• 【喀麦隆雅温得性发展障碍的观察性研究。】 复制标题 收藏 收藏
    DOI:10.1515/jpem-2019-0458 复制DOI
    作者列表:Sap SNU,Mbono Betoko R,Etoa Etoga M,Mure PY,Morel Y,Dahoun S,Mouafo Tambo F,Moiffo B,Sobngwi E,Koki Ndombo P
    BACKGROUND & AIMS: :Introduction According to the current classification of the Lawson Wilkins Pediatric Endocrine Society (LWPES) and the European Society for Pediatric Endocrinology (ESPE) of Disorders of Sex Development (DSD), etiologies vary around the world. Ethnic or genetic diversity probably explains this variability. We therefore conducted the present study on etiologies of DSDs in a country from central Africa. Methods We carried out an observational retrospective study at the Pediatric Endocrinology Unit of the Mother and Child Centre of the Chantal Biya Foundation in Yaounde, Cameroon from May 2013 to December 2019. All patients diagnosed with a DSD were included, and incomplete files excluded. Results We included 80 patients diagnosed with DSD during the study period. The 46,XX DSD were the most frequent in our study population (n = 41, 51.25%), with congenital adrenal hyperplasia (CAH) as the main diagnosis. The 46,XY DSD accounted for 33.75% and sex chromosome DSD group represented 15% of the study population. Conclusions DSDs are not an exceptional diagnosis in a Sub-Saharan context. 46,XX DSD are the most prevalent diagnosis in our setting. The diagnosis of all these affections is late compared to other centers, justifying advocacy for neonatal screening of DSDs in our context.
    背景与目标: :简介根据劳森·威尔金斯(Lawson Wilkins)儿科内分泌学会(LWPES)和欧洲性发育障碍小儿内分泌学会(ESPE)的当前分类,病因在世界各地有所不同。种族或遗传多样性可能解释了这种可变性。因此,我们在中部非洲一个国家进行了有关DSD病因的本研究。方法我们于2013年5月至2019年12月在喀麦隆雅温得Chantal Biya基金会母婴中心儿科内分泌科进行了观察性回顾性研究。所有诊断为DSD的患者均包括在内,但不完整的文件被排除在外。结果我们纳入了80名在研究期间诊断为DSD的患者。在我们的研究人群中,46,XX DSD是最常见的(n = 41,51.25%),以先天性肾上腺皮质增生(CAH)为主要诊断。 46,XY DSD占33.75%,性染色体DSD组占研究人群的15%。结论在撒哈拉以南地区,DSD并不是一种例外的诊断。 46,XX DSD是我们环境中最常见的诊断。与其他中心相比,所有这些疾病的诊断都晚了,这证明了在我们的背景下倡导新生儿筛查DSD的合理性。
  • 【蚂蚁Petalomyrmex phylax的交配系统和社会结构的变化与喀麦隆范围的扩大有关。】 复制标题 收藏 收藏
    DOI:10.1111/j.1558-5646.2007.00044.x 复制DOI
    作者列表:Dalecky A,Debout G,Estoup A,McKey DB,Kjellberg F
    BACKGROUND & AIMS: :Past climate shifts have led to major oscillations in species distributions. Hence historical contingencies and selective processes occurring during such phases may be determinants for understanding the forces that have shaped extant phenotypes. In the plant-ant Petalomyrmex phylax (Formicinae), we observed spatial variation in number of queens in mature colonies, from several queens (high polygyny) in the median part of its distribution to a moderate number of queens (weak polygyny) or even only a single queen (monogyny) in the southwesternmost populations. This variation did not correlate with indicators of variation in current nest site availability and colony turnover, the supposedly determinant selective forces acting on gyny in ants. We show here that the variation in social structure correlates with a historical process corresponding to a progressive colonization of coastal southern Cameroon by the ant. Using microsatellite markers, we observed a clear pattern of isolation by distance except for the southernmost populations. Measures of genetic variability that do not take into account allele size were at equilibrium in all except the southernmost populations, suggesting recent foundation of the latter. Measures of genetic diversity taking into account allele size showed a clinal north-south decrease in variance of allele size. We propose that southern populations have yet to regain allele size variance after bottlenecks associated with the foundation of new populations, and that this variance is regained over time. Hence variation in social structure mirrors an old but still active southward colonization process or metapopulation dynamics, possibly in association with an expansion of the rain forest habitat during the late Holocene. A low number of queens in ant colonies is typically associated with strong dispersal capacity. We therefore suggest that the initial founders of new populations belong to the monogynous to weakly polygynous phenotype, and that queen number progressively increases in older populations.
