) and Global Physical Activity Questionnaire (GPAQ) respectively. Odd ratios and 95% confidence intervals were calculated and a statistical significance was set for p-value < 0.05. Results: The mean age was 32 ±6 years and 70.9% female. BOS prevalence was 66.3% with 71.4% in females and 53.9% in males (p = 0.002). Of the 232 participants with BOS, 65.7%, 52% and 53.7% had moderate to high emotional exhaustion, depersonalization and decreased personal accomplishment, respectively. Moderate to high PA as well as poor SQ were not significantly associated with BOS while longer sleep duration (>8 h) was associated with a greater odd of BOS. Conclusions: The prevalence of BOS was high among healthcare professionals. While PA showed no protective effects, high sleep duration could increase its risk. [ABSTRACT FROM AUTHOR]

Background: Living areas in developing countries impact seriously lifestyle by modifying energy consumption and energy expenditure. Thus, urbanization is associated with less practice of physical activity (PA), a leading cause of metabolic syndrome (MetS) which prevalence vary in African countries. The present study aimed to assess the effect of PA on MetS according to urbanization level in the littoral region, Cameroon. Methods: A cross-sectional study was conducted in three geographical settings (urban, semi-urban, and rural) in the littoral region in Cameroon. A total of 879 participants were included (urban: 372, semi-urban: 195 and rural: 312). MetS was defined according to the International Federation of Diabetes 2009. The level of PA was assessed using the Global Physical Activity questionnaire. Results: Low level of PA was (P < 0.0001) reported in urban (54.5%), semi-urban (28.7%) and rural (16.9%) and high level in rural area (77.9%). The prevalence of MetS was higher in urban areas (37.2%), then rural (36.8%) and finally semi-urban (25.9%). Hyperglycemia (p = 0.0110), low HDL-c (p < 0.0001) and high triglyceridemia (p = 0.0068) were most prevalent in urban residents. Participants with low level of PA were at risk of MetS (OR: 1.751, 95% CI 1.335–2.731, p = 0.001), hyperglycemia (OR: 1.909, 95% CI 1.335–2.731, p = 0.0004) abdominal obesity(OR: 2.007, 95% CI 1.389–2.900, p = 0.0002), low HDL-c (OR: 1.539, 95% CI 1.088–2.179, p = 0.014) and those with moderate level of PA were protected against high blood pressure(OR: 0.452, 95% CI 0.298–0.686, p = 0.0002) and compared to those with high level of PA. Urban dwellers were at the risk of MetS compared to rural residents (OR: 1.708, 95% CI. 1.277–2.285, p = 0.003) and protected against high blood pressure (OR:0.314, 95% CI 0.212–0.466, p < 0.0001), abdominal obesity (OR: 0.570, 95% CI 0.409–0.794, p = 0.0009), and low HDL-c (OR: 0.725, 95% CI 0.534–0.983, p = 0.038) compared to rural residents. Conclusions: MetS was more prevalent in urban dwellers and was associated with a low level of PA. [ABSTRACT FROM AUTHOR]

Antiretroviral therapy (ART) has improved the lifespan of people living with HIV. However, their immune system remains in a state of sustained activation/ inflammation, which favors viral replication and depletion of helper T-cells with varying profiles according to ART-response. We herein sought to ascertain the inflammatory profile of adolescents living with perinatal HIV-1 infection (ALPHI) receiving ART in an African context. In this cross-sectional and comparative study among ART-experienced ALPHI in Yaoundeé -Cameroon,HIV-1 RNA wasmeasured by Abbott Real-time PCR; CD4 cells were enumerated using flow cytometry; serum cytokines were measured by ELISA; HIV-1 proviral DNA was genotyped by Sanger-sequencing; and archived drug resistance mutations (ADRMs) were interpreted using Stanford HIVdb.v9.0.1. Overall, 73 adolescents were enrolled (60 ALPHI and 13HIV-1 negative peers) aged 15 (13-18) years; 60.00%were female. ART median duration was 92 (46-123) months; median viral load was 3.99 (3.17-4.66) RNA Log10 (copies)/mL and median CD4 count was 326 (201-654) cells/ mm³. As compared to HIV-negative adolescents, TNFa was highly expressed among ALPHI (p<0.01). Following a virological response, inflammatory cytokines (IFNγ and IL-12), anti-inflammatory cytokines (IL-4 and IL-10) and inflammation-related cytokines (IL-6 and IL-1b) were highly expressed with viral suppression (VS) vs. virological failure (VF), while the chemokine CCL3 was highly expressed with VF (p<0.01). Regarding the immune response, the inflammatory cytokine TNFα was highly expressed in those that are immunocompetent (CD4≥500 cell/mm³) vs. immunocompromised (CD4<500 cell/mm³), p ≤ 0.01; while chemokine CCL2 was highly expressed in the immunocompromised (p<0.05). In the presence of ADRMs, IL-4 and CCL3 were highly expressed (p=0.027 and p=0.043 respectively). Among ART-experienced ALPHI in Cameroon, the TNFα cytokine was found to be an inflammatory marker of HIV infection; IFNγ, IL-1β, IL-6, and IL-12 are potential immunological markers of VS and targeting these cytokines in addition to antiretroviral drugs may improve management. Moreover, CCL3 and CCL2 are possible predictors of VF and/or being immunocompromised and could serve as surrogates of poor ART response. [ABSTRACT FROM AUTHOR]

Virological response to antiretroviral therapy (ART) remains a challenge for HIV-infected children and adolescents due to non-optimization of pediatric ART for resource-limited settings. In this study, we aimed to investigate factors associated with virologic failure (VF) in HIV-infected-children and adolescents on ART in Cameroon. A prospective patient-based cohort study was conducted among HIV-infected children (0–9 years) and adolescents (10–19 years) followed-up between November 2018 and October 2019 in 38 healthcare centers located in the Littoral region of Cameroon. The 1st viral load (VL) was assessed after 6 months of ART initiation and the 2nd VL between 3 and 6 six months later in patients with VL ≥1000 copies/ml in accordance with the national algorithm using Abbott Real-Time HIV-1 Viral Load Assay. Multivariate analyses were performed to identify the determinants of higher risk of VF. Of 1,029 HIV-infected children and adolescents (393 children and 636 adolescents), 801 (77.8%) cumulatively presented with VL <1000 copies/mL within 12 months on ART. Adolescents were more likely to have VF than children (24.5% vs 18.3%, OR: 1.39; 95%CI: 1.00–1.93; p = 0.047). Patients followed-up in decentralized care units were significantly more likely to have VF compared to those attending the accredited treatment centers (26.1% vs 16.6%, OR: 1.88, 95%CI: 1.37–2.58; p<0.001). Our findings show a high rate of VL suppression (VLS, 77.8%) among HIV-infected children and adolescents, albeit lower than the established target of 90%. Being adolescent and patients followed in the decentralized care units are high risk factors for VF, thereby necessitating routine therapeutic education of patients and guardians in resource limited countries to improve VLS. [ABSTRACT FROM AUTHOR]

Background: The issue of excessively heavy schoolbags remains a public health concern in Africa. This study aimed to determine the weight of schoolbags among students in the public and private sectors of Yaoundé city, Cameroon and identify factors associated with low back pain. Methods: A cross-sectional study was conducted during the first term of the 2020/2021 academic year in French-speaking private and public primary schools in Yaoundé city, Cameroon. The study involved 2000 pupils (8.41±2.11 years), with 1000 from the public sector and 1000 from the private sector. The variables analyzed included weight, height, and schoolbag weight. A questionnaire, developed specifically for this study and based on the Standardized Nordic Body Map Questionnaire, was used to collect socio-demographic information and assess potential musculoskeletal low back pain. A diagram was included to indicate the lower back area for reporting pain. The questionnaire was administered, and each student answered it, with assistance from the investigator if needed. Descriptive and inferential statistics, as well as multiple logistic regressions, were employed for data analysis. Results: The average weight of the children and their schoolbags was 28.51±8.04 kg and 4.04±1.72 kg, respectively. Nearly 45% of the pupils were carrying a schoolbag weighing more than 15% of their body weight, and 23% reported experiencing low back pain. Schoolbag weights ranging from 10-15% of body weight were associated with a threefold higher risk (OR=2.66; 95% CI=1.65 -- 4.31; P<0.0001) of developing low back pain. Pupils in the public sector had a lower risk (OR=0.28; P<0.0001) of developing low back pain. Conclusion: Children in the private sector experience low back pain more frequently. Carrying heavy schoolbags is associated with low back pain among pupils. [ABSTRACT FROM AUTHOR]

