Antibodies to the hepatitis delta virus (HDV) were found in 17.6% of 233 hepatitis B virus surface antigenpositive subjects in Cameroon. Phylogenetic analyses showed the presence of HDV-1, HDV-5, HDV-6, and HDV-7 genotypes. These results enrich the limited data on HDV prevalence and molecular diversity in Cameroon.Hepatitis delta virus (HDV) is associated with hepatitis B virus (HBV) infection and is frequently related to more severe disease than that due to the underlying HBV monoinfection (5, 10). HDV infection has a worldwide distribution, but its frequency varies greatly throughout different geographic regions. It is highly endemic in the Middle East, in the Mediterranean area, in the Amazonian region, and in several African countries (3). Genomic analysis of HDV isolates from different regions of the world reported at least eight phylogenetically distinct genotypes with dissimilar geographic distributions. Apart from HDV genotype 1 (HDV-1), which is ubiquitous, each virus clade is geographically localized: HDV-2 is found in Japan, Taiwan, and Russia; HDV-4 is found in Taiwan and Japan; HDV-3 is found in the Amazonian region; and HDV-5, HDV-6, HDV-7, and HDV-8 are found in Africa (6). The role of these HDV genotypes is not yet well determined, but some studies have suggested an association between the severity of disease and infection with different HDV genotypes (4, 8). The two studies conducted 2 decades ago on HDV infection in Cameroon have reported the prevalence of antibodies against HDV (HDV-Ab) of 6.5% and 27.3%, respectively (9, 12). In spite of this high prevalence, no data on HDV genotype diversity in Cameroon are available. Therefore, in the present study, we investigated the current HDV seroprevalence and the genotype diversity in Cameroonian patients with chronic HBV infection.This study was performed on plasma samples from 233 hepatitis B virus surface antigen (HBsAg) carriers (mean age, 34.5 years; 79 women and 154 men) seen at two medical care centers in Yaounde, Cameroon, from May 2008 to May 2009. As recommended by the Cameroonian Society of Gastroenterology, in addition to the HBV DNA quantification and the assessment of biochemical liver enzyme, HDV screening should be part of the screening of HBsAg carriers, considering the endemicity of this infection in Central Africa. The analyses included in HDV screening are HDV antibody (HDV-Ab) and HDV RNA quantification for HDV-Ab-positive patients. During the medical consultation, HBsAg carriers were screened for HDV infection and were asked to participate in this study. For carriers who agreed to participate, written informed consent was obtained for HDV genotyping, since this analysis is not part of the original protocol in a routine workup of liver disease.The presence of HDV-Ab was determined by the Murex anti-delta assay (Abbott, Wiesbaden, Germany), and HBV DNA viral load was determined by the Abbott RealTime HBV quantification kit (Abbott Molecular Inc., Rungis, France) according to the manufacturer's protocol. During routine workup of th...

IntroductionL'infection à Hélicobacter pylori concerne la moitié de la population mondiale, principalement dans les pays en voie de développement où l'infection atteint 80% de la population. Le but de notre étude était de déterminer la prévalence de l'infection à Hélicobacter pylori et de mettre en évidence les déterminants de l'infection ainsi que les maladies associées au Cameroun.MéthodesL’étude concernait 171 sujets symptomatiques référés pour une fibroscopie œsogastroduodénale au Centre Hospitalier et Universitaire de Yaoundé et au Centre Médical la Cathédrale. L'infection à H.pylori était objectivée par un test rapide à l'uréase kit commercial Pronto Dry® (Medical Instruments Corporation, Solothurn, Switzerland).RésultatsLa prévalence globale de l'infection à Hélicobacter pylori était de 72,5% (124/171) (Intervalle de Confiance (IC) à 95% 65,2-79,1%) et dans chaque groupe d’âge (moins de 40ans, 40-50ans, plus de 50ans) de 83,1%(64/77), 67,4%(29/43) et 60,8%(31/51) respectivement. En analyse univariée, le risque de l'infection était significativement élevé dans le groupe de moins de 40ans comparé au groupe de 40-50ans (Risque Relatif (RR) 0,42 IC 95% 0,16-1,1, p = 0,04 pour le groupe 40-50ans) et comparé au groupe de plus de 50ans (RR 0,73; 0,57-0,93, p = 0,004 pour le groupe de plus de 50ans). La prévalence de l'infection à H.pylori était de 63,0% (17/27) pour l'ulcère duodénal, 50%(4/8) pour l'ulcère gastrique et 100%(2/2) pour le cancer gastrique.ConclusionA prévalence de l'infection à H.pylori au Cameroun est très élevée et significativement liée à l’âge de moins de 40 ans.

