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The efficacy of first-line antiretroviral therapy (ART) may be hampered by the presence of HIV drug resistance (HIVDR). We described HIV-1 pre-treatment drug resistance (PDR) patterns, effect of viral clades on PDR, and programmatic implications on first-line regimens in Cameroon. A sentinel surveillance of PDR was conducted from 2014 to 2019. Sequencing of HIV-1 protease and reverse transcriptase was performed, and HIVDR was interpreted using Stanford HIVdb.v.9.4. In total, 379 sequences were obtained from participants (62% female, mean age 36 ± 10 years). The overall PDR rate was 15.0% [95% CI: 11.8–19.0] nationwide, with significant disparity between regions (p = 0.03). NNRTI PDR was highest (12.4%), of which 7.9% had DRMs to EFV/NVP. Two regions had EFV/NVP PDR above the 10% critical threshold, namely the Far North (15%) and East (10.9%). Eighteen viral strains were identified, predominated by CRF02_AG (65.4%), with no influence of genetic diversity PDR occurrence. TDF-3TC-DTG predictive efficacy was superior (98.4%) to TDF-3TC-EFV (92%), p < 0.0001. The overall high rate of PDR in Cameroon, not substantially affected by the wide HIV-1 genetic diversity, underscores the poor efficacy of EFV/NVP-based first-line ART nationwide, with major implications in two regions of the country. This supports the need for a rapid transition to NNRTI-sparing regimens, with TDF-3TC-DTG having optimal efficacy at the programmatic level.

Background: The germs of waterborne diseases are often associated with an increase in resistance, which contrasts with the discovery of new active molecules, thus complicating treatment. Research is therefore undertaken to discover new substances with therapeutic potential. Although plants are an important source for obtaining interesting compounds, methods based on synthetic chemistry make it possible to obtain compounds inspired by those found in nature and presenting equally important properties. One group of these compounds, called chalcone, is of great importance nowadays due to the diversity of biological activities it presents; therefore, many chalcone derivatives are synthesized and their biological activities evaluated. Methodology: The compounds were synthesized by Claisen-Schmidt condensation in a basic medium (potash 5%). The reaction was followed by thin layer chromatography. At the end of the reaction, filtration after cooling of the reaction medium allowed the collection of part of the product that precipitated, while liquid-liquid extraction (water-acetate) allowed to obtain the rest still dissolved. The products obtained were purified by column chromatography using the Hexane/Ethyl Acetate system. The characterization of the products was carried out on the physical properties and also the nuclear magnetic resonances of the proton and carbon 13. The use of isolation media for each of the 04 bacteria studied, namely ENDO, SS, TCBS and BEA agars, permitted the isolation of Escherichia coli, Salmonella typhi, Vibrio cholerae and Streptococcus feacalis, respectively. The microbiological technique for counting bacterial colonies in solid medium, as well as the microdilution in liquid medium allowed the evaluation of the action of the different chalcones. Results: Four O-propargyl vanillinic chalcones 5a-5d were obtained by Claisen Schmidt condensation method with respective yields of 63.6%; 66.7%; 66.7% and 70.0%. The evaluation of their antibacterial activities was done on four strains of bacteria including E. coli, S. typhi, V. cholerae and S. feacalis isolated from wells in the city of Yaoundé. Statistical data from the results of the solid-state bacterial colony counting technique revealed a lack of significance (p > 0.05) with respect to the variation of the mean bacterial abundance as a function of the concentrations of each chalcone (except that of the S. feacalis with respect to compound 5b). The results of the microdilution test showed the lowest MIC values with compound 5d (250 µg/mL), against S. typhi. Chalcones 5c and 5d exhibited better activity on E. coli (MIC value of 500 µg/mL) compared to the reference antibiotic: ampicillin (MIC > 1000 µg/mL). Chalcones 5a and 5b were the least active on all bacteria studied, with MIC values greater than or equal to 1000. Conclusions: The microdilution tests showed an antibacterial activity of the synthesized compounds, with a better activity for the chalcone 5d.

