Introduction since 1971, Cameroon is facing a growing series of cholera epidemics despite all the efforts made by the government to address this huge public health threat. In 2020, in addition to the COVID-19 pandemic, Cameroon recorded a high cholera case fatality rate of 4.3% following epidemics noted in the South, Littoral and South-West regions. The Cameroon Ministry of Public Health, has thus organized a reactive vaccination campaign against cholera to address the high mortality rate in the affected health districts of those regions. The objective of this study was to describe the challenges, best practices and lessons learned drawing from daily experiences from this reactive vaccination campaign against cholera. Methods we conducted a cross-sectional study drawn from the results of the campaign. We had a target population of 631,109 participants aged 1 year and above resident of the targeted health areas. Results the overall vaccination coverage was 64.4% with a refusal rate ranging from 0-10% according to health districts. Vaccination coverage was the lowest among people aged 20 years and above. The main challenge was difficulty maintaining physical distanciation, the main best practice was the screening of all actors taking part at the vaccination against COVID-19 and we found that emphasizing on thorough population sensitization through quarter heads and social mobilizers and adequately programming the campaign during a good climate season is crucial to achieving good vaccination coverage. Conclusion lessons learned from this study could serve to inform various agencies in the event of planning rapid mass vaccination programs during pandemics.

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The Cameroon health system is divided into central, intermediate and peripheral levels. Of the 43 health districts with a measles outbreak in Cameroon in 2011, only the Nylon Health District organized a documented outbreak response immunization. We present the methods and results of the response campaign solely shouldered by the district and intermediate level. The risk group, targets and neighborhoods to be vaccinated were identified after a detailed analysis of initial cases. The intermediate level defined strategies, provided logistics, capacity building and 41% of the operational budget while 59% was completed by the peripheral level. Microsoft Office Excel 2007 was used to estimate coverage rates and to draw an epidemic curve. The response immunization campaign was organized on the 14th epidemiological week, 10 weeks after the onset of the outbreak which ended 11 weeks thereafter. A total of 15867(108.5%) children aged 9-59 months were vaccinated in five health areas at a direct cost (vaccines excluded) of 71.34FCFA ($0.143) per vaccinated child. An additional 824 children aged 9-59 months were vaccinated around the residence of notified cases in neighborhoods which were not involved in the response campaign. The number of cases after the response campaign was lower than before. Once vaccines are available, prompt outbreak response campaigns can be organized at operational level to obtain commendable results instead of depending solely on international organizations or central levels. Decision makers at the intermediate and operational levels should redeploy available funds during emergencies to prevent the development of extreme public health conditions.

The performance based financing approach is being tested in four regions of Cameroon, including the Littoral region. Our study aimed to study the effects associated with the implementation of the performance based financing approach within the health facilities based in the health district of Edea in the Littoral region in Cameroon. We’ve carried out a crosssectional analytical study among 178 health personnel from 21 health facilities under PBF-contract within the health district of Edea. We have studied their sociodemographic characteristics, the individual and collective effects resulting from the performance based financing subsidies and the level of job satisfaction. Participants’ job satisfaction was measured with the French version of the Minnesota satisfaction scale. The results were presented in a descriptive and analytical form at the alpha = 5% and the P-value 5%. We recruited 113 women and 65 men. The mean age was 39.19 ± 8.95 years. The individual results of the performance based financing were the regular collection of subsidies between F CFA 20-40.000 (42.1%), the improvement of working conditions (74.2%) and living conditions (67.4%) and the acquisition of new skills (69.7%). Collectively, participants confirmed the increase of the users attendance (65.7%), the improvement of the internal organization (79.8%), the purchase of new equipment (84.3%) and the improved quality of health care (86%). Satisfaction is influenced by age (P=0.016), gender (P=0.01), occupational category (P=0.04), type of health facility (P=0.02) and the amount of subsidies (P=0.03). The healthcare personnel’s were satisfied with the improvement of their social conditions (66.67%), working conditions (62.88%), the transparency in health centers management (69%) and their involvement in the health centers’ functioning (76.6%). Participants were dissatisfied with their salaries (70.2%) and the lack of opportunities for advancement (47.8%). The positive effects of the performance based financing approach contributed to the job satisfaction of the healthcare workers in the Edea health district. These results should prompt the government to extend the performance based financing approach to communities and other health districts in Cameroon.

BackgroundDespite being certified guinea worm free in 2007, Cameroon continues surveillance efforts to ensure rapid verification of any suspected reoccurrence. This includes the investigation of every rumor and confirmation of each suspicious expulsed worm. This paper presents fieldwork carried out to investigate a guinea worm rumor in Cameroon which turned out to be an Onchocerca volvulus mimicking Dracunculus medinensis.MethodsThe investigation included a field visit to the subsistence farming community where the rumor was reported. During the visit, interviews were conducted with health staff who managed the case and the elderly farmer from whom the worm was retrieved. An investigation of any potential missed guinea worm cases was also conducted through interviews with community residents and reviews of the health facility’s medical records. This was combined with laboratory analyses of water samples from the community’s water sources and the retrieved worm which was removed from the patient via wrapping it around a stick.ResultsMicroscopy and molecular analyses of the retrieved worm revealed a female Onchocerca volvulus whose expulsion strongly mimicked guinea worm. In addition to presenting findings of our investigation, this paper discusses distinguishing elements between the two parasites and gives an overview of guinea worm eradication efforts in Cameroon as well as current challenges to the worm’s eradication globally.ConclusionsThe investigation findings suggest the evolving Onchocerca volvulus worm tropisms’ adaptive survival behavior worth further investigation. Strategies used to successfully control guinea worm in Cameroon could be adapted for Onchocerca volvulus control.