Severe side effects following ivermectin treatment of onchocerciasis in areas of co-endemicity with loaisis have been an impediment for the work of the African Programme for Onchocerciasis Control (APOC) in forested regions of several countries. Doxycycline has been shown to be effective in the treatment of onchocerciasis and has the added advantages of killing adult Onchocerca volvulus but neither adult Loa loa nor their microfilariae. This drug therefore offers great potential for the treatment of onchocerciasis in areas of co-endemicity with loiasis. The limitation of use of this drug is the duration of treatment that may pose a potential problem with therapeutic coverage and compliance with treatment. To benefit from the advantages that doxycycline offers in the treatment of onchocerciasis, it will be necessary to establish an effective distribution system that can access remote communities. This study assessed the feasibility of a large-scale distribution of doxycycline for the treatment of onchocerciasis in areas of co-endemicity with loiasis using a community-directed approach.
In Cameroon, since the first epidemiological week held in 2015, snakebites have been registered among Potential Epidemic Diseases (PED). In the Centre Region, the most densely populated of the country, weekly reports of snakebites are generated at health districts level for monthly data updates. To contribute to the better management of snakebite cases, an observational study was conducted to assess the snakebite reporting rate in the Centre Region of Cameroon. The results of this retro-prospective survey were confronted to those of the weekly epidemiological surveillance system, recorded in the PED regional data base. The incidence of bites was relatively high (36.6 bites per 100,000 inhabitants), as well as the general attack rate (about 49 envenomations per 100 victims). The lethality recorded was 2.5% and the mortality was about 1 death per 100,000 inhabitants a year. The sex ratio was largely female biased (61.6%). The bites occurred mostly during the rainy season (73.0%). Bitten victims were mainly farmers (47.4%), and agriculture was the main risk factor. The comparative analysis of the data suggested a high non-reporting rate of snakebite cases (67.8%). Snakebite is an endemic condition in the Centre Region of Cameroon. Because of the high rate of non-reporting of cases, the collection of information from the registers of the health facilities only appears not enough to assess the real importance of envenomation in this Region.
Rapid scale-up of antiretroviral therapy (ART) and limited access to genotyping assays in low-resource settings (LRS) are inevitably accompanied by an increasing risk of HIV drug resistance (HIVDR). The current study aims to evaluate early warning indicators (EWI) as an efficient strategy to limit the development and spread of preventable HIVDR in these settings, in order to sustain the performance of national antiretroviral therapy (ART) rollout programmes.
Snakebite envenoming is a life-threatening disease in humans and animals and a major public health issue in rural communities of South-East Asia and sub-Saharan Africa. Yet the impact of snakebite on domestic animals has been poorly studied. This study aimed to describe the context, clinical features, treatment, and outcomes of snakebite envenoming in domestic animals in Nepal and Cameroon. Primary data on snakebite in animals were recorded from a community-based nation-wide survey on human and animal snakebite in Nepal and Cameroon (Snake-byte project). Mobile teams collected data on snakebite in humans and animals in 13,879 and 10,798 households in Nepal and Cameroon respectively from December 2018 to June 2019. This study included 405 snakebite cases (73 in Nepal and 332 in Cameroon) in multiple types of animals. An interview with a structured questionnaire collected specific information about the animal victims.
The World Health Organization (WHO) classifies snake bites as neglected public health problem affecting mostly tropical and subtropical countries. In Africa there are an estimated 1 million snake bites annually with about half needing a specific treatment. Women, children and farmers in poor rural communities in developing countries are the most affected. Case management of snake bites are not adequate in many health facilities in developing countries where personnel are not always abreast with the new developments in snake bite management and in addition, quite often the anti-venom serum is lacking. We report the case of a medical doctor bitten by a cobra in the rural area of Poli, Cameroon while asleep in his bedroom. Lack of facilities coupled with poor case management resulted ina fatal outcome.
Snakes responsible for bites are rarely identified, resulting in a loss of information about snakebites from venomous species whose venom effects are poorly understood. A prospective clinical study including patients bitten by a snake was conducted in Cameroon between 2019 and 2021 to evaluate the efficacy and tolerability of a marketed polyvalent antivenom. Clinical presentation during the first 3 days of hospitalization was recorded following a standardized protocol. This ancillary study aimed to assess the frequency of bites by the different species encountered in Cameroon and to describe the symptoms of bites by formally identified species. Of the 447 patients included in the study, 159 (35.6%) brought the snake that caused the bite that was identified by a specialist. Out of these, 8 specimens could not be identified due to poor condition, 19 were non-venomous species, and 95 belonged to Echis romani—formerly E. ocellatus—species. The remaining 37 specimens included 2 Atheris squamigera, 12 Atractaspis spp., 2 Bitis arietans, 11 Causus maculatus, 1 Dendroaspis jamesoni, 1 Naja haje, 1 N. katiensis, 5 N. melanoleuca complex, and 2 N. nigricollis. Symptoms, severity of envenomation, and post-treatment course are described. Symptoms and severity of bites are consistent with cases described in the literature, but some specific features are highlighted.