Seasonal Pattern and Occurrence of Schistosoma haematobium Egg Excretion among Pregnant Women in Munyenge, South West Region, Cameroon

Aim:The aim of this study was to describe temperature, precipitation pattern and the occurrence of maternal urogenital schistosomiasis (UGS) in Munyenge in 2017. Study Design:It was a twelve-month cross-sectional study.Study Site and Duration:The study was carried out in Munyenge from January to December 2017. Materials and Methods:Volunteer pregnant women attending antenatal care clinic were enrolled consecutively on a monthly basis from January to December 2017. A semi-structured questionnaire was used to obtain information on socio-demographic data and water contact behaviour. Urine samples were analysed for presence of microhaematuria and/or Schistosoma haematobiumova using filtration method. Monthly land surface temperature (LST) and precipitation were sourced from MODIS and CHIRPS satellite data respectively. Statistical analyses performed were analysis of variance, student t-test and correlation analysis. Results:The mean annual temperature was 27.18 ± 0.74°C. Monthly temperatures were fairly constant (range: 26.12 to 28.82°C). Precipitation varied greatly(range: 0.26 -12.75mm) with a mean of 6.58 ± 4.5mm. A marginal negative correlation (r = -0.586; P= .04) was observed between stream usage and precipitation where stream usage reduced with increase in precipitation. Generally, there was high dependence on the stream as source of water (60.9 -90.6%) in the study area. Dependency on the stream was associated (r = 0.603; P= .03) with domestic and bathing activities. The annual prevalence of maternal UGS was 24.1% (77/320) with a high occurrence during the rainy season (16.6%; 53/320) than the dry season (7.5%; 24/320) but the difference was not significant (χ2= 2.26; P= .13). There was no significant difference between months. Conclusion:Our findings show no seasonal variation in the occurrence of maternal UGS in Munyenge. Transmission of infection may be perennia

Active Case Detection and Prevalence of Urinary Schistosomiasis and Malaria in Pupils of Kotto Barombi, Southwest Cameroon Using the CyScope® Fluorescence Microscope.

Aim: This study was aimed at assessing the use of the CyScope® fluorescence microscope to determine the prevalence of urinary schistosomiasis (US) and malaria in Kotto Barombi. Experimental Design: The study was a cross-sectional survey. Place and Duration of Study: The study was carried out in Kotto Barombi, Cameroon from April to May, 2013. Methodology: Urine and blood samples were collected from 216 pupils. US eggs were detected in urine by centrifugation and CyScope® methods for schistosome eggs. Malaria parasites were detected using Giemsa-stained blood films and CyScope® methods. The performance characteristics of the CyScope® for both infections were determined using light microscopy as gold standard. Results: Overall prevalence of US was 43.4% and 48.5% by light microscopy and CyScope® respectively. Prevalence of US was significantly higher (P<0.01) in the Kotto Barombi Island (78.3%) than Mainland (33.8%). US prevalence was not affected by age, sex and socio-economic class (SEC). Mean intensity of US was 8.1 eggs/10 ml urine (Confidence interval, CI = 4.3–11.9). It was significantly higher (P =.01) in pupils from Island (36.5 eggs/10 ml, CI: 17.7–55.3) than Mainland (8.8 eggs/10 ml; 7.1–10.5), males (19.2 eggs/10 ml urine; CI: 9.2–29.2) than females (17.8 eggs/10 ml urine; CI: 13.1–22.5) and highest (P = .046) in the ≤6 years age group (36.9 eggs/10 ml; CI: 20.4–53.4) when compared with pupils in other age groups. Sensitivity and specificity of CyScope® for US were 90.6% and 83.8% respectively. Overall prevalence of malaria was 19.0% and 41.2% by light microscopy and CyScope® respectively and the difference was significant (P = .01). Malaria prevalence and density were not influenced by age; sex and SEC. Sensitivity and specificity of CyScope® for malaria were 68.3% and 64.9% respectively. Conclusion: The CyScope® could be a useful tool for active case detection of both diseases especially in areas that lack electricity.

Plasmodium falciparum Specific IgE, IgG and Anti-GPI IgG Antibodies in Cameroonian Children with Severe and Uncomplicated Malaria.

