Factors influencing integration of mental health screening and treatment at HIV clinic settings in Cameroon: a qualitative study of health providers' perspectives.

BACKGROUND: Mental disorders are common among people with HIV (PWH) and are associated with poor HIV outcomes. Despite high unmet mental health needs among PWH, use of evidence-based mental health screening and treatment protocols remains limited at HIV treatment facilities across low-resource settings. Integrating mental health services into HIV care can reduce this gap. This study's objective was to explore factors that influence integration of mental health screening and treatment into HIV clinics in Cameroon. METHODS: We analyzed 14 in-depth interviews with clinic staff supporting PWH at three urban HIV treatment clinics in Cameroon. Interviews focused on current processes, barriers and facilitators, and types of support needed to integrate mental health care into HIV care. Interviews were recorded and transcribed. French transcripts were translated into English. We used thematic analysis to identify factors that influence integration of mental health screening and treatment into HIV care in these settings. Ethical review boards in the United States and Cameroon approved this study. RESULTS: Respondents discussed a lack of standardized mental health screening processes in HIV treatment facilities and generally felt ill-equipped to conduct mental health screening. Low community awareness about mental disorders, mental health-related stigma, limited physical space, and high clinic volume affected providers' ability to screen clients for mental disorders. Providers indicated that better coordination and communication were needed to support client referral to mental health care. Despite these barriers, providers were motivated to screen clients for mental disorders and believed that mental health service provision could improve quality of HIV care and treatment outcomes. All providers interviewed said they would feel more confident screening for mental disorders with additional training and resources. Providers recommended community sensitization, training or hiring additional staff, improved coordination to manage referrals, and leadership buy-in at multiple levels of the health system to support sustainable integration of mental health screening and treatment into HIV clinics in Cameroon. CONCLUSIONS: Providers reported enthusiasm to integrate mental health services into HIV care but need more support and training to do so in an effective and sustainable manner.

Irvingia gabonensis baill. (African Mango): A comprehensive review of its ethnopharmacological significance, unveiling its long-standing history and therapeutic potential.

ETHNOPHARMACOLOGICAL RELEVANCE: Irvingia gabonensis (Aubry-Lecomte ex O'Rorke) Baill. (IG) is a multipurpose tree native to tropical Africa such as Equatorial Guinea, Nigeria, Gabon, and Cameroon with high ethnomedicinal values. AIM OF THE STUDY: This review emphasizes the ethnopharmacological significance, phytochemical, and functional properties of African mango, focusing on its potential for human health and industrial applications. MATERIALS AND METHODS: Literature published on IG was traced by different databases, including the Egyptian Knowledge Bank database (EKB), ScienceDirect, PubMed, Google Scholars, Research Gate, Web of Science, Elsevier, and Scopus. Numerous keywords were used to achieve an inclusive search in the databases, like 'African Mango', 'Bush Mango', 'Irvingia gabonensis', 'Wild Mango', 'Dika Nut', 'Phytochemistry', 'Traditional uses', 'Functional foods', 'Polyphenols', 'Ogbono', 'Ellagic acid and its derivatives', and 'Pharmacological activities'. RESULTS: Different parts of IG have been employed in traditional medicine and recorded a great success. The ripe fruit pulp was consumed fresh or processed into juice and wine documented for anti-diarrheal, anti-diabetic, anti-ulcer, hepatoprotective, antimicrobial, and anti-inflammatory properties. The kernels, which are widely traded and incorporated into traditional dishes, remain an integral part of culinary traditions. Seeds have folkloric uses for weight loss and are popular as blood thinners and anti-diabetics. Where the bark is reported for dysentery, colic, scabies, toothache, and various skin conditions. In Senegal, the stem bark is employed for gonorrhea, hepatic disorders, and gastrointestinal ailments. The leaves possess the potential to enhance renal and hepatic functions, safeguarding these vital organs against the detrimental effects of toxic substances. Pulp is rich in vitamin C, carbohydrates, and proteins. Oil is the major constituent of the seed, which is mainly composed of myristic and lauric acids. The defatted extracts are characterized by flavonoid glycosides and ellagic acid derivatives. Despite their widespread use, IG extracts are still inadequately characterized phytochemically and merit further investigation within the realm of scientific research. Encouragingly, toxicity studies have demonstrated the relative safety of IG extract at the administered doses. CONCLUSION: The review extends our knowledge of the health benefits of IG, where these effects could be attributed to the phytochemicals present.

Anti-Shigella and antioxidant-based screening of some Cameroonian medicinal plants, UHPLC-LIT-MS/MS fingerprints, and prediction of pharmacokinetic and drug-likeness properties of identified chemicals.

