20 research outputs found
Delayed entry into HIV care after diagnosis in two specialized care and treatment centres in Cameroon: the influence of CD4 count and WHO staging
No full textAbstract Background Delayed entry into HIV care has complicated the challenges faced in sub-Saharan Africa due to the high HIV burden. A clear knowledge of the factors affecting delayed entry will be essential in directing interventions towards reducing delayed entry into HIV care. There exist very limited data on delayed entry in Cameroon despite its relevance; hence this study was conducted to determine the rate of delayed entry and its associated factors in HIV programmes in Cameroon. Methods Data used for this study was routine data obtained from the files of HIV patients who were diagnosed between January 1, 2015 and June 30, 2015 at Limbe and Buea regional hospital HIV centers in the South West region of Cameroon. Data analysis was done using SPSS version 20. Results Of the 223 patients included in the study, nearly one-quarter of patients (22.4 %) delayed to enter HIV care within 3 months. Those who delayed to enter care were less likely to present at first diagnosis (using HIV rapid test) with symptoms such as fever > 1 month (5 % versus 30 %, p = 0.01) and weight loss > 10 % (13 % versus 48 %, p < 0.001). Alcohol consumption, WHO stage and CD4 count levels were also associated with delayed entry in bivariate analysis. In multivariate analysis only CD4 count greater than 500cells/μl and WHO stages I and II were independently associated with delayed entry into HIV care within 3 months. Conclusion In the South West region of Cameroon, approximately 1 out of 4 patients delay to enter HIV care. This high proportion of patients who delay to enter care correlates to the findings recorded by other studies in sub Saharan Africa. Interventions tackling delayed entry into HIV care might need to be favorably directed towards patients that have high CD4 counts and are at very early WHO clinical stages
Driving hospital transformation with SLMTA in a regional hospital in Cameroon
No full textBackground: Inspired by the transformation of the Regional Hospital Buea laboratory through implementation of the Strengthening Laboratory Management Toward Accreditation (SLMTA) programme, hospital management adapted the SLMTA toolkit to drive hospitalwide quality improvement.Objective: This paper describes changes in the hospital following the quality improvement activities in hygiene and sanitation, the outpatient waiting area and the surgical and maternity wards.Methods: In March 2011, hospital management established a quality improvement task force and created a hospital-wide quality improvement roadmap, following the SLMTA model. The roadmap comprised improvement projects, accountability plans, patient feedback forms and log books to track quality indicators including patient wait time, satisfaction level, infection rates, birth outcomes and hospital revenue.Results: There was steady improvement in service delivery during the 11 months after the introduction of the quality improvement initiatives: patient wait time at the reception was reduced from three hours to less than 30 minutes and patient satisfaction increased from 15% to 60%. Treatment protocols were developed and documented for various units, infrastructure and workflow processes were improved and there was increased staff awareness of the importance of providing quality services. Maternal infection rates dropped from 3% to 0.5% and stillbirths from 5% to < 1%. The number of patients increased as a result of improved services, leading to a 25% increase in hospital revenue.Conclusion: The SLMTA programme was adapted successfully to meet the needs of the entire hospital. Such a programme has the potential to impact positively on hospital quality systems; consideration should be made for development of a formal SLMTA-like programme for hospital quality improvement.This research was supported by the US President\u2019s Emergency Plan for AIDS Relief (PEPFAR) through the CDC,Global Health Systems Solution (GHSS) serving as mentors and the entire management, staff and healthcommittee of the RHB.CDC-302014PEPFAR/United States634
Afr J Lab Med
No full textBackgroundIn 2009, Ghana adopted the Strengthening Laboratory Management Toward Accreditation (SLMTA) programme in order to improve laboratory quality. The programme was implemented successfully with limited donor funding and local human resources.ObjectivesTo demonstrate how Ghana, which received very limited PEPFAR funding, was able to achieve marked quality improvement using local human resources.MethodLocal partners led the SLMTA implementation and local mentors were embedded in each laboratory. An in-country training-of-trainers workshop was conducted in order to increase the pool of local SLMTA implementers. Three laboratory cohorts were enrolled in SLMTA in 2011, 2012 and 2013. Participants from each cohort attended in a series of three workshops interspersed with improvement projects and mentorship. Supplemental training on internal audit was provided. Baseline, exit and follow-up audits were conducted using the Stepwise Laboratory Quality Improvement Process Towards Accreditation (SLIPTA) checklist. In November 2013, four laboratories underwent official SLIPTA audits by the African Society for Laboratory Medicine (ASLM).ResultsThe local SLMTA team successfully implemented three cohorts of SLMTA in 15 laboratories. Seven out of the nine laboratories that underwent follow-up audits have reached at least one star. Three out of the four laboratories that underwent official ASLM audits were awarded four stars. Patient satisfaction increased from 25% to 70% and sample rejection rates decreased from 32% to 10%. On average, $40 000 was spent per laboratory to cover mentors' salaries, SLMTA training and improvement project support.ConclusionBuilding in-country capacity through local partners is a sustainable model for improving service quality in resource-constrained countries such as Ghana. Such models promote country ownership, capacity building and the use of local human resources for the expansion of SLMTA.CC999999/Intramural CDC HHS/United State
Decentralised facility-based training as an alternative model for SLMTA implementation : the Cameroon experience
No full textBackground: The Strengthening Laboratory Management Toward Accreditation (SLMTA) programme is designed to build institutional capacity to help strengthen the tiered laboratory system. Most countries implement the SLMTA three-workshop series using a centralised model, whereby participants from several laboratories travel to one location to be trained together.Objectives: We assessed the effectiveness and cost of conducting SLMTA training in a decentralised manner as compared to centralised training.Methods: SLMTA was implemented in five pilot laboratories in Cameroon between October 2010 and October 2012 by means of a series of workshops, laboratory improvement projects and on-site mentorship. The first workshop was conducted in the traditional centralised approach. The second and third workshops were decentralised, delivered on-site at each of the five enrolled laboratories. Progress was monitored by repeated audits using the Stepwise Laboratory Quality Improvement Process Towards Accreditation (SLIPTA) checklist.Results: Audit scores for all laboratories improved steadily through the course of the programme. Median improvement was 11 percentage points after the first (centralised) training and an additional 24 percentage points after the second (decentralised) training. The estimated per-laboratory cost of the two training models was approximately the same at US$21 000. However, in the decentralised model approximately five times as many staff members were trained, although it also required five times the amount of trainer time.Conclusion: Decentralised SLMTA training was effective in improving laboratory quality and should be considered as an alternative to centralised training.This programme was financed with funds from PEPFAR through a cooperative agreement with CDC. It was implemented in collaboration with CDC\u2019s office in Cameroon, with technical support from CDC\u2019s Division of Global HIV/AIDS laboratory team.CDC-292014PEPFAR/United States634
Pattern of Antimicrobial Resistance among Bacterial Isolates from Urogenital Clinical Specimens: A Descriptive Study from the Buea Health District, Cameroon
No full text
Trend in the Seroprevalence of Transfusion Transmissible Infections (TTIs) from 2019 to 2023 at the Blood Transfusion Service of the Buea Regional Hospital, Southwest Region, Cameroon
No full textBackground: Transfusion-transmissible infections (TTIs) are of significant public health concern, as they can be transmitted through blood transfusions. Monitoring the trends and prevalence of TTIs is crucial for ensuring the safety of the blood supply and implementing effective preventive measures. This study aimed to analyzed the trend in seroprevalence of TTIs, including HIV, hepatitis B (HBV), hepatitis C (HCV), and syphilis (TPHA), among blood donors in the Buea Regional Hospital (BRH) from 2019 to 2023. Materials and Methods: This retrospective study was conducted using data from the Buea Regional Hospital Blood Transfusion Service. The study population included all blood donors who donated blood from January 2019 to December 2023. Serological testing for TTIs was performed using standard diagnostic methods. The prevalence of each TTI was calculated for each year, and the trends were analyzed using statistical tests and expressed as frequency tables, Chi square, logistic regression. Significance was set at p=0.05. Results: A total of 11,256 donors were tested and 919 (8.12%) blood donors tested positive for at least one TTI agent during the study period. The overall positivity rates were 8.23%, 9.48%, 6.65%, 8.29%, and 8.24% for 2019, 2020, 2021, 2022, and 2023, respectively. The prevalence of individual TTIs showed significant variations, with TPHA being the most prevalent (2.96%), followed by HBV (2.58%), HCV (1.15%), and HIV (1.24%). Socio-demographic factors, such as gender, marital status, occupation, and age, were found to be significantly associated (p<0.001) with the odds of testing positive for a TTI. Conclusion: The trend in the prevalence of TTIs among blood donors in the Buea Health Area was characterized by fluctuations over the five-year period. 
