PROJETS RÉALISÉS
This project aims at reducing the morbidity of COVID-19 in Douala through early case detection (at community and health facility level) and sensitization to reduce exposure to a risk of contamination.
Funders: CDC (Center for Disease Control and Prevention) through the Global Health Security Agenda program, with the intermediary of IMC (International Medical Corps).
Partners:
- The Ministry of Public Health, Cameroon
- Littoral Regional Delegation of Public Health
- Bangue District Health Service
- Bonassama District Health Service
- Deido District Health Service
- Cite des Palmiers District Health Service
- Meilleur Accès aux Soins de Santé (M.A. SANTE)
Period: From January 1, 2021 to September 30, 2021
Team members: Project coordinator: Pr. Jérôme ATEUDJIEU ; Project supervisor: M. Trevor MBOH ANYAMBOD ;Assistant project supervisor: M. Yves Le grand NAPA TCHUEDJI ; Monitoring and Evaluation officer: M. NTSEKENDIO Paul NYIBIO ; Data Manager: M. Hervé TCHOKOMENI
Summary:
Cameroon is facing COVID-19 outbreak since March 6, 2020. In November 18, 2020, the 56th SitRep reported 23,528 confirmed cases, 435 deaths (CFR=1.8%), 169/190 (88.9%) districts affected and 916 active cases over the national territory. Littoral, including Douala, is one of the most affected and vulnerable regions of the country in terms of confirmed cases and deaths1,. It is known to carry the highest burden of health personnel (553 affected) and pregnant women affected (72 affected). Despite the interventions implemented by the Cameroon Ministry of health and partners, the spread of the disease continues.
REMMOCC project is implemented in Cameroon since January 2021 with the aim of reducing the mortality and morbidity of COVID 19 in Douala through health facility and community based activities. The projects’ activities target the most affected health districts of Douala in terms of COVID 19. In order to reach the objective, community health volunteers were trained to sensitize households on COVID 19 contamination and prevention, and to identify suspected cases in households. They implemented household sensitization and surveillance of suspected cases from March to September 2021. Case detection was also done in each health facility by dedicated focal points through registers’ review. Identified suspected cases were tested, linked to care and their contacts identified for potential positive cases detection. In the framework of the project, health facilities’ and health districts’ surveillance focal points and data managers were also trained on epidemiological surveillance and data analysis respectively.
Activities:
Conduction of a baseline situational analysis in the targeted health district ; Training of community volunteers and health facilities’ focal points ; Household sensitization activities ; Household surveillance (suspected case identification) and reporting ; Health facility-based surveillance (case detection and testing, investigation and contact tracing) ; Project end survey ; Preliminary results restitution to Littoral local health authorities
Publications:
- In progress
This project aimed at reducing mother to child HIV transmission (MTCT) by improving access to PMTCT (Prevention of Mother-to-Child Transmission) services with involvement of traditional birth attendants (TBA) in two health districts in the Far North region of Cameroon.
Funder: Positive Action for Children Fund (PACF)
Partners:
- Cameroon Ministry of Public Health
- Mada and Kousseri Health Districts
- Meilleur Accès aux soins de Santé (M.A. SANTE)
Period: From April 2018 to April 2020.
Team members:
Project coordinator: Pr. ATEUDJIEU Jérôme; Mepoubong Kengne Alida ; Ayam Mey ; Sitena Ouma
Summary
In the Northern region of Cameroon, most pregnant women give birth at home (due to limited access to antenatal care interventions) with the assistance of unskilled birth attendants. Prevention of Mother-to-Child Transmission (PMTCT) of HIV is among the key HIV prevention strategies set by the Cameroon National AIDS Control Committee (NACC) to fight HIV/AIDS. Despite efforts being done in the implementation of this strategy, PMTCT implementation remains suboptimal especially in this region endowed with numerous restrictive factors such as: spontaneous terrorist attacks, poor access to healthcare services, low income status, harsh climatic conditions, limited access to electricity, water and sanitation, and bad road network.
M.A.SANTE implemented the AT-PMEL project from April 2018 to April 2020 in Mada and Kousseri Health Districts situated in the lake Chad Basin in the Far North region of Cameroon. HIV screening sessions (targeting mainly pregnant women with the aim to refer them to health facilities for better healthcare) were organised in collaboration with traditional birth attendants and health facilities. PMTCT activities were done in health facilities and communities of Mada and Kousseri Health Districts. An end line survey was equally implemented by collecting and comparing data on some key indicators in the targeted and neighboring control communities.
Activities
- Development of protocol, procedures and tools
- Training of traditional birth assistants, health facility focal points and supervisors
- Field project implementation
- Implementation of end line survey
- Report drafting
Publication:
- In progress
The primary aim of this project was to determine changes in the vibriocidal geometric mean titers (GMT) in participants who received the second dose of oral cholera vaccine (OCV) at different intervals: 2 weeks, 6 months and 11 months following the first dose of vaccine administration.
