Conference Material > Video (talk)
Ntone R
Epicentre Scientific Day Paris 2021. 2021 June 10
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
Confl Health. 2020 November 30; Volume 14; DOI:10.1186/s13031-020-00327-4
Gignoux EM, Sontsa OT, Mudasiru A, Eyong J, Ntone R, et al.
Confl Health. 2020 November 30; Volume 14; DOI:10.1186/s13031-020-00327-4
Background
In 2017, Field access was considerably limited in the Far North region of Cameroon due to the conflict. Médecins Sans Frontieres (MSF) in collaboration with Ministry of health needed to estimate the health situation of the populations living in two of the most affected departments of the region: Logone-et-Chari and Mayo-Sava.
Methods
Access to health care and mortality rates were estimated through cell phone interviews, in 30 villages (clusters) in each department. Local Community Health Workers (CHWs) previously collected all household phone numbers in the selected villages and nineteen were randomly selected from each of them. In order to compare telephone interviews to face-to-face interviews for estimating health care access, and mortality rates, both methods were conducted in parallel in the town of Mora in the mayo Sava department. Access to food was assessed through push messages sent by the three main mobile network operators in Cameroon. Additionally, all identified legal health care facilities in the area were interviewed by phone to estimate attendance and services offered before the conflict and at the date of the survey.
Results
Of a total of 3423 households called 43% were reached. Over 600,000 push messages sent and only 2255 were returned. We called 43 health facilities and reached 34 of them. In The town of Mora, telephone interviews showed a Crude Mortality Rate (CMR) at 0.30 (CI 95%: 0.16–0.43) death per 10,000-person per day and home visits showed a CMR at 0.16 (0.05–0.27), most other indicators showed comparable results except household composition (more Internally Displaced Persons by telephone).
Phone interviews showed a CMR at 0.63 (0.29–0.97) death per 10,000-person per day in Logone-et-Chari, and 0.30 (0.07–0.50) per 10,000-person per day in Mayo-Sava. Among 86 deaths, 13 were attributed to violence (15%), with terrorist attacks being explicitly mentioned for seven deaths. Among 29 health centres, 5 reported being attacked and vandalized; 3 remained temporally closed; Only 4 reported not being affected.
Conclusion
Telephone interviews are feasible in areas with limited access, although special attention should be paid to the initial collection of phone numbers. The use of text messages to collect data was not satisfactory is not recommended for this purpose. Mortality in Logone-et-Chari and Mayo-Sava was under critical humanitarian thresholds although a considerable number of deaths were directly related to the conflict.
In 2017, Field access was considerably limited in the Far North region of Cameroon due to the conflict. Médecins Sans Frontieres (MSF) in collaboration with Ministry of health needed to estimate the health situation of the populations living in two of the most affected departments of the region: Logone-et-Chari and Mayo-Sava.
Methods
Access to health care and mortality rates were estimated through cell phone interviews, in 30 villages (clusters) in each department. Local Community Health Workers (CHWs) previously collected all household phone numbers in the selected villages and nineteen were randomly selected from each of them. In order to compare telephone interviews to face-to-face interviews for estimating health care access, and mortality rates, both methods were conducted in parallel in the town of Mora in the mayo Sava department. Access to food was assessed through push messages sent by the three main mobile network operators in Cameroon. Additionally, all identified legal health care facilities in the area were interviewed by phone to estimate attendance and services offered before the conflict and at the date of the survey.
Results
Of a total of 3423 households called 43% were reached. Over 600,000 push messages sent and only 2255 were returned. We called 43 health facilities and reached 34 of them. In The town of Mora, telephone interviews showed a Crude Mortality Rate (CMR) at 0.30 (CI 95%: 0.16–0.43) death per 10,000-person per day and home visits showed a CMR at 0.16 (0.05–0.27), most other indicators showed comparable results except household composition (more Internally Displaced Persons by telephone).