ETHNOPHARMACOLOGICAL RELEVANCE: Shigella infection is a public health problem responsible for approximately 700,000 deaths annually. The management of this disease is impaired by the emergence of multidrug-resistant Shigella species, highlighting the urgent need to search for alternative treatment options. In this regard, investigating medicinal plants traditionally used for the treatment of dysentery, diarrheal infections, and/or associated symptoms in endemic regions might provide an opportunity to identify phytochemicals that could be further used as a basis for the development of future anti-shigella drug candidates. AIM OF THE STUDY: This study was designed to investigate the anti-shigella and antioxidant-based ethnopharmacological potency of some Cameroonian medicinal plants with an emphasis on pharmacokinetic properties of the identified chemical pharmacophore. MATERIALS AND METHODS: Briefly, plant species were selected and collected based on their ethnopharmacological uses and information reported in the literature. Crude aqueous, ethanolic, methanolic, and hydroethanolic (30:70, v/v) extracts from these plants were prepared and then screened for their anti-Shigella activity against four Shigella strains and cytotoxicity against Vero and Raw cell lines using microdilution and resazurin-based methods, respectively. The antioxidant activities of potent extracts were evaluated using DPPH, ABTS, NO, and FRAP scavenging assays. The chemical profile of potent extracts was performed using the UHPLC-LIT-MS/MS and the pharmacokinetic properties, druglikeness, and likely molecular targets of the chemical scaffolds identified were predicted using SwissADME and SwissTargetPredictor. RESULTS: Thirty-nine (39) plants belonging to 26 plant families were harvested. Out of the 228 extracts tested, 18 extracts originating from 6 plants (15.38 %) were active (MICs 250-1000 µg/mL) and nontoxic toward Vero (CC50 129.25-684.55 µg/mL) and Raw cell lines (CC50 336.20 to >1000 µg/mL). Six potent extracts from the two plants exhibited moderate to potent DPPH (SC50 8.870-54.410 µg/mL), ABTS (SC50 12.020-27.36 µg/mL), and NO (SC50 0.02-195.85 µg/mL) scavenging activities. Later, these extracts showed interesting ferric iron-reducing power (1.28-12.14 µg equivalent NH2OH/g of extract). The shortest onset of action time (4 and 6 h) observed following inhibition kinetics studies was observed with extracts BFSHE, PMSE, and PMSM. The UHPLC-LIT-MS/MS and some databases (Mass Spectral Library (NIST 14), Human Metabolome Database (HMD), MassBank, SuperNatural 3.0, The Food Database (FooDB), and Chemical Entities of Biological Interest (ChEBI)) allowed the annotation of 18 and 17 metabolites in the extracts from stem bark of P. macrophylla and B. ferruginea respectively. Pharmacokinetic prediction of these chemicals showed that compound 6 (4,6a-bis(Hydroxymethyl)-9a-methyl-3-oxo-1a,1b,3,5,6,6a,7a,9a-octahydrobis (oxireno)[2',3':5,6; 2″,3'':9,10]cyclodeca[1,2-b]furan-5-yl methacrylate), compound 8 (Corynoxeine), and compounds 35 (Stachybotrydial acetate) demonstrated acceptable druglike and pharmacokinetic properties and might act through inhibition of kinase, transferase, protease, oxidoreductase, and family AG protein-linked receptors. CONCLUSION: The findings from this investigation demonstrated that Cameroonian medicinal plants are suitable reservoirs of anti-Shigella and antioxidant agents with good drug candidate properties.

Association between malaria and undernutrition among pregnant women at presentation for antenatal care in health facilities in the Mount Cameroon region.

In resource limited settings, malaria and undernutrition are major public health problems in pregnancy. Therefore, this study assessed the association between malaria infection and undernutrition among pregnant women in the Mount Cameroon area. This cross-sectional study enrolled 1,014 pregnant women consecutively over a year. A structured questionnaire was used to collect socio-demographic information and clinical data. Maternal nutrition was assessed using dietary diversity (DD). Peripheral blood samples collected were used for the diagnosis of malaria parasitaemia by microscopy whereas haemoglobin (Hb) levels were determined using an Hb meter. Logistic regression was used to determine factors associated with malaria and dietary diversity. The prevalence of malaria infection and undernutrition was 17.8% and 89.6% respectively. In addition, of those infected with malaria, geometric mean parasite density was 301/µL of blood (range: 40-9280) while mean DD score was 3.57±0.82 (range: 1-7). The odds of being infected with malaria parasitaemia was highest among women enrolled in the rainy season (OR = 1.58, P = 0.043), who were farmers (OR = 2.3, P = 0.030), had a household size of < 4 individuals (OR = 1.48, P = 0.026) and who were febrile (OR = 1.87, P < 0.001). Also, attending clinic visits in Mutengene Medical Centre (OR = 2.0, P = 0.012) or Buea Integrated Health Centre (OR = 2.9, P = < 0.001), being < 25 years (OR = 2.4, P = 0.002) and a farmer (OR = 10.6, P = 0.024) as well as < 4 clinic visits (OR = 1.62, P = 0.039) were identified as predictors of undernutrition. Furthermore, the association between malaria and DD was statistically significant (P = 0.015). In this study, undernutrition was highly frequent than malaria infection. Thus, there is an urgent need to improve maternal awareness through nutritional counselling and health campaigns on the benefits of consuming at least five food groups. Besides, improved maternal dietary nutrient intake is likely to have impact on the burden of malaria parasite infection.

