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This chapter highlights a high rate of water crisis across sub-Saharan Africa (SSA) despite its huge hydro-potential. Factors contributing to water stress include rainfall deficit and drought, increased water requirements, population growth, urbanization, and poverty. Coupled with the uneven distribution of water resources and mismanagement of water facilities, the gap between the demand for water and available supply has deepened. This has led almost half of the SSA population to drink water from unprotected sources. Moreover, many millions travel far distances and spend several hours daily to collect water. Children and women are mainly involved in water collection. The growing scarcity of water in Africa has a negative impact on economic growth. Besides, water shortages are at the heart of many social crises in SSA and have become directly or indirectly the first cause of death in Africa linked to waterborne diseases. The prevailing water-related diseases include malaria, typhoid fever, cholera, poliomyelitis, etc. To attain the African agenda 2063, national governments in SSA need a multidisciplinary approach integrating, supervising informal settlements of the population in urban and peri-urban areas; improving water storage capacity; increasing irrigation potential for agriculture; and having a good understanding of the epidemiology of waterborne diseases.

One of the crucial public health problems today is emerging and re-emerging of multidrug-resistant bacterial pathogens coupled with a decline in the development of new antimicrobials. Non-typhoidal Salmonella is classified among the multidrug-resistant bacterial pathogens of international concern. To predict their multidrug resistance potentials, 19 assembled genomes (partial genomes) of 23 non-typhoidal Salmonella isolated at the Yaounde abattoir between December 2014 and November 2015 from live cattle (n=1), beef carcass (n=19), butchers’ hands (n=1) and the beef processing environments (n=2) were explored using whole-genome sequencing. Phenotypically, while approximately 22% (n=5) of Salmonella isolates showed moderate resistance to streptomycin, 13.04 % (n=3) were multidrug-resistant. Genotypically, all the Salmonella isolates possessed high multidrug resistance potentials against several classes of antibiotics (third-generation cephalosporin and fluoroquinolone), which are assigned highest priority drugs by the World Health Organization. Moreover, more than 31% of the isolates exhibited resistance potentials to polymyxin, considered as the last resort drug with both clinical and veterinary relevance. Additionally, close to 80% of non-typhoidal Salmonella isolates in this study harboured ‘‘silent resistant genes’’ and thus constituted potential reservoirs of antibiotic resistance to other foodborne bacteria. Plasmids also appear to play a critical role in the horizontal transfer of antibiotic resistance genes of some isolates. The isolates showed a high degree of pathogenicity and possessed key effector proteins to establish infection in their hosts, including humans. The overall results demand prudent use of antibiotics and constant monitoring of antimicrobial resistance of non-typhoidal Salmonella in the Cameroonian abattoirs.Author summaryNon-typhoidal Salmonella has been classified among the multidrug resistant bacterial pathogens of international concern. A growing resistance to a broad range of antibacterial compounds in animals and clinical settings has been reported in Non-Typhoidal Salmonella. Current knowledge of their antibiotic resistance profile is essential to inform policy decisions for the choice of appropriate management of invasive salmonellosis. The significance of our research consists in predicting the multidrug resistance, pathogenicity and virulence potentials of Salmonella organisms using whole genome sequencing. This unveils the need for the development of a diagnostic model that takes into account the genotype–phenotype antibacterial resistance profile of Salmonella, which is of both clinical and veterinary relevance.

Nsimeyong (Damas), one of the residential areas of Yaounde, Capital city of Cameroon experiences water shortages making residents rely on other sources of water including streams, springs, boreholes and wells. Water samples were aseptically collected from the processing plants and from five sites of Nsimeyong area. This study was aimed at assessing suspected heavy metals and coliforms of water collected from fifteen alternative water supply sources in this area. Heavy metals (Pb and Cd) were determined using an Atomic Absorption Spectrophotometer. The International Organization for Standardization (ISO) 9308-2:1990b last reviewed and confirmed in 2017 was used to determine the Most Probable Number (MPN) of total coliforms by the five-tube MPN table. The presence of presumptive E. coli was confirmed on Sugar, Indole, and Motility (SIM) media at 44⁰C and by the addition of Kovac's reagent to tryptone water. Water samples showed higher concentrations of Pb beyond the maximum permissible level (0.1mg/l). With the exception of processed tap water at home, all other alternative sources of water used in Damas registered Cd above the World Health Organization recommendation (0.03mg/l). Unlike Cd (p = 0.0001), the difference among Pb content of water samples at the collection sites was not statistically significant (p = 0.1416). More than 66% of water samples (of which closed to 39% were open wells) had MPN value for total coliform beyond the permissible level (

