Complementary foods in Africa are often poor sources of bioavailable iron. We assessed the efficacy of iron‐fortified wheat‐based infant cereal (IC) to reduce the risk of iron deficiency anemia in children aged 18–59 months in Cameroon. A 6‐month double‐blind, cluster‐randomized controlled trial was conducted in 2017 among anemic (hemoglobin 7–11 g/dl) but otherwise healthy children. In conjunction with usual diet, children received two 50 g servings/day of a standard, micronutrient‐fortified IC (providing 3.75 mg iron/serving; n = 106) or the same IC without iron fortification ( n = 99). Anthropometric measurements, blood sampling, and systematic deworming were performed in all children at baseline (pre‐intervention), 3, and 6 months. Mean hemoglobin, ferritin adjusted for C‐reactive protein (CRP), serum iron, transferrin saturation, prevalence of anemia, iron deficiency, and iron deficiency anemia as well as anthropometrics were compared between the groups at baseline, 3, and 6 months. Compared to the control group, children consuming the iron‐fortified IC had significantly higher baseline‐adjusted mean hemoglobin (10.0 ± 1.8 vs. 9.7 ± 1.4 g/dl, respectively; p = .023), ferritin adjusted for CRP (16.1 ± 8.3 vs. 9.5 ± 7.5 μg/L, p < .001), serum iron (14.5 ± 3.9 vs. 11.2 ± 4.4 μg/dl; p < .001), and transferrin saturation (19.0 ± 17.4 vs. 10.7 ± 12.5%; p ˂ .001) at 6 months. The prevalence of anemia, iron deficiency, and iron deficiency anemia at 6 months decreased by a larger extent in the iron‐fortified group versus controls (all p < .01). In addition, at 6 months, children in the iron‐fortified group demonstrated higher weight‐for‐age z ‐scores ( p = .016) compared to the control group. Wheat‐based IC fortified with 7.5 mg ferrous fumarate administered daily for 6 months improved iron and nutritional status and decreased the prevalence of iron deficiency anemia in children aged 18–59 months in Salapoumbé, Cameroon.

BackgroundVaccination is a major, but simple and cost effective public health intervention in the prevention of infectious diseases, especially in children. Nowadays, many children still miss scheduled vaccines in the Extended Program of Immunization (EPI) or are being vaccinated after the recommended ages.This study was aimed at assessing vaccination completeness and timeliness in children aged 0 to 11 months attending the vaccination clinic of the Yaounde Gynaeco-Obstetric and Pediatric Hospital.MethodsThis was an observational cross-sectional study over a period of 3 months (1st February to 30th April 2016). 400 mothers were interviewed and their children’s vaccination booklets analyzed. Information on the children and the parents was collected using a pretested questionnaire. Data analysis was done using SPSS version 20 software. Bivariate and multivariate analysis with logistic regression was done to assess the determinants of completeness and timeliness.ResultsA total of 400 mother-infant pairs were sampled. The vaccination completeness rate was 96.3%. This rate varied between 99.50% for BCG and 94.36% for IPV. Most of the children were born at the Yaounde Gynaeco-Obstetric and Pediatric hospital where they were regularly receiving their vaccines. The proportion of correctly vaccinated infants was 73.3%. The most differed vaccines were BCG, PCV13 and IPV. Factors influencing immunization completeness were the father’s profession and the mother’s level of education.ConclusionsDespite the high immunization coverage, some children did not complete their EPI vaccines and many of them took at least one vaccine after the recommended age.Electronic supplementary materialThe online version of this article (10.1186/s12887-017-0954-1) contains supplementary material, which is available to authorized users.

Background The outbreak of COVID-19 has imposed many challenges on health systems. The purpose of this study was to describe the impact of the COVID-19 pandemic on the clinical activity of pediatricians. Methods We conducted a cross-sectional and descriptive online survey among pediatricians practicing in Cameroon. Data were collected through an anonymous pre-tested Google Form®. Results Among the 118 pediatricians eligible for the survey, 101 responded (85.6%), of whom 61.2% were women. The pediatric outpatient consultations dropped significantly from 60.4% of pediatricians seeing more than 30 patients per week before the pandemic to 9.9% during the pandemic ( P < 0.000). According to the occupancy rate of hospitalisation beds, 45.5% of pediatricians reported having 76–100% of pediatric hospitalisation beds occupied per week before the pandemic but no pediatrician reported a similar rate during the pandemic ( P < 0.000). There was a significant increase in the use of telehealth, ranging from no pediatrician using telehealth “very frequently” before the pandemic to 23.8% using it during the pandemic ( P < 0.000). Most of the pediatricians had at their disposal surgical masks (96%), care gloves (80.2%), hydroalcoholic gel (99.0%), and soap and water (86.1%). For the management of children, 90.1% and 71.3% of pediatricians experienced difficulties accessing COVID-19 PCR and chloroquine, respectively, and 74.3% declared difficulties for proper isolation of patients. More than half (65.3%) of the pediatricians interviewed were “very afraid” or “extremely afraid” of being infected with SARS-Cov-2, respectively 45.5% and 19.8%. The most frequent reasons included fear of infecting their relatives (85.1%) and of developing a severe form of the disease (43.6%). The reluctance to consult health services expressed by the parents was due to: fear of being infected when leaving their home and especially in the health facility (96%), strict compliance with confinement (30.7%), and financial difficulties of families (13.9%). Conclusion This work highlights the impact of the coronavirus pandemic on the clinical activity of Cameroonian pediatricians. Since the beginning of the pandemic, there has been a significant drop in the use of health facilities, which probably has a negative impact on children's overall level of health. Although the preventive measures explain this drop in attendance at health facilities, the parents’ fear of being infected when leaving the house was the predominant reason likely to explain this drop in attendance at health facilities. This could constitute an axis for developing messages to parents to encourage a gradual return to child health services.