The popularity of doping in competitive sports is relevant for all those involved in sports, particularly for evaluating anti-doping policy measures. However, there is a gap of information that addresses this subject so far. As a consequence, the prevalence of doping in competitive sports in resource limited countries is unknown. Even though it is challenging to uncover the exact prevalence of herbal products with prohibited activity such as doping, various methods put in place by world antidoping agency (WADA) have now been adopted to uncover parts of this particular problem, and enables the circumvention to some extend the issues of honesty, definition problems and the limits of pharmacological evidence. It is evident that current doping control test results can show a distinct underestimation of true doping prevalence in low middle income countries (LMIC). Nowadays, doping is a critical issue at international levels of sporting competitions. Athletes’ use of herbal supplements has seen a significant increase in the past two decades. At the top of the list of popular herbs used in sports are echinacea and ginseng, whereas garlic, St. John’s wort, soybean, ephedra and others are also gaining popularity or have been historically prevalent. Despite the increasing popularity of herbal supplements, recent events have illustrated possible concerns regarding efficacy and safety of herbal supplements usage. Remarkable sports performances at the end of the 20th century raised suspicions about herbal supplement use by athletes, prompting the formation of WADA. With WADA creation it was not long when the deaths of two professional athletes raised concerns that the herbal supplement ephedra, may have contributed to their deaths. These events and others have prompted clinicians and scientists to reexamine and evaluate the role of herbal supplements in competitive sports. This review attempts to give an insight into the use of herbal supplement in doping within the concept of play clean to win clean. An attempt has been made to provide guidance on the efficacy and side effect of most used herbal supplements found in sporting activities, especially in international competitive sports.

Orthodox medical practice depends greatly on the use of high throughput (HTP) pure pharmaceutical new chemical entities, with a purity that can easily be evaluated and whose efficacy and toxicity can show a dose-dependent, clear structure-activity relationships (SAR). On the contrary, natural products contain mixtures of natural bioactive metabolites that have not undergone any chemical analyses and whose mechanism of action is not known. Medicinal mushrooms have been used throughout the history of mankind for the treatment of various diseases including cancer. Nowadays they have been intensively studied and generated research interest in an attempt to reveal the chemical nature and mechanisms of action of their bioactive molecules. Targeted treatment of diseases, non-harmful for healthy tissues, has become a major objective in recent times and metabolites of fungal origin provide a vast reservoir of potential new chemical entities. There are many examples of mushrooms common for use globally that demonstrate the complex nature of their pharmaceutical potential This review paper attempts to show that some aspects of fungotherapy of the disease have been well studied. We also give an insight into the role of mushroom metabolites for treatment of diseases types that are especially susceptible to the fungal treatments.

Orchids are well known for their beautiful exotic flowers, and food-flavoring products which make them a resource of great economic importance in the global horticultural and food industries. In Cameroon, orchids are particularly important for their tubers which are used for food and traditional medicine. Orchids are therefore of considerable economic importance, traded within and across the regions and out of the country. Few research works have reported for these orchids in Cameroon exploring mostly identification and taxonomy. It is therefore the responsibility and duty of the local population to valorize the tubers for national use based on their awareness of the hidden potentials for food and medicine. Many people will have eaten orchids without realizing, due to the countless products in international trade that contain the seeds of artificially propagated Vanilla orchids. However, this legal trade is only one example of orchids being used as ingredients in food and drink. One example is the trade in chikanda, a cake made from the ground tubers of terrestrial orchids and consumed in several countries in Central and East Africa. Another product made from the ground tubers of terrestrial species is salep, which is used as an ingredient in hot drinks and ice cream and consumed mainly in Turkey and neighboring countries. The high exploitation with no biodiversity and conservation strategic plan by indigenes is a call for concern about the sustainability as future existence of these wild edible orchids is highly threatened; reason why orchids are on the international red list. This paper reviews the ethnobotanical and medicinal uses of orchid roots and tubers with a focus on Cameroon. The review highlights some of the areas that require more focus in terms of research and policy interventions, namely identification of all edible orchids, domestication of edible orchids, and trade controls. Focusing on Cameroon, this paper reviews and examines the edible root and tuber orchids developments based on information from some of the work that has been done in Cameroon, the ethnobotanic, ethnopharmacological and medicinal uses of these orchids.

Human genomic diversity has been shaped by both ancient and ongoing challenges from viruses. The current coronavirus disease 2019 (COVID-19) pandemic caused by severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) has had a devastating impact on population health. However, genetic diversity and evolutionary forces impacting host genes related to SARS-CoV-2 infection are not well understood. We investigated global patterns of genetic variation and signatures of natural selection at host genes relevant to SARS-CoV-2 infection (angiotensin converting enzyme 2 [ACE2], transmembrane protease serine 2 [TMPRSS2], dipeptidyl peptidase 4 [DPP4], and lymphocyte antigen 6 complex locus E [LY6E]). We analyzed data from 2,012 ethnically diverse Africans and 15,977 individuals of European and African ancestry with electronic health records and integrated with global data from the 1000 Genomes Project. At ACE2, we identified 41 nonsynonymous variants that were rare in most populations, several of which impact protein function. However, three nonsynonymous variants (rs138390800, rs147311723, and rs145437639) were common among central African hunter-gatherers from Cameroon (minor allele frequency 0.083 to 0.164) and are on haplotypes that exhibit signatures of positive selection. We identify signatures of selection impacting variation at regulatory regions influencing ACE2 expression in multiple African populations. At TMPRSS2, we identified 13 amino acid changes that are adaptive and specific to the human lineage compared with the chimpanzee genome. Genetic variants that are targets of natural selection are associated with clinical phenotypes common in patients with COVID-19. Our study provides insights into global variation at host genes related to SARS-CoV-2 infection, which have been shaped by natural selection in some populations, possibly due to prior viral infections.

