Background: Monitoring of the expanded program on immunization's performance is not only limited to routine periodic reports but equally includes surveys. Based on unpublished national EPI surveillance data from the past 5 years in Cameroon, the Foumban health district has reported a high number of vaccine preventable disease suspected cases. Contradictory information on the immunization coverage in this district exists from both administrative data and published literature. As a result, the objective of this study was to estimate the immunization coverage and dropout rate in age group 12-23 months and timeliness in age group 0-59 months among children in Foumban Health District (Cameroon), in 2018. Method: This was a descriptive cross-sectional study targeting randomly selected children aged 0-59 months from Foumban health district. Data were collected by trained and supervised surveyors using a pretested questionnaire to describe the immunization coverage, timeliness and dropout rate in eighty clusters of about thirty buildings selected by stratified random sampling in July 2018. Results: In total, 80 clusters covering 2121 buildings were selected and all were reached (100%). A total of 1549 (81.2%) households accepted to participate in the survey and 1430 children aged 0-59 months including 294 (20.6%) aged 12-23 months were enrolled into the study. Of these 1430 children, 427 [29.9 (27.4-32.2)%] aged 0-59 months were vaccinated with evidence. In the age group 12-23 months, the immunization coverage with evidence of BCG, DPT-Hi + Hb 3 and measles/rubella were 28.6(23.4-33.9)%, 22.8 (18.1-27.6)% and 14.3 (10.3-18.1)% respectively. Within age group 0-59 months; the proportion of children who missed their vaccination appointments increased from 23.3 to 31.7% for the vaccine planned at birth (BCG) and last vaccine planned (Measles/Rubella) for the EPI program respectively. In age group 12-23 months; the specific (DPT-Hi + Hb1-3) and general (BCG-Measles/Rubella) dropout rates of vaccination with evidence were 14.1 and 50.0% respectively. Conclusion: Documented immunization coverage, dropout rate and timeliness in Foumban Health district are lower than that targeted by the Cameroon EPI. Competent health authorities have to take necessary actions to ensure the implementation of national guidelines with regards to children access to immunization. Also, studies have to be conducted to identify determinants of low immunization coverage and delays in immunization schedules as well as high dropout rates.

IntroductionCancer is a public health problem that affect women more than men. The aim of the study was to describe the epidemiological and histopathological features of gynecological malignancies in the city of Yaoundé, Cameroon.MethodsThis was a descriptive cross-sectional study of histologically proven gynecological cancers over a 10-year period (2008-2017) in the Gynecology and Pathological Anatomy Departments of the University Teaching Hospital of Yaoundé.ResultsA total of 682 cancers were identified among which, 342 gynecological cancers, for an overall frequency of 50.1% and an annual frequency of 34.2 cases on average. There was a trend suggesting an increase annual frequency over time. The cervix was the most frequent location with 182 cases (53.2%); followed by breast with 96 cases (28.1%); endometrium with 33 cases (9.7%) and ovaries 15 cases (4.4%). These patients were on average 51.9±13.7 years old, mostly housewives (56.8%), married (60.4%), multiparous (61.3%) and referred (62.6%). Histopathologically, cervical cancer was predominantly squamous cell carcinoma (86.8%), invasive (80.9%) and well differentiated (45.5%). For breast cancers, the majority were ductal carcinomas (78.1%), invasive (92%), and histological grade SBR II (50.6%). The most common histopathological types of endometrial and ovarian cancer were adenocarcinoma (72.2%) and serous cystadenocarcinoma (46.7%), respectively.ConclusionGynecological cancers are common. Screening is expected to increase at 30 years for cervical cancer and start at age 40 with mammography for breast cancer.

