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Introduction. Antimicrobial resistance represents a growing public health threat. One of the World Health Organization’s strategic objectives is “strengthening knowledge through surveillance and research.” Sub-Saharan African countries are still far from achieving this objective. We aimed to estimate and compare the prevalence of antibacterial resistance in 2010 and 2017 in Cameroon. Methods. We conducted a retrospective study on all clinical specimens cultured in Centre Pasteur du Cameroun (CPC) in 2010 and 2017. Data were extracted from the CPC’s laboratory data information system software and then managed and analyzed using R. Bacterial resistance rates were calculated in each year and compared using chi-square or Fisher’s tests, and relative changes were calculated. Outcomes included acquired resistance (AR), WHO priority resistant pathogens, some specific resistances of clinical interest, and resistance patterns (multi, extensively, and pan drug resistances) for five selected pathogens. Results. A total of 10,218 isolates were analyzed. The overall AR rate was 96.0% (95% CI: 95.4–96.6). Most of WHO priority bacterial resistance rates increased from 2010 to 2017. The most marked increases expressed as relative changes concerned imipenem-resistant Acinetobacter (6.2% vs. 21.6%, +248.4%, p = 0.02 ), imipenem-resistant Pseudomonas aeruginosa (13.5% vs. 23.5%, +74.1%, p < 0.01 ), 3rd generation-resistant Enterobacteriaceae (23.8% vs. 40.4%, +65.8%, p < 10 − 15 ), methicillin-resistant Staphylococcus aureus (27.3% vs. 46.0%, +68.6%, p < 0.002 ), fluoroquinolone-resistant Salmonella (3.9% vs. 9.5%, +142.9%, p = 0.03 ), and fluoroquinolone-resistant Enterobacteriaceae (32.6% vs. 54.0%, +65.8%, p < 10 − 15 ). For selected pathogens, global multidrug resistance was high in 2010 and 2017 (74.9% vs. 78.0% +4.1%, p = 0.01 ), intensively drug resistance rate was 5.8% (7.0% vs. 4.7%; p = 0.07 ), and no pan drug resistance has been identified. Conclusion. Bacterial resistance to antibiotics of clinical relevance in Cameroon was high and appeared to increase between 2010 and 2017. There is a need for regular surveillance of antibacterial resistance to inform public health strategies and empirically inform prescription practices.

International audience; Cameroon is thought to have one of the highest prevalences of hepatitis C virus (HCV) infection in the world (4.9% among adults). A marked cohort effect exists in several communities where approximate to 50% of the elderly are infected. Better assessment of HCV distribution is needed for planning treatment programmes. We tested for HCV antibodies 14150 capillary blood samples collected during the 2011 Demographic and Health Survey, whose participants were representative of the Cameroonian population aged 15-49 (both genders) and 50-59years (men only). Historical data on exposure to medical care were collected and factors associated with HCV assessed through logistic regression and geospatial analyses. To estimate prevalence in all persons aged 15years, we used data from the survey for the 15-59years fraction and modelled a cohort effect for older individuals. The nationwide HCV prevalence was 0.81% for the 15-49years group, and 2.51% for all individuals aged 15years. Only 0.2% of individuals aged 15-19 were seropositive. Among participants aged 15-44years, HCV was associated with age, rural residence and, for males, with ritual circumcision. For those aged 45-59years, HCV was associated with age and access to medical care in the late 1950s. Prevalence of HCV seropositivity in Cameroon is half of previous estimates. Nationwide surveys are essential to rationalize resources allocation. The high prevalence among older cohorts, a colonial legacy, has had little spillover into younger cohorts. HCV-free generations might be attainable in countries not plagued with intravenous drug abuse.

International audience; As a follow-up to the first AfroREB (Africa Rabies Expert Bureau) meeting, held in Grand-Bassam (Côte-d'Ivoire) in March 2008, African rabies experts of the Afro-REB network met a second time to complete the evaluation of the rabies situation in Africa and define specific action plans. About forty French speaking rabies specialists from Northern, Western and Central Africa and Madagascar met in Dakar (Senegal), from March 16th to 19th, 2009. With the participation of delegates from Tunisia, who joined the AfroREB network this year, 15 French speaking African countries were represented. Experts from the Institut Pasteur in Paris, the Alliance for Rabies Control, and the Southern and Eastern African Rabies Group (SEARG, a network of rabies experts from 19 English speaking Southern and Eastern African countries) were in attendance, to participate in the discussion and share their experiences. AfroREB members documented 146 known human rabies cases in all represented countries combined for 2008, for a total population of 209.3 million, or an incidence of 0.07 cases per 100,000 people. Even admitting that the experts do not have access to all reported cases, this is far from the WHO estimation of 2 rabies deaths per 100,000 people in urban areas and 3.6 per 100,000 in rural Africa. It was unanimously agreed that the priority is to break the vicious cycle of indifference and lack of information which is the main barrier to human rabies prevention.; Le Bureau des experts de la rage du continent africain (AfroREB) s’est réuni pour la seconde fois, en mars 2009, pour poursuivre leur évaluation de la situation de la rage en Afrique et définir des plans d’action. Une quarantaine d’éminents spécialistes de la rage venant de 15 pays d’Afrique francophone se sont retrouvés à Dakar avec des représentants de l’Institut Pasteur de Paris, du réseau anglophone SEARG (groupe de spécialistes de la rage d’Afrique australe et orientale) et de l’Alliance mondiale contre la rage. En Afrique, de nombreux cas de rage ne sont ni identifiés ni rapportés. Alors que l’OMS estime à 25 000 le nombre de décès annuels dus à la rage sur ce continent (2 à 3,6 décès pour 100 000 habitants), les membres d’AfroREB ont comptabilisé, en tout et pour tout, en 2008, 146 cas pour leurs 15 pays, soit 0,07 cas pour 100 000 habitants. La priorité est de briser le cercle vicieux de l’indifférence et du manque d’information, afin de pouvoir lutter contre la rage humaine.

