Journal Article > ResearchFull Text
Sci Afr. 2021 July 1; Volume 12; e00802.; DOI:10.1016/j.sciaf.2021.e00802
Fai KN, Corine TM, Bebell LM, Mbroingong AB, Nguimbis EBPT, et al.
Sci Afr. 2021 July 1; Volume 12; e00802.; DOI:10.1016/j.sciaf.2021.e00802
Official case counts suggest Africa has not seen the expected burden of COVID-19 as predicted by international health agencies, and the proportion of asymptomatic patients, disease severity, and mortality burden differ significantly in Africa from what has been observed elsewhere. Testing for SARS-CoV-2 was extremely limited early in the pandemic and likely led to under-reporting of cases leaving important gaps in our understanding of transmission and disease characteristics in the African context. SARS-CoV-2 antibody prevalence and serologic response data could help quantify the burden of COVID-19 disease in Africa to address this knowledge gap and guide future outbreak response, adapted to the local context. However, such data are widely lacking in Africa. We conducted a cross-sectional seroprevalence survey among 1,192 individuals seeking COVID-19 screening and testing in central Cameroon using the Innovita antibody-based rapid diagnostic. Overall immunoglobulin prevalence was 32%, IgM prevalence was 20%, and IgG prevalence was 24%. IgM positivity gradually increased, peaking around symptom day 20. IgG positivity was similar, gradually increasing over the first 10 days of symptoms, then increasing rapidly to 30 days and beyond. These findings highlight the importance of diagnostic testing and asymptomatic SARS-CoV-2 transmission in Cameroon, which likely resulted in artificially low case counts. Rapid antibody tests are a useful diagnostic modality for seroprevalence surveys and infection diagnosis starting 5-7 days after symptom onset. These results represent the first step towards better understanding the SARS-CoV-2 immunological response in African populations.
Journal Article > ResearchFull Text
J Public Health Afr. 2024 October 24; Volume 15 (Issue 1); 578.; DOI:10.4102/jphia.v15i1.578
Tchiasso D, Mendjime P, Nana Wandji BS, Yuya F, Stanton AM, et al.
J Public Health Afr. 2024 October 24; Volume 15 (Issue 1); 578.; DOI:10.4102/jphia.v15i1.578
BACKGROUND
Little is known about attitudes towards COVID-19 vaccination in sub-Saharan Africa, where immunisation coverage is the lowest in the world.
AIM
The study aimed to identify factors associated with COVID-19 vaccine hesitancy and uptake in Cameroon, and assess changes in these factors over a period of time.
SETTING
The study was conducted in the ten regions of Cameroon.
METHODS
The authors conducted a two-phase cross-sectional survey in the 10 regions of Cameroon, from July 2021 to August 2021 (Phase one) and from August 2022 to September 2022 (Phase two). We analysed reasons for vaccine hesitancy descriptively and used logistic regression to assess factors associated with hesitancy.
RESULTS
Overall, we enrolled 12 109 participants: 6567 (54.23%) in Phase one and 5542 (45.77%) in Phase two. Of these, 8009 (66.14%) were not interested in receiving the COVID-19 vaccine (n = 4176 in Phase one, n = 3833 in Phase two). The refusal rate increased significantly in the northern region from 27.00% in Phase 1 to 60.00% in Phase two. The leading contributor to COVID-19 vaccine hesitancy was fear that the vaccine was dangerous, which was significantly associated (95% confidence interval [CI], p < 0.05%) with vaccine refusal in both phases. Overall, 32.90% of participants (n = 2578) perceived the COVID-19 vaccine to be dangerous. Advanced age, male gender, Muslim religion and low level of education were associated with vaccine acceptance. Participants reported that healthcare workers were the most trusted source of information about the COVID-19 vaccine by 5005 (42.84%) participants.
CONCLUSION
Despite the investment of the Ministry of Health and its partners in community engagement, focussing on communication about the vaccine efficacy, tolerance and potential adverse events, fear of the vaccine remains high, likely leading to vaccine hesitancy in Cameroon between 2021 and 2022.
