Functional availability of medical oxygen for the management of hypoxaemia in Cameroon: A nationwide facility-based cross-sectional survey.

Background: Medical oxygen is essential for managing hypoxaemia, which has a multifactorial origin, including acute and chronic lung diseases such as pneumonia, asthma, and severe malaria. The coronavirus disease 2019 (COVID-19) revealed substantial gaps in the availability and accessibility of safe medical oxygen, especially in low- and middle-income countries (LMICs). This study aimed to assess the availability and sources, as well as the barriers to the availability of functional medical oxygen in hospitals in Cameroon. Methods: This was a nationwide cross-sectional descriptive study conducted from 26 March to 1 June 2021. Using a convenient sampling technique, we sampled accredited public and private COVID-19 treatment centres in all ten regions in Cameroon. Representatives from the selected hospitals were provided with a pre-designed questionnaire assessing the availability, type, and state of medical oxygen in their facilities. All analyses were performed using R. Results: In total, 114 hospitals were included in this study, with functional medical oxygen available in 65% (74/114) of the hospitals. About 85% (23/27) of the reference hospitals and only 59% (51/87) of the district hospitals had available functional medical oxygen. Compared to district hospitals, reference hospitals were more likely to have central oxygen units (reference vs. district: 10 vs. 0%), oxygen cylinders (74 vs. 42%), and oxygen concentrators (79 vs. 51%). The most common barriers to the availability of medical oxygen were inadequate oxygen supply to meet needs (district vs. reference hospitals: 55 vs. 30%), long delays in oxygen bottle refills (51 vs. 49%), and long distances from oxygen suppliers (57 vs. 49%). Conclusions: The availability of medical oxygen in hospitals in Cameroon is suboptimal and more limited in districts compared to reference hospitals. The cost of medical oxygen, delays related to refills and supplies, and long distances from medical sources were the most common barriers to availability in Cameroon.

Cosmic-ray exposure assessment using particle and heavy ion transport code system: case study Douala-Cameroon.

According to UNSCEAR, cosmic radiation contributes to ~16% (0.39 mSv/y) of the total dose received by the public at sea level. The exposure to cosmic rays at a specific location is therefore a non-negligible parameter that contributes to the assessment of the overall public exposure to radiation. In this study, simulations were conducted with the Particle and Heavy Ion Transport code System, a Monte Carlo code, to determine the fluxes and effective dose due to cosmic rays received by the population of Douala. In minimum solar activity, the total effective dose considering the contribution of neutron, muon+, muon-, electron, positron and photon, was found to be 0.31 ± 0.02 mSv/y at the ground level. For maximum solar activity, it was found to be 0.27 ± 0.02 mSv/y at ground level. During maximum solar activity, galactic cosmic rays are reduced by solar flares and winds, resulting in an increase in the solar cosmic-ray component and a decrease in the galactic cosmic-ray component on Earth. This ultimately leads to a decrease in the total cosmic radiation on Earth. These results were found to be smaller than the UNSCEAR values, thus suggesting a good estimation for the population of Douala city located near the equatorial line. In fact, the cosmic radiation is more deflected at the equator than near the pole. Muons+ were found to be the main contributors to human exposure to cosmic radiation at ground level, with ~38% of the total effective dose due to cosmic exposure. However, electrons and positrons were found to be the less contributors to cosmic radiation exposure. As regards the obtained results, the population of Douala is not significantly exposed to cosmic radiation.

Setting up a data system for monitoring malaria vaccine introduction readiness and uptake in 42 health districts in Cameroon.

Three months after the first shipment of RTS,S1/AS01 vaccines, Cameroon started, on 22 January 2024, to roll out malaria vaccines in 42 districts among the most at risk for malaria. Cameroon adopted and implemented the World Health Organization (WHO) malaria vaccine readiness assessment tool to monitor the implementation of preintroduction activities at the district and national levels. One week before the start of the vaccine rollout, overall readiness was estimated at 89% at a national level with two out of the five components of readiness assessment surpassing 95% of performance (vaccine, cold chain and logistics and training) and three components between 80% and 95% (planning, monitoring and supervision, and advocacy, social mobilisation and communication). 'Vaccine, cold chain and logistics' was the component with the highest number of districts recording below 80% readiness. The South-West and North-West, two regions with a high level of insecurity, were the regions with the highest number of districts that recorded a readiness performance below 80% in the five components. To monitor progress in vaccine rollout daily, Cameroon piloted a system for capturing immunisation data by vaccination session coupled with an interactive dashboard using the R Shiny platform. In addition to displaying data on vaccine uptake, this dashboard allows the generation of the monthly immunisation report for all antigens, ensuring linkage to the regular immunisation data system based on the end-of-month reporting through District Health Information Software 2. Such a hybrid system complies with the malaria vaccine rollout principle of full integration into routine immunisation coupled with strengthened management of operations.