Diagnosis and treatment challenges of autism spectrum disorder at a reference hospital in Douala, Cameroon.

BACKGROUND: Autism spectrum disorder (ASD) is a neurodevelopmental disability associated with deficiency in social interaction, unusual development of social communication, and restricted or repetitive behaviors, interests and activities. This study aimed to describe management of pediatric ASD in Cameroon, a resource-constrained Central Africa country. METHODS: A retrospective study was conducted between December 2021 and May 2022 at the Pediatrics department of a reference hospital in the town of Douala. Data of interest of children with ASD were collected through eligible medical records and telephone discussions with their parents/guardians. RESULTS: Medical records of 145 children with ASD aged 2-15 years were included in the study, giving a hospital ASD prevalence of 3.7%. Time delay between parental concerns and hospital management was specified in 69 (47.58%) children, and among them 38 (55.07%) had a mean delay ± SD was less than five months. Children were mainly males (76%) and aged 4-5 years (37.93%), with mean age ± SD of 44.4 ± 22.2 months old. The main consultation reason was delayed language development (100%). Mean time delay between parental concerns and the first medical consultation was 18 months (range 1-60 month). Attention deficit hyperactivity disorder were found in 68.18% of children aged ≥ 6 years old. Neuropsychology (66.2%) was the most frequently used intervention. Some children were treated using traditional medicine. CONCLUSIONS: Management of pediatric ASD is strongly influenced by socioeconomic and cultural context. It is crucial to implement behavioral change campaigns in community, organize training sessions to medical staff on diagnosis and treatment of ASD, and provide specialized centers with skilled staff and equipped material.

Barriers and facilitators to ART adherence among ART non-adherence people living with HIV in Cameroon: A qualitative phenomenological study.

BACKGROUND: Antiretroviral therapy (ART) needs to be taken for life with near perfect levels of adherence for it to be effective. Nonetheless, ART non-adherence is still observed in sub-Saharan African (SSA) countries such as Cameroon. The objective of this study was to assess the factors influencing non-adherence and or adherence among people living with HIV (PLWH) who have experienced non-adherence to ART in Cameroon. METHODS: A descriptive qualitative study of PLWH who have experienced non-adherence with ART in Cameroon was conducted. Data were collected using in-depth interviews. Collected data were analyzed using the NVIVO 12 software. RESULTS: In total, 43 participants participated in this study. The Southwest and Littoral regions each contributed 15 (34.88%) of participants, participants' mean age was 37.1 years (SD: 9.81) and majority 34 (82.93%) were females. ART adherence barriers include those related to patient (forgetfulness, business with other things, unwillingness to swallow drugs daily), medication (side effects), health service (arrogance of caregivers, occasional drug shortages at treatment centre, poor counseling of patient), stigma (fear of status disclosure), use of alternative treatment (traditional medicine, prayers and deliverance), resource limitation (limited food, limited finances), environmental/social (limited or no home support), and political instability (disruption of free circulation by ghost towns, roadblocks and gunshots in some regions). ART adherence facilitators include social support (family and peer support), aligning treatment with patient's daily routines (align ART with schedule of family members), use of reminders (phone alarm, sound of church bell), health sector/caregiver support (messages to patient, financial support, proper counseling), and patient's awareness of HIV status/ART knowledge (awareness of HIV positive status, Knowledge of ART benefits). CONCLUSION: ART adherence barriers in Cameroon include those related to patient, medication, health service, stigma, use of alternative treatment, resource limitation, environmental/social, and political instability. ART adherence facilitators include social support, aligning treatment with patient's daily routines, use of reminders, health sector/caregiver support, and patient's awareness of HIV status/ART knowledge. Given these barriers and facilitators, continuous information provision and consistent support both from patients' families and caregivers are needed to improve adherence among patients. Further studies including many regions and larger samples using both in-depth and focused group discussions as well as quantitative approaches are required to uncover the burden related to ART non-adherence.

