Valerie Makoge

Co-infections of malaria and geohelminthiasis in two rural communities of Nkassomo and Vian in the Mfou health district, Cameroon.

Background Human co-infection with malaria and helmimths is ubiquitous throughout Africa. Nevertheless, its public health significance on malaria severity remains poorly understood. Methodology/Principal Findings To contribute to a better understanding of epidemiology and control of this co-infection in Cameroon, a cross-sectional study was carried out to assess the prevalence of concomitant intestinal geohelminthiasis and malaria, and to evaluate its association with malaria and anaemia in Nkassomo and Vian. Finger prick blood specimens from a total of 263 participants aged 1–95 years were collected for malaria microscopy, assessment of haemoglobin levels, and molecular identification of Plasmodium species by PCR. Fresh stool specimens were also collected for the identification and quantification of geohelminths by the Kato-Katz method. The prevalence of malaria, geohelminths, and co-infections were 77.2%, 28.6%, and 22.1%, respectively. Plasmodium falciparum was the only malaria parasite species identified with mean parasite density of 111 (40; 18,800) parasites/µl of blood. The geohelminths found were Ascaris lumbricoides (21.6%) and Trichuris trichiura (10.8%), with mean parasite densities of 243 (24; 3,552) and 36 (24; 96) eggs/gram of faeces, respectively. Co-infections of A. lumbricoides and P. falciparum were the most frequent and correlated positively. While no significant difference was observed on the prevalences of single and co-infections between the two localities, there was a significant difference in the density of A. lumbricoides infection between the two localities. The overall prevalence of anaemia was 42%, with individuals co-infected with T. trichiura and P. falciparum (60%) being the most at risk. While the prevalence of malaria and anaemia were inversely related to age, children aged 5–14 years were more susceptible to geohelminthiasis and their co-infections with malaria. Conclusion/Significance Co-existence of geohelminths and malaria parasites in Nkassomo and Vian enhances the occurrence of co-infections, and consequently, increases the risk for anaemia.

Passie voor gezondheid

Het bevorderen van gezondheid is vaak gericht op het voorkómen en bestrijden van ziekte, waarbij het zoeken naar determinanten van ziekte en gezondheidsrisico’s voorop staat, zowel op individueel als maatschappelijke niveau. Met deze benadering is op zichzelf niets mis. Er zijn zo onmiskenbaar grote successen geboekt. Toch knaagt er iets omdat deze benadering van gezondheid vooral focust op ziekte, beperkingen en ongezonde keuzes, terwijl gezondheid op zich een positief concept is.

Knowledge, Attitudes and Practices towards Malaria in Mbonge and Kumba Sub-divisions in Cameroon

Aims: To assess knowledge, attitudes and practices regarding transmission, prevention and treatment of malaria in four rural settings and one urban neighborhood. Study Design: Cross-sectional descriptive survey carried out in Cameroon. Place and Duration of Study: This study took place in rural Mbonge division (Pete, Marumba-1, Marumba-2, and Bai Manya) and one neighbourhood in a urban town (Kumba), South West region of Cameroon between May and July 2015. Methodology: 227 participants (118 males and 109 females) took part in this study. Information was collected with a pre-tested questionnaire with mostly closed-ended questions and a few open-ended questions. Questions focused on socio-demographic parameters, knowledge attitudes and practices with respect to malaria. Data was analysed using SPSS Statistics version 22 (SPSS Inc. IBM). p values <0.05 were considered significant. Results: 118(52%) males and 109(48.0%) females were part of this study. Malaria was listed as the most common disease in all the settings without exception. In the rural settings, respondents related transmission of malaria to mosquito as follows: 53.3% in Pete, 70.7% in Marumba-2, 53.3% in Marumba-1, 65% in Bai Manya. In the urban setting, Kumba, 85.4% of respondents said malaria was caused by a mosquito bite. Other factors listed as ways in which malaria was transmitted include: using the same cup, dirtiness, dirty water, through drugs, bad environment, wind, sun and red fly. Mosquito nets were predominantly used for malaria prevention. These were obtained mostly as government donations. Respondents sought formal help mostly after 48 hours from onset of symptoms. Self-medication was commonly practiced irrespective of setting. Conclusion: This study has shown that participants in Mbonge sub-division and Buea-road Kumba have gaps in knowledge about malaria transmission, prevention and treatment. There is a need for tailored health-education intervention building on formal and local knowledge to reduce the imposed burden of malaria.

Health-Seeking Behaviour towards Poverty-Related Disease (PRDs): A Qualitative Study of People Living in Camps and on Campuses in Cameroon

Poverty-Related Diseases (PRDs) emphasize poverty as a ‘breeding-ground’ for a range of diseases. The study presented here starts from the premise that poverty is a general condition that can limit people’s capacity to prevent, mitigate or treat diseases. Using an interpretation of health seeking behaviour (HSB), inspired by the salutogenic approach, we investigated how people deal with PRDs, their ability and strategies put in place to cope. We collected HSB data from two groups of respondents in Cameroon: labourers of the Cameroon Development Corporation (CDC) living in settlements called camps and students of the state universities of Buea and Yaoundé living in settlements we refer to as campuses. By selecting these groups, the study offers a unique view of how different people cope with similar health challenges. We carried out semi-structured interviews with 21 camp dwellers and 21 students in a cross-sectional study. Our findings revealed 1) respondents use multiple resources to cope with PRDs. 2) Respondents’ perceptions of diseases and connection with poverty closely ties to general hygienic conditions of their living environment. 3) Utilisation of health facilities is not strongly dependent on financial resources. 4) Volatile health facilities are a major challenge and reason for people to revert to other health resources. The study brings out the need for organisations (governmental and non-governmental) to strengthen people’s capacities to cope with health situations through better health and housing policies geared at incorporating practices currently used by the people and supporting pro-hygienic initiatives.

