BackgroundCameroon is known to be endemic with trachoma. To appreciate the burden of the disease and facilitate the national planning of trachoma control in the integrated control program for the neglected tropical diseases, an epidemiological mapping of trachoma was conducted in the Far North region in 2010–11.MethodologyA cross-sectional, cluster random sampling survey was carried out. The survey focused on two target populations: children aged 1 to 9 years for the prevalence of active trachoma and those aged 15 and over for the prevalence of trichiasis (TT). The sample frame was an exhaustive list of villages and neighborhoods of Health Districts (HDs). The World Health Organization simplified trachoma grading system was used for the recognition and registration of cases of trachoma.Principal Findings48,844 children aged 1 to 9 years and 41,533 people aged 15 and over were examined. In children aged 1–9 years, the overall prevalence of trachomatous inflammation–follicular (TF) was 11.2% (95% confidence intervals (CI): 11.0–11.5%). More girls were affected than boys (p = 0.003). Thirteen (13) of 27 HDs in the region showed TF prevalence of ≥10%. The overall TT prevalence was 1.0% (95% CI: 0.9–1.1%). There were estimated 17193 (95% CI: 12576–25860) TT cases in the region. The prevalence of blindness was 0.04% (95% CI: 0.03–0.07%) and visual impairment was 0.09% (95% CI: 0.07–0.13%).Conclusions/SignificanceThe survey confirmed that trachoma is a public health problem in the Far North region with 13 HDs qualified for district-level mass drug administration with azithromycin. It provided a foundation for the national program to plan and implement the SAFE strategy in the region. Effort must be made to find resources to provide the surgical operations to the 17193 TT cases and prevent them from becoming blind.

Background Severe adverse events after treatment with ivermectin in individuals with high levels of Loa loa microfilariae in the blood preclude onchocerciasis elimination through community-directed treatment with ivermectin (CDTI) in Central Africa. We measured the cost of a community-based pilot using a test-and-not-treat (TaNT) strategy in the Soa health district in Cameroon. Methods Based on actual expenditures, we empirically estimated the economic cost of the Soa TaNT campaign, including financial costs and opportunity costs that will likely be borne by control programs and stakeholders in the future. In addition to the empirical analyses, we estimated base-case, less intensive, and more intensive resource use scenarios to explore how costs might differ if TaNT were implemented programmatically. Results The total costs of US$283 938 divided by total population, people tested, and people treated with 42% coverage were US$4.0, US$9.2, and US$9.5, respectively. In programmatic implementation, these costs (base-case estimates with less and more intensive scenarios) could be US$2.2 ($1.9–$3.6), US$5.2 ($4.5–$8.3), and US$5.4 ($4.6–$8.6), respectively. Conclusions TaNT clearly provides a safe strategy for large-scale ivermectin treatment and overcomes a major obstacle to the elimination of onchocerciasis in areas coendemic for Loa loa. Although it is more expensive than standard CDTI, costs vary depending on the setting, the implementation choices made by the institutions involved, and the community participation rate. Research on the required duration of TaNT is needed to improve the affordability assessment, and more experience is needed to understand how to implement TaNT optimally.

BackgroundTo estimate the prevalence of trachoma in the North Region of Cameroon in order to facilitate the planning of trachoma control activities in this region, a survey was carried out in 2011 and 2012 in 15 health districts (HDs).MethodologyA cross-sectional, two-stage cluster random sampling survey was carried out. The survey focused on two target populations: children aged 1 to 9 years for the prevalence of Trachomatous Inflammation-Follicular (TF) and those aged 15 and over for the prevalence of Trachomatous Trichiasis (TT). The sample frame was an exhaustive list of villages and neighborhoods of HDs. The World Health Organization simplified trachoma grading system was used for the recognition and registration of cases of trachoma.Principal Findings30,562 children aged 1 to 9 years and 24,864 people aged 15 and above were examined. In children aged 1–9 years, the overall prevalence of TF was 4.2% (95% confidence intervals (CI): 4.0–4.5%). Three (3) of 15 HDs in the region showed TF prevalence of ≥10% (Poli, Rey Bouba, and Tcholliré). The overall TT prevalence was 0.25% (95% CI: 0.20–0.33%). There were estimated 1265 TT cases in the region. The prevalence of blindness was 0.01% (95% CI: 0.00–0.03%), low vision was 0.11% (95% CI: 0.07–0.17%), and corneal opacity was 0.22% (95% CI: 0.17–0.29%).Conclusions/SignificanceThis survey provides baseline data for the planning of activities to control trachoma in the region. The overall prevalence of TF in the region is 4.2%, and that of TT is 0.2%; three HDs have a TF prevalence ≥10%. These three HDs are eligible for mass drug administration with azythromycin, along with the implementation of the “F” and “E” components of the SAFE strategy.

