Burnout syndrome and associated factors among university teaching staff in Cameroon: Effect of the practice of sport and physical activities and leisures.

OBJECTIVES: This study aimed to evaluate the epidemiology of burnout syndrome among university teaching staff in Cameroon; and to establish if the practice of physical activities and leisures could have preventive effect. METHODS: A cross-sectional study using a self-administered questionnaire on socio-demographic characteristics, socio-professional conditions, Maslach Burnout Inventory-Educator Survey (MBI-ES) to evaluate burnout syndrome, and Ricci-Gagnon metrics to assess level of physical activities practice among grades of teaching staff, in the various faculties of the University of Douala, Cameroon. RESULTS: Three hundreds and three teaching staff members aged 43±7 years were included (69% males). The prevalence of burnout syndrome was 68%, distributed within the three dimensions as follows: emotional exhaustion (15.2%), depersonalization (32.1%) and loss of personal accomplishment (22.1%), with 57% low level, 38% moderate and 6% severe. Burnout affected respectively 55.4% lecturers, 38.3% senior lecturers and 6.3% professors. Burnout was significantly associated with poor working conditions (P=0.0001), unsatisfactory salary (P=0.0001), part time teaching in private university institutions (P=0.027), sensation of strenuous job (P=0.002), conflict with colleagues (P=0.028), sedentariness (P=0.007). Sport and physical activities showed significant protective effect against burnout (P=0.004), the same with leisures (P=0.016). CONCLUSION: The prevalence burnout syndrome is high among university teaching staff in Cameroon. The practice of sport and physical activities and leisures has a protective effect against burnout syndrome.

[Burnout syndrome among generalist medical doctors of Douala region (Cameroon): Can physical activities be a protective factor?] / Syndrome de burnout chez les médecins généralistes de la région de Douala (Cameroun) : les activités physiques peuvent-elles être un facteur protecteur ?

BACKGROUND: This study aimed to evaluate and document the importance of Burnout syndrome among generalist medical doctors (GMD) since no investigation have been carried in Cameroon. METHODS: Cross-sectional study including 85 GMD using a self-administered questionnaire on socio-demographic characteristics, socioprofessional conditions, Maslach Burnout Inventory - Human Services Survey (MBI-HSS) to evaluate burnout, and Ricci-Gagnon physical activities level metrics. RESULTS: 77 GMD (90.6 %) reported having never heard about burnout. Mean age was 29 years (range 24-42 years). The MBI-HSS revealed that 36 GMD (42.4 %) were victims of burnout, with 27 (31.8 %) at a low level, 8 (9.4 %) moderate and one (1.2 %) severe. Burnout was associated with distance from home to job place (p ⟨ 0.05), strenuous job (p = 0.04), number of children in charge (p = 0.007), number of hospital attended (p = 0.003), number of hours of labor per day (p = 0.0001), conflicts with the hierarchy (p = 0.01), number of guards per month (p = 0.01). Physical activities practice did not showed significant preventive effect on burnout (p = 0.3) (Odds-ratio = 1.45, IC 95 % 0.6, 3.45). CONCLUSIONS: Burnout syndrome is not well known among GMD in Douala, though having a high prevalence. Various socio-demographic and socio-professional factors are associated and contribute to increase the level of affect. Burnout seems to be a vicious somato-psycho-somatic disorder. This study did not found a protective or preventive effect of physical activities on burnout.

