ABSTRACT. The recommended schedule for killed oral cholera vaccine (OCV) is two doses, 2 weeks apart. However, during vaccine campaigns, the second round is often delayed by several months. Because more information is needed to document antibody responses when the second dose is delayed, we conducted an open-label, phase 2, noninferiority clinical trial of OCV. One hundred eighty-six participants were randomized into three dose-interval groups (DIGs) to receive the second dose 2 weeks, 6 months, or 11.5 months after the first dose. The DIGs were stratified into three age strata: 1 to 4, 5 to 14, and > 14 years. Inaba and Ogawa vibriocidal titers were assessed before and after vaccination. The primary analysis was geometric mean titer (GMT) 2 weeks after the second dose. Data for primary analysis was available from 147 participants (54, 44, and 49 participants from the three DIGs respectively). Relative to the 2-week interval, groups receiving a delayed second dose had significantly higher GMTs after the second dose. Two weeks after the second dose, Inaba GMTs were 55.1 190.3, and 289.8 and Ogawa GMTs were 70.4, 134.5, and 302.4 for the three DIGs respectively. The elevated titers were brief, returning to lower levels within 3 months. We conclude that when the second dose of killed oral cholera vaccine was given after 6 or 11.5 months, vibriocidal titers were higher than when given after the standard period of 2 weeks. This provides reassurance that a delayed second dose does not compromise, but rather enhances, the serological response to the vaccine.

Background Researchers are responsible for the protection of health research participants. The purpose of this study was to identify and prioritize the training needs of researchers involved in human health research in Cameroon. Methods It was a cross-sectional study conducted in all the Cameroon regions in the last quarter of 2020. It targeted researchers involved in human health research selected by systematic stratified sampling from health and training institutions, and health facilities. Data were collected using a face-to-face administered questionnaire deployed in Smartphones via the ODK-collect. The distribution of participants’ exposure to research ethics training was described as well as their knowledge on the related regulatory texts. A score was used to rank the training needs identified by the participants. Results Of 168 reached participants, 134 (79.76%) participated in the study. A total of 103 (76.87%) researchers reported having received training in human health research ethics and 98 (73.13%) perceived need of training in research ethics. Of those involved in clinical, vaccine, and field trials, 63.64, 33.33, 52.53% have been exposed respectively to related training regarding participants’ protection. Having received at least one training in research ethics significantly increase the proportion of researchers systematically submitting application for ethical evaluation prior to implementation (OR = 3.20 (1.31–7.78)). Training priorities identified by researchers include: guidelines and regulations on health research ethics and research participant’s protection in Cameroon, procedures for evaluating research protocols, protection of research participants in clinical trials, and fundamental ethics principles. Conclusion The coverage of researchers in training regarding research participant protection remains limited in a number of areas including those related to clinical trial participant protection and research participant protection in Cameroon. Improving this coverage and addressing perceived needs of researchers are expected to contribute in improving their ability in playing their role in research participant protection.

Blood transfusion is a health care procedure that can expose the donor and receiver to risks. The knowledge and practices of healthcare personnel on blood transfusion are necessary to anticipate and/or prevent the occurrence of avoidable transfusion risks. The aim of this study was to assess the training needs of health personnel on blood donor selection procedure. Methods: We conducted a cross-sectional study targeting health personnel in health facilities that reported contributing in offering blood transfusion services in the West region of Cameroon between March and May 2022. A questionnaire administered face to face was used to collect data from the targeted health personnel exhaustively included from health facilities. Knowledge and practices were assessed by estimating the rate of correct answers. STATA software was used to analyze the data. Results: Of the 41 health facilities that reported offering blood transfusion services, 35 (85.3%) were covered. Category 5 and 4 health facilities were respectively 23 (65.7%) and 9 (25.7%). Among the 325 health personnel involved in transfusion, 302 (92.9%) were reached among which, 201 (66.6%) were female and 127 (42.1%) were nurses. Two hundred and ten (69.5%) had already received training on blood transfusion and 268 (88.7%) expressed a need for training on blood transfusion of which 139 (51.8%) on blood donors' selection. Sixteen (5.3%) knew how to identify blood donor and 116 (38.4) knew the minimum required tests to be performed on the donors' blood before the transfusion. Six (2.0%) out of 302 health personnel were able to select blood donors and identify minimum tests to be performed on donors' blood. Conclusion: There is a real need for training of health personnel on the blood donor selection process. Health authorities should ensure that all health personnel involved in blood transfusion receive a minimum of training in blood donor selection and testing.

Background The role of traditional birth attendants (TBA) in improving outcomes related to maternal and child health remains controversial. We performed an up-to-date systematic review to pool together available data on the impact of TBA interventions on materno-fetal outcomes. Methods A systematic literature search was conducted on PubMed, Cochrane, Scopus, and 3ie databases (search date: 22nd August 2022) to identify original research articles which studied health outcomes in populations of pregnant women and children following TBA-related interventions. Data on the frequency of the outcome (expressed as proportions) occurring in study populations with and without the intervention were extracted. The data were synthesized and used for meta-analysis, with the creation of sub-groups as appropriate for comparisons. The Cochran-Mantel-Haenszel method was used to generate Odds ratios (OR) with 95% confidence intervals (CI) for data analysis. Results Of the 744 studies found during the initial database search, data was extracted from 45 eligible studies representing observations from 194,699 women and 199,779 children. We found that the involvement and/or training of TBAs in maternal and child healthcare does not significantly contribute to reducing maternal mortality (pooled OR: 0.91, 95% CI: 0.42–1.98) or infant morbidity (pooled OR: 0.85, 95% CI: 0.57–1.27). However, TBA-related interventions proved useful in curbing both neonatal mortality (pooled OR: 0.77, 95% CI: 0.71–0.84) and maternal morbidity (pooled OR: 0.63, 95% CI: 0.43–0.93). Overall, TBA involvement was associated with increased uptake of some health interventions including antenatal consultations, delivery by a skilled birth attendant, early breastfeeding, and immunization (pooled OR: 2.42, 95% CI: 1.75–3.35). Conclusions Based on studies conducted in the past, it appears that proper training and supervision could render TBAs useful in addressing shortages in maternal and child health actors. This finding is particularly relevant for remote communities with few trained healthcare workers and even fewer health facilities. Large community-based prospective studies may be required to investigate the materno-fetal benefits and cost-effectiveness of integrating TBAs within present-day health systems in SSA. Registration: This systematic review was not registered.