Funder: DOVE Project John Hopsking University
Partners :
- Ministry of Public Health
– Division de la Recherche Opérationnelle en Santé (DROS)
-. Cameroon National Ethics Committee for Human Health Research
- John Hopkins Bloomberg School of Public Health, USA
- Meilleur Accès aux soins de Santé (M.A. SANTE)
Period: October 2018 to February 2020
Team members:
Principal investigator: Pr. David Sack, M.D. Johns Hopkins Bloomberg School of public Health, USA ; Project coordinator : Pr. ATEUDJIEU Jérôme ; Nafack Sonia ; Kengmo Ismael ; Maponjou Sybelle ; Beyala Landry ; Ayor Tembei Maureen
Summary
Cholera is a life-threatening disease. Compliance with hygiene measures and vaccination are among other measures to fight against the disease. Oral cholera vaccine (OCV) is now being used widely to prevent cholera in areas at risk. The standard dosing schedule of OCV is two doses with the second dose given 2 weeks after the first dose. This project was conceived and implemented to assess whether the immune response of the second dose of oral cholera vaccine (OCV) administered at extended intervals (2 weeks, 06 months and 11 months) is equivalent to that of the manufacturer which is two weeks after the first dose. After obtaining administrative authorizations and ethical clearance consent participants were recruited. Vaccination and blood collection were done during a year and a half at the Medical Center of Soboum located in the Littoral region of Cameroon. Serum samples were analyzed at M.A. SANTE Laboratory to determine the vibriocidal response at different periods of time. Results from this project are expected to serve as evidence to improve the use and efficiency of OCV during outbreaks.
Activities:
– Obtaining administrative authorizations and Ethical clearance
– Community sensitization
– Enrolment of participants
– Vaccination and follow-up of participants
– Pharmacovigilance of participants
– Sample analyses in the laboratory
Publications:
– In progress
In Cameroon, knowledge about the ethical and administrative evaluation of clinical research and participant protection remains limited; and the recommended system for detecting, reporting, investigating and preventing known and unknown adverse events following drug exposure exists, but it is not implemented in health facilities and does not work well in drug-using health programmes.
BREESAFCA (« Strengthening the regulatory framework to upgrade ethical review of clinical research and drugs safety monitoring in Cameroon ») is a project that aims to strengthen the protection of research participants and pharmacovigilance through the strengthening of regulatory frameworks in research ethics and pharmacovigilance, the establishment of Human Health Research Ethics Committees and pharmacovigilance units, and the training of Human Health Research Ethics Committee
members, researchers, and pharmacovigilance personnel in Cameroon. This project is funded by EDCTP (« European&Developing Countries Clinical Trial Partnership ») and is implemented by the Division of Operational Health Research, the Directorate of Pharmacy, Medicines and Laboratories of the Ministry of Public Health of Cameroon, the Research Ethics Committee and the NGO M.A. SANTE (Better Access to Health Care). The prerequisite for the above-mentioned training is the conduct of a needs assessment study on training in research ethics and pharmacovigilance by M.A. SANTE. It is expected that this study will identify and prioritise training needs and targets in terms of the protection of research participants so that these can be used in the programming and design of the training modules planned within the framework of the BREEDSAFCA project.
RESEARCH QUESTION
What are the different training needs in ethics for the protection of research participants and in pharmacovigilance in Cameroon
OBJECTIVES
Assess training needs for the protection of research participants and in pharmacovigilance in Cameroon.
Methodology
It was a descriptive cross-cutting study that collected data on one hand on the training needs in research ethics from members of Human Health Research Ethics Committees, researchers, and training institutes; and on the other hand on the training needs in pharmacovigilance for health personnel, pharmacists, health training and health programmes in Cameroon using specific questionnaires pre-tested and administered face-to-face. The data was collected during the period of June 2020 by trained investigators.
ACTIVITIES
The activities that are carried out so far are :
– Development of the protocol and data collection tools ;
– Pretext of the data collection tools ;
– Submission of the Protocol to the National Research Ethics Committee;
– Submission of the protocol to the different target institutions of the project for obtaining administrative authorisations;
– Development of the digital tools for the survey;
– Training of supervisors and investigators;
– Data collection;
– Data processing;
Future activities to be carried out are data analysis, report writing and dissemination of results to project partners. The results of this research will be used for the programming and design of the training modules planned within the framework of the BREEDSAFCA project.
The primary aim of the project was to describe the epidemiology of cholera in the Far North region of Cameroon, investigate its seasonality and identify effective cholera surveillance methods for resource-limited settings.
