Catholic University of Central Africa

Malaria continues to pose a major public health challenge in sub-Saharan Africa (SSA), where more than 95% of global cases and deaths occur. Despite WHO Global Technical Strategy for Malaria (GTS) targeting a 90% reduction in malaria mortality by 2030, progress is hindered by persistent transmission conditions, fragile health systems, and emerging resistance to drugs and insecticides. Epidemiological models are increasingly applied to guide malaria control, yet their diversity and complexity present both opportunities and limitations for policy use. The aim of the proposed systematic review is to explore the epidemiological models that have been applied to malaria transmission in SSA, discuss how these models have been applied in informing malaria control measures as well as long-term elimination planning, and address the methodological strengths, limitations, challenges in implementing them, and their policy and strategic implications. This study presents a systematic review of malaria modeling efforts in SSA, with a focus on the strengths, weaknesses, and practical applications of different approaches. Following PRISMA 2020 guidelines and a PROSPERO-registered protocol, we searched five databases (PubMed, Scopus, LILACS, Web of Science, and African Medicus Index) for studies published up to December 31, 2024. Eligible articles were screened by three independent reviewers using predefined PECO criteria, and data were extracted on study context, model type, interventions, populations, and outcomes. The quality of the methodology used in the modelling studies that were included was determined using the ISPOR-SMDM good research practices framework. This framework assesses major areas of model structure, assumptions, transparency, validation and reporting. Since most of the included studies represented mechanistic epidemiologic transmissionmodels, rather than clinical prediction, studies, a formal risk-of-bias instrument, like PROBAST, was not utilized. Risk of bias was actually not measured, the modelling quality and reporting practices were instead appraised with the help of the ISPOR-SMDM assessment. Following systematic screening, a total of 102 studies met the inclusion criteria. The most prevalent models were transmission-focused models (52.9%, 54 articles), which involved disease dynamics. Intervention models contributed 21.6% (22 articles), optimal control models 9.8% (10 articles) and combined optimal control-cost-effectiveness models 15.7% (16 articles). Key gaps include limited incorporation of drug and insecticide resistance, migration dynamics, and climate variability. We conclude that future modeling for SSA must be better tailored to local transmission patterns, age-specific vulnerabilities, and programmatic needs, while promoting open access, transparent methods, and collaborative use cases. Strengthening the alignment between modeling outputs and policy priorities will be critical for achieving effective and sustainable malaria control in the region.

Abstract Objective Healthcare workers (HCWs) are at increased risk of COVID-19 infection and play a critical role in influencing public vaccine acceptance. This study aimed to assess vaccination coverage and identify the determinants of vaccine uptake among healthcare workers in Cameroon, in order to inform targeted strategies to strengthen immunization programs and improve epidemic preparedness. Results Among 406 participants (75.6% female, 65.5% aged 30-44 years, 61.3% nurses), 42.4% were fully vaccinated against COVID-19, while only 4.7% had completed the cholera vaccine series. Coverage varied across districts, with Biyem-Assi (53.0%) and Odza (46.0%) recording the highest COVID-19 uptake, and Nkolndongo (11.5%) leading for cholera vaccination. Independent predictors of COVID-19 uptake included being a nurse (aOR = 3.96; 95% CI: 2.07-7.81; p = 0.001) and laboratory technician professions (aOR = 8.00; 95% CI: 1.38-69.8; p =0.032). For cholera vaccination, working in internal medicine wards (aOR=11.2; 95% CI: 1.04-120; p = 0.046) and being a nurse (aOR = 1.54; p = 0.001) emerged as significant predictors. Although 62.8% of HCWs perceived their work environment as high-risk, knowledge of recommended vaccines was limited, with only 18.7% aware of cholera vaccination recommendations. Strengthening vaccine education, improving accessibility, and reducing financial barriers could enhance vaccine acceptance among HCWs. These findings provide important insights for designing targeted immunization strategies in Cameroon and similar contexts.