Background Central Africa is one of the largest areas of high endemicity for human T-cell leukemia virus-1 (HTLV-1). However, no preventive measures are yet implemented to reduce its transmission, which can be sexual, from mother-to-child, or through contaminated blood products. Rare zoonotic transmissions from nonhuman primates (NHPs) have also been reported in this region. Here we investigated the HTLV-1 prevalence and associated risk factors in a rural population in Cameroon. Methods From 2019 to 2021, we performed a cross-sectional survey in the eastern region of Cameroon. HTLV-1 infection was first screened by ELISA, then tested by western blot and envelope gene targeted polymerase chain reaction. Risk factors associated with HTLV-1 infection were identified by logistic regression in univariable and multivariable analyses. Results Among 3400 participants, HTLV-1 prevalence was 1.1% (95% confidence interval [CI],.7–1.5). Factors independently associated with HTLV-1 infection were Pygmy ethnicity (adjusted odd ratio [aOR], 2.9; 95% CI, 1.3–6.2), history of surgery (aOR, 6.3; 95% CI, 2.2–17.8), and NHP bite (aOR, 6.6; 95% CI, 2.2–19.8). Conclusions These results suggest both iatrogenic and zoonotic transmission of HTLV-1 in Cameroon. Further studies are needed to assess the risk of nosocomial transmission of HTLV-1, to guide public health authorities in implementing preventive measures to control HTLV-1 transmission. [ABSTRACT FROM AUTHOR]

Purpose: Research on gill monogeneans of Characiform has made it possible to find two new species belonging to the genus Annulotrema. The purpose of this paper is to carry out their morphological description. Methods: Specimens of Brycinus macrolepidotus were captured in the Nyong River at Akonolinga. Each monogenean was mounted between slide and cover slip in a drop of glycerin ammonium picrate mixture. The sclerotized parts of their haptor and reproductive organs were then drawn and measured. Results: Two new species of Annulotrema were described. Annulotrema ngombiensis n. sp. is morphologically close to Annulotrema tenuicirra Paperna, 1973 and Annulotrema pikei Price, Peebles and Bamford, 1969. However, the new species differs from these other two mainly by the characteristic well-marked terminal cap and the tubiform prostatic reservoir of the accessory part of its MCO, as well as by its dorsal bar with a characteristic triangular piece in the middle of the fork and its ventral bar without filaments. Annulotrema nkengfacki n. sp. is distinguished from all other species previously described as well as from its closest congeners, Annulotrema helicocirra Paperna, 1973 and Annulotrema bouixi Birgi, 1988 by the structure of its MCO whose accessory part is composed of a trapezoid structure surmounted by another which is forked-shaped and by its arched-shaped ventral bar with an inner lining. Conclusion: Brycinus macrolepidotus from Cameroon can harbour two species of Annulotrema, both described in the current study. This result contributes to the knowledge of the species diversity of this genus in the Nyong Basin. [ABSTRACT FROM AUTHOR]

Background: Musculoskeletal Disorders (MSDs) are very common conditions in the workplace. Among professional drivers, there would be an increased risk of developing these disorders. Identifying the associated factors would allow us to better devise effective prevention strategies. Our objective was to determine the prevalence of MSDs among taxi drivers in the city of Yaoundé and to search for associated factors, mainly the level of physical activity.Methods: We conducted an analytical cross-sectional study of 151 adult male professional taxi drivers. We used a non-probabilistic consecutive and non-exhaustive sampling method. Sociodemographic, anthropometric and occupational data were collected. MSDs over the past 12 months were assessed using the Nordic Questionnaire and physical activity level was determined by the World Health Organization (WHO) Global Physical Activity Questionnaire (GPAQ). Univariate logistic regression models, followed by a multivariate logistic regression, were used to determine factors associated with the presence of MSDs.Results: The overall prevalence of MSDs was 86.8% (95% CI 80.8 - 91.4); the most affected areas were mainly the lower back (72.8%) the neck (42.4%), and the knees (29.1%). Job dissatisfaction was associated with MSDs (OR = 2.1 95%CI = 1.1-3.9). Most taxi drivers (62.9%) had a low physical activity level and no association was found between the physical activity level and MSDs.Conclusions: MSDs are common ailments among taxi drivers in Yaoundé (Cameroon). There is a need to think about how to address job dissatisfaction and better identify other associated factors in order to define good prevention strategies. [ABSTRACT FROM AUTHOR]

The objective of this study was to determine the rates of virological failure (VF) and HIV drug resistance (HIVDR) amongst adolescents on antiretroviral Therapy (ART). A retrospectively designed study was conducted in 10 healthcare centers for adolescents living with HIV (ALHIV) in the two main cities of Cameroon (Yaoundé and Douala), from November 2018 to May 2019. Sociodemographic, clinical, therapeutic and laboratory parameters were collected from medical records. All enrolled ALHIV had viral load (VL) measurements following the national guidelines. All patients with a VL ≥ 1000 copies/ml were called to perform genotyping tests. The chi-square test was used to determine the factors associated with VF. Out of the 1316 medical records of ALHIV, we included 1083 ALHIV having a VL result. Among them, 276 (25.5%) were experiencing VF, and VF was significantly higher in ALHIV with suboptimal adherence (p<0.001), older adolescents (p<0.05), those who lived outside the city where they were receiving ART (p<0.006), severely immunocompromised (p<0.01) and started ART at infancy (p<0.02). Among the 45/276 (16.3%) participants with an available genotyping resistance testing (GRT) result, the overall rate of HIVDR was 93.3% (42/45). The most common mutations were K103N (n = 21/42, 52.3%) resulting in high-level resistance to Efavirenz and Nevirapine, followed by M184V (n = 20/42, 47.6%) and thymidine analog mutations (n = 15/42, 35.7%) associated with high-level resistance to Lamivudine and Zidovudine respectively. The high rate of VF and HIVDR among ALHIV regularly followed in health facilities in Cameroon highlights the need to develop interventions adapted to an adolescent-centered approach to preserve future ART options. [ABSTRACT FROM AUTHOR]

Monogenea is a taxon containing flatworms that are primarily parasites of the skin and gills of fish. The African tetra, Brycinus kingsleyae (Günther, 1896), is a commercial fish species in artisanal fisheries in Southern Cameroon. Although the gill monogeneans of this fish species have been described, no ecological research has been carried out on this component community. The present study was conducted in the Nyong River to provide the first data about some factors that influence the structure of its infracommunities. In dry seasons, 70 fish specimens consisting of 27 males and 43 females of fork length between 9.5 and 14.1 cm were sampled. The analysis of their gill filament number indicated that the gill system of B. kingsleyae is heterogeneous because this factor varies with the length of the fish and depends on the gill arch. The studied guild consisted only of core species: Annulotrema combesi Birgi, 1988, Annulotrema maillardi Birgi, 1988, Annulotrema nyongensis Birgi, 1988, Annulotrema bouixi Birgi, 1988, and Characidotrema regia Birgi, 1988. The number of gill filaments and the parasitic load increased with the fish length, indicating that larger hosts provide a greater diversity of niches for parasites. Monogenean species exhibit various occupation patterns of gill arches, sectors, zones and gender differences in parasitological indices. This study reveals that the host length and sex, filament number, gill arch, sector and zone are largely responsible for structuring the studied component community. [ABSTRACT FROM AUTHOR]

Objectives: To formatively evaluate the HIGHER Women consortium’s Mentor Protégée Program (MPP) and derive lessons for successful African women scientist mentorship. Design: Desk review of program documents and cross-sectional surveys of mentors and protégées. Setting: All 10 regions of Cameroon Participants: Women working in health research participating in the MPP. Interventions: Building health research skills and providing support for women to cope within the African psychosocial environment using a holistic approach. Main outcome measures: Formed mentor-protégés duos applying the MPP with measurable accomplishments. Results: The consortium counted 121 members with 103 protégées and 18 mentors. Of 103 protégées, 35 responded to the 2018 survey, while 77 responded to the 2022 survey. Mentioned benefits of the program included an increase in scientific peer-reviewed journal publications and presentations at national and international conferences. In the 2022 survey, a Pearson correlation showed an r of 0.41, which, although not statistically significant (p = .592), suggests a positive correlation between the increased number of peer-reviewed articles and increased number of years as HIGHER Women protégées. Conclusions: Mentorship programs can help over time to bridge the gender gaps within Africa as well as the gaps between African-led research and the rest of the world while making a meaningful contribution to enhancing the quality, diversity, and productivity of researchers. A mentoring program such as the HIGHER Women MPP can be improved by leveraging local and international partners to foster the mentoring program’s sustainability, scalability, and expanded reach. [ABSTRACT FROM AUTHOR]