Aims: We investigated the role of antibodies in the pathogenesis of severe malaria in children by measuring and comparing plasma levels of antibodies to glycosyl phosphatidy linositol (GPI) and crude Plasmodium falciparum extract. Study Design: Cross-sectional case-control study. Place and Duration of Study: Five health institutions in two towns and seven primary schools in the South West region of Cameroon between April 2003 and December 2005. Methodology: A total of 649 children including 25, 156 and 233 cases of cerebral malaria (CM), severe malaria anaemia (SMA) and uncomplicated malaria (UM) respectively were recruited from health institutions and 233 apparently healthy controls (HC) from schools using predefined inclusion criteria. Malaria parasitaemia was determined by light microscopy using Giemsa-stained thick blood smears, haemoglobin level using a haemoglobinometer and blood cell count using a haemocytometer. The levels of total IgE, P. falciparum IgG, IgE and anti-GPI IgG antibodies were measured from plasma by the ELISA technique. Results: The mean white blood cell count (WBC) was higher in the severe malaria group compared with the HC group. Geometric mean parasite densities were significantly different (P<0.001) amongst the study groups but similar in the two severe malaria groups (Severe Malaria Anaemia and Cerebral Malaria). Seropositivity for IgG antibodies to P. falciparum was different within the study groups (P<0.001) and higher in the clinical cases compared to the HC group. Mean levels of anti-GPI IgG and P. falciparum specific IgE and IgG antibodies were significantly different among the study participant categories. Mean plasma levels of these antibodies were higher in the UM and HC groups when compared with the severe malaria groups. There was a significant positive correlation between the age of the participant and levels of anti-GPI IgG (P<0.001), P. falciparum IgE (P = 0.027) and total IgE (P = 0.020) antibodies. Conclusion: Our observation of lower levels of anti-GPI and P. falciparum specific IgE antibodies in the severe group compared with the control group suggest a protective role of these antibodies in the pathogenesis of severe malaria. The correlation observed between P. falciparum IgE, IgG and GPI IgG antibody levels with age confirm previous reports that immunity to malaria develops with age and is partially dependent on antibody production.

Factors associated with the uptake of intermittent preventive treatment of malaria in pregnancy in the Bamenda health districts, Cameroon

Introduction: the World Health Organization (WHO) recommends that in malaria endemic areas with moderate to high transmission rates, pregnant women presenting for antenatal clinic (ANC) should receive at least three doses of intermittent preventive treatment in pregnancy (IPTp) for malaria between the 16th and 36th weeks of pregnancy at intervals of 4 weeks between doses. Several challenges remain in effective implementation of IPTp policy making the targeted coverage (80%) of the third doses of IPTp far from being achieved. The main objective of this study was to assess factors associated with the uptake of IPTp among pregnant women attending ANCs in the Bamenda Health District. Methods: to reach our objectives, we carried out a cross-sectional study following informed consent with thirty-nine (39) healthcare workers (HCW) and four hundred (400) pregnant women who were either in the third trimester of pregnancy or had recently given birth in any of thirty-six (36) health facilities (HF) within the Bamenda Health District (BHD) from May to August 2014. All sites within the BHD were included. The participants were selected by simple random sampling. The principal research instrument was a structured and pre-tested questionnaire that was designed to capture socio-demographic data and data related to stage of pregnancy and knowledge about IPTp. Data was entered using Ms Excel and analysed using SPSS v20.0. Descriptive statistics (frequencies and percentages) was used to report findings. We used Chi-Square test to compare the categorical variables (Fischer's exact test was used in cases were conditions for Chi-Square test were not met). Results: uptake for at least one dose of IPTp was 95.3% (381/400) and 54.9% (209/400) had received all three doses, 15.5% (59/400) received only one dose and 4.8% (19/400) did not receive any of the doses of IPTp. Knowledge about IPTp was associated with an increase uptake of IPTp (P<0.001). All health care providers were knowledgeable about the importance and use of IPTp. However, 35.9% reported not receiving any training on IPTp. Among the health providers, 28.2% did not know when to start IPTp and 43.59% did not know when to stop IPTp. Out of all the health care providers, 30.77% complained of medication (sulfadoxine-Pyrimethamine) stock out and 84.62% practiced the policy of direct observed therapy. Conclusion: the uptake of the third dose of IPTp is poor in the Bamenda Health District and this may be attributed to medication stock out and inadequacy of routine trainings for the health providers. The good practice observed was that of direct observed therapy by HCWs. Patient knowledge about IPTp in our study was associated with better uptake of IPTp. Encouraging education of pregnant women on the importance of IPTp, providing routine training to HCWs and promoting direct observation of therapy may improve on IPTp uptake during pregnancy