Clausen aanisata is used in African traditional medicine to treat a variety of infectious and parasitic diseases. Infectious diseases are a major public health problem especially in developing countries where resistance to commonly used antibiotics is growing exponentially. The objective of this study was to evaluate the antibacterial activity of Clausena anisata on cariogenic and periodonthopatic bacteria. This was a laboratory experimental study using macerated hydroethanolic extracts of the stem and leaves of Clausena anisata in a water-ethanol mixture (30:70) for 48 hours. Phytochemical screening revealed flavonoids, tannins, alkaloids, coumarins, phenols, triterpenes and saponosides, these being more abundant in the leaves. The antibacterial activity of the hydroethanolic extracts was evaluated against different clinically isolated strains of three Gram negative (Aggregatibacter actinomycetemcomitan, Fusobacterium nucleatum and Prevotella intermedia) and two Gram positive (Streptococcus mutans and Latobacillusspp) bacteria. Polyphenols found more in the leaves extract was estimated at 62.8 mgTAE/g against 36.8 mgTAE/g in the stem bark extract. The study revealed that the leaves extract had bactericidal and bacteriostatic activity on isolated strains of Aggregatibacter actinomycetemcomitan and Fusobacterium nucleatum being the most susceptible with MICs of 50 mg/ml whereas the stem bark showed bacteriostatic activity on all isolated strains with Aggregatibacter actinomycetemcomitan being the most susceptible with MIC of 50 mg/ml. The antimicrobial action of the plant could be exploited in formulation of mouth washes and other medications in the management of oral infections like periodontitis and tooth dacay.

The drug discovery and development processes are designed to guarantee that drugs are efficacious, nontoxic and of high standards of quality for human consumption. However, patient’s population with access to drugs at approval is only a fraction of the final target population. Therefore, a thorough understanding of the safety of medicines is generally only achieved after the marketing authorization of the drug, followed by pharmacovigilance or post marketing surveillance. Pharmacovigilance (PHV) is defined by WHO as “the science and activities that deals with the detection, assessment, understanding and prevention of the adverse drug reactions or any other possible drug-related interactions”. Health professionals, patients, drug manufacturers and drug regulatory authorities are therefore highly involved in the practice of PHV. Cameroon imports 95 % of drugs and health care products. Therefore, an effective mastery of the knowledge, attitude and practice of PHV will help to elaborate the development of our pharmacovigilance systems. This paper gives an overview of pharmacovigilance in Cameroon for unlocking the drug development process focusing on the past, present and future.

Breast cancer (BC) is the second most commonly diagnosed cancer worldwide, with an annual incidence of about 1.7 million (11.9%). In Africa and Cameroon, BC accounts for 28% and 33.4% respectively of all cancers, hence it is a health and an economic burden. This study was conducted to investigate the perception and practice of breast self-examination among breast cancer patients, evaluate the pharmacoeconomics of chemotherapy against phyto-therapy and to relate these to the stage of presentation at hospital. A cross-sectional survey was carried out on 75 tradi-practitioners in the North West Region who treat BC and on 85 BC patients who attended the Regional Hospital Bamenda. Pharmacoeconomic analyses were done on the cost of treatment of BC using each of the health interventions. The structured questionnaires had four sections labelled A through D. Section A of both questionnaires demanded background information from the participants such as their location (village), type of community, the date of interview and the consent; Section B demanded demographic characteristics of the participants; Section C was concerned with the management of breast cancer; Section D contained questions whose responses enabled the researcher to calculate the cost of treatment. From the study, 15.3% of respondents knew and practised BSE. The mean delay before presentation for medical evaluation was 10.9 months for those who knew and practiced BSE, the average costs of treating BC by chemotherapy and by phyto-therapy were $3,042 and $1,500 respectively. We conclude that BSE greatly influences the stage of presentation of BCPs at the hospital for consultation, with those who know and practise it having a lower mean delay of presentation at the hospital for treatment. We also conclude that the treatment of breast cancer using plant preparations is apparently less costly than by conventional chemotherapy but with no evidence in the delay of time-to-metastasis.Keywords: Knowledge, pharmacoeconomics, breast cancer, breast self-examination, chemotherapy, phyto-therapy