The management of rare disease patients from a grassroot perspective: the role of patients' organizations in the global recognition of rare diseases in Cameroon.

Introduction: rare diseases (RD) are extremely complex health conditions. Persons affected by these conditions in Cameroon are often neglected in society and health systems through the inexistence of policies and programs. In Cameroon, there exists no program or policy conceived to address their needs in terms of access to quality health care, timely and reliable diagnosis, treatments, education, etc. The consequence is that persons living with a RD (PLWRD) and their families do not participate in social life. The unique fate of PLWRD reveals that the principle of social justice and equity is flawed in Cameroon. However, patients, in order to survive in society, rely on patients' organizations (PO) to improve their quality of life (QoL) and advocate for a better consideration in the society. The aim of this paper is to highlight how initiatives from a grassroot perspective like POs can inform decision-makers to address the needs of PLWRD and their families. Methods: the study associated a systematic literature review and semi-structured interviews with parents of children suffering from a RD and who are members of a PO. Through the systematic literature review we highlighted the impact POs have in the development of research on RDs, patient literacy, patient empowerment and advocacy while semi-structured interviews brought out the needs of patients and their families. Results: findings, on the one hand show that, in Cameroon PLWRD face a number of challenges like the incurability of their condition, catastrophic medical expenses, stigmatization and marginalization, etc. and though in POs their QoL still remains poor. On the other hand, where POs are empowered they are key actors in research on RDs and help decision-makers on having a better insight into the type of RD that exists across a geographical area, the sociodemographic profile of patients, etc. for a better management of PLWRD. Conclusion: the study suggests that the ministry of public health should create a network with existing RD POs to adequately meet the needs of PLWRD.

Assessment of Evidence-Based Practice (EBP) among physiotherapists in Cameroon: a cross-sectional survey.

BACKGROUND: Evidence-Based Practice (EBP) is reported to ease effective and adequate decision making for all works of life including health professionals. Investigating the level of implementation of EBP among physiotherapists helps to identify barriers and propose solutions for its extensive implementation. Despite available data on EBP elsewhere, it remains limited or non-existent in Cameroon. This study was designed to establish the current state of EBP among physiotherapists in Cameroon, by assessing knowledge, practice, and barriers to its implementation. METHODS: A cross-sectional survey was conducted online among French- and English-speaking physiotherapists in Cameroon over a period of six months from April to July 2023, using the EBP2 questionnaire. This enabled us to collect socio-demographic data from participants and information on their knowledge, understanding and practice of EBP and possible barriers to EBP according to 5 domains (Confidence, Relevance, Terminology, Practice, Compatibility) scored out of 100. Data were analysed using IBM SPSS 25.0 software and Pearson correlations (95% CI) and significance (p < 0.05). RESULTS: A total of 110 physiotherapists practising in the 10 regions of Cameroon participated in the study. The majority were male (54.5%), the median age was 34 years (age range 20 to 50), the median year of graduation was 2019 (range 2004 to max 2022) with 72.7% never having knowledge or training in EBP. Participants scored below 50/100 for 3 domains (confidence, relevance, and compatibility) showing poor general knowledge and understanding of EBP, although they generally had a positive attitude towards EBP. The use of EBP in practice was low (26.3/100 SD. 6.5), despite that they appeared to have a good understanding of research terminology (55.4 SD. 17.2). Level of study of participants did not appear to significantly influence domain scores (P > 0.05). The main barriers to practice were lack of time (75.1%), workload (66%), cost of access to information resources like databases for seek informations about recent support protocols (60%), ease of access to computers (49%), and lack of resources or skills (49%). CONCLUSION: Physiotherapists in Cameroon have a poor knowledge of EBP and a low level of practice of EBP, despite an overall positive attitude towards it. These results could inform stakeholders of higher education on the need to improve training of physiotherapy students in the domain of EBP in Physiotherapy. Also, it will help in raising the level of scientific research and promoting the implementation of EBP in Cameroon.