The health security planning process transforms recommendations from various evaluations into priority actions to strengthen countries' capacity for emergency preparedness using the One Health approach. Although the World Health Organization (WHO) has developed many tools to facilitate the planning process of a National Action Plan for Health Security (NAPHS) across the various components, a series of multisectoral workshops is still needed to complete the process. In this article, we report on the process of developing Cameroon's NAPHS and propose an innovative solution to improve the process. The NAPHS development process was conducted from May to December 2018. The WHO NAPHS framework, adapted to the local context, guided the process. The WHO planning matrix was used to plan activities and the WHO NAPHS costing tool was used to facilitate the costing exercise. A total of 84 Joint External Evaluation recommendations were translated into activities included in Cameroon's NAPHS. Among these activities, the majority (56%) were of medium priority. The total cost of a 5-year NAPHS was US$87,668,356, with almost half (49%) of the budget allocated to activities in the "Prevent" category and more than a third (35%) allocated to the "Detect" category. The top 3 cost drivers were immunization (22%), the national laboratory system (21%), and antimicrobial resistance (16%). The NAPHS informed policymakers of planned activities and funding needs to fast-track the development of health security capacities. Running gaps in funding will be addressed during a resource mapping exercise. To improve the overall planning process, a web-based support solution, where stakeholders select from a menu of recommendations from the Joint External Evaluation to develop a NAPHS, should be developed to improve the NAPHS development process. [ABSTRACT FROM AUTHOR]

Background: In most studies, the virological response is assessed during the first two years of antiretroviral treatment initiated in HIV-infected infants. However, early initiation of antiretroviral therapy exposes infants to very long-lasting treatment. Moreover, maintaining viral suppression in children is difficult. We aimed to assess the virologic response and mortality in HIV-infected children after five years of early initiated antiretroviral treatment (ART) and identify factors associated with virologic success in Cameroon.Methods: In the ANRS-12140 Pediacam cohort study, 2008-2013, Cameroon, we included all the 149 children who were still alive after two years of early ART. Virologic response was assessed after 5 years of treatment. The probability of maintaining virologic success between two and five years of ART was estimated using Kaplan-Meier curve. The immune status and mortality were also studied at five years after ART initiation. Factors associated with a viral load < 400 copies/mL in children still alive at five years of ART were studied using logistic regressions.Results: The viral load after five years of early ART was suppressed in 66.8% (60.1-73.5) of the 144 children still alive and in care. Among the children with viral suppression after two years of ART, the probability of maintaining viral suppression after five years of ART was 64.0% (54.0-74.0). The only factor associated with viral suppression after five years of ART was achievement of confirmed virological success within the first two years of ART (OR = 2.7 (1.1-6.8); p = 0.033).Conclusions: The probability of maintaining viral suppression between two and five years of early initiated ART which was quite low highlights the difficulty of parents to administer drugs daily to their children in sub-Saharan Africa. It also stressed the importance of initial viral suppression for achieving and maintaining virologic success in the long-term. Further studies should focus on identifying strategies that would enhance better retention in care and improved adherence to treatment within the first two years of ART early initiated in Sub-Saharan HIV-infected children. [ABSTRACT FROM AUTHOR]

Objectives. This study assessed musculoskeletal disorders (MSDs) and their correlates among heavy load carriers in Yaounde city, Cameroon. Methods. A descriptive cross-sectional study was conducted on 301 healthy male handlers. Descriptive statistics were used to determine prevalence while logistic regression was performed to determine associated factors. Results. MSD prevalence was 100 and 87.7% during the last 12 months and 7 days, respectively. Main sites affected were, respectively, the lower back (84.1 and 61.1%), hips/thighs (81.1 and 47.2%) and neck (74.7 and 43.2%). MSD risk factors were age 25–30 years during the last 12 months (odds ratio [OR] = 2.8; 95% confidence interval [CI] [−1.2, 6.5]) and 7 days (OR = 4.2; 95% CI [−1.7, 10.7]) for the neck and the last 12 months (OR = 2.6; 95% CI [−1.1, 5.8]) for shoulders. Overweight was a risk factor for wrists/hands in the last 12 months (OR = 2.7; 95% CI [−11.0, 7.2]). Seniority of 5–10 years was a risk factor for the lower back (OR = 1.8; 95% CI [−1.0, 3.3]) and hips/thighs (OR = 3.2; 95% CI [−1.7, 5.8]) in the last 7 days. Conclusion. Handlers showed high MSD prevalence in most sites, e.g., lower back, upper back, hips/thighs, shoulders and neck. Associated significant factors were age, overweight and seniority. [ABSTRACT FROM AUTHOR]

Background There is no gold standard for tuberculosis diagnosis in children. Clinical Case Definitions for Classification of Intrathoracic Tuberculosis in Children were proposed by international experts in 2012 and updated in 2015. We aimed to compare the 2012 and 2015 Clinical Case Definitions in HIV-infected children with suspected tuberculosis. Methods We enrolled HIV-infected children with suspected tuberculosis in Burkina Faso, Cambodia, Cameroon, and Vietnam (ANRS [Agence Nationale de Recherches sur le SIDA et les hépatites virales] 12229 PAANTHER [Pediatric Asian African Network for Tuberculosis and HIV Research] 01 Study). We classified children using the 2012 and 2015 Case Definitions considering as tuberculosis cases those with confirmed tuberculosis and those with probable and unconfirmed tuberculosis in the 2012 and the 2015 classifications, respectively. We assessed agreement between both classifications. Results Of 438 children enrolled, 197 (45.0%) children were classified as tuberculosis (45 confirmed, 152 probable) using the 2012 Case Definition and 251 (57.3%) were classified as tuberculosis (55 confirmed, 196 unconfirmed) using the 2015 classification. Inter-classification agreement for tuberculosis diagnosis was 364/438, 83.1%, with a kappa statistic of 0.667 (95% confidence interval 0.598-0.736). Of 152 children with probable tuberculosis (2012), 142 (93.4%) were considered as tuberculosis by the 2015 version and 10 (6.6%) as unlikely tuberculosis including 9 with spontaneous clinical improvement. Of 132 possible tuberculosis (2012), 58 (43.9%) were reclassified as tuberculosis (2015). Conclusions Agreement between the 2 versions of the Case Definition was substantial but more children were considered as tuberculosis using the 2015 version. Spontaneous symptom resolution reinforces both confidence in the "unlikely" category as being children without tuberculosis and the importance of the clinician's treatment decision in the study. [ABSTRACT FROM AUTHOR]

The mangrove forests surrounding Douala, Cameroon, have a long history of human impact due to rapid urbanization, resulting in patches of true mangrove forest interspersed with areas dominated by the mangrove-associated Pandanus species. A survey carried out to assess the possible shift in crab fauna composition and dominance between mangrove and Pandanus dominated areas revealed an undescribed phytotelmic habitat for Platychirarma buettikoferi. This species was found colonizing the natural reservoirs of fresh water represented by Pandanus spp. Our results show P. buettikoferi to be ecologically dependent upon Pandanus spp., and absent on the mangrove floor and trees, strongly indicating a phytotelmic adaptation. Our data suggest that this species is a facultative phytotelmic species well adapted to Pandanus spp. dominated areas. Further studies on the reproductive biology and feeding behaviour of P. buettikoferi may shed light on this unique phytotelmic lifestyle and its role in mangrove ecosystem functioning. Résumé: Les forêts de mangroves entourant Douala, au Cameroun, ont une longue histoire d'impacts humains en raison de l'urbanisation rapide. Celle-ci résulte en des parcelles de forêt de mangrove entrecoupées de zones dominées par Pandanus , espèce associée à la mangrove. Une étude faite pour évaluer le changement dans la composition faunistique de crabes et la dominance entre les zones dominées par les mangroves et les Pandanus a révélé un habitat phytotelmique pour Platychirarma buettikoferi , jamais décrit auparavant. Cette espèce a été trouvée en train de coloniser les réservoirs naturels d'eau douce représentés par Pandanus spp. Nos résultats montrent que P. buettikoferi est écologiquement dépendant de Pandanus spp., et absent du sol et des arbres de la mangrove, ce qui indique fortement une adaptation phytotelmique. Nos données suggèrent que cette espèce est une espèce phytotelmique facultative bien adaptée aux zones dominées par Pandanus spp. D'autres études sur la biologie reproductive et le comportement alimentaire de P. buettikoferi pourraient documenter ce mode de vie phytotelmique unique, ainsi que son rôle dans le fonctionnement de l'écosystème de la mangrove. [ABSTRACT FROM AUTHOR]

