University Teaching Hospital of Yaounde

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.

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.

BackgroundPeople living with early‐onset Alzheimer's disease (EOAD) are often misdiagnosed or experience delays in diagnoses due to their young age of onset, non‐amnestic presentation, and rapid clinical progression. Brief digital cognitive measures may be a valuable and scalable alternative to traditional tests for early detection of EOAD. We examined the associations of the UCSF Tablet‐based Cognitive Assessment Tool (TabCAT) tests with clinical and pathophysiologic markers of AD in the multisite Longitudinal Early Onset Alzheimer's Disease Study.Method83 cognitively unimpaired controls and 392 patients with a clinical diagnosis of EOAD (MCI or mild dementia) underwent TabCAT testing, including 2 tests of executive function/attention (Match, Flanker) and 2 visuospatial tests (Line Length and Line Orientation; Figure 1A). First, we assessed correlations between TabCAT scores and classic pen‐and‐paper tests in the whole cohort using ranked coefficients. Second, we used receiver operating characteristic analyses to examine each cognitive score's ability to distinguish between Aβ‐ (n = 95) and Aβ+ (n = 297) clinically impaired patients, as defined by a quantification‐aided visual read of Florbetaben‐PET. We then investigated regional associations between TabCAT scores and Flortaucipir (tau)‐PET using voxel‐wise analyses in the Aβ+ patients.ResultIn the whole cohort, Match and Flanker were associated with all pen‐and‐paper tests, with strongest correlations observed with the MMSE, MoCA, and Trails A (r's >0.7). As expected, Line Length and Line Orientation tests showed strongest correlations (r's >0.4) with traditional tasks that rely on visuospatial skills: Benson Figure Copy and Trails A (Figure 1B). Of TabCAT tests, Match best discriminated Aβ+ from Aβ‐ patients (Area Under the Curve (AUC)=0.82), outperforming the MMSE (AUC=0.75) and MoCA (AUC=0.75), and comparable to the overall best performing test Benson Figure Recall (AUC=0.85; Figure 2). In Aβ+ patients, Match and Flanker correlated with tau‐PET signal in most cortical areas, especially dorsal frontal and parietal areas. The Line tests were specifically associated with occipital tau‐PET signal (Figure 3).ConclusionIn this large multisite study, TabCAT measures show good concurrent validity and associations with pathophysiological markers of AD: Aβ‐PET positivity and neuroanatomical specific patterns of tau‐PET. These digital measures have promise for frontline identification and early diagnosis of patients with EOAD.

BackgroundThe quality of postoperative care is a critical determinant of patient safety in neurosurgery, particularly in low-resource settings. This study evaluated the quality of postoperative care in the neurosurgery department of Sylvanus Olympio University Hospital in Lomé, Togo.MethodsWe conducted a descriptive, cross-sectional study from October to December 2024, including patients who underwent neurosurgical procedures and received postoperative care in the neurosurgery ward. Data were collected using a structured checklist, medical record audits, and patient satisfaction surveys.ResultsA total of 51 patients were included (mean age: 37.1 ± 21.6 years; male-to-female ratio: 4.67). Traumatic brain injury accounted for 45% of surgical indications. Compliance with perioperative procedural standards was observed in 64.9% of cases, while only 13.7% of postoperative prescriptions adhered to standard protocols. Postoperative complications occurring during the inpatient hospital stay were observed in 13.7% of patients, and the mortality rate was 1.96%. Despite systemic shortcomings, 64.7% of patients reported overall satisfaction with their care.ConclusionSubstantial gaps remain in the application of standardized postoperative procedures, particularly in documentation and timing of care. Strengthening written protocols, enhancing staff training, and institutionalizing regular audits may improve neurosurgical outcomes in low-resource settings.

IntroductionThe association between alcohol consumption and vitamin D status in young men remains controversial. Few data are available from sub-Saharan Africa, although necessary for better prevention of metabolic bone disease in adulthood. This study aimed to analyze the relationship between regular alcohol consumption and vitamin D status in young Cameroonian men.MethodsIt was a cross-sectional study on healthy males aged 18 to 45 with regular alcohol consumption within the last three months. We assessed their ethylic index (EI), hematological and hepatic biomarkers of chronic alcohol consumption, and 25 (OH) vitamin D (25(OH)D) concentrations, which were compared according to alcohol consumption (low < 20, moderate 20-39.9 and elevated ≥ 40 g/day) using ANOVA.Results155 participants were included, with a mean age of 31 (SD 6) years, a median alcohol consumption duration of 10 [7; 15] years and a median EI of 24 [14; 27] g/day. They mostly consumed beer (95%), with low (42%) and elevated (23%) predominant consumptions. Vitamin D deficiency (< 20ng/mL) was found in 63%. There was no difference in mean 25(OH)D concentrations between the three alcohol consumption groups. No correlation was found between the biomarkers of chronic alcohol consumption studied and 25(OH)D concentrations.ConclusionsThere appears to be no relationship between 25(OH)D concentrations and daily alcohol consumption in young Cameroonian men. Nevertheless, more data are needed, including vitamin D metabolism parameters to better understand this relationship.

