Rationale:Approximately 20 years ago, studies conducted in the city of Bouaké revealed a high level of malaria transmission, primarily due to the Anopheles gambiae vector increasing during the rainy season. The National Malaria Control Program implemented control efforts involving the distribution of long-lasting insecticidal nets (LLINs). However, the political and military crisis from 2002 to 2011 caused many residents to leave the city, leaving the natural environment largely undisturbed. The subsequent return of the population to Bouaké necessitated implementing new LLIN-based control programs. New research studies are needed to collect data on malaria transmission parameters. This study is conducted within this context. The objective is to assess vector-borne malaria transmission by determining entomological parameters in the city's three health districts. Materials and methods:Investigations were conducted in urban areas during the rainy season from June 10 to 29, 2016, in Bouaké's three health districts (Northwest, Northeast, and South). Mosquitoes were collected from human-biting samples and identified. We examined the feeding behavior of female vectors and estimated the entomological parameters of malaria transmission. We determined the physiological age of the female vectors by dissecting their ovaries and detected mosquitoes infected with Plasmodium falciparum using the ELISA-CSP test. Results:Only the malaria vector species An. gambiae was collected. The species exhibited a tendency toward endophagy and had an average parturition rate exceeding 90% in all districts. Aggressive densities of the species were 3.6, 15.5, and 14.4 bites/ person/night (b/p/n) in the Northwest, Northeast, and South districts, respectively. The infection rates were 4.2%, 2.9%, and 1.9% in the Northwest, Northeast, and South districts, respectively, with entomological inoculation rates of 0.15, 0.45, and 0.22 b/p/n. Conclusion:Malaria transmission occurs in all three districts of Bouaké, with levels twice as high in the Northeast District. This transmission is carried out by the An. gambiae species, which exhibited a tendency toward endophagous feeding at all sites.
Background:Long-lasting insecticidal nets (LLINs) are widely used in sub-Saharan Africa to reduce the transmission of malaria. Their operational lifespan under field conditions depends on many factors. This article presents some of the factors associated with the decline in LLIN efficacy in urban and rural settings in Kribi, southern Cameroon. Methods:This study, conducted in 2019, aimed to evaluate the usage and residual efficacy of the nets against two strains of Anopheles gambiae s.l.: a local strain with an unknown insecticide susceptibility status and a sensitive reference laboratory strain. Results:A total of 540 households were surveyed. LLIN coverage was similar in rural (69.0%) and urban (68.6%) areas. The proportion of children under five years of age using LLINs was comparable in both settings (88.6%: 651/735). PermaNet 2.0 nets were more degraded than other brands in rural areas, while Yorkool nets were more degraded in urban areas. Mortality rates for the Kisumu strain ranged from 21.6% to 99.6% for LLINs that had been washed more than 20 times, and from 0.8% to 76.5% for the wild-type strain. Those washed with bar soap retained their lethal properties better than those washed with harsh detergents. Similarly, nets dried in the shade retained their lethal properties better than nets hung out in the sun. Conclusion:The study population used MILDAs, especially for children. The fiber composition of the nets, the type of detergent used, and exposure to sunlight are factors that influence the insecticidal efficacy of the nets.
Introduction:Screening for multidrug-resistant pulmonary tuberculosis (MDR-PTB) by using the Xpert MTB/ RIF test to detect rifampicin resistance as a surrogate marker for this form of tuberculosis may lead to suboptimal treatment if resistance to other drugs in the treatment regimen is not also determined. The objective of this study was to analyze the patterns of drug resistance to anti-tuberculosis drugs in patients with rifampicin-resistant pulmonary tuberculosis (RR-PTB) who were treated with the standardized 9-11-month regimen in Yaoundé, Cameroon. Materials and methods:This retrospective, cross-sectional study examined the results of anti-tuberculosis drug susceptibility tests in RR-PTB patients who received the standardized 9-11-month treatment regimen at the specialized MDR-PTB treatment center of the Jamot Hospital in Yaoundé from 2013 to 2022. Results:A total of 322 RR-PTB patients were included in the study. Of these, 281 (87.3%) were resistant to at least one of the tested drugs. The pattern of resistance was 43.2% for one drug, 41.6% for two drugs, and 2.5% for three or more drugs. Resistance to isoniazid was the most common (87.3%), followed by ethambutol (42.2%), fluoroquinolones (3.4%), and amikacin (1.9%). Discussion – Conclusion:The majority of RR-PTB patients in Yaoundé had MDR-PTB, and pre-extensively drug-resistant TB was rare. However, the GeneXpert-based strategy for identifying drug-resistant cases (which detects only rifampicin resistance) could lead to the initiation of suboptimal treatment for a non-negligible proportion of patients in our setting. This could result in the amplification of resistance and the transmission of increasingly resistant strains within the community. We recommend that the National Tuberculosis Control Program (NTCP) of Cameroon should adopt and rapidly roll out the new short-course treatment regimen recommended by the World Health Organization given the lack of rapid tests in our country capable of detecting resistance to the various drugs used in the standard 9-11-month regimen.
Introduction:Burkina Faso ranks among the African countries with high maternal mortality rates, with a ratio of 198 per 100,000 live births. Maternal health remains a major concern in this country. Several factors contribute to this mortality rate. Our study aimed to identify factors associated with maternal deaths at Tengandogo University Hospital, a referral hospital in Burkina Faso. Methods:This was a retrospective case-control study. We selected records pertaining to women admitted to the maternity and intensive care units between January 1, 2017, and December 31, 2022. The cases included all women admitted for a pregnancy-related complication who subsequently died. The control group was randomly selected from women admitted for childbirth and/ or pregnancy-related complications during the study period who did not die during pregnancy or within 42 days after delivery. Our sample consisted of one case for every two controls. Logistic regression was used to identify associated factors. Results:A total of 146 deaths were recorded, but 124 cases (22 records were unusable) and 248 controls were analyzed. The indoor maternal mortality ratio was 1,960 per 100,000 live births (146/7,450). The mean age of the women who died was 28.5 ± 7.1 years. Of those women, 73 (58.9%) lived in rural areas, 109 (87.9%) were unemployed, 118 (84.7%) were referred from a primary or secondary health facility, 106 (89.1%) were transported by ambulance, 67 (54%) were multiparous, and 68 (57.1%) delivered vaginally. Preeclampsia/eclampsia was present in 15% of the women and retroplacental hematoma (RPH) was present in 13%. The factors independently associated with maternal death were RPH (OR = 4.6, 95% CI [1.6-12.7]), ambulance transport (OR = 3.8, 95% CI [1.9-7.9]), and vaginal delivery (OR = 2.6, 95% CI [1.5-4.5]). Conclusion:The indoor maternal mortality rate is high. It is necessary to strengthen obstetricians' skills in the early detection of RPH and hemorrhage management. Improving the ability to detect complications during prenatal care and labor and delivery is also essential for better obstetric decision-making. The Ministry of Health should ensure adequate conditions for patient evacuation.