Phone interviews showed a CMR at 0.63 (0.29–0.97) death per 10,000-person per day in Logone-et-Chari, and 0.30 (0.07–0.50) per 10,000-person per day in Mayo-Sava. Among 86 deaths, 13 were attributed to violence (15%), with terrorist attacks being explicitly mentioned for seven deaths. Among 29 health centres, 5 reported being attacked and vandalized; 3 remained temporally closed; Only 4 reported not being affected.
Conclusion
Telephone interviews are feasible in areas with limited access, although special attention should be paid to the initial collection of phone numbers. The use of text messages to collect data was not satisfactory is not recommended for this purpose. Mortality in Logone-et-Chari and Mayo-Sava was under critical humanitarian thresholds although a considerable number of deaths were directly related to the conflict.
Journal Article > ResearchFull Text
Trop Med Infect Dis. 2020 November 17; Volume 5 (Issue 4); 172.; DOI:10.3390/tropicalmed5040172
Kwedi Nolna S, Ntone R, Fouda Mbarga N, Mbainda S, Mutangala W, et al.
Trop Med Infect Dis. 2020 November 17; Volume 5 (Issue 4); 172.; DOI:10.3390/tropicalmed5040172
BACKGROUND
Based on the premise that Africans in rural areas seek health care from traditional healers, this study investigated a collaborative model between traditional healers and the national Human African Trypanosomiasis (HAT) programs across seven endemic foci in seven central African countries by measuring the model's contribution to HAT case finding.
METHOD
Traditional healers were recruited and trained by health professionals to identify HAT suspects based on its basics signs and symptoms and to refer them to the National Sleeping Sickness Control Program (NSSCP) for testing and confirmatory diagnosis.
RESULTS
35 traditional healers were recruited and trained, 28 finally participated in this study (80%) and referred 278 HAT suspects, of which 20 (7.19%) were CATT positive for the disease. Most cases originated from Bandundu (45%) in the Democratic Republic of Congo and from Ngabe (35%) in Congo. Twelve (4.32%) patients had confirmatory diagnosis. Although a statistically significant difference was not shown in terms of case finding (p = 0.56), traditional healers were able to refer confirmed HAT cases that were ultimately cared for by NCSSPs.
CONCLUSION
Integrating traditional healers in the control program of HAT will likely enhance the detection of cases, thereby, eventually contributing to the elimination of HAT in the most affected communities.
Based on the premise that Africans in rural areas seek health care from traditional healers, this study investigated a collaborative model between traditional healers and the national Human African Trypanosomiasis (HAT) programs across seven endemic foci in seven central African countries by measuring the model's contribution to HAT case finding.
METHOD
Traditional healers were recruited and trained by health professionals to identify HAT suspects based on its basics signs and symptoms and to refer them to the National Sleeping Sickness Control Program (NSSCP) for testing and confirmatory diagnosis.
RESULTS
35 traditional healers were recruited and trained, 28 finally participated in this study (80%) and referred 278 HAT suspects, of which 20 (7.19%) were CATT positive for the disease. Most cases originated from Bandundu (45%) in the Democratic Republic of Congo and from Ngabe (35%) in Congo. Twelve (4.32%) patients had confirmatory diagnosis. Although a statistically significant difference was not shown in terms of case finding (p = 0.56), traditional healers were able to refer confirmed HAT cases that were ultimately cared for by NCSSPs.
CONCLUSION
Integrating traditional healers in the control program of HAT will likely enhance the detection of cases, thereby, eventually contributing to the elimination of HAT in the most affected communities.
Journal Article > ResearchFull Text
J Viral Hepat. 2018 July 26; Volume 25 (Issue 12); DOI:10.1111/jvh.12974
Bilounga Ndongo C, Eteki L, Siedner MJ, Mbaye R, Chen JH, et al.