    背景与目标: :过去的气候变化导致物种分布出现重大波动。因此,在这些阶段中发生的历史偶然性和选择性过程可能是理解已形成现存表型的力的决定因素。在植物蚂蚁Petalomyrmex phylax(Formicinae)中,我们观察到成熟菌落中皇后数量的空间变化,从分布中位数的几个皇后(高多生)到中等数量的皇后(弱多生)甚至仅最西南人口中的一个女王(单身女)。这种变化与当前巢位可用性和菌落周转率的变化指标无关,所谓的决定因素是对蚂蚁的gyny作用的决定性选择力。我们在这里表明,社会结构的变化与一个历史过程相关,该历史过程对应于蚂蚁在喀麦隆南部沿海地区逐渐殖民。使用微卫星标记,除了最南端的种群外,我们观察到了清晰的距离隔离模式。除最南端的种群外,所有未考虑等位基因大小的遗传变异性指标均处于平衡状态,这表明后者是最近的基础。考虑等位基因大小的遗传多样性测度表明,等位基因大小方差在南北逐渐减少。我们提出,南方人群在与新人群的基础相关的瓶颈之后,尚未恢复等位基因大小的变异,并且随着时间的流逝,这种变异得以重新获得。因此,社会结构的变化反映了一个古老但仍然活跃的南方殖民化过程或种群迁移动态,这可能与全新世晚期雨林栖息地的扩张有关。蚁后蚁后数量少通常与强大的扩散能力有关。因此,我们建议新种群的最初建立者属于单性的到弱多性的表型,并且在较老的种群中女王的数量逐渐增加。
  • 【在喀麦隆西部农村地区,未经药物治疗的HIV-1感染者中出现了与抗逆转录病毒疗法耐药相关的主要突变。】 复制标题 收藏 收藏
    DOI:10.1097/01.qai.0000226793.16216.55 复制DOI
    作者列表:Koizumi Y,Ndembi N,Miyashita M,Lwembe R,Kageyama S,Mbanya D,Kaptue L,Numazaki K,Fujiyama Y,Ichimura H
    BACKGROUND & AIMS: :The prevalence of antiretroviral therapy (ART) resistance-associated mutations among HIV-1 strains in western Cameroon was evaluated by genotypically analyzing strains isolated from drug-naive individuals. Proviral DNA was extracted from 54 blood samples and amplified by polymerase chain reaction of protease, reverse transcriptase, integrase, and envelope genes. At least 4 clones per sample were analyzed. Of 54 HIV-1 strains, 45 (83.3%) had a concordant subtype or circulating recombinant form (CRF) designation: 40 CRF02_AG, 2 subtype A1, 2 G, and 1 F2. The remaining 9 (16.7%) had a discordant subtype: 6 subtype A1/CRF02_AG, 2 D/CRF02, and 1 G/CRF02. Protease inhibitor-associated primary resistance mutations were found in 4 (7.4%) cases: M46L with full clones in 1 case, and M46I, M46L, and V82A as minor populations in 1 case each. Reverse transcriptase inhibitor-associated primary resistance mutations were found in 5 (9.8%) samples: Y188C in 2 cases, and L100I, M184V, and V75I in 1 case each, although all of these mutations were found as minor populations. This is one of the first reports of the emergence of primary ART resistance mutations among drug-naive, non-B subtype HIV-1-infected individuals in Cameroon. Follow-up studies should be conducted to assess whether these drug-resistant mutants found as minor populations might impact future ART.
    背景与目标: :通过基因型分析从单纯毒品患者中分离出的菌株,评估了喀麦隆西部HIV-1菌株中抗逆转录病毒疗法(ART)耐药相关突变的患病率。从54个血液样本中提取原病毒DNA,并通过蛋白酶,逆转录酶,整合酶和包膜基因的聚合酶链反应进行扩增。每个样品至少分析了4个克隆。在54个HIV-1毒株中,有45个(83.3%)具有一致的亚型或循环重组形式(CRF)名称:40 CRF02_AG,2个亚型A1、2 G和1 F2。其余9个(16.7%)具有不一致的亚型:6个亚型A1 / CRF02_AG,2个D / CRF02和1个G / CRF02。蛋白酶抑制剂相关的原发性耐药突变发生在4个(7.4%)病例中:具有完整克隆的M46L 1例,少数人群M46I,M46L和V82A分别为1例。在5个样本(9.8%)中发现了与逆转录酶抑制剂相关的主要耐药突变:2例患者为Y188C,1例患者为L100I,M184V和V75I,尽管所有这些突变都是次要人群。这是在喀麦隆未接受过药物治疗的非B亚型HIV-1感染者中出现原发性ART抗药性突变的报道之一。应该进行后续研究,以评估这些作为少数人群发现的耐药突变体是否可能影响未来的抗逆转录病毒治疗。
  • 【喀麦隆雅温得城市环境中冈比亚按蚊幼虫的空间分布。】 复制标题 收藏 收藏
    DOI:10.1186/s40249-019-0597-6 复制DOI
    作者列表:Djamouko-Djonkam L,Mounchili-Ndam S,Kala-Chouakeu N,Nana-Ndjangwo SM,Kopya E,Sonhafouo-Chiana N,Talipouo A,Ngadjeu CS,Doumbe-Belisse P,Bamou R,Toto JC,Tchuinkam T,Wondji CS,Antonio-Nkondjio C
    BACKGROUND & AIMS: BACKGROUND:The rapid and unplanned urbanization of African cities is considered to increase the risk of urban malaria transmission. The present study objective was to assess factors influencing the spatio-temporal distribution of Anopheles gambiae s.l. larvae in the city of Yaoundé, Cameroon. METHODS:All water bodies were checked once every 2 months for the presence of mosquito larvae from March 2017 to May 2018 in 32 districts of Yaoundé. Physico-chemical characteristics including the size, depth, turbidity, pH, temperature, conductivity, sulfates, organophosphates, hydrogen peroxide (H2O2), conductivity, iron and calcium were recorded and analyzed according to anopheline larvae presence or absence. High resolution satellite images from landsat sentinel Enhanced Thematic Mapper were used for spatial mapping of both field and environmental variables. Bivariate and multivariate logistic regression models were used to identify variables closely associated with anopheline larvae distribution. RESULTS:A total of 18 696 aquatic habitats were checked and only 2942 sites (15.7%) contained anopheline larvae. A high number of sites with anopheline larvae (≥ 69%) presented late instar larvae (L3, L4 and pupae). Anopheline mosquito larvae were sampled from a variety of breeding sites including puddles (51.6%), tire prints (12.9%), wells (11.7%) and drains (11.3%). Bivariate logistic regression analyses associated anopheline larvae presence with the absence of predators, absence of algae, absence of vegetation and depth of less than 1 m. Conductivity, turbidity, organophosphates, H2O2 and temperature were significantly high in breeding sites with anopheline larvae than in breeding sites without these larvae (P <  0.1). Anopheline species collected included An. coluzzii (91.1%) and An. gambiae s.s. (8.9%). GIS mapping indicated a heterogeneous distribution of anopheline breeding habitats in the city of Yaoundé. Land cover analysis indicated high variability of the city of Yaoundé's landscape. CONCLUSIONS:The data confirms adaptation of An. gambiae s.l. to the urban domain in the city of Yaoundé and calls for urgent actions to improve malaria vector control.