Background: At the beginning of March 2020, Cameroon experienced its first cases of infection with the new coronavirus (SARS-COV-2). Very quickly, there was a drop in the rate of hospital attendance. The purpose of this study was to observe the variations in the uptake of pediatric consultations and vaccinations in a pediatric hospital. Methods: A descriptive and retrospective cross-sectional study was carried out using consultation and vaccination statistics from a pediatric hospital in the city of Yaoundé, political capital of Cameroon, from January 2016 to May 2020. Data were entered in Microsoft Excel and exported to R software (Version 3.3.3) for statistical analysis. First, time series raw data (before and after COVID-19) were plotted and the trend estimated by locally weighted scatterplot smoothing (LOWESS) methods. Then a classic seasonal decomposition was performed to distinguish between seasonal trends and irregular components using moving averages. The Webel–Ollech overall seasonality test (WO test) was also run to formally check for seasonality. The results of the study are presented as narrative tables and graphs. Results: Following the partial confinement recommended by the government of Cameroon, the number of pediatric consultations decreased by 52% in April and by 34% in May 2020 compared with rates during the same periods in 2019 ( p = 0.00001). For antenatal visits, the rates dropped by 45% and 34%, respectively, in April and May 2020 compared with 2019. The demand for immunization services also declined. As a result, the demand for BCG vaccines, third-dose tracer vaccines (diphtheria, tetanus, pertussis), polio, and MMR in children as well as tetanus vaccines in childbearing women dropped significantly. Conclusion: The start of the COVID-19 pandemic was accompanied by a significant drop in consultation and vaccination activities. If no action is taken to correct this phenomenon, the ensuing months could be marked by a considerable increase in patients, sometimes suffering from vaccine-preventable diseases. The death rate could increase considerably in the pediatric population.

BackgroundLoss to follow-up (LTFU) is a cause of potential bias in clinical studies. Differing LTFU between study groups may affect internal validity and generalizability of the results. Understanding reasons for LTFU could help improve follow-up in clinical studies and thereby contribute to goals for prevention, treatment, or research being achieved. We explored factors associated with LTFU of mother-child pairs after inclusion in the ANRS 12140-Pediacam study.MethodsFrom November 2007 to October 2010, 4104 infants including 2053 born to HIV-infected mothers and 2051 born to HIV-uninfected mothers matched individually on gender and study site were enrolled during the first week of life in three referral hospitals in Cameroon and scheduled for visits at 6, 10 and 14 weeks of age. Visits were designated 1, 2 and 3, in chronological order, irrespective of the child’s age at the time of the visit. Mother-child pairs were considered lost to follow-up if they never returned for a clinical visit within the first six months after inclusion. Uni- and multivariable logistic regression were adjusted on matching variables to identify factors associated with LTFU according to maternal HIV status.ResultsLTFU among HIV-unexposed infants was four times higher than among HIV-exposed infants (36.7% vs 9.8%, p < 0.001). Emergency caesarean section (adjusted Odds Ratio (aOR) = 2.46 95% Confidence Interval (CI) [1.47-4.13]), young maternal age (aOR = 2.29, 95% CI [1.18-4.46]), and absence of antiretroviral treatment for prophylaxis (aOR = 3.45, 95% CI [2.30-5.19]) were independently associated with LTFU among HIV-exposed infants. Factors associated with LTFU among HIV-unexposed infants included young maternal age (aOR = 1.96, 95% CI [1.36-2.81]), low maternal education level (aOR = 2.77, 95% CI [1.95-3.95]) and housewife/unemployed mothers (aOR = 1.56, 95% CI [1.16-2.11]).ConclusionFailure to return for at least one scheduled clinical visit is a problem especially among HIV-unexposed infants included in studies involving HIV-exposed infants. Factors associated with this type of LTFU included maternal characteristics, socio-economic status, quality of antenatal care and obstetrical context of delivery. Enhanced counselling in antenatal and intrapartum services is required for mothers at high risk of failure to return for follow-up visits.Electronic supplementary materialThe online version of this article (doi:10.1186/s12889-015-1555-2) contains supplementary material, which is available to authorized users.