J Viral Hepat. 2018 July 26; Volume 25 (Issue 12); DOI:10.1111/jvh.12974
Hepatitis B virus (HBV) infection is hyperendemic in Cameroon, and health care workers (HCWs) are at high-risk of infection. We aimed to assess prevalence, risk factors and vaccine coverage of HBV infection among HCWs in Cameroon. We conducted a cross-sectional study in 16 hospitals across all regions of Cameroon. HCWs were tested for HBV using rapid diagnostic tests (RDT). We collected data on socio-demographics and HBV vaccination status. We estimated prevalence of HBV and used Poisson regression models with robust standard errors to model the prevalence ratios of HBV positivity between covariates. We enrolled 1,824 of 1,836 eligible HCWs (97.5%). The mean age was 34 (SD: 10) years, 65.3% (n=1787) were women, and 11.4% (n=1747) had three or more doses of the HBV vaccine. Overall, we found a HBV prevalence of 8.7% (95% CI: 5.2 - 14.3%). Patient transporters had the highest crude prevalence (14.3%; 95%CI: 5.4-32.9%), whereas medical doctors had the lowest (3.2%; 95%CI: 0.8%-12.1%). The Far North Region had the highest prevalence of HBV (24.0%; 95%CI: 18.3%-30.8%). HBV prevalence decreased with increasing doses of the HBV vaccine (10.3% for no doses vs 3.5% for three or more doses; P<0.001). In conclusion, approximately 1 in 12 HCWs in Cameroon have evidence of HBV infection, yet fewer than 1 in 6 have been fully vaccinated. Our results illustrate the urgent need to scale up systematic HBV screening and targeted vaccination of HCWs in the region. This article is protected by copyright. All rights reserved.
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
Conference Material > Abstract
Ntone R
Epicentre Scientific Day Paris 2021. 2021 June 10
CONTEXT
Early diagnosis of Buruli Ulcer (BU) improves its management and limits any sequelae. However, access to PCR diagnostics remains limited. This study aimed to validate a clinical diagnostic score (CDS) and assess its acceptability by patients and caregivers.
METHODS
We included patients with chronic wounds in Akonolinga, Ayos and Bankim. For each participant, nurses and doctors separately completed the CDSCDS composed of 11 parameters and the PCR was carried out at the Pasteur Center in Cameroon. We performed focus group discussions and individual interviews to assess the acceptability of CDS by patients and caregivers, and the psychological status of patients (MINI and QSCPGS tests).
RESULTS
Between January 2018 to October 2019, 340 CDSs were administered. Among the patients, 139 (38.2%) had positive PCRs and 225 (61.8%) negative PCRs. The average age was 26.5 years (1-85 years) and 35.9% were women. CDS achieved sensitivity and specificity of 69.3% (60.5% - 77.2% CI) and 94.1% (89.7% - 97.0% CI) respectively compared to PCR. The positive (PPV) and negative predictive values were 88.9% (81.0% - 94.3% CI) and 81.8% (75.9% - 86.7% CI), respectively. The correlation coefficient between Doctors and Nurses was 0.8955. We observed a high acceptability of CDS in patients and caregivers. Among the patients, 36% (N = 73) suffered from depression, 25% suicidal urges and 75% (N = 55) felt stigmatized and / or discriminated against.
CONCLUSIONS
The UB CDS detects more than 70% (PPV) of UB patients confirmed by PCR (WHO recommendation). The good performance of nurses and the high acceptability of the CDS make it a major tool for decentralized management of UB, thus limiting the sequelae and its psychological impact.
KEY MESSAGE
The Clinical Diagnostic Score is an effective tool that can be easily used by health personnel for the adequate management of BU in rural areas.
This abstract is not to be quoted for publication.
Early diagnosis of Buruli Ulcer (BU) improves its management and limits any sequelae. However, access to PCR diagnostics remains limited. This study aimed to validate a clinical diagnostic score (CDS) and assess its acceptability by patients and caregivers.
