Benign acute viral myositis in African migrants: A clinical, serological, and pathological study.

BACKGROUND: Several viruses have been described as causes of acquired inflammatory myopathies; however, the mechanisms by which they cause muscle disease are still unclear. The aim of this study was to describe the laboratory features of benign acute myositis in a small case series. METHODS: A detailed pathological and serological analysis was performed in five African migrants who developed an acute viral myositis complicated by rhabdomyolysis. RESULTS: Muscle biopsies clearly documented an inflammatory myopathy with histological features similar to polymyositis including CD8+ T cells surrounding and invading nonnecrotic muscle fibers, CD68+ macrophages and major histocompatibility complex class I antigen upregulation. In addition, positivity for myositis-specific antibodies (MSA), in particular anti-aminoacyl tRNA synthetases, was found in the serum of two patients. CONCLUSIONS: Our study demonstrated that T-cell mediated injury occurs in muscle of patients with acute viral myositis, and that MSA may be present in the serum of these patients.

Waiting for the Second Treat: Developing Culture-Specific Modes of Self-Regulation.

The development of self-regulation has been studied primarily in Western middle-class contexts and has, therefore, neglected what is known about culturally varying self-concepts and socialization strategies. The research reported here compared the self-regulatory competencies of German middle-class (N = 125) and rural Cameroonian Nso preschoolers (N = 76) using the Marshmallow test (Mischel, 2014). Study 1 revealed that 4-year-old Nso children showed better delay-of-gratification performance than their German peers. Study 2 revealed that culture-specific maternal socialization goals and interaction behaviors were related to delay-of-gratification performance. Nso mothers' focus on hierarchical relational socialization goals and responsive control seems to support children's delay-of-gratification performance more than German middle-class mothers' emphasis on psychological autonomous socialization goals and sensitive, child-centered parenting.

Infants' Social Experiences in Three African Sociocultural Contexts.

This study introduces a peri-urban context of poverty to the study of child development in Africa in contrast to the more typical assessments in middle-class and rural contexts. Spot observations were used to assess universal caregiving behaviors toward seventy-six 3-month-old infants. Results show that middle-class infants experienced distal parenting behaviors instantiated by mothers, whereas rural children experienced proximal parenting practices in interactions with others. Infants growing up in poverty had mothers and other caretakers involved at mostly low levels. They experienced low levels of body contact, body stimulation, and object stimulation, and high levels of face-to-face positions. The study indicates that caregiving in the context of poverty does not necessarily follow familiar pathways and needs to be contextualized accordingly.

Relationship Between Subjectively Evaluated Health and Fear of Death Among Elderly in Three Cultural Contexts.

It is often argued that declining health in elderly people makes death more salient and threatening. However, we argue that health, optimism, and social support interact to predict fear of death in samples from Cameroon, the Czech Republic, and Germany. Low health was associated with enhanced fear of death for participants who received only little social support. As the measure of optimism did not comply with psychometric requirements in the Cameroonian sample, the three-way interaction was tested only in the Czech and German samples. It was found that the two-way interaction was further qualified by optimism in that low health was associated with enhanced fear of death for participants with little social support unless they reported pronounced optimism. Thus, internal and external resources, respectively, can serve to buffer the effect of declining health on the fear of death in the elderly.

Implicit Racial Biases in Preschool Children and Adults From Asia and Africa.

This research used an Implicit Racial Bias Test to investigate implicit racial biases among 3- to 5-year-olds and adult participants in China (N = 213) and Cameroon (N = 257). In both cultures, participants displayed high levels of racial biases that remained stable between 3 and 5 years of age. Unlike adults, young children's implicit racial biases were unaffected by the social status of the other-race groups. Also, unlike adults, young children displayed overt explicit racial biases, and these biases were dissociated from their implicit biases. The results provide strong evidence for the early emergence of implicit racial biases and point to the need to reduce them in early childhood.

Children's Family Drawings as Expressions of Attachment Representations Across Cultures: Possibilities and Limitations.