    背景与目标: 背景:非洲城市的快速和无计划的城市化被认为增加了城市疟疾传播的风险。本研究的目的是评估影响冈比亚按蚊的时空分布的因素。幼虫在喀麦隆雅温得市。
    方法:从2017年3月至2018年5月,在雅温得的32个地区,每2个月对所有水体进行一次蚊子幼虫检查。记录并根据an鱼幼虫的存在与否,记录并分析其理化特性,包括大小,深度,浊度,pH,温度,电导率,硫酸盐,有机磷酸盐,过氧化氢(H2O2),电导率,铁和钙。来自Landats定点增强型专题制图仪的高分辨率卫星图像用于野外和环境变量的空间制图。使用双变量和多元逻辑回归模型来确定与按蚊幼虫分布密切相关的变量。
    结果:总共检查了18 696个水生栖息地,只有2942个地点(15.7%)含有按蚊幼虫。大量带有按蚊幼虫的部位(≥69%)呈晚龄幼虫(L3,L4和p)。从各种繁殖地点取样了按蚊蚊幼虫,包括水坑(51.6%),轮胎印迹(12.9%),水井(11.7%)和排水管(11.3%)。双变量逻辑回归分析分析了相关的按蚊幼虫的存在,没有捕食者,没有藻类,没有植被以及深度小于1μm。带有按蚊幼虫的繁殖场所的电导率,浊度,有机磷酸盐,H2O2和温度均显着高于没有这些幼虫的繁殖场所(P <0.1)。收集的按蚊种包括An。 coluzzii(91.1%)和An。冈比亚(8.9%)。 GIS测绘表明雅温得市的按蚊繁殖生境分布不均。土地覆盖分析表明,雅温得市的地貌变化很大。
    结论:数据证实了An的适应性。冈比亚有限公司雅温得市的城市范围,并呼吁采取紧急行动以改善对疟疾的控制。
  • 【喀麦隆热带雨林中森林砍伐对鸟类血友病寄生虫流行和蚊子丰富的影响。】 复制标题 收藏 收藏
    DOI:10.1016/j.ijpara.2019.10.006 复制DOI
    作者列表:Tchoumbou MA,Mayi MPA,Malange ENF,Foncha FD,Kowo C,Fru-Cho J,Tchuinkam T,Awah-Ndukum J,Dorazio R,Nota Anong D,Cornel AJ,Sehgal RNM
    BACKGROUND & AIMS: :Habitat change caused by deforestation can modify the interactions of many biotic and abiotic factors, and in turn influence patterns of diseases in wild birds. Whether deforestation directly or indirectly affects the prevalence of avian haemosporidian parasites through their hosts and/or vectors is still not well understood. We sampled understory bird communities (insectivorous, frugivorous, granivorous and nectarivorous birds) and mosquitoes in three habitats showing a gradient of deforestation (pristine forest, fragmented forest, and young palm oil plantation), to assess the effects of habitat changes on avian haemosporidian (Plasmodium and Haemoproteus) prevalence and its relationship to bird feeding guilds and mosquito abundance. Blood samples of 845 individual birds belonging to 85 species and 27 families were collected in the three habitat types and screened using microscopy and PCR. Plasmodium infections were detected in 136 individuals (16.09%) and varied significantly among habitat types while Haemoproteus infections were detected in 98 individuals (11.60%) and did not vary significantly among habitat types. However, the prevalence of Plasmodium and Haemoproteus in bird feeding groups varied significantly among habitats. Nectarivorous and granivorous birds had the highest Plasmodium and Haemoproteus prevalence, respectively. The abundance of mosquitoes varied significantly among habitat types and the prevalence of Plasmodium significantly and positively correlated with mosquito abundance in fragmented forest. This study highlights the importance of host and mosquito determinants in the transmission dynamics of avian Plasmodium and Haemoproteus infections following habitat changes. Selective logging favored an increase in the prevalence of Plasmodium in insectivores, the prevalence of Haemoproteus in nectarivores and the abundance of female mosquitoes while, the establishment of the palm oil plantation favored an increase in the prevalence of Plasmodium in granivores and Haemoproteus in nectarivores. Species feeding behavior is also an important determinant to consider for a better understanding of patterns of parasite infections in a changing environment.
    背景与目标: 森林砍伐引起的生境变化可以改变许多生物和非生物因素的相互作用,进而影响野生鸟类的疾病模式。砍伐森林是通过其宿主和/或媒介直接或间接影响禽血吸虫病寄生虫的流行仍未得到很好的了解。我们在三个森林砍伐呈梯度变化的栖息地(原始森林,零散森林和年轻的棕榈油种植园)中采样了地下鸟类群落(食虫,食肉,食肉和肉食性鸟类)和蚊子,以评估栖息地变化对禽血孢子虫的影响(疟原虫和嗜血杆菌的患病率及其与鸟类饲养协会和蚊子数量的关系。在这三种栖息地类型中收集了来自85个物种和27个科的845只鸟类的血样,并使用显微镜和PCR进行了筛选。在136个个体中检出了疟原虫感染(16.09%),并且在生境类型之间存在显着差异,而在98个个体中检出的血型变形杆菌感染(11.60%)在生境类型之间没有显着差异。但是,鸟类饲喂组中的疟原虫和变形血红蛋白的患病率在栖息地之间存在显着差异。肉食性和肉食性鸟类的疟原虫和血生变形杆菌患病率最高。在不同的生境类型中,蚊子的丰度差异很大,而疟原虫的患病率与零散森林中的蚊虫的丰度显着正相关。这项研究强调了寄主和蚊子决定因素在栖息地变化后禽疟原虫和血红蛋白感染的传播动力学中的重要性。选择性伐木有利于食虫中疟原虫的流行,油桃中嗜血杆菌的流行和雌性蚊子的丰富,而棕榈油种植园的建立则有利于食肉动物中疟原虫的流行和油桃中嗜血菌的流行。物种的进食行为也是要考虑的一个重要决定因素,以便更好地了解不断变化的环境中的寄生虫感染模式。
  • 【喀麦隆雅温得关键pfcrt点突变以及对氯喹的体内外响应分析。】 复制标题 收藏 收藏
    DOI:10.1086/320726 复制DOI
    作者列表:Basco LK,Ringwald P
    BACKGROUND & AIMS: :The putative key codon (Lys-76 in sensitive parasites and Thr-76 in resistant parasites) of the novel candidate gene for chloroquine resistance, Plasmodium falciparum chloroquine resistance transporter (pfcrt), was determined by polymerase chain reaction-restriction fragment length polymorphism from 111 Cameroonian isolates and was compared with in vivo and in vitro responses to chloroquine. The key codon was significantly associated (P< .001) with responses in vivo (92% sensitivity and 76% specificity) and in vitro (97% sensitivity and 81% specificity). Some discordant results were due to multiclonal infections. The high, but not perfect, correlation between the pfcrt polymorphism and the phenotype implies that a single point mutation in codon 76 of the pfcrt gene is the major, but possibly not the sole, determinant for chloroquine resistance.