Background African populations provide a unique opportunity to interrogate host-microbe co-evolution and its impact on adaptive phenotypes due to their genomic, phenotypic, and cultural diversity. We integrate gut microbiome 16S rRNA amplicon and shotgun metagenomic sequence data with quantification of pathogen burden and measures of immune parameters for 575 ethnically diverse Africans from Cameroon. Subjects followed pastoralist, agropastoralist, and hunter-gatherer lifestyles and were compared to an urban US population from Philadelphia. Results We observe significant differences in gut microbiome composition across populations that correlate with subsistence strategy and country. After these, the variable most strongly associated with gut microbiome structure in Cameroonians is the presence of gut parasites. Hunter-gatherers have high frequencies of parasites relative to agropastoralists and pastoralists. Ascaris lumbricoides, Necator americanus, Trichuris trichiura, and Strongyloides stercoralis soil-transmitted helminths (“ANTS” parasites) significantly co-occur, and increased frequency of gut parasites correlates with increased gut microbial diversity. Gut microbiome composition predicts ANTS positivity with 80% accuracy. Colonization with ANTS, in turn, is associated with elevated levels of TH1, TH2, and proinflammatory cytokines, indicating an association with multiple immune mechanisms. The unprecedented size of this dataset allowed interrogation of additional questions—for example, we find that Fulani pastoralists, who consume high levels of milk, possess an enrichment of gut bacteria that catabolize galactose, an end product of lactose metabolism, and of bacteria that metabolize lipids. Conclusions These data document associations of bacterial microbiota and eukaryotic parasites with each other and with host immune responses; each of these is further correlated with subsistence practices.

Background: Dental caries is also known as tooth decay is as a result of the softening of hard dental tissues from factors of multiple origins, with dental plaque bacteria being one of the most important factors. Due to the resistance of microorganisms to common antibiotics, modern medical sciences had been looking for new approaches in the treatment and prevention of oral diseases. Objective: This study aimed to phytochemically characterise, evaluate the antibacterial activity of propolis on bacteria responsible for dental caries. Methodology: This was an experimental study that took place in the Laboratory of Chemistry and Microbiology (Clinque Universities des Montagne (CUM)) of Bangangté between January to April 2018. Chemical screening of the aqueous and hydroethanolic extracts revealed the presence of secondary metabolites namely alkaloids, flavonoids, tannins, coumarins, saponins and terpenes, those being more abundant in the aqueous extract. The content of flavonoids was high. Macro-dilution was used to determine the minimum inhibitory concentrations (MIC) of propolis and Müller Hinton agar was used for obtaining the minimum bactericidal concentrations (MBC) and determination of inhibition diameters of the bacteria. Results: The flavonoid content in the aqueous extract was estimated at 222.85 mg/ml and 18.77 mg/ml for the hydroalcoholic extracts. S mutans and Lactobacillus spp. were isolated from samples collected from caries affected teeth. The aqueous extract of propolis generally generates greater inhibition diameters than that of the hydroalcoholic extract on both lactobacillus and Streptococcus mutans, The MBC of the aqueous extract on S. mutans and Lactobacillus spp. was 50 mg/ml and the MIC was 25 mg/ml. The hydroalcoholic extract did not have MBC on both S. mutans and Lactobacillus spp. However, the MIC of this extract on both bacteria was 50 mg/ml. These antibacterial properties were not statically significant as that of gentamicin. Conclusion: The evaluation of the antibacterial activity of our various extracts by determination of the MIC and MBC revealed that propolis was endowed with inhibitory properties vis-à-vis the growth of most bacterial strains tested: Streptococcus mutans and Lactobacillus spp. all 2 being gram-positive bacteria.

Background Peptic ulcer is a major public health problem that affects about of world rsquo s population It is a disease resulting from an imbalance between gastro protective and aggressive factors of the gastric mucosa The treatment of this disease is usually long expensive and also the difficulty in accessibility of the modern medications to the local population in rural zones Peptic ulcer represent nearly of cases of consultation in the services of gastroenterology in Cameroon This makes poor patients rely on traditional medicine for their health problems The objective of this study was to evaluate the antioxidant properties of secondary metabolites in aqueous extracts of Ficus thonningii Blume tested on Wistar rats Material and methods MDA Catalase Glutathione Pepsin SOD ASAT ALAT Creatinine XO total proteins were quantified using standard techniques Phytochemical screening of plant aqueous extract for secondary metabolites was done Results The extraction yield of the hydro ethanolic extract of the bark of F thonningii Blume was Phytochemical screening The hydro ethanolic extract had the greatest number of secondary metabolites at the end of the phytochemical screening However decoction and infusion extraction produced high level of polyphenol than the other extraction methods Saponins was produced mainly from ethanolic maceration The extract also showed a non significant increase of SOD Catalase and glutathione in the preventive and curative activity A dose dependent significant decrease p lt in MDA p lt in the preventive evaluation Conclusion This study showed that the hydro ethanolic extract of the mixture of the dried bark of Ficus thonningii Blume had a promising antioxidant activity at mg kg The administration of this extract at concentration up to mg kg could have a potential effect of vascular protection and hepatic protection