The present study explored the cross-cultural appropriateness of children's family drawings as a measure for attachment quality. The sample consisted of 63 children aged 6 years from two diverse ecosocial contexts: middle-class families from Berlin, Germany (n = 32) and rural farming families from small villages around Kumbo, Cameroon (n = 31). The analysis of drawings with two classical attachment procedures, the Checklist of Drawing Signs (Kaplan & Main, 1986) and the Global Rating Scales (Fury, 1996), revealed substantial cultural differences. The results thus substantiated children's drawings as important cultural documents. Implications of the findings, however, are discussed in consideration of culture-specific conceptions of attachment relationships as indicated by cultural variations in mother's socialization goals.

Sexual Abuse in Cameroon: A Four-Year-Old Girl Victim of Rape in Buea Case Study.

A young girl was brought to the emergency unit after suffering sexual abuse by an older male. Additional abuses against women and girls include physical beating, forced marriage, female genital mutilation, breast ironing, widow's rites, psychological abuse, and discrimination in education, finance, employment, and legal access. Cameroon has adopted strategies aimed at eliminating violence against women, including ratification of international policies, penal codes, and support of local and international efforts that promote women; however, many of the laws remain in name only and are rarely enforced, given women's lack of financial access to quality lawyers and an unsympathetic male-dominated police force. Underreporting and culturally accepted abuses remain a challenge, too, as the country seeks to understand the extent of abuses and how to effectively fight against them. A complete paradigm shift in cultural attitude toward the female gender is required for abuses to cease.

Ritual tooth modification among the Baka pygmies in Cameroon.

INTRODUCTION: Ritual tooth mutilation is a relatively understudied human body mutilatory practices. The purpose of the study was to examine the effects of ritual tooth modification, teeth cleaning measures and herbal medications for their oral health problems among the Baka pygmies in Cameroon. MATERIALS AND METHODS: This cross-sectional study was conducted between January and March, 2012 using semi-structured questionnaire as the tool of data collection. Intra-oral examinations were carried out to determine the dental hard tissue loss using Smith and Knight Tooth Wear Index (TWI). RESULTS: Fifty-six pygmies with ritual tooth modification made of 34 males (60.7%) and 22 females (39.3%) with a mean age of 31 years were interviewed and had oral health examination. The reported age at which the tooth modification was done was between 10 and 15 years with mean age as 12 ± 1.66 years. More than half (58.9%) of the participants reported the tooth filing as painful and nearly two-thirds (64.3%) of the participants reported having persistent pain afterwards. The upper right central and lateral incisors were the most commonly modified teeth. A total of 42.9%, 12.5% and 7.1% of the participants had Smith and Knight TWI scores of 2, 3 and 4 respectively. All the participants reported cleaning their teeth at least once-daily with about two-thirds (66.1%) of them doing so with chewing stick. The majority (67.9%) of the participants reported cleaning their teeth for cosmetic reasons [to remove dirt' (60.7%) and 'to remove stains' (7.1%)]. The oral health problems among the participants in form of tooth sensitivity, toothache and dental abscess were treated with plant-based traditional medicines from Irvingia gabonensis, Ricinodendron heudoletti, Pterocarpus soyauxii, Alchornea cordifolia and Piptadeniastrum africanum. CONCLUSION: Ritual tooth modification is a painful mutilatory practice which is culturally significant for the Baka pygmies without health benefit. There is need for intervention to stop this harmful traditional practices among the pygmies. Further studies is recommended to elucidate the medicinal and pharmaceutical benefits of plants used for tooth sensitivity and other oral health problems by the pygmies.

8q24 risk alleles in West African and Caribbean men.