BUT: Le but de cette étude était d'évaluer et documenter l'importance du syndrome de burnout parmi les médecins généralistes (MG), dans un contexte d'une absence totale de données sur cette affection au Cameroun. METHODES: Etude transversale incluant 85 médecins généralistes, à l'aide d'un questionnaire auto-administré sur les caractéristiques sociodémographiques, les conditions socioprofessionnelles, le Maslach Burnout Inventory - Human Services Survey (MBI-HSS) pour évaluer le burnout et le questionnaire de Ricci-Gagnon pour déterminer le niveau des activités physiques. RESULTATS: 77 MG (90,6 %) ont déclaré n'avoir jamais entendu parler du burnout. L'âge variait de 24 à 42 ans. Le MBI-HSS a révélé que 36 (42,4 %) étaient victimes du burnout, dont 27 (31,8 %) à un niveau faible, 8 (9,4 %) modéré et 1 (1,2 %) sévère. Le burnout était associé à la distance domicile-lieu de travail (p ⟨ 0,05), à la charge du travail (p = 0,04), au nombre d'enfants à charge (p = 0,007), au nombre d'hôpitaux de consultation (p = 0,003), au nombre d'heures de travail par jour (p = 0,0001), aux conflits avec la hiérarchie (p = 0,01), au nombre de gardes par mois (p = 0,01). La pratique des activités physiques n'a pas montré un effet préventif significatif sur le burnout (p = 0,3) (odds-ratio = 1,45, IC 95 % 0,6, 3,45). CONCLUSIONS: Bien qu'ayant une prévalence élevée, le burnout n'est pas bien connu parmi les MG à Douala. Divers facteurs sociodémographiques et socio-professionnels sont associés et contribuent à augmenter le niveau de l'affection. Le burnout semble être un trouble somato-psycho-somatique vicieux.

[Distribution and ecology of the Savannah human African trypanosomiasis vectors in disturbed forest zone in south Cameroon: about case in the Doumé forest]. / Distribution et écologie des vecteurs de la trypanosomose humaine africaine de type savanicole en zone de forêt dégradée au sud Cameroun: cas du foyer de Doumé.

Vector control through trapping in the foci of humid forest areas is rather difficult because of the wide spreading of tsetse flies and transmission sites of human African trypanosomiasis. In fact, traps should be a priori set up everywhere to stop the transmission. The identification of the disease transmission sites enables efficient trapping through localisation of dangerous tsetse flies habitats needing vector control measures. The study of adult tsetse flies and teneral tsetse flies spatial distribution and human vector contacts was conducted in Doumb to determine the transmission of human African trypanosomiasis for efficient vector control. Glossina fuscipes fuscipes was the only tsetse fly captured with a very low apparent density of 0.13 tsetse flies per trap and per day. Furthermore, the disease transmission in the focus was not found uniform. In fact, human vector contacts are high in two villages (Paki and Mendin) located in the highly disturbed forest zones. These contacts occur in humid shallows where teneral tsetse flies were only captured around streams and forest galleries. The Doumé focus presents therefore characteristics of savannah focus where river banks and nearby biotopes are the main target sites for vector control campaigns.

Distribution of the members of Anopheles gambiae and pyrethroid knock-down resistance gene (kdr) in Guinea-Bissau, West Africa.

An entomological survey conducted in 2002 in Guinea Bissau aimed i) to study the distribution of the members of Anopheles gambiae Giles complex (Diptera: Culicidae) throughout four ecological areas extended from mangrove to savannah ii) to evaluate the insecticide susceptibility status of these malaria vectors exposed to permethrin 0.75% and DDT4%, and finally iii) to investigate the occurrence and the spread of the Leu-Phe knock down resistance (kdr) gene associated with pyrethroid and DDT resistance within these vector populations. Adult female mosquitoes issued from indoor morning collections were tested using WHO procedures, test kits and impregnated papers to assess their insecticide susceptibility status. Tested specimens were identified by PCR assays and characterized for the kdr gene. Malaria vectors were mainly dominated elsewhere by An. gambiae s.s. (both S and M molecular forms) living in sympatry with low proportion of An. melas in the littoral. An. gambiae s.s. tested populations were fully susceptible both to permethrin 0.75% and to DDT 4% irrespective to their location and ecotypes. The Leu-Phe kdr mutation was detected at low frequency only in two sites respectively urban (Bissau) and Guinea-savannah (Gabu) areas. It occurred only in the S molecular form in Gabu (at the frequency of 0.14) and both in the S and M molecular forms in Bissau at the frequency of 0.06 and 0.02 respectively. These results suggested that the populations of An. gambiae s.s., the most frequent malaria vector in Guinea Bissau, still remain cross-susceptible to pyrethroids and DDT This susceptibility status and the frequency of resistance mechanism such as the kdr mutation must be monitored in the future particularly in the urban and savannah areas with continuous and intensive use of insecticides.