Redondoviridae is a newly established family of circular Rep-encoding single-stranded (CRESS) DNA viruses found in the human ororespiratory tract. Redondoviruses were previously found in ∼15% of respiratory specimens from U.S. urban subjects; levels were elevated in individuals with periodontitis or critical illness. Here, we report higher redondovirus prevalence in saliva samples: four rural African populations showed 61 to 82% prevalence, and an urban U.S. population showed 32% prevalence. Longitudinal, limiting-dilution single-genome sequencing revealed diverse strains of both redondovirus species (Brisavirus and Vientovirus) in single individuals, persistence over time, and evidence of intergenomic recombination. Computational analysis of viral genomes identified a recombination hot spot associated with a conserved potential DNA stem-loop structure. To assess the possible role of this site in recombination, we carried out in vitro studies which showed that this potential stem-loop was cleaved by the virus-encoded Rep protein. In addition, in reconstructed reactions, a Rep-DNA covalent intermediate was shown to mediate DNA strand transfer at this site. Thus, redondoviruses are highly prevalent in humans, found in individuals on multiple continents, heterogeneous even within individuals and encode a Rep protein implicated in facilitating recombination. IMPORTANCE Redondoviridae is a recently established family of DNA viruses predominantly found in the human respiratory tract and associated with multiple clinical conditions. In this study, we found high redondovirus prevalence in saliva from urban North American individuals and nonindustrialized African populations in Botswana, Cameroon, Ethiopia, and Tanzania. Individuals on both continents harbored both known redondovirus species. Global prevalence of both species suggests that redondoviruses have long been associated with humans but have remained undetected until recently due to their divergent genomes. By sequencing single redondovirus genomes in longitudinally sampled humans, we found that redondoviruses persisted over time within subjects and likely evolve by recombination. The Rep protein encoded by redondoviruses catalyzes multiple reactions in vitro, consistent with a role in mediating DNA replication and recombination. In summary, we identify high redondovirus prevalence in humans across multiple continents, longitudinal heterogeneity and persistence, and potential mechanisms of redondovirus evolution by recombination.

We investigated global patterns of genetic variation and signatures of natural selection at host genes relevant to SARS-CoV-2 infection (ACE2, TMPRSS2, DPP4,andLY6E). We analyzed novel data from 2,012 ethnically diverse Africans and 15,997 individuals of European and African ancestry with electronic health records, and integrated with global data from the 1000GP. AtACE2,we identified 41 non-synonymous variants that were rare in most populations, several of which impact protein function. However, three non-synonymous variants were common among Central African hunter-gatherers from Cameroon and are on haplotypes that exhibit signatures of positive selection. We identify strong signatures of selection impacting variation at regulatory regions influencingACE2expression in multiple African populations. AtTMPRSS2, we identified 13 amino acid changes that are adaptive and specific to the human lineage. Genetic variants that are targets of natural selection are associated with clinical phenotypes common in patients with COVID-19.

Kola nut (Kola nitida, Malvaceae) is one of the nuts consumed for socio-cultural reasons in West Africa sub-region and it has been used in Western African and Anglo-American herbal medicine as an antidepressant. The aim of this study was to evaluate the beneficial and adverse effect of kola nut consumption on the oral cavity. This was a cross sectional survey conducted on Kola nuts consumers using a qualitative in-vitro analytical phyto-chemical screening and microbiological activity testing of the Kola nut samples. One hundred and two volunteers participated in the study that was made up of 66(64.4 %) males and 36(35.3%) of females. Kola nuts consumers had the age of participants ranging between 20 to 60 years and derived from all social classes of the West African community. There was a high prevalence of dental attrition 95(93.3 %), arrested caries 95(93.3 %), and extrinsic stains 91(90 %). The DMFT (Decayed/Missing/Filled Teeth) score was 4.7. The phytochemical screening of Kola nut showed the presence of phenol, tannin, flavonoids, alkaloids, anthocyanin, sterol, and antraquinone. Methanol extracts of Kola nitida showed no activity against the isolates of Candida spp. But there was less activity against Streptococcus spp and an average activity against Actinomycetes and isolate of Lactobacillus spp respectively. Kolanut exhibited some degree of remineralization oral hard tissues, causing esthetic problems (dental staining) and non-carious dental tooth wear (attrition). Kola nut inhibited the growth of cariogenic bacteria and did not inhibit the growth of Candida albicans. Studies on intra-oral activities needs some further investigations to establish its importance to dental oral care. Results showed that extract of Kola nitida had antibacterial effects by inhibiting the growth of cariogenic bacteria of the mouth at certain level of concentration. The poor oral health seeking behaviours of participants were observed as factors contributing to a poor oral hygiene status and consequently the impairment of oral health of the kola nut consumers.