Funder:
Bill and Melinda Gates Foundation (as part of the DOVE project “Delivering Oral Cholera Effectively”)
Partners:
– Johns Hopkins Bloomberg School of public Health
-Meilleur Accès aux Soins de Santé (M.A. SANTE)
Study team
-Pr David Sack (Principal investigator), Pr Ateudjieu Jerome (Local principal investigator), Mr. Yakum Martin Ndinakie (in charge of Follow-up of activities), Miss NOUETCHOGNOU Julienne Stephanie (Monitor), Mr. EBILE Akoh Walter (Data manager)
Project description
The current perception of cholera in Africa is that outbreaks occur suddenly and unexpectedly. To verify this hypothesis in the Cameroon context, this project was implemented to demonstrate the established seasonality of Cameroon. We conducted a cholera surveillance system in the Far North region of Cameroon using innovative epidemiological and laboratory methods which are sustainable for resource limited settings. This project was conducted from 2013 in the Far North region of Cameroon as it was the region with the most reported cases of cholera and presented many at risks factor such as being bordered by the Lake Chad. Prior to the study, administrative authorizations were obtained, the protocol developed and approved by the national ethics committee in human health research. Six health facilities from the health districts of Kousseri, Mada, Makary and Goulfey were selected at sentinel sites. In the study sites, study nurses were trained to enroll by collecting diarrhea samples of study participants who visited health facilities for treatment of severe watery diarrhea and dehydration. Combined to the latter, environmental samples of surface water sources were collected periodically to ensure joint environmental surveillance. The samples were used to conduct clinical analysis for cholera identification including dipsticks tests and molecular methods.
The results of this project are expected to describe the epidemiology and seasonality of cholera in Cameroon.
The following activities were carried:
– Obtention of administrative authorization and ethical clearance
– Enrolment of participants in the study; Samples’ collection ; Samples’ analysis in the laboratory
Results’ dissemination
The results of the project and the main recommendations were presented to local health authorities of the Far North region and to the Cameroon Ministry of Public Health.
Publications
– Ateudjieu, J., Yakum, M.N., Goura, A.P. et al. Health facility preparedness for cholera outbreak response in four cholera-prone districts in Cameroon: a cross sectional study. BMC Health Serv Res 19, 458 (2019). https://doi.org/10.1186/s12913-019-4315-7
– Yakum MN, Ateudjieu J, Guenou E, Walter EA, Ram M, Debes AK, Njimbia AC, Nafack SS, Sack DA. Health seeking behaviour among suspected cases of cholera in Cameroonian health districts in Lake Chad basin. BMC Res Notes. 2017 Aug 30;10(1):433. doi: 10.1186/s13104-017-2756-9. PMID: 28854951; PMCID: PMC5577771.
Thèse présentée et soutenue publiquement en vue de l’obtention du diplôme de Master Professionnel en Epidémiologie et Santé Publique au Département des Sciences Biomédicales, Faculté des Sciences, Université de Dschang
Année académique 2013-2014
Etudiant : SAAH FOPA Michael Amedé 1
Directeur : Dr ATEUDJIEU Jérôme, MD, MPH, Ph.D 123
jateudj@yahoo.fr ; Jerome.ateudjieu@masante-cm.org
Superviseur: Pr TUME Christopher, Ph.D, MC 1
Financé par: DOVE PROJECT
Abstract
Justification : Au Cameroun, l’accès à l’eau potable est encore limité et inégalement repartit sur le territoire national avec des tableaux alarmants à la partie septentrionale du pays. Dans le but de contribuer à la réduction de la mortalité et la morbidité due aux maladies diarrhéiques, nous proposons d’évaluer la relation entre les comportements des populations liés à l’eau et la survenue des cas de diarrhée dans le ménage.
Matériels et méthodes : Une étude transversale descriptive suivant un échantillonnage aléatoire à plusieurs niveaux a été menée du 1er Décembre 2013 au 2 Février 2014 dans les Districts de Santé de Goulfey, Mada et Makary. Les données ont été collectées par administration en face à face d’un questionnaire structuré dans les ménages et par une grille d’observation pour les points d’eau.
Résultats : Quatre-vingt communautés issues de 17 Aires de Santé sur 26 ont été incluses. Parmi les 531 familles visitées, 527 (99,3%) ont été interviewées couvrant ainsi une population de 4786 personnes avec 1408 enfants de moins de 5 ans. Nous avons recensé 288 points d’eau artificiels et 29,5% étaient non fonctionnels. Parmi les points d’eaux fonctionnels, 30,5% (60) ont été classés comme améliorés, et probablement non contaminés. La plupart des ménages (66,2%) utilisaient principalement le forage comme source d’eau et les eaux de surface étaient aussi utilisées dans 6% des ménages. Vingt-quatre soit 4,5% des ménages étaient connectés à un réseau de distribution CDE, 7% (37) des foyers avaient un bon accès géographique à une source d’eau potable. Des comportements inadéquats des ménages ont été recensés lors du choix des sources d’eau (21,5%) ; lors de la collecte et du transport de l’eau (42,7%) ;lors du stockage de l’eau (81,5%) et lors de l’utilisation (73,8%).Nous avons noté une prévalence de la morbidité diarrhéique de 13,3% en générale et de 25,9% chez les enfants de moins de 5 ans pendant les deux semaines précédant l’enquête. Le type de source d’eau utilisé; le rôle des enfants dans la collecte et le transport de l’eau étaient les principaux déterminants comportementaux liés à l’eau statistiquement associés à l’incidence d’au moins un cas de diarrhée avec respectivement les rapports de côtes de 2,09 et 2,43 et des valeurs-P de 0,002 et 0,001.