    背景与目标: :通过聚合酶链反应-限制性片段长度多态性分析,确定了新的候选氯喹抗性候选基因,恶性疟原虫氯喹抗性转运蛋白(pfcrt)的推定关键密码子(敏感寄生虫中的Lys-76和抗性寄生虫中的Thr-76)。并与111种喀麦隆分离物进行了比较,并与体内和体外对氯喹的反应进行了比较。关键密码子与体内(92%敏感性和76%特异性)和体外(97%敏感性和81%特异性)应答显着相关(P <.001)。一些不一致的结果是由于多克隆感染引起的。 pfcrt多态性与表型之间的高度相关但不是完美的相关性意味着pfcrt基因第76位密码子的单点突变是决定氯喹抗性的主要因素,但不是唯一的决定因素。
  • 【经过青蒿素类抗疟药物治疗后居住在喀麦隆的38岁法国外籍男子的血红蛋白尿。】 复制标题 收藏 收藏
    DOI:10.1016/j.tmaid.2007.01.003 复制DOI
    作者列表:Ezzedine K,Pistone T,Receveur MC,Cressend T,Diéval C,Malvy D
    BACKGROUND & AIMS: :Massive haemoglobinuria is encountered rarely during the course of malaria. It is usually considered a diagnostic criterion for severe malaria, together with anaemia, acute renal failure and jaundice. Haemoglobinuria can also present among expatriates travelling to endemic areas following repeated exposure to quinoline or arylaminoalcohol drugs. A case is described of haemoglobinuria developing in a 38-year-old French expatriate diagnosed concurrently with numerous tropical infections, and treated on presumptive basis with an antimalarial regimen containing artemisinin derivatives. Haemoglobinuria resolved spontaneously within a few days. Although this case does not definitely indicate a causal link between haemoglobinuria and artemisinin derivatives, the risk of such infrequent side-effects should be taken into account in pharmacovigilance monitoring. Moreover, the patient illustrates the multifaceted pathology that can be encountered with tropical infections.
    背景与目标: :在疟疾过程中很少会遇到大规模的血红蛋白尿。通常认为它是严重疟疾,贫血,急性肾衰竭和黄疸的诊断标准。反复接触喹啉或芳基氨基醇类药物后,前往流行地区的外籍人士中也会出现血红蛋白尿。描述了一例血红蛋白尿,该血红蛋白尿症是在38岁的法国外籍人士中发展的,被诊断出与多种热带感染同时发生,并在推定的基础上用含有青蒿素衍生物的抗疟方案进行治疗。血红蛋白尿在几天内自发消退。尽管这种情况并未明确表明血红蛋白尿和青蒿素衍生物之间存在因果关系,但在药物警戒监测中应考虑这种罕见副作用的风险。此外,患者说明了热带感染可能遇到的多方面病理。
  • 【在喀麦隆,未接受过抗逆转录病毒治疗的HIV-1感染者中整合酶链转移抑制剂抗性突变的患病率。】 复制标题 收藏 收藏
    DOI:10.1093/jac/dkaa383 复制DOI
    作者列表:Wenk BM,Mbunkah HA,Nsanwe NN,Mbu ET,Besong LM,Sama BA,Orock E,Leemann C,Metzner KJ
    BACKGROUND & AIMS: OBJECTIVES:In Cameroon, the integrase (IN) strand transfer inhibitor (INSTI) dolutegravir was recently introduced for the treatment of HIV-1 infection. Since pretreatment HIV-1 drug resistance can jeopardize the success of ART, and considering the high heterogeneity of circulating HIV-1 subtypes in Cameroon, we investigated the prevalence of pretreatment HIV-1 resistance to INSTIs. METHODS:Fingerprick dried blood spot samples were collected from 339 newly diagnosed HIV-1-infected individuals between 2015 and 2016 in four hospitals in Cameroon. Universal primers were designed to amplify the HIV-1 IN region from amino acid 1 to 276. Amplicons were sequenced with Illumina next-generation sequencing and analysed with the Polymorphism Analysis Sequencing (PASeq) platform, using the Stanford HIV Drug Resistance Database to interpret HIV-1 drug resistance mutations (DRMs). RESULTS:The amplification/sequencing success rate was 75.2% with 255/339 sequences obtained. Applying a cut-off of 1%, major DRMs to INSTIs were detected in 13 (5.1%) individuals, but only 1 individual harboured an INSTI DRM (E92G) at a nucleotide frequency ≥15%. However, 140/255 (54.9%) individuals harboured polymorphic accessory INSTI DRMs, mainly at high frequencies. In line with that observation, HIV-1 subtype diversity among individuals was high. CONCLUSIONS:Pretreatment HIV-1 resistance to INSTIs was low in the study sites, which supports the use of INSTIs in Cameroon. Nevertheless, further studies are necessary to assess the impact of polymorphic accessory INSTI DRMs on INSTI-based ART regimens.