Objective The objective of this systematic review is to synthesize and present the best available evidence on community perceptions and practices relating to trachoma in Africa. Introduction Globally, trachoma is the leading cause of blindness and is responsible for about 1.4% of all cases of blindness. The African continent is the worst affected, with about 1.9 million cases of trichiasis (61%). While interventions are currently being implemented to combat the disease in Africa, very little is known by decision makers about community perceptions and practices relating to trachoma, which may hinder successful implementation. Inclusion criteria Studies with participants, regardless of their health status, gender, religion and ethnicity, aged 14 and over conducted in any African country, will be considered. Studies on Africans, conducted out of the continent and those involving healthcare professionals, will not be included in this review. Methods Qualitative studies, published in English from 1996 onwards. will be considered. Databases to be searched will include, but not be limited to: PubMed, CINAHL, Embase and PsycINFO. Study selection, critical appraisal and data extraction will be conducted by two independent reviewers, using the appropriate JBI methodology and any disagreement will be resolved by discussion or with a third reviewer. Qualitative findings will be synthesized using the appropriate JBI methodology, following the meta-aggregation approach. Where textual pooling is not possible, the findings will be presented in narrative form. The ConQual approach will be used to grade synthesized findings, and these will be presented in a Summary of Findings.

BACKGROUND: Epilepsy is a global public health problem affecting people of all ages, sex, races, nations and social class. The majority of the 50 million people with epilepsy live in developing countries, with a prevalence rate of five to 10 people per 1000. The disease poses an enormous psychological, social and economic burden on patients. An estimated 90% of people with epilepsy in developing countries do not receive treatment due to sociocultural, economic and political factors. Current treatment interventions are limited to the clinical management of the disease and are largely driven by the healthcare provider's perspective, ignoring the experiences of people living with epilepsy (PLWE). Objective: The aim of this review was to identify, critically appraise, extract, synthesize and present the best and most current available evidence on the experiences of PLWE in developing countries. Review questions: • What are the experiences of PLWE regarding the causes of their condition? • What are the experiences of PLWE regarding treatment of epilepsy? • How has epilepsy shaped the social relationships of the affected persons? Inclusion criteria: Types of participants People living with epilepsy in developing countries (Africa, Asia, Eastern Europe and Latin America). Types of intervention(s)/phenomena of interest The experiences of PLWE in developing countries with particular attention on the causes, treatment and its impact on their social relationships. Types of studies Primary research studies with a qualitative design not limited to phenomenology, ethnography, grounded theory, ethnomethodology, phenomenography, critical theory, interpretative or feminist analysis, case study, narrative studies and action research. Context: Qualitative studies conducted in hospitals and community settings in developing countries. Search strategy: A three-step search strategy was used to identify published and unpublished studies in the English language from the 1990s to the present. Methodological quality: Identified studies that met the inclusion criteria were retrieved and critically appraised by two independent reviewers prior to their inclusion using the Joanna Briggs Institute Qualitative Assessment and Review Instrument (JBI-QARI). Data extraction: Data were extracted from included papers using the recommended data extraction form embedded in the JBI-QARI. Data synthesis: Findings, where possible, were pooled using the JBI-QARI. It involved the meta-aggregation of findings to generate a set of statements that represented that aggregation, through assembling the findings rated according to their quality, and categorizing these findings on the basis of similarity in meaning. Results: From the 13 studies included in the review, 113 findings were extracted to create categories. Eight categories were created from which three synthesized findings were produced. The synthesized findings were: Synthesized finding 1: People living with epilepsy believed that the disease was caused by factors such as fever, demonic power, beatings, witchcraft, curses and God. Patients also had differing views as to whether the disease was contagious or hereditary. They indicated that the disease manifested as seizures, triggered by fever, stress, depression and anger. Synthesized finding 2: People living with epilepsy used biomedical and traditional methods to treat epilepsy and also developed strategies for coping with the disease beyond seeking treatment. Synthesized finding 3: People living with epilepsy had negative and positive experiences in their social relationships. The negative experiences were linked to the social, psychological and economic burden of the disease on patients, whereas the social support they got from friends, peers, family and community members were the positive aspects. Conclusion: People living with epilepsy attribute the cause of the disease to agents like fever, demonic power and witchcraft. Patients use biomedical and traditional methods to treat the disease and have also developed various coping strategies (like prayers and concealment) alongside treatment. Epilepsy has negative effects on the social relationships of patients and is a social, psychological and economic burden for patients. However, there are some positive effects like the social support they receive from family members, friends and the community. © 2016 by Lippincott williams & Wilkins, Inc. Language: en

What are the experiences of women living with infertility in Africa?

REVIEW QUESTION/OBJECTIVE The aim of this review is to synthesize the best available evidence on the perceptions of blood donation among people living in Africa.