Introduction: Exclusive breastfeeding is fundamental for the good health and development of the mother and the child. According to the World Health Organization (WHO), breastfeeding after childbirth should be initiated within 30 minutes. For a number of reasons, WHO recommendations on guiding principles for infants and young children feeding are often not followed. Objective: To determine the reasons for the delayed initiation of breastfeeding in newly delivered women. Means and Method: We carried out a mixed cross-sectional study over a period of six months from December 1 st 2018 to May 31 st 2019, at the Yaoundé Gynaeco-Obstetric and Pediatric Hospital. We included all mothers with full-term or premature babies weighing ≥ 2000 grams and those whom initiated breastfeeding more than one hour after delivery. The mother's reasons for delaying breastfeeding initiation were recorded using a dictaphone and data were accurately extracted for analysis. Results: We interviewed 153 mothers. Their mean age was 27.9 ± 6.2 years. The main reasons for delaying breastfeeding initiation were caesarean delivery (22%), the belief in "spoiled milk" (21%), lack of knowledge about the time to initiate breastfeeding (21%), baby asleep (18%), and lack of instruction given to the mother by the health staff (2%). Conclusion: Delayed breastfeeding was common in our context. Improving the quality of breastfeeding involves communication, to break beliefs about spoiled milk, and strengthening mothers' knowledge for optimal breastfeeding processes in accordance with WHO's guidelines.

Abstract:Objective: To investigate the epidemiological trends of measles in the Littoral, North-west, South-west and Western regions of Cameroon in order to improve measles control. Design and Methods:Cross-sectional study of retrolective data collected on cases of measles from January 1997 to April 2003 and stored in registers at regional levels. Child age, immunization and disease status, complications and outcomes were recorded.Results: 33,268 cases of measles were registered. The trend was endemo-epidemic with outbreaks occurring between February and April. The average incidence rate was 4.8‰ per year with 4.1‰ reported in 1998, 5.8‰ in 2001, and 0.9‰ in 2002. Complete data sets for 16,637 cases indicate that 47.4% were children aged 9 to 59 months. Those less than 9 months represented 15.2% of the cases. More than half (415 cases) of the 766 cases with known immunization status (54.2%) representing 2.5% of the 16,637 total cases had received the measles vaccine. Complications were frequent in the Western (53.7%) and the Littoral (33.7%) regions and 53.3% of all complications were bronchopulmonary infections. The global case fatality rate was 1.6%, and 2.1% in children less than 9 months with a significant tendency to decrease with age (p<10 -4 ). The most frequent cause-related disorders of death were malnutrition (34.4%), neurological (35.3%) and digestive (26.2%).Conclusion: measles was a public health problem in Cameroon with vaccinated and unvaccinated children both affected within the period of study. Those less than 9 months old, carried the highest burden of the disease in terms of mortality.

BackgroundWhile most child deaths are caused by highly preventable and treatable diseases such as pneumonia, diarrhea, and malaria, several sociodemographic, cultural and health system factors work against children surviving from these diseases.MethodsA retrospective verbal/social autopsy survey was conducted in 2012 to measure the biological causes and social determinants of under–five years old deaths from 2007 to 2010 in Doume, Nguelemendouka, and Abong–Mbang health districts in the Eastern Region of Cameroon. The present study sought to identify important sociodemographic and household characteristics of the 1–59 month old deaths, including the coverage of key preventive indicators of normal child care, and illness recognition and care–seeking for the children along the Pathway to Survival model.FindingsOf the 635 deceased children with a completed interview, just 26.8% and 11.2% lived in households with an improved source of drinking water and sanitation, respectively. Almost all of the households (96.1%) used firewood for cooking, and 79.2% (n = 187) of the 236 mothers who cooked inside their home usually had their children beside them when they cooked. When 614 of the children became fatally ill, the majority (83.7%) of caregivers sought or tried to seek formal health care, but with a median delay of 2 days from illness onset to the decision to seek formal care. As a result, many (n = 111) children were taken for care only after their illness progressed from mild or moderate to severe. The main barriers to accessing the formal health system were the expenses for transportation, health care and other related costs.ConclusionsThe most common social factors that contributed to the deaths of 1–59–month old children in the study setting included poor living conditions, prevailing customs that led to exposure to indoor smoke, and health–related behaviors such as delaying the decision to seek care. Increasing caregivers’ ability to recognize the danger signs of childhood illnesses and to facilitate timely and appropriate health care–seeking, and improving standards of living such that parents or caregivers can overcome the economic obstacles, are measures that could make a difference in the survival of the ill children in the study area.