Many infectious diseases including malaria, lymphatic filariasis, chikungunya and dengue are transmitted by mosquitoes. Understanding the entomological diversity in a given area is critical for defining health risks, but also to design and evaluate control measures. Our study aimed to establish an entomological database of the Culicidae fauna in two clusters (Nyalla and Kambo) in the city of Douala in Cameroon. A longitudinal study was conducted from August to December in the Nyalla and Kambo neighbourhoods in the city of Douala. Culicidae larvae were weekly collected and reared until adult emergence. Adults were then morphologically identified using reference identification keys. A total of 20 breeding sites were productive out of an approximately 90 sites prospected. Water collections, pits, swamps and cinder blocks were main categories of larval habitats. In total, 2125 mosquito larvae were collected and reared during the survey. A total of 1790 mosquito adults emerged and were further identified and distributed among three genera: Culex (73.3%); Anopheles (22.6%) and Aedes (4.1%). Eleven Culicidae species were identified: Culex duttoni, Cx. descens, Cx. poicilipes, Cx. univittatus, Cx tigripes, Cx. antennatus, Cx. simpsoni, Cx. pipiens, Anopheles gambiae sl, Aedes aegypti and Ae. albopictus. Culex duttoni (39%) and An. gambiae s.l. (22.6%) were the main species recorded. The equitability, species richness and abundance of these genera was influenced by the nature of breeding sites and physical parameters including rainfall and temperature. The present study provides insights on the entomological diversity of the Culicidae fauna in the study area. Such information will help to orientate the fight against mosquito vectors in conjunction with the species and the types of breeding sites. [ABSTRACT FROM AUTHOR]

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To evaluate systems and services for management of diabetes and diabetic retinopathy. The National Program for Blindness Control conducted a nationwide descriptive study from 1st February to 31st October 2016. Data was collected using WHO's:"Tool Assessment of Diabetic Retinopathy and Diabetes Management Systems" adapted to the context. Using direct interviews, all previously identified stakeholders, were involved from all levels of management and throughout the territory. The IBM version 20 software permitted analysis. Out of the 48 individuals selected, 46 agreed to participate in the survey. Four participants (8.7%) worked at the central level of the Ministry of Public Health, 2 (4.4%) were NGOs partners, 6 (13%) diabetic patients, and 34 (73.9%) health staff. According to the answers of participants, diabetes stands among priorities in the national health policy. Diabetic care services have been integrated into the National action plan for Chronic Non-Communicable Diseases, but a specific program for control of diabetes has not been created neither are national guidelines recommended by the Ministry available. Some health facilities provide care for diabetes and its complications. Modern technologies for evaluation and follow-up of diabetes of its complications are available only in tertiary level hospitals and in some private clinics. The cost of care obtained is the responsibility of the patients and families. The political will to manage diabetes and diabetic retinopathy is recognized by stakeholders and beneficiaries but not translated into an effective program. A suitable implementation strategy is necessary. [ABSTRACT FROM AUTHOR]

Objective: In the present study, we aimed to evaluate the virological failure (VF) and drug resistance among treated HIV-infected children after five years follow-up in the ANRS-Pediacam cohort in Cameroon. Methods: From November 2007 to October 2011, HIV-infected children born to HIV-infected mothers were included in the ANRS-PEDIACAM study and followed-up for more than 5 years. Plasma viral load (VL) was measured at each visit (every three months until month 24 and every 6 months thereafter). VF was the main outcome and HIV drug resistance test was performed using the ANRS procedures and algorithm. Results: Data from 155 children were analyzed. The median age at combination antiretroviral therapy (cART) initiation was 4.2 months (interquartile range (IQR): 3.2–5.8), with 103 (66.5%) children taking LPV/r-containing regimen and 51 (32.9%) children taking NVP. After five years follow-up, 63 (40.6%; CI: 32.9–48.8) children experienced VF. The median duration between cART initiation and VF was 22.1 months (IQR: 11.9–37.1) with a median VL of 4.8 log10 (IQR: 4.0–5.5). Among the 57 children with HIV drug resistance results, 40 (70.2%) had at least one drug resistance mutation. The highest resistance rates (30.4–66.1%) were obtained with Lamivudine; Efavirenz; Nevirapine and Rilpivirine. Conclusions: These results show high resistance to NNRTI and emphasize the need of VL and resistance tests for optimal follow-up of HIV-infected people especially children. [ABSTRACT FROM AUTHOR]

A new species of freshwater crab of the genus Potamonemus Cumberlidge & Clark, 1992 is described from Mount Manengouba Reserve and Bakossi National Park in the tropical rainforests of southwestern Cameroon, Central Africa. Potamonemus man sp. nov. is recognized by characters of the carapace and chelipeds. In addition, a phylogenetic analysis based on partial sequences of three mitochondrial DNA genes (COI, 12S rRNA, and 16S rRNA) that included representatives of all other freshwater crab genera found in Cameroon recovered each of the new species as a distinct lineage. A diagnosis and illustrations of the new species are provided, and it is compared to the other species of Potamonemus. Brief notes are provided on the ecology of the new species and the two other species of Potamonemus. An identification key to the species of Potamonemus is provided. The conservation status of the genus is discussed. [ABSTRACT FROM AUTHOR]

Background: Routine Health Information Systems (RHIS) of low-income countries function below the globally expected standard, characterised by the production and use of poor-quality data, or the non-use of good quality data for informed decision making. This has negatively influenced the health service delivery and uptake. This study focuses on identifying the factors associated with the performance of RHIS of the health facilities (HF) in Yaoundé, so as to guide targeted RHIS strengthening.Methods: A HF-based cross-sectional study in the 6 health districts (HDs) of Yaoundé was conducted. HFs were chosen using stratified sampling with probability proportional to size per HD. Data were collected, entered into Microsoft Excel 2013 and analysed with IBM- SPSS version 25. Consistency of the questionnaire was measured using Cronbach's alpha coefficient. Pearson's chi-square (and Fisher exact where relevant) tests were used to establish relationships between qualitative variables. Associations were further quantified using unadjusted Odd ratio (OR) for univariable analysis and adjusted odds ratio (aOR) for multivariable analysis with 95% confidence interval (CI). A p-value of less than 0.05 was considered statistically significant.Results: Of 111 selected HFs; 16 (14.4%) were public and 95 (85.6%) private. Respondents aged 24-60 years with an average of 38.3 ± 9.3 years; 58 (52.3%) males and 53(47.7%) females. Cronbach's alpha was 0.96 (95%CI: 0.95-0.98, p < 0.001), proving that the questionnaire was reliable in measuring RHIS performances. At univariable level, the following factors were positively associated with good performances: supportive supervision (OR = 3.03 (1.1, 8.3); p = 0.02), receiving feedback from hierarchy (OR = 3.6 (0.99, 13.2); p = 0.05), having received training on health information (OR = 5.0 (1.6, 16.0); p = 0.003), and presence of a performance evaluation plan (OR = 3.3 (1.4, 8.2), p = 0.007). At multivariable level, the only significantly associated factor was having received training on health information (aOR = 3.3 (1.01, 11.1), p = 0.04).Conclusion: Training of health staff in the RHIS favors RHIS good performance. Hence, emphasis should be laid on training and empowering staff, frequent and regular RHIS supervision, and frequent and regular feedback, for an efficient RHIS strengthening in Yaoundé. [ABSTRACT FROM AUTHOR]