Availability of the current and future water resources in Equatorial Central Africa: case of the Nyong forest catchment in Cameroon.

To anticipate disasters (drought, floods, etc.) caused by environmental forcing and reduce their impacts on its fragile economy, sub-Saharan Africa needs a good knowledge of the availability of current water resources and reliable hydroclimatic forecasts. This study has an objective to quantify the availability of water resources in the Nyong basin and predict its future evolution (2024-2050). For this, the SWAT (Soil and Water Assessment Tool) model was used. The performance of this model is satisfactory in calibration (2001-2005) and validation (2006-2010), with R2, NSE, and KGE greater than 0.64. Biases of - 11.8% and - 13.9% in calibration and validation also attest to this good performance. In the investigated basin, infiltration (GW_RCH), evapotranspiration (ETP), surface runoff (SURQ), and water yield (WYLD) are greater in the East, probably due to more abundant rainfall in this part. The flows and sediment load (SED) are greater in the middle zone and in the Southwest of the basin, certainly because of the flat topography of this part, which corresponds to the valley floor. Two climate models (CCCma and REMO) predict a decline in water resources in this basin, and two others (HIRHAM5 and RCA4) are the opposite. However, based on a statistical study carried out over the historical period (2001-2005), the CCCma model seems the most reliable. It forecasts a drop in precipitation and runoff, which do not exceed - 19% and - 18%, respectively, whatever the emission scenario (RCP4.5 or RCP8.5). Climate variability (CV) is the only forcing whose impact is visible in the dynamics of current and future flows, due to the modest current (increase of + 102 km2 in builds and roads) and future (increase of + 114 km2 in builds and roads) changes observed in the evolution of land use and land cover (LULC). The results of this study could contribute to improving water resource management in the basin studied and the region.

Understanding Community Participation in Tree Planting and Management in Deforested Areas in Cameroon's Western Highlands.

Deforestation and forest degradation continue to take place at alarming rates in Africa despite global net forest loss reductions. This is prompting large-scale forest restoration involving community volunteers to prevent, halt and reverse the loss of biodiversity for the sustainable development of forest landscapes in Africa. The study explored the motivations, challenges, barriers and negotiation strategies of community volunteers in ecosystem restoration and conservation initiatives in Cameroon's Western Highlands (Mount Bamboutos landscape), given that many such interventions are not achieving desired targets and goals. A total of 134 respondents involving farmers and local implementing NGO workers were interviewed, using semi-structured open-ended questionnaires. One focus group discussion was held with paramount traditional rulers to assess the strength, weaknesses, opportunities and threats (SWOT) of the community-led ecosystem restoration and conservation initiative. The principal components analysis with oblique (Direct oblimin) rotation was used to reduce the number of constitutive items in each dimension of motivation, challenge and barrier to community participation. Linear regression analysis was used to examine how the different dimensions of motivations, challenges and barriers influence community participation. Community participation was initially driven more by environmental motivations given the highly deforested and degraded Mount Bamboutos landscape, but later on driven more by economic and community motivations. Social factors were least expressed and non-significant predictors of participation. Community participation was primarily limited by management, financial, psychological, personal, and information challenges and barriers. Providing financial incentives to cover daily subsistence costs of food and transport was a key negotiation strategy that increased community participation. Conservation organisations should capitalise on environment, community and social motivational appeals during community education and awareness campaigns to increase voluntary community participation. The local knowledge on ecosystem restoration and conservation motivations, challenges, barriers, negotiation strategies, recommendations and SWOT analysis provide relevant baseline information for environment management decision-makers in Cameroon and other Sub-Saharan African countries.

Barriers and Motivations for Health Insurance Subscription Among Health-Care Users in Cameroon.

