COVID-19 perceptions and vaccine hesitancy: Acceptance, attitude, and barriers among Cameroonians.

BACKGROUND: Information about Cameroonians' views toward coronavirus disease 2019 (COVID-19) and amenability to receiving a vaccine is emerging. Learning more about Cameroonians' vaccine perspectives could guide prevention messaging and facilitate optimal communication modalities. OBJECTIVES: The primary objective of this study was to analyze the willingness to receive a COVID-19 vaccine among Cameroonians, pending availability. The secondary objectives were to assess perceptions of COVID-19's origin and to gauge views toward government-mandated vaccinations. METHODS: An 11-item questionnaire queried Cameroonians in-person and online, from March through May 2021, about their demographics and whether they believed that COVID-19 was man-made, whether COVID-19 vaccinations should be governmentally mandated, and whether they would receive a COVID-19 vaccine, if available. A free-text option inviting rationales for COVID-19 vaccine hesitancy was included. In-person participation took place on the grounds of St. Louis University in Douala, Cameroon, and was restricted to participants lacking Internet access or electronic mobile devices. Online participation included use of an electronic link that contained questionnaire content located within Google Forms. RESULTS: A total of 591 respondents participated by replying to at least 8 items on the questionnaire, 386 online and 205 in-person. Over 80% stated that they previously received a seasonal influenza vaccine. Roughly, 87% reported unwillingness to receive a COVID-19 vaccine, if available. Approximately 95% of respondents disagreed with governmental mandates on COVID-19 vaccinations. About 75% attributed COVID-19 to man-made as opposed to natural beginnings. Seven respondents' free-text comments cited lacking confidence in a COVID-19 vaccine, discriminatory COVID-19 vaccine distribution patterns in other parts of the world relative to Africa, and improper COVID-19 vaccine approval timeline. CONCLUSION: Raising awareness of COVID-19 misconceptions and barriers to vaccine acceptance is integral to accomplishing immunization goals. Cameroonians' pessimism in this study toward COVID-19 vaccination was multifaceted. Our findings signal a need for additional research that requests more qualitative insights, for example, interviews, focus groups, into vaccine aversion.

Knowledge, attitude, and adherence to malaria control guidelines and the prevalence of Plasmodium species infection in localities across transmission and ecological zones in Cameroon.

Background: Despite a scale up of control interventions over the years, malaria remains a major public health and economic concern in Cameroon, contributing considerably to hospitalization and deaths. The effectiveness of control strategies depends on the extent of adherence by the population to national guidelines. This study assessed the influence of human knowledge, attitudes, and practices related to malaria and its control on the prevalence of malaria parasite infection, with implications for the elimination of the disease. Methodology: This is a cross-sectional community and hospital-based study, covering the five ecological and three malaria transmission zones in Cameroon. A pre-tested semi-structured questionnaire was used to document socio-demographic and clinical parameters as well as knowledge, attitudes, and practices toward malaria control and management. Consenting participants were screened for malaria parasite with rapid diagnostic test (mRDT) of the peripheral blood. Association between qualitative variables was determined using the chi-square test and logistic regression analysis. Results: A total of 3,360 participants were enrolled, 45.0% (1,513) of whom were mRDT positive, with 14.0% (451/3,216) and 29.6% (951/3,216) having asymptomatic parasitaemia and malaria, respectively. Although most participants knew the cause, symptoms, and control strategies, with 53.6% (1,000/1,867) expertly knowledgeable about malaria overall, only 0.1% (2/1,763) individuals were fully adherent to malaria control measures. Conclusion: The risk of malaria in Cameroon remains high, with the population considerably knowledgeable about the disease but poorly adherent to national malaria control guidelines. Concerted and more effective strategies aimed at improving knowledge about malaria and adherences to control interventions are necessary to ultimately eliminate the disease.

Awareness of and willingness to use HIV pre-exposure prophylaxis among community residents.