Conclusion : Dans le bassin du Lac Tchad, l’accès à l’eau est limité et inégalement répartie. Les habitudes inadéquates liées à l’eau contribuent à augmenter la fréquence des diarrhées. Afin de renverser cette tendance, l’identification des stratégies pour la pérennisation de l’approvisionnement en eau et le changement des comportements liés à l’eau seront utiles.
Mots clés : comportement, accès à l’eau, maladies diarrhéiques, facteurs de risques, Lac Tchad
- Département des Sciences Biomédicales, Faculté des Sciences, Université de Dschang
- Division de la Recherche Opérationnelle en Santé, Ministère de la Santé publique du Cameroun
- A. SANTE (Meilleur Accès aux Soins de Santé)
Thèse présentée et défendue publiquement en vue de l’obtention du Master Professionnel en Epidémiologie et Santé Publique, Département des Sciences Biomédicales, Faculté des Sciences, Université de Dschang.
Année académique 2013-2014
Etudiante : NAFACK SONKENG Sonia 1
Directeur : Dr ATEUDJIEU Jérôme, MD, MPH, Ph.D 123
jateudj@yahoo.fr ; Jerome.ateudjieu@masante-cm.org
Financé par: DOVE PROJECT ; M.A. SANTE
Abstract
Justification : La surveillance épidémiologique est une des stratégies de lutte contre les cancers du col de l’utérus. Au Cameroun, elle n’est pas accessible aux populations de tous les niveaux de la pyramide sanitaire à cause de l’absence de stratégie de surveillance adéquate. L’objectif de cette étude était d’évaluer la faisabilité de la mise en place d’une surveillance épidémiologique continue des cancers du col de l’utérus dans le District de Santé de Dschang.
Méthodes : Il s’agissait d’une étude transversale, descriptive et analytique qui a impliquée pendant quatre mois l’évaluation de la disponibilité des ressources et des Connaissances et Attitudes Pratiques (CAP) du personnel soignant du District de Santé de Dschang sur les cancers du col. Une surveillance épidémiologique de trois mois du cancer du col a été mise en place chez les femmes âgées de 20 à 65 ans à l’Hôpital de District de Dschang (HDD) par l’inspection visuelle du col de l’utérus et le frottis cervical.
Résultats : Quatre-vingt personnels de santé, 30 Formations Sanitaires ainsi que 528 femmes ont été incluses dans cette étude. 38,8% du personnel de santé disent que le déterminant principal du cancer du col de l’utérus est le Virus du Papillome Humain ; 21,3% savent que la prévention peut se faire par la vaccination. 42(52,5%) personnels affirment qu’i1 faut prescrire le frottis devant une femme malade et 19% personnels déclarent l’avoir déjà prélevé. Vingt huit structures de santé (93,3%) avaient le nécessaire pour le prélèvement du frottis tandis que, 12(40%) disposaient du matériel nécessaire pour la réalisation de l’Inspection Visuelle du col après application de l’Acide acétique et du Lugol Iodine (VIA/VILI). Par rapport à la fréquence de femmes régulièrement enregistré à l’HDD, la surveillance épidémiologique mise sur pied a permis de dépister 54 fois plus de femmes. Au cours de cette période, 38(7,8%) lésions précancéreuses (frottis) et 234 (48%) cas de marquage au VIA/VILI ont été répertoriés.
Conclusion : La mise en place d’une surveillance épidémiologique continue des cancers du col est faisable dans un Hôpital de District ; pour une conduite adéquate, il serait nécessaire de l’approvisionner en un minimum de ressource et d’améliorer la formation du personnel de santé sur la surveillance de cette pathologie.
Mots clés : Surveillance épidémiologique, cancer, col de l’utérus, District de Santé, Dschang.
1-Département des Sciences Biomédicales, Facultés des Sciences, Université de Dschang
2-Division de la Recherche Opérationnelle en Santé, Ministère de la Santé Publique, Cameroun
3-M.A. SANTE (Meilleur Accès aux Soins de Santé/ Better Access to Health Care)