Cameroon National Research Articles

OC 8378 REQUIREMENTS FOR THE ETHICAL CONDUCT OF CLINICAL RESEARCH IN CAMEROON, SUB-SAHARAN AFRICA: THE IMPORTANCE OF ACTIVE MONITORING

BackgroundPrevious evaluation of the state of ethics regulation in Cameroon revealed: law regulating clinical research is lacking; existing committees lack infrastructure and financial support to sustainably review and effectively monitor approved protocols. The present Cameroon National Ethics Committee (CNEC)-EDCTP project aimed at implementing and evaluating active monitoring of clinical research in Cameroon.MethodsBetween 2011–2013, approved clinical trials and protocols involving transfer of biological materials abroad were consecutively monitored. The monitoring tool, a questionnaire on the conformity of key documents e.g. research protocols, ethical clearance, informed consent documents, investigator’s brochure, with a focus on GCP standards was sent to promoters/investigators ten days prior to the field visit. Teams of two-three monitors, made up of CNEC members and independent consultants, were mobilised per site (hospital/research institute/NGO). Reports with key recommendations were submitted to CNEC for review and approval, to different promoters/investigators, and the Regulatory Authority for action; the monitoring summary was submitted to EDCTP.ResultsUp to 22 site visits were done throughout the country, monitoring about 30 protocols within 11 hospitals, 9 research institutes, a National Programme and a non-governmental organisation. All sites had ethical clearance and administrative authorisation for research. From the registered number of research participants, less than half of the signed consent forms were available. Other issues were the lack of full involvement of local investigators, inexistence of material transfer and data sharing agreements with collaborative studies, non-implication of study communities/participants. As educators-consultants, monitors formulated recommendations to investigators, ethics committees and regulatory authority, insisting on the implication of local PI/collaborators with defined percentages of time to be devoted for research and good participatory practice among research communities/participants.ConclusionActive monitoring shows some formality in the application of ethical/administrative clearance in Cameroon. However, complex issues raised confirm the necessity of continuous monitoring to meet the high standards for clinical research ethics in Cameroon.

Marie-Claire Matip and Thérése Kuoh-Moukoury as (In)Visible Pioneers: Early Works by Women Writers and the Struggle for Inclusion in Cameroon's National Educational Program

Marie-Claire Matip and Thérése Kuoh-Moukoury as (In)Visible Pioneers: Early Works by Women Writers and the Struggle for Inclusion in Cameroon's National Educational Program

Comparative Immuno-Virological and Clinical Responses to Antiretroviral Therapy between HIV-1 Group O- and HIV-1 Group M-Infected Patients (ANRS 12168 DynaMO Study)

Backgroud: HIV-1/O presents a high level of genetic divergence relative to HIV-1/M which impacts viral load monitoring and drug susceptibility; however, its impact on therapeutic outcomes is still poorly known. The aim of this study was to determine if responses to standardised cART based on 2NRTIs 1IP/r were similar between group O and M infections despite strain divergence. Methods: We performed an open non-randomised study comparing the immunological, virological and clinical responses to cART, in naive and paired HIV-1/O- versus HIV-1/M-infected patients. Each HIV-1/O patient was matched to two HIV-1/M patients on sex, age, CD4 cell count, haemoglobin level, and HBsAg status. The primary endpoint was the proportion of patients with an undetectable plasma viral load (pVL<60cp/mL) at W48. Secondary endpoints were: the proportion of patients with an undetectable pVL at W24 and W96, and the proportion of patients with a CD4 cell count gain of more than 50% maintained at W96. Findings: 47 HIV-1/O patients and 94 HIV-1/M patients were included, whose mean pVL at baseline was significantly lower for HIV-1/O (4·2 log cp/mL) compared to HIV-1/M (5·2 log cp/mL; p<0.001). At W48, no significant difference was observed in the ITT population with 80·9 % of HIV-1/O patients having undetectable pVL compared to 75·5 % of HIV-1/M patients. Differences at W24 and W96 were not significant either. Regarding the immunological response, a difference in the gain of more than 50% of CD4 cells at W96 was observed in favour of HIV-1/M. Interpretation: Our data demonstrate the non-inferiority of 2NRTIs 1IP/r for treating HIV-1/O infections. This result should now lead to consideration of such combinations as a solid alternative in a context of natural resistance of O strains to NNRTI class. This study also shows significant differences in baseline replication and CD4 recovery, suggesting a specific pathophysiology which now needs to be explored. Clinical Trial Number: This study is registered with ClinicalTrial.gov with the number NCT00658346. Funding Statement: This work was supported by the Agence Nationale de Recherche sur le SIDA – Inserm ANRS – (grant number 12168). Declaration of Interests: The authors declared no conflict of interest. Ethics Approval Statement: The research protocol was approved by the Cameroon National Ethics Committee, the Cameroon Health Ministry, the French Ethics Committee of Saint Germain en Laye (France), the CCTIRS (Comite Consultatif sur le Traitement de l’Information en matiere de Recherche dans le domaine de la Sante) and the CNIL (Commission Nationale de l’Information et des Libertes).