    背景与目标: 目的:在喀麦隆,最近引入了整合酶(IN)链转移抑制剂(INSTI)多洛格韦用于治疗HIV-1感染。由于预处理HIV-1的耐药性可能会危害ART的成功,并且考虑到喀麦隆循环中HIV-1亚型的高度异质性,我们研究了预处理HIV-1对INSTIs耐药的普遍性。
    方法:2015年至2016年之间,在喀麦隆的四家医院中,从339名新诊断的HIV-1感染者中采集了指尖干血斑样本。设计通用引物以扩增HIV-1 IN区(氨基酸1至276)。使用Illumina下一代测序技术对扩增子进行测序,并使用多态性分析测序(PASeq)平台进行分析,并使用斯坦福大学HIV耐药数据库来解释HIV -1耐药性突变(DRM)。
    结果:扩增得到255/339个序列,成功率为75.2%。临界值设为1%时,在13名(5.1%)个体中检测到了主要的INRMs DRM,但只有1名个体的核苷酸频率≥15%带有INSTI DRM(E92G)。但是,有140/255(54.9%)个人携带多态附件INSTI DRM,主要是在高频下。与该观察结果一致,个体间HIV-1亚型的多样性很高。
    结论:在研究地点,HIV-1对INSTIs的抗药性较低,这支持在喀麦隆使用INSTIs。尽管如此,仍需要进一步的研究来评估多态性辅助INSTI DRM对基于INSTI的ART方案的影响。
  • 【喀麦隆男性饮酒和婚外性行为。】 复制标题 收藏 收藏
    DOI:10.1186/1472-698X-7-6 复制DOI
    作者列表:Kongnyuy EJ,Wiysonge CS
    BACKGROUND & AIMS: BACKGROUND:The spread of HIV in sub-Saharan Africa is believed to be driven by unsafe sex, and identification of modifiable risk factors of the latter is needed for comprehensive HIV prevention programming in the region. Some previous studies suggest an association between alcohol abuse and unsafe sexual behaviour, such as multiple concurrent sexual partnerships and inconsistent condom use in sex with non-spousal non-cohabiting partners. However, most of these studies were conducted in developed countries and the few studies in Africa were conducted among well-defined social groups such as men attending beer halls or sexually transmitted infection clinics. We therefore examined the association between alcohol and extramarital sex (a sign of multiple concurrent sexual partnerships) among men in a population-based survey in Cameroon; a low-income country in sub-Saharan Africa with a high rate of alcohol abuse and a generalised HIV epidemic. METHODS:We analyzed data from 2678 formally married or cohabiting men aged 15 to 59 years, who participated in the 2004 Cameroon Demographic and Health Survey, using a multivariate regression model. RESULTS:A quarter of the men (25.8%) declared having taken alcohol before their last sexual intercourse and 21% indicated that the last sex was with a woman other than their wife or cohabiting partner. After controlling for possible confounding by other socio-demographic characteristics, alcohol use was significantly associated with having extramarital sex: adjusted odds ratio (OR) 1.70, 95% confidence intervals (CI) 1.40 to 2.05. Older age (30-44 years: OR 3.06, 95%CI 2.16-4.27 and 45-59 years: OR 4.10, 95%CI 2.16-4.27), higher education (OR 1.25, 95%CI 1.10-1.45), and wealth (OR 1.71, 95%CI 1.50-1.98) were also significantly associated with higher odds of having extramarital sex. The men were more likely to have used a condom in their last sex if it was extramarital (OR 10.50, 95%CI 8.10-13.66). Older age at first sex (16-19 years: OR 0.81, 95%CI 0.72-0.90 and > 19 years: OR 0.74, 95% CI 0.65-0.87) and being the head of a household (OR 0.17, 95%CI 0.14-0.22) significantly decreased the odds of having sex outside of marriage. Religion and place of residence (whether urban or rural) were not significantly associated with extramarital sex. CONCLUSION:Alcohol use is associated with having multiple concurrent non-spousal sexual partnerships among married men in Cameroon. We cannot infer a causal relationship between alcohol abuse and unsafe sex from this cross-sectional study, as both alcohol use and unsafe sexual behaviour may have a common set of causal personal and social factors. However, given the consistency with results of studies in other settings and the biologic plausibility of the link between alcohol intake and unsafe sex, our findings underscore the need for integrating alcohol abuse and HIV prevention efforts in Cameroon and other African countries with similar social profiles.
    背景与目标: 背景:艾滋病毒在撒哈拉以南非洲的传播被认为是由不安全的性行为所驱动,因此,对该地区进行全面的艾滋病毒预防规划需要确定后者的可改变的危险因素。先前的一些研究表明,酗酒与不安全的性行为之间存在关联,例如,多个并发性伴侣关系以及与非配偶非同居伴侣发生性行为时使用避孕套不一致。但是,这些研究大多数是在发达国家进行的,而非洲的少数研究是在明确定义的社会群体中进行的,例如参加啤酒馆或性传播感染门诊的男人。因此,我们在喀麦隆进行了一项以人口为基础的调查,研究了男性饮酒与婚外性行为之间的关联(多种并发性伴侣关系的迹象)。撒哈拉以南非洲的一个低收入国家,酗酒率很高,艾滋病毒泛滥。
    方法:我们使用多元回归模型分析了参加2004年喀麦隆人口与健康调查的2678名15至59岁正式结婚或同居男性的数据。
    结果:四分之一的男性(25.8%)宣布在他们最后一次性交之前已饮酒,而21%的男性表示最后一次性交是与妻子或同居伴侣以外的女性进行的。在控制了其他社会人口统计学特征可能造成的混淆之后,饮酒与婚外性别显着相关:调整后的优势比(OR)为1.70,95%置信区间(CI)为1.40至2.05。年龄较大(30-44岁:OR 3.06,95%CI 2.16-4.27和45-59岁:OR 4.10,95%CI 2.16-4.27),高等教育(OR 1.25,95%CI 1.10-1.45)和财富(OR 1.71,95%CI 1.50-1.98)也与婚外性发生几率高有关。如果婚外恋,男性更可能在最后一次性交中使用安全套(OR 10.50,95%CI 8.10-13.66)。初婚年龄较大(16-19岁:OR 0.81,95%CI 0.72-0.90,> 19岁:OR 0.74,95%CI 0.65-0.87)并且是一家之主(OR 0.17,95%CI 0.14 -0.22)大大降低了婚外发生性行为的几率。宗教和居住地点(无论是城市还是农村)与婚外性别没有显着相关。
    结论:在喀麦隆已婚男子中,酗酒与多个同时存在的非配偶性伴侣有关。我们不能从这项横断面研究中推断出酗酒与不安全性行为之间的因果关系,因为饮酒和不安全性行为都可能具有共同的因果性个人和社会因素。但是,鉴于与其他环境下的研究结果保持一致,并且饮酒与不安全性行为之间的联系具有生物学上的合理性,我们的发现强调了在喀麦隆和其他具有相似社会背景的非洲国家中,必须整合酗酒和艾滋病毒预防工作。
  • 【喀麦隆北部牛中与Onchocerca ochengi有关的新基因型“ Siisa形式”的分子证据。】 复制标题 收藏 收藏
    DOI:10.1016/j.actatropica.2013.05.011 复制DOI
    作者列表:Eisenbarth A,Ekale D,Hildebrandt J,Achukwi MD,Streit A,Renz A
    BACKGROUND & AIMS: :Onchocerca ochengi, a filarial nematode parasite from African Zebu cattle is considered to be the closest relative of Onchocerca volvulus, the causative agent of river blindness. Both Onchocerca species share the vector, black flies of the Simulium damnosum complex. Correct identification of their infective third-stage larvae in man-biting vectors is crucial to distinguish the transmission of human or animal parasites. In order to identify different closely related Onchocerca species we surveyed the sequences from the three mitochondrial loci 12S rRNA, 16S rRNA and coxI in both adult worms isolated from Onchocerca-induced nodules in cattle and infective third stage larvae isolated from vector flies from North Cameroon. Two distinct groups of mitochondrial haplotypes were found in cattle as well as in flies. One of them has been formerly mentioned in the literature as Onchocerca sp. 'Siisa', a filaria isolated from the vector S. damnosum sensu lato in Uganda with hitherto unknown host. Both variants are found sympatric, also in the same nodule of the animal host and in the vector. In the flies we also found the mitochondrial haplotype that had been described for O. volvulus which is about equally different from the two previously mentioned ones as they are from each other. These results suggest a higher genetic diversification of Onchocerca ochengi than previously reported.