Perceptions of Cancer in Parents of Adolescent Daughters in Northwest Cameroon.

BACKGROUND: Cancer is a rapidly rising cause of morbidity and mortality in sub-Saharan Africa. Cervical cancer, in particular, is still one of the leading causes of mortality for women in this setting. The uptake of healthcare services is in part influenced by patients' belief systems. We sought to better understand the perception of cancer in the Kom tribe of Northwest Cameroon. METHODS: A qualitative research study was completed using a semi-structured interview guide and one-on-one interviews with 45 parents of girls aged 9-14 years. These girls were candidates for free HPV vaccination to prevent cervical cancer. The interviews were recorded, transcribed, and analyzed using ATLAS.ti 9. RESULTS: Thirty-five mothers and ten fathers with a median age of 42 yo were interviewed from Mbingo, Belo, Njinikom, and Fundong. Half of the parents were farmers, with three being herbalists or traditional medicine doctors. Seventy-seven percent had either no or only primary school education. None had had cancer. All knew at least one person with cancer. The most common word for cancer in the Kom language is "ngoissu". It can refer to a bad infection or cancer. The occurrence of ngoissu is the result of either a curse placed on you, ancestral retribution, or transgressing the ngoulatta (snail shell spoken over and usually placed in a garden). The implications are that treatment of ngoissu must involve the traditional doctor who determines the spiritual issue and prescribes a remedy (like a herb or tea) and/or an incantation. Within the context of cancer, this can lead to a delay in diagnosis until the disease is no longer curable by conventional therapies. CONCLUSION: Ways to bridge biomedical healthcare services and traditional medicine are needed, especially in tribal contexts where the latter is an integral part of daily life.

Disparities in cervical cancer screening programs in Cameroon: a scoping review of facilitators and barriers to implementation and uptake of screening.

BACKGROUND: Cervical cancer is the fourth most common cancer worldwide. Organized screening has achieved significant reductions in cervical cancer incidence and mortality in many high-income countries (HICs). But the gap between HICs and low-and-middle-income countries (LMICs) is still substantial as the highest burden of the disease is in LMICs. Cameroon is a LMIC, where cervical cancer is the leading cause of cancer-related deaths among women, only 3-5% of eligible women have been screened and there is no effective national cervical cancer prevention program. OBJECTIVE(S): Identify facilitators and barriers to the implementation and uptake of existing cervical cancer screening programs in Cameroon to inform the implementation of a comprehensive national program. METHODS: We conducted a scoping review using the Preferred Reporting Items for Systematic Reviews and Meta-analysis, extension for Scoping Reviews (PRISMA-ScR). Google Scholar and five electronic databases (PubMed, CINAHL, Embase, Cochrane library and Web of Science) were searched systematically from 2012 to 2022. Articles on cervical cancer screening programs in Cameroon were eligible for inclusion. Two reviewers independently screened search results and extracted relevant data. RESULTS: A total of 182 articles were identified using our search strategy, and 20 were included. There was scarcity of publications from the North, Adamawa, East and South regions of Cameroon. Barriers and facilitators found were presented using the World Health Organisation framework for health systems. Cross-cutting barriers were: (1) the lack of a national training curriculum for screening providers with no elaborate, harmonized screening and treatment algorithm for cervical precancers; and (2) women's lack of information about cervical cancer screening activities. Conversely, provision of screening services at a low or no cost to women in some programs and the feasibility of using novel point of care screening methods like the Human Papillomavirus DNA test were identified as facilitators. CONCLUSION: This scoping review indicates that there are knowledge and research gaps concerning the state of cervical cancer screening services in some regions of Cameroon. Moreover, it underlines the need for comprehensive cancer control policies and practices integrating all six-health system building blocks to reduce disparities between regions, and rural versus urban areas in Cameroon.

A cross-sectional survey on the use of herbal tea among Cameroonian adults (18-65 years).

