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Search Results: 1 - 10 of 12403 matches for " Christopher Kuaban "
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HIV testing, HIV status and outcomes of treatment for tuberculosis in a major diagnosis and treatment centre in Yaounde, Cameroon: a retrospective cohort study
Yone Eric,Kuaban Christopher,Kengne André
BMC Infectious Diseases , 2012, DOI: 10.1186/1471-2334-12-190
Abstract: Background Human immuno-deficiency virus (HIV) infection and tuberculosis are common and often co-occurring conditions in sub-Saharan Africa (SSA). We investigated the effects of HIV testing and HIV status on the outcomes of tuberculosis treatment in a major diagnosis and treatment centre in Yaounde, Cameroon. Methods Participants were 1647 adults with tuberculosis registered at the Yaounde Jamot’s Hospital between January and December 2009. Multinomial logistic regression models were used to relate HIV testing and HIV status to the outcomes of tuberculosis treatment during follow-up, with adjustment for potential covariates. Results Mean age of participants was 35.5 years (standard deviation: 13.2) and 938 (57%) were men. Clinical forms of tuberculosis were: smear-positive (73.8%), smear-negative (9.4%) and extra-pulmonary (16.8%). Outcomes of tuberculosis treatment were: cure/completion (68.1%), failure (0.4%), default (20.1%), death (5.2%) and transfer (6.3%). Using cure/completion as reference, not testing for HIV was associated with adjusted odds ratio of 2.30 (95% confidence interval: 1.65-3.21), 2.26 (1.29-3.97) and 2.69 (1.62-4.46) for the risk of failure/default, death and transfer respectively. The equivalents for a positive test among those tested (1419 participants) were 1.19 (0.88-1.59), 6.35 (3.53-11.45) and 1.14 (0.69-1.86). Conclusions Non-consent for HIV testing in this setting is associated with all unfavourable outcomes of tuberculosis treatment. However been tested positive was the strongest predictor of fatal outcome. Efforts are needed both to improve acceptance of HIV testing among patients with tuberculosis and optimise the care of those tested positive.
Spirometric Reference Equations for Semi-Urban and Urban Bantu Cameroonians  [PDF]
Eric Walter Pefura-Yone, Nadine Fleurette Kanko-Nguekam, André Pascal Kengne, Adamou Dodo Balkissou, André Noseda, Christopher Kuaban
Open Journal of Respiratory Diseases (OJRD) , 2013, DOI: 10.4236/ojrd.2013.34025
Abstract: Background: Spirometric reference values vary substantially across ethnic groups, and remain largely poorly characterized among Africans. We derived spirometric reference equations for adult Cameroonians and compared their performance with those derived from other ethnic groups. Methods: Spirometric variables according to the American Thoracic Society/European Respiratory Society 2005 guidelines were acquired in voluntary healthy non-smoker subjects in Yaounde (Capital City) and Foumbot (semi-urban area in West Region), in Cameroon during November 2011 to January 2012 (Yaounde) and August 2012 (Foumbot). Reference equations were derived separately for men and women from multiple linear regressions. Results: A total of 411 subjects (206 men) met the inclusion criteria. The mean age was 39.5 ± 16.1 years (min - max: 18 - 85 years) for men and 39.2 ± 14.1 years (18 - 90 years) for women. Age and height were the only variables significantly associated with spirometric values in the final linear regression models. Derived reference values were lower than those derived from Global Lung Initiative 2012 equations for different ethnic groups, except for the forced expiratory volume in 1 second/forced vital capacity ratio (FEV1/FVC ratio). The mean FEV1/FVC ratio was 0.88 ± 0.07 for Cameroonian men and 0.89 ± 0.07 for Cameroonian women. Variations in the performance of derived models in bootstrap internal validation were marginal. Conclusion: This study highlights the importance of deriving specific predictive equations for each ethnic group. The use of adjustment factors applied to Caucasian equations when compared with the values derived in our study leads to an overestimation of the values for FEV1 and FVC.