    背景与目标: :Onchocerca ochengi,一种来自非洲封布牛的丝状线虫寄生虫,被认为是河盲症的病原体Onchocerca volvulus的近亲。两种Onchocerca物种都共享Simulium damnosum复合体的黑蝇媒介。在咬人载体中正确鉴定其感染性第三阶段幼虫对于区分人类或动物寄生虫的传播至关重要。为了鉴定不同的密切相关的Onchocerca物种,我们调查了从牛的Onchocerca诱导结节分离的两种成虫和从北喀麦隆媒介蝇中分离的感染性第三阶段幼虫的两个线粒体基因座12S rRNA,16S rRNA和coxI的序列。在牛和苍蝇中发现了两组不同的线粒体单倍型。其中之一以前在文献中被称为Onchocerca sp.。 'Siisa',一种丝虫病,从乌干达的S. damnosum sensu lato病媒中分离出来,具有迄今未知的宿主。两种变体都是同伴的,也存在于动物宿主的相同结节和载体中。在果蝇中,我们还发现了针对食蟹曲霉的线粒体单倍型与彼此之前提到的两个大约相同。这些结果表明Onchocerca ochengi的遗传多样性高于以前的报道。
  • 【蝙蝠的肉链和喀麦隆山地区感染埃博拉病毒的风险的感知。】 复制标题 收藏 收藏
    DOI:10.1186/s12889-020-08460-8 复制DOI
    作者列表:Akem ES,Pemunta NV
    BACKGROUND & AIMS: BACKGROUND:Local people's interaction with bats render them vulnerable to Ebola Virus Disease (EVD). This paper examines perceptions of risk involved in the hunting, handling, processing and consumption of bat meat in the Mount Cameroon region of Southwest Cameroon. It focuses on the myriad cultural beliefs, gendered patterns of activity and institutional arrangements in which the bat meat production chain is embedded. METHODS:We conducted 30 ethnographic interviews with a sample of purposively selected men and women involved in the bat meat trade. The interviews were tape recorded, transcribed verbatim and inductive analysis was performed on the data. FINDINGS:The findings suggests that more urban men than villagers and hunters consume bat meat. Different practices and behaviours expose the mostly uneducated, young, single men and women to the risk of Ebola infection depending on their differential level of intervention in the human-bat interaction and value chain linking hunters, sellers and customers. The killing of bats with the mouth during hunting expose hunters (young men) while the preparation of bat carcasses for consumption also put women, (mostly young and unmarried) at risk. CONCLUSIONS:This study demonstrates that the complexity and nuances of gender, poverty and Ebola outcomes predispose some marginal groups to the risk of infection with zoonotic diseases. There is the need to improve public health intervention and health education among the rural masses in the Mount Cameroon region.
    背景与目标: 背景:当地人与蝙蝠的互动使他们容易感染埃博拉病毒病(EVD)。本文考察了喀麦隆西南部喀麦隆山地区捕猎,处理,加工和食用蝙蝠肉的风险意识。它着重于蝙蝠肉生产链所嵌入的无数文化信仰,活动的性别模式和制度安排。
    方法:我们进行了30次人种学访谈,收集了有意挑选的参与蝙蝠肉贸易的男女样本。对访谈进行录音,逐字记录,并对数据进行归纳分析。
    调查结果表明,食用蝙蝠肉的城市男人多于村民和猎人。不同的行为方式使大多数未受过教育的年轻单身男女面临埃博拉病毒感染的风险,这取决于他们对人与蝙蝠互动以及将猎人,卖方和顾客联系起来的价值链的干预程度不同。在狩猎过程中用嘴杀死蝙蝠会使猎人(年轻男子)暴露,而准备食用蝙蝠尸体也使妇女(大多是年轻的和未婚的)面临危险。
    结论:这项研究表明,性别,贫困和埃博拉结局的复杂性和细微差别使一些边缘人群容易受到人畜共患疾病的感染。有必要在喀麦隆山地区的农村群众中加强公共卫生干预和健康教育。
  • 【通过宏基因组学分析在喀麦隆的稻草色果蝠中检测到了新型高度趋异的沙波病毒。】 复制标题 收藏 收藏
    DOI:10.1038/emi.2017.20 复制DOI
    作者列表:Yinda CK,Conceição-Neto N,Zeller M,Heylen E,Maes P,Ghogomu SM,Van Ranst M,Matthijnssens J
    BACKGROUND & AIMS: :Sapoviruses (SaVs) belong to the Sapovirus genus, in the family Caliciviridae. They have been associated with gastroenteritis in humans and in pigs but not in other animals. In addition, some strains from pigs, chimpanzees and rodents show close sequence identity with human SaVs thereby suggesting the possibility of interspecies transmissions. Bats are known to be a major reservoir of zoonotic viruses, however, very little is known about the genetic diversity of SaVs in bats. To explore the genetic diversity of bat SaVs, fecal samples of Eidolon helvum and Epomophorus gambianus were treated according to the NetoVIR protocol and sequenced by Illumina technology. Nearly complete genome sequences of six highly divergent SaVs and one partial SaV (only VP1 region) were identified in Eidolon helvum and based on sequence identities and phylogenetic analysis, they potentially represent two novel genogroups, only distantly related to known SaVs. Furthermore, comparing these sequences with currently used screening primers and probes indicated that the novel SaVs would not be detected in routine epidemiological screening studies in humans in case an interspecies transmission would occur. Therefore, we designed and validated new primers that can detect both human and bat SaVs. In this study, we identified multiple novel bat SaVs, however, further epidemiological studies in humans are needed to unravel their potential role in gastroenteritis.
