RESUMEN
High rates of lost to follow-up (LTFU) in the Prevention of Mother-To-Child Transmission of HIV (PMTCT) programs in Cameroon will only contribute in hindering the successful implementation of the program. The objective of this study was to determine the reasons of LTFU of mother-child pairs enrolled in the PMTCT program in Dschang District Hospital (DDH): Cameroon. Methods: A retrospective cohort study was carried out in HIV+ exposed children delivered in the DDH from1st Jan 2012 - 31st Dec 2014, who were greater than or equal to 18 months at the study period (1st August - 30th September 2016) and whose mothers were enrolled in the PMTCT program for at least 3 months. Children were considered LTFU if they did not return to the hospital for the establishment of their HIV status at 18 months. A complementary cross-sectional study was done whereby a structured questionnaire was administered to the LTFU group via telephone calls, in order to determine the causes of LTFU. Data was collected from hospital registers and analyses done using Epi info 7.1.3.3 software. Results: A total of 141 mother-child pairs were eligible for the study, 76 were reachable via phone calls and 36 (47.37%) met the case definition of LTFU. Out of the 36 (47.37%) children LTFU, lack of information, 19(65.52%); lack of support from male partners, 4(11.11%); Poor behavior of health personnel, 2 (5.56%); forgetfulness, negligence/time wasting, unavailability of results, fear of child being infected, and family problems were all listed at equal proportions of, 3(6.90%) as well as financial problem, 1 (2.78%) were all causes of LTFU identified in this study.
Asunto(s)
Infecciones por VIH , Transmisión Vertical de Enfermedad Infecciosa , Complicaciones Infecciosas del Embarazo/epidemiología , Camerún/epidemiología , Estudios Transversales , Femenino , Infecciones por VIH/epidemiología , Infecciones por VIH/transmisión , Hospitales de Distrito , Humanos , Lactante , Recién Nacido , Transmisión Vertical de Enfermedad Infecciosa/prevención & control , Transmisión Vertical de Enfermedad Infecciosa/estadística & datos numéricos , Perdida de Seguimiento , Masculino , Madres , Embarazo , Resultado del Embarazo , Estudios RetrospectivosRESUMEN
This study reports the results of a survey conducted among students of the University of Dschang, on STI/HIV/AIDS, the Stigma-Discrimination pair and sexual behaviors. METHODS: This was a descriptive cross-sectional study conducted during the months of January and February 2017. We collected data by a face to face questionnaire administered to students of the University of Dschang. The codification, process and analysis have been done using the software EPI-Info 7.3.1.1, with the threshold of significance set at 0.05. RESULTS: A total of 520 individuals participated in this survey, with more than half (62.7%, n = 326/520) aged between 20-30 years, with a male/female sex ratio of 1,031. The vast majority (83%, n = 418/520) of them were in the undergraduate cycle. The main modes of transmission cited included: the combination of items such as blood transfusion / soiled objects / Mother-to-child transmission/ unprotected sex for 36.3% of respondents (n = 186/516) although 21.9 % (n = 112/516) of them admitted not knowing any modes of transmission of STIs / HIV. Also, 74.2% (n = 386/520) of respondents were sexually active, with the estimated age of sex debut being over 18 years (53.9%; 208/386) for half of them. Of the 36.2% (n = 186/514) respondents who reported knowing someone with STI / HIV and AIDS, the first feeling they had with regards to them was pity (86.6%; n = 386/446), followed by fear in 11.7% (n = 52/446) of respondents but yet 40.2% (n = 208/518) admitted they have never heard of discrimination. CONCLUSION: Stigma and discrimination in the student milieu remains a major barrier to students' development who, becoming sexually active at a very early age, are more exposed to the risk of contracting STI / HIV. Sensitization actions should be implemented within university campuses and reproductive health courses for young adults, included in the academic curriculum for a significant reduction in the number of new infections.
Asunto(s)
Síndrome de Inmunodeficiencia Adquirida , Infecciones por VIH , Conocimientos, Actitudes y Práctica en Salud , Enfermedades de Transmisión Sexual , Estudiantes de Medicina/psicología , Adulto , Camerún , Condones , Estudios Transversales , Femenino , VIH , Humanos , Transmisión Vertical de Enfermedad Infecciosa , Masculino , Conducta Sexual , Estudiantes , Encuestas y Cuestionarios , Universidades , Adulto JovenRESUMEN
Background: Surveillance of SARS-CoV-2 variants of concern (VOCs) and lineages is crucial for decision-making. Our objective was to study the SARS-CoV-2 clade dynamics across epidemiological waves and evaluate the reliability of SNPsig® SARS-CoV-2 EscapePLEX CE in detecting VOCs in Cameroon. Material and methods: A laboratory-based study was conducted on SARS-CoV-2 positive nasopharyngeal specimens cycle threshold (Ct)≤30 at the Chantal BIYA International Reference Centre in Yaoundé-Cameroon, between April-2020 to August-2022. Samples were analyzed in parallel with Sanger sequencing and (SNPsig® SARS-CoV-2 EscapePLEX CE), and performance characteristics were evaluated by Cohen's coefficient and McNemar test. Results: Of the 130 sequences generated, SARS-CoV-2 clades during wave-1 (April-November 2020) showed 97 % (30/31) wild-type lineages and 3 % (1/31) Gamma-variant; wave-2 (December-2020 to May-2021), 25 % (4/16) Alpha-variant, 25 % (4/16) Beta-variant, 44 % (7/16) wild-type and 6 % (1/16) mu; wave-3 (June-October 2021), 94 % (27/29) Delta-variant, 3 % (1/29) Alpha-variant, 3 % (1/29) wild-type; wave-4 (November-2021 to August-2022), 98 % (53/54) Omicron-variant and 2 % (1/54) Delta-variant. Omicron sub-variants were BA.1 (47 %), BA.5 (34 %), BA.2 (13 %) and BA.4 (6 %). Globally, the two genotyping methods accurately identified the SARS-CoV-2 VOCs (P = 0.17, McNemar test; Ka = 0.67). Conclusion: Genomic surveillance reveals a rapid dynamic in SARS-CoV-2 strains between epidemiological waves in Cameroon. For wide-spread variant surveillance in resource-limited settings, SNPsig® SARS-CoV-2 EscapePLEX CEkit represents a suitable tool, pending upgrading for distinguishing Omicron sub-lineages.