Prevalence of onchocerciasis, attitudes and practices and the treatment coverage after 15 years of mass drug administration with ivermectin in the Tombel Health District, Cameroon.

INTRODUCTION: Onchocerciasis is an infection caused by Onchocerca volvulus. It affects 37 million people of which 99% are in Africa. This study assessed the prevalence of onchocerciasis after 15 years of mass drug administration with ivermectin. METHODS: This was a population based cross sectional study. Questionnaires covering participants' identity and attitudes and practices of community respondents towards ivermectin were administered. The treatment coverage was obtained by review of records of mass drug administration from 1999 to 2015. The epidemiological evaluation of infection status was done by parasitological examination of skin snips and nodule palpation in individuals in five health areas of the district. RESULTS: A total of 400 participants were randomly selected. Of these, 56.0% were males, 62.0% single, 59.5% farmers and 98.0% Christians. Participants with good attitudes towards community directed treatment with ivermectin made up 80.5% while 47.8% of the participants had good practice. The highest treatment coverage achieved was 88.0% in 2010 while lowest was 57.0% in 2002. Less than 2% had microfilaria and 6.0% had nodules. There was no statistically significant difference in the prevalence of microfilaria with respect to age. There was a statistically significant difference in the distribution of nodules (χ2=73.6, p=0.001) among the different age groups. The greatest rate of infection (2.1%) was among farmers. CONCLUSION: This study showed that the prevalence reduced compared to other prevalence studies in Cameroon. The study area was hypo-endemic for onchocerciasis.

Prevalence and risk factors associated with hypertension among adults in a rural setting: the case of Ombe, Cameroon.

INTRODUCTION: High blood pressure is the most common cardiovascular disorder affecting approximately one billion people globally and remains a major contributor to the global burden of non-communicable diseases and mortality. Hypertension, once rare in traditional African societies, is now a major public health problem probably because of a rise in its risk factors. In sub-Saharan Africa, an estimated 74.7 million individuals live with hypertension. This study was designed to determine the prevalence and identify risk factors associated with hypertension in adults aged 21 years and above in Ombe village, a rural Cameroonian setting in sub-Saharan Africa. METHODS: This study was a cross-sectional community based survey from March to September 2016 (seven months) in the village of Ombe, a rural community in the southwest region of Cameroon. Following ethical clearance from the Institutional Review Board (IRB) of the Faculty of Health Science, University of Buea and administrative authorization, 243 participants (141 males and 102 females) through multi-stage sampling were randomly selected to take part in the study following consent which was voluntary and without any form of coercion. The principal research instrument was a questionnaire adapted from the WHO STEPwise approach to chronic disease risk factor surveillance- Instrument v2.1 which was administered to participants. The self-administered questionnaire collected socio-demographic information, data related to knowledge and practices related to hypertension, anthropometric data (weight and height from which the body mass index (BMI) was calculated). The blood pressure of study participants was measured. Data was entered using Microsoft Excel, then imported and analysed in SPSS v22.0. Frequencies and percentages were determined for categorical variables. Means and standard deviations (mean ± SD). Univariate and multivariate logistic regression analysis were used to investigate factors associated with high blood pressure (hypertension). RESULTS: The results showed that 19.8% of the adult population had hypertension. Of the 243 respondents, 77.7% understood what is hypertension, 85% indicated that they could tell some consequences of high blood pressure (they indicated hypertension affects the heart, brain and kidneys) and 63.3% of study participants had never checked their blood pressure. Age greater than 40 years, harmful alcohol intake for more than 10 years, physical inactivity and obesity (BMI ≥ 25Kg/m2) were variables associated with hypertension on univariate analysis. Following multivariate analysis, independent risk factors for hypertension in our study were: physical inactivity (Adj. OR 2.6, 95%CI: 1.3-4.4, p = 0.021), regular alcohol consumption for more than 10 years (Adj. OR 2.9, 95%CI: 1.6-5.1, p = 0.014) and being older than 40 years of age: Adj. OR 2.5, 95%CI: 1.02-4.1, p = 0.002 in age category 41-60 years and this age related risk was even higher in persons older than 60 years of age Adj. OR 4.5, 95%CI: 2.1-6.3, p = 0.002. CONCLUSION: The findings of this study showed the prevalence of high blood pressure among adults in Ombe (a rural community in Cameroon) was 19.8%. Old age, alcohol consumption, and physical inactivity were independent risk factors for hypertension. Despite the population demonstrating knowledge about hypertension and its possible poor consequences on health, less than half had ever gone for blood pressure checks. Interventions to improve physical activity, reduce alcohol consumption and boost health seeking (high blood pressure screening) behaviour will be beneficial as preventive measures in combatting hypertension.