Cameroonian Children Research Articles

Clinical, Histologic, and Therapeutic Pattern of Posterior Fossa Tumors in Children in Cameroon: A Cross-sectional Study.

Posterior fossa tumors are significant in pediatric neurooncological populations due to their frequency and morbimortality. We convey a 10-year experience managing pediatric posterior fossa tumors at two reference centers in Cameroon. We conducted a cross-sectional study with data collected retrospectively in the Neurosurgery Department of the Central and General Hospitals of Yaounde from January 2010 to December 2019. Included in the study were all patients aged 0-15 years who underwent surgery for posterior fossa tumors. We retained 43 pediatric posterior fossa tumor files, representing 47.89% of pediatric brain tumors. The male/female sex ratio was 0.86, with a mean age of 6.93 ± 4.345 years. The predominant clinical presentations were headaches + vomiting (97.7%), visual impairment (67.4%), and altered consciousness (14%). The vermis was the most frequent site affected (46.5%). Hydrocephalus was found to be associated with the tumor in 30 patients (69.8%). Tumor excision was total in 90.7% of cases, with cerebrospinal fluid diversion performed within the surgery in 83% of cases. Pilocytic astrocytomas represented 37.2%, medulloblastomas 30.25%, ependymomas 6.9%, and brainstem gliomas 4.6%. The postoperatory mortality rate was 20.9%. The survival rate at 5 years for medulloblastomas was 43%. Pediatric posterior fossa tumors are frequent. Pilocytic astrocytomas are the most common histologic type, followed by medulloblastomas. Radical surgery is the leading standard of care. Adjuvant treatment remains limited.

Evaluation of Viral Suppression in Paediatric Populations: Implications for the Transition to Dolutegravir-Based Regimens in Cameroon: The CIPHER-ADOLA Study.

Mortality in children accounts for 15% of all AIDS-related deaths globally, with a higher burden among Cameroonian children (25%), likely driven by poor virological response. We sought to evaluate viral suppression (VS) and its determinants in a nationally representative paediatric and young adult population receiving antiretroviral therapy (ART). A cross-sectional and multicentric study was conducted among Cameroonian children (<10 years), adolescents (10-19 years) and young adults (20-24 years). Data were collected from the databases of nine reference laboratories from December 2023 to March 2024. A conditional backward stepwise regression model was built to assess the predictors of VS, defined as a viral load (VL) <1000 HIV-RNA copies/mL. Overall, 7558 individuals (females: 73.2%) were analysed. Regarding the ART regimen, 17% of children, 80% of adolescents and 83% of young adults transitioned to dolutegravir (DTG)-based regimens. Overall VS was 82.3%, with 67.3% (<10 years), 80.5% (10-19 years) and 86.5% (20-24 years), and p < 0.001. VS was 85.1% on a DTG-based regimen versus 80.0% on efavirenz/nevirapine and 65.6% on lopinavir/ritonavir or atazanavir/ritonavir. VS was higher in females versus males (85.8% versus 78.2%, p < 0.001). The VS rate remained stable around 85% at 12 and 24 months but dropped to about 80% at 36 months after ART initiation, p < 0.009. Independent predictors of non-VS were younger age, longer ART duration (>36 months), backbone drug (non-TDF/3TC) and anchor drug (non-DTG based). In this Cameroonian paediatric population with varying levels of transition to DTG, overall VS remains below the 95% targets. Predictors of non-VS are younger age, non-TDF/3TC- and non-DTG-based regimens. Thus, efforts toward eliminating paediatric AIDS should prioritise the transition to a DTG-based regimen in this new ART era.