BACKGROUND: Multiple genetic studies have confirmed associations of 8q24 variants with susceptibility to prostate cancer (CaP). However, the magnitude of risk conferred in men living in West Africa is unknown. METHODS: Here we determine the prevalence of 8q24 risk alleles and test for association with CaP risk alleles in West African (WA) descent populations from rural Nigeria, Cameroon, and the Caribbean island of Jamaica. Ten 8q24 SNPs were genotyped in histologically confirmed CaP cases (n = 308) and clinically evaluated controls (n = 469). In addition, unrelated individuals from Sierra Leone (n = 380) were genotyped for comparison of allele frequency comparisons. RESULTS: SNPs rs6983561, rs7008482, and rs16901979 were significantly associated with CaP risk in WAs (P < 0.03). No associations with CaP were observed in our Caribbean samples. Risk alleles for rs6983267, rs7008482, and rs7000448 were highly prevalent (>84%) in West Africa. We also reveal that the A-risk allele for the 'African-specific' SNP bd11934905 was not observed in 1,886 chromosomes from three WA ethnic groups suggesting that this allele may not be common across West Africa, but is geographically restricted to specific ethnic group(s). CONCLUSIONS: We provide evidence of association of 8q24 SNPs with prostate cancer risk in men from Nigeria and Cameroon. Our study is the first to reveal genetic risk due to 8q24 variants (in particular, region 2) with CaP within two WA countries. Most importantly, in light of the disparate burden of CaP in African-Americans, our findings support the need for larger genetic studies in WA descent populations to validate and discern function of susceptibility loci in the 8q24 region.

An asset-based approach to vulnerability: the case of small-scale fishing areas in Cameroon and Nigeria.

This paper analyses vulnerability to poverty of rural small-scale fishing communities using cross-section data from 295 households in Cameroon and 267 in Nigeria. We propose a vulnerability measure that incorporates the idea of asset poverty into the concept of expected poverty, which allows decomposing expected poverty into expected structural-chronic, structural-transient, and stochastic-transient poverty. The findings show that most households in our study areas are expected to be structurally-chronic and structurally-transient poor. This underlines the importance of asset formation for long-term poverty reduction strategies. Further refinements are possible with longitudinal data and information about future states of nature.

Knowledge, attitudes and practice with respect to epilepsy among secondary school students in the Kumbo West Health District - North West Region- Cameroon.

BACKGROUND: The main goal of this study was to obtain baseline data on awareness and attitudes and practices with respect to epilepsy among secondary school students. METHODS: We interviewed a total of 659 students from three randomly selected secondary schools in the Kumbo West Health District, using a 12-item questionnaire in English. RESULTS: About 94.7% had heard about epilepsy, 25.8% had read on the subject, 55.2% knew someone with epilepsy and 77.7% had witnessed a seizure. While 37.9% of students would object to association with people with epilepsy (PWE), 47.8% would object to marriage with PWE. About 77.2% would offer equal employment to PWE although 72.7% believed there were jobs not suitable for PWE. Up to 58% of our sample thought epilepsy is contagious and about 62.2% of them declared that epilepsy is curable. Respectively 65%, 9%, and 30% would recommend a medical doctor, a traditional healer and God's help for treatment of epilepsy. Independent determinants of attitudes were found to be: the belief that epilepsy is a form of insanity or is contagious, having witnessed a seizure, being female, being a Christian and having a higher level of education. CONCLUSION: There was a high level of awareness on epilepsy and the negative attitudes observed among these students were better than those reported in the same community. The determinants of negative attitudes were found to be diversified, confirming our hypothesis of variation, and our data further suggest that the interplay between these factors may be more complex than generally thought. This requires further qualitative study.

Controlled cyclophotocoagulation with the 940 nm laser for primary open angle glaucoma in African eyes.

BACKGROUND: "Controlled cyclophotocoagulation" is a real-time dosage control which reduces the complications of transscleral cyclophotocoagulation to a negligible amount in European eyes. Applied to a few African eyes, however, the method failed. Obviously, the physical parameters of the laser procedure need adjustment to African eyes. METHOD AND MATERIAL: After theoretical investigations and tests in African cadaver eyes, 940 nm laser wavelength instead of 810 nm and a different fiber coupling had solved the problem of physical differences between European and African eyes to a large extent. The method was then applied to 272 eyes of 188 patients with primary open-angle glaucoma, of which it was possible to follow 26 eyes of 18 patients for at least 1 year. Median age of the patients was 63.7 years, with the youngest 16.8 years, the oldest 88.8 years. Either 16 or 24 laser spots were applied at random. If both eyes were treated, they were treated in the same session. RESULTS: The average intraocular pressure (IOP) reduction after 1 year was 7.5 mmHg, with average glaucoma drug reduction from 1.5 to 1.2 substances. At least one pop spot occurred in 32% of the eyes. No statistically significant difference between 16 and 24 spots was found. No severe complications such as intraocular bleeding, hypotony <7 mmHg, choroidal detachment or phthisis were observed. CONCLUSION: Controlled cyclophotocoagulation with the 940 nm laser is a safe method which can be applied as the first-choice treatment to African primary open-angle glaucoma eyes. Individual IOP prediction, however, is very difficult.