HIV treatment has significantly improved with the introduction of potent antiretroviral therapy (ART), particularly dolutegravir (DTG)-based regimens. With suboptimal adherence reported in resource-limited settings (RLS), real-word evidence on DTG-effectiveness within ART clinics is limited. This study assessed virological response, drug resistance profiling and HIV-1 diversity among ART recipients at the Yaoundé Central Hospital (YCH), Cameroon. A facility-based study was conducted at YCH from May-2023 to February-2025. HIV plasma viral load (PVL) was measured by RT-PCR. Viral suppression (VS) was defined as PVL < 1,000copies/mL. Genotypic resistance testing (GRT) was performed for participants with PVL≥1,000copies/mL. Drug resistance mutations (DRMs) were interpreted using Stanford HIVdb v9.8 and statistics were performed with significance at p < 0.05. Among 6,364 participants enrolled (median-age: 50 [IQR:42–59] years; 71% women), 76% (4,811/6364) were on DTG-based regimens. Median ART-duration was 13 [IQR:9.03–17.4] years, including 3.4 [IQR:3–5] years of DTG-exposure in the DTG-based sub-group. Overall, 93.2% (5,932/6,364) participants achieved VS in 2025; 94% among DTG-based versus 91% among DTG-sparing regimens (OR = 1.66; p = 0.000002). Interestingly, VS was higher with age ≥50years (aOR = 1.44; p < 0.001), DTG-based ART (aOR = 1.65; p < 0.0001) and DTG-exposure ≥3.4years (aOR = 1.29; p = 0.044). Between 2021 and 2025 specifically, VS remained consistently high among participants; with those on DTG-based showing significantly higher and more durable VS compared to those on DTG-sparing therapies (relative risk of failure > 1 for DTG-sparing throughout). Furthermore, from those virally unsuppressed in 2025, 9% (39/432) were lost-to-follow-up, 22% (94/432) were transfer-out to other health facilities and 65% (232/432) re-suppressed after enhanced adherence counselling; leaving us with 17 participants eligible for GRT (PVL≥1000copies/mL). GRT was successful for 70.5% (12/17) and DRMs detected in 83% (10/12), including major DRMs to protease inhibitors (17%), to nucleoside reverse transcriptase inhibitors (75%) and to non-nucleoside reverse transcriptase inhibitors (83%). CRF02_AG (75%) was the prevailing HIV-1 group M clade, followed by A3, D, and CRF18_cpx (each 8.3%). These real-life data reveal viral suppression rates closer to the epidemic control (95%) among DTG-based recipients, especially with older age and DTG-exposure over three years. Considering the broad HIV diversity observed, these findings are essential for modelling the long-term effectiveness of DTG in RLS and beyond. Register on 10/05/2023; Ethical Clearance Number 2023/022045/CEIRSH/ESS/BC.

Hypertension is a public health problem with serious social, economic, and health consequences. The World Health Organization (WHO) estimates that 1 in 3 adults worldwide suffers from hypertension. In Cameroon, the prevalence of hypertension is estimated at 35%, with nearly 17,000 deaths recorded each year. This study aimed to determine the factors associated with the occurrence and complications of hypertension at the Sangmelima Referral Hospital (SRH). A total of 528 patients treated in the cardiology department of the SRH were identified between January and December 2023. The data were analyzed using SPSS 28 software. Binary logistic regression determined the odds ratios and 95% confidence intervals associated with each variable. Differences were statistically significant for a p-value &lt; 0.05. At the SRH, the annual incidence of hypertension was 16.13%. Hypertension was present in 78.8% of patients. The factors associated with the occurrence and complications of hypertension were age (OR=1.028; p=0.003 ), level of education (OR=15.49; p=0.023), marital status (OR=3.859; p=0.04), hypercholesterolemia (OR=2.856; p=0.01), monthly income (OR=0.882; p=0.026), number of dependents (OR=1.231; p=0.025), food security (OR=16.666; p p&lt;0.001), tobacco consumption (OR=8.592; p=0.041), fruit and vegetable consumption (OR=0.027; p=0.031), salt/sugar consumption (OR=8.129; p&lt;0.001), place of residence (OR=4.794; p=0.005), access to essential technologies (OR=8.851; p=0.002), and use of traditional care (OR=3.137; np=0.032). HTA at the HRS is associated with several factors. In order to limit the impact of hypertension, it is crucial to emphasize improving socioeconomic and health conditions.