Effectiveness of malaria chemoprevention in the first two years of life in Cameroon and Côte d’Ivoire compared to standard of care: study protocol for a population-based prospective cohort impact evaluation study

BackgroundPerennial malaria chemoprevention (PMC) is a chemoprevention strategy endorsed by the World Health Organization (WHO) and is increasingly being adopted by National Malaria Programmes. PMC aims to reduce morbidity and mortality caused by malaria and anaemia in in young children through provision of antimalarial drugs at routine contact points with the local health system. This study aims to evaluate the impact of the programmatically-implemented country-tailored PMC programmes targeting children up to two years of age using sulfadoxine-pyrimethamine (SP) on the incidence of malaria and anaemia in children in Cameroon and Côte d’Ivoire.MethodsWe will assess the impact of PMC using passive and active monitoring of a prospective observational cohort of children up to 36 months of age at recruitment in selected study sites in Cameroon and Côte d’Ivoire. The primary and secondary outcomes include malaria, anaemia and malnutrition incidence. We will also conduct a time-series analysis of passively detected malaria and anaemia cases comparing the periods before and after PMC introduction. This study is powered to detect a 30% and 40% reduction of malaria incidence compared to the standard of care in Cameroon and Côte d’Ivoire, respectively.DiscussionThis multi-country study aims to provide evidence of the effectiveness of PMC targeting children in the first two years of life on malaria and anaemia and will provide important information to inform optimal operationalization and evaluation of this strategy.Trial RegistrationCameroon - NCT05889052; Côte d’Ivoire - NCT05856357.

The Plight of the Child in Charles Dicken’s Oliver Twist and John Nkemngong Nkengasong’s Achakasara

This paper examines the ordeal of the Victorian English and Postcolonial Cameroonian children through the lenses of Charles Dickens’ Oliver Twist and John Nkemngong Nkengasong’s Achakasara. Child abuse cuts across universality, timelessness, racial and gender constructs. The child in these two societal backgrounds undergoes untold suffering perpetrated by adults and their fellow children. They are exploited for commercial purposes, at the expense of their education and wellbeing. They experience physical assault through undeserved beating under the guise of domestic correction with pending eventualities being psychological trauma. A continuity of intentional abuse consciously impacts the child to view his place of birth and development as a problem. That child sees the streets as a better option. Very high probability abounds that these streets are not suitable for the developmental processes of the child but at that point, his/her actions are shaped by convictions. Dickens and Nkengasong take interest what happens to a child, in their respective societies. They pen with certainty that conventional Victorian England and contemporary Postcolonial Cameroonian societies are fraught with different shades of injustices, jeopardising the future of the younger generations. This paper is vehiculated by the Psychoanalytic theory, with focus on Anna Freud’s dimension of Psychoanalysis. Anna Freud is a child psychoanalyst concerned with the upbringing of children. The purpose of this paper is to portray the various abuses experienced by the child as demonstrated in Dickens’ Oliver Twist and Nkengasong’s Achakasara.

Inequality of educational opportunity among primary school children in Cameroon

Despite several education policies related to the Sustainable Development Goals, educational inequalities persist at the primary school level in Cameroon. However, little is known on students’ circumstances and efforts in an attempt to reduce these inequalities. The aim of this paper therefore is to analyse inequality of opportunity in Cameroon’s primary education sector. Using the 2014 and 2019 PASEC databases, we decompose students’ reading and mathematics test scores based on Shapley and non-parametric approaches to assess the role of household, school and environmental circumstances. Results show that inequality of opportunity contributes between 38.1 % and 46.3 % of total inequality for between 2014 and 2019 in test scores. Interestingly, school factors like school type, location, resources, and class size, have a bigger impact than students’ family background. Policies to improve school conditions should focus on rural and under-resourced areas in terms of educational materials, while improving school inspections and reducing class sizes may be more effective in reducing educational inequalities.