Influence of HIV infection on the clinical presentation and outcome of adults with acute community-acquired pneumonia in Yaounde, Cameroon: a retrospective hospital-based study
Eric Walter Yone, Adamou Balkissou, André Kengne, Christopher Kuaban
BMC Pulmonary Medicine , 2012, DOI: 10.1186/1471-2466-12-46
Abstract: Medical files of 106 patients (51 men) aged 15?years and above, admitted to the Pneumology service of the Yaounde Jamot Hospital between January 2008 and May 2012, were retrospectively studied.Sixty-two (58.5%) patients were HIV infected. The median age of all patients was 40?years (interquartile range: 31.75-53) and there was no difference in the clinical and radiological profile of patients with and without HIV infection. The median leukocyte count (interquartile range) was 14,600/mm3 (10,900-20,600) and 10,450/mm3 (6,400-16,850) respectively in HIV negative and HIV positive patients (p?=?0.002). Median haemoglobin level (interquartile range) was 10.8?g/dl (8.9-12) in HIV negative and 9.7?g/dl (8–11.6) in HIV positive patients (p?=?0.025). In-hospital treatment failure on third day (39.5% vs. 25.5.1%, p?=?0.137) and mortality rates (9% vs. 14.5%, p?=?0.401) were similar between HIV negative and HIV positive patients.Clinical and radiological features as well as response to treatment and in hospital fatal outcomes are similar in adult patients hospitalised with acute community-acquired pneumonia in Yaounde. In contrast, HIV infected patients tend to be more anaemic and have lower white cell counts than HIV negative patients. Larger prospective studies are needed to consolidate these findings.Acute community-acquired pneumonia (CAP) is a common cause of morbidity and mortality in sub-Saharan Africa (SSA)[1-3], where it is highly frequent in people with HIV infection [4]. The possible effects of HIV infection on the evolution of CAP are still controversial. For instance, whether HIV infection negatively impacts on fatal outcome in patients with CAP is still uncertain [1,3,5-7], justifying at times the exclusion of HIV patients from trials on CAP [6]. In spite of the proven efficacy of empirical antibiotic treatment on CAP in people with HIV [8-10], the management of the condition in SSA is still compromised by the lack of bacteriological investigations. Moreover, the
Estimates of Genetic Variability of Mycobacterium tuberculosis Complex and Its Association with Drug Resistance in Cameroon  [PDF]
Larissa Kamgue Sidze, Emmanuel Mouafo Tekwu, Christopher Kuaban, Jean-Paul Assam Assam, Jean-Claude Tedom, Stefan Niemann, Matthias Frank, Véronique N. Penlap Beng
Advances in Infectious Diseases (AID) , 2013, DOI: 10.4236/aid.2013.31007
Abstract:

The present study investigates the genetic diversity among Mycobacterium tuberculosis complex circulating in the Centre region of Cameroon and analyzes the relationship between genotypes and drug resistance patterns. Spoligotyping was performed by PCR-amplification followed by the reverse hybridization of 298 cultured specimens. Spoligotypes patterns were identified by comparison to reference strains in SPolDB4 database via the MIRU VNTR plus web application. About 97.65% of all tuberculosis (TB) cases were attributed to M. tuberculosis. A total of 65 different profiles were identified. Of these, 40 were represented as Shared Types (ST) while the others were orphans. LAM10_CAM and Haarlem families were the most prevalent genetic families with 51.01% and 14.09% respectively. ST 61, a member of the LAM10_ CAM family formed the largest cluster with 128 (42.95%) isolates. No association was found between genotypes with regard to drug resistance and HIV sero-status. However, there was a significant association between genotypes and age groups. Patients belonging to 15 - 24 and 35 - 44 age groups were more likely infected by LAM10_CAM strains compared to others. The population structure of Mycobacterium tuberculosis complex strains from the Centre region was found to be diverse and the spoligotype 61 of the LAM10_CAM family was highly predominant. Isolates of the LAM10_CAM seem to be not associated with drug resistance.