BackgroundThe District Health Information Software (DHIS2), adopted as national health information system by the ministry of public health in Cameroon, did not integrate neglected tropical diseases (NTD) program data. Integrating NTD program data into the national DHIS2 might require more than technical skills. Our study aimed to explore the factors that affect acceptability and use of DHIS2 by NTD stakeholders for successful integration of NTD program data into the national DHIS2. MethodsFor purposes of this mixed-methods study, the data were collected through a self-administered questionnaire targeting NTD stakeholders at different levels of the health pyramid from all the ten Regions in Cameroon. The questionnaire was based on a modified Unified Theory of Acceptance and Use of Technology (UTAUT) model, supplemented by a qualitative analysis to assess the acceptability, and use of the DHIS2 as a platform for NTD program data in Cameroon. ResultsWe found 81.9% (95% confidence interval, CI=0.784-0.859; standard error=0.019) of intention to use DHIS2 for NTDs program data and 18.4% (95% CI=0.130-0.289; standard error=0.041) of actual use among survey participants. Social influence (β=0.269, P=0.000), voluntariness of use (β=0.243, P=0.000), performance expectancy (β=0.186, P=0.010), and training adequacy (β=0.199, P=0.000) would positively influence intention to use DHIS2. Computer anxiety (β=-0.230, P=0.000) and technology experience (β=0.374, P=0.000) would have a significant negative and positive effect on actual use, respectively. The most critical challenges in using DHIS2 referred to facilitating conditions (conditions of the work environment), specifically electricity and internet connection, impeding actual use of DHIS2. ConclusionsOur study revealed that NTD stakeholders in Cameroon are ready to accept DHIS2 for NTD program in Cameroon. However, to ensure its successful implementation. For example, we recommend that NTD program managers plan adequate support in providing proper training, non-vendor specific 2G-3G-4G internet modems with data bundle and smartphones/laptops to ease the use of DHIS2 by NTD stakeholders. We showed that acceptability of DHIS2 studied through UTAUT model should be complemented with a qualitative analysis for richer insights.Neglected tropical diseases (NTDs) are endemic in Cameroon, especially lymphatic filariasis, onchocerciasis, schistosomiasis, soil-transmitted helminthiasis, and trachoma. Strategies to tackle these diseases are mainly based on the preventive chemotherapy (PCT), during periodic mass drug administration (MDA) campaigns and intensified disease management campaigns. The monitoring and evaluation system is defined accordingly to maintain a data-dri-Moungui HC, Nana-Djeunga HC, Nko'Ayissi GB, Sanou A, Kamgno J. Mixed-methods evaluation of acceptability of the District Health Information Software (DHIS2) for neglected tropical diseases program data in Cameroon.

Background: Many control methods have been implemented to tackle onchocerciasis and great successes have been achieved, leading to a paradigm shift from control of morbidity to interruption of transmission and ultimately elimination. The mandate of the African Programme for Onchocerciasis Control (APOC) ended in 2015, and endemic countries are to plan and conduct elimination activities by themselves, with technical assistance by the Expanded Special Project for Elimination of Neglected Tropical Diseases (ESPEN). To this end, an elimination expert committee was set up in Cameroon in 2018. This committee identified the need to update the data on the current situation of onchocerciasis. The present study aims to systematically review and report all available epidemiological data, including prevalence, intensity and transmission of onchocerciasis to provide pertinent information that will be useful to design optimal strategies to achieve onchocerciasis elimination in Cameroon. Methods: PubMed/MEDLINE, EMBASE and Web of Science will be searched from inception onwards. Grey literature will be identified through Google Scholar searches, dissertation databases and other relevant documents such as government reports. Eligible studies will be mostly observational, including cohort and cross-sectional surveys. No limitations will be imposed on publication status and study period. The primary outcomes will be (1) the prevalence and intensity of Onchocerca volvulus infection in humans, (2) transmission intensity and (3) impact of interventions on prevalence, intensity and transmission of onchocerciasis. Secondary outcomes will be environmental and sociodemographic factors supporting the primary outcomes. Two reviewers will independently screen all citations, full-text articles and abstract data. Potential conflicts will be resolved through discussion. Methodological quality including bias will be appraised using appropriate approaches. A narrative synthesis will describe quality and content of the epidemiological evidence. Prevalence and intensity of infection estimates will be stratified according to gender, age, geographical location and year of publication.