African root and tuber scale (ARTS) Stictococcus vayssierei Richard is a serious constraint to the production of cassava (Manihot esculenta Crantz) in Central Africa, and the food and income security for smallholder farmers. Therefore, to improve the production of cassava it is urgent to determine the appropriate cultural practices that lower ARTS infestation pressure. This study tests the single and combined effects of stem cutting portion and crop variety on ARTS infestation levels'. A split-plot design with four cassava varieties (TMS 96/0023, Excel, Miboutou and Douma) as the main plots and three stem cuttings portions of these varieties (lower, middle and upper portions of the mother plant) as sub-plots was used. The results showed that at 12 months after planting (MAP), lower portions of the local variety Douma showed the highest fresh shoots (2.95 ± 0.13 kg) than the upper portions (2.08 ± 0.09 kg) of the Excel variety. The portions at lower of the Excel variety were the most infested (118-158.38 and 126.75 ARTS) at 3, 6 and 9 MAP respectively. The yield of local variety Douma was higher (20.00-20.11 t ha− 1) in plots planted with portions at middle and lower, followed by yields of TMS 96/0023 variety (19.00 t ha− 1) in plots planted with the lower portions. Overall, irrespective of the cassava variety, the lower portion 16.49 t ha− 1 resulted in higher yield than those the upper portion 10.81 t ha− 1. [ABSTRACT FROM AUTHOR]

Background: The high rate of mortality among HIV-vertically infected adolescents might be favoured by HIV drug resistance (HIVDR) emergence, which calls for timeous actions in this underserved population. We thus sought to evaluate program quality indicators (PQIs) of HIVDR among HIV-vertically infected adolescents on antiretroviral therapy (ART). Methods: A study was conducted in the Centre region of Cameroon among adolescents (10–19 years) receiving ART in two urban (The Mother–Child Centre of the Chantal BIYA Foundation, the National Social Welfare Hospital) and three rural (Mfou District Hospital, Mbalmayo District Hospital and Nkomo Medical Center) health facilities. Following an exhaustive sampling from ART registers, patient medical files and pharmacy records, data was abstracted for seven PQIs: on-time drug pick-up; retention in care; pharmacy stock outs; dispensing practices; viral load coverage; viral suppression and adequate switch to second-line. Performance in PQIs was interpreted following the WHO-recommended thresholds (desirable, fair and/or poor); with p < 0.05 considered significant. Results: Among 967 adolescents (888 urban versus 79 rural) registered in the study sites, validated data was available for 633 (554 in urban and 79 in rural). Performance in the urban vs. rural settings was respectively: on-time drug pick-up was significantly poorer in rural (79% vs. 46%, p = 0.00000006); retention in care was fair in urban (80% vs. 72%, p = 0.17); pharmacy stock outs was significantly higher in urban settings (92% vs. 50%, p = 0.004); dispensing practices was desirable (100% vs. 100%, p = 1.000); viral load coverage was desirable only in urban sites (84% vs. 37%, p < 0.0001); viral suppression was poor (33% vs. 53%, p = 0.08); adequate switch to second-line varied (38.1% vs. 100%, p = 0.384). Conclusion: Among adolescents on ART in Cameroon, dispensing practices are appropriate, while adherence to ART program and viral load coverage are better in urban settings. However, in both urban and rural settings, pharmacy stock outs, poor viral suppression and inadequate switch to second-line among adolescents require corrective public-health actions to limit HIVDR and to improve transition towards adult care in countries sharing similar programmatic features. [ABSTRACT FROM AUTHOR]

Three new species of the Cameroonian endemic freshwater crab genus Buea Cumberlidge, Mvogo Ndongo, Clark & Daniels, 2019 are described. The new species were collected from protected areas in the Southwest region of Cameroon, the Korup and Bakossi National Parks and the Mt. Nlonako Ecological Reserve. These species are distinguished from each other and from the type species of the genus, Buea asylos (Cumberlidge, 1993), by a combination of morphological characters (carapace, thoracic sternum, chelipeds, and male first gonopod) and by partial sequences of three mitochondrial DNA genes (COI, 12S rRNA, and 16S rRNA). A phylogenetic analysis that included representatives of all other freshwater crab genera found in Cameroon recovered each of the new species as a well-supported distinct lineage. An identification key is also provided for the four species of Buea and the conservation status of the new species is discussed. [ABSTRACT FROM AUTHOR]

Background: The purpose of this study was to determine the prevalence of Burnout syndrome (BOS), risk factors and the effect of physical activity in six professions in Cameroon. Methods: 2012 participants completed questionnaires related to socio-demographic conditions and work perception. Appropriate Maslach Burnout Inventory (MBI) psychometers were used for specific professions. Level of physical activity and sports practice was determined using the Ricci and Gagnon scale. Results: The overall prevalence of burnout was 67.9%; with 5.3% high; 34.3% moderate; and 60.4% low degree. 42.2% of victims of BOS were in high loss of personal achievement, 39.9% in high depersonalization of and 38.2% in high emotional exhaustion. Higher prevalence of BOS was found in Army (85.3%) and educational sectors (78.5% in secondary school teachers (SET) and 68% in university teaching staff (UTS)). BOS was significantly associated (p ˂ 0.05) with distance from home to workplace, number of children per participant, number of hospitals attended, number of guards per month, labour hours per day, conflicts with the hierarchy, conflicts with colleagues, poor working conditions, unsatisfactory salary, part time teaching in private university institutions, job seniority, sedentariness. Apart from UTS, no association was observed between the level of physical activity and occurrence of BOS. Conclusion: Burnout is a reality in occupational environments in Cameroon. [ABSTRACT FROM AUTHOR]

Background: The International Health Regulations state that early detection and immediate reporting of unusual health events is important for early warning and response systems. Objective: To describe a pilot surveillance program established in health facilities in Yaoundé, Cameroon in 2017 which aimed to enable detection and reporting of public health events. Methods: Cameroon's Ministry of Health, in partnership with the US Centers for Disease Control and Prevention, Cameroon Pasteur Center, and National Public Health Laboratory, implemented event‐based surveillance (EBS) in nine Yaoundé health facilities. Four signals were defined that could indicate possible public health events, and a reporting, triage, and verification system was established among partner organizations. A pre‐defined laboratory algorithm was defined, and a series of workshops trained health facilities, laboratory, and public health staff for surveillance implementation. Results: From May 2017 to January 2018, 30 signals were detected, corresponding to 15 unusual respiratory events. All health facilities reported a signal at least once, and more than three‐quarters of health facilities reported ≥2 times. Among specimens tested, the pathogens detected included Klebsiella pneumoniae, Moraxella catarrhalis, Streptococcus pneumoniae, Haemophilus influenza, Staphylococcus aureus, Pneumocystis jiroveci, influenza A (H1N1) virus, rhinovirus, and adenovirus. Conclusions: The events detected in this pilot were caused by routine respiratory bacteria and viruses, and no novel influenza viruses or other emerging respiratory threats were identified. The surveillance system, however, strengthened relationships and communication linkages between health facilities and public health authorities. Astute clinicians can play a critical role in early detection and EBS is one approach that may enable reporting of emerging outbreaks and public health events. [ABSTRACT FROM AUTHOR]

Purpose: To evaluate the ocular alignment following esotropia surgery in our setting. Patients and Methods: We conducted a cross sectional descriptive study which spanned 19 years, from October 1999 to September 2018 at the Douala General Hospital and the Yaoundé Central Hospital. Complete medical records of patients who underwent surgery for esotropia during the study period were included. Data collected included age at diagnosis, sex, age of onset of esotropia, age at surgery, refractive error, type of surgery performed, pre and post-operative angle of deviation. The outcome was considered good when the postoperative angle was ≤ 10 prism diopters (PD). Results: Four hundred and ninety patients with primary esotropia were seen during the study period. Only 155 returned for follow-up after wearing the full cycloplegic correction for a minimum period of 3 months. Accommodative esotropia was found in 32 cases (20.6%). Among the 123 cases requiring surgery, 63 cases underwent surgery (51.2%). Fifty-nine complete records were included (59.3% females and 40.7% males). The mean age at the time of diagnosis was 6.5 ± 6.1 years and the mean age at the time of surgery was 8.7 ± 6.1 years. The mean preoperative angle at distance was 42.8 ± 10.8 PD. The outcome was good in 91.5% of cases. No factor influenced the outcome of surgery. Conclusion: The outcome of esotropia surgery was good in this study. This could serve to increase patient motivation to accept surgery in our setting. [ABSTRACT FROM AUTHOR]

