Catholic University of Cameroon
Bamenda, Cameroon

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Marcellin F.,French Institute of Health and Medical Research | Marcellin F.,Aix - Marseille University | Bonono C.-R.,Catholic University of Cameroon | Blanche J.,French Institute of Health and Medical Research | And 6 more authors.
AIDS | Year: 2010

OBJECTIVE: Cameroon has initiated a national programme of HIV care decentralization providing access to antiretroviral therapy (ART) for patients with CD4 cell counts less than 200 cells/μl or AIDS stage. Current clinical research suggests these criteria may be too stringent. This study aimed at evaluating the effect of not receiving ART on patients'psychosocial outcomes. DESIGN: The national cross-sectional survey EVAL (ANRS 12-116) collected psychosocial and clinical data for 3151 patients attending HIV services (September 2006 to March 2007). METHODS: Propensity score matching was used to control for demographic/clinical-immunological differences between patients receiving ART and those who did not. Generalized linear models were used to assess the impact, for different CD4 cell levels, of "not receiving" ART on health-related quality of life (HRQoL) inconsistent condom use with a sexual partner either serodiscordant or of unknown HIV status, self-reported symptoms and disclosure of HIV status to relatives or friends. RESULTS: Seventy-eight per cent of patients included in the survey were receiving ART. Non-treated patient breakdown was as follows: 8% (CD4<200 or AIDS stage), 5% (200≤CD4≤350) and 8% (CD4>350). In the multivariate matched-pairs analysis, impaired physical HRQoL, more frequent inconsistent condom use, more self-reported symptoms and less frequent disclosure of HIV status were all significantly associated (P < 0.0001) with not receiving ART, irrespective of the CD4 cell level. CONCLUSION: In addition to increasing clinical effectiveness, earlier initiation of ART at less severe immune-depression levels than previously recommended by World Health Organization guidelines for low-resource settings may be justified for improving subjective health and positive prevention among people living with HIV. © 2010 Wolters Kluwer Health | Lippincott Williams & Wilkins.

Boyer S.,French Institute of Health and Medical Research | Boyer S.,Aix - Marseille University | Eboko F.,University of Paris 13 | Camara M.,Catholic University of Cameroon | And 4 more authors.
AIDS | Year: 2010

BACKGROUND: The independent evaluation of the Cameroonian antiretroviral therapy (ART) Programme, which reached one of the highest coverage in the eligible HIV-infected population (58%) in Sub-Saharan Africa, offered the opportunity to assess ART outcomes in the context of the decentralization of HIV care delivery. MATERIALS AND METHODS: A cross-sectional survey (EVAL, ANRS 12-116, 2007) was carried out in a random sample of 3151 HIV-positive patients (response rate 90%) attending 27 treatment centres at the different level of the healthcare delivery (central, provincial and district), as well as in the exhaustive sample of doctors in charge of HIV care in these centres (response rate 92%, n = 97). Multivariate two-level analyses were conducted to assess the impact of the level of healthcare delivery on CD4 cell gains since initiation of treatment and adherence to treatment in the subsample of patients who were ART-treated for 6 months or more (n = 1985). RESULTS: District treatment centres were characterized by more limited technical and human resources but a lower workload. ART-treated patients followed up in these centres had significantly lower socioeconomic status. After adjustment for other explanatory factors, immunological improvement was similar in patients followed up at the central and district level, whereas adherence to ART was better both at provincial and district levels. CONCLUSION: Success in scaling-up access to ART in Cameroon has been facilitated by decentralization of the healthcare system. Long-term sustainability urgently implies better integration of this HIV-targeted programme in the global healthcare reform of financing mechanisms, management of human resources and drug procurement systems. © 2010 Wolters Kluwer Health | Lippincott Williams & Wilkins.

Boyer S.,French Institute of Health and Medical Research | Boyer S.,Aix - Marseille University | Abe C.,Catholic University of Cameroon | Spire B.,French Institute of Health and Medical Research | And 3 more authors.
Current Opinion in HIV and AIDS | Year: 2011

