Malaria and helminth co-infection in children living in a malaria endemic setting of mount Cameroon and predictors of anemia.

A study was carried out with 425 children aged 0-14 yr residing in Bolifamba, Cameroon, to investigate the effect of Plasmodium falciparum malaria and intestinal helminth coinfection on anemia and to identify significant predictors of anemia in the community. Blood was collected by finger prick to determine malaria parasitemia and packed cell volume (PCV). The Kato-Katz technique was used to assess the prevalence and egg load of intestinal helminths. The prevalence of P. falciparum malaria, intestinal helminth infections, and coinfection was 64.2%, 38.3%, and 24.7%, respectively. Coinfections in which heavy helminth loads were detected had corresponding high mean P. falciparum parasite loads >5,000/microl compared with coinfections involving light helminth burden. The overall prevalence of anemia was 30.8%. Anemia prevalence increased significantly with P. falciparum parasite load >5,000/microl compared with lower densities (chi2 = 6.734, P = 0.034). Anemia prevalence was significantly higher in febrile children compared with nonfebrile children (chi2 = 6.041, P = 0.014). Children infected exclusively with P. falciparum recorded the highest prevalence of anemia compared with uninfected children, those with coinfections, and those harboring only helminths. This difference in prevalence was significant (chi2 = 6.734, P = 0.031). Multiple regression analysis exposed fever (P > 0.001) and age (P = 0.004) as significant predictors of anemia.

Public health implications of contamination of Franc CFA (XAF) circulating in Buea (Cameroon) with drug resistant pathogens.

BACKGROUND: Studies in different parts of the world have implicated money as a vehicle for transmission of pathogens. Such information which is necessary to facilitate infection control strategies is lacking in many sub-Saharan countries including Cameroon. This study analyzed the Franc de la Communauté Financiere d'Afrique (Franc CFA), the currency used in Cameroon and other countries in the Central African sub-region, as a potential vehicle for transmission of pathogenic bacteria and fungi, particularly drug-resistant strains, to generate findings which could create awareness on currency contamination and serve as a guide when formulating health policies on currency. METHODS: Two hundred and thirteen currency samples representing various denominations of notes and coins randomly collected from diverse sources in Buea, Cameroon were analyzed for bacteria and fungi. The sensitivity of bacterial isolates to antibiotics was tested using the disc diffusion method. The relationship between contamination and physical state, source or denomination of currency was assessed using the χ2 test. All statistics were discussed at 0.05 significance level. RESULTS: Two hundred (93.9%) samples were contaminated with notes (96.6%) showing higher contamination than coins (88.2%). Uncirculated (mint) samples showed no contamination. There was a significant difference (P<0.05) in contamination with respect to currency denomination, physical state and source. All samples from butchers and patients/personnel in hospitals were contaminated. Lower denominations showed significantly higher (P = 0.008) levels of contamination than higher denominations. Dirty currency was more contaminated than clean currency. Nine bacterial species were isolated. Coagulase-negative Staphylococcus (CoNS) (54.9%) and Staphylococcus aureus (20.1%) predominated. Among the fungi detected, Aspergillus sp (17.3%) and Penicillium sp (15.9%) showed higher frequency of occurrence. Bacteria were susceptible (100%) to ceftriaxone, gentamicin, norfloxacin and ofloxacin. Susceptibility to amoxicillin, penicillin, ampicillin, vancomycin and cotrimoxazole was low. Staphylococci were resistant (100%) to vancomycin, penicillin G, and amoxicillin. CoNS in addition showed resistance (100%) to cotrimoxazole. CONCLUSIONS: The CFA franc circulating in Buea could serve as a vehicle for transmission of drug resistant pathogenic or potential organisms and contamination could be due to currency usage and handling as mint notes were not contaminated. Hygiene practices during or after handling currency is greatly encouraged to prevent infection.

Prevalence of falciparum malaria together with acute diarrhoea in children residing in a malaria endemic zone.

To investigate an association between diarrhoea and malaria in children, a study was conducted in Buea on 215 children ranging from 0 - 5 years of age attending the Buea District hospital as out patients. Out of this number 118 (54.9/ ) had acute diarrhoea. The control group without diarrhoea comprised 97 children. Thick blood smears were examined to detect malaria parasites. The prevalence of malaria in the study population was 60/ and mean parasite density was 4460.4 parasites/microl of blood (SD+/-3047.8). There was no significant difference in parasitaemia in children with and without diarrhoea (p>0.5). The prevalence of concurrent malaria and diarrhoea was 20% compared with 40% malaria prevalence in children without diarrhoea. We conclude that there was no association between malaria and diarrhoea in the study population.

Effects of ABO/Rh blood groups, G-6-P-D enzyme activity and haemoglobin genotypes on malaria parasitaemia and parasite density.

The main objective was to investigate the effects of ABO/Rh blood groups, haemoglobin genotype and G-6-P-D enzyme activity on malaria. The study was carried out in Buea, South West Province, Cameroon. Subjects consulting at health care facilities in Buea were randomly recruited into the study. A total of 121 febrile patients 1-60 years old comprised the study subjects. Thin and thick blood films were prepared for malaria parasite detection. G-6-P-D enzyme activity was assayed using the met-haemoglobin reduction test. Determination of haemoglobin genotypes was by a rapid screening method alongside electrophoresis. Malaria positive patients were treated. The highest malaria prevalence of 74.5 % was in Group O individuals and the lowest of 58.6% in group B individuals. Mean parasite density (Log(10)(-1)/ul blood) in the various blood groups was not significantly different. Individuals with G-6-P-D deficiency had a significantly lower malaria prevalence (47.5%) when compared with active individuals. Mean parasite density in enzyme deficient and active individuals was 3.7(SD+/- 3.9) and 4.4(SD +/-5.0) respectively and the difference was significant (p < 0.05). Malaria prevalence was lower (57.5%) in HbS individuals when compared with HbAA (74.6%) and HbSS (60%) but parasite density was not significantly different. Our results suggest that individuals with blood group O who have the HbAA genotype and show G-6-P-D enzyme activity may be more susceptible to malaria. Information on the influence of these genetic factors on malaria would be useful in the better management of the disease in the study area.

The prevalence of Candida albicans-associated diarrhoea in Buea, South West Cameroon.

A total of 362 stool specimens were collected from 184 and 178 patients presenting at the Buea district Hospital with and without diarrhoea, respectively. The samples were screened and cultured for Candida albicans using standard microbiological procedures. Of the 184 diarrhoeic stool cultures, 35.9% showed C. albicans overgrowth as indicated by count >or=10(4) CFL/mL. Of the 178 non diarrhoeic stool cultures, C. albicans was identified in 23.6% of samples and counts were all <10(4) CFU/mL. An association was observed for C. albicans overgrowth and diarrhoea (p<0.001). The majority of isolates (87.8%) from the 66 samples showing candida overgrowth were susceptible to Amphotericin B in anti-fungal drug sensitivity assays. Results of the study highly suggest that C. albicans is an important cause of diarrhoea in the study area. We recommend that this fungus should be routinely checked in individuals presenting with diarrhoea particularly children and patients on prolonged or frequent antibiotic therapy.