The taxonomy of the freshwater crab genus Louisea Cumberlidge, 1994, is reviewed based on type material and newly obtained specimens from three different localities in southwestern Cameroon. The genus is endemic to Cameroon and previously included two species: L. edeaensis (Bott, 1969) (type species) from Lake Ossa wetland complex (altitudes below 400 m asl) and L. balssi (Bott, 1959) from Kumba and Mt. Manengouba (altitudes above 1300 m asl). Here two new species of Louisea are described based on morphological and/or genetic data: L. nkongsamba sp. nov. from the Nlonako Ecological Reserve (1000-1400 m asl) in the sub-montane zone and L. yabassi sp. nov. from Yabassi in the lowlands. A redescription and amended diagnostic features of L. edeaensis and L. balssi are provided, and the genus diagnosis is updated to accommodate all four species. An identification key is also provided for the species of Louisea. A tree of phylogenetic relationships based on three mtDNA loci (COI, 12S rRNA, and 16S rRNA) supports the taxonomic revision, and indicates speciation of Louisea species along an altitudinal gradient, but further phylogenetic analyses are needed to understand whether this can lend support to the hypothesis that there is a montane centre of speciation along the Cameroon Volcanic Line. The phylogenetic tree also shows that Buea Cumberlidge, Mvogo Ndongo, Clark & Daniels, 2019 and Potamonemus Cumberlidge & Clark, 1992 are sister genera that may be derived from the Louisea lineage. [ABSTRACT FROM AUTHOR]

Background: Vertical (VT) transmission of HIV remains a public health concern in sub-Saharan Africa. Objective: To investigate the VT rate and factors associated with transmission in routine practice in three referral hospitals in Cameroon. Methods: All HIV-infected mothers who delivered in maternity wards or sought paediatric services during the first postnatal week from November 2007 to October 2010 were invited to participate in the ANRS-Pediacam cohort. Their infants were followed at 6, 10 and 14 weeks of life and HIV status was determined from the 6th week of life using real-time PCR. For those who were breastfed and negative at the first PCR, a second test was performed 6 weeks after breast-feeding was stopped. Logistic regression was performed to identify the independent risk factors of VT. Results: Overall, 2053 HIV-exposed infants were enrolled. Of these, 1827 were tested for HIV including 1777 before the age of 3 months, and 59 were HIV-infected, resulting in an overall early VT rate of 3.3% (CI 2.5–4.3). The VT rate was significantly associated with the type of maternal exposure to ART (0.5%, 2/439, p<0.001, CI 0.0-1.6) in mothers who commenced HAART before pregnancy, 1.9% (6/321, CI 0.7–4.0) in mothers who commenced HAART during pregnancy, 4.1% (34/837, CI 2.8–5.6) in those on short-course ART and 11.1% (17/153, CI 6.6–17.2) in mothers not receiving ART. On multivariate analysis, the type of exposure to ART remained significantly associated with being small for gestational age (aOR 5.0, CI 2.4–10.3, p < 0.001) and female gender (aOR 2.1, CI 1.2–3.8, p = 0.01). Conclusion: The successfully low rate of VT transmission of HIV in mothers who commenced HAART in early pregnancy strongly supports the need to improve access to diagnosis and early treatment of all women of childbearing age with HIV through the national PMTCT programme. Abbreviations: ANRS: French National Agency for Research on AIDS and Viral Hepatitis; ART: antiretroviral therapy; ARV: antiretroviral; AUDIPOG: Association des Utilisateurs de Dossiers Informatisés en Pédiatrie, Obstétrique et Gynécologie; CHM/MCC-CBF: The Central Hospital Maternity/Mother and Child Centre of the Chantal Biya Foundation; EHC: Essos Hospital Centre; EPI: Expanded Programme on Immunization; HAART: highly active antiretroviral therapy; HBV: hepatitis B virus; IQR: interquartile range; LH: Laquintinie Hospital; MTCT: mother-to-child transmission; NVP: nevirapine; Pediacam: Pediatrie Cameroun; PMTCT: prevention of mother-to-child transmission; SGAG: small for gestational age and gender; UNAIDS: Joint United Nations Program on HIV/AIDS; WHO: World Health Organization; ZDV: zidovudine; 3TC: lamivudine. [ABSTRACT FROM AUTHOR]

Background: Long-term growth in HIV-infected infants treated early in resource-limited settings is poorly documented. Incidence of growth retardation, instantaneous risk of death related to malnutrition and growth parameters evolution during the first five years of life of uninfected and early treated HIV-infected children were compared and associated factors with growth retardation were identified. Methods: Weight-for-age (WAZ), weight-for-length (WLZ), and length-for-age (LAZ) Z-scores were calculated. The ANRS-PEDIACAM cohort includes four groups of infants with three enrolled during the first week of life: HIV-infected (HI, n = 69), HIV-exposed uninfected (HEU, n = 205) and HIV-unexposed uninfected (HUU, n = 196). The last group included HIV-infected infants diagnosed before 7 months of age (HIL, n = 141). The multi-state Markov model was used to describe the incidence of growth retardation and identified associated factors. Results: During the first 5 years, 27.5% of children experienced underweight (WAZ<-2), 60.4% stunting (LAZ<-2) and 41.1% wasting (WLZ<-2) at least once. The instantaneous risk of death observed from underweight state (35.3 [14.1–88.2], 84.0 [25.5–276.3], and 6.0 [1.5–24.1] per 1000 person-months for 0–6 months, 6–12 months, and 12–60 months respectively) was higher than from non-underweight state (9.6 [5.7–16.1], 20.1 [10.3–39.4] and 0.3 [0.1–0.9] per 1000 person-months). Compared to HEU, HIL and HI children were most at risk of wasting (adjusted HR (aHR) = 4.3 (95%CI: 1.9–9.8), P<0.001 and aHR = 3.3 (95%CI: 1.4–7.9), P = 0.01 respectively) and stunting for HIL (aHR = 8.4 (95%CI: 2.4–29.7). The risk of underweight was higher in HEU compared to HUU children (aHR = 5.0 (CI: 1.4–10.0), P = 0.001). Others associated factors to growth retardation were chronic pathologies, small size at birth, diarrhea and CD4< 25%. Conclusions: HIV-infected children remained at high risk of wasting and stunting within the first 5 years period of follow-up. There is a need of identifying suitable nutritional support and best ways to integrate it with cART in pediatric HIV infection global care. [ABSTRACT FROM AUTHOR]

Buea gen. nov. is established to accommodate the freshwater crab Potamonemus asylos, from south-western Cameroon, Central Africa. This new genus is defined based on molecular evidence combined with morphological characters of the mandible and the first and second gonopods. Buea asylos comb. nov. is endemic to Cameroon, and is here compared with, and distinguished from, other freshwater crabs occurring in that country. Buea gen. nov. is the fifth freshwater crab genus known from Cameroon. The removal of P. asylos from Potamonemus leaves this genus with two species, P. mambilorum and P. sachsi, both of which are illustrated here and compared with the new genus. An amended key to the Potamonautinae genera is provided. Zoobank ID (LSID) This published work and the nomenclatural acts it contains have been registered in ZooBank, the online registration system for the ICZN. The ZooBank Life Science Identifiers (LSIDs) can be resolved and the associated information viewed through any standard web browser by appending the LSID to the prefix . [ABSTRACT FROM AUTHOR]