Realising the Right to Primary Education for Refugee and Asylum-Seeking Children in Cameroon: Appraising the Legal Framework, Compliance and Challenges

Realising the Right to Primary Education for Refugee and Asylum-Seeking Children in Cameroon: Appraising the Legal Framework, Compliance and Challenges

Immunoglobulin G (IgG) specific responses to recombinant Qβ displayed MSP3 and UB05 in plasma of asymptomatic Plasmodium falciparum-infected children living in two different agro-ecological settings of Cameroon.

in areas with intense perennial malaria transmission, limited data is available on the impact of environmental conditions especially rainfall on naturally acquired immunity against promising malaria vaccine candidates. For this reason, we have compared IgG antibody responses specific to Plasmodium spp. derived MSP3 and UB05 vaccine candidates, in plasma of children living in two areas of Cameroon differing in rainfall conditions. data about children less than 5 years old was collected during the years 2017 and 2018. Next malaria asymptomatic P. falciparum (Pf) infected children were selected following malaria test confirmation. MSP3 and UB05 specific IgG antibody responses were measured in participant´s plasma using enzyme-linked immunosorbent assay (ELISA). interestingly, IgG antibody responses specific to UB05 were significantly higher (p<0.0001) in Pf-negative children when compared to their asymptomatic Pf-infected counterparts living in monomodal rainfall areas. In contrast, a significantly higher (p<0.0001) IgG response to MSP3 was observed instead in asymptomatic Pf-infected children in the same population. In addition, IgG responses specific to UB05 remained significantly higher in bimodal when compared to monomodal rainfall areas irrespective of children´s Pf infection status (p<0.0055 for Pf-positive and p<0.0001 for negative children). On the contrary, IgG antibody responses specific to MSP3 were significantly higher in bimodal relative to monomodal rainfall areas (P<0.0001) just for Pf-negative children. thus IgG antibody responses specific to UBO5 are a better correlate of naturally acquired immunity against malaria in Pf-negative Cameroonian children especially in monomodal rainfall areas.

Development of a composite scoring system to rank communities at high risk of zero-dose children in Cameroon: A geospatial analysis.

Despite growing efforts to improve access to vaccination, millions of children, especially in developing countries, have not received a single dose of diphtheria, tetanus, and pertussis (DTP) vaccine. Consequently, they are often called zero-dose children (ZDC). With limited health resources, prioritising communities for rapid and mass zero-dose catch-up vaccination in missed communities to avert epidemic outbreaks is complicated by unreliable denominators used to compute vaccination coverages. Incorporating other indicators of access and utilisation of vaccination services can help with identifying and ranking missed communities based on the likelihood of finding ZDC. We described the process of generating a scoring method to rank health areas in Cameroon based on their likelihood of containing ZDC. We used geospatial analysis to compute and aggregate health area characteristics, including hard-to-reach (HTR) areas (defined as areas of settlement above a one- (for urban areas) or 15-kilometre radius (for rural areas) beyond a vaccinating health facility), amount of area covered by slums and new area settlement, and percentage of children unvaccinated for DTP-1. We attributed a weight based on the ability to limit accessibility or utilisation of vaccination services to each characteristic and computed the score as a weighted average of health area characteristics. The health area score ranged from 0 to 1, with higher scores representing a higher likelihood of containing ZDC. We stratified the analysis by rural and urban health areas. We observed substantial district and regional variations in health area scores, with hotspots health areas (administrative level 4) observed in the Far North (0.83), North (0.81), Adamawa (0.80), East (0.75), and South West (0.67) regions. The Adamawa region had the highest percentage of health areas with the highest score (78%), followed by the East (50%), West (48%), and North (46%) regions. For most regions (Far North, South, South West, Littoral, West, and North West), DTP-1 contributed the most to the score. However, HTR settlement areas within a health area contributed substantially to the overall score in the East, North, and Adamawa regions. We found substantial variations in health area scores with hotspots in the Far North, North, Adamawa, East, and South West regions. Although DTP-1 could be used as an indicator to identify health areas with ZDC for most communities, HTR settlement area was a valuable indicator in ranking priority health areas in the East, North, and Adamawa regions, further emphasising the need to consider other indicators before prioritisation.

