Trends in immunological markers of transfusion transmissible infections among blood donors in Mamfe District Hospital, Southwest Cameroon.

BACKGROUND: Blood transfusion is associated with exposure to blood Transfusion Transmissible Infection (TTIs). The threat posed by the blood-borne pathogens is disproportionately distributed in different healthcare facilities in Cameroon. Thus, there is a need for continuous surveillance of TTIs in the country. This study aimed to assess the screening procedure for blood transfusion and determine the trend in immunological markers of TTIs among blood donors at the Mamfe District Hospital. METHODS: A prospective descriptive, cross-sectional and analytical study was conducted at Mamfe District Hospital from March to May 2022. A total of 165 blood donors were recruited by the consecutive sampling method. Donors were screened using both Rapid diagnostic tests,T. pallidum haemagglutination test and indirect enzyme-linked immunosorbent assay (ELISA) for the detection of TTIs. Data generated was entered into an Excel spreadsheet and analysed using the statistical software R, version 4.2.0. Statistical analysis included descriptive statistics of percentages, means ± standard deviation, and student t-test was used to compare both diagnostic techniques, and was considered significant when p < 0.05. RESULTS: A hundred and sixty-five donors were enrolled in the study with a male preponderance giving a male-female sex ratio of 22.5 and a mean age of 32.23 ± 8.60 years. The majority (75.2%) of the donors were of the O-positive blood type, repeat donors (69.1%) and were mainly family replacement and paid donors as against the voluntary blood donors (39.4% and 37.0% vs. 23.6% respectively). overall TTIs prevalence was 18.78% (31/165) (), with HBsAg being the most predominant marker at 12.12% (20/165) followed by Treponema pallidum, HCV and HIV antibodies at 4.85 (8/165), 1.21%(2/165), 0.60% (1/165) respectively. Except for the HBV, The prevalence of TTIs was higher when using a single RDT than the ELISA test, and the difference was significant (p < 0.05). CONCLUSION: Bloodborne pathogens remain a major menace to safe blood transfusion practice in Mamfe district hospital and their detection could be easily missed if the RDT method alone is used for donor screening. Therefore, the donor screening protocol in Mamfe District Hospital should systematically incorporate a confirmation diagnostic test such as ELISA.

The impact of health education on the prevalence of faecal-orally transmitted parasitic infections among school children in a rural community in Cameroon.

BACKGROUND: Faecal-orally transmitted parasites are those parasites which are spread through faecal contamination of food and drinks. Infections with these parasites are among the most common in the world being responsible for considerable morbidity and mortality, especially in children. This study was carried out to determine the impact of health education on the prevalence of faecal-orally transmitted parasitic infections among primary school children in a typical African rural community. METHODS: An intervention study was conducted in two villages in the South-West Region of Cameroon. A total of 370 volunteer pupils aged between 5-15 years were enrolled in the study out of which 208 were from Kake II (experimental arm) and 162 from Barombi-Kang (control arm). The research was conducted in two phases. In phase 1, stool samples were collected from all participants and analyzed using the formol-ether concentration technique and health education was given to the pupils in the experimental village but not in the control village. Phase 2 was conducted six months later during which only stool samples were collected and analyzed from both villages. RESULTS: Before health education intervention (phase 1) faecal-orally transmitted parasites were present in 106 (50.9%) stool specimens collected in Kake II and in 84 (51.5%) of those collected in Barombi-kang. The difference in prevalence between these two villages was not significant (P>0.05). After health education intervention (phase 2), 56 (26.9%) stool specimens were positive for faecal-oral parasite in Kake II and 92 (54.7%) in Barombi-kang, and the difference in prevalence between these two villages was statistically significant (P0.05). The change in the prevalence of infection was significant in Kake II (50.9% vs. 26.9%, P0.05). Hence, health education applied in the experimental village was responsible for the drop in the prevalence observed, especially among pupils infected with Ascaris lumbricoides (24.9% vs. 3.4%, P=0.004) CONCLUSION: Health education through the framework of schools can be used as a strategy for the control of faecal-orally transmitted parasitic infections among children in African rural communities.

The impact of Health Education on the Prevalence of Faecalorally Transmitted Parasitic Infections among School Children in a Rural Community in Cameroon

Intestinal parasitic infections (IPIs) are among the most prevalent infections in humans in developing countries and are responsible for considerable morbidity and mortality. Most of them are transmitted by the faecal-oral route. In general; situations involving unhygienic conditions promote transmission [1]. These infections are globally endemic and have been described as constituting the greatest single worldwide cause of illness and disease [2]. They are associated with poor hygiene and lack of access to safe water [3]. Food handlers play an important role in their transmission [4]. Ignorance is also a contributing factor to transmission especially among people living in rural areas where level of awareness is relatively low [5]. Like the majority of the parasitic diseases; these infections are influenced by human behaviour especially their hygienic practices; and failure to take advantage of available screening services or comply with treatment [6]. In Cameroon; IPIs are recognized by the Ministry of Public Health to be an important public healthproblem ranking second to malaria [7]. There has been periodic de-worming in most endemic areas in the country; but studies suggest that there is a high rate of re-infection [8]. A change in hygienic behaviour is advocated to reduce these infections. Health education; especially in rural communities where the level of awareness is quite low and sanitary conditions poor [9] could contribute to the reduction of the prevalence of infection: This issue is addressed in this study. Methods : Ten villages in the South-West Region of Cameroon were grouped in pairs. The grouping was based on the fact that each pair was made of 2 rural communities sharing the same social; geographical and climatic features. The pair comprising Kake II and Barombi-Kang was randomly selected among five. An intervention study was conducted from January 2010 to July 2010 in two primary schools in the 2 selected villages (Kake II and Barombi-kang). They are separated by a distance of about 30 Km. Theformer village served as the experimental school; whilst the latter served as the control (random selection). The two villages are typical African rural communities. There is no pipe-borne water; electricity; or drainage system. Each of the villages has a government primary school; but no secondary school. The inhabitants are farmers practicing peasant farming and petty trading. Prior to the start of this study; permission was sought from the school authorities and parents were informed about the purpose; objectives and benefits of the study; as their involvement was a key factorfor its success. They were made to understand that it was not a school obligation to take part in the study; neither was it a prerequisite for accessing publicly available health facilities. Written informed parental consent forms were distributed one week prior to the beginning of sample collection. An ethical clearance was obtained from the Regional Delegation of Health of the South West Region in Buea (Ref.R11/MPH/SWP/RDPH/FP-R/5341/94)