Marie-José Essi

A public private partnership to fight against malaria along the Chad-Cameroon pipeline corridor: I. Baseline data on socio-anthropological aspects, knowledge, attitudes and practices of the population concerning malaria

BackgroundMalaria is ranked as the major public health problem in Cameroon, representing 50% of illness in less than five year old children, 40-45% of medical consultation and 40% of the annual home income spent on health. The Cameroon Oil Transportation Company (COTCO) that exploits the Chad-Cameroon pipeline in Cameroon territory, initiated in 2010, a public private partnership project to control malaria along the pipeline corridor. A research component was included in the project so as to guide and evaluate the control measures applied in this pipeline corridor. This study presents the baseline socio-anthropological data as well as the knowledge, attitudes and practices of the local population concerning malaria, its transmission, management and prevention.MethodsA descriptive cross-sectional survey was undertaken in four sentinel sites (one site per ecological zone) along the Chad-Cameroon pipeline corridor. Three structured questionnaires were used for the survey. Two of them were addressed to the heads of households (one for census and the other to collect information concerning the characteristics of houses and living conditions in households as well as their knowledge, attitudes and practices concerning malaria). The last questionnaire was used to collect information on malaria management and prevention. It was addressed to women who had delivered a living child within the past three years. Interviewers were recruited from each village and trained for two consecutive days on how to fill the different questionnaires. All data were analysed at 5% significant level using Epi-Info, SPSS and Cs PRO 4.0 STATA. Values of p ≤ 0.05 were considered statistically significant.ResultsInterviews were conducted in 2597 households (Bipindi 399, Bélabo 835, in Meidougou 820 and Dompta 543). Whatever the study site, 50% of the heads of household were workers of the agro-pastoral sector. Most of the heads of household were men (average 77.4% for men and 22.6% for females). The walls of households were mostly made-up of earth blocks and access to media was low. There were significant differences between mean ages and educational level of the heads of household. Significant differences were also observed between the characteristics of houses and the sites located in the southern regions (Bipindi and Bélabo) and those located in the northern regions (Meidougou and Dompta). The later household heads were younger and less educated than those in the other regions.In most of the study sites, paracetamol was cited as the first intention drug for malaria treatment, followed by chloroquine, a banned drug. More than half of the households studied had a correct knowledge of malaria and its mode of transmission: 120/155 (77.1%) in Bipindi, 244/323 (74.5%) in Bélabo, 171/235 (72.8%) in Meidougou and 118/218 (54.1%) in Dompta. Fever and headache were the malaria signs/symptoms most often cited by the households. An important percentage of pregnant women did not take any malaria prophylaxis during their last pregnancy (up to 43.4% in Bélabo).ConclusionIn all the study sites, there were conditions that indicated the all year round transmission of malaria (characteristics of houses and limited access to media making sensitization campaigns difficult). In general, most households had a good knowledge of malaria and its mode of transmission. However, malaria treatment drugs were most often inappropriate. In this study, recommendations were made in order to guide the implementation of control measures.

The effect of free diabetes care on metabolic control and on health-related quality of life among youths with type 1 diabetes in Cameroon

Objective To assess the effect of free diabetes care on metabolic control and on health-related quality of life (HRQoL) of youths living with type 1 diabetes in Cameroon. Research design and methods We conducted a clinical audit of a multicenter prospective cohort, performed in three of the nine clinics of the ‘Changing Diabetes in Children’ (CDiC) project in Cameroon. We collected data on demography, glycemic control, diabetes acute complications, and patients’ HRQoL at baseline and after 1 year of follow-up. Results One hundred and four patients (51 female) were included. The mean age was 16±2 years (min–max: 9–18), the mean duration of diabetes was 5±3 years, and the mean HbA1C level was 11.4%±2.7%. A significant reduction in HbA1c (11.4%±2.7% vs 8.7±2.4%), episodes of severe hypoglycemia (27/104 vs 15/104), and episodes of ketoacidosis (31/104 vs 7/104) were observed after 1 year (p<0.05). We did not observe any significant difference in the total HRQoL score (p=0.66). However, we observed a significant decrease in diabetes-associated symptoms (p<0.05). Age, level of education, duration of diabetes, glycemic control, and the presence or absence of diabetes complications did not significantly affect the total HRQoL score. Conclusions One year after free diabetes care offered through the CDiC project, a significant improvement was observed in glycemic control and acute complications of diabetes, but not in the total score of HRQoL of youths living with type 1 diabetes enrolled in the project.