Background: Viral load is still the marker of choice for monitoring adherence to combined antiretroviral therapy (cART) and confirming the success of HIV treatment. Unfortunately it is difficult to access in many resource-poor settings. We aimed to measure the performance of caregiver reporting adherence for detecting virological failure in routine practice during the first 2 years after cART initiation in infants.Methods: PEDIACAM is an ongoing prospective cohort study including HIV1-infected infants diagnosed before 7 months of age between November 2007 and October 2011 in Cameroon. Adherence was assessed using a questionnaire administered every 3 months from cART initiation; the HIV-RNA viral load was determined at the same visits. Virological failure was defined as having a viral load ≥ 1000 cp/mL at 3 and 12 months after cART initiation or having a viral load ≥ 400 cp/mL at 24 months after cART initiation. The performance of each current missed and cumulative missed dose defined according to adherence as reported by caregiver was assessed using the viral load as the gold standard.Results: cART was initiated at a median age of 4 months (IQR: 3-6) in the 167 infants included. The cumulative missed dose showed the best overall performance for detecting virological failure after 12 months of cART (AUC test, p = 0.005, LR + =4.4 and LR- = 0.4). Whatever the adherence reporting criterion, the negative predictive value was high (NPV ≥ 75%) 12 and 24 months after cART initiation, whereas the positive predictive value was low (PPV ≤ 50%).Conclusions: The adherence questionnaire administered by the health care provider to the infants' caregivers is not reliable for detecting virological failure in routine practice: its positive predictive value is low. However, the cumulative missed dose measurement may be a reliable predictor of virological success, particularly after 12 months of cART, given its high negative predictive value. [ABSTRACT FROM AUTHOR]

Background: Loss to follow-up (LTFU) is a cause of potential bias in clinical studies. Differing LTFU between study groups may affect internal validity and generalizability of the results. Understanding reasons for LTFU could help improve follow-up in clinical studies and thereby contribute to goals for prevention, treatment, or research being achieved. We explored factors associated with LTFU of mother-child pairs after inclusion in the ANRS 12140-Pediacam study. Methods: From November 2007 to October 2010, 4104 infants including 2053 born to HIV-infected mothers and 2051 born to HIV-uninfected mothers matched individually on gender and study site were enrolled during the first week of life in three referral hospitals in Cameroon and scheduled for visits at 6, 10 and 14 weeks of age. Visits were designated 1, 2 and 3, in chronological order, irrespective of the child's age at the time of the visit. Mother-child pairs were considered lost to follow-up if they never returned for a clinical visit within the first six months after inclusion. Uni- and multivariable logistic regression were adjusted on matching variables to identify factors associated with LTFU according to maternal HIV status. Results: LTFU among HIV-unexposed infants was four times higher than among HIV-exposed infants (36.7% vs 9.8%, p < 0.001). Emergency caesarean section (adjusted Odds Ratio (aOR) = 2.46 95% Confidence Interval (CI) [1.47-4.13]), young maternal age (aOR = 2.29, 95% CI [1.18-4.46]), and absence of antiretroviral treatment for prophylaxis (aOR = 3.45, 95% CI [2.30-5.19]) were independently associated with LTFU among HIV-exposed infants. Factors associated with LTFU among HIV-unexposed infants included young maternal age (aOR = 1.96, 95% CI [1.36-2.81]), low maternal education level (aOR = 2.77, 95% CI [1.95-3.95]) and housewife/unemployed mothers (aOR = 1.56, 95% CI [1.16-2.11]). Conclusion: Failure to return for at least one scheduled clinical visit is a problem especially among HIV-unexposed infants included in studies involving HIV-exposed infants. Factors associated with this type of LTFU included maternal characteristics, socio-economic status, quality of antenatal care and obstetrical context of delivery. Enhanced counselling in antenatal and intrapartum services is required for mothers at high risk of failure to return for follow-up visits. [ABSTRACT FROM AUTHOR]

Objective: This study aimed to describe the clinical characteristics of patients with infantile hypertrophic stenosis, management and its outcome in two tertiary care centres in Cameroon. Results: A total of 21 patients were included from the two centres. The mean age at presentation was 5.2 ± 1.2 weeks, predominantly male with a male-to-female ratio of 4.25:1. The triad of vomiting, visible peristalsis and palpable mass was present in only 7 (33.3%) of the participants. The diagnosis was confirmed with ultrasounds in all participants. Ramstedt pyloromyotomy was done in all participants and in 9.5% of the participants it was complicated by intra-operative duodenal perforation whereas in the postoperative period the most common complications were vomiting (6, 28.6%), sepsis (2, 9.5%), and paralytic ileus (2, 9.5%). The mortality rate from the series is 9.5%. According to univariate logistic regression: severe dehydration [OR = 5.41, 95% CI = (3.11-6.97), p = 0.002], hypokalaemia [OR = 2.63, 95% CI = (1.02-5.91), p = 0.042] and surgical site infection [OR = 3.12, 95% CI (1.22-5.64), p = 0.023] were the main predictors of mortality whereas postoperative hospital length of stay > 5 days was significantly associated with surgical site infection [OR = 2.44, 95% CI = (1.12-6.44), p = 0.002] and postoperative nausea and vomiting [OR = 3.64, 95% CI = (1.18-6.64), p = 0.022]. [ABSTRACT FROM AUTHOR]

Background: The outcome of CMV/HIV co-infection in infants treated early with combined antiretroviral therapy (cART) in resource-limited settings has not been described. We aimed to estimate the prevalence and identify factors associated with early CMV infection in HIV-infected and non-infected infants included in a study in Cameroon, and to compare HIV disease progression and survival after 1 year of early cART, following infants' CMV status.Methods: HIV-infected infants followed from birth or from HIV diagnosis before 7 months old and HIV-uninfected infants born to HIV-infected or uninfected mothers were tested for CMV at a median age of 4.0 months [Interquartile range (IQR): 3.4-4.9]. Multivariable logistic regression was performed to identify factors associated with CMV infection. Early cART was offered to HIV-infected infants: mortality, immunological and virological outcomes were assessed.Results: Three hundred and sixty-nine infants were tested. The proportion of infants infected with CMV at baseline was significantly higher in HIV-infected than in HIV-uninfected groups (58.9% (86/146) vs 30.0% (67/223), p < 0.001). At baseline, median CMV viral load was higher in HIV-infected (3.7 log copies/ml [IQR; 3.1-4.3]) than in HIV-uninfected infants (2.8 log copies [IQR; 2.1-3.4], p < 0.001). cART was initiated in 90% of HIV-infected infants (132/146) at a median age of 4.0 months (IQR; 3.2-5.9); in this sub-group CMV infection was independently associated with being followed from the time of HIV diagnosis rather than from birth (aOR = 3.1, 95%CI [1.2-8.0]), born to a non-single mother (aOR = 3.4[1.4-8.1]), and breastfeeding (aOR = 7.3 [2.7-19.4]). HIV-infected infants were retested after a median of 7.1 months [4.8-9.5]: CMV was undetectable in 37 of the 61 (60.7%) initially CMV-infected cases and became detectable in 8 of the 38 (21.1%) initially CMV-negative cases. After 1 year of cART, the probability of death (0.185 vs 0.203; p = 0.75), the proportion of cases with HIV RNA viral load <400 copies/ml (75.5% vs 61.5%; p = 0.17) and the mean CD4 percentage increase (10.97% vs 6.88%; p = 0.15) did not differ between CMV+ and CMV- infants.Conclusions: We observed a high prevalence of CMV infection among HIV-infected infants. Early initiation of cART may have limited the negative impact of CMV even in the absence of specific anti-CMV treatment. [ABSTRACT FROM AUTHOR]

Mangroves are critically threatened by human activities, despite the important ecosystem functions and services they provide. Mangroves in Cameroon represent no exception to the worldwide trend of mangrove destruction, especially around Douala, on the Wouri river estuary. In two sites around Douala, we assessed the presence of sterols, PAHs, PCBs, DEHP, DDT and its metabolite p,p'-DDE and potentially toxic metals in sediment samples. As a proxy of ecological quality, we measured the diversity and abundance of macrobenthos assemblages. We detected p,p'-DDE contamination, with concentrations higher than 3 μg kg − 1 in 16 out of 26 samples which were attributed to recent widespread use of DDT. The detection of sterols revealed faecal contamination. Significant sensitivity of the macrobenthos to contaminants was revealed, with possible implications on the overall mangrove vulnerability to climate change and on the provision of ecosystem services to local populations. [ABSTRACT FROM AUTHOR]