Review Question What are the experiences of women and young girls (adolescents) who suffer from OF in developing countries? Specific Review Questions 1. What are the experiences of women and young girls regarding interventions for OF? 2. What are the experience of women and young girls regarding social relationships? Criteria for considering studies for this review Types of participants /populations This review will consider studies with focus on the social, cultural and consequences on women and young adolescents of child bearing age suffering from OF. Consideration will also be given to studies from developing countries such as Latin America, Asia and Africa. Phenomena of interest This review will consider studies that focus on the experiences of women and young adolescent girls who suffer with OF. The experiences may consider but are not limited to support, management, surgical intervention and social relationships. Anticipated outcomes The aim of this review is to present a comprehensive synthesis of the experiences of women and young girls who have both been victims of and/or are living with OF. This review will aim to identify themes / categories that relate to the perspectives of women and adolescents girls.

Review Objective This review seeks to generate the best available synthesized findings that will guide practice and policy to incorporate patients perspective in the management of BU in Africa. Specific review questions 1. What are the experiences of people regarding the etiology, prevention and treatment of BU in Africa? 2. How does infection and disability from BU shape social relationships between affected persons and the community in which they live? Objective This review is out to present the best available evidence about the experiences of persons infected and disabled from BU in Africa. Specifically, this review seeks to present the most current evidence regarding: 1. People’s experiences about BU 2. The impact of infection and disabilities from BU on social relationships. Criteria for considering studies for this review Participants This review will consider primary research on African countries and will include children, adolescence and adults of both sexes who have been infected and disabled from BU. Phenomena of interest The phenomena of interest will be the subjective experiences of persons infected and disabled from BU regarding the disease and its impact on social relationships. Context The context for this review will be Africa. The reason being that although BU has been identified in some parts of Australia3, it is most common, and has a very heavy burden in Africa. This implies that studies out of Africa will be excluded. The review will consider people’s experiences both within the community and in clinical settings (hospitals).

The aim of this study was to isolate compounds from Cameroonian propolis extracts and to test their antibacterial activities against bacteria isolated from carcass at the Yaound� slaughterhouse. The n-hexane, ethyl acetate and ethanol extracts of propolis samples from Ngaoundal and Tala-Mokolo were separated by successive silica gel column chromatography to give six triterpenes. Their structures were determined as 25-cyclopropyl-3β-hydroxyurs-12-ene (7), cycloart-3β-hydroxy-12, 25(26)-diene (8), lup-20(29)-en-3-one (9), olean-12-en-3β, 28-diol (10), lup-20(29)-en-3β-oate (13) and 3β-hydroxylup-20(29)-ene (14). Compounds 7 and 8 were new triterpene derivatives while 10 and 13 were isolated for the first time from propolis. The structures of all the compounds were established on the basis of spectroscopic analysis. Phytochemical screening of the methanol extract (5) revealed the presence of alkaloids, reducing compounds, coumarins, saponins and tannins accounting for its broad spectrum antibacterial activities. The six isolated compounds and crude extracts were tested for antimicrobial activity against some Gram negative bacteria. The methanol extract (5) of propolis samples was active against Escherichia coli and Pseudomonas aeruginosa (MIC: 0.2 mg/ml) whereas the isolated compounds 7, 8 and 10 exclusively exhibited antimicrobial activity against Salmonellas pp (MIC: 0.1-0.15 mg/ml). The MIC values of all the four propolis products were greater than that of the standard drug (Amoxicillin): 0.1-0.2 mg/ml versus 0.4 mg/ml. Nevertheless, further pharmacological and toxicity studies on experimental animals are necessary to establish the safety of the propolis products for its use as topical antimicrobial agents.

This study compared body composition estimates using deuterium dilution, multiple-frequency bioelectrical impedance analysis (BIA), and skinfold thickness techniques in a group of Cameroonian lactating women.Body fat, fat-free mass, and total body water in 44 Cameroonian lactating women (2.63 ± 1.31 mo postpartum) were assessed by deuterium dilution, the Siri or black-specific derived Durnin-Womerley equation, and 12 BIA-prediction equations developed in samples of subjects of white, black, black-and-white, or unspecified racial background, respectively.Compared with deuterium dilution, anthropometry and BIA-based predictive equations overestimated body fat by 2.7 to 11.7 kg; thus, fat-free mass and total body water were underestimated. In all cases, the significant biases resulted in large 95% limits of agreement, yielding unacceptable potential bias at the level of the individual. However, the exclusion of suprailiac skinfold in the calculation, yielding to non-significant (P0.05) bias, improved the prediction of body composition in Cameroonian lactating women using the Durnin-Womersley and Siri equations.It is essential to adjust the Durnin-Womersley equation before using it in the Siri equation for the prediction of body composition in lactating women. Further development and cross-validation of prediction equations from BIA specific to lactating women is needed.