The shifts in intergenerational relations in Cameroon and their potential impact on the health of older adults.

INTRODUCTION: Africa is experiencing a gradual demographic shift due to rising life expectancy and increasing urbanisation. In sub-Saharan Africa, elderly individuals typically reside with their children. The rise in life expectancy by almost a decade and the prevalence of precarious living conditions raise concerns about the sustainability of the healthcare system, which has traditionally relied on intergenerational solidarity. METHODS: The research aims to analyse the evolving role of older adults in Cameroonian society and to examine the potential impact of this change on intergenerational relationships and the health of older adults. A qualitative methodology was employed, using intergenerational focus groups in Cameroon. RESULTS: Traditionally, older adults held a central role in knowledge transmission through discourse. However, the modernisation of society is challenging this position.The emergence of new technologies, particularly communication tools, is leading to a questioning of older adults' experiential knowledge. Societal changes are contributing to a decline in respect for older adults in discourse. Older adults deplore these societal changes and fear for their place in society while young people are questioning the central role of older people in society. DISCUSSION: These changes could reduce the sense of usefulness of older people, with negative consequences for their health. Several studies have highlighted the impacts of ageism on the health of older adults in industrialised countries. However, there are little data on the impact of the marginalisation of older adults on their health in industrialising societies. Further research is needed to study the impact on the health of older adults.

Low antiretroviral therapy uptake and low early retention among pregnant women who tested positive for human immunodeficiency virus in informal health centers in urban and semi-rural settings in Cameroon: a prospective cohort study.

Introduction: Despite the efforts of Cameroon's Ministry of Public Health against informal health centers (IHCs) because of their illegitimacy, the number of IHCs is increasing in Cameroon. Most of these IHCs have antenatal care services and screen pregnant women for HIV. However, nothing is known about the subsequent outcomes of those who tested positive for HIV. This study aimed to assess the initiation of antiretroviral therapy (ART) in ART-naïve pregnant women screened HIV positive in IHCs within three months of diagnosis and their ART retention at three months post-initiation. In addition, we sought to identify the factors associated with ART non-initiation in this population. Methods: May 01, 2019 to August 31, 2020, we carried out a prospective cohort study of ART-naïve pregnant women who attended their first antenatal care visit and screened HIV positive at IHCs in the cities of Douala and Ebolowa in Cameroon. Standardized questionnaires were used to interview consenting participants at three points: the day of the delivery of the antenatal HIV test result, three months later, and three months after ART initiation. The data collected were entered into KoboCollect and analyzed using SPSS V23.0 software. The Chi-square test was used to compare proportions, Kaplan Meier techniques and Cox proportional hazards regression was used to estimate retention in ART and identify factors associated with ART non-retention, respectively. Results and discussion: A total of 85 ART-naïve pregnant women living with HIV were enrolled in the study. The median age and gestational age at the first antenatal care visit were 29 years (interquartile range (IQR), 2333.5) and 28weeks of amenorrhea (IQR, 2032), respectively. Only 34% (29/85) initiated ART, and 65.5% (19/29) of the initiators were retained in ART three months later. Lack of perceived self-efficacy to initiate ART (adjust Hazard Ratio = 5.57, 90% CI: 1.29 to 24.06), increased the probability of not be retaining in ART by any time during three months post initiation. Given the low ART uptake and the low retention in care among pregnant women living with HIV screened in IHCs, PMTCT policies in Cameroon should pay greater attention to this population, to facilitate their continuum of PMTCT care.

Factors associated to bed net use in Cameroon: a retrospective study in Mfou health district in the Centre Region.

INTRODUCTION: Insecticide treated net remains a tool of choice for malaria prevention in Cameroon. However, data suggests that its use by the population, especially vulnerable groups remains low. Moreover, there is a paucity of information about factors influencing its use. We sought out to identify factors associated with net use in Mfou health district, prior to distribution of long lasting insecticides treated nets (LLINs) in households. METHODS: A two-stage cluster random sampling was conducted in 4 health areas with an average of 13 villages each. A total of 541 households were selected and heads interviewed using a structured household questionnaire. Data collected were entered into a database and multivariate logistic regression analyses of the association between net use and explanatory factors were performed using SPSS. RESULTS: Net possession and use were respectively, 59.7 and 42.6%; thus, 2 out of 5 people who spent the previous night in households, slept under a net. Factors associated with net use included: net density≥0.5 (OR=8.88, 95% CI: 6.24-12.64), age≥5 years (OR=0.37, 95%CI: 0.28-0.47), secondary education (OR=1.41, 95% CI: 1.11-1.80) compared to primary/no education, parent status (OR=3.32, 95% CI: 2.31-4.76), house construction (OR=1.37, 95% CI: 1.10-1.71) and environment characteristics (OR=1.46, 95% CI: 1.18-1.80). CONCLUSION: These data suggest that a universal coverage with one LLIN for two people should be achieved in households. Then, malaria health education should be conducted to re-enforce net use among school-aged children and adolescents, as well as older household members. Moreover, management of environment and improvement in houses construction are necessary.