Étude des accidents électriques d'origine professionnelle à Yaoundé.

The frequency of work-related electrical injuries has dropped but their characteristics remain unknown in our country. This survey aimed to describe the work-related electrical injuries that occurred in Yaounde during the period 2005-2014. The study was carried out in Yaounde-based central level hospitals from February 1st, 2015 to May 10th, 2015. Data from the files of the victims of these accidents were collated and analyzed. Socio-demographic, professional and epidemiological data were described and results were presented in descriptive mode. The sample comprised 25 males (83.3%) and 5 females (16.7%). The mean age was 28±8.3 years. Three out of four victims were working in the informal sector. Accidents were caused by low voltage current (56.7%). The victims were usually electricians and electrical workers (24%). Accidents occurred at various locations, such as in workshops and in the yard and at different times of the day. We recommend that specific training sessions targeting these workers of the informal sector be organized in order to prevent these dangerous accidents.

The epidemiology of Plasmodium falciparum malaria in two Cameroonian villages: Simbok and Etoa.

In support of ongoing immunologic studies on immunity to Plasmodium falciparum, demographic, entomologic, parasitologic, and clinical studies were conducted in two Cameroonian villages located 3 km apart. Simbok (population = 907) has pools of water present year round that provide breeding sites for Anopheles gambiae, whereas Etoa (population = 485) has swampy areas that dry up annually in which A. funestus breed. Results showed that individuals in Simbok receive an estimated 1.9 and 1.2 infectious bites per night in the wet and dry season, respectively, whereas individuals in Etoa receive 2.4 and 0.4 infectious bites per night, respectively. Although transmission patterns differ, the rate of acquisition of immunity to malaria appears to be similar in both villages. A prevalence of 50-75% was found in children < 10 years old, variable levels in children 11-15 years old, and 31% in adults. Thus, as reported in other parts of Africa, individuals exposed to continuous transmission of P. falciparum slowly acquired significant, but not complete, immunity.

Importance of low dispersion of Anopheles gambiae (Diptera: Culicidae) on malaria transmission in hilly towns in south Cameroon.

The dispersion of Anopheles gambiae Giles s.l. from larval breeding places was examined in the towns of Yaounde and Edea, Cameroon. The study areas are characterized by hilly reliefs of approximately 40 m and by larval breeding places in the swampy valleys. Mosquito density was estimated by night-biting indoor catches carried out during 1 yr in three districts, with four collecting houses in each, along a transect from 0 (at the valley bottom) to 350 m (at the hilltop). In each district, the human-biting rate decreased gradually from valley bottom to hilltop. In two districts, the observed densities were zero at 200 and 250 m from breeding places. In the third district where the habitat is less dense, there was a 50% reduction in biting mosquitoes at 350 m from valley bottom. Our studies confirm that dense habitat in the urban area is associated with a low degree of vector dispersion. It emphasizes that slope is another factor which limits dispersion. These findings explain why malaria transmission is heterogenous (range, 0-45 infective bites per man per year) inside the districts and occurs mainly around swamps in the valleys. These data are important when considering the uncontrolled urbanization which is occurring in the undeveloped areas in the valleys.

[Anopheles species and the transmission of malaria in the forest/savannah transition zone in central Cameroon]. / La faune anophélienne et la transmission du paludisme dans une zone de transition forêt/savane au centre du Cameroun.

