Acute febrile illness is a common problem managed by clinicians and health systems globally, particularly in the Tropics. In many regions, malaria is a leading and potentially deadly cause of fever; however, myriad alternative etiologies exist. Identifying the cause of fever allows optimal management, but this depends on many factors including thorough knowledge of circulating infections. Arboviruses such as dengue (DENV) cause fever and may be underdiagnosed in sub-Saharan Africa where malaria is a major focus. We examined cases of fever in western Cameroon that tested negative for malaria and found 13.5% (13/96) were due to DENV, with 75% (9/12) of these being DENV serotype 2 infections. Two complete DENV2 genomes were obtained and clustered closely to recent isolates from Senegal and Burkina Faso. The seroprevalence of DENV in this region was 24.8% (96/387). Neutralizing antibodies to DENV2 were detected in all (15/15) seropositive samples tested. Chikungunya (CHIKV) is an arthritogenic alphavirus that is transmitted by Aedes mosquitoes, the same principal vector as DENV. The seroprevalence for CHIKV was 15.7% (67/427); however, CHIKV did not cause a single case of fever in the 96 subjects tested. Of note, being seropositive for one arbovirus was associated with being seropositive for the other (Χ2 = 16.8, p<0.001). Taken together, these data indicate that Aedes-transmitted arboviruses are endemic in western Cameroon and are likely a common but underappreciated cause of febrile illness. This work supports the need for additional study of arboviruses in sub-Saharan Africa and efforts to improve diagnostic capacity, surveillance systems, and arbovirus prevention strategies.

BackgroundToxoplasmosis is a widely distributed zoonotic disease, caused by the protozoan parasite Toxoplasma gondii. T. Infections can result in stillbirths, abortions or congenital defects during pregnancy, as well as toxoplasmic encephalitis in HIV/AIDS patients. This study aimed to determine the seroprevalence and risk factors for T. gondii infection in women seeking antenatal and medical care in the locality of Njinikom, North West of Cameroon.MethodsWe conducted a cross-sectional study from August to December 2014 consecutively enrolling 178 consenting women aged 15 to 49 years attending antenatal care or medical check-ups at the hospital. A questionnaire survey was administered to study participants and potential risk factors for Toxoplasma exposure sought. Venous blood was collected and serum from each participant analysed for T. gondii infection as evidenced by the presence of anti-T. gondii IgG and IgM antibodies detected using the indirect enzyme-linked immunosorbent assay (ELISA) technique. The proportion of anti-T. gondii antibody positivity calculated as the percentage of antibody seropositivity to T. gondii antigens. Predictors of T. gondii infection were analysed by univariate and multivariate regression and association with T. gondii seropositivity assessed. Epi-Info 3.5.4 was used for statistical analyses. A p < 0.05 was considered significant for all analyses.ResultsThe seroprevalence of anti-T. gondii antibodies (IgM or IgG) were 54.5 % (97/178). Among seropositive women, 88.7 % (86/97), 30.9 % (30/97), and 19.6 % (19/97) were respectively seropositive for IgG antibody, IgM antibody and both IgM and IgG antibodies. Among the risk factors evaluated, only the consumption of raw or undercooked meat (p = 0.02) was observed to be an independent risk factor of T. gondii infection. The consumption of unwashed vegetables and fruits was significant (p = 0.01) only with simple logistic regression analysis.ConclusionsOur findings suggest recent T. gondii exposure is high in our study population, and may constitute a significant risk factor for stillbirths, abortions or congenital defects during pregnancy in women attending antenatal care, or toxoplasmic encephalitis in those who are immunosuppressed such as in HIV/AIDS. Education and screening of HIV-positive individuals and pregnant women for T. gondii infection may be important primary prevention strategies in this population.

Introduction Hepatitis B virus (HBV) is a bloodborne virus which can be transmitted via percutaneous and mucocutaneous exposure to infected body fluid. Healthcare workers (HCWs) who are continuously exposed to different body fluids are at an increased risk of contracting and transmitting this virus. It is thus important to evaluate the knowledge and attitude of HCWs towards HBV and the prevalence of HBV infection among them. Methods This cross-sectional study was carried out between April and September 2017. Overall, 398 HCWs were recruited for this study. Knowledge on the route of HBV transmission and attitude towards HBV were evaluated using a well-structured questionnaire. Hepatitis B surface antigen (HBsAg) positivity was obtained using the Monolisa HBsAg ULTRA kit (Bio-Rad). Data were analysed using SPSS V.20. results Among the HCWs who participated in this study, 338 (84.9%) had heard of HBV, and 269 (67.6%) of them had adequate knowledge on the route of HBV transmission. Medical doctors were the most knowledgeable among biomedical workers and students (76.5%). The rate of stigma was highest among nurses (87, 38.8%). The prevalence of HBsAg positivity was high (42, 10.6%) given that there is an efficient and available vaccine. Overall, over 70% of HCWs invited to participate in this study responded. Conclusion Knowledge on the route of HBV transmission was fair, and the level of stigmatisation of HBV-infected patients and the prevalence of HBV infection were high in this study. A sensitisation campaign should be carried out to educate HCWs on HBV, thus reducing the level of stigma associated with HBV as well as the probability of contracting HBV as a nosocomial infection.

SummaryTo improve on the diagnosis of onchocerciasis, especially light infections, we developed and evaluated an oncho-dipstick test based on the detection of Onchocerca volvulus specific antigens in urine and tears. The test was able to detect as little as 25 ng/ml of parasite specific antigens in samples and took as little as 3 h. Evaluation of the assay on 456 residents of an onchocerciasis hyperendermic area in Cameroon resulted in 408 (89.5%) positives in urine and 374 (82%) positives in tears. The prevalence of onchocerciasis in the study area, as determined by Rapid Epidemiological Mapping of Onchocerciasis (REMO) and skin snip methods, was 52 and 36.8%, respectively. The sensitivity of the oncho-dipstick assay was 100% in urine and 92% in tears; its specificity was 100% in both. Concordance between urine and tear test results from the same individuals was 87%. The test strips were sufficiently reactive when left at room temperature for up to 8 months. The test would be useful for laboratory diagnosis of onchocerciasis in low transmission zones and to ascertain successful treatment of patients in experimental drug studies.