PURPOSE OF REVIEW: Given the lack of evidence on how to best design and implement antiretroviral therapy (ART) scaling-up policies, operational research has seen a surge in interest. There is, however, little published information on the contribution of operational research in ART programs' implementation or in improvement of associated outcomes. The article focuses therefore on how operational research may contribute to such improvements and what the key enabling factors are for its integration into program frameworks. RECENT FINDINGS: One of the most systematic operational research linked to a national ART program on the African continent was conducted in Cameroon between 2006 and 2010. Along with operational research carried out elsewhere in Africa, it helped demonstrate that a strategy of decentralizing HIV care can increase treatment coverage and improve early access to care, while maintaining good clinical outcomes. Multipartnership between local researchers, national authorities, healthcare professionals and the civil society is the key enabling factor for the relevance of operational research and the translation of its results into policy and practice. SUMMARY: In spite of a dramatic increase in access to ART during recent years in low-income countries, the fight against HIV remains a failure in terms of the goal of breaking the pandemic dynamic. Operational research is needed more than ever to face this challenge. © 2011 Lippincott Williams & Wilkins, Inc.

Ndong I.C.,North West University South Africa | Ndong I.C.,Catholic University of Cameroon | Ndong I.C.,University of Yaounde I | Van Reenen M.,North West University South Africa | And 4 more authors.
Malaria Journal | Year: 2014

Results: Analysis revealed that 4,230 febrile patients were received from 2006-2012. Of these febrile cases, 29.30% were confirmed positive. Between 2006 and 2012 confirmed malaria positive cases of those tested fluctuated, dropping from 53.21% in 2006 to 17.20% in 2008; then rising to 35.00% in 2011 and, finally, dropping to 18.2% of those tested in 2012. The prevalence in females and males across all age groups were similar: a slightly higher risk of males to have malaria (OR = 1.08, 95% CI 0.94-1.25) were not practically significant. Of those tested, the 5 to < 15 years and the 1 to < 5 years age groups were the hardest hit by malaria in the area. A practically visible and significant association was observed between the age and gender with regards to the number of malaria positive results (Pearson ×2= 153.675, p < 0.00001, Cramer's V = 0.352). Malaria prevalence exhibited a fluctuating yet declining trend, as observed over the 28 quarters between January, 2006 and December, 2012.Conclusions: The changes to the treatment guidelines appear to result in a declining trend as was observed between 2006 and 2008. However, malaria admissions fluctuated between 2008 and 2012. There is, therefore, a need to step up control efforts of especially the vulnerable groups, such as the very young. © 2014Ndong et al.; licensee BioMed Central Ltd.Background: Malaria is the leading cause of death worldwide. It is urgent to assess the impact of interventions and scaled-up control efforts. Despite reported reduction in malaria prevalence in Africa, the trends in Cameroon are not yet fully understood. The aim of this study was to investigate the trends in malaria admissions among febrile patients seeking treatment over a seven-year period (2006-2012) in an endemic area in Cameroon, hypothesizing a declining trend. This period followed changes in malaria treatment policy. The objectives were to identify possible trends in malaria admissions and to evaluate the impact of changes to treatment guidelines on the prevalence.Methods. Data was collected through consultation and perusal of laboratory and prescription registers of the Mbakong Health Centre. Data analysis was conducted using SPSS and SAS Statistics.

Mungwe J.N.,Polytechnic of Milan | Mungwe J.N.,Catholic University of Cameroon | Colombo E.,Polytechnic of Milan
Proceedings of the 5th IEEE Global Humanitarian Technology Conference, GHTC 2015 | Year: 2015

Over 44 million biogas digesters of several designs are disseminated in Developing Countries (DCs) to improve access to modern energy services to 2.6 billion people who depend on traditional biomass. In terms of numbers this technology seems to be of high performance and any designs could be mass disseminated everywhere in DCs. This paper has two objectives: (i) to present an overview of domestic digesters performance in DCs, (ii) to describe a Decision Making Model (DMM) that is developed to identify the most appropriate digester design for mass dissemination in a particular region. Performances are characterized in terms of functional state, effectiveness in producing biogas, process efficiency and pathogen reduction: 50% of the digesters in DCs are reported in good functional state and 80% provide 3-4 hours of biogas per day. In terms of process efficiency, 58-94% volatile solids degradation is reported, 96% coliform and 99% Escherichia coli are eliminated. The DMM is based on the Analytic Hierarchy Process, the Energy Indicators for Sustainable Development and other performance indicators. It is applied to rural areas of Cameroon to select the digester design among five types. The Nepali GGC2047 design seems to result as the most appropriate for mass dissemination in this country. © 2015 IEEE.