A longitudinal study on malaria vectors and transmission was carried out in a forest-savannah transitional area in Cameroon. Indoor all night mosquito collections on human bait were performed during one year in two villages: Nditam and Ngoume. Nditam was located in a secondary forest block surrounded by savannah, while Ngoume was situated in an ancient forest block. The results showed that at Nditam, only one anopheline species was collected, that was Anopheles gambiae s.l.. The average daily biting rate was 2.4 bites per man per night. The sporozoitic index of An. gambiae was 9.4%. The entomological inoculation rate was therefore estimated at 0.225 infective bite per man per night that is to say 82 infective bites per man per year. Malaria transmission was low during the year, but an important increase was observed in September, when the rainfall was at its peak. At Ngoume, no Anopheles mosquito was collected. Therefore, malaria transmission was not observed in that village.

[Malaria in the village of Yaounde (Cameroon). 3. Parasitological study in 2 central districts]. / Le paludisme dans la ville de Yaoundé (Cameroun). 3. Etude parasitologique dans deux quartiers centraux.

A parasitological study of malaria was carried out in two central districts of Yaounde (Cameroon) for one year. The Essos district was built near marshy shallows. The Obili district was comparable to Essos but there were many poorly maintained fish breeding pounds. Surveys were carried out quarterly in each district with a sample of 22 and 16 families at Essos and Obili respectively. The whole members of the families were examined. The study showed that the plasmodic index cumulated for the two districts was 25.4 +/- 2.7% (n = 960). The gametocytic index was 1.7 +/- 0.8% and the parasitic density was 310 parasites/microliters of blood. A significative difference in the plasmodic index was observed between the two districts: 28.7 +/- 3.6% (n = 592) in Essos and 20.1 +/- 4.1% (n = 368) in Obili (p < 0.02). The plasmodic index was higher in the 6 to 15 age group (37.5%) but the higher parasitic density was observed in the 0 to 5 age group (1,100 parasites/microliters of blood). Seasonal variations were noticed with the higher indexes in small dry season and the lower indexes in the big dry season.

[Malaria in Yaounde (Cameroon). Cost and antivectorial control at the family level]. / Le paludisme-maladie dans la ville de Yaoundé (Cameroun). Prise en charge et lutte antivectorielle au niveau familial.

In order to evaluate the financial charges of antivector control and disease at family level for "malaria disease" as perceived by Yaounde inhabitants, the authors carried out a transverse survey on a representative sample of populations derived from sampling surveys at different degrees. Malaria, so defined, represents a dominating endemic for which the yearly financial effort consented by each family amounts to 57,000 FCFA which represents medical care and entailed services as well as the purchase of chemicals for antivector control. The development of more efficient therapeutic behaviours and promotion of greater use of remanent insecticide impregnated bed nets comes in first in setting up training programmes aimed at health personnels and populations who are under their responsibility.

[Levels of malaria transmission: methods and parameters]. / L'évaluation des niveaux de transmission palustre: méthodologies et paramètres.

Evaluation of malaria transmission levels is necessary to compare ecologically diverse areas and to assess the effectiveness of efforts to control the disease. The purpose of this report is to describe useful techniques for descriptive epidemiology and potentially pertinent indicators regarding the three links in the epidemiological chain: transmission from mosquito to man, transmission from man to mosquito, and sporogonic cycle. Standards for evaluation of transmission from mosquito to man are now well established. Techniques and resulting data, mostly entomological, have been validated in numerous multicenter and multidiscipline studies before and after implementation of control measurements. Evaluation of transmission from man to mosquito has not yet been extensively studied. Gametocyte index does not appear to be a good indicator of infectivity in mosquitoes. Two other parameters that have been proposed in the literature are rate of human infectivity to mosquitoes and probability that a bloodmeal will be infectious. However these evaluation techniques have been neither subjected to comparative study nor validated in epidemiological surveys. The third factor for evaluation of malaria transmission levels involves sexual development of the gametocytes (sporogonic cycle) in the vector. Two indicators that might be useful in this regard are quantification of early-stage parasites in the stomach of the mosquito and study of blood factors in subjects in whom inhibition transmission has been documented. Since these methods have been used only sporadically, further study will be needed to validate this approach to evaluate transmission level.