Background With the phase-out of stavudine (d4T), change to first-line regimens with zidovudine (AZT) or tenofovir (TDF) in resource-limited settings (RLS) might increase risks of cross-resistance to nucleos(t) ide reverse transcriptase inhibitors (NRTI). This would restrict the scope of switching to the World Health Organisation (WHO)-recommended standard second-line combinations (SLC) without HIV drug resistance (HIVDR)-testing in routine clinical practice. Methods An observational study was conducted among 101 Cameroonian patients (55.4% male, median [IQR] age 34 [10–41] years) failing first-line antiretroviral therapy (ART) in 2016, and stratified into three groups according to NRTIs exposure: exposure to both thymidine analogues AZT “and” D4T (group-A, n = 55); exposure to both TDF and AZT “or” D4T (group-B, n = 22); exposure solely to D4T (group-C, n = 24). Protease-reverse transcriptase HIVDR was interpreted using the HIVdb penalty scores (≥60: high-resistance; 20–59: intermediate-resistance

Introduction With the exception of breast cancer, gynecologic neoplasms constitute the most common cancers that complicate pregnancy. Pregnancy therefore presents a window of opportunity for all pregnant women who do not take part in routine free cervical cancer screening program to undergo a free voluntary cytological test and human papillomavirus (HPV) DNA testing. This study aimed to determine prevalent HPV genotypes among pregnant women using exfoliated cells from cervical swabs and determine risk factors responsible for the upsurge of cervical precancerous lesions. Methods In a cross-sectional study conducted from October 2017 to March 2018, a total of 482 pregnant women were enrolled. Cervical swabs and samples for cytology were collected from each enrolled participant during their routine prenatal consultation. The Papanicolaou's (Pap) staining technique was performed and all cervical swab samples were amplified through conventional PCR. HPV genotypes were identified using the Roche Linear Array Genotyping Assay. SAS 9.2 software (SAS Institute Inc., USA) was used for statistical analysis and p values >0.05 were considered significant. Results Among the 482 participants, 354 (73.4%) had normal cytology and 128 (26.6%) had abnormal cytology. HPV DNA was identified in 62/464 (13.4%). The most prominent HPV types identified were HPV 16 (24%), HPV 18 (36.4%), HPV 45 (28%), HPV 53 (18.9%) and HPV 67 (24.3%). Early intercourse, number of sexual partners and age at first pregnancy were some of the risk factors that influenced the etiology of preinvasive cervical lesion. Conclusions Prevalent HPV types identified in our study were HPV 16, 18, 45, 53 and 67. Organizing effective screening programs in prenatal care facilities is crucial in order to detect prevalent HR-HPV types and precursors for cervical lesions. The addition of HPV vaccination in the national immunization program with focus on the different epidemiological HPV genotypes circulating in the country is warranted.

BackgroundWith the scale-up of antiretroviral therapy (ART), pre-treatment drug resistance (PDR) appears ≥10% amongst ART-initiators in many developing countries, including Cameroon. Northwest region-Cameroon having the second epidemiological burden of HIV infection, generating data on PDR in these geographical settings, will enhance evidence-based decision-making.ObjectivesWe sought to ascertain levels of PDR and HIV-1 clade dispersal in rural and urban settings, and their potential association with subtype distribution and CD4-staging.MethodsA cross-sectional study was conducted from February to May 2017 among patients recently diagnosed with HIV-infection and initiating ART at the Bamenda regional Hospital (urban setting) and the Mbingo Baptist hospital (rural setting). Protease and reverse transcriptase sequencing was performed using an in-house protocol and pre-treatment drug resistance mutations were interpreted using Stanford HIVdb.v8.3. Phylogeny was performed for subtype assignation.ResultsA total of 61 patient sequences were generated from ART initiators (median age: 37 years old; 57.4% female; median CD4 cell count: 184 [IQR: 35-387] in urban vs. 161 [IQR: 96-322] cells/mm3 in rural). Overall, the level of PDR was 9.8% (6/61). Of note, burden of PDR was almost doubled in urban (12.9% [4/31]) compared to rural setting 6.7% (2/30), p = 0.352). Fifteen (15) PDR mutations were found among four patients the urban settings [6 resistance mutations to NRTIs:[M41L (2), E44D (1), K65R (1), K70E (1), M184V/I (2), K219R (1)] and 6 resistance mutations to NNRTIs: K103N (1), E138A/G (2), V179E (1), M230L (1), K238T (1), P225H (1)] against two (02) mutations found in two patients in the rural setting[2 resistant mutations to NNRTIs: E138A (1) and Y188H (1)]. The rural setting showed more genetic diversity (8 subtypes) than the urban setting (5 subtypes), with CRF02_AG being the most prevalent clade (72.1% [44/61]). Of note, level of PDR was similar between patients infected with CRF02_AG and non-CRF02_AG infected (9.1% [4/44]) vs. 11.8% [2/17]), p = 1.000). Moreover, PDR appeared higher in patients with CD4 cell count ConclusionsPDR is at a moderate rate in the Northwest region of Cameroon, with higher burden within urban populations. CRF02_AG is the most predominant clade in both urban and rural settings. No effect of HIV molecular epidemiology and CD4-staging on the presence of PDR in patients living in these settings was found. Our findings suggest close monitoring, NNRTI-sparing regimens or sequencing for patients initiating ART, especially in urban settings.