Reflections on Political Ecology of Mount Cameroon’s Prunus Africana

This paper written for World-Ecology Research Network Conference at University of Helsinki, August 2018, reflects upon developments in capitalism of Prunus Africana within a theoretical framework of co-management critique. On the case of Mount Cameroon in Sub-Saharan West Africa, I argue processes of commercialization and socio-economic repercussions surrounding Prunus Africana: a plant that serves for treatment of prostatic diseases – interwoven with bureaucratic initiatives of sustainable management. By reviewing published literature, I argue the involvement of stakeholders in capitalist arrangements from the 1990s to periods following the establishment of Mount Cameroon National Park – significantly scrutinized by Convention on International Trade in Endangered Species (CITES), European Commission, and the International Union for Conservation of Nature (IUCN). Major actors include Mount Cameroon Prunus Management Company (MOCAP) endorsed by the state; state subsidiaries Cameroon Development Corporation (CDC) and Limbe Botanic Garden (LBG); collaborate buyers – Plantecam and Afriquia Medicament (AFRIMED); and Prunus Africana Harvesters’ Unions in nearby villages. Analysis demonstrate benefits in sustainable harvesting of Prunus, whilst raising ontological concerns of resource-appropriation, elite control, unsatisfactory labour wages, and vulnerabilities of traditional ecological knowledge to commercialization.

The Climate and Health Impacts of Achieving National Target Levels of Liquefied Petroleum Gas (LPG) Adoption in Cameroon: Findings from Policy Modelling According to the Cameroon National LPG Masterplan

IntroductionAs part of its commitments to becoming an emerging economy by 2035, the Cameroon Government has set a target that by 2030, 58% of the population will be using Liquefied Petroleum Gas (LPG) as a cooking fuel, compared to less than 20% in 2014. The aims of this study were to estimate the potential impacts of this planned LPG expansion (Masterplan) on population health and climate change mitigation.MethodsWe developed mathematical models to measure the health and climate impacts of expanding LPG adoption for household cooking in Cameroon over two periods:1. Short-term (2017-2030); Comparing Master Plan with a counterfactual LPG adoption of 32% in 2030, in line with current trends.2. Long-term (2031-2100, climate modelling only); Assuming Cameroon will become a mature and saturated LPG market by 2100 (73% adoption, based on Latin American countries). We compared this with a counterfactual adoption of 41% by 2100, in line with current trends.ResultsBy 2030, successful implementation of the masterplan was estimated to save about 23,000 lives and avert 760,000 disability-adjusted-life-years compared to naturally increasing trends in LPG adoption. For the same period reductions in component emissions of more than a third were found, leading to an annual cooling effect of -4.4 Mt CO2-equivalent (calculated with 50% renewable biomass), by applying the Global Warming Potential with a 100-year time horizon, and a global cooling of -0.1 milli &amp;#176;C in 2030. For 2100, a cooling impact for the Masterplan leading to LPG saturation (73%) was estimated to be -0.70 milli &amp;#176;C assuming 90% renewable biomass, increasing to -0.93 milli &amp;#176;C with 50% renewable biomass.ConclusionMeeting the government target of 58% of the population using LPG through successful implementation of the Masterplan will have significant positive impacts on population health and on climate, through reductions of emissions influencing climate and associated global cooling.

Genetic characterization of influenza B virus in Cameroon and high frequency of reassortant strains.

