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Echis ocellatus is one of the most deadly snakes known to humans, yet the procurement of antivenom for the treatment of these snakebites in Africa has become increasingly difficult and expensive. There is no consensus for the management of victims, and little is known of actual recent experiences with these cases in ordinary health care settings in Africa. All cases of snakebite reliably identified as bites of E. ocellatus and admitted to Kolofata District Hospital, northern Cameroon, from January 1993 to December 2002 were described retrospectively or prospectively. Of 134 cases admitted, 63% were male, three-quarters were aged < 30 years, and 85% survived. Pasteur polyvalent antivenom for Africa was administered intravenously in all but 1 case, but patients rarely received more than 10 mL. In most cases, appropriate antivenom can be administered effectively at a fraction of the recommended dose (20-60 mL), even in patients with serious complications presenting days after having been bitten; however, death is more likely in late presenters.

Two-hundred-and-thirty-seven consecutive cases of neonatal tetanus treated in a rural health facility in Nigeria were reviewed. In spite of a high proportion of short incubation cases, a relatively simple, low-cost protocol yielded results compatible with those obtained in tertiary care settings in Africa. An incubation period of 6 days or less was the strongest predictor of mortality. Other prognostic factors were related to cord care and affected boys more than girls. Incidence was 40 per cent greater during the rainy season than during the dry season.

Objective: Trachoma (Chlamydia-triggered blinding infection) provoked irreversible visual impairment in about 8 million people in 2011, and the prevalence among children with dirty faces is more than three fold that among children with clean faces. In 250 villages with a high prevalence of trachoma (Kolofata district, Far North Region, Cameroon), the lack of water for facial cleanliness was reported during trachoma awareness campaigns. The objective of this study was to determine if the lack of water was linked with the absence of means to dig wells.Methods: Wells, waterholes, motorcycles, irrigation pumps, electricity, goats and oxen, cell phones and distance from waterholes were recorded in January 2011 in 50 randomized villages of Kolofata’s district.Results: The number of villages with <25 goats and <5 oxen was 0 and the number of adults owning <1 goat was 0. The cost of a pail of water was 0.01 USD. Motorcycles, cell phones and televisions have been reported in more than 66% of villages. The cost for the construction of lined shaft wells ranged between 15–35 goats and 0.5–3 oxen; the cost for drinking water wells ranged between 50–200 goats and 3–30 oxen.Discussion: No link between the means for digging wells at the village level and access to water was found. Social solidarity, which refers to a social debt owed by each person to his/her group, should be added to training guides to gauge its ability to release people from the dead end of having to wait for external assistance to gain access to water.