Background: Measles is a highly contagious viral disease associated with high morbidity and mortality in developing countries. As an infection with no specific treatment, its control is most importantly through vaccin...Background: Measles is a highly contagious viral disease associated with high morbidity and mortality in developing countries. As an infection with no specific treatment, its control is most importantly through vaccination and adequate disease surveillance. National immunization coverage for the first dose of measles/rubella vaccine in 2019 was 71%. As a result, measles continues to rage with outbreaks not sparing the North West Region (NWR) of Cameroon, hence the need for proper surveillance. Objective: Assess performance of measles case-based surveillance in the NWR of Cameroon. Methods: This was a cross-sectional, descriptive study with retrospective collection of measles surveillance records carried out at the Regional Delegation of Public Health from 2009 to 2015. The data collected using a structured form were: number of persons suspected of measles;number of persons reported to district service;number of persons whose samples were collected and forwarded to the laboratory;number whose results reached the Expanded Programme on Immunization (EPI) Central unit and the time lapse between successive phases. Results: Although not all planned activities were carried out, a constant increase in planned and carried out monitoring activities was found. The average time taken from onset of signs and symptoms in a measles case to consultation at a health facility, from consultation to notification of case to district service, from notification to investigation, from investigation to receipt of biological sample at laboratory, from receipt of sample to provision of results to the EPI Central unit, and from collection of sample to reception of results at the Central EPI unit was 2.59 days, 1.5 days, 1.5 days, 2.6 days, 4 days and 6.6 days respectively. Conclusion: There was an overall rising trend in the performance of measles case-based surveillance, although the high priority site visits witnessed a stagnation during the period, a large scale measles epidemic occurred (2015). The duration between phases of the surveillance system was within acceptable limits of WHO standards for an effective system. However, the proportion of samples reaching the laboratory and whose results are received at EPI Central Unit was 77.6%, which is lower than ≥80% prescribed by WHO.展开更多
Background:Contemporary data on the immunologic,haematologic and virologic responses and predictors of virologic failure after initiation of free antiretroviral treatment in Cameroon are needed to evaluate the current...Background:Contemporary data on the immunologic,haematologic and virologic responses and predictors of virologic failure after initiation of free antiretroviral treatment in Cameroon are needed to evaluate the current treatment-monitoring algorithm and to complement efforts to scale-up and improve on the management of HIV infections.Methods:This was a cross-sectional study conducted between October 2010 and June 2012.A total of 951 participants aged 18-74 years were recruited from selected approved HIV treatment centres of the Northwest and Southwest regions.This comprised 247 males and 704 females.Demographic,self-reported risk behaviours and socioeconomic data were obtained using a structured questionnaire.Full blood and CD4+T-cell counts were done using standard automated techniques.Determination of viral load(VL)was done using Abbott RealTime HIV-1 m2000™system.Data was analysed using SPSS version 17.The statistical significance level was P<0.05.Results:The median duration of antiretroviral therapy(ART)was 24 months.The population mean CD4+T-cell count was 255.3 cells/μL[95%CI,236.8-273.9].Overall,45.9%,43.8%and 10.2%of the participants had CD4+T-cell counts of<200 cells/μL,200-499 cells/μL and>500 cells/μL respectively.Anaemia was present in 26.2%of the participants with 62.3%,25.7%and 12%described as mild,moderate and severe anaemia respectively.Virologic failure occurred in 23.2%of the participants with 12.3%having VL>10,000 RNA copies/mL.Meanwhile 76.8%of patients attained adequate viral suppression with 40.8%having undetectable viral load.The age group 18-29 years(p=0.024),co-infection with tuberculosis(p=0.014),anaemia(p=0.028)and distance from the treatment centre(p=0.011)independently predicted virologic failure.Conclusion:The majority of the participants achieved adequate viral suppression after≥6 months of ART.Despite these favourable immuno-haematologic and virologic outcomes,the National AIDS Control Program should step-up efforts to improve on antiretroviral drug distribution,as well as proper assessment and management of anaemia,foster early diagnosis and treatment of tuberculosis and enhance treatment adherence counselling especially in younger patients.展开更多