[The application of parasitologic tests for malaria in health centers in southern Cameroon]. / La pratique de l'examen parasitologique du paludisme dans les formations sanitaires au sud du Cameroun.

The correct diagnosis of malaria requires a parasitological blood examination. A survey has been carried out in rural and urban health centers of the Center Province in Cameroon to evaluate the practical use of thick smears for the diagnosis of malaria. A total of 28 health centers were visited (17 government health centers and 11 belonging to Christian missions). None of the 17 government health centers had all the materials necessary to prepare blood smears (slides, vaccinostyles, cotton, reagents for staining, microscope, immersion oil). Ten out of 11 laboratories of the missions health did so. The abilities of the microscopist were tested by using 2 thick smears, one with 2 or 3 trophozoïtes of Plasmodium falciparum per field, the other being negative. Six out of 24 microscopists failed to give a correct diagnosis. This survey shows the need to improve laboratory equipment in public health centers and for regular training of microscopists.

[Effectiveness of coils and mats for protection against malaria vectors in Cameroon]. / Efficacité des serpentins et des diffuseurs en plaquettes dans la protection contre les vecteurs du paludisme au Cameroun.

The evaluation of the effectiveness of coils and mats on mosquitoes, especially malaria vectors was carried out in the Southern Cameroon. The study was performed in the Nsimalen village from November 1993 to August 1994. Two brands of coils: Timor and Moon Tiger containing 0.15% W/W of esbiothrin and two brands of mats: ARS MATS (containing d-allethrin) and Moon Tiger (with S biothrin and diethyl-toluamide) were tested. The evaluation was based on night catches on human bait inside houses. A catcher was sitting at two meters of a coil or a mat. Mosquitoes were caught during five consecutive nights per month in five houses. Two of the five houses were protected with the coils, two others with the mats and the fifth was used as control. Each night, coils and mats were rotated in such a way that at the end of the five nights, each house has been protected twice with coils, twice with mats and had served once as control. The composition of the mosquito samples collected was analysed and the reduction rate of bites was calculated for each method. A thousand and twenty nine mosquitoes were caught in all. Two hundred and fifty nine mosquitoes in houses with coils, 180 in those with mats and 590 in the houses which served as control. Anopheles moucheti and Mansonia s.p. accounted more than 90% of the samples; Anopheles gambiae s.s. represented 4 to 9%. Coils reduced malaria vectors bites by 82.8% and mats by 90.5%. Mansonia bites were reduced by 66% only.(ABSTRACT TRUNCATED AT 250 WORDS)

Experimental investigation and modelling of tritium washout by precipitation in the area of the nuclear power plant of Paks, Hungary.

Tritium occurs in nature in trace amounts, but its concentration is changing due to natural and artificial sources. Studies focusing on natural tritium have to take into account the effect of artificial sources. Also, the impact of tritium is an important issue in environmental protection, e.g. in connection with the emissions from nuclear power plants. The present work focuses on the rain washout of tritium emitted from the Paks nuclear power plant in Hungary. Rainwater collectors were placed around the plant and after a period of precipitation, rainwater was collected and analysed for tritium content. Samples were analysed using low-level liquid scintillation counting, with some also subject to the more accurate (3)He ingrowth method. The results clearly show the trace of the tritium plume emitted from the plant; however, values are only about one order of magnitude higher than environmental background levels. A washout model was devised to estimate the distribution of tritium around the plant. The model gives slightly higher concentrations than those measured in the field, but in general the agreement is satisfactory. The modelled values demonstrate that the effect of the plant on rainwater tritium levels is negligible over a distance of some kilometres.

Exploiting the potential of vector control for disease prevention.