Hepatitis B virus (HBV) and specifically occult HBV infection (OBI) remains concerning in transfusion medicine in many countries. This study aimed to determine the burden of overt and occult HBV infections and characterize the circulating viral genotypes among blood donors in Gabon. A facility-based study was conducted among blood donors at the Gabon National Blood Transfusion Centre in 2022. Screening for HBsAg and anti-HBc was done using ELISA; characterization of OBI (defined serologically as HBsAg- but anti-HBc+) was done using HBV DNA viral load (VL); and HBV Pol/S sanger-sequencing was performed for the analysis of immune-escape and drug resistance mutations. Data were analyzed with p < 0.05 considered significant. Overall, 283 participants were enrolled: 218 (77.0%) males, median age 31 (26–35) years and 264 (93.3%) frequent donors. HBV seropositivity revealed 25.1% (71/283) overt infection (i.e. HBsAg + and anti-HBc+) and 5.7% (16/283) OBI (HBsAg- but anti-HBc+). All OBI cases (16/16) had HBV DNA VL < 10 IU/ml versus 37.5% (6/16) VL < 10 IU/ml, 25% (4/16) VL between ]10–500] IU/ml, and 37.5% (6/16) VL > 500 IU/ml among controls (overt infections). Genotyping was successful for 15.6% (5/32) participants with VL > 500 IU/ml (p = 0.02). Following genotyping, 80% (4/5) participants (VL > 2000 IU/ml) had at least one immune escape mutation (sT131N, sR122K, sG145A) and rtI169L mutation associated with drug resistance was detected in one donor. Molecular phylogeny revealed genotypes A (80%; 4/5) and E (20%; 1/5). HBV seropositivity was 25.1%, markedly higher than the estimated prevalence in the general population and therefore of significant concern. Likewise, the observed OBI prevalence of 5.7% represents a substantial risk to transfusion safety.

ABSTRACT Climate change is reshaping society's moral expectations of business corporations. Its increasing threat to ecological stability and intergenerational well‐being has propelled corporations, once viewed solely as economic entities, into the forefront of climate‐justice debates. This Advanced Review surveys scholarly developments, mainly from the early 2000s to 2025, on the ethical principles, institutional structures, and practical performance of corporate climate responsibility. Focusing on traditional distributive factors, such as causality and capacity, along with the emerging importance of collaboration, the article examines how the literature addresses corporate responsibility in climate issues. It differentiates between corporations as secondary justice agents or market‐driven actors, whose duties involve mitigation, and primary agents or political actors, tasked with influencing regulations, advocating responsibly, and addressing systemic inequalities. The review clarifies the spectrum of interventions and evaluation metrics while exploring conflicts between profit motives and sustainability. It concludes by outlining a future research agenda at the intersection of political philosophy, business ethics, and climate ethics. This article is categorized under: Climate, Nature, and Ethics &gt; Ethics and Climate Change Climate, Nature, and Ethics &gt; Climate Change and Human Rights Climate, Nature, and Ethics &gt; Climate Change and Global Justice

Abstract Options available to the Congo Basin’s countries to fulfill their engagements to implement the Kunming-Montreal Framework’s target 3 by protecting 30% of each of their national land and inland waters and marine space were reviewed. At its face value, Congo Basin would need to increase its land and inland water protected areas network by 583,975-km 2 (or an additional 14% of the 4,081,143 km 2 of the entire region). Increasing protected areas by this magnitude is economically, socially, psychologically, and managerially problematic. Gazetting new protected areas using recent history’s methods is likely to meet resistance and would require enormous conceptual and material resources. Possible ways to address these problems include identification of existing potentials and mechanisms to be used to increase the geographic extent of protected areas without necessarily creating new strict protected areas. Sound corridors, sacred sites, community conservation areas, and high-value conservation areas within extractive concessions offer such possibilities, if they are democratically and officially recognized. Creating new protected areas to preserve currently underrepresented ecosystems remains a necessity. If corridors, sacred sites, and other mechanisms are recognized, secured, and managed adequately in addition to existing protected areas, Congo Basin countries can go beyond the Kunming-Montreal Framework by 2030. Lack of sustainable financial capacity is the chief impediment to increasing protected areas networks; lack of internal financial resources and the reluctance of the global community to financially support biodiversity conservation are the most difficult problems to solve for the Congo Basin to achieve its goals.