BACKGROUND: In respect of the WHO's commendation to incorporate traditional medicine (TM) in health care, the Cameroon government wants to promote the use of the traditional medicine and is resolute on encouraging the treatment of patients with alternative medicine from traditional sources. This study explores the use of herbal tea by Cameroonian adults to prevent or treat diseases and the socio-demographic determinants of tea use among participants. METHODS: A cross-sectional survey was conducted among 307 Cameroonian adults (18-65 years) randomly selected within 4 hospitals and 4 communities in the Centre and Southwest regions of Cameroon between 04/01-20/04/2022, using interviewer administered semi-structured questionnaires. Binary logistic regression analysis was conducted to determine the association between variables. RESULTS: Over four-fifth (89.3%) of participants had taken herbal teas at least once within the last 2 years prior to the survey, and most participants used the teas for the prevention and treatment of Covid-19 (67.9%), malaria (59.7%) and typhoid fever (35%). Most respondents took the teas warm (75%), and the treatment dosage used by most respondents (51%) was "one glass in the morning and evening for one to two weeks". The teas taken by 70% of users had bad or bitter taste and 52.2% of them were uncomfortable with the bad taste. However, the majority of users completed their treatment dosage (72%), 90.5% of them were willing to use teas for treatment if prescribed in health facilities in future, and 90.1% were in support that herbal teas should be prescribed in hospitals. There was no significant association (p ≥ 0.05) between sociodemographic characteristics of participants and herbal tea use. However, the major motivating factor for acceptability of herbal tea use was treatment effectiveness (52.7%). CONCLUSION: There is high prevalence of herbal tea use among adults Cameroonians in the studied settings in the Centre and Southwest regions of Cameroon, with a positive opinion and willingness to use teas if prescribed in health facilities. Authorities must ensure the effectiveness and safety of traditional medicine served in health facilities, to enhance compliance and adequate use.

Knowledge about Asymptomatic Malaria and Acceptability of Using Artemisia afra Tea among Health Care Workers (HCWs) in Yaoundé, Cameroon: A Cross-Sectional Survey.

Malaria is the most widespread endemic disease in Cameroon, and asymptomatic Plasmodium (gametocyte) carriers (APCs) constitute more than 95% of infectious human reservoirs in malaria endemic settings. This study assesses the knowledge of asymptomatic malaria (ASM) among health care workers (HCWs) in health facilities (HFs) in the Centre Region of Cameroon and the acceptability of using Artemisia afra tea to treat APCs. A cross-sectional descriptive survey was conducted among 100 HCWs, in four randomly selected HFs in the Centre Region, in the period of 1-20 April 2022, using semi-structured self-administered questionnaires. Logistic regression analyses were performed to determine factors associated with knowledge. More than seven in eight (88%) respondents were aware of the existence of ASM, 83% defined ASM correctly, 75% knew how it was diagnosed, 70% prescribe ACTs for APCs, and 51.1% were informed about ASM transmission. The professional category of HCWs was significantly associated with their knowledge of the existence and transmission of ASM, and longevity of service was associated with knowledge of transmission (p < 0.05). Two-thirds (67%) of respondents knew about Artemisia afra tea, 53.7% believed that it was effective in treating ASM, and 79% were willing to prescribe it if authorized. There was a fair level of knowledge of ASM among HCWs in the study settings.

Beliefs and attitudes of traditional healers regarding epilepsy in Cameroon.

INTRODUCTION: People living with epilepsy suffer from stigmatization, overprotection, or exclusion, thus, part of these population in developing countries uses traditional medicine as a first resort. METHODS: We prospectively conducted a study to determine the knowledge, attitudes, and practices (KAP) of traditional healers (THs) concerning epilepsy. Over a 9-month period, we included 208 THs practicing in the Littoral, Center and West regions of Cameroon who agreed to participate in the study. The THs were interviewed using a standardized questionnaire. Data were analyzed using Epi Info version 7.2 software. RESULTS: Two-hundred and eight THs were recruited, with a mean age ± standard deviation (SD) of 49.9 ± 11.4 years, and 169 (81.2%) were male. Primary 77(37.0%) and secondary 67(32.2%) levels of education were the most represented, and most of the THs had more than 10 years of professional experience. One hundred and forty-one TH (68,7%) had poor knowledge about epilepsy. The independent factors associated with poor knowledge were female sex, Muslim religion, and marital status of cohabitation. One hundred and eighty-four THs (88.4%) had a good attitude and practices toward people with seizures. Factors independently associated with poor practices and attitude were rural residence, Muslim religion, and education level. CONCLUSION: Our result confirmed that THs had poor knowledge about epilepsy but good attitudes and practices about epilepsy. THs were in favor of future collaboration with modern medicine in the care of people living with epilepsy.

Nutrient Profiles of Commercially Produced Complementary Foods Available in Burkina Faso, Cameroon, Ghana, Nigeria and Senegal.