Prevalence of prolonged otitis media with effusion among 2 to 3 years old Cameroonian children in the era of 13-valent pneumococcal conjugate vaccines

ObjectivesThere is data scarcity on the overall effects of pneumococcal conjugate vaccines (PCVs) on otitis media (OM) in low- and middle-income countries. The impact of the 13-valent PCV (PCV13) program on OM was evaluated in Cameroon where infant vaccination was implemented in July 2011 using a 3-dose primary series at 6, 10 and 14 weeks of age. MethodsThrough community-based surveillance, we used a retrospective cohort study design to assess OM prevalence among PCV13-vaccinated children aged 24 to 36 months in 2015. This was compared with a 2013 age-matched cohort of PCV13-unvaccinated children. OM was diagnosed by clinical inspection for chronic suppurative OM (CSOM) and tympanometry for OM with effusion (OME). CSOM was defined as draining of the middle ear with duration of more than 2 weeks and prolonged OME was defined as a flat ‘type B’ tympanogram. PCV13-vaccinated and PCV13-unvaccinated cohorts were compared by calculating prevalence odds ratios for OM and baseline characteristics. ResultsAltogether, 111 OM cases were identified; 42/433 (9.7%) in the PCV13-unvaccinated in 2013 and 69/413 (16.7%) in the PCV13-vaccinated cohort in 2015. In the 2013 baseline survey, 3/433 (0.7%) children were identified with unilateral CSOM compared to 9/413 (2.2%) in the PCV13-vaccinated cohort in 2015. Bilateral prolonged OME was diagnosed in 7/433 (1.6%) PCV13-unvaccinated children and in 12/413 (2.9%) in PCV13-vaccinated children. Proportions of children with unilateral prolonged OME were 31/433 (7.2%) in the PCV13-unvaccinated group compared with 48/413 (11.6%) in the PCV13-vaccinated group. Multivariate logistic regression analysis showed evidence that PCV13-vaccinated children in 2015 had 40% less risk of contracting OM compared to PCV13-unvaccinated children in 2013 (adjusted prevalence odds ratios = 0.60 [95% confidence interval: 0.38 to 0.94], P = 0.025). Additionally, attributable proportion estimates show that, 58% of OM infections among the PCV13-vaccinated group would still have occurred despite PCV13 vaccination. ConclusionOur findings provide significant evidence on the effect of PCV13 in decreasing OM or OME among children in this age group. It also supports justification for government's continuation of PCV13 immunization program in the absence of GAVI's funding. Further research is needed to assess the long-term impact of the PCV13 program on in OM Cameroon.

A Bayesian spatio-temporal framework to assess the effect of seasonal malaria chemoprevention on children under 5 years in Cameroon from 2016 to 2021 using routine data

BackgroundMalaria affects millions of Cameroonian children under 5 years of age living in the North and Far North regions. These regions bear the greatest burden, particularly for children under 5 years of age. To reduce the burden of disease in these regions, Cameroon adopted the Seasonal Malaria Chemoprevention (SMC) in 2016 and has implemented it each year since its adoption. However, no previous studies have systematically assessed the effects of this intervention in Cameroon. It is important to understand its effect and whether its implementation could be improved. This study aimed to assess the effect of SMC in Cameroon during the period 2016–2021 on malaria morbidity in children under 5 years of age using routine data.MethodsData on malaria cases were extracted from the Cameroon Health Monitoring Information System (HMIS) from January 1, 2011, to December 31, 2021. Health facilities report these data monthly on a single platform, the District Health Information System version 2 (DHIS2). Thus, a controlled interrupted time-series model in a Bayesian framework was used to evaluate the effects of the SMC on malaria morbidity.ResultsSMC implementation was associated with a reduction in the incidence of uncomplicated malaria cases during the high-transmission periods from 2016 to 2021. Regarding the incidence of severe malaria during the high-transmission period, a reduction was found over the period 2016–2019. The highest reduction was registered during the second year of implementation in 2017:15% (95% Credible Interval, 10–19) of uncomplicated malaria cases and 51% (47–54) of confirmed severe malaria cases.ConclusionThe addition of SMC to the malaria intervention package in Cameroon decreased the incidence of uncomplicated and severe malaria among children under 5 years of age. Based on these findings, this study supports the wide implementation of SMC to reduce the malaria burden in Cameroon as well as the use of routine malaria data to monitor the efficiency of the strategy in a timely manner.