CONTRIBUTION
The study highlight regional variations in COVID-19 vaccine acceptance in Cameroon, with factors age, gender, religion and education influencing willingness to vaccine. Trust in health workers was high, indicating that, tailored, community-led vaccination strategies are key for improving vaccine uptake, not only for COVID-19 but also for future epidemics.
Journal Article > ResearchFull Text
Toxins. 2024 March 22; Volume 16 (Issue 4); 165.; DOI:10.3390/toxins16040165
Benhammou D, Chippaux JP, Ntone R, Madec Y, Amta P, et al.
Toxins. 2024 March 22; Volume 16 (Issue 4); 165.; DOI:10.3390/toxins16040165
Snakebite envenomation (SBE) is a public health issue in sub-Saharan countries. Antivenom is the only etiological treatment. Excellent tolerance is essential in managing SBE successfully. This study aimed to evaluate tolerance of InoserpTM PAN-AFRICA (IPA). It was conducted on fourteen sites across Cameroon. IPA was administered intravenously and repeated at the same dose every two hours if needed. Early and late tolerance was assessed by the onset of clinical signs within two hours and at a visit two weeks or more after the first IPA administration, respectively. Over 20 months, 447 patients presenting with a snakebite were included. One dose of IPA was administered to 361 patients and repeated at least once in 106 patients. No significant difference was shown between the proportion of adverse events in patients who received IPA (266/361, 73.7%) and those who did not (69/85, 81.2%) (p = 0.95). Adverse reactions, probably attributable to IPA, were identified in four (1.1%) patients, including one severe (angioedema) and three mild. All these reactions resolved favorably. None of the serious adverse events observed in twelve patients were attributed to IPA. No signs of late intolerance were observed in 302 patients. Tolerance appears to be satisfactory. The availability of effective and well-tolerated antivenoms would reduce the duration of treatment and prevent most disabilities and/or deaths.
Conference Material > Poster
Eyong J, Fai KN, Nikolay B, Gignoux EM, Nsaibirini R, et al.
Epicentre Scientific Day 2024. 2024 May 23
Français
Journal Article > ResearchFull Text
Sci Afr. 2023 October 4; Online ahead of print; e01925.; DOI:10.1016/j.sciaf.2023.e01925
Eyong J, Fai KN, Nikolay B, Gignoux EM, Nsaibirini R, et al.
Sci Afr. 2023 October 4; Online ahead of print; e01925.; DOI:10.1016/j.sciaf.2023.e01925
BACKGROUND
Although the first year of the COVID-19 pandemic in Africa did not produce the expected catastrophe, the true impact of COVID-19 in the Cameroonian population was unclear. We therefore assessed the seroprevalence of anti-SARS-CoV-2 antibodies and retrospective mortality in a representative sample of the general population in the 10 administrative regions of Cameroon more than one year after the first confirmed cases of COVID-19 in these regions. We aimed to assess the extent of SARS-COV-2 infection and to detect potential increases in the crude mortality rate (CMR) during the SARS-COV-2 pandemic phase.
METHODS
We assessed retrospective mortality and seroprevalence of anti-SARS-CoV-2 antibodies in the 10 capital cities of Cameroon using representative samples of the general population. The study included nested anti-SARS-CoV-2 antibody prevalence surveys and retrospective mortality surveys and was conducted between 27 July 2021 and 31 August 2021. To further analyse crude mortality rates by age group and COVID wave, pre-pandemic and pandemic periods were stratified. Both laboratory-based assays (ELFA) and rapid diagnostic tests (RDT) were used to measure anti-SARS-CoV-2 seroprevalence.
RESULTS
The crude mortality rate (CMR) increased from 0.06 deaths per 10 000 persons per day (pre-pandemic) to 0.17 deaths per 10 000 persons per day (pandemic). The increase in CMR was more pronounced in people aged 20-35 years (pre-pandemic 0.02 deaths per 10 000 persons per day; pandemic 0.06 deaths per 10 000 persons per day). The estimated seroprevalence among unvaccinated persons was 9.5% (RDT) and 15.4% (laboratory-based).
CONCLUSION
The seroprevalence results showed that cases were significantly underdetected by the national surveillance systems.