INTRODUCTION: Surgical care is a significant component of the overall health expenditure in low- and middle-income countries. In Cameroon, out-of-pocket payments for surgical service are very high with many patients declining potentially curative surgical procedures. Less than 2% of the population is enrolled in a health insurance scheme leading to a propensity for catastrophic health expenses when accessing care. To assess the perceived barriers and motivations for health insurance subscription among health-care users in Cameroon. METHODS: This was a cross-sectional community-based qualitative study conducted in the Center Region of Cameroon. A total of 37 health-care users (health insurance subscribers and nonsubscribers) were purposively identified. Four focused group discussions and thirteen in-depth interviews were conducted. All anonymized transcripts were analyzed using a thematic analysis approach. RESULTS: The six major themes identified as barriers to health insurance subscription were lack of trust in the existing health insurance schemes, inadequate knowledge on how health insurance works, premiums believed to be too expensive, the complexity of the claims processing system, minimal usage of health-care services and practice of self-medication. Motivational factors included the knowledge of having access to quality health services even without money in the event of an unforeseen illness and having a large family/household size. The importance of mass sensitization on the benefits of health insurance was noted. CONCLUSION: Health insurance is still very underutilized in Cameroon. This results in significant out-of-pocket payment for health services by Cameroonians with catastrophic consequences to households. With most Cameroonians in the informal sector and underemployed, it is imperative to put in place a national strategic plan to overcome existing barriers and increase health insurance coverage especially among the poor. This has the potential to significantly increase access to safe, quality, timely and affordable surgical care.

A retrospective cohort study on the cost-effectiveness analysis of kidney transplantation compared to dialysis in Cameroon: evidence for policy.

Introduction: chronic kidney disease affects one in ten adults in Cameroon. Haemodialysis was the only renal replacement therapy (for adults) in Cameroon and its sub-region until November 10, 2021. Thereafter through May 2022, the Yaoundé General Hospital successfully completed four living-donor kidney transplants. This paper examines policy implications. Methods: medical records of cohorts of kidney failure patients who started haemodialysis at Yaoundé General Hospital in 2012 (n=106) and 2017 (n=118) were abstracted retrospectively through 2021 and their survival analyzed with Microsoft Excel and Kaplan-Meier curves. Using hospital data, the literature, and price indexes, the annual medical cost per patient of dialysis and living-donor kidney transplantation in 2022 prices was derived. Results: the 9.5-year survival rate for the 2012 cohort was 11% and the 5-year rate for the 2017 cohort was 18%. Annual haemodialysis cost per patient averaged $17,681 (26.5% from households and 73.5% from government). Initial transplantation costs averaged $10,530 per patient, all borne by the government. Under the brand-drug option, first-year transplantation follow-up costs $19,070 (4% for laboratory and 96% for drugs). Conclusion: annually, haemodialysis in Cameroon costs per patient 12 times the country's average income ($1,537), driven especially by the costs of equipment purchase, maintenance, and consumables. Cameroon's initial cost of transplantation is lower than in other African countries. Generic drugs could lower annual follow-up costs by 89%. If Cameroon could achieve long-term survival with generic drugs after kidney transplantation, that modality would become a reasonable option for selected kidney failure patients (e.g. younger and without other comorbidities).

The faces behind vaccination: unpacking the attitudes, knowledge, and practices of staff of Cameroon's Expanded program on Immunization.

BACKGROUND: Immunization is regarded as one of the most cost-effective public health interventions in global health. However, its cost-effectiveness depends greatly on the knowledge and skills of vaccinators. With the growing complexity of immunization programs, the need for a well-trained vaccination workforce cannot be overemphasized. In this study, we assessed the knowledge, attitudes, and practices among vaccination staff in Cameroon. METHODS: Through a descriptive cross-sectional design, we used structured questionnaires and observation guides to collect data from vaccination staff in health facilities that were selected by a multistage sampling method. Data were analyzed using STATA 13 software. RESULTS: Overall, we collected data from Expanded Program on Immunization focal staff in 265 health facilities across 68 health districts. Over half (53%) of the surveyed facilities were found in rural areas. Nearly two-thirds of health facilities had immunization focal staff with knowledge gaps for each of the four basic immunization indicators assessed. In other words, only 37% of staff knew how to estimate coverages, 36% knew how to inteprete the EPI monitoring curve, 35% knew how to prepare vaccine orders, and 37% knew how to estimate vaccine wastage. In terms of practices, staff waited for more than ten children to be present before opening a 20-dose vaccine vial in 63% of health facilities, and more than five children to be present before opening a 10-dose vaccine vial in 80% of surveyed facilities. Provision of vaccine-specific information (informing caregiver about vaccine received, explanation of benefits and potential side effects) during immunization sessions was suboptimal for the most part. CONCLUSION: This study suggests marked deficits in immunization knowledge among vaccination staff and exposes common attitudes and practices that could contribute to missed opportunities for vaccination and hinder vaccination coverage and equity in Cameroon. Our findings highlight the urgent need to invest in comprehensive capacity building of vaccination staff in Cameroon, especially now that the immunization program is becoming increasingly complex.