Influenza B is broadly divided into B/Victoria and B/Yamagata lineages based on its genetic and antigenic properties. We describe in this study the first report on genome characterization of type B influenza virus in the Cameroon National Influenza Center (NIC) between 2014 and 2017. Respiratory samples were collected as part of the influenza surveillance activity in the NIC. RNA products were tested for the presence of influenza using the CDC Influenza A/B typing panel. Thirty-five samples positive for influenza B were selected for sequencing three gene segments (HA, NA, and M) and phylogenetic trees were generated by MEGA version 6.0. Nucleotide phylogenetic analysis of the HA gene revealed the presence of three major clades among Cameroonian strains. All Victoria lineages grouped into B/Victoria clade 1A, while, Yamagata lineages grouped into Yamagata clade 2 (2014 strains) and Yamagata clade 3 (2015-2017). We observed a high frequency of reassortant viruses with Yamagata-like HA gene and Victoria-like NA gene (27.4%; 23/84). The results from this study confirm variations in the genome composition of type B influenza virus and emphasize on the relevance of molecular surveillance for spotting peculiar genetic variants of public health and clinical significance.

Spatial distribution and species abundance area of Non Timber Forest Products in the Mount Cameroon National Park and adjoining forest zones

Spatial distribution and species abundance area of Non Timber Forest Products in the Mount Cameroon National Park and adjoining forest zones

Human Wildlife Conflict: Causes, Consequences and Management Strategies in Mount Cameroon National Park South West Region, Cameroon

Human Wildlife Conflict: Causes, Consequences and Management Strategies in Mount Cameroon National Park South West Region, Cameroon

Detection and Solutions for Non-Technical Losses in Cameroon Electricity Network

The purpose of this study was to provide a tool to detect NTLs and subsequently, discuss the establishment of a prepaid system in Cameroon. The conception of a prepayment system for electric power or other utility commodity distribution using Wi-Fi and GSM to store and transfer value (money or KWh, meters reading indexes) from the client module to cut-off module then to platform of the system and deliver power to the customer from the power distribution system. This system is also used as fraud detection model for the Cameroon National Electricity Company.

Map of biomedical research in Cameroon; a documentary review of approved protocols from 1997 to 2012

BackgroundOver the last decade, there has been a rapid increase in biomedical research in Cameroon. However, the question of whether these research projects target major health priorities, vulnerable populations and geographic locations at risk remains to be answered. The aim of this paper is to describe the state of biomedical research in Cameroon which is a key determinant that would guide future health care policies and promote equitable access to healthcare.MethodsA documentary review of all approved protocols (proposals) of biomedical research projects, from 1997 through 2012, at the Cameroon National Ethics Committee. Protocols were reviewed systematically by independent reviewers and data were extracted on a grid. Data were analyzed by calculating proportions at 95% confidence interval, chi-square test (chi2) and p-values.ResultsTwo thousand one hundred seventy two protocols were reviewed for data extraction. One thousand three hundred ninety-five (64.7%) were student projects, 369 (17.0%) projects had international sponsors, and 1528 (72.4%) were hospital-based studies. The most targeted domain was the fight against diseases 1323 (61.3%); mostly HIV 342 (25.8%) and Malaria 136 (10.3%). Over half of the studies were concentrated in the Centre region 1242 (57.2%), with the least projects conducted in the Northern region 15 (0.7%). There was strong evidence that international and local sponsors would influence the research site (p-value = 0.01) and population targets (p-value = 0.00).ConclusionAlthough biomedical research targets some important diseases that pose a great burden to Cameroonians, the most vulnerable populations are excluded from research. Biomedical research scarcely addresses other components of the health system and emerging diseases of vital public health importance. We recommend that the government should play a central role, between researchers from academic institutions, sponsors, NGOs and research institutions, to ensure that biomedical research addresses the health priorities of Cameroonians. It should include vulnerable populations, and address other components of the health system for a balance. These recommendations are critical to ensuring that future research informed health policies reflect the health needs of the populations and promote equity in healthcare access.

Intellectual Housewives, Journalism, and Anglophone Nationalism in Cameroon, 1961–1972

Abstract This article argues that female journalists used their advice columns in the West Cameroon State to maintain Anglophone Cameroonian cultural identity and unity from 1961 to 1972. As public intellectuals, they sought to regulate women’s behaviors in order to preserve and redefine ideas of Anglophone Cameroonian political identity as well as concepts about gender norms and cultural values. From this position, they urged women to follow what they deemed suitable African cultural values and to join women’s organizations. At the same time, they endeavored to protect what they imagined as a unified Anglophone cultