Effects of Malaria and HIV Infection on Anemia and T-cells Levels in Children in Douala City, Cameroon.

Introduction Human immunodeficiency virus (HIV) infection and malaria are priority health issues for sub-Saharan Africa. Both diseases worsen each other through their effect on the immune and hematological systems. This study aimed to determine the effects of HIV infection and asymptomatic malaria on anemia and T-cells counts in children in the city of Douala in the republic of Cameroon. Method From May to November 2016, 197 HIV infected and 98 HIV-free non-febrile children up to 19 years old (128 male and 167 female) participated in the study. All HIV-infected children were receiving antiretroviral treatment and co-trimoxazole. Malaria diagnosis was performed using Giemsa-stained thick blood film; immunological and hematological parameters were assessed through a flow cytometer and an automated analyzer respectively. Chi-squared or Fischer's exact tests was used to compare the proportions, Mann-Whitney and ANOVA tests were used for the means. Statistical significance was set at p˂0.05. Results The prevalence of malaria was 8.8%, and that of anemia was 40.7%. CD4+-T cells were higher in malaria-infected children, both in HIV positive and negative (p=0.049). No significant association was found between malaria parasitemia and CD8+-T cell levels, both in HIV-positive and negative children (p=0.41). Anemia was higher in HIV-positive children (p=0.019), especially in those with severe immunosuppression (p=0.001) and in younger children (p=0.0083). Children on HIV treatment presented lower malaria prevalence (8.6% versus 10.10%), though the difference was not significant (p=0.7068). Malaria infection was associated with lower hemoglobin levels (10.5±1.7 versus 11.2±1.4; p=0.016). Conclusion Malaria infection may enhance CD4+-T cells. Both malaria and HIV infection lead to a drop in hemoglobin levels. The HIV treatment protocol may reduce malaria prevalence.

Malaria screening at the workplace in Cameroon.

Malaria remains a major health problem in Cameroon; It accounts for 38% of consultations, 24% of deaths and 36.8% of absenteeism in the country. The negative economic impact of malaria has encouraged a new control approach targeting companies. In this regard, a cross sectional study was conducted from February 2015 to June 2017 in 14 companies in the town of Douala. This study aimed at determining the prevalence, control practices of employees and identifying associated factors with malaria. A total of 2705 workers were interviewed and systematically screened for malaria using LED fluorescence microscopy (CyScope®). All positive cases were given a malaria treatment. The prevalence of malaria and asymptomatic malaria was 30.1% and 28.9% respectively; asymptomatic malaria accounted for 95.7% of all positive diagnostic test. Malaria infection was significantly higher in employees aged 36-60 years (30.5%) and having completed primary studies (36%). ITNs ownership and utilization were 86.36% and 77.23% respectively. The risk for malaria infection has significantly decreased with age and educational level while the employees' level of education and size of households were significantly associated with the regular utilization of ITNs. This is the first study assessing malaria prevalence and risk factors in workplace in Cameroon and using a novel diagnostic tool. This study outlines a high prevalence of malaria infection, especially asymptomatic carriage, high rates of ITNs ownership and utilization, as well as the influence of level of education, age and household size as associated factors. Active case detection of asymptomatic carriers through systematic screening of employees at workplace and their treatment is feasible with the Cyscope microscope and could be a good complement to ongoing control strategies.

Schistosomiasis among pregnant women in Njombe-Penja health district, Cameroon.

INTRODUCTION: Schistosomiasis is a neglected tropical disease with endemic foci in Cameroon. Epidemiological data on schistosomiasis in pregnancy are scarce in the country. This study describes the prevalence, diversity and factors associated with schistosomiasis in pregnant women in Njombe-Penja where schistosomiasis was first reported in 1968. METHODOLOGY: Two hundred and eighty-two (282) pregnant women were enrolled at first antenatal consultation between April and December 2016. A questionnaire was used to document socio-economic and obstetric information. Stool and terminal urine samples were collected and analysed using Kato-Katz/Formol-Ether concentration techniques and centrifugation methods respectively. Haemoglobin concentration was measured from finger prick blood, using an URIT®-12 electronic haemoglobinometer. Bivariate and logistic regression were used for statistical analyses with Epi-Info version 7.2.1.0. Statistical significance level was set at 0.05. RESULTS: The overall prevalence of schistosomiasis was 31.91%. Schistosoma guineensis, S. haematobium and S. mansoni infections were found in 0.35% (n = 1), 4.96% (n = 14) and 28.01% (n = 79) of participants, respectively. Co-infection with two species of Schistosoma was found in 4.44% of these women. The prevalence of this disease was significantly higher in younger women (≤ 20 years old) and among residents of Njombe. All S. haematobium infected women were anemic and infection was associated with significantly lower haemoglobin levels (p = 0.02). CONCLUSION: The prevalence of schistosomiasis is high among pregnant women in Njombe-Penja, with some adverse effects on blood levels. Three Schistosoma species were found. Female of childbearing age should be considered for mass drug administration.

Intestinal parasitic and candida infection associated with HIV infection in Cameroon.

INTRODUCTION: HIV causes progressive impairment of the cellular immune system leading to increased susceptibility to infectious agents. Parasitic infestations are common in HIV-infected patients and usually lead to diarrhoea. Few studies have addressed the issue of intestinal parasites among HIV-infected persons in Cameroon.  This investigation was conducted in Douala, Cameroon, to assess the prevalence of gastrointestinal parasites in HIV-infected patients, taking into account their immune status and treatment course. METHODOLOGY: Stool and blood samples were collected from 201 HIV-positive patients for the investigation of intestinal pathogens and CD4+ counts. RESULTS: Fifty-six (27.9%) patients harbored pathogens. The most frequent pathogens were Candida spp. (14.9%), Cryptosporidium spp. (7.5%), Entamoeba histolytica, and Entamoeba dispar (3%). The presence of pathogens was significantly associated with diarrhoea, as they were found in 48.6% of diarrhoeic stools and 23.2% of non-diarrhoeic stools (OR = 3.14, p= 0.0018). Prevalence of pathogens and diarrhoea were significantly higher in patients with CD4+ counts ≤ 200 cells/µL (OR = 2.17, p = 0.0349 and OR = 8.46, p = 0.000019 respectively). CONCLUSIONS: This study highlights the need for investigating intestinal pathogens in HIV-infected patients presenting with diarrhoea, especially when their CD4+ counts are low.