"Hunting Otherwise" : Women's Hunting in Two Contemporary Forager-Horticulturalist Societies.

Although subsistence hunting is cross-culturally an activity led and practiced mostly by men, a rich body of literature shows that in many small-scale societies women also engage in hunting in varied and often inconspicuous ways. Using data collected among two contemporary forager-horticulturalist societies facing rapid change (the Tsimane' of Bolivia and the Baka of Cameroon), we compare the technological and social characteristics of hunting trips led by women and men and analyze the specific socioeconomic characteristics that facilitate or constrain women's engagement in hunting. Results from interviews on daily activities with 121 Tsimane' (63 women and 58 men) and 159 Baka (83 women and 76 men) show that Tsimane' and Baka women participate in subsistence hunting, albeit using different techniques and in different social contexts than men. We also found differences in the individual and household socioeconomic profiles of Tsimane' and Baka women who hunt and those who do not hunt. Moreover, the characteristics that differentiate hunter and non-hunter women vary from one society to the other, suggesting that gender roles in relation to hunting are fluid and likely to change, not only across societies, but also as societies change.

Multidrug-resistant patients receiving treatment in Niger who are infected with M. tuberculosis Cameroon family convert faster in smear and culture than those with M. tuberculosis Ghana family.

In this study, we analyzed the M. tuberculosis complex (MTBc) population structure among multidrug-resistant TB (MDR-TB) patients in Niger and tested whether the Cameroon family displayed a slower response to MDR-TB treatment. We genotyped baseline clinical isolates that had been collected from pulmonary MDR-TB patients recruited consecutively between 2008 and 2016 in Niger. Spoligotyping was used to analyze the genetic diversity of mycobacterial lineages, and Kaplan Meier's analysis to compare treatment outcomes. A total of 222 MTBc isolates were genotyped; 204 (91,9%) were identified as the Euro-American L4 lineage, with the Ghana family (106, 47,4%) and the Cameroon family (63, 28,4%) being predominant. Patients infected by Cameroon family isolates 61(96,8%) showed faster conversion (log-rank p < 0.01) than those infected with Ghana family isolates (91,5%), and were more likely to experience favorable outcome (adjusted odds ratio [aOR] 4.4; 95%CI 1.1-17.9]; p = 0.015). We found no association between MTBc families and second-line drug resistance profiles (p > 0.05). Our findings show that MDR-TB in Niger is caused by major spoligotypes of the Euro-American L4; with more rapid smear and culture conversion in patients infected with the Cameroon family. These first insights may alert clinicians that slow conversion may be associated with the type of infecting strain.

General public awareness, perceptions, and attitudes with respect to epilepsy in the Akwaya Health District, South-West Region, Cameroon.

BACKGROUND: This study was part of a series mandated by the Ministry of Public Health's National Epilepsy Control Program to obtain baseline data for a community-adapted epilepsy education program. METHODS: We conducted 387 face-to-face interviews with subjects without epilepsy aged 15 years and above in 12 villages of the Akwaya Health District, Cameroon. RESULTS: Most respondents (97.9%) had heard or read about epilepsy, 90.2% knew someone with epilepsy, and 90.4% had witnessed a seizure. About 51.4% would object to association with people with epilepsy (PWE), 68.7% would object to marriage to PWE, while 41.6% would offer them equal employment. For treatment, 30.2% would suggest going to a traditional healer or witch doctor, while 3.9% would not recommend any treatment at all. Predictors of attitudes were male gender, low or no level of education, having children, knowledge of the cause of epilepsy, and beliefs that epilepsy is contagious or is a form of insanity. CONCLUSION: The high level of public awareness on epilepsy in the Akwaya Health District may suggest a high prevalence. This contrasts with prevailing negative attitudes. Our data provide new evidence for our hypothesis of regional variation in the determinants of epilepsy stigma in Cameroon.