Political instability and hiv/aids response in the south west and north west regions of Cameroon: a qualitative study.

BACKGROUND: Politically motivated violence and insecurity continue to be a major threat to progress in HIV epidemic control and a significant contributor to health inequality. Despite a decreasing HIV/AIDS disease burden, the Republic of Cameroon in West Africa is experiencing ongoing political instability in her North and South West Regions. Our study used qualitative methods to better understand key frontline health care providers' (fHCP) perceptions of the effects of political instability on HIV/AIDS response gains in Cameroon since 2018, as well as lessons learned for overcoming them. METHODS: Between July and August 2022, semi-structured, in-depth key informant interviews involving 10 purposively selected participants were conducted in the two regions. Interviews were recorded and transcribed verbatim, coded thematically, and analyzed manually. RESULTS: Six overarching themes emerged from the transcribed key informant interviews. They were as follows: Challenge with access to and availability of health care services (HIV care, commodity supply chain) in the smaller communities; Impact on continuity of treatment; Increased risk of new HIV infections; The socioeconomic impact of the crisis on the quality of life; The impact of the crisis on fHCPs' physical and mental health and the health system'; and Coping mechanisms. CONCLUSIONS: Frontline healthcare workers have acknowledged the significant impact the current political instability has had in hindering the development and advancement of a successful local response to HIV/AIDS in the two impacted regions of Cameroon. Coordinated efforts must be made to strengthen the health sector in areas such as HIV healthcare decentralization, supply chain, and protecting frontline healthcare workers from political quagmires in order to lessen the impact of the nation's socio-political crisis on the HIV/AIDS response and, more generally, on the entire health sector.

Cost-effectiveness of community-based household tuberculosis contact management for children in Cameroon and Uganda: a modelling analysis of a cluster-randomised trial.

BACKGROUND: WHO recommends household contact management (HCM) including contact screening and tuberculosis-preventive treatment (TPT) for eligible children. The CONTACT trial found increased TPT initiation and completion rates when community health workers were used for HCM in Cameroon and Uganda. METHODS: We did a cost-utility analysis of the CONTACT trial using a health-system perspective to estimate the health impact, health-system costs, and cost-effectiveness of community-based versus facility-based HCM models of care. A decision-analytical modelling approach was used to evaluate the cost-effectiveness of the intervention compared with the standard of care using trial data on cascade of care, intervention effects, and resource use. Health outcomes were based on modelled progression to tuberculosis, mortality, and discounted disability-adjusted life-years (DALYs) averted. Health-care resource use, outcomes, costs (2021 US$), and cost-effectiveness are presented. FINDINGS: For every 1000 index patients diagnosed with tuberculosis, the intervention increased the number of TPT courses by 1110 (95% uncertainty interval 894 to 1227) in Cameroon and by 1078 (796 to 1220) in Uganda compared with the control model. The intervention prevented 15 (-3 to 49) tuberculosis deaths in Cameroon and 10 (-20 to 33) in Uganda. The incremental cost-effectiveness ratio was $620 per DALY averted in Cameroon and $970 per DALY averted in Uganda. INTERPRETATION: Community-based HCM approaches can substantially reduce child tuberculosis deaths and in our case would be considered cost-effective at willingness-to-pay thresholds of $1000 per DALY averted. Their impact and cost-effectiveness are likely to be greatest where baseline HCM coverage is lowest. FUNDING: Unitaid and UK Medical Research Council.

Cost of implementing a doxycycline test-and-treat strategy for onchocerciasis elimination among settled and semi-nomadic groups in Cameroon.

