Mortality risk factors among HIV-exposed infants in rural and urban Cameroon.

OBJECTIVES: HIV-exposed infants, including those who do not become infected, have higher morbidity and mortality rates than HIV unexposed infants. The underlying mechanisms of this difference are largely unknown. The objective of this study was to identify the risk factors for mortality among HIV-exposed (infected as well as uninfected) infants in a prevention of mother-to-child transmission (PMTCT) programme in Cameroon. METHODS: We analysed the data from 319 mother-infant pairs included in a PMTCT programme at a rural and an urban hospital between 2004 and 2012. The programme offered free formula feeding, monthly follow-up visits and antiretroviral therapy (ART) according to national PMTCT guidelines. Mother-infant pairs were divided in three study groups, based on year of recruitment and study site: (I) rural hospital, 2004-07; (II) rural hospital, 2008-12; (III) urban hospital, 2008-12. RESULTS: Two hundred and eighty-five medical records were included in the final analysis. Infant mortality rates were 23.9%, 20.0% and 5.3% in group I, II and III, respectively (P = 0.02). Hazard ratios of infant mortality were 6.4 (P < 0.001) for prematurity, 4.6 (P = 0.04) for no maternal use of ARTs, 5.6 (P = 0.025) for mixed feeding, 2.7 for home deliveries (P = 0.087) and 0.4 (P = 0.138) for urban study group. CONCLUSIONS: In this programme, prematurity, no ART use, and the practice of mixed feeding were independent predictors of infant mortality. Mixed feeding and not using ART increased the hazard of death, probably through its increased risk of HIV infection. Although mortality rates were significantly higher in the rural area, rural setting was not a risk factor for infant mortality. These findings may contribute to the development of tailor-made programmes to reduce infant mortality rates among HIV-exposed infants.

Evaluation of HIV and AIDS knowledge in rural Cameroon men with the use of a questionnaire.

INTRODUCTION: HIV/AIDS, the most important health problem in Africa, is the leading cause of death on the continent. Ignorance on HIV/AIDS status will hamper treatment and prevention. To investigate the level of HIV/AIDS knowledge among men in a rural area, we performed a questionnaire study on HIV/AIDS knowledge in men living in Banga Bakundu, a rural village in Cameroon. METHODS: Forty-eight men, aged 17-66 years, were interviewed. They were divided in 2 groups: ≤ 29 years, being those young enough to be able to have knowledge about HIV/AIDS at the time of their first sexual contact, and those > 29 years who weren't. A semi-structured clinical interview was performed to obtain information about socio-demographic characteristics, sexual activity, knowledge about HIV/AIDS and its prevention. RESULTS: There is an overall good HIV/AIDS knowledge and what should be done about it. Men with a higher level of education and more HIV/AIDS knowledge seem to take less preventive measures. The differentiation per age group showed that age influenced the data on knowledge and behaviour. CONCLUSION: Our data are consistent with other studies. Remarkable is the difference in HIV/AIDS knowledge between the 2 age groups, and the relation between HIV/AIDS knowledge and sexual habits and prevention. Sufficient HIV/AIDS knowledge did not lead to significant changes in sexual behaviour. The questionnaire showed to provide sufficient information and was easy to use. Further research should be performed.