African apes are endemically infected with numerous Plasmodium spp. including close relatives of human Plasmodium falciparum, Plasmodium vivax, Plasmodium ovale, and Plasmodium malariae. Although these ape parasites are not believed to pose a zoonotic threat, their ability to colonise humans has not been fully explored. In particular, it remains unknown whether ape parasites are able to initiate exo-erythrocytic replication in human hepatocytes following the bite of an infective mosquito. Since animal studies have shown that liver stage infection can result in the excretion of parasite nucleic acids into the bile, we screened faecal samples from 504 rural Cameroonians for Plasmodium DNA. Using pan-Laverania as well as P. malariae- and P. vivax-specific primer sets, we amplified human P. falciparum (n = 14), P. malariae (n = 1), and P. ovale wallikeri (n = 1) mitochondrial sequences from faecal DNA of 15 individuals. However, despite using an intensified PCR screening approach we failed to detect ape Laverania, ape P. vivax or ape P. malariae parasites in these same subjects. One faecal sample from a hunter-gatherer contained a sequence closely related to the porcupine parasite Plasmodium atheruri. Since this same faecal sample also contained porcupine mitochondrial DNA, but a matching blood sample was Plasmodium-negative, it is likely that this hunter-gatherer consumed Plasmodium-infected bushmeat. Faecal Plasmodium detection was not secondary to intestinal bleeding and/or infection with gastrointestinal parasites, but indicative of blood parasitaemia. Quantitative PCR identified 26-fold more parasite DNA in the blood of faecal Plasmodium-positive than faecal Plasmodium-negative individuals (P = 0.01). However, among blood-positive individuals only 10% - 20% had detectable Plasmodium sequences in their stool. Thus, faecal screening of rural Cameroonians failed to uncover abortive ape Plasmodium infections, but detected infection with human parasites, albeit with reduced sensitivity compared with blood analysis.

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 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 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.

Introduction In Cameroon, a manifold diversity of HIV strains exists with CRF02_AG and unique recombinant forms (URFs) being the predominant strains. In recent years, a steady increase in URFs and clade F2 viruses has been monitored through partial genome sequencing. There is an information gap in the characterization of emerging URFs along the full genome, which is needed to address the challenges URFs pose towards diagnosis, treatment and HIV‐1 vaccine design. Method Eighteen Cameroonian URFs from samples collected between the years 2000 and 2015 were studied using a newly developed near full genome sequencing (NFGS) protocol based on variable nested RT‐PCRs with a versatile primer set. Near full genomes were characterized for recombination patterns and sequence signatures with possible impact on antiretroviral treatment or Env‐directed immune responses. Third‐generation sequencing (3GS) of near full or half genomes (HGs) gave insight into intra‐patient URF diversity. Results The characterized URFs were composed of a broad variety of subtypes and recombinants including A, F, G, CRF01_AE, CRF02_AG and CRF22_01A1. Phylogenetic analysis unveiled dominant CRF02_AG and F2 recombination patterns. 3GS indicated a high intra‐patient URF diversity with up to four distinct viral sub‐populations present in plasma at the same time. URF pol genomic analysis revealed a number of accessory drug resistance mutations (DRMs) in the ART‐naïve participants. Genotypic env analysis suggests CCR5 usage in 14/18 samples and identified deviations at residues, critical for gp120/gp41 interphase and CD4 binding site broadly neutralizing antibodies in more than half of the studied URFs. V1V2 sites of immune pressure in the human RV144 vaccine study varied in more than a third of URFs. Conclusions This study identified novel mosaic patterns in URFs in Cameroon. In line with the regional predominance of CRF_02AG and the increased prevalence of clade F2, prominent CRF_02AG and F2 background patterns were observed underlying the URFs. In the context of the novel mosaic genomes, the impact of the identified accessory DRMs and Env epitope variations on treatment and immune control remains elusive. The evolving diversity of HIV‐1 URFs in Cameroon requires continuous monitoring to respond to the increasing challenges for diagnosis, antiretroviral treatment and prevention.