Mungwe J.N.,Polytechnic of Milan | Mungwe J.N.,Catholic University of Cameroon | Colombo E.,Polytechnic of Milan | Adani F.,University of Milan | Schievano A.,University of Milan
Biomass and Bioenergy | Year: 2016

The fixed dome digester design is the most deployed small scale biogas technology in sub-Sahara Africa (SSA). This design is deployed on mono-feedstock-wet anaerobic digestion (WAD) principle. Little or nothing has been reported in the literature on the sustainability in terms of the actual field operation and performance of this design within the SSA context. This study aims at bridging this gap and bringing additional insights to the scientific literature by investigating the sustainability of the Nepali–type fixed dome digester within the context of rural Cameroon. The investigations were evaluated in terms of operating parameters, biogas production, production rate and productivity of the digester. In addition the local investment cost of the design was analyzed. The design was operated on multiple-locally-available feedstock mixed with water at an average of 3:1 ratio resulting in a higher than design TS of 16%. The design, thus was operated towards the dry anaerobic digestion principle, highlighting insufficient mono-feedstock and water scarcity for a sustainable operation of the design within the context of rural SSA. The average biogas production was 1.2 m3 biogas/day, giving average volumetric production rate of 0.16 m3 biogas/m3 digester day−1 and yields of 0.18 m3 biogas/kg VS respectively. This low performance compared with the potential mesophilic biogas production rate of 0.27 m3 biogas/m3 digester day−1 could be linked to insufficient mixing of digester content and low operating temperatures. Gas storage facility (dome), skilled labour and cement made significant contributions to the investment cost of the digester. The Levelized cost of Energy from the digester was less than 1 € cents/MJ. © 2016 Elsevier Ltd

PubMed | University of Yaounde I, Swiss Tropical and Public Health Institute, Ministry of Public Health, Catholic University of Cameroon and University of Buea
Type: Journal Article | Journal: PLoS neglected tropical diseases | Year: 2016

Cameroon achieved the elimination target of leprosy in 2000, and has maintained this status ever since. However, a number of health districts in the country continue to report significant numbers of leprosy cases. The aim of this study was to assess the burden of leprosy in Cameroon from 2000 to 2014.We obtained and analysed using the new leprosy burden concept of analysis, leprosy surveillance data collected between 2000 and 2014 from the National Leprosy Control Programme.Cameroon achieved leprosy elimination in 2000, registering a prevalence rate of 0.94/10,000 population. The prevalence rate dropped further to reach 0.20/10,000 population (78% reduction) in 2014. Similarly, the new case detection rate dropped from 4.88/100,000 population in 2000 to 1.46/100,000 population (85.3% reduction) in 2014. All 10 regions of the country achieved leprosy elimination between 2000 and 2014; however, 10 health districts were still to do so by 2014. The number of high-leprosy-burden regions decreased from 8 in 2000 to 1 in 2014. Seven and two regions were respectively medium and low-burdened at the end of 2014. At the health districts level, 18 remained at the high-leprosy-burdened level in 2014.The leprosy prevalence and detection rates as well as the overall leprosy burden in Cameroon have dropped significantly between 2000 and 2014. However, a good number of health districts remain high-leprosy-burdened. The National Leprosy Control Programme should focus efforts on these health districts in the next coming years in order to further reduce the burden of leprosy in the country.

Boyer S.,French Institute of Health and Medical Research | Boyer S.,Aix - Marseille University | Clerc I.,French Institute of Health and Medical Research | Clerc I.,Aix - Marseille University | And 7 more authors.
Social Science and Medicine | Year: 2011