    背景与目标: :Sapoviruses(SaVs)属于杯状病毒科Sapovirus属。它们与人类和猪的胃肠炎有关,但与其他动物无关。另外,来自猪,黑猩猩和啮齿动物的一些菌株显示与人SaV紧密的序列同一性,从而暗示了种间传播的可能性。蝙蝠是人畜共患病毒的主要储藏库,但是,关于蝙蝠中SaVs的遗传多样性知之甚少。为了探索蝙蝠SaV的遗传多样性,根据NetoVIR协议处理了Eidolon helvum和Epomophorus gambianus的粪便样品,并通过Illumina技术进行了测序。在Eidolon helvum中鉴定了6个高度趋异的SaV和一个部分SaV(仅VP1区域)的近乎完整的基因组序列,并且基于序列同一性和系统发育分析,它们潜在地代表了两个新的基因组,仅与已知的SaV远缘相关。此外,将这些序列与目前使用的筛选引物和探针进行比较表明,如果发生种间传播,则不会在人类的常规流行病学筛选研究中检测到新型SaV。因此,我们设计并验证了可以同时检测人和蝙蝠SaV的新引物。在这项研究中,我们鉴定了多种新型蝙蝠SaV,但是,需要进一步的人类流行病学研究来揭示其在胃肠炎中的潜在作用。
  • 【从染色体角度的适应性辐射:来自喀麦隆Barombi Mbo湖的丽鱼科鱼类(丽鱼科:Teleostei)的染色体组稳定性的证据。】 复制标题 收藏 收藏
    DOI:10.3390/ijms20204994 复制DOI
    作者列表:Majtánová Z,Indermaur A,Nyom ARB,Ráb P,Musilova Z
    BACKGROUND & AIMS: :Cichlid fishes are the subject of scientific interest because of their rapid adaptive radiation, resulting in extensive ecological and taxonomic diversity. In this study, we examined 11 morphologically distinct cichlid species endemic to Barombi Mbo, the largest crater lake in western Cameroon, namely Konia eisentrauti, Konia dikume, Myaka myaka, Pungu maclareni, Sarotherodon steinbachi, Sarotherodon lohbergeri, Sarotherodon linnellii, Sarotherodon caroli, Stomatepia mariae, Stomatepia pindu, and Stomatepia mongo. These species supposedly evolved via sympatric ecological speciation from a common ancestor, which colonized the lake no earlier than one million years ago. Here we present the first comparative cytogenetic analysis of cichlid species from Barombi Mbo Lake using both conventional (Giemsa staining, C-banding, and CMA3/DAPI staining) and molecular (fluorescence in situ hybridization with telomeric, 5S, and 28S rDNA probes) methods. We observed stability on both macro and micro-chromosomal levels. The diploid chromosome number was 2n = 44, and the karyotype was invariably composed of three pairs of meta/submetacentric and 19 pairs of subtelo/acrocentric chromosomes in all analysed species, with the same numbers of rDNA clusters and distribution of heterochromatin. The results suggest the evolutionary stability of chromosomal set; therefore, the large-scale chromosomal rearrangements seem to be unlikely associated with the sympatric speciation in Barombi Mbo.
    背景与目标: :丽鱼科鱼类由于其快速的适应性辐射而引起了广泛的生态和生物分类多样性,因此受到了科学界的关注。在这项研究中,我们检查了11个形态独特的丽鱼科物种,这是喀麦隆西部最大的火山口湖Barombi Mbo特有的,即Konia eisentrauti,Konia dikume,Myaka myaka,Pungu maclareni,Sarotherodon steinbachi,Sarotherodon lohbergeri,Sarotherodon linnellii,Sarotheromate mariae,Stomatepia pindu和Stomatepia mongo。据推测,这些物种是通过共同祖先的同伴生态物种进化而来的,该祖先在一百万年前就定居在该湖中。在这里,我们展示了使用常规(吉姆萨染色,C带和CMA3 / DAPI染色)和分子(与端粒,5S和28S rDNA探针进行荧光原位杂交)方法对Barombi Mbo Lake丽鱼科鱼进行的首次比较细胞遗传学分析。 。我们观察到宏观和微观染色体水平的稳定性。在所有分析物种中,二倍体染色体数为2n = 44,并且核型始终由三对亚元/亚亚中心染色体和19对亚目/近端染色体组成,具有相同的rDNA簇数和异染色质分布。结果表明染色体组的进化稳定性。因此,大规模的染色体重排似乎不太可能与Barombi Mbo中的同胞形态有关。
  • 【喀麦隆Bamenda卫生区的孕妇对备胎和并发症准备情况的认识和实践。】 复制标题 收藏 收藏
    DOI:10.1186/s12884-019-2511-4 复制DOI
    作者列表:Ijang YP,Cumber SNN,Nkfusai CN,Venyuy MA,Bede F,Tebeu PM
    BACKGROUND & AIMS: BACKGROUND:Birth preparedness and complication readiness has as goal to reduce maternal and neonatal mortality. This concept developed by the organizations of the United Nations permits pregnant women and their families seek health care without delay in case of obstetric complications and delivery. Though its benefits have been proven in several countries, little is known of this in Cameroon and specifically in the North West Region. Therefore, the intention of the study was to assess the awareness and practice of birth preparedness and complication readiness in this health district. METHODS:This was a facility-based cross sectional study carried out in the Bamenda health district of the North West Region, Cameroon. Three hundred forty-five pregnant women of ≥32 weeks gestational age seen at the antenatal consultation units were recruited. The dependent variable was birth preparedness and complication readiness while the independent variables were the socio-demographic and reproductive health characteristics. Data collected was analyzed with SPSS and Microsoft excel. Frequency distributions were used to determine the awareness and practice of birth preparedness and complication readiness. RESULTS:Of the 345 pregnant women included in this study, 159(46.1%) were aware of birth preparedness and complication readiness. The practice of birth preparedness and complication readiness was unsatisfactory as only 65(18.8%) were considered prepared. CONCLUSION:Education and counselling on birth preparedness and complication readiness is not made available to the pregnant women resulting in poor knowledge. Thus, reflected in the low practice of preparation for birth and its complication observed.
