Background The World Health Organization has prioritized the use of new technologies to assist in health care delivery in resource-limited settings. Findings suggest that the use of SMS on mobile phones is an advantageous application in health care delivery, especially in communities with an increasing use of this device. Objective The main aim of this trial is to assess whether sending weekly motivational text messages (SMS) through mobile phones versus no text messaging will improve retention in care and promote adherence to treatment and health outcomes among patients receiving HIV treatment in Fako Division of Cameroon. Methods This is a multisite randomized controlled single-blinded trial. Computer-generated random block sizes shall be used to produce a randomization list. Participants shall be randomly allocated into the intervention and control groups determined by serially numbered sealed opaque envelopes. The 156 participants will either receive the mobile phone text message or usual standard of care. We hypothesize that sending weekly motivational SMS reminders will produce a change in behavior to enhance retention; treatment adherence; and, hence, health outcomes. Participants shall be evaluated and data collected at baseline and then at 2, 4, and 6 months after the launch of the intervention. Text messages shall be sent out, and the delivery will be recorded. Primary outcome measures are retention in care and adherence to treatment. Secondary outcomes are clinical (weight, body mass index), biological (virologic suppression, tuberculosis coinfection), quality of life, treatment discontinuation, and mortality. The analysis shall be by intention-to-treat. Analysis of covariates shall be performed to determine factors influencing outcomes. Results Recruitment and random allocation are complete; 160 participants were allocated into 3 groups (52 in the single SMS, 55 in the double SMS, and 53 in the control). Data collection and analysis are ongoing, and statistical results will be available by the end of August 2019. Conclusions The interventions will contribute to an improved understanding of which intervention types can be feasible in improving retention in care and promoting adherence to antiretroviral therapy. Trial Registration Pan African Clinical Trial Registry in South Africa PACTR201802003035922; https://pactr.samrc.ac.za/TrialDisplay.aspx?TrialID=3035 International Registered Report Identifier (IRRID) DERR1-10.2196/15680

Emergency medical services with pre-hospital care remain poorly developed in sub-Saharan Africa and the developing world at large. The provision of timely treatment during life-threatening emergencies is not a priority for many health systems in developing countries. In this review, the authors reviewed the evidence indicating the need to develop and/or strengthen emergency medical care systems in sub-Sahara Africa with perspectives drawn from Cameroon.

Background Up to the 21st century, traditional, complementary and alternative medicine(TCAM) is still used despite the wide spread of orthodox medicine. The magnitude, predictors and types of herbal remedies used for COVID-19 are assessed to tailor evidence based policy and drug formulation against COVID-19. Methods A community based cross sectional study was conducted among 1100 respondents from nine (9) communities selected in three health districts from May to July 2020. Pretested structured questionnaire were used to collect data from selected households on the use of TCAM, predictors as well as on the herbal preparations used for COVID-19. Nineteen (19) traditional healers were also interviewed on the types of herbal preparations use on patients tested or suspected for COVID-19 and the signs and symptoms identified. P-value < 0.05 were considered to be statistically significant in multivariate logistic regression analysis. Atlas ti V 7.5 was used for types of herbal species reported. Results Of the 1100 participants sampled, 754 (68.5%) had used TCAM in the last 12 months, 95%CI: 66.3–71.5. A total of 24.4% [95%CI: 20.6–29.1] of the participants used herbal remedies for COVID-19. Allium sativum, Azadirachta indica, Zingiber officinale, Artemisia annua were most commonly used herb for COVID-19. Cough, catarrh and fever were the main symptoms of COVID-19. Herbalists 79.7% [95% CI: 77.3–82.1] and bone setters 14.9% [95% CI: 12.8–17.0] were mostly visited. Logistic regression analysis showed age > 41 years (95% CI: 1.09–4.91), being a farmer (95% CI: 1.99–5.34), income levels between 185–370 USD (95% CI: 1.33–4.55), participants who resided in a rural setting (95% CI: 1.04–3.98), being knowledgeable on TCAM (95% CI: 1.54–6.45) and having a positive attitude towards TCAM (95% CI: 1.94–6.45) were predictors for TCAM use. Conclusion TCAM is widely used even in the era of orthodox medicine, and many factors contribute to its use in the Southwest region of Cameroon which should be taken into consideration in healthcare interventions that are sensitive to TCAM. Herbal preparations used during the COVID-19 pandemic can serve as baseline for drug development through efficacy and toxicity tests.

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Introduction: The use of traditional preparations for the induction or acceleration of labor remains a common practice in our country in particular and in Africa in general with sometimes derogatory outcomes for the mother and the fetus. Goal: The objective was to assess immediate maternal and neonatal outcomes in women who reported having used the traditional pharmacopoeia for utero-tonic purposes. Methodology: We conducted a multi-centric crosssectional study with prospective data collection in the maternities of the Laquintinie Hospital, Bonassama District and Nylon Hospitals. It took place over a period of seven months, from 1st October 2016 to 31st April 2017. This included all women who reported having used the unconventional pharmacopoeia for utero-tonic purposes before or after contractions started. The student and Chi-square tests were interpreted at the statistical threshold of 5% and the 95% confidence intervals. Results: We recruited 168 cases, 68.5% of the 245 women interviewed. The mean age was 27.1 ± 0.41 years; 55% of our respondents had a secondary level of education; 80% of them were admitted at term and 43% were multiparous. Nulliparity predisposed to traditional pharmacopoeia use (RR = 1.55, CI = 0.79-3.03