Ready-to-Eat Foods: A Potential Vehicle for the Spread of Coagulase-Positive Staphylococci and Antimicrobial-Resistant Staphylococcus aureus in Buea Municipality, South West Cameroon
No full textThe consumption of ready-to-eat (RTE) foods contaminated with coagulase-positive staphylococci (CoPS) and especially Staphylococcus aureus puts consumers at a potential risk of food-borne disease or colonization and subsequent infection. This cross-sectional study determined the levels of CoPS and the presence of S. aureus in RTE foods sold in Buea municipality. A total of 420 RTE food samples, comprising 70 each of cake, bread, fruit salad, meat hot-pot, suya, and boiled rice were randomly purchased from February to August 2020. The CoPS counts were determined by culturing on Baird-Parker agar, and S. aureus was identified by amplification of the nuc gene using the polymerase chain reaction. All S. aureus isolates were screened for the presence of classical staphylococcal enterotoxin genes. To determine antimicrobial resistance profiles, each isolate was tested against 11 antimicrobials. Oxacillin-resistant S. aureus strains were analyzed for the presence of the mecA gene. Overall, 161 (38.3%) samples had detectable levels of CoPS ranging from 2.0 to 5.81 log10 CFU/g. Based on CoPS levels, 37 (8.81%) of the 420 RTE food samples–only fruit salad and meat hot-pot, had unsatisfactory microbiological quality. A total of 72 S. aureus isolates, comprising 52.78% from fruit salad, 16.67% from meat hot-pot, 12.5% from boiled rice, 9.72% from suya, 5.56% from bread, and 4.17% from cake, were recovered. None of the S. aureus isolates possessed any of the classical enterotoxin genes. All the isolates were susceptible to vancomycin and ofloxacin, while 68 (94.44%) and 66 (91.67%) were susceptible to oxacillin and ciprofloxacin, respectively. Resistance to penicillin (93.06%) was highest, followed by amoxicillin (91.67%) and erythromycin (79.17%). Four isolates were identified as methicillin-resistant S. aureus, all of which carried the mecA gene. A total of 24 antibiotypes were identified. Our findings showed that RTE foods sold in the Buea municipality are likely vehicles for the transmission of CoPS and antimicrobial-resistant S. aureus
Morphological and molecular identification of pathogenic fungi of Monodora myristica Dunal kernels and their response to different phytoextracts
No full textIdentification of fungi from calabash nutmeg kernels was based on their morphological characteristics and analysis of the internal transcribed spacer (ITS) sequences of their genomic DNA. Antifungal activity of aqueous,methanolic and ethanolic extracts of four plants species (Azadirachta indica, Citrus sinensis, Moringa oleifera and Tithonia diversifolia) was tested in vitro at 50, 75, 100 and 125 mg/ml for aqueous extracts and 40, 60, 80 and 100 mg/ml for methanolic and ethanolic extracts. Mancozeb (1 mg/ml) and distilled water were used as positive and negative controls, respectively. The most frequently isolated fungi were Cercospora purpurea (34.28%), Fusarium oxysporum (23.81%) and Aspergillus flavus (17.14%). C. purpurea and F. oxysporum isolates were more aggressive after inoculation on healthy kernels. All the extracts tested, inhibited the growth of the fungi compared to the negative control, except the aqueous extract of T. diversifolia against C. purpurea and F. oxysporum and the methanolic extract of M. oleifera against F. oxysporum at 75 mg/ml.
The efficiency of aqueous extracts of M. oleifera and C. sinensis was significantly lower (P<0.05) as compared to the reference fungicide on growth of A. niger at 125 mg/ml. Antifungal activity of methanolic extracts of A. indica, C. sinensis and T. diversifolia as well as ethanolic extracts of A. indica and M. oleifera was significantly equal to mancozeb at 100 mg/ml on A. flavus. Aqueous extracts of M. oleifera and methanolic extracts of A. indica and C. sinensis could be used for protection of Monodora myristica kernels against post-harvest fungi
Driving hospital transformation with SLMTA in a regional hospital in Cameroon
No full textBackground: Inspired by the transformation of the Regional Hospital Buea laboratory through implementation of the Strengthening Laboratory Management Toward Accreditation (SLMTA) programme, hospital management adapted the SLMTA toolkit to drive hospital wide quality improvement.
Objective: This paper describes changes in the hospital following the quality improvement activities in hygiene and sanitation, the outpatient waiting area and the surgical and maternity wards.
Methods: In March 2011, hospital management established a quality improvement task force and created a hospital-wide quality improvement roadmap, following the SLMTA model. The roadmap comprised improvement projects, accountability plans, patient feedback forms and log books to track quality indicators including patient wait time, satisfaction level, infectionrates, birth outcomes and hospital revenue.
Results: There was steady improvement in service delivery during the 11 months after the introduction of the quality improvement initiatives: patient wait time at the reception was reduced from three hours to less than 30 minutes and patient satisfaction increased from 15% to 60%. Treatment protocols were developed and documented for various units, infrastructure and workflow processes were improved and there was increased staff awareness of the importance of providing quality services. Maternal infection rates dropped from 3% to 0.5% and stillbirths from 5% to < 1%. The number of clients increased as a result of improvedservices, leading to a 25% increase in hospital revenue.
Conclusion: The SLMTA approach was adapted successfully to meet the needs of the entire hospital. Such a programme has the potential to impact positively on hospital quality systems; consideration should be made for development of a formal SLMTA-like programmefor hospital quality improvement