IntroductionDu fait de l'accès limité au laboratoire au Cameroun, la prise en charge des cas de diarrhée dans la plus part des formations sanitaires est basée sur le diagnostic de présomption. L'objectif de notre étude était de déterminer la distribution et la sensibilité aux antibiotiques habituellement prescrits contre les bactéries pathogènes associés aux diarrhées à l'Hôpital Régional Annexe de Kousseri(HRAK) de Juillet à Octobre 2015.MéthodesIl s'agissait d'une étude descriptive et transversale ciblant toute personne consentante consultant pour diarrhée à l'HRAK pendant la période d'étude. De chaque patient était collectés un échantillon de selles et les données par questionnaire anonyme administré en face à face. Chaque échantillon de selles était cultivé sur milieu spécifique aux enterobactéries et analysé suivant la méthode standard de coproculture. La sensibilité des souches isolées aux antibiotiques fréquemment prescrits, a été évaluée et les proportions des patients présentant chaque germe pathogène et de germe sensible à chaque antibiotique étaient estimées.RésultatsAu total 45(30,0%) des 150 cas de diarrhée inclus étaient associés à une bactérie enteropathogéne dont 37(82,2%) chez les enfants de 0 à 5 ans. Escherichia coli était la bactérie la plus représentée avec 30 cas(66%) suivis des cas de Salmonella spp, 7(16%); Vibrio spp, 5(11%); Aeromonas spp, 2(4%) et Shigella spp, 1(2%). Les antibiogrammes réalisés ont montré que 17(56,7%), 14(46,7%) et 5(16,7%) E. coli étaient sensibles à la Ciprofloxacine, Ceftriaxone, au Cotrimoxazole respectivement. 4(57,14%), 2(28,57%) Salmonella spp. était sensible au Ceftriaxone et au cotrimoxazole respectivement.ConclusionPrès du tiers des cas de diarrhée consultant à l'HRAK en saison de pluie sont associés à au moins une bactérie pathogène. La sensibilité des germes isolés aux antibiotiques couramment prescrits reste très limitée. Dans les formations sanitaires de l'Extrême Nord Cameroun ou le personnel de santé est obligé de faire des prescriptions d'antibiotiques contre les diarrhées sur la base des diagnostics de présomption, un système de surveillance des germes associés et de la sensibilité de ceux-ci aux antibiotiques prescrits en routine devra être mis en place.

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 In Cameroon, the coverage, completeness, and timeliness of the Expanded Programme on Immunization (EPI) vaccines administration in children have remained heterogeneous and below the national and districts targets in several districts. In an effort to solve this problem, many interventions have been tested but none has shown significant improvement of the situation. Objective This trial aims to test whether involving Community Volunteers to assess children vaccination status and demographic movements and using recorded data to plan catch-up immunization sessions can improve children vaccination timeliness, completeness and coverage. Methods Communities of the Foumban Health district, West region of Cameroon will be selected and assigned to either intervention or control groups using a restricted randomization of 2. In the intervention group, one Community Volunteer per community will be trained to visit households and record EPI-targeted children in a register, record their demographic movements, and assess their immunization status monthly for a year. The information recorded will be snapped and sent to the competent health center immunization team through WhatsApp. These will be used to plan and implement monthly community catch up immunization sessions in collaboration with the community volunteer. In the control group, the routine immunization sessions will be conducted with health centers organizing either weekly vaccination sessions for communities situated not farther than 5 kilometers away from the health facility or monthly vaccination sessions in communities situated more than 5 kilometers away from the health center. Baseline, mid-term and end-line surveys will be conducted to assess and compare immunization coverage, timeliness, and completeness. Results Funded in 2018, data collection started in 2018 and has been completed. Data analysis and reporting are ongoing. Conclusions This trial is expecting to test an innovative approach to improving children’s immunization timeliness, completeness and coverage of immunization by tracking EPI targeted population vaccination status and denominator at household level and building collaboration between the community and health facilities vaccination teams to organize monthly community-based response vaccination sessions. This intervention is expected to improve children sustainable access to EPI vaccination as it offers assessing and responding to their immunization needs at monthly basis using low cost local human resources. Trial Registration Pan African Clinical Trials Registry ID PACTR201808527428720; tinyurl.com/u058qnse International Registered Report Identifier (IRRID) DERR1-10.2196/21734