Although the first year of the COVID-19 pandemic in Africa did not produce the expected catastrophe, the true impact of COVID-19 in the Cameroonian population was unclear. We therefore assessed the seroprevalence of anti-SARS-CoV-2 antibodies and retrospective mortality in a representative sample of the general population in the 10 administrative regions of Cameroon more than one year after the first confirmed cases of COVID-19 in these regions. We aimed to assess the extent of SARS-COV-2 infection and to detect potential increases in the crude mortality rate (CMR) during the SARS-COV-2 pandemic phase.
METHODS
We assessed retrospective mortality and seroprevalence of anti-SARS-CoV-2 antibodies in the 10 capital cities of Cameroon using representative samples of the general population. The study included nested anti-SARS-CoV-2 antibody prevalence surveys and retrospective mortality surveys and was conducted between 27 July 2021 and 31 August 2021. To further analyse crude mortality rates by age group and COVID wave, pre-pandemic and pandemic periods were stratified. Both laboratory-based assays (ELFA) and rapid diagnostic tests (RDT) were used to measure anti-SARS-CoV-2 seroprevalence.
RESULTS
The crude mortality rate (CMR) increased from 0.06 deaths per 10 000 persons per day (pre-pandemic) to 0.17 deaths per 10 000 persons per day (pandemic). The increase in CMR was more pronounced in people aged 20-35 years (pre-pandemic 0.02 deaths per 10 000 persons per day; pandemic 0.06 deaths per 10 000 persons per day). The estimated seroprevalence among unvaccinated persons was 9.5% (RDT) and 15.4% (laboratory-based).
CONCLUSION
The seroprevalence results showed that cases were significantly underdetected by the national surveillance systems.
Other > Pre-Print
Res Sq. 2021 February 2; DOI:10.21203/rs.3.rs-156679/v1
Buri D, Njuwa FK, Matchim L, Akendji B, Eteki L, et al.
Res Sq. 2021 February 2; DOI:10.21203/rs.3.rs-156679/v1
BACKGROUND
Infection with SARS-CoV-2 can lead to a detectable serological immune response even though extent of its protection is still not yet well known. We report long duration and resurgence of SARS-CoV-2 in patients with COVID-19.
METHODS
We included a cohort of 99 participants from our non-blinded non-randomized evaluation of COVID-19 tests in Cameroon. Demographic and clinical information was collected from participants including self-reported age, race, ethnicity, and gender. Qualitative data was described as proportions while quantitative data was described with means and accompanying ranges.
RESULTS
Duration of PCR for SARS-CoV-2 positivity was found to range from 4 – 81 days, with mean duration of 32.8 days in patients with PCR-positive. We also identified 4 participants who also had SARS-CoV-2 resurgence within a three-month period.
CONCLUSION
These observations raise questions on clinical decision to release COVID-19 cases from isolation after 14 days.
Infection with SARS-CoV-2 can lead to a detectable serological immune response even though extent of its protection is still not yet well known. We report long duration and resurgence of SARS-CoV-2 in patients with COVID-19.
METHODS
We included a cohort of 99 participants from our non-blinded non-randomized evaluation of COVID-19 tests in Cameroon. Demographic and clinical information was collected from participants including self-reported age, race, ethnicity, and gender. Qualitative data was described as proportions while quantitative data was described with means and accompanying ranges.
RESULTS
Duration of PCR for SARS-CoV-2 positivity was found to range from 4 – 81 days, with mean duration of 32.8 days in patients with PCR-positive. We also identified 4 participants who also had SARS-CoV-2 resurgence within a three-month period.
CONCLUSION
These observations raise questions on clinical decision to release COVID-19 cases from isolation after 14 days.
Journal Article > ResearchFull Text
PLoS Negl Trop Dis. 2023 November 8; Volume 17 (Issue 11); e0011707.; DOI:10.1371/journal.pntd.0011707
Chippaux JP, Ntone R, Benhammou D, Madec Y, Noël G, et al.
