Syphilis and HIV Infection among Pregnant Women Previously Screened Negative during Their First Antenetal Care Visit (ANC) at Some Selected Health Facilities in the Buea Health District, Cameroon

Syphilis and HIV are amongst the world’s most widespread diseases, particularly in low-income countries. Syphilis and HIV infections during pregnancy have been associated with numerous adverse pregnancy outcomes. Of concern now are the rising rates of congenital syphilis and HIV in Cameroon. Cameroon only mandates testing pregnant women for syphilis and HIV during their first ANC visit. This study was aimed at determining the incidence of new syphilis and HIV infections and factors associated with pregnant women who previously tested negative during their first ANC visit. A cohort design was used, where 335 pregnant women were followed up for a period from December 2019 to August 2020. A blood sample was drawn and the serum was analyzed using the WANTAI ELISA and AIDTM HIV 1 + 2 Ag/Ab ELISAPlus test methods for syphilis and HIV respectively at three intervals. A questionnaire was used to identify risk factors. Data was analyzed using SPSS 23.0. Out of the 335 pregnant women who were followed up during this study, 49 (14.6%) were later diagnosed with syphilis (32 in 2nd trimester and 17 in 3rd trimester). 54 (16.1%) were diagnosed with HIV infection (13 at two months post-1st-trimester visit, 23 in the 2nd trimester and 18 in the 3rd trimester). Lastly, 10 (2%) were co-infected with syphilis and HIV of which 8 occurred during 2nd trimester and 2 in the 3rd trimester. The factors associated with contracting new syphilis infections include;younger age group aOR (1.302, 95% CI), leaving in an urban area aOR (3.158, 95% CI), lower level of education (Primary and no formal) with aOR of (9.055, 95% CI) (P = 0.001) and (6.764, 95% CI) (P = 0.006) respectively, inadequate knowledge on the diseases aOR (2.176, 95% CI), women unaware of their partner status aOR (3.190, 95% CI). Most factors associated with contracting new HIV infections were similar to the factors associated with contracting new syphilis infections post 1st ANC visit aOR (1.174, 95% CI) and pregnant women with more than one sexual partner aOR (7.342, 95% CI) were observed for HIV infection.. There is an increased incidence of new infection of syphilis and HIV post first ANC screening in the Buea Health District, Cameroon. The need for constant education on the identifiable factors and these diseases, and screening during every ANC visit irrespective of their previous laboratory results is warranted.

Pap Smear Screening, the Way Forward for Prevention of Cervical Cancer? A Community Based Study in the Buea Health District, Cameroon

Introduction: Cancer of the cervix is the second most common gynecologic malignancy in the world due to lack of awareness and poor uptake of cervical cancer screening services especially in low income countries. In Cameroon, though there is a national cervical cancer-screening program the service has been limited to some main cities without an appreciable impact. Aims: The objectives of this study were to determine the knowledge, attitude, practice towards Pap smear screening, thus evaluating its suitability as a screening procedure in Cameroon, through this pilot study in the Buea Health District. Methods: The study was a community-based cross-sectional descriptive survey that involved 309 women. Women from 18 years were enrolled for the study from 9th?October to 20th?November 2013. Results: The mean age of the participants was 32.3 years (SD = 11.7 years). Most of the women (29.5%) who had gone for the Pap test were in the 41 - 50 years age group. Only 3.6% of the study participants had “good” knowledge of cervical cancer and Pap smear screening. Approximately 20% of the women had a previous Pap smear test with 55.7% of them having the test just once. Eighty two percent of those who had secondary and tertiary levels of education had never had a Pap smear test. Awareness of risk factors for cervical cancer was low. Fear of pain, positive results after screening, non-curability of cervical cancer were some factors associated with a low Pap test uptake (p < 0.05). Conclusion: There is poor knowledge and perceived barriers by women about Pap smear screening and follow-up services. For an impact to be made in the prevention of cervical cancer, Pap smear screening is not the preferred method because of these limitations in this community.