The online version contains supplementary material available at 10.1007/s13337-025-00927-9.

The results of a global survey on blood safety measures to prevent transfusion-transmitted infectious diseases (TTIDs) were analysed, focusing on TTID testing requirements, practices and associated donor actions (vigilance). Responses by country/region (C/R) were categorized by World Bank income (WBI) levels: low- and lower middle-income (LLMI), upper middle-income (UMI) and high-income (HI). Consensus responses were used for C/Rs with multiple survey responses. Regions within China and India were analysed separately. Survey questions on TTID testing and donor vigilance were compared across WBI levels. Responses from 74 C/Rs representing 65 countries and Hong Kong were analysed. All C/Rs reported mandatory human immunodeficiency virus (HIV), hepatitis B virus (HBV) and hepatitis C virus (HCV) screening, with a few exceptions for syphilis. Most testing standards were set by national law, using antibody and/or antigen testing for HIV, HBV and HCV; antibody testing was common for syphilis. Nucleic acid testing (NAT) was less common in LLMI than in UMI and HI C/Rs. Confirmatory testing was reported by almost all (96%) C/Rs, often using the same screening test. All C/Rs provided educational material to donors, and deferred/notified donors based on reactive/positive TTID results. Most C/Rs reported reactive/positive results to a central entity, and 89% withdrew and destroyed in-date units from previous collections. All reporting C/Rs screened for HIV, HBV and HCV, with most using confirmatory testing. Advanced tests such as NAT were less common in LLMI C/Rs. Donor vigilance was consistent across income groups, with education, notification and deferral for TTID results, and most reporting withdrawal/destruction of previous collections.

Context and objective. The hepatocellular (HCC) is one of main digestive cancer in Sub-Saharan Africa countries. The study aimed to describe clinical characteristics, management and outcomes of patients with HCC in Yaoundé (Cameroon). Methods. This was a retrospective cohort study in 4 hospital centers of Yaoundé (Cameroon). Medical records of patients diagnosed with HCC between December 2015 and December 2022 were included. These records consisted of demographic characteristics, cause of disease, clinical and para clinical signs, treatment and survival status. Results. Information on 227 patients with HCC were obtained. The sex ratio was 2.4 M/F with a median age of 53 years [IQR 38-68]. Hepatitis B virus was the leading cause of HCC for 94 patients (41.4%), and hepatitis C virus for 73 patients (32,1%). Patients were mostly symptomatic, presenting with a tumoral syndrom in 148 patients (65.2%). Abdominal ultrasonography shows a multinodular HCC in 91/161 (53.1%). The management was mostly palliative 219 (96.5%), and the median survival was 93 days. Conclusion. HCC is observed in young male adults with a viral B or C hepatitis. Treatment is mostly palliative with a poor outcome. Received: March 7th, 2024 Accepted: December 24th, 2024 https://dx.doi.org/10.4314/aamed.v18i2.10

Many studies have shown that Human Immunodeficiency Virus (HIV) infection and/or exposure to antiretroviral drugs during pregnancy can influence a child's neurocognitive development. Moreover, the family and social challenges experienced by some HIV-infected children may have a negative impact on their academic performance. The objective of this study was to estimate the frequency of school delay among HIV-infected adolescents followed up in the ANRS 12225-Pediacam III cohort in Cameroon and identify associated factors. The cohort consists of three groups of children enrolled before the age of 7 months: HIV-infected (HI; n = 210), HIV-exposed uninfected (HEU; n = 205); and HIV-unexposed uninfected (HUU; n = 196)). Data were collected from these children from the project's inception in 2007 until 2022 and analysed retrospectively. School delay was defined as the occurrence of at least two instances of grade retention at either primary or secondary education levels. After performing a descriptive analysis, we used the Kaplan-Meier method and Cox regression to identify determinants of school delay. A total of 405 children were considered; of whom 51.4% were male. The overall frequency of first school delay was 29.1% (118/405; 95% CI:24.8; 33.8), which differed significantly between the children's groups. In multivariate analysis, the risk of school delay was significantly higher among children living with HIV compared to HUU (adjusted hazard ratio (aHR): 2.7; 95% CI:1.66-4.64), male children (aHR: 1.9; 95% CI:1.33-2.84), children born from low educated mothers (aHR: 3.0; 95% CI:1.58-5.95), and children whose parents were not living together (aHR: 1.5; 95% CI:1.02; 2.39).