Although vector control has proven highly effective in preventing disease transmission, it is not being used to its full potential, thereby depriving disadvantaged populations of the benefits of well tried and tested methods. Following the discovery of synthetic residual insecticides in the 1940s, large-scale programmes succeeded in bringing many of the important vector-borne diseases under control. By the late 1960s, most vector-borne diseases--with the exception of malaria in Africa--were no longer considered to be of primary public health importance. The result was that control programmes lapsed, resources dwindled, and specialists in vector control disappeared from public health units. Within two decades, many important vector-borne diseases had re-emerged or spread to new areas. The time has come to restore vector control to its key role in the prevention of disease transmission, albeit with an increased emphasis on multiple measures, whether pesticide-based or involving environmental modification, and with a strengthened managerial and operational capacity. Integrated vector management provides a sound conceptual framework for deployment of cost-effective and sustainable methods of vector control. This approach allows for full consideration of the complex determinants of disease transmission, including local disease ecology, the role of human activity in increasing risks of disease transmission, and the socioeconomic conditions of affected communities.

Vector-control synergies, between 'roll back malaria' and the Global Programme to Eliminate Lymphatic Filariasis, in the African region.

The perspectives and opportunities for controlling the mosquito vectors of Wuchereria bancrofti in tropical Africa are summarized and discussed. The countries covered by the World Health Organization's African Region have about one third of the world's burden of lymphatic filariasis (LF) as well as large shares of the planet's malaria and of many other vector-borne diseases. African LF is entirely caused by nocturnally periodic W. bancrofti, filarial nematode that is transmitted in urban East Africa by Culex quinquefasciatus, and in rural areas across tropical Africa by the same anopheline species that transmit the Plasmodium spp. causing human malaria. The standard practices for controlling the vectors of malarial parasites - house-spraying with residual insecticides and the use of bednets (preferably pre-treated with insecticide) for personal and community protection - can be simultaneously effective against both LF and malaria. Although mass drug administrations remain the main stay of the current strategy for LF elimination, the vector-control activities of the 'Roll Back Malaria' campaign can be expected to reduce the transmission of W. bancrofti in co-endemic areas. The relevant issues of programme management and integrated vector control are briefly reviewed.

Malaria vectors and transmission in an area deforested for a new international airport in southern Cameroon.

Nsimalen, a village in Southern Cameroon, has been deforested over a surface of 370 hectares for the construction of the new Yaounde international airport (Cameroon). Mosquitoes night catches on human bait were performed over a year in two hamlets of this village, one adjoining the airport and the other situated 3 kilometers off the deforested area. The aim of the survey was to observe malaria vectors and transmission around the airport and to record malaria epidemiological changes resulting from deforestation. The findings showed that the main malaria vector was Anopheles moucheti (95% of the vector population). Anopheles gambiae was also present but in very small quantities. The increased density of the latter near the airport combined with the low parity rates, indicated that deforestation favoured the breeding of this species. Malaria transmission was estimated at 106 and 68 infective bites per man per year in hamlets close to and far away from the airport zone respectively. An. gambiae accounted for 13% of the transmission in the hamlet adjoining the airport and 0% three kilometers off the airport.

Status of pyrethroid resistance in Anopheles gambiae sensu lato.

The present study confirms the presence of pyrethroid resistance among Anopheles gambiae s.l mosquitos in Côte d'Ivoire and reports the observation of such resistance in two other countries in West Africa (Benin and Burkina Faso). Malaria vector populations from Cameroon (Central Africa), Senegal (West Africa) and Botswana (southern Africa) were found to be susceptible to pyrethroids. In the most resistant mosquito populations, resistance to permethrin was associated with reduced mortality, not only with respect to this compound but also towards deltamethrin. Moreover, a significant increase in knockdown time was observed in some mosquito populations before any decrease in mortality, suggesting that knockdown time could be a good indicator for the early detection of pyrethroid resistance. In view of the current extension of such resistance, there is an urgent need to set up a network in Africa to evaluate its development. It is also vital that the impact of this resistance on pyrethroid-impregnated bednets be assessed.