METHODS
We included patients with chronic wounds in Akonolinga, Ayos and Bankim. For each participant, nurses and doctors separately completed the CDSCDS composed of 11 parameters and the PCR was carried out at the Pasteur Center in Cameroon. We performed focus group discussions and individual interviews to assess the acceptability of CDS by patients and caregivers, and the psychological status of patients (MINI and QSCPGS tests).
RESULTS
Between January 2018 to October 2019, 340 CDSs were administered. Among the patients, 139 (38.2%) had positive PCRs and 225 (61.8%) negative PCRs. The average age was 26.5 years (1-85 years) and 35.9% were women. CDS achieved sensitivity and specificity of 69.3% (60.5% - 77.2% CI) and 94.1% (89.7% - 97.0% CI) respectively compared to PCR. The positive (PPV) and negative predictive values were 88.9% (81.0% - 94.3% CI) and 81.8% (75.9% - 86.7% CI), respectively. The correlation coefficient between Doctors and Nurses was 0.8955. We observed a high acceptability of CDS in patients and caregivers. Among the patients, 36% (N = 73) suffered from depression, 25% suicidal urges and 75% (N = 55) felt stigmatized and / or discriminated against.
CONCLUSIONS
The UB CDS detects more than 70% (PPV) of UB patients confirmed by PCR (WHO recommendation). The good performance of nurses and the high acceptability of the CDS make it a major tool for decentralized management of UB, thus limiting the sequelae and its psychological impact.
KEY MESSAGE
The Clinical Diagnostic Score is an effective tool that can be easily used by health personnel for the adequate management of BU in rural areas.
This abstract is not to be quoted for publication.
Journal Article > ResearchFull Text
Int J Tuberc Lung Dis. 2016 September 1; Volume 20 (Issue 9); 1199-1204.; DOI:10.5588/ijtld.15.0897
Kwedi Nolna S, Kammogne ID, Ndzinga R, Afanda B, Ntone R, et al.
Int J Tuberc Lung Dis. 2016 September 1; Volume 20 (Issue 9); 1199-1204.; DOI:10.5588/ijtld.15.0897
SETTING
With 15 080 new cases in 2013, Cameroon is a country with high tuberculosis (TB) incidence and prevalence. Understanding the community's knowledge, attitude and practice (KAP) about TB is key to TB control in such endemic settings.
OBJECTIVES
To assess TB-related KAP in Cameroon by describing the sociodemographics of respondents, to identify barriers to seeking care and to explore attitudes and experiences of stigma and discrimination related to TB in communities.
DESIGN
We conducted a cross-sectional descriptive study using structured questionnaires to assess and compare TB KAP in the entire territory.
RESULTS
The results showed that Cameroonians have insufficient understanding of TB, numerous erroneous health assumptions and beliefs concerning TB, and erroneous information about the symptoms and mode of transmission of the disease.
CONCLUSION
Negative attitudes and poor practices are obstacles to elimination and control efforts. The National Tuberculosis Control Programme should generate more effective strategies to reach the populations, paying particular attention to rural populations.
With 15 080 new cases in 2013, Cameroon is a country with high tuberculosis (TB) incidence and prevalence. Understanding the community's knowledge, attitude and practice (KAP) about TB is key to TB control in such endemic settings.
OBJECTIVES
To assess TB-related KAP in Cameroon by describing the sociodemographics of respondents, to identify barriers to seeking care and to explore attitudes and experiences of stigma and discrimination related to TB in communities.
DESIGN
We conducted a cross-sectional descriptive study using structured questionnaires to assess and compare TB KAP in the entire territory.
RESULTS
The results showed that Cameroonians have insufficient understanding of TB, numerous erroneous health assumptions and beliefs concerning TB, and erroneous information about the symptoms and mode of transmission of the disease.
CONCLUSION
Negative attitudes and poor practices are obstacles to elimination and control efforts. The National Tuberculosis Control Programme should generate more effective strategies to reach the populations, paying particular attention to rural populations.
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.