In low-income countries, health system deficiencies may undermine treatment continuity and adherence to antiretroviral therapy (ART) that are crucial for the success of large-scale public ART programs. In addition to examining the effects of individual characteristics, on non-adherence to ART and treatment interruption behaviors - i.e. treatment interruption for more than 2 consecutive days during the previous 4 weeks, this study aims to extend our knowledge on the role played by healthcare supply-related characteristics in shaping these two treatment outcomes. These effects are examined using multilevel logistic models applied to a sub-sample of 2381 ART-treated patients followed-up in 27 treatment centers in Cameroon (ANRS-EVAL survey, 2006-2007).Multivariate models show that factors common to both non-adherence and treatment interruption include binge drinking (at the individual-level) and large hospital size (at the healthcare supply-level). Among the individual factors, financial difficulties of paying for HIV-care are the major correlates of treatment interruption [Adjusted Odds Ratio (AOR) 95% confidence interval (CI) = 11.73(7.24-19.00)]. By contrast, individual factors associated with an increased risk of non-adherence include: having a main partner but not living in a couple compared to patients living in a couple [AOR(95%CI) = 1.51(1.14-2.01)]; experience of discrimination in the family environment [AOR(95%CI) = 1.74(1.14-2.65)]; a lack of regular meals [AOR(95%CI) = 1.93(1.44-2.57)], and switching antiretroviral drugs (ARV) regimen [AOR(95%CI) = 1.36(1.08-1.70)]. At healthcare facility-level, the main correlate of ART interruption was antiretroviral stock-outs [AOR(95%CI) = 1.76(1.01-3.32)] whereas the lack of psychosocial support from specialized staff and lack of task-shifting to nurses in medical follow-up were both associated with a higher-risk of non-adherence [respective AOR (95%CI) = 2.81(1.13-6.95) and 1.51(1.00-3.40)].Results reveal different patterns of factors for non-adherence and treatment interruption behaviors. They also suggest that psychosocial support interventions targeted at the individual patient-level will not be sufficient to achieve favorable treatment outcomes if not combined with interventions focused on strengthening health systems, including appropriate drug supplies and human resources policies, as well as sustainable and equitable financing mechanisms. © 2011 Elsevier Ltd.

PubMed | Heilongjiang Bayi Agricultural University, South China Agricultural University, Guangdong Academy of Agricultural Sciences and Catholic University of Cameroon
Type: | Journal: Infection, genetics and evolution : journal of molecular epidemiology and evolutionary genetics in infectious diseases | Year: 2016

We previously demonstrated that the survival time of BALB/c mice challenged with Toxoplasma gondii RH strain was prolonged by immunising the mice with a eukaryotic vector expressing the protein ROP16 of T. gondii. Building upon previous findings, we are exploring improved vaccination strategies to enhance protection. In this work, a novel recombinant canine adenovirus type 2 expressing ROP16 (CAV-2-ROP16) of T. gondii was constructed and identified to express ROP16 in Madin-Darby canine kidney cells (MDCK) cells by western blot (WB) and indirect immunofluorescence (IFA) assays. Intramuscular immunisation of BALB/c mice with CAV-2-ROP16 was performed to evaluate the humoral and cellular immune responses. This vaccination triggered significant humoral and cellular responses, including ROP16-stimulated lymphoproliferation (P<0.05). Compared to control groups, the CAV-2-ROP16 immunised mice had high production of IFN-, IL-2 and IL-12 (P<0.05), with a predominance of IgG2a production, but not IL-10 (P>0.05), revealing that a predominant Th1-type response had developed. The cell-mediated cytotoxic activity with high levels of IFN- and TNF- was significantly increased in both CD4

Navti L.K.,Ludwig Maximilians University of Munich | Navti L.K.,Catholic University of Cameroon | Ferrari U.,Ludwig Maximilians University of Munich | Tange E.,Catholic University of Cameroon | And 2 more authors.
BMC Public Health | Year: 2014

Background: The pattern of obesity in relation to socioeconomic status is of public health concern. This study investigates whether the association between height and obesity in children is affected by their socioeconomic background. It also explores the relationship between high birth weight and obesity. Methods. School children, (N = 557; 5 to 12 years old) were recruited from randomly selected primary schools in a cross-sectional study including 173 rural and 384 urban children in the North West Region of Cameroon. Socioeconomic status (SES) and birth weight were obtained using a self administered questionnaire. Anthropometric measures included height, weight, BMI, waist circumference and percentage body fat. These measures were transformed into age and sex-standardized variables. Then participants were divided according to quartiles of height SDS. Results: The highest frequencies of overweight/obesity (18.8%), abdominal overweight/obesity (10.9%) and high body fat/obesity (12.3%) were observed among the tallest children from a high socioeconomic background. Univariate analyses indicate that children of high SES (39.9%), fourth height quartile (33.1%) and of high birth weight (54.8%) were significantly (p < 0.001) more likely to be overweight/obese. Multivariate analyses showed high SES (OR 8.3, 95% CI 3.9 - 15.4), fourth height quartile (OR 9.1, 95% CI 3.4 - 16.7) and high birth weight (OR 0.1, 95% CI 0.06 - 0.2) as independent predictors of overweight/obesity. Conclusions: This study confirms that children coming from a high socioeconomic background and being tall are at particular risk of becoming obese. © 2014 Navti et al.; licensee BioMed Central Ltd.

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