Introduction: During the last decade, the prevalence of the intestinal carriage of extended spectrum beta-lactamases – producing Escherichia coli (ESBL- E. coli ) has continued to increase worldwide in the community, especially in developing countries. Hence, we undertook a study to determine the ESBL- E. coli fecal carriage rate and the associated risk factors in Cameroonian women. Methodology: A total of 86 women suspected of community-acquired urinary tract infections (UTI) were included in 10 health structures from May 2011 to April 2012. After filling a questionnaire, they provided a stool sample that was plated on selective media for ESBL producing bacteria. The identification of strains was obtained with mass spectrometry and the antibiotic susceptibility by disk diffusion in agar media. The ESBL type was determined by PCR. The relative abundance of ESBL- E. coli was measured for positive samples. Eventually, the presence of antibiotics in stool was assessed. Results: The carriage rate of ESBL- E. coli was 57/86 (66.3%). Phenotypic and molecular characterization showed that all ESBL- E. coli strains contained group 1 CTX-M enzymes. Multivariate analysis showed that ESBL- E. coli fecal carriage was associated with the presence of antibiotics in stools (p < 0.05). Although not significant, mean ESBL relative abundance tended to be higher in patients with antibiotic exposure. Conclusions: Our results show that the carriage of ESBL- E. coli fecal carriage in women with UTI suspicion from the Cameroonian community is extremely high and associated with recent antibiotic intake.

Context Harungana madagascariensis Lam is commonly used in Cameroonian folk medicine for the treatment of malaria and typhoid fever. Objective To investigate the therapeutic potentials of H. madagascariensis aqueous leaf extract for the treatment of salmonellosis ( e.g. typhoid fever, gastroenteritis). Materials and methods A Salmonella Typhimurium-infected rat model was used. The faeces of these rats were analysed for viable Salmonella Typhimurium before and after infection, and during the treatment period. The physiological, biochemical and histopathological markers of possible side effects of the extract were also studied using standard methods and kits. Results and discussion The in vivo antisalmonellal study revealed that this extract significantly ( P Salmonella Typhimurium recovered from faeces, and could stop salmonellosis after 10 days of treatment for male and female rats, with non-toxic doses. However, the biochemical and histological analyses revealed that at relatively high-doses (≥100 mg/kg for females and 200 mg/kg for males) the extract could induce liver damage, as illustrated by a rise of serum transaminases (ALT and AST), significant inflammation of the parenchyma and portal vein, as well as cell necrosis. There were also increases in cholesterol levels in both sexes. No significant unwanted side effect of the extract was observed on the kidney, as shown by both serum and urinary creatinine, and urinary protein levels. Conclusion The results obtained showed that H. madagascariensis has a promising antisalmonellal effect and, therefore, the potential to provide an effective treatment against salmonellosis, including typhoid fever.

Pest management in most sub-Saharan subsistence agriculture involves mainly the use of botanicals that are either applied as powders, solvent extracts, ash or essential oils. Two hydrogenated monoterpenes (&alpha, pinene and 3-carene) from Cupressus sempervirens were tested against Sitophilus zeamais in the laboratory to evaluate the contact and fumigation effects on the mortality of adult and immature weevils, progeny production, and grain damage. Contact toxicity of the terpenes was investigated at these concentrations: 0.08, 4, 8 and 12 ppm (terpene/maize), while fumigant action was studied at the following doses: 1, 2, 3, and 4 ppm. The results indicate that insecticidal effects were concentration-dependent since mortality increased with dosage and exposure periods. After a 14-day exposure period at the concentration of 12 ppm of &alpha, pinene and 3-carene/grain, more than 98% mortality of the mature weevils was observed at concentrations of 4.1333 and 1.642 ppm respectively and progeny production was reduced by 98% and 100%, respectively. When &alpha, pinene and 3-carene were applied as fumigants, LC50s (lethal concentrations that generate 50% mortality) of 1.402 and 0.610 ppm were obtained after 24 h of exposure, respectively. At concentrations above 3 ppm, both monoterpenes acted as repellents to weevils and reduced grain damage by 80%. Both monoterpenes inhibited the development of immature stages of the weevil and reduced progeny by up to 94%. These compounds are very promising and effective and could be exploited as novel phytoinsecticides against the maize weevil.