Abstract Background Malaria remains a major cause of morb​idity an‌d mortality in sub​-Saharan Afri‌ca. I‌n C‌ameroon, malaria accounts for 48% of all hospital admissions, 30% of morbidity and 67% of childhood mortality per year, despite ongoin‌g con‍trol st‍rategi​es. H​owever, data on c⁠ommunity acceptability of this vac​ci‍ne remain limite‍d. T‌h‌i​s study ai⁠med⁠ to assess the acceptabi‌li‍t⁠y of the malaria vacc⁠ine and⁠ ident⁠i​fy factors ass⁠ociated among c‍aregivers of children unde‍r 25 mon‌ths in‌ the Soa He‍alth Distr​ict, C‌ameroo​n. Methods A community-‌based cros‌s-se⁠c‍t⁠ional d‍escriptiv‍e and analytical s​tudy‍ was condu‌c⁠ted between March and November 2024. Careg‍ivers⁠ of children under 25 months⁠ residin‍g in the Soa‍ H​ealth​ Di​strict were recruited using a non-pr‍ob⁠a‍bility‌ convenience sampling method. Data were c‍ollected using a structured, pre-te‌ste⁠d questio​nnaire⁠ and analysed using R‌ softwar⁠e. As‌soci⁠ations between ind‍ependent variable​s and vacc‌ine accept⁠a⁠bil⁠it‍y were ass‍es​sed using Pearson’s chi-⁠square or Fisher’s exact tests. Multivariable logistic‍ regression model‌ was used to estimate adjusted odd ratio (aOR) at​ a 95% confidence level. A p-value &lt;​ 0.05 was considered statistic​ally significant. ‌Resu⁠lts A total of 54​1 caregive‌rs particip⁠ated⁠ in t‌he stud‍y. Overall, 73.4% of careg‍ivers exp⁠re​s⁠sed w​illingne‌ss to vacci⁠nate‍ their childre⁠n agains‍t malaria‍. Higher odds of vaccine‌ acceptability wer‍e obs​erved a‌m⁠on‌g careg​ivers residing in Ngali II (aOR = 12.20;‍ 95% CI:⁠ 3.23-46.​02; p &lt;0.001 ),‍ Ko​ulou (aO​R = 5.66; 9​5% CI: 1.74-18.35; p= 0.004 ), Soa (aOR‌ = 4.23; 95%‌ CI: 1.59-1‌1.25​; p= 0.004 ), and Eban‌g (aOR = 2.66; 95% CI: 1.16-6.14; p= 0.021 ), Female caregiv​ers (aOR =⁠ 1.8‌5; 9​5% CI: 1.06-3.​22; p= 0.031 ), Catholics (aO​R = 3.85; 95%‌ CI: 1.18-12.51; p =0.025 ), caregivers who h⁠ad p‍rior‍ aware⁠ness of the malaria va⁠ccine (aOR = 2.06‍; 95% CI: 1.‍28-3.30; p=0.003 ), ​ caregivers wh⁠o sought treatment in hospit‌als (aO‌R = 2⁠.02; 95% CI: 1.15-3‍.55; p =0.015 ) or used str​ee​t‍ medicine (aOR = 2.46; 95% CI: 1.09-5.​55; p=0.03 ). Conclusi‍on Acce⁠ptabi‌lity of the malaria va‌ccine among caregivers in the Soa Health District was relativel‍y high and was significantly influenced by geo​graphic location, s​ex,‍ religion, health-seeking behaviour, and awareness of the⁠ vaccine.‌ Targeted health e‌duc‍ati‍on and cul‌turally sensitive community engagement s​t​rategies‍ are‍ essential to improve vac⁠cine acceptability and su⁠pp⁠ort‌ the successf‌u‍l s‍cale‍-u​p of⁠ ma‍lari‌a vacci​nation programmes in Came​roon a​nd o​ther endemic se‌ttings.

Problems related to the nutritional status of adolescents represent a major public health issue worldwide, due to their impact on health and their increasing frequency. This study aims to assess the nutritional status of adolescents in a school environment in Douala, Cameroon. A descriptive and analytical study was carried out between March and November 2023, involving 511 adolescents aged 8 to 15. Data were collected in four secondary schools using a structured questionnaire. Anthropometric measurements were taken to calculate body mass index (BMI). Results were analyzed using RStudio software, and descriptive statistics were applied. Relationships between variables were assessed using logistic regression models, applied to a sample including individuals of both sexes, with a significance level set at p < 0.05. The mean age of the participants was 11.9 ± 1.30 years, with girls (50.7%) slightly more numerous than boys (49.3%). According to IOTF (International Obesity Task Force) reference thresholds, the overall extent of obesity (8.8%), overweight (19.4%) and undernutrition (7.44%) among adolescent girls in the city of Douala was considerable, and the independent predictors of overweight/obesity were mainly living in a villa [AOR = 3.52; CI95%: 1.16–11.28; p = 0.026], marital status (divorced parents) [AOR = 1.88; IC95%: 1.173.00; p = 0.007], number of children between 1 and 3 [AOR = 1.81; IC95%: 1.14–3.92; p = 0.012]. In addition, age between 10 and 11 years (AOR = 2.88; CI95%: 1.62–5.19; p < 0.001], male gender [AOR = 2.16; CI95%: 1.49–3.15; p < 0.001] and walking [AOR = 1.89; CI95%: 1.07–3.37; p = 0.027] were significantly associated with undernutrition. This study highlights the urgent need for targeted interventions to reduce malnutrition among adolescents in Douala schools. It is crucial to integrate nutrition awareness programs and physical activities into the school curriculum. The involvement of parents and communities is essential to create an environment conducive to healthy food choices and an active lifestyle, in order to combat the growing nutritional challenges facing young people in Cameroon.