Poverty-related diseases (PRDs): unravelling complexities in disease responses in Cameroon

BackgroundIn Cameroon, poverty-related diseases (PRDs) are a major public health concern. Research and policies addressing PRDs are based on a particular understanding of the interaction between poverty and disease, usually an association between poverty indicators and health indicators for a specific country or region. Such indicators are useful but fail to explain the nature of the linkages between poverty and disease or poverty and health. This paper presents results of a study among university students, unravelling how they perceive diseases, the linkages with poverty, their responses to diseases and the motivations behind reported responses.Based on the health belief model, this cross-sectional study was carried out among 272 students at the universities of Buea and Yaoundé in Cameroon. Data were collected using questionnaires containing items matching the research objectives. The questionnaires were self-completed.ResultsMalaria was considered as the most common disease perceived and also a major PRD. Contrary to official rankings of HIV/AIDS and TB, cholera and diarrhoea were considered as other major PRDs. Also, typhoid fever was perceived to be more common and a PRD than HIV/AIDS and TB combined. The most prominently attributed cause for disease was (lack of) hygiene. In response, students deployed formal and/or informal healthcare strategies, depending on factors like available money, perceived severity of the disease and disease type. Discrepancies were observed in respondents’ response to diseases generally and to malaria in particular. Even though, overall, respondents pre-dominantly reported a formal healthcare response toward diseases in general, for malaria, informal responses dominated. There was an overall strong awareness and (pro)activity among students for dealing with diseases.ConclusionsAlthough the high use of informal facilities and medication for malaria may well be a reason why eradication is problematic, this seems to be a deliberate strategy linked to an awareness of the limitations of the formal health system. In any intervention intended to foster health, it is therefore vital to consider people’s perceptions toward diseases and their response strategies. Our results give important leads to health promotion interventions to develop group-specific programs.

Health dynamics in camps and on campuses: stressors and coping strategies for wellbeing among labourers and students in Cameroon

ABSTRACT Purpose: For many people living in low-income countries, poverty implies an increased exposure to conditions that threaten health and wellbeing as well as reduced capacity to maintain health. Despite the challenging conditions caused by poverty, people may consider themselves healthy because they have learned to cope with their situation probably as a result of life experiences which expose people to both challenges and potential solutions. In this paper we present results from studying health and wellbeing challenges and mechanisms to cope with challenges among two different groups of people who are living under conditions of poverty: workers of the Cameroon Development Corporation (CDC) and students of the university of Buea and the university of Yaoundé. Methods: We performed a cross-sectional study, interviewing 21 CDC workers and 21 students. Results Our study reveals context-specific stressors emerging from poor work conditions and study pressure as well as non-context-specific stressors perceived by respondents as living conditions, poor healthcare and financial uncertainty. Respondents devised coping mechanisms to overcome exactly those stressors such as searching for additional money sources, preventive action towards hazardous living conditions and alternative medical support. Conclusion: We conclude that supporting and promoting such avenues is essential for enhanced and continuous coping with stressors.

Poverty and health among CDC plantation labourers in Cameroon: Perceptions, challenges and coping strategies

Creating better access to good quality healthcare for the poor is a major challenge to development. In this study, we examined inter-linkages between poverty and disease, referred to as poverty-related diseases (PRDs), by investigating how Cameroon Development Corporation (CDC) camp dwellers respond to diseases that adversely affect their health and wellbeing. Living in plantation camps is associated with poverty, overcrowding, poor sanitation and the rapid spread of diseases. In a survey of 237 CDC camp dwellers in Cameroon, we used the health belief model to understand the drivers (perceived threats, benefits and cues for treatment seeking) of reported responses. Using logistic regression analysis, we looked for trends in people’s response to malaria. We calculated the odds ratio of factors shown to have an influence on people’s health, such as food, water, sanitation challenges and seeking formal healthcare for malaria. Malaria (40.3%), cholera (20.8%) and diarrhoea (17.7%) were the major PRDs perceived by camp dwellers. We found a strong link between what respondents perceived as PRDS and hygiene conditions. Poverty for our respondents was more about living in poor hygiene conditions than lack of money. Respondents perceived health challenges as stemming from their immediate living environment. Moreover, people employed self-medication and other informal health practices to seek healthcare. Interestingly, even though respondents reported using formal healthcare services as a general response to illness (84%), almost 90% stated that, in the case of malaria, they would use informal healthcare services. Our study recommends that efforts to curb the devastating effects of PRDs should have a strong focus on perceptions (i.e. include diseases that people living in conditions of poverty perceive as PRDs) and on hygiene practices, emphasising how they can be improved. By providing insights into the inter-linkages between poverty and disease, our study offers relevant guidance for potentially successful health promotion interventions.