Cost-effectiveness of community-based household tuberculosis contact management for children in Cameroon and Uganda: a modelling analysis of a cluster-randomised trial

WHO recommends household contact management (HCM) including contact screening and tuberculosis-preventive treatment (TPT) for eligible children. The CONTACT trial found increased TPT initiation and completion rates when community health workers were used for HCM in Cameroon and Uganda. We did a cost-utility analysis of the CONTACT trial using a health-system perspective to estimate the health impact, health-system costs, and cost-effectiveness of community-based versus facility-based HCM models of care. A decision-analytical modelling approach was used to evaluate the cost-effectiveness of the intervention compared with the standard of care using trial data on cascade of care, intervention effects, and resource use. Health outcomes were based on modelled progression to tuberculosis, mortality, and discounted disability-adjusted life-years (DALYs) averted. Health-care resource use, outcomes, costs (2021 US$), and cost-effectiveness are presented. For every 1000 index patients diagnosed with tuberculosis, the intervention increased the number of TPT courses by 1110 (95% uncertainty interval 894 to 1227) in Cameroon and by 1078 (796 to 1220) in Uganda compared with the control model. The intervention prevented 15 (-3 to 49) tuberculosis deaths in Cameroon and 10 (-20 to 33) in Uganda. The incremental cost-effectiveness ratio was $620 per DALY averted in Cameroon and $970 per DALY averted in Uganda. Community-based HCM approaches can substantially reduce child tuberculosis deaths and in our case would be considered cost-effective at willingness-to-pay thresholds of $1000 per DALY averted. Their impact and cost-effectiveness are likely to be greatest where baseline HCM coverage is lowest. Unitaid and UK Medical Research Council.

Pubertal patterns in children with sickle cell anemia: A case–control study in Cameroon

BackgroundPuberty may be impaired in children with sickle cell anemia (SCA). Therefore, we aimed to explore the clinical and hormonal features of puberty in Cameroonian children. MethodsIn a case–control study, we included 64 children aged 8–18 years with SCA matched to healthy controls. We assessed height, weight, body mass index, body composition, and Tanner stages. Hormonal measurements included anti-mullerian hormone, follicle-stimulating hormone, luteinizing hormone, and sex hormones (estrogens/testosterone). We used the Mann–Whitney Wilcoxon test to compare the median values between cases and controls. We looked for associations between the severity criteria of SCA and delayed puberty through multivariate analysis. ResultsDelayed puberty was reported in 27.3% of girls and 10% of boys with SCA. The median age of menarche was delayed by 2 years compared to controls. SCA patients had a low lean body mass compared to controls (p = 0.03). Anti-mullerian hormone levels were significantly higher in boys with SCA than those of controls (45.9 ng/mL vs. 17.65 ng/mL; p = 0.018). A history of severe infection, acute chest syndrome, and low hemoglobin level was associated with delayed sexual maturation in children with SCA. ConclusionOur study revealed delayed puberty in children with SCA. Moreover, puberty is affected by the severity of the disease. This highlights the importance of regular monitoring of puberty during the follow-up of these children.

The risk of prematurity in Cameroonian children born after in vitro fertilisation.