ObjectivesTo document patients’ and healthcare professionals’ (HCP) experiences with hepatitis B virus (HBV) and hepatitis C virus (HCV) diagnosis and care, as well as consequences of these infections on patients’ life trajectories in Cameroon, an endemic country in sub-Saharan Africa.DesignQualitative sociological study combining in-depth interviews and observations of medical consultations. Interviews and observations transcripts were thematically analysed according to the following themes: circumstances and perceptions surrounding hepatitis screening, counselling and disclosure, information provided by HCP on hepatitis prevention and treatment, experience of access to care and treatment, social/economic trajectories after diagnosis.SettingHIV and gastroenterology/medical services in two reference public hospitals in Yaoundé (Cameroon).Participants12 patients affected by HBV and/or HCV (co-infected or not with HIV), 14 HCP, 14 state and international stakeholders.FindingsMany patients are screened for HBV and HCV at a time of great emotional and economic vulnerability. The information and counselling delivered after diagnosis is limited and patients report feeling alone, distressed and unprepared to cope with their infection. After screening positive, patients struggle with out-of-pocket expenditures related to the large number of tests prescribed by physicians to assess disease stage and to decide whether treatment is needed. These costs are so exorbitant that many decide against clinical and biological follow-up. For those who do pay, the consequences on their social and economic life trajectories are catastrophic.ConclusionLarge out-of-pocket expenditures related to biological follow-up and treatment pose a real challenge to receiving appropriate care. Free or reasonably priced access to hepatitis B and C treatments can only be effective and efficient at reducing the hepatitis disease burden if the screening algorithm and the whole pretherapeutic assessment package are simplified, standardised and subsidised by comprehensive national policies orientated towards universal healthcare.

BackgroundWhile influenza surveillance has increased in most developing countries in the last few years, little influenza surveillance has been carried out in sub-Saharan Africa and no information is available in Central Africa. The objective of this study was to assess the prevalence of influenza viruses circulating in Yaounde, Cameroon and determine their antigenic and genetic characteristics.MethodsThroat and/or nasal swabs were collected from November 2007 to October 2008 from outpatients with influenza-like illness (ILI) in Yaounde, Cameroon and analyzed by two different techniques: a one-step real time reverse transcription-polymerase chain reaction (RT-PCR) and virus isolation in MDCK cells. Typing and subtyping of virus isolates was performed by hemagglutination inhibition (HI), and viruses were sent to the WHO Collaborating Centre in London, UK for further characterization and analyses of antiviral resistance by enzyme inhibition assay and nucleotide sequencing.ResultsA total of 238 patients with ILI were sampled. During this period 70 (29%) samples were positive for influenza by RT-PCR, of which only 26 (11%) were positive by virus isolation. By HI assay, 20 of the 26 isolates were influenza type A (10 H3N2 and 10 H1N1) and 6 were influenza type B (2 B/Victoria/2/87 lineage and 4 B/Yagamata/16/88 lineage). Seven (70%) of the H1N1 isolates were shown to be resistant to oseltamivir due to a H275Y mutation.ConclusionsThis study confirmed the circulation of influenza A(H1N1), A(H3N2) and B viruses in the human population in Central Africa and describes the emergence of oseltamivir-resistant A(H1N1) viruses in Central Africa.

BackgroundHepatocellular Carcinoma (HCC) is one of the commonest cancers in Central Africa, a region with the unusual peculiarity to be hyperendemic for infections with Hepatitis B, C and D viruses. However, data estimating the respective proportions of HCC cases attributable to these viruses are still limited in this area. The current study was undertaken to determine the role of these viruses in HCC compared to non-HCC Cameroonian patients.MethodsA case–control study was conducted in the Gastroenterology Unit of Central Hospital of Yaounde in collaboration with Centre Pasteur of Cameroon. Blood samples of all HCC cases (n = 88) and matched control individuals without known liver disease (n = 85) were tested for serological markers of Hepatitis B, C and D viral infections using commercially available enzyme immune-assay kits. Hepatitis B and C viral loads were quantified for positive patients by real-time PCR using commercial kits.ResultsThe mean age was 46.0 ± 18 and 42.1 ± 16 years old for HCC-patients and controls, respectively for a 2.3 Male/Female sex ratio. The prevalence of hepatitis B surface antigen, antibody to HCV and antibody to HDV were significantly higher in HCC patients (65.90, 20.26 and 26 % respectively) than in control patients (9.23, 4.62 and 1 %) (P < 2.5 10−5). The risk factors analysis showed that both HBV and HCV infections were strongly associated with HCC development in Cameroon with crude odds ratios of 15.98 (95 % CI 6.19-41.25) and 7.33 (95 % CI 2.09-25.77), respectively. Furthermore, the risk of developing HCC increased even more significantly in case of HBV and HDV co-infections with the odd ratio of 29.3 (95 % CI, 4.1-1231). HBV-DNA level was significantly higher in HBsAg-positive HCC-patients than in HBsAg-positive controls with (6.3 Log IU/mL and 5.7 Log IU/mL) respectively (P < 0.05).ConclusionHBV and HCV infections are the mains factors of HCC development in Cameroon. Our results show that patients co-infected with HDV are at very high risk to develop HCC. An active surveillance program of patients and, foremost, an easier access to antivirals and primary prevention measures are crucial steps to reduce the incidence of HCC in this country. Due to the lack of truly efficient antiviral therapy, the fate of HDV-infected patients remains, however, particularly worrying.