The nutritional quality of commercially produced complementary food (CPCF) varies widely, with CPCF in high-income settings often containing excessive levels of sugar and sodium. Little is known about the nutritional quality of CPCF available in the West Africa region, despite their potential to improve the nutrition of infants and young children (IYC). This study evaluated the nutritional quality of CPCF available in five West African countries using the WHO Europe nutrient profiling model (NPM) and assessed their suitability for IYC based on label information. The proportion that would necessitate a "high sugar" warning was also determined, and the micronutrient (iron, calcium, and zinc) content was assessed against IYC-recommended nutrient intakes. Of the 666 products assessed, only 15.9% were classified as nutritionally suitable for promotion for IYC. The presence of added sugar and excessive sodium levels were the most common reasons for a product to fail the nutrient profiling assessment. Dry/instant cereals contributed the highest percentage of recommended nutrient intake (RNI) per serving. This highlights the need for policies to improve the nutritional quality of CPCF in West Africa, including labeling standards and the use of front-of-pack warning signs to promote product reformulation and clearly communicate nutritional quality to caregivers.

In vitro anti-yeast activity, kinetics and mechanism of action of essential oils from two cameroonian medicinal plants.

BACKGROUND: Treatment of Candida infections have become increasingly difficult due to antifungal drug resistance, which has drawn attention toward the search for innovative and effective drugs. This study aimed to assess the activity of essential oils (EOs) from Pentadiplandra brazzeana Baillon (PB) root and Drypetes gossweileri S. Moore (DG) stem bark against Candida albicans and Candida parapsilopsis strains, and determine their antifungal mechanism when tested alone or combined. METHODS: The anticandidal activity of the EOs using the checkerboard format was assessed using the broth micro-dilution technique. The checkerboard microtiter test was performed to evaluate the interaction of the EOs. The in vitro pharmacodynamics of the EOs alone or combined, using time-kill assays, following the chequerboard technique were evaluated. The anticandidal mode of action of these EOs, combined or not, was investigated using the sorbitol protection assay, and the ergosterol binding assay. Differences (p < 0.05) between the experimental and the control groups were evaluated using one way analysis of variance (ANOVA) followed by Tukey's test for multiple comparisons. RESULTS: Essential oils (EOs) from Drypetes gossweileri (DG) stem bark showed activity with MIC value of 62.5 µg/mL against Candida albicans and Candida parapsilopsis, whereas EOs from Pentadiplandra brazzeana (PB) root exhibited MICs of 125 µg/mL and 250 µg/mL against the respective yeasts. The EOs were fungicidal with synergism on C. parapsilopsis and additivity on C. albicans, with 2 to 64-fold drop in MIC values. The MIC combination of 31.25/7.81 µg/mL and 1.95/31.25 µg/mL (DG/PB EOs) required 20 and 18 h of exposure, respectively to effectively kill 99.9% of the inoculum. This fungicidal effect was accompanied by alteration of the cell walls and membranes of yeasts. CONCLUSION: The potency of the EOs combinations indicates further directions in their investigation as potential anticandidal agents.

Antiplasmodial, Antioxidant, and Cytotoxic Activity of Bridelia micrantha a Cameroonian Medicinal Plant Used for the Treatment of Malaria.

Introduction: Resistance to common antimalarial drugs and persistence of the endemicity of malaria constitute a major public health problem in Cameroon. The aim of this study was to evaluate the in vitro antiplasmodial, antioxidant, and cytotoxic activities of aqueous and ethanol extracts of Bridelia micrantha used by Cameroonian traditional healers for the treatment of malaria. Methods: Aqueous and ethanolic stem bark extracts were prepared according to standard procedures. The SYBR Green method was used for antiplasmodial activity on strains of Plasmodium falciparum sensitive to chloroquine (3D7) and resistant (Dd2). In vitro antioxidant activities of B. micrantha were determined using the scavenging activity of 2,2'-diphenyl-1-picrylhydrazyl, nitric oxide, ferric reducing power, and hydrogen peroxide as well as their cytotoxicity on RAW 264.7 macrophage cells and red blood cells (RBC). Results: The aqueous and ethanol extracts of Bridelia micrantha showed antiplasmodial activity on the 3D7 strain with IC50 of 31.65 ± 0.79 µg/ml and 19.41 ± 2.93 µg/ml, respectively, as well as 37.64 ± 0.77 µg/ml and 36.22 ± 1.04 µg/ml for the Dd2 strain, respectively. The aqueous and ethanol extracts showed free radical scavenging properties. The IC50 aqueous and ethanol extract was approximately 0.0001737 µg/ml, 42.92 µg/ml, 1197 µg/ml, 63.78 µg/ml and 4.617 µg/ml, 429.9 µg/ml, 511 µg/ml, and 69.32 µg/ml for DPPH, NO, H2O2, and FRAP, respectively, which were compared to ascorbic acid (8.610e - 005 µg/ml, 2901 µg/ml, 3237 µg/ml, and 18.57 µg/ml). The aqueous and ethanol extracts of B. micrantha were found to be nontoxic with CC50 values of 950 ± 6.6 µg/ml and 308.3 ± 45.4 µg/ml, respectively. Haemolysis test showed that the two extracts were not toxic. Conclusion: These results suggest that B. micrantha can serve as an antimalarial agent. However, further studies are needed to validate the use of B. micrantha as an antimalarial.