Central African Field Epidemiology and Laboratory Training Program: building and strengthening regional workforce capacity in public health
Gervais Ondobo Andze, Abel Namsenmo, Benoit Kebella Illunga, Ditu Kazambu, Dieula Delissaint, Christopher Kuaban, Francois-Xavier Mbopi-Kéou, Wilfred Gabsa, Leopold Mulumba, Jean Pierre Bangamingo, John Ngulefac, Melissa Dahlke, David Mukanga, Peter Nsubuga
Pan African Medical Journal , 2011,
Abstract: The Central African Field Epidemiology and Laboratory Training Program (CAFELTP) is a 2-year public health leadership capacity building training program. It was established in October 2010 to enhance capacity for applied epidemiology and public health laboratory services in three countries: Cameroon, Central African Republic, and the Democratic Republic of Congo. The aim of the program is to develop a trained public health workforce to assure that acute public health events are detected, investigated, and responded to quickly and effectively. The program consists of 25% didactic and 75% practical training (field based activities). Although the program is still in its infancy, the residents have already responded to six outbreak investigations in the region, evaluated 18 public health surveillance systems and public health programs, and completed 18 management projects. Through these various activities, information is shared to understand similarities and differences in the region leading to new and innovative approaches in public health. The program provides opportunities for regional and international networking in field epidemiology and laboratory activities, and is particularly beneficial for countries that may not have the immediate resources to host an individual country program. Several of the trainees from the first cohort already hold leadership positions within the ministries of health and national laboratories, and will return to their assignments better equipped to face the public health challenges in the region. They bring with them knowledge, practical training, and experiences gained through the program to shape the future of the public health landscape in their countries. Pan African Medical Journal 2011; 10(Supp 1):4
Strong Decrease in Streptomycin-Resistance and Absence of XDR 12 Years after the Reorganization of the National Tuberculosis Control Program in the Central Region of Cameroon
Larissa Kamgue Sidze, Emmanuel Mouafo Tekwu, Christopher Kuaban, Jean-Paul Assam Assam, Jean-Claude Tedom, Sara Eyangoh, Fran?ois-Xavier Fouda, Désiré Nolna, Francine Ntoumi, Matthias Frank, Véronique N. Penlap Beng
PLOS ONE , 2014, DOI: 10.1371/journal.pone.0098374
Abstract: Background In the 1990s, resistance rates of 15% for streptomycin-resistance and 0.6% for multidrug-resistance (MDR) were reported from the Central Region of Cameroon. This work assesses drug resistant tuberculosis in this region 12 years after reorganization of the National Tuberculosis Control Program (NTCP). Methods This cross-sectional study was conducted from April 2010 to March 2011 in Jamot Hospital in Yaoundé, Cameroon. Only patients with smear positive pulmonary tuberculosis were included. Sputa were cultured and subsequently underwent drug susceptibility testing (DST). All consenting individuals were tested for their HIV status. Results A total of 665 smear positive pulmonary tuberculosis patients were enrolled. The HIV prevalence was 28.5% (95%CI [25.2–32.1]). Of the 582 sputa that grew Mycobacterium tuberculosis complex species, DST results were obtained for 576. The overall resistance rate was 10.9% (63/576). The overall resistance rates for single drug resistance were: isoniazid-resistance 4.7% (27/576), streptomycin-resistance 3.3% (19/576), rifampicin-resistance 0.2% (1/576), kanamycin-resistance 0.2% (1/576) and ofloxacin-resistance 0.2% (1/576). The MDR rate was 1.1% (6/576) and no extensively drug resistant tuberculosis (XDR) was detected. Conclusions The data show that reorganization of the NTCP resulted in a strong decrease in streptomycin-resistance and suggest that it prevented the emergence of XDR in the Central Region of Cameroon.