To evaluate the risk of prematurity in Cameroonian children born after in vitro Fertilisation. A retrospective cohort study. Conducted at the pediatric department of the Hospital Center for Research and Application in Endoscopic Surgery and Human Reproduction (HCRAESHR) in Yaoundé over eight months. Every newborn born after in vitro fertilisation (exposed group) and those born after spontaneous conception (non-exposed group) from a singleton pregnancy were included. Multiple pregnancies were excluded. One hundred newborns per group were recruited and matched according to the mode of delivery. The main outcome measure was prematurity at birth. Data were collected from the medical records of the newborns and reported on individual questionnaires. The t Student test was used to assess the differences in gestational age between the two groups. The generalised linear model using binomial probability distribution was used for multivariate analysis to determine prematurity risk factors. All results with a p-value ≤ 0.05 were considered statistically significant. Prematurity was significantly predominant in the exposed group (22% and 5%, respectively, p=0.002) compared to the non-exposed group. The risk of prematurity in the exposed group was 4.4 times higher than in the non-exposed group. After controlling for confounders (the maternal age, the sex of the baby, and maternal hypertension), this risk increased significantly from 4.4 to 7.67 (p=0.001). This study demonstrated the first evidence from our part of the world showing that in vitro fertilisation is an absolute risk of prematurity. None declared.

Understanding Asymptomatic Malaria: The Utility of Wild-Derived Mouse Diversity

Abstract With over 200 million clinical cases per year leading to over 600,000 deaths, malaria is still a significant global health problem. Up to 80% of individuals in some malaria-endemic areas can have asymptomatic carriage of Plasmodium infections (no overt symptoms) and are thought to be a significant reservoir for malaria transmission. Many asymptomatic Plasmodium-infected individuals show mild anemia and vascular activation and have an increased risk for co-morbidities such as typhoidal Salmonella. Currently, the immunological mechanisms governing asymptomatic Plasmodium carriage are poorly understood, partly due to a lack of immunologically intact asymptomatic animal models. Here, utilizing a unique genetically diverse SPF wild-derived mouse colony we address the immunological underpinnings of asymptomatic malaria. This model shows that asymptomatic Plasmodium carriage is genetically controlled. Furthermore, wild-derived mice have varying levels of anemia associated with non-lethal Plasmodium yoelii XNL infection; some mice exhibit an asymptomatic phenotype with mild anemia independently of parasitemia. Anemia levels correlate with the production of TNF-a and IL-10, which is consistent with patterns seen in asymptomatic children in Cameroon. CD4 T cells producing IL-10 and IFN-g were also correlated with the severity of anemia, with few T regulatory cells that expanded during infection, consistent with the pattern of circulating CD4 T cells responses seen in pediatric asymptomatic malaria. Previously unknown genes are also found in GWAS analysis in these mice. Our results highlight that this novel model can be used to determine the immune mechanisms that underpin the asymptomatic carriage of Plasmodium parasites. Supported by a grant from NIH (R01AI167422)

Cross-Sectional Height-Specific Changes in Serum Lipid Concentrations in Cameroon Children

Background: Information on the relationship between height and changes in serum lipids in children is scarce in Cameroon. The aim of this study is to determine prevalence of dyslipidemia with respect to age and gender and assess the association between height increase and serum lipid changes in Cameroon children. Methods: This hospital-based cross-sectional analysis included 472 boys and 534 girls between the ages of 5 and 16 years. Body height, weight, and waist circumference (WC) of children were measured and z-scores calculated. Total cholesterol-TC, triglycerides-TG, low density lipoprotein cholesterol-LDL-C and high-density lipoprotein cholesterol-HDL-C concentrations in fasting blood samples were determined by enzymatic method using an automated clinical chemistry analyzer (RX Monaco, UK). Children were divided into increasing quartiles of height z-score. Multiple linear regression analysis was used to compare mean lipid concentrations across quartiles of height z-score after controlling for age, gender, body weight, WC and fasting blood glucose. Results: The prevalence of elevated TC and LDL-C were respectively 18.5% and 19.2% higher in girls than boys. Also, the prevalence of elevated TC and TG was highest among younger (5- to 9-year-old) girls and boys respectively. There was a significant decrease in mean TC (168.8 to 127.2 mg/dl; p p = 0.019) and LDL-C (91.1 to 69.4 mg/dl; p = 0.018) in boys; and a significant decrease in mean TC (171.2 to 144.7 mg/dl; p = 0.004) and HDL-C (62.8 to 28.7 mg/dl; p p = 0.053) and the decrease in TG (p = 0.211) and LDL-C (p = 0.732) in girls with increasing height were not significant. Conclusion: Serum lipids decreased with increasing height after controlling for different variables. This study indicates that short children have higher serum lipid concentrations and this may increase the risk of lipid disorders, which may persist into adulthood.

Key predictors of undernutrition among children 6–59 months in the Buea Health District of the Southwest region of Cameroon: a cross sectional community-based survey

BackgroundAccording to the 2018 Demographic and Health Survey, undernutrition remains a public health problem among Cameroonian children under-five. This varies across the country, greatest in areas with ongoing humanitarian crisis, such as the Southwest region. However, data on the burden of undernutrition in the Southwest region is sparse. This study aimed to assess the prevalence and predictors of undernutrition among children under-five in the Buea health district of the Southwest region of Cameroon.MethodsThis was a community based cross-sectional study of 321 children under-five/caretaker pairs, surveyed from households selected using multistage randomized sampling. Data were collected by trained data collectors, with the aid of a structured, pre-tested questionnaire that captured information on sociodemographic characteristics, food security, dietary diversity and anthropometric measurements. The weight, height/length and mid upper arm circumference (MUAC) were measured using standardized instruments. Stunting, Wasting and Underweight of children were calculated from Z-scores of Height-for-age (HAZ), Weight-for-height (WHZ) and Weight-for-age (WAZ) based on 2006 WHO standards. Data was analysed using SPSS version 27.0. Predictors of malnutrition were obtained using multivariate logistic regression, adjusting for potential confounders.ResultsOverall, 31.8% (102/321) of the children were undernourished (26.5% stunted, 1.6% underweight, 3.7% wasted). Drinking water from inappropriate sources (OR: 2.32, 95% CI: 1.30–4.15) and a Dietary Diversity Score < 4 (OR: 2.59, 95%CI: 1.46–4.61) were independently associated with increased risk of stunting. Children of the male sex were more likely to be wasted than females (OR: 5.34, 95%CI: 1.09–26.14).ConclusionChildhood undernutrition, particularly stunting is common in the Buea Health District. Risk factors of undernutrition identified are potentially modifiable, highlighting the need for nutrition specific and sensitive interventions to improve dietary diversity, and the need to improve access to safe drinking water, and educate caretakers on the importance of clean potable water, good sanitation and hygiene for the proper growth and development of their children.

Effects of Different Processing Methods on the Iron, Zinc and Other Nutrients Content of Biofortified Beans (&lt;i&gt;Phaseolus vulgaris L&lt;/i&gt;.)

Iron deficiency anemia remains a real public health problem among young children in Cameroon. To reduce it, iron biofortification of legumes was developed to improve the iron nutritional status of the children. This study aimed to assess the effect of different processing methods on the iron, zinc and other nutrients content of biofortified bean cultivars (Phaseolus vulgaris L.) from Cameroon. Firstly, a survey was done in the city of Douala on different processes applied to the bean seeds before cooking. The raw and cooked sample of seeds were analysed for proximate and antinutrients composition, using AOAC methods for macronutrients content and atomic absorption spectrophotometry for minerals. The traditional bean cultivar served as control. From the results of the survey, beans treatment were divided into four groups: raw, boiled, soaked and boiled, boiled with limestone. The results showed that different processing methods led to an increase in protein (19.53%-27.66%), and crude fibre (4.46%-7.99%) but a decrease in carbohydrate (62.23%-53.28 %), lipids (5.48%-3.32%) contents. The biofortified bean showed statistically significant differences in iron and zinc contents compared to the traditional bean. Soaked and boiled biofortified bean had higher mineral contents compared to the traditional bean. Processing improved significantly (p<0.05) the nutritional value of the beans by reducing the antinutrient contents. Boiling with limestone was found to have the highest level of reduction effect on the tannin, oxalate, phytate and saponin. Biofortified bean cultivar could be used as food formulation material for infants and young children to prevent micronutrients deficiencies.