Prevalence and pregnant women's knowledge of maternal obesity and excessive gestational weight gain among women attending antenatal care in Fako Division, Cameroon.

Introduction: obesity poses significant public health concerns, being a risk factor for most non-communicable diseases and future cardiovascular diseases. Maternal obesity could be associated with adverse maternal-foetal outcomes, and there is a scarcity of data regarding obesity in pregnancy in our setting. Our objective was to determine the prevalence and knowledge of obesity and excessive Gestational Weight Gain (GWG) among pregnant women attending ANC in the Fako Division. Methods: we conducted a hospital-based cross-sectional study from January 28 to May 29, 2020, in the Limbe District Hospital (LDH) and Buea Road Integrated Health Centre (BRIHC). We collected data on socio-demographic prevalence, including knowledge of obesity and excessive GWG among pregnant women. Data was analysed using IBM SPSS version 26. Results: out of the 317 participants included, 58.9% (n=185) were aged 20-29 years, 36% (n=116) unemployed. The mean gestational age was 28.82 ± 7.75 weeks and 33.1% (n=105) were nulliparous. The prevalence of obesity in pregnancy and excessive GWG were 42.3% (n=134) and 41.6% (n=132) respectively. Respondents who consumed alcohol were more likely to be obese (aOR: 2.11, 95% CI 1.19-3.71; p; = 0.01). Those aged <20 (aOR: 0.064, 95% CI 0.007-0.57; p= 0.014) and 20-29 years (aOR: 0.297, 95% CI 0.16-0.56; p<0.001) were less likely to be obese than those 30-39 years. 46.1% (n=147) had poor knowledge of the complications of obesity in pregnancy, while 77.3% (n=245) had moderate knowledge of the safe and effective weight management methods during pregnancy. Late ANC booking was associated with excessive GWG (P=0.002). Conclusion: maternal obesity and excessive GWG is highly prevalent among ANC clients in the Fako Division, with excessive GWG being associated with late ANC booking. Hence, there is a need to design community-based interventions that could increase rates of early booking visits and consequently increase its benefits.

Limb Injuries and Disability in the Southwest Region of Cameroon.

INTRODUCTION: Extremity injuries are a leading cause of morbidity in low- and middle-income countries (LMICs), often resulting in marked short-term and long-term disabilities. Most of the existing knowledge on these injuries originates from hospital-based studies; however, poor access to health care in LMICs limits these data because of inherent selection bias. This subanalysis of a larger population-level cross-sectional study in the Southwest Region of Cameroon aims to determine patterns of limb injury, treatment-seeking behaviors, and predictors of disability. METHODS: Households were surveyed in 2017 on injuries and subsequent disability sustained over the previous 12 months using a three-stage cluster sampling framework. Subgroups were compared using the chi square, Fisher exact, analysis of variance, Wald, and Wilcoxon rank-sum tests. Logarithmic models were used to identify predictors of disability. RESULTS: Of 8,065 subjects, 335 persons (4.2%) sustained 363 isolated limb injuries. Over half of the isolated limb injuries (55.7%) were open wounds while 9.6% were fractures. Isolated limb injuries most commonly occurred in younger men and resulted from falls (24.3%) and road traffic injuries (23.5%). High rates of disability were reported, with 39% reporting difficulty with activities of daily living. Compared with individuals with other types of limb injuries, those with fractures were six times more likely to seek a traditional healer first for care (40% versus 6.7%), 5.3 times (95% CI, 1.21 to 23.42) more likely to have any level of disability after adjustment for injury mechanism, and 2.3 times more likely to have difficulty paying for food or rent (54.8% versus 23.7%). DISCUSSION: Most traumatic injuries sustained in LMICs involve limb injuries and often result in high levels of disability that affect individuals during their most productive years. Improved access to care and injury control measures, such as road safety training and improvements to transportation and trauma response infrastructure, are needed to reduce these injuries.

Chronic Gastric Ulcer Healing Actions of the Aqueous Extracts of Staple Plant Foods of the North-West, Adamawa, and West Regions of Cameroon.