Phytoremediation Potential of Some Macrophytes from a Car Wash Stream in Buea, South Western Cameroon

Phytoremediation is a cheap and environmentally friendly technique in which green plants in situ are used to clean the soil, sediments and water of heavy metals. This study investigated the phytoremediation potential of six naturally occurring macrophytes from Nange (a stream in Buea municipality where cars have been driven into and washed for over 20 years). Plant samples were collected before and after car wash, then analysed for copper, zinc, lead and cadmium accumulation. There was an increase in concentration of all the four heavy metals in water after carwash point, with Zn having the highest concentration (0.27 mg/L). Mean concentration of the heavy metals in the water showed that Zn and Pb had the highest concentrations (0.24 mg/L each) while the least concentration was obtained in Cu (0.12 mg/kg). Heavy metal concentrations in the sediments were higher after car wash point than before. Cadmium had the highest concentration (5.58 mg/kg) while Cu had the least (0.75 mg/kg). Ludwigia peruviana had the highest BAFs for all the heavy metals (22.95 for Cu, 33.41 for Zn, 21.79 for Pb and 7.85 for Cd). Species with the leasts were: Anubias barteri for Cu (7.16), Polygonum persicaria for Zn (14.28), Rorippa nasturtium-aquaticum for Pb (11.60) and Vallisneria spiralis for Cd (1.98). L. peruviana had the highest BAC values (Cu = 10.11, Zn = 14.73, Pb = 11.39, Cd = 3.85) and BCF values (Cu = 12.84, Zn = 18.67, Pb = 10.40, Cd = 4.00). A. barteri had the highest TF (Cu = 1.49, Zn = 1.27, Cd = 1.99) except for Pb where both A. barteri and L. peruviana each had a TF of 1.10. While all the six plants were found to be good accumulators of the heavy metals, L. peruviana showed remarkable efficiency indicating that the species is a good candidate for cleaning such environments.

The Legal Aspect of Waste Management in Cameroon with Focus on the Buea Municipality

Waste production remains an inevitable part of human activity on earth. The history of waste reveals that high levels of urbanisation, sustained urban growth and increasing residential neighbourhoods remain commensurate to poor sanitation and quality of life if proper measures are not taken. This paper therefore examines the legal practices involved in waste management and to understand the challenges faced as well as propose solutions towards an improved waste management system. The work constitutes mainly secondary source data that includes the existing laws on waste management in Cameroon and other documents relating to waste from different ministries. The residents of Buea and workers of the waste management company were interviewed to get their views on waste management in Buea. Also, field observations were made to compare results with field realities. The collected data was analysed using the content analysis and descriptive techniques. Results obtained proved that there exist well stated laws for waste management in Cameroon. However, there is poor implementation of the existing laws with evidence of waste littering within neighbourhoods and along the streets. This study concludes that there should be proper sensitization of the public about existing laws and to strengthen the waste management process with use of the laws. An all-integrated approach with active community participation was recommended as a way out towards sustainable waste management in Buea.

Comparative evaluation of a rapid diagnostic test,an antibody ELISA,and a pLDH ELISA in detecting asymptomatic malaria parasitaemia in blood donors in Buea,Cameroon

Background:In malaria endemic areas,infected blood donors serve as a source of infection to blood recipients,which may adversely affect their prognosis.This necessitates the proper screening of blood to be used for transfusion in these areas.The purpose of this study was to determine the prevalence of malaria parasitaemia in blood donors in Buea,Cameroon,and to evaluate the performance of a rapid diagnostic test(RDT),a malaria antibody enzyme-linked immunosorbent assay(ELISA),and a Plasmodium lactate dehydrogenase(pLDH)ELISA in the detection of asymptomatic malaria parasitaemia in the target population.Methods:In a prospective study conducted between September 2015 and June 2016,1240 potential blood donors were enrolled.The donors were screened for malaria parasites using Giemsa microscopy(GM)and a RDT.A sub-sample of 184 samples,comprising 88 positive and 96 negative samples,were selected for the evaluation of the pLDH ELISA and the antibody ELISA.The chi-square test and correlation analysis were performed as part of the statistical analyses.The statistical significance cut-off was set at P<0.05.Results:The prevalence of malaria parasitaemia in this study was found to be 8.1%(95%CI:6.6-9.7).The prevalence was not observed to be dependent on the age or sex of the participants.The RDT had a sensitivity(88.0%),specificity(99.1%),and negative predictive value(99.0%)higher than the ELISAs.The performance of the pLDH ELISA,which demonstrated the highest positive predictive value(91.6%),was generally comparable to the RDT.The sensitivity was lowest with the antibody ELISA(69.9%),which also demonstrated the highest false positive and false negative rates.The detection threshold for the pLDH(three parasites/μl)was lower compared to the RDT(50-60 parasites/μl).Non-significant positive correlations were observed between the parasite density and the pLDH titers and malaria antibody titers.Conclusions:Overall,the RDT and the pLDH ELISA demonstrated a perfectly correlated agreement with GM,meanwhile the antibody ELISA demonstrated a substantially correlated agreement with GM.The pLDH is therefore recommended for mass screening of blood(to detect malaria parasitaemia)for transfusions in the study area.However,where this is not feasible,an RDT will suffice.