BACKGROUND: Onchocerciasis is a neglected tropical disease with 217.5 million people globally at risk of having the infection. In both settled and semi-nomadic communities of Massangam Health District in Cameroon, Sightsavers has been carrying out test-and-treat with doxycycline and twice-yearly ivermectin distribution. This paper focuses on the cost of test-and-treat with doxycycline in the two community contexts of settled and semi-nomadic. METHODS: For the valuation, a combination of gross or micro-costing was used to identify cost components, as well as bottom-up and top-down approaches. The opportunity costs of vehicle and equipment use were estimated and included. Not included, however, were the opportunity costs of building use and Ministry of Public Health staff salaries. We only captured the incremental costs of implementing test-and-treat activities as part of a functional annual community-directed treatment with the ivermectin programme. RESULTS: We estimate the economic cost per person tested and cost per person treated in Massangam to be US$135 and US$667 respectively. Total implementation cost in the settled community was US$79,409, and in the semi-nomadic community US$69,957. Overall, the total economic cost of implementing the doxycycline test-and-treat strategy for onchocerciasis elimination in Massangam came to US$168,345. Financial costs represented 91% of total costs. CONCLUSIONS: Unit costs of test-and-treat in both settled and semi-nomadic communities are higher than unit costs of community-directed treatment with ivermectin. However, it is critical to note that a two-year implementation shows a significantly larger reduction in infection prevalence than the preceding 20 years of annual community-directed treatment with ivermectin. Test-and-treat with doxycycline may be a cost-effective intervention in places where the prevalence of microfilaria is still high, or in hard-to-reach areas where community-directed treatment with ivermectin and MDA coverage are not high enough to stop transmission or where marginalised populations consistently miss treatment.

Assessment of infraorbital foramen position using computed tomography-scan in a cohort of Cameroonian adults: landmarks in facial surgery and anesthesiology.

Introduction: the infraorbital foramen (IOF) is a hole located in the maxillary bone and delivering passage to the infra orbital vascular-nervous bundle. It is an essential structure in the management of orofacial pathologies. Its precise location allows optimal anesthesia of the infraorbital nerve during cleft lip and palate surgery or alcoholization during the management of essential V2 neuralgia. The aim of our research was to determine the morphology and morphometry of the infraorbital foramen in a sample of the Cameroonian population. Methods: we included 208 CT-scans of patients meeting our search criteria. We determined the shape of the IOF and evaluated the transverse and vertical diameters of the IOF. We assessed the distance of the IOF from the maxillary alveolar crest and the infraorbital margin. The Student test was used to determine the association between different variables. The P-value of 0.05 was considered significant and the confidence interval was 95%. Results: male subjects represented 52.4% (n=109) of our participants and the mean age of our population was 26 years ± 7.3. The mean transverse diameter of the left IOF was 1.97 mm ± 0.51 while 1.78 mm ± 0.53. The IOF was more often medial to the lateral palpebral commissure-nasal wing line on the left and right (78.8% and 72.6%, respectively). Our sample showed that in 54.6% (n=113) of subjects, the IOF was oval on the left side, whereas on the right side, the IOF was oval in 52.3% (n=109) of patients. Conclusion: our study showed that to locate the IOF in a Cameroonian individual, one must palpate the vestibular mucosa opposite the maxillary first molar. Then, one must follow the line passing over this tooth, the IOF is located at about 7 mm from the infra-orbital border and 16 mm from the lateral nasal wall. We have shown that the IOF is located medial to the line connecting the nasal wing to the external palpebral commissure.

Assessment of the availability, accessibility, and quality of sexual and reproductive health services for young people in conflict affected zones of Cameroon: a mixed method study.

INTRODUCTION: Despite ongoing programs to improve young people's Sexual and Reproductive Health Services (SRHS) in the conflict plagued North West and South West Regions of Cameroon, there is limited evidence-based information evaluating SRHS. This study, therefore, aims to investigate the availability, accessibility, and quality of SRHS provided to young people in the North West and South West Regions of Cameroon. METHOD: This is a cross-sectional mixed-methods sequential explanatory study conducted among healthcare providers and young people between 10 and 24 years in 6 selected urban and rural areas in North West and South West regions. Data was collected between December 2021 and September 2022 using an adopted checklist. A descriptive analysis was conducted for quantitative data. An inductive analysis was conducted for the qualitative data to construct themes. The findings from the quantitative and qualitative responses were triangulated. RESULTS: There were 114 participants, 28 healthcare providers and 86 young people. Most provider participants were nurses (n = 18, 64.3%), working in religious facilities (n = 14, 50.0%), with diplomas as state registered nurses (n = 9, 32.1%). Also, more than half of young people (51.2%) were less than 20 years old, while there were more male young people (51.2%) than female young people (48.8%). Most respondents agreed that SRHS services were available, though they think they are not designed for young people and have limited awareness campaigns about the services. Reasons such as limited use of written guidelines, affected quality of SRHS. Participants revealed shyness, resistance from religious groups and families, insecurities from political instability, and inadequate training, among others, as barriers to SRH accessibility. CONCLUSION: The study shows that SRHS are available but are not specifically designed for young people. Inadequate publicity for these services, coupled with the political crises and the ongoing COVID-19 pandemic, has increased young people's inaccessibility to SRHS. Young people usually have to finance the cost of most of the SRHS. The quality of service delivery in the facilities is inadequate and must therefore be improved by developing safe, youth-friendly centers staffed with well-trained service providers.