PLoS Negl Trop Dis. 2023 November 8; Volume 17 (Issue 11); e0011707.; DOI:10.1371/journal.pntd.0011707
BACKGROUND
Snakebites is a serious public health issue but remains a neglected tropical disease. Data on antivenom effectiveness are urgently needed in Africa. We assessed effectiveness of Inoserp PAN-AFRICA (IPA), the recommended antivenom available in Cameroon.
METHODOLOGY/PRINCIPAL FINDINGS
We enrolled 447 patients presenting with snakebite in 14 health facilities across Cameroon. At presentation, cytotoxicity, coagulation troubles and neurotoxicity were graded. We administered two to four vials of antivenom to patients based on hemotoxic or neurotoxic signs. We renewed antivenom administration to patients with persistence of bleedings or neurotoxicity 2 hours after each injection. We defined early improvement as a reduction of the grade of envenomation symptoms 2 hours after first injection. Medium-term effectiveness was investigated looking at disappearance of symptoms during hospitalization. After hospital discharge, a home visit was planned to assess long-term outcomes.
Between October 2019 and May 2021, we enrolled 447 (93.7%), including 72% from the savannah regions. The median [IQR] age was 25 [14–40]. Envenomation was diagnosed in 369 (82.6%) participants. The antivenom was administered to 356 patients (96.5%) of whom 256 (71.9%) received one administration. Among these patients, cytotoxic symptoms were observed in 336 (94.4%) participants, coagulation disorders in 234 (65.7%) participants and neurotoxicity in 23 (6.5%) participants. Two hours after the first administration of antivenom, we observed a decrease in coagulation disorders or neurotoxicity in 75.2% and 39.1% of patients, respectively. Complete cessation of bleedings and neurotoxicity occurred in 96% and 93% of patients within 24 hours, respectively. Sequelae have been observed in 9 (3%) patients at the home visit 15 days after hospital admission and 11 (3%) died including one before antivenom injection.
CONCLUSIONS/SIGNIFICANCE
We confirmed good effectiveness of the IPA and highlighted the rapid improvement in bleeding or neurotoxicity after the first administration. Sequential administrations of low doses of antivenom, rigorously assessed at short intervals for an eventual renewal, can preserve patient safety and save antivenom.
Snakebites is a serious public health issue but remains a neglected tropical disease. Data on antivenom effectiveness are urgently needed in Africa. We assessed effectiveness of Inoserp PAN-AFRICA (IPA), the recommended antivenom available in Cameroon.
METHODOLOGY/PRINCIPAL FINDINGS
We enrolled 447 patients presenting with snakebite in 14 health facilities across Cameroon. At presentation, cytotoxicity, coagulation troubles and neurotoxicity were graded. We administered two to four vials of antivenom to patients based on hemotoxic or neurotoxic signs. We renewed antivenom administration to patients with persistence of bleedings or neurotoxicity 2 hours after each injection. We defined early improvement as a reduction of the grade of envenomation symptoms 2 hours after first injection. Medium-term effectiveness was investigated looking at disappearance of symptoms during hospitalization. After hospital discharge, a home visit was planned to assess long-term outcomes.
Between October 2019 and May 2021, we enrolled 447 (93.7%), including 72% from the savannah regions. The median [IQR] age was 25 [14–40]. Envenomation was diagnosed in 369 (82.6%) participants. The antivenom was administered to 356 patients (96.5%) of whom 256 (71.9%) received one administration. Among these patients, cytotoxic symptoms were observed in 336 (94.4%) participants, coagulation disorders in 234 (65.7%) participants and neurotoxicity in 23 (6.5%) participants. Two hours after the first administration of antivenom, we observed a decrease in coagulation disorders or neurotoxicity in 75.2% and 39.1% of patients, respectively. Complete cessation of bleedings and neurotoxicity occurred in 96% and 93% of patients within 24 hours, respectively. Sequelae have been observed in 9 (3%) patients at the home visit 15 days after hospital admission and 11 (3%) died including one before antivenom injection.
CONCLUSIONS/SIGNIFICANCE
We confirmed good effectiveness of the IPA and highlighted the rapid improvement in bleeding or neurotoxicity after the first administration. Sequential administrations of low doses of antivenom, rigorously assessed at short intervals for an eventual renewal, can preserve patient safety and save antivenom.