Assessment of the Content and Utilization of Antenatal Care Services in a Rural Community in Cameroon: A Cross-Sectional Study

Background: Pregnant women receive antenatal care (ANC) to ensure favorable pregnancy outcomes. Despite the high ANC coverage rate registered nationally in Cameroon;rural women, women with no formal education and those in the most deprived quintile still face difficulties in having access to quality ANC. The impact of the aforementioned factors on ANC use in the Muea Health Area (MHA) is unknown. The objective of this study was to determine the proportion of women attending ANC and the factors influencing ANC attendance in the MHA. Materials and Methods: This was a community based, analytical, cross sectional survey that involved pregnant women and women with children less than two years old who gave an informed consent or assent. Data were collected using a semi structured questionnaire. EPI info Version 7 and Stat Pac for Windows version 12??1998-2011 (Stat Pac Inc, Bloomington, USA) were used for data analysis. Associations were considered statistically significant for p values less than 0.05. Results: Two hundred and twenty women were interviewed. The mean age was 25 years (SD 5.28). Ninety-nine percent of women had at least one ANC visit meanwhile 84.8% had at least four ANC visits. Only 27.2% of women booked for ANC in the first trimester. Rural (Maumu) residence was associated with inappropriate ANC attendance (attending less than four times) (χ2?= 18.5;p = 0.001). Semi urban women (87%;95% C.I. = 85.10% - 89.0%) were more likely to attend four or more sessions than rural (Maumu) women (60.7%;95% C.I. = 44.2% - 77.3%) (p = 0.001). Participant’s educational level was a significant predictor of early booking for ANC (χ2?= 26.8;p = 0.0002). Semi urban wom- en (79.1%;95% C.I. = 76.0% - 82.2%) were significantly more likely to have a vaginal examination done than rural (Maumu) women (42.1%;95% C.I. = 17.5% - 68.2%) (p = 0.0001). Women who met a doctor during ANC (84.0%;95% C.I. = 80.8% - 87.0%) were more likely to have a vaginal examination done than women who only met a nurse or a midwife during ANC (65.0%;95% C.I. = 57.7% - 71.4%) (p = 0.002). One third of women did not have a vaginal examination performed?during ANC. 45.83% and 47.6% neither did a stool test nor received an insecticide treated net (ITN) respectively. Conclusion: Women in the MHA start their antenatal care late, so they should be encouraged to book early for antenatal surveillance. Furthermore, efforts should be made to increase the access of these women to quality ANC services and to adequately trained ANC providers.

岩藻糖基抗原在宫颈鳞癌的表达及意义

目的 探讨人宫颈鳞癌组织的岩藻糖基 (fucose ,Fuc)化的水平及其意义。方法 1992年 1月至 1996年12月采用凝集素组织化学染色技术 ,以能与糖链α -Fuc特异性结合的生物素标记的荆豆凝集素 (biotinylatedulexeuropeausagglutinin ,BUEA)检测了 10 0例宫颈鳞癌、15 0例宫颈不典型增生及 5 0例正常宫颈组织的Fuc表达 ,应用图像分析系统定量分析其表达水平。结果 Fuc在非癌组织中无表达 ,在宫颈癌组织中的表达率为 76 % ,Fuc在细胞分化程度低、临床分期晚、有转移、复发及预后差的患者中的显著高表达 (P <0 0 1或P <0 0 5 )。结论 Fuc的表达可作为反映宫颈癌恶性潜能和患者预后的一项新的指标。