COVID-19 in a Region of Cameroon hit by armed conflict

Abstract

Introduction the emergence of more transmissible SARS-CoV-2 variants like Delta and Omicron have triggered the next wave of COVID-19 in many parts of the world. Here we report a surge in COVID-19 cases and deaths in the Northwest (NW) Region of Cameroon, which is plagued with low immunization coverage and armed conflict. Methods a cross-sectional study was conducted in September 2021 and data on COVID-19 cases and vaccination were reviewed from the Ministry of Health database from January 1 st , 2020 to September 4 th , 2021. The security situation of the region was obtained from the districts and regional health managers. Data were analyzed with MS Excel and results presented as trends and proportions. Results since the onset of COVID-19 pandemic, there is an increasing prevalence in cases in the NW. Between epidemiological week 34-35 of 2021, there was a surge in COVID-19 cases in the NW. More than 70% of all COVID-19 related deaths reported in the country during epidemiological week-35 were recorded in this region. Despite this high mortality, COVID-19 vaccine uptake remains very low in the region. Indeed, just 0.6% of the 962,036-target population 18-years and above are fully immunized after 6-months of vaccination. Conclusion though the country´s epi-curve does not suggest a third wave currently, the NW is experiencing a steady COVID-19 case surge amid insecurity and the circulation of the Delta variant. There is therefore a need to adopt innovative strategies to improve immunization and strengthen other SARS-CoV-2 preventive measures in this region.

Impact of periodic intensification of routine immunization within an armed conflict setting and COVID-19 outbreak in Cameroon in 2020

“…With the emergence of this disease, there was a global disruption of health service delivery. There were curfews, restrictions of movements, and mass interventions, including access to healthcare and outreach vaccination services globally and in Cameroon [ 20 , 32 ]. This pandemic further caused millions of children to miss their vaccine doses and favored outbreaks worldwide, particularly in the African Region [ 9 , 32 ].…”

“…Notwithstanding, the first case of COVID-19 was reported in Cameroon in March 2020, and this region investigated its first case about a month later [ 38 ]. Though fewer disease cases were reported in SW, the prevalence of the COVID-19 continued to increase every week [ 13 , 20 , 21 ].…”

“…Even though none of the health workers involved in PIRI presented with COVID-19 symptoms during and three weeks following PIRI, the risk of COVID-19 spread remained. Moreover, in early 2020, screening for COVID-19 was not common, especially in the rural communities of Cameroon [ 20 ]. Also, at the onset, polymerized chain reaction (PCR) was the primary test done in three diagnostic sites located in the center and littoral regions of the country [ 39 ].…”

“…This region was hit by insecurity in late 2016, resulting in the mass displacement of a considerable proportion of its population. The conflict has also resulted in the looting and destruction of health facilities, abduction and killing of health workers, and distortion of the health system in the region [ 19 , 20 ]. On April 2, 2020, the region recorded its first case of COVID-19.…”

“…This crisis was also associated with the deterioration of the surveillance indicators of the significant vaccine-preventable diseases (measles, yellow fever, polio, and neonatal tetanus) [ 19 ]. A surge in vaccine-preventable conditions and low vaccine uptakes are associated with armed violence and vaccine hesitance to life-saving vaccines in this setting [ 20 , 21 ].…”