Background: The consequences of maternal HIV infection for fetal growth are controversial. Here, we estimated the frequency of small for gestational age and gender (SGAG) among neonates born to HIV-infected or uninfected mothers and assessed the contribution, if any, of maternal HIV to the risk of SGAG. Methods: The data used were obtained from the ANRS-Pediacam cohort in Cameroon. Pairs of newborns, one to a HIV-infected mother and the other to an uninfected mother, were identified during the first week of life, and matched on gender and recruitment site from 2007–2010. SGAG was defined in line with international recommendations as a birth weight Z-score adjusted for gestational age at delivery and gender more than two standard deviations below the mean (−2SD). Considering the matched design, logistic regression modeling was adjusted on site and gender to explore the effect of perinatal HIV exposure on SGAG. Results: Among the 4104 mother-infant pairs originally enrolled, no data on birth weight and/or gestational age were available for 108; also, 259 were twins and were excluded. Of the remaining 3737 mother-infant pairs, the frequency of SGAG was 5.3% (95%CI: 4.6–6.0), and was significantly higher among HIV-infected infants (22.4% vs. 6.3%; p<.001) and lower among HIV-unexposed uninfected infants (3.5% vs. 6.3%; p<.001) than among HIV-exposed uninfected infants. Similarly, SGAG was significantly more frequent among HIV-infected infants (aOR: 4.1; 2.0–8.1) and less frequent among HIV-unexposed uninfected infants (aOR: 0.5; 0.4–0.8) than among HIV-exposed uninfected infants. Primiparity (aOR: 1.9; 1.3–2.7) and the presence of any disease during pregnancy (aOR: 1.4; 1.0–2.0) were identified as other contributors to SGAG. Conclusion: Maternal HIV infection was independently associated with SGAG for HIV-exposed uninfected infants. This provides further evidence of the need for adapted monitoring of pregnancy in HIV-infected women, especially if they are symptomatic, to minimize additional risk factors for SGAG. [ABSTRACT FROM AUTHOR]

Global declines in biodiversity, together with widespread degradation of ecosystem services, have led to urgent calls to safeguard. Humans maintain plants around their houses to increase their quality of life. In the present study, 90 and 30 plots of 50 m2 each were studied in urbanised and rural areas in Cameroon. In each plot, vascular plant species were identified and their coefficient of abundance-dominance was determined. Different diversity indices were calculated to compare the flora of urbanised and rural areas as well as the distribution of plants. A total of 119 species belonging to 95 genera and 45 families were sampled. Shannon-Weaver diversity index, Pielou and Sheldon values vary when taking into account not only erected or wooded plants, but also herbs and erected or wooded plants. Plots near houses in urban areas comprised weeds, ornamentals and fruits, whereas in rural areas medicinal or edible plants dominated. Based upon the results, we conclude that the use of plants as food, medicinal resources or for other purposes, might be helpful for biodiversity conservation, ecosystem services, the management of resources and to fight poverty. However, the composition of the flora is likely to change as urbanisation proceeds. [ABSTRACT FROM AUTHOR]

Background: Early infant diagnosis (EID) of HIV is a key-point for the implementation of early HAART, associated with lower mortality in HIV-infected infants. We evaluated the EID process of HIV according to national recommendations, in urban areas of Cameroon. Methods/Findings: The ANRS12140-Pediacam study is a multisite cohort in which infants born to HIV-infected mothers were included before the 8th day of life and followed. Collection of samples for HIV DNA/RNA-PCR was planned at 6 weeks together with routine vaccination. The HIV test result was expected to be available at 10 weeks. A positive or indeterminate test result was confirmed by a second test on a different sample. Systematic HAART was offered to HIV-infected infants identified. The EID process was considered complete if infants were tested and HIV results provided to mothers/family before 7 months of age. During 2007-2009, 1587 mother-infant pairs were included in three referral hospitals; most infants (n = 1423, 89.7%) were tested for HIV, at a median age of 1.5 months (IQR, 1.4-1.6). Among them, 51 (3.6%) were HIVinfected. Overall, 1331 (83.9%) completed the process by returning for the result before 7 months (median age: 2.5 months (IQR, 2.4-3.0)). Incomplete process, that is test not performed, or result of test not provided or provided late to the family, was independently associated with late HIV diagnosis during pregnancy (adjusted odds ratio (aOR) = 1.8, 95%CI: 1.1 to 2.9, p = 0.01), absence of PMTCT prophylaxis (aOR = 2.4, 95%CI: 1.4 to 4.3, p = 0.002), and emergency caesarean section (aOR = 2.5, 95%CI: 1.5 to 4.3, p = 0.001). Conclusions: In urban areas of Cameroon, HIV-infected women diagnosed sufficiently early during pregnancy opt to benefit from EID whatever their socio-economic, marital or disclosure status. Reduction of non optimal diagnosis process should focus on women with late HIV diagnosis during pregnancy especially if they did not receive any PMTCT, or if complications occurred at delivery. [ABSTRACT FROM AUTHOR]

Background: Injuries are quickly becoming a leading cause of death globally, disproportionately affecting sub-Saharan Africa, where reports on the epidemiology of injuries are extremely limited. Reports on the patterns and frequency of injuries are available from Cameroon are also scarce. This study explores the patterns of trauma seen at the emergency ward of the busiest trauma center in Cameroon's capital city. Materials and methods: Administrative records from January 1, 2007, through December 31, 2007, were retrospectively reviewed; information on age, gender, mechanism of injury, and outcome was abstracted for all trauma patients presenting to the emergency ward. Univariate analysis was performed to assess patterns of injuries in terms of mechanism, date, age, and gender. Bivariate analysis was used to explore potential relationships between demographic variables and mechanism of injury. Results: A total of 6,234 injured people were seen at the Central Hospital of Yaoundé's emergency ward during the year 2007. Males comprised 71% of those injured, and the mean age of injured patients was 29 years (SD = 14.9). Nearly 60% of the injuries were due to road traffic accidents, 46% of which involved a pedestrian. Intentional injuries were the second most common mechanism of injury (22.5%), 55% of which involved unarmed assault. Patients injured in falls were more likely to be admitted to the hospital ( p < 0.001), whereas patients suffering intentional injuries and bites were less likely to be hospitalized ( p < 0.001). Males were significantly more likely to be admitted than females ( p < 0.001) Discussion: Patterns in terms of age, gender, and mechanism of injury are similar to reports from other countries from the same geographic region, but the magnitude of cases reported is high for a single institution in an African city the size of Yaoundé. As the burden of disease is predicted to increase dramatically in sub-Saharan Africa, immediate efforts in prevention and treatment in Cameroon are strongly warranted. [ABSTRACT FROM AUTHOR]

Background: This trial aims at testing the efficacy of weekly reminder and motivational text messages, compared to usual care in improving adherence to Highly Active Antiretroviral Treatment in patients attending a clinic in Yaoundé, Cameroon. Methods and Design: This is a single-centered randomized controlled single-blinded trial. A central computer generated randomization list will be generated using random block sizes. Allocation will be determined by sequentially numbered sealed opaque envelopes. 198 participants will either receive the mobile phone text message or usual care. Our hypothesis is that weekly motivational text messages can improve adherence to Highly Active Antiretroviral Treatment and other clinical outcomes in the control group by acting as a reminder, a cue to action and opening communication channels. Data will be collected at baseline, three months and six months. A blinded program secretary will send out text messages and record delivery. Our primary outcomes are adherence measured by the visual analogue scale, self report, and pharmacy refill data. Our secondary outcomes are clinical: weight, body mass index, opportunistic infections, all cause mortality and retention; biological: Cluster Designation 4 count and viral load; and quality of life. Analysis will be by intentionto- treat. Covariates and subgroups will be taken into account. Discussion: This trial investigates the potential of SMS motivational reminders to improve adherence to Highly Active Antiretroviral Treatment in Cameroon. The intervention targets non-adherence due to forgetfulness and other forms of non-adherence. Trial Registration: Pan-African Clinical Trials Registry PACTR201011000261458 http://clinicaltrials.gov/NCT01247181. [ABSTRACT FROM AUTHOR]

Exposure to nonhuman primates has led to the emergence of important diseases, including Ebola hemorrhagic fever, AIDS, and adult T-cell leukemia. To determine the extent of exposure to nonhuman primates, persons were examined in 17 remote villages in Cameroon that represented three habitats (savanna, gallery forest, and lowland forest). Questionnaire data were collected to assess whether persons kept wild animal pets; hunted and butchered wild game; had experienced bites, scratches, or injuries from live animals; or had been injured during hunting or butchering. While all villages had substantial exposure to nonhuman primates, higher rates of exposure were seen in lowland forest sites. The study demonstrates that exposure is not limited to small groups of hunters. A high percentage of rural villagers report exposure to nonhuman primate blood and body fluids and risk acquiring infectious diseases. [ABSTRACT FROM AUTHOR]