    背景与目标: 背景:为降低孕产妇和新生儿的死亡率,目标是做好出生准备和并发症的准备。联合国组织提出的这一概念允许孕妇及其家庭在产科并发症和分娩时立即获得医疗保健。尽管它的好处已在几个国家得到证明,但在喀麦隆,特别是在西北地区,人们对此知之甚少。因此,该研究的目的是评估该卫生区对备胎和并发症准备情况的认识和实践。
    方法:这是在喀麦隆西北地区巴门达(Bamenda)卫生区进行的基于设施的横断面研究。招募了三百四十五名在产前咨询部门见到的孕周≥32周的孕妇。因变量是出生准备和并发症准备情况,而自变量是社会人口统计学和生殖健康特征。使用SPSS和Microsoft excel对收集的数据进行分析。频率分布用于确定对备胎和并发症准备情况的了解和实践。
    结果:本研究包括的345名孕妇中,有159名(46.1%)知道要做好分娩准备和并发症准备工作。备胎和并发症准备情况的实践并不令人满意,因为只有65(18.8%)被认为已备胎。
    结论:没有为孕妇提供有关备胎和并发症准备的教育和咨询,导致知识不足。因此,这反映在对分娩的低准备做法及其所观察到的并发症上。
  • 【使用自我样本进行HPV测试的“测试和治疗”策略进行社区宫颈癌筛查的可行性:来自非洲喀麦隆农村的经验。】 复制标题 收藏 收藏
    DOI:10.1002/ijc.32746 复制DOI
    作者列表:Fokom Domgue J,Futuh B,Ngalla C,Kakute P,Manjuh F,Manga S,Nulah K,Welty E,Schmeler K,Welty T
    BACKGROUND & AIMS: :To achieve higher coverage and effectiveness in limited-resource settings, World Health Organization (WHO) guidelines for cervical cancer prevention recommend a screen-and-treat strategy with high-risk human papillomavirus (HPV) testing. We piloted a real-word project to examine the feasibility of this approach in rural Cameroon. Nurses from the Women's Health Program (WHP) of the Cameroon Baptist Convention Health Services (CBCHS) educated women in remote villages on cervical cancer prevention. At a follow-up visit, they explained to nonpregnant women aged 30-65 how to self-collect vaginal specimens for HPV testing with the careHPV assay. The cytobrush specimens were transported in coolers to a CBCHS laboratory for analysis. The nurses returned to villages to inform women of their results, examined HPV-positive women in the primary health centers (PHCs) using visual inspection with acetic acid and Lugol's iodine (VIA/VILI) enhanced by digital cervicography (DC) to guide treatment. Of the 1,270 eligible women screened (mean age: 44.7 years), 196 (15.4%) were HPV-positive, of whom 185 (94.4%) were examined, 16 (8.6%) were VIA/VILI-positive, 8 (4.3%) were VIA/VILI-inadequate, one (0.5%) was VIA/VILI-uncertain and 161 (87.0%) were treated with thermal ablation. One woman had LEEP, and another woman with invasive cancer was treated at a referral facility. The cytobrushes broke off in the vaginas of two women (removed in the village) and in the bladder of another (surgically removed). Community-based cervical cancer screening with self-collected specimens for HPV testing is feasible in rural Cameroon. Education on the proper sampling procedure and follow-up of women who are HPV-positive are essential.
    背景与目标: :为了在有限的资源范围内实现更高的覆盖率和有效性,世界卫生组织(WHO)预防宫颈癌的指南建议采用高危型人乳头瘤病毒(HPV)测试的筛查和治疗策略。我们试行了一个实话实说的项目,以研究这种方法在喀麦隆农村地区的可行性。喀麦隆浸信会卫生服务中心(CBCHS)的妇女健康计划(WHP)的护士对偏远村庄的妇女进行了宫颈癌预防教育。在后续访问中,他们向30-65岁的未怀孕妇女解释了如何通过careHPV测定法自我收集阴道标本进行HPV检测。将细胞刷样品在冷却器中运输到CBCHS实验室进行分析。护士返回村庄告知妇女其结果,在初级保健中心(PHC)中对人乳头瘤病毒呈阳性的妇女进行了目视检查,并用醋酸和通过数字宫颈造影(DC)增强的卢戈尔碘(VIA / VILI)来指导治疗。在接受筛查的1,270名合格女性(平均年龄:44.7岁)中,有196名(15.4%)的HPV阳性,其中接受检查的有185名(94.4%),有16名(8.6%)的VIA / VILI阳性,其中8名(4.3%) )表示VIA / VILI不足,其中一种(0.5%)表示VIA / VILI不确定,另有161例(87.0%)经过热消融治疗。一名妇女患有LEEP,另一名患有浸润性癌症的妇女在转诊机构接受了治疗。该细胞刷在两名妇女的阴道内破裂(在该村被拆除),在另一名妇女的膀胱内破裂(通过手术被拆除)。在喀麦隆农村地区,使用自行收集的标本进行HPV检测的社区宫颈癌筛查是可行的。必须对正确的抽样程序进行教育,并对HPV阳性妇女进行随访。

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