U.S.: extended jail sentence of HIV-positive pregnant woman from Cameroon overturned.

In May 2009, a U.S. District Court judge sentenced Quinta Layin Tuleh, a pregnant HIV-positive woman from Cameroon, to 238 days incarceration for the possession of fake immigration documents. The judge defended the extended sentence on the grounds that it was necessary to protect her "unborn child" from contracting HIV.

Prevalence of post-traumatic stress disorder, depression and somatisation in recently arrived refugees in Germany: an epidemiological study.

AIMS: Despite recent worldwide migratory movements, there are only a few studies available that report robust epidemiological data on the mental health in recent refugee populations. In the present study, post-traumatic stress disorder (PTSD), depression and somatisation were assessed using an epidemiological approach in refugees who have recently arrived in Germany from different countries. METHODS: The study was conducted in a reception facility for asylum-seekers in Leipzig, Germany. A total of 1316 adult individuals arrived at the facility during the survey period (May 2017-June 2018), 569 of whom took part in the study (N = 67 pilot study and N = 502 study sample; response rate 43.2%). The questionnaire (11 different languages) included sociodemographic and flight-related questions as well as standardised instruments for assessing PTSD (PCL-5), depression (PHQ-9) and somatisation (SSS-8). Unweighted and weighted prevalence rates of PTSD, depression and somatisation were presented stratified by sex and age groups. RESULTS: According to established cut-off scores, 49.7% of the respondents screened positive for at least one of the mental disorders investigated, with 31% suffering from somatisation, 21.7% from depression and 34.9% from PTSD; prevalence rates of major depression, other depressive syndromes and PTSD were calculated according to the DSM-5, which indicated rates of 10.3, 17.6 and 28.2%, respectively. CONCLUSIONS: The findings underline the dramatic mental health burden present among refugees and provide important information for health care planning. They also provide important information for health care systems and political authorities in receiving countries and strongly indicate the necessity of establishing early psychosocial support for refugees suffering from psychological distress.

Hyper-reactive malarial splenomegaly in a patient with human immunodeficiency virus.

Both hyperreactive malarial splenomegaly (HMS) and HIV infection are highly prevalent in sub-Saharan Africa, but the inter-relationships between the two conditions are not clearly defined. Diagnosis of HMS is particularly difficult in HIV-infected patients, and detection of circulating malaria parasites by polymerase chain reaction (PCR) may represent a useful diagnostic tool.

Social Networks and Knowledge Transmission Strategies among Baka Children, Southeastern Cameroon.

The dynamics of knowledge transmission and acquisition, or how different aspects of culture are passed from one individual to another and how they are acquired and embodied by individuals, are central to understanding cultural evolution. In small-scale societies, cultural knowledge is largely acquired early in life through observation, imitation, and other forms of social learning embedded in daily experiences. However, little is known about the pathways through which such knowledge is transmitted, especially during middle childhood and adolescence. This study presents new empirical data on cultural knowledge transmission during childhood. Data were collected among the Baka, a forager-farmer society in southeastern Cameroon. We conducted structured interviews with children between 5 and 16 years of age (n = 58 children; 177 interviews, with children being interviewed 1-6 times) about group composition during subsistence activities. Children's groups were generally diverse, although children tended to perform subsistence activities primarily without adults and with same-sex companions. Group composition varied from one subsistence activity to another, which suggests that the flow of knowledge might also vary according to the activity performed. Analysis of the social composition of children's subsistence groups shows that vertical and oblique transmission of subsistence-related knowledge might not be predominant during middle childhood and adolescence. Rather, horizontal transmission appears to be the most common knowledge transmission strategy used by Baka children during middle childhood and adolescence, highlighting the importance of other children in the transmission of knowledge.