The aim of the study was to describe the morbidity and mortality of gynaecological laparoscopy in a pilot center of Cameroon. It was a monocentric retrospective study over a period of seven years. All files of patients who had laparoscopic surgery in the service were reviewed. Files with incomplete information were excluded. Complications were defined as an event that had modified the usual cause of the procedure or of the postoperative period. They were classified as surgical complications (during insertion of Veress needle and trocarts, intraoperative and postoperative complications) also reorganised as major and minor complications and anaesthetic complications. The rate of laparoconconversion was noted. The data of 609 patients was gathered and examined. Their mean age was 31.57 (19-63years). The mean parity and gestity was 0.77 and 1.82, respectively. The common findings in their past history were sexually transmitted infection (39.9%), criminal abortions (35.03%) and previous surgery (39.1%). Infertility was the main indication of the surgery (76.3%) followed by postmyomectomy adhesiolysis (15%). The main operative findings were adhesions (78.16%). The mortality rate is 0.16%. The surgical morbidity rate is 2.46% with 0.99% of complications during insertion of Veress needle and trocarts and 1.48% during surgery. Among these complications, 1.8% were minor complications and 0.66%, major ones. Five patients had complications due to anaesthesia (0.82%). Postoperative complications (8.3%) were of low gravity and were mainly digestive, infectious and moderate vaginal bleeding. The rate of laparoconversion was 2.46%, mainly due to difficulties during surgery. This study shows that operative gynaecologic laparoscopy is associated with acceptable mortality and morbidity rate in our milieu.

Uterine fibroids are the most common benign tumor seen in women at reproductive age. The association of pregnancy and uterine fibroids is about 0.5 to 4%.In order to evaluate the complications of this association in our milieu, we carried out this prospective study. The main objective was to compare the incidence of complications of pregnancy and delivery in two groups of women: group 1 (women with uterine fibroids) and group 2 (women without fibroids). They were matched (ratio 1/1) on women age (plus or minus one), gestational age, gravidity (plus or minus one) and parity.Eighty patients in each group 1 were recruited. The mean age was 31.2 years in group 1 and 30.8 years in group 2. Degeneration of fibroids occurred in 15% of cases. The incidence of threatened abortion (51.3% versus 18.8%; RR: 2.7 [1.7-4.5]; p=0.00002), threaten premature delivery (26.3% versus 10%; RR: 2.6 [1.2-5.6]; p=0.008), premature delivery (22.5% versus 7.9%; RR: 2.9 [1.2-6.9]), tocolytic treatment (48.8% versus 20.0%; RR: 2.4 [1.5-4.0]; p=0.0001) and Caesarean section (40% versus 13.8%; RR: 3.1 [1.6-5.9]; p=0.0001) were significantly increased in group 1 than in group 2. We also noticed a moderate increased of the incidence of abortions (11.3% versus 5%; RR: 2.3 [0.7-7.0]), breech presentation (11.3% versus 5%; p=0.3); however, the difference was not statistically significant in two groups.We concluded that pregnancy in women with uterine fibroids is a high-risk pregnancy and needs a particular follow-up.

Bleach sputum concentration and fluorescence microscopy (FM) are reportedly more sensitive than direct Ziehl-Neelsen (ZN) sputum smears for tuberculosis detection, and might be particularly valuable for human immunodeficiency virus (HIV)-positive patients excreting fewer bacilli. This study, implemented in Yaoundé, Cameroon, determined the yield from both direct and bleach-concentrated FM and ZN duplicate smears against culture on Löwenstein-Jensen medium, with HIV testing from the sputa. From 418 HIV-positive and 518 HIV-negative tuberculosis suspects, 185 (44.3%) and 243 (46.9%) cultures, respectively, grew Mycobacterium tuberculosis. Direct ZN was positive for, respectively, 87 (47.0%) and 202 (83.1%) of the culture-positive cases. Proportional incremental yield over direct ZN from ZN and FM bleach smears was 14.9% (P < 10(-3)) and 17.2% (P < 10(-4)) for HIV-positive versus 4.9% (P < 10(-2)) and 2.0% (non-significant) for HIV-negative cases. There was no gain from direct FM. Bleach FM showed 2% excess false positives. The bleach concentration, therefore, increases the yield of ZN and FM, particularly from HIV-positive patients, but with a higher risk for false positives with bleach FM. With excellent baseline direct ZN, the gain remains modest. Field studies under real-life conditions are needed to determine whether it is worth the risks and operational challenges in HIV high-prevalence populations. FM was not more sensitive than ZN in this study, probably because of sub-optimal objective power and background staining. Culture on solid media with sparing laurylsulfate decontamination was clearly superior for HIV-positives, but it remains to be seen if culture also leads to more cases started on treatment routinely.