Reactive mass vaccination campaign against cholera in the COVID-19 context in Cameroon: challenges, best practices and lessons learned.

INTRODUCTION: since 1971, Cameroon is facing a growing series of cholera epidemics despite all the efforts made by the government to address this huge public health threat. In 2020, in addition to the COVID-19 pandemic, Cameroon recorded a high cholera case fatality rate of 4.3% following epidemics noted in the South, Littoral and South-West regions. The Cameroon Ministry of Public Health, has thus organized a reactive vaccination campaign against cholera to address the high mortality rate in the affected health districts of those regions. The objective of this study was to describe the challenges, best practices and lessons learned drawing from daily experiences from this reactive vaccination campaign against cholera. METHODS: we conducted a cross-sectional study drawn from the results of the campaign. We had a target population of 631,109 participants aged 1 year and above resident of the targeted health areas. RESULTS: the overall vaccination coverage was 64.4% with a refusal rate ranging from 0-10% according to health districts. Vaccination coverage was the lowest among people aged 20 years and above. The main challenge was difficulty maintaining physical distanciation, the main best practice was the screening of all actors taking part at the vaccination against COVID-19 and we found that emphasizing on thorough population sensitization through quarter heads and social mobilizers and adequately programming the campaign during a good climate season is crucial to achieving good vaccination coverage. CONCLUSION: lessons learned from this study could serve to inform various agencies in the event of planning rapid mass vaccination programs during pandemics.

Surgical site infection leading to gangrene and amputation after ambulatory surgical care of an ingrown toenail: a case report.

BACKGROUND: Currently, the management of ingrown toenail (onychocryptosis) ranges from conservative medical management to surgical treatment. Surgical management is typically performed as an outpatient procedure due to it numerous advantages such as the simplicity of the technique and the low incidence of postoperative complications. The most common postoperative complications are recurrences and surgical site infections, whereas gangrene complicating a surgical site infection has been scarcely reported. We are reporting a rare complication following ambulatory surgery untimely requiring amputation. CASE PRESENTATION: A twelve-year-old boy was referred to our orthopedic surgical department for a surgical site infection complicating an initial surgical management of a left ingrown big toenail leading to a dry gangrene of the affected toe. The gangrene toe was amputated under peripheral nerve block and the patient was discharged home the same day on antibiotics, analgesics and with sessions of rehabilitation and psychological support planned. The postoperative course was uneventful at 6 months of follow-up. CONCLUSION: The authors report this case to draw clinicians' attention, especially wound care specialists, orthopedists and podiatrists to this rare but potentially debilitating disease.