Assessment of heavy metals' pollutions and potential risks associated to the rocks of Pouma subdivision-Cameroon.

The present study aimed to assess the ecological and health risks of the Pouma rock samples. Twenty-three (23) trace element concentrations were evaluated. The concentrations of these trace elements were compared with those of quartzite from other countries and with global reported values. When compared with the world values, the concentrations of trace metals were below the world average values except that of Barium. The ecological risk assessment was carried out using the geo-accumulation index, contamination factors and the potential ecological risk index. The geo-accumulation index and contamination factors showed that the quartzite of Pouma subdivision are not polluted and not contaminated by the investigated metal except for Barium and Mercury. The health risk assessment using the USEPA (United States Environmental Protection Agency) method showed that there is a possible non-carcinogenic risk from Al2O3 (for children and adults) and from Cr for Children. However, there is a tolerable and high carcinogenic risk due to Cr for adults and children, respectively. It was found independently for non-carcinogenic and carcinogenic risk that the exposure via the ingestion route is the most dangerous for adults and children.

Assessment of immunization data management practices in Cameroon: unveiling potential barriers to immunization data quality.

BACKGROUND: One crucial obstacle to attaining universal immunization coverage in Sub-Saharan Africa is the paucity of timely and high-quality data. This challenge, in part, stems from the fact that many frontline immunization staff in this part of the world are commonly overburdened with multiple data-related responsibilities that often compete with their clinical tasks, which in turn could affect their data collection practices. This study assessed the data management practices of immunization staff and unveiled potential barriers impacting immunization data quality in Cameroon. METHODS: A descriptive cross-sectional study was conducted, involving health districts and health facilities in all 10 regions in Cameroon selected by a multi-stage sampling scheme. Structured questionnaires and observation checklists were used to collect data from Expanded Program of Immunization (EPI) staff, and data were analyzed using STATA VERSION 13.0 (StataCorp LP. 2015. College Station, TX). RESULTS: A total of 265 facilities in 68 health districts were assessed. There was limited availability of some data recording tools like vaccination cards (43%), maintenance registers (8%), and stock cards (57%) in most health facilities. Core data collection tools were incompletely filled in a significant proportion of facilities (37% for registers and 81% for tally sheets). Almost every health facility (89%) did not adhere to the recommendation of filling tally sheets during vaccination; the filling was instead done either before (51% of facilities) or after (25% of facilities) vaccinating several children. Moreso, about 8% of facilities did not collect data on vaccine administration. About a third of facilities did not collect data on stock levels (35%), vaccine storage temperatures (21%), and vaccine wastage (39%). CONCLUSION: Our findings unveil important gaps in data collection practices at the facility level that could adversely affect Cameroon's immunization data quality. It highlights the urgent need for systematic capacity building of frontline immunization staff on data management capacity, standardizing data management processes, and building systems that ensure constant availability of data recording tools at the facility level.

De-medicalized and decentralized HIV testing: a strategy to test hard-to-reach men who have sex with men in Cameroon.

Conventional HIV testing performed by a health professional has shown its limitations in targeting marginalized and vulnerable populations. Indeed, men who have sex with men (MSM) due to social discrimination are often uncomfortable using this service at the health facilities level. In this perspective, new differentiated approaches have been thought through de-medicalized and decentralized HIV testing (DDHT). This HIV testing strategy enables overcoming the structural, legal, and social barriers that prevent these populations from quickly accessing HIV services. This article discusses the prerequisites and added value of implementing this strategy for MSM living in a criminalized context and its implication in decentralizing health services toward the community level.