Objective: To determine the impact of Human Immuno-Deficiency Virus (HIV) on co-infection with Mycoplasma hominis and Ureaplasma urealyticum in HIV-infected women. Methodology: A case-control analytical study based on standardized questionnaire interview and cervical sample collection after informed consent obtained among HIV-positive and HIV-negative women from January 2nd, 2017 to June 30th, 2017 received at the laboratory of Laquintinie Hospital in Douala. Samples collected were used for mycoplasma research, quantification, and antibiogram using the mycoplasma IES kits. Socio-demographic, clinical and biological variables of interest were entered and analyzed on Microsoft Office Excel 2013 and Statistical Package for Social Sciences (SSPS) software version 20 and the chi-square correlation test was used with significance at the threshold of P <5%. Results: We analysed 136 samples of women aged 18-65years, among which 96 HIV+(cases) matched with 40 HIV-(controls). The mean age of the case group was 39.08±10.22 years and that of the control group was 33.28±8.68 years. Genital mycoplasmas were found in 58.3% of cases, with a high frequency for U. urealyticum (19.8%) against 2.1% for M. hominis and the two germs were associated in 32.3% of cases. In the control group, the carrier rate was 62.5%, with a frequency of 17.5% for Ureaplasma alone and no carrier for M. hominis alone. Co-infection with the two germs in this group was 40%. The majority of HIV+women had a CD4 count above 200, and no significant association was found between CD4 count and the presence of mycoplasma in these women (P=0.094). Conclusion: Mycoplasma infection is common in HIV+ women. However, there is no significant association between the CD4 count and the presence of these mycoplasmas.

Introduction: The early detection of precancerous lesions being very important for the preventive management of cervical cancer, we felt it was important to identify these lesions on potential backgrounds including HIV-positive (HIV+) women to suggest control strategies of cervical cancer in Cameroon. Objective: To determine the prevalence of precancerous lesions in women infected with the human immunodeficiency virus (HIV), to investigate the determinants of the HIV and cervical cancer association, and to make recommendations regarding cervical cancer screening in these patients of the city of Douala. Methodology: Our study was a case-control cross-sectional study from July 2017 to December 2017 (6 months) including 108 women among which 34 HIV+ matched with 74 HIV−. HIV serology was done using the complete HIV enzygnost test. Cervical smears for cytological lesions were fixed to the cyto-fixator and then stained by the Papanicolaou technique and read under an optical microscope. The cervical smear slides for viral excretion were fixed with a methanol-acetone mixture of equal volume; HPV testing was done by the indirect immune-peroxidase technique using P16 protein. The excretion of HSV type 1 & 2 was investigated by the indirect immunofluorescence technique using the Simplex Virus type 1 & 2 Rabbit anti-Herpes from DAKO (France). Results: The two groups of women were compared with the chi square test with a significance threshold of P < 0.05. The average age was 40.07 with extremes of 21 and 71 years and a standard deviation of 9.99. Of the 34 HIV+ patients, 23 had an abnormal cervix compared to 36 cases of abnormal cervix among HIV− with a statistically significant difference (P = 0.006649). 12 cases of dysplasia were observed in the 34 HIV+ women and distributed as follows: 0% of mild dysplasia, 18.92% of How to cite this paper: moderate dysplasia and 13.51% of severe dysplasia. In HIV− women we detected 6 cases of dysplasia including 1.35% of mild dysplasia, 4.05% of moderate dysplasia and 2.70% of severe dysplasia. Regarding HPV infection, we observed 21 cases of HPV among 34 HIV+ women (61.76%) against 23 cases in HIV− women (31.08%); we did not detect any cases of HSV. Conclusion: The prevalence of precancerous lesions remains high in HIV+ women, hence the need to include routine screening for precancerous lesions in all HIV+ women at all ages, as well as the routine search for HPV excretion in all those with cellular dysplasia.

Introduction: According to the World Health Organization (WHO), adolescence is the period of growth between 10 and 19years of age. Complications from pregnancy are the second leading cause of death for adolescent girls aged 15 to 19 worldwide. Objective: Our objective was to study the sexual practices of adolescent girls in secondary schools in the Douala 3rd district as well as their contraceptive attitudes towards precocious pregnancies. Methodology: We conducted a case-control analytical study from November 8th, 2018 to June 26th, 2019 in ten secondary schools in the Douala 3rd district. We matched, around the obstetric variable, a case group with this history to a control group who declared not to have had one and studied the different strategies used to avoid the occurrence of pregnancy. Data analysis was done using SPSS 20.0 software. The significance threshold was set at p<0.05. Results: A total of 445 consenting adolescent girls were selected, including 89 cases and 356 controls. The multivariate analysis of the results showed that the factors associated with the occurrence of teenage pregnancies were: an age greater than 17years (aOR=1.91; CI=1.64-2.33), being single with a boyfriend (aOR=6.48; CI=3.33-12.60), the use of the male condom and the after pill (aOR=6.73; CI=3.53-12.83, aOR=4, 34; CI=1.86-10.11), find out about sexuality from your sexual partner or on social networks (aOR=2.24; IC=1.11-4.54, aOR=1.78; IC=1.01-3.13), do not ask your parents (aOR 2.20; IC=1.31-3.70), alcohol consumption (aOR=2.01; IC=1, 23-3.29), multi sexual partnership (aOR=2.89; CI=1.24-6.69), an age difference of more than 5years with partner (aOR=2.24; CI=1.16-4.35). Conclusion: The teenager of the 3rd district of Douala is subject to early and unsafe sexuality and underuses family planning services which lead to precocious pregnancy.