The emergence of artemisinin-resistant parasites since the late 2000s at the border of Cambodia and Thailand poses serious threats to malaria control globally, particularly in Africa which bears the highest malaria transmission burden. This study aimed to obtain reliable data on the current state of the kelch13 molecular marker for artemisinin resistance in Plasmodium falciparum in Cameroon. DNA was extracted from the dried blood spots collected from epidemiologically distinct endemic areas in the Center, Littoral and North regions of Cameroon. Nested PCR products from the Kelch13-propeller gene were sequenced and analyzed on an ABI 3730XL automatic sequencer. Of 219 dried blood spots, 175 were sequenced successfully. We identified six K13 mutations in 2.9% (5/175) of samples, including 2 non-synonymous, the V589I allele had been reported in Africa already and one new allele E612K had not been reported yet. These two non-synonymous mutations were uniquely found in parasites from the Littoral region. One sample showed two synonymous mutations within the kelch13 gene. We also observed two infected samples with mixed K13 mutant and K13 wild-type infection. Taken together, our data suggested the circulation of the non-synonymous K13 mutations in Cameroon. Albeit no mutations known to be associated with parasite clearance delays in the study population, there is need for continuous surveillance for earlier detection of resistance as long as ACTs are used and scaled up in the community.

Background: Viral load (VL) monitoring in the clinical follow-up of HIV patients to detect treatment failure is not routinely offered in Cameroon. The study was designed to characterize virological response on antiretroviral treatment (ART) among adults living with HIV and to identify predictors of virological failure (VF). Methods: Between November 2014 and January 2016, a prospective, population-based cohort study was conducted among HIV-positive adults under first-line treatment and monitored at the Accredited HIV Care Center (AHCC) of Laquintinie Hospital of Douala. Clinical and biological data at the initiation of ART were collected from patients' medical records. HIV VL at 12 and 24 months after the patient started treatment on ART were performed using quantitative real-time PCR protocol with the generic HIV Roche TaqMan assay. Descriptive and logistic regression analysis were performed in Stata SE11 version in data analysis. Results: Overall 150 (45.5%) of 330 adults living with HIV were tested with at least one VL, and of these patients, 51 (34.0%) were tested with two VL during the followed-up. The VF was observed in 13 of 51 (25.5%) patients and among them, 8 (61.5%) switched to second-line ART regimens. Thirty-five (68.6%) of the 51 patients had an undetectable VL at the first VL measurement, and seven (13.7%) patients subsequently developed viral load rebound (VLR) on tritherapy. Using a multivariate analysis, the risk of VF was seven times higher in HIV adults who did not respect the medication hours (OR = 7.38, 95%CI = 1.56-34.90, p = 0.012) and eleven times higher in patients with none or primary school education (OR = 11.38, 95% CI = 2.41-53.76, p = 0.002). Conclusion: Low education level and poor adherence are the main risk factors for VF. Strengthening therapeutic failure prevention strategies and routine VL surveillance would allow early detection of VF and contribute in achieving the third goal of UNAIDS which recommends "90-90-90" targets for People Living with HIV in resourcelimited settings.

Effectiveness of Anonymous and free Voluntary Counseling and Testing (AVCT) Centers in the HIV prevention and care can be threatened by a low use of its service delivery, especially in developing countries. This study was designed to obtain reliable data on the current state of the quality of the services and, evaluate the factors that are associated with use of one Accredited HIV/AIDS Treatment Center (AHTC). A cross-sectional and prospective study was conducted among adults attending the AHTC of the Douala Laquintinie Hospital (DLH), Cameroon. Anonymous interviews including both open and closed ended questions were conducted in participants selected by convenience sampling. Descriptive and logistic regression analyses were performed using StataSE11 software (version 11 SE) in data analysis. Overall 80 (64%) of 125 adult volunteers for HIV testing reported that the reception at AHTC was excellent and 69.6% (80/115) of those who underwent the pre-test and among them, 49.6% were satisfied with the pre-test. Less than half of the participants were explained the merits of HIV testing. The interview was conducted in a confidential framework in 60% of those who underwent the pre-test and, 41.7% explained the merits of HIV testing. Among the 10 evaluated minimal items that the provider should have addressed, less than 6 items were done in 66.9% of the participants and between 9 and 10 items for 11.3%. Informed consent agreement was obtained in 89.60% of volunteers. Knowledge of HIV status was more reported among men than women who reported more requesting the HIV testing for prevention strategies for an exclusive sexual relation (p=0.038). The prevalence of HIV infection was 25.6% and, primary education remained significantly associated with higher risk of HIV infection in multivariate analysis (OR=0.11; IC95%=0.015-0.72; p=0.022). These results highlight the important of the appropriate sensibilization for the responsible implementation of the pretest counseling steps by health care providers in the AHTC of the DLH.

Introduction: With unprecedented speed, several SARS-CoV-2 vaccines have been developed and made accessible through bilateral and COVAX initiatives within 2 years after the first Covid-19 case report. As we strive to achieve global control with these new vaccines, old challenges arise, including the acceptability of these COVID-19 vaccines, vaccination coverage and effectiveness, vaccine hesitancy. Understanding how reluctant populations may be to Covid-19 vaccines and what factors may be causing these concerns may improve the ability of public health workers and communicators to maximize vaccine uptake.Methods: A cross-sectional, analytical study with a semi-structured questionnaire using a randomized, stratified sampling technique was conducted during this study. Data were collected using SPSS software. Categorical data related to demographic variables were presented as frequencies and proportions. Univariate and multivariate associations between independent variables and primary outcomes were tested using the T test or chi-square test, as appropriate.Results and discussion: We found a statistically significant Covid-19 vaccination acceptabilityamong health professionals (54.88%) and a low acceptability in 28-34 years old (11.78%) (P= 0.006 and OR= 0.53 (0.33 - 0.83). Of 771 male participants, only 19.71% were willing to be vaccinated with any vaccine. University education was a risk factor for non-acceptance of vaccination. The refusal of vaccination was statistically significant in non-civil servants, non-medical professionals and civil servants.COVID-19 vaccine illiteracy, infomedics, knowledge of variant type, vaccine hesitancy, low monthly income, and poverty were risk factors in the acceptability of vaccine and uptake.Infodemics linked hesitancy to Covid-19 vaccination was correlated with local beliefs on the severity and risk of Covid-19, as well as COVID-19 vaccines uncertainty,unknownvaccine safety and effectiveness on local populations. Combined efforts in defining and implementing contextual COVID-19 mass vaccination solutions and initiativesis vital to increase acceptance, trust and uptake in curbing the growing public health menace in Cameroon.