Community perception of the determinants of unmet needs of family planning among married women in Buea Health District, Southwest Region, Cameroon.

Introduction: in Cameroon, and more specifically in the Buea Health District of the Southwest Region, there are still a few unmet family planning needs. Many women desire to avoid getting pregnant, but do not use an effective form of birth control. A focus group discussion among married women in the Buea health district was necessary to explore the determinants of unmet family planning in order to promote access to and use of long-acting modern contraceptive methods because most research studies have only focused on the quantitative aspect. Methods: focus groups were held in the community and in the medical facilities as part of the study's qualitative exploratory strategy. To invite the participants, invitations were sent out. A qualitative survey of 10-12 respondents was carried out by the researcher, in each Focus Group the discussed topics included factors that encourage the use of FP methods, making the switch from traditional to modern FP methods, family planning methods decision-making, accessibility of FP in the context of the COVID-19 pandemic. Each focus group discussion lasted 1 hour 30 minutes, the perception was collected in an audiotape recorder and later transcript verbatim. The team conducted 10 Focus Group Discussion (FGD) (four of each of the topic areas). The FGD team provided participants with light refreshments. Results: a total of 10 focus groups were conducted, reaching a total participant of 107. The N-Vivo analysis software was used to analyze the data. The following are some of the key participant perceptions that have been reported. Perceptions of family planning; for health reasons as well as social expectations and pressures, having children earlier in marriage was a wise decision. While there are certain issues with having children early in life, such as the mother's maturity and financial stability, having a kid as soon as feasible is the best option. It is best to have children within the first two years of marriage, with a three-to-five-year gap between them. Reasons for changing from traditional to modern family planning; The most significant issues with current birth control techniques (such as condoms, pills (postinor-2), implants, injectables, and IUDs) are those that affect a woman's body. Regardless of the issues, they experience with contraception, there are some benefits to utilizing it. Both modern and classic FP methods have the potential to fail. Making family planning decisions; extended families, particularly mothers-in-law, have a strong influence on family planning and size decisions, and family members assist in resolving FP issues and challenges. Participants want to know about the adverse effects of current birth control techniques, especially in the long run, and how contraceptives affect a future pregnancy. Accessibility of FP in the context of the COVID-19 pandemic; participants have mixed perceptions of whether the COVID-19 context influences their accessibility to family planning. Conclusion: the focus groups demonstrated that participants have a nuanced and sophisticated awareness of pertinent topics that significantly impact them. While cultural and social conventions surrounding family planning difficulties and decision-making continue to put pressure on women, traditional and modern family planning methods are well-known. Participants also reported a strong desire to learn more about family planning alternatives, the effects of different methods on their bodies, and to have access to a wider selection of general and specialized family planning services. Fear was produced by the backdrop of COVID-19, but women are rapidly overcoming these fears to have access to family planning.

Prevalence, risk factors and management of common mental health disorders in Cameroon: a systematic review protocol.

BACKGROUND: Mental health disorders (MHDs) are considered a serious public health concern globally. The burden of mental health conditions is estimated to be higher in low-income and middle-income countries, including Cameroon, where reliable estimates are lacking. This review aims to synthesise evidence on the prevalence of MHDs, the effectiveness of mental health management interventions and identify risk factors for MHDs in Cameroon. METHOD: This review will systematically search electronic databases for studies focusing on one or more MHDs of interest within the context of Cameroon. We will include cohort, case-control and cross-sectional studies which assessed the prevalence or risk factors for MHDs in Cameroon and intervention studies to provide evidence on the effectiveness of interventions for managing MHDs. Two reviewers will independently perform all screening stages, data extraction and synthesis. We will provide a narrative synthesis and, if we identify enough articles that are homogeneous, we will perform a meta-analysis using a random effect model. The strength of the evidence will be assessed using the Grading of Recommendation, Assessment, Development and Evaluation approach. CONCLUSION: This review will contribute to the current body of knowledge by providing a synthesis of current evidence on the prevalence of common MHDs, risk factors for different MHDs and the effectiveness of interventions for managing different mental health conditions in Cameroon. ETHICS AND DISSEMINATION: This study will involve synthesis of published literature and does not warrant ethical approval. The findings will be disseminated through internationally peer-reviewed journals related to mental health. PROSPERO REGISTRATION NUMBER: CRD42022348427.