INTRODUCTION: Human Immunodeficiency Virus (HIV) Pre-exposure prophylaxis (PrEP) helps to decrease HIV acquisition and transmission rates. The purpose of this study was to assess awareness of HIV PrEP and willingness to use it, if available, among individuals residing in Buea, Cameroon. METHODS: Residents in different communities throughout Buea, Cameroon participated in the study through survey completion with their responses assessed by age, marital status, highest level of education completed, profession, and health area (urban or rural). RESULTS: 421 participants completed the survey with the majority being 20-29 years of age, single, having secondary or tertiary education, residing in rural Cameroonian areas. Eighty percent of respondents had not previously heard of HIV PrEP. Ninety-five percent of the study sample expressed willingness to use HIV PrEP, if available. Participants ages 40 years old and above were less aware of HIV PrEP than those 39 years old and younger. Primary education, serving in the role of a nurse, doctor, or scientist, along with hospital affiliations were characteristics closely associated with HIV PrEP awareness. Participants younger than 20 years old were less likely to report willingness to use HIV PrEP whereas married participants found HIV PrEP to be a more favorable option. CONCLUSIONS: Awareness of HIV PrEP was minimal with healthcare personnel having more familiarity. Willingness to use HIV PrEP decreased by age but higher among married participants. Further promotion of HIV PrEP and facilitating its accessibility can lead to less transmissions of HIV worldwide.

Malaria Perceptions among Medicine Vendors in Buea Community: An Assessment of Knowledge of Malaria and Conditions of Antimalarial Drug Dispensing.

BACKGROUND: Lack of knowledge of rational use of antimalarial drugs among medicine vendors is a serious problem, notably in areas of intense transmission. These misunderstandings increase the risks of resistance and adverse drug reactions. This study aimed to assess knowledge of malaria and environments wherein medicine vendors dispense antimalarials in the Buea community. METHODS: Administration of a community-based cross-sectional survey of a random sample of 140 medicine vendors living within the Buea community occurred between March and June 2017. The survey sought to obtain information from medicine vendors on their general knowledge of malaria as well as their dispensing practices. Statistically significant findings were associated with p ≤ .05. RESULTS: The majority of participants were aware that use of insecticide - treated bed nets (ITNs) and maintenance of a clean environment equate to effective malaria prevention efforts. Alternatively, only one-third of participants correctly attributed the causative organism of malaria to being protozoan. Participants employed within drugstore settings had less knowledge of malaria than their hospital/community counterparts did. A directly proportional relationship existed between the amount of experience that participants had in their respective disciplines with an increased knowledge of malaria overall. CONCLUSION: These findings reveal fluctuating knowledge of malaria among study participants. Reported antimalarial dispensing practices also warrants room for improvement. Routine monitoring and evaluation to prevent emergence of resistant strains to current efficacious antimalarials remains paramount.

In Vivo Efficacy of Artesunate/Sulphadoxine-Pyrimethamine versus Artesunate/Amodiaquine in the Treatment of Uncomplicated P. falciparium Malaria in Children around the Slope of Mount Cameroon: A Randomized Controlled Trial.

BACKGROUND: The development and spread of antimalarial drug resistant parasites contributes to the global impact of the disease. In vivo efficacy assessments of treatments for Plasmodium falciparum malaria are essential for ensuring effective case management. Artemisinin-based combinations have been adopted as the first-line treatment for uncomplicated P. falciparum malaria in Cameroon since 2004. METHODS: A total of 177 children aged six-months to 10 years with uncomplicated mono-infected falciparum malaria were randomized (1:1) to receive artesunate/sulphadoxine-pyrimethamine (AS/SP) or artesunate/amodiaquine (AS/AQ) pediatric tablets and followed up for 28 days according to the standard World Health Organization in vivo drug efficacy monitoring protocol. The primary and secondary endpoints were PCR uncorrected and corrected cure rates, as measured by adequate clinical and parasitological response (ACPR) on day 28. RESULTS: The PCR corrected cure rate was high, overall (88.1%, 95% CI 83.1-93.1), 85.9% (95% CI 78.2-93.6), and 90.2% (95% CI 83.8-96.6) for AS/SP and AS/AQ, respectively. Twenty-one treatment failures were observed during follow-up, constituting one (4.6%), 14 (8.2%), and six (3.5%) early treatment failure (ETF), late clinical failure (LCF), and late parasitological failure (LPF), respectively. The drugs were well tolerated with no serious adverse events. CONCLUSIONS: Both AS/SP and AS/AQ are highly effective and well-tolerated treatments for uncomplicated P. falciparum malaria around the slope of Mount Cameroon.