WHO recommended collaborative TB/HIV activities: evaluation of implementation and performance in a rural district hospital in Cameroon
HA Yumo, C Kuaban, F Neuhann
Pan African Medical Journal , 2011,
Abstract: Background: The objective of the study was to assess the implementation and the performance of recommended collaborative TB/HIV activities in Batibo District Hospital (BDH) and to determine the prevalence of HIV in TB patients in this rural locality. Methods: The implementation of collaborative TB/HIV activities was assessed through interviews with health workers in the hospital. The implementation score was calculated as the proportion of recommended activities effectively implemented in the hospital. The performance of implemented activities and the prevalence of HIV were determined through review in HIV and TB registers of routine data for the period 2003-2008. Results: The implementation of collaborative TB/HIV activities though triggered by the existence of both TB and HIV units in the hospital was only moderate with an implementation score of 50%. All implemented activities aimed at reducing the burden of HIV in TB patients. The performance of implemented activities was in average 61% (n=179) and 82% (n=77) respectively regarding HIV testing among TB patients and antiretroviral therapy coverage in TB/HIV co-infected patients. Provision of isoniazid preventive therapy (IPT) was inexistent in this hospital due mainly to the lack of tuberculin skin test and isoniazid tablets. The prevalence of HIV among TB patients in this rural locality was 53%. This prevalence was 55% in females and 44% in males (p=0.19). Conclusion: The implementation of collaborative TB/HIV activities in BDH was effective only regarding activities to reduce the burden of HIV among TB patients. There is urgent need to strengthen the capacity of this rural health facility in providing IPT services.
What Role Can Propinquity Play in the Development of New National Allegiances? Immigrant Latinos Establishing Ties to the United States through Out-Group Contact  [PDF]
Christopher Olds
Advances in Applied Sociology (AASoci) , 2012, DOI: 10.4236/aasoci.2012.21002
Abstract: Contact theory has primarily been applied to the study of interactions between Blacks and Whites, with particular emphasis on changes in the attitudes of Whites towards Blacks. How individual contact with an out-group can influence not just attitudes, but also actual behavior, has not been thoroughly explored. Through an analysis of the 2006 Latino National Survey, using a measure that contrasts the intensity of individual social interaction with various ethnic and racial groups, the study shows that a high intensity of friendly social contact with African-Americans increases the likelihood Latino immigrants will establish a closer link to the social and political structures of the United States. Latino immigrants are potentially experiencing movement towards deprovincialization through high levels of friendly social interaction with African-Americans. The development of friendly personal interactions with an out-group stigmatized in the mother country can help Latino immigrants develop an optimistic view of life in the host country.
Net primary production and carbon cycling in coast redwood forests of central California  [PDF]
Christopher Potter
Open Journal of Ecology (OJE) , 2012, DOI: 10.4236/oje.2012.23018
Abstract: A simulation model to estimate net primary productivity (NPP) has been combined with in situ measurements of soil carbon dioxide (CO2) emissions and leaf litter pools in three coast redwood forest stands on the central California coast. Monthly NPP was predicted from the CASA model using 250-meter resolution vegetation index (VI) inputs. Annual NPP was predicted to vary from 380 g·C·m-2·yr-1 to 648 g·C·m-2·yr-1 at central coast redwood sites over the years 2007 to 2010. Measured soil respiration rates at between 0.5 to 2.2 g·C·m-2·d-1 were slightly below the range of measurements previously reported for a second-growth mixed (redwood and Douglas-fir) conifer forests. Although warm monthly temperatures at the southern-most redwood forest sites evidently results in elevated stress levels to sustained redwood growth into the dry summer months of June and July, these redwood stands appear to sequester CO2 from that atmosphere into forest biomass for a net positive ecosystem carbon balance each year.
Ten Years of Vegetation Change in Northern California Marshlands Detected Using Landsat Satellite Image Analysis  [PDF]
Christopher Potter
Journal of Water Resource and Protection (JWARP) , 2013, DOI: 10.4236/jwarp.2013.55048
Abstract:

The Landsat Ecosystem Disturbance Adaptive Processing System (LEDAPS) methodology was applied to detect changes in perennial vegetation cover at marshland sites in Northern California reported to have undergone restoration between 1999 and 2009. Results showed extensive contiguous areas of restored marshland plant cover at 10 of the 14 sites selected. Gains in either woody shrub cover and/or from a recovery of herbaceous cover that remains productive and evergreen on a year round basis could be mapped out from the image results. However, LEDAPS may not be highly sensitive changes in wetlands that have been restored mainly with seasonal herbaceous cover (e.g., vernal pools), due to the ephemeral nature of the plant greenness signal. Based on this evaluation, the LEDAPS methodology would be capable of fulfilling a pressing need for consistent, continual, low-cost monitoring of changes in marshland ecosystems of the Pacific Flyway.

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