文摘Background: Measles is a highly contagious viral disease associated with high morbidity and mortality in developing countries. As an infection with no specific treatment, its control is most importantly through vaccination and adequate disease surveillance. National immunization coverage for the first dose of measles/rubella vaccine in 2019 was 71%. As a result, measles continues to rage with outbreaks not sparing the North West Region (NWR) of Cameroon, hence the need for proper surveillance. Objective: Assess performance of measles case-based surveillance in the NWR of Cameroon. Methods: This was a cross-sectional, descriptive study with retrospective collection of measles surveillance records carried out at the Regional Delegation of Public Health from 2009 to 2015. The data collected using a structured form were: number of persons suspected of measles;number of persons reported to district service;number of persons whose samples were collected and forwarded to the laboratory;number whose results reached the Expanded Programme on Immunization (EPI) Central unit and the time lapse between successive phases. Results: Although not all planned activities were carried out, a constant increase in planned and carried out monitoring activities was found. The average time taken from onset of signs and symptoms in a measles case to consultation at a health facility, from consultation to notification of case to district service, from notification to investigation, from investigation to receipt of biological sample at laboratory, from receipt of sample to provision of results to the EPI Central unit, and from collection of sample to reception of results at the Central EPI unit was 2.59 days, 1.5 days, 1.5 days, 2.6 days, 4 days and 6.6 days respectively. Conclusion: There was an overall rising trend in the performance of measles case-based surveillance, although the high priority site visits witnessed a stagnation during the period, a large scale measles epidemic occurred (2015). The duration between phases of the surveillance system was within acceptable limits of WHO standards for an effective system. However, the proportion of samples reaching the laboratory and whose results are received at EPI Central Unit was 77.6%, which is lower than ≥80% prescribed by WHO.
基金BioCollections Worldwide Inc.,Miami,Florida,USA,provided financial support and performed viral load analysisFinancial assistance was also received from the University of Buea 2009-2010 Research Grant awarded to Professor Theresa Nkuo-Akenji.
文摘Background:Contemporary data on the immunologic,haematologic and virologic responses and predictors of virologic failure after initiation of free antiretroviral treatment in Cameroon are needed to evaluate the current treatment-monitoring algorithm and to complement efforts to scale-up and improve on the management of HIV infections.Methods:This was a cross-sectional study conducted between October 2010 and June 2012.A total of 951 participants aged 18-74 years were recruited from selected approved HIV treatment centres of the Northwest and Southwest regions.This comprised 247 males and 704 females.Demographic,self-reported risk behaviours and socioeconomic data were obtained using a structured questionnaire.Full blood and CD4+T-cell counts were done using standard automated techniques.Determination of viral load(VL)was done using Abbott RealTime HIV-1 m2000™system.Data was analysed using SPSS version 17.The statistical significance level was P<0.05.Results:The median duration of antiretroviral therapy(ART)was 24 months.The population mean CD4+T-cell count was 255.3 cells/μL[95%CI,236.8-273.9].Overall,45.9%,43.8%and 10.2%of the participants had CD4+T-cell counts of<200 cells/μL,200-499 cells/μL and>500 cells/μL respectively.Anaemia was present in 26.2%of the participants with 62.3%,25.7%and 12%described as mild,moderate and severe anaemia respectively.Virologic failure occurred in 23.2%of the participants with 12.3%having VL>10,000 RNA copies/mL.Meanwhile 76.8%of patients attained adequate viral suppression with 40.8%having undetectable viral load.The age group 18-29 years(p=0.024),co-infection with tuberculosis(p=0.014),anaemia(p=0.028)and distance from the treatment centre(p=0.011)independently predicted virologic failure.Conclusion:The majority of the participants achieved adequate viral suppression after≥6 months of ART.Despite these favourable immuno-haematologic and virologic outcomes,the National AIDS Control Program should step-up efforts to improve on antiretroviral drug distribution,as well as proper assessment and management of anaemia,foster early diagnosis and treatment of tuberculosis and enhance treatment adherence counselling especially in younger patients.