Aim: This study is aimed at establishing phenolic compound profile and assessing the possible antiulcer activities of aqueous extracts of some staple plant foods from the West and North-West regions of Cameroon against chronic gastric ulcer models in rats. Materials and Methods: Phenolic constituents of extracts were evaluated using HPLC-DAD. Aqueous extracts of Corchorus olitorius, Solanum nigrum, Vigna unguiculata, Triumfetta pentandra, "nkui" spices, and "yellow soup" spices were tested at two doses (200 and 400 mg/kg). After treatments, animals were sacrificed, healing percentage and antioxidant status (catalase, superoxide dismutase, and glutathione peroxidase) were evaluated, and histological examination of gastric mucosa was realized. Results: HPLC-DAD revealed that p-hydroxybenzoic and protocatechuic acids were the phenolic compound present in all extracts. Oral administration of extracts (200 and 400 mg/kg) significantly reduced ulcer surface value and significantly increased mucus production compared to the control groups (p < 0.05). Histological study supported the observed healing activity of different extracts characterized by a reduced inflammatory response. Moreover, administration of aqueous extracts increased the activity of antioxidant enzymes. Conclusion: This study revealed that aqueous extracts of Solanum nigrum, Corchorus olitorius, Vigna unguiculata, Triumfetta pentandra, "yellow soup" spices, and "nkui" spices possess healing antiulcer effects against models of gastric ulcers. The antiulcer mechanisms involved may include increase of gastric mucus production and improvement of the antioxidant activity of gastric tissue. These activities may be due to the phenolic compounds identified in the extracts, especially p-hydroxybenzoic and protocatechuic acids present in all extracts and with known antioxidant, cytoprotective, and healing properties. However, all the diets may promote the healing process of chronic ulcers caused by excessive alcohol consumption/stress.

A severe case of Plasmodium falciparum malaria imported by a French traveler from Cameroon to French Guiana despite regular intake of Artemisia annua herbal tea.

The use of herbal tea with Artemisia annua by travelers and traditional communities in Africa has increased in recent years as a supposed form of malaria prophylaxis, although its use is not recommended due to lack of efficacy. The risk of severe malaria complications that can lead to death is real regarding said behavior, and awareness needs to be raised. We report a case of severe Plasmodium falciparum malaria imported in the Amazon rainforest by a traveler returning from Cameroon who treated himself with Artemisia annua herbal tea.

Traditional knowledge of plants used in hunting and fishing practices among Baka hunter-gatherers of eastern Cameroon.

BACKGROUND: Baka hunter-gatherers have a well-developed traditional knowledge of using plants for a variety of purposes including hunting and fishing. However, comprehensive documentation on the use of plants for hunting and fishing in eastern Cameroon is still lacking. METHOD: This study aimed at recording plants used for hunting and fishing practices, using focus group discussion, interviews and field surveys with 165 Baka members (90 men and 75 women) of different age groups in 6 villages. RESULTS: The most frequent techniques used for hunting and fishing are the use of animal traps, fishing lines, dam fishing, hunting with dogs and spear hunting. We recorded a total of 176 plant species used in various hunting practices, the most frequently cited one being Zanthoxylum gilletii (De Wild.) P.G.Waterman, Greenwayodendron suaveolens (Engl. & Diels) Verdc., Microcos coriacea (Mast.) Burret, Calamus deërratus G.Mann & H.Wendl. and Drypetes sp. These plants are used for a variety of purposes, most frequently as hunting luck, psychoactive for improving the dog's scent and capacity for hunting, materials for traps, and remedies for attracting animals and for making the hunter courageous. CONCLUSION: Plants used for hunting purposes here are embedded in a complex ecological and cultural context based on morphological characteristics, plant properties and local beliefs. This study provides a preliminary report and leaves room for further investigations to improve the documentation of the traditional knowledge systems of the studied community.

Impacts of micronutrient intervention programs on effective coverage and lives saved: Modeled evidence from Cameroon.

Policymakers are committed to improving nutritional status and to saving lives. Some micronutrient intervention programs (MIPs) can do both, but not to the same degrees. We apply the Micronutrient Intervention Modeling tool to compare sets of MIPs for (1) achieving dietary adequacy separately for zinc, vitamin A (VA), and folate for children and women of reproductive age (WRA), and (2) saving children's lives via combinations of MIPs. We used 24-h dietary recall data from Cameroon to estimate usual intake distributions of zinc and VA for children 6-59 months and of folate for WRA. We simulated the effects on dietary inadequacy and lives saved of four fortified foods and two VA supplementation (VAS) platforms. We estimated program costs over 10 years. To promote micronutrient-specific dietary adequacy, the economic optimization model (EOM) selected zinc- and folic acid-fortified wheat flour, VA-fortified edible oils, and bouillon cubes, and VAS via Child Health Days in the North macroregion. A different set of cost-effective MIPs emerged for reducing child mortality, shifting away from VA and toward more zinc for children and more folic acid for WRA. The EOM identified more efficient sets of MIPs than the business-as-usual MIPs, especially among programs aiming to save lives.