THE INEFFECTIVE SOCIO-EDUCATIONAL POLICIES ON STREET CHILDREN PHENOMENON IN AKWA DOUALA 1

This paper study the consequences of ineffective social and educational policies on the phenomenon of Street Children in Cameroon the case of Akwa within the Douala I sub-Division. Despite the negative life entails in the street, these children have come up with strategies to enable them overcome the hazards and ugly face of the street. This guarantees their long stay away from home. My main interest is to find out to what extent social control mechanism manage the phenomenon of street children in Cameroon whereas all effort made to retrieve them only lead to their increasing numbers. Based on findings; over a period of 8 years Cameroon has a total of 170000 street children and the mechanism put in place for reintegration back to families is weak and slow. This research will contribute to the amelioration of the socio-educational policies of the state and private social services on how to manage the policies of street children in Cameroon. KEY WORDS: Street children, social policy, educational policy, Akwa

Clinical, biochemical, and biomolecular aspects ofcongenital adrenal hyperplasia in a group ofCameroonian children and adolescents.

Congenital adrenal hyperplasia (CAH) remains one of the most challenging endocrine disorders todiagnose, manage, and treat, especially in Africa where there is lack of neonatal screening program, and limited access to care. Data on biomolecular anomaly are sparse, therefore type of mutations are unknown, increasing management challenges and genetic counseling. The present study aims to describe clinical, biomolecular aspects of a group of Cameroonian patients. We did an observational retrospective study atthe pediatric endocrinology unit of the Mother and ChildCentre of the Chantal Biya Foundation in Yaounde from May 2013 to December 2019, including all patients diagnosed with CAH. We consecutively included 31 patients aged lessthan 21 years, diagnosed CAH. Median age at diagnosis was 1.71 years (IQR 0.08-2.57 years). Abnormal genitalia was the main complain in 48.4%(n=15). The most prevalent genetic anomaly found in our study population (n=24) wason CYP11, found in 16 patients (66.6%) followed byCYP21A2 mutation found in 8 patients. Homozygous mutation of p.Q356X was found in half of patients with 11hydroxylase deficiency. This mutation was mostly foundin people from semi-Bantu tribes, declared non consanguineous. 11 hydroxylase deficiency is the most prevalent form of CAH found in this group of Cameroonian children.

Epidemiological, clinical, and treatment-related features of children with cerebral palsy in Cameroon: A hospital-based study

BackgroundPediatric cerebral palsy (CP) remains a poorly studied public health problem in sub-Saharan Africa, especially in Cameroon. This study aimed at determining the epidemiological, clinical, and treatment-related characteristics of CP in Cameroonian children. MethodsA cross-sectional study was conducted at the pediatric department of the Douala Gynaeco-Obstetric and Pediatric Hospital (DGOPH). Medical records of children attending the department during the study period were reviewed. Only medical records of children aged from 3 months to 15 years and diagnosed with CP were included. Parents/guardians of children presenting with CP were contacted and invited to come with their children to the DGOPH where they were examined by a pediatric neurologist. A questionnaire designed for the study was used to collect sociodemographic, clinical, paraclinical, and treatment data for each child. ResultsOut of the 4064 medical records reviewed, CP was diagnosed in 198 children (4.86%). These children were predominantly male (53.6%), aged 3–24 months (54.0%). Perinatal disorders were the main CP etiologies, especially neonatal asphyxia (55.1%), jaundice (32.8%), and neonatal infections (25.8%). Most of the children were born at term (81.6%) and by vaginal delivery (62.6%), with a normal birth weight (83.2%). Several comorbidities were found including speech delay (74.2%) and epilepsy (34.4%). The patients with CP presented predominantly with the spastic form of the disease, especially spastic quadriplegia (44.3%). Less than half of the children were managed at hospital, while the majority of parents were following various traditional treatments. ConclusionAddressing preventable causes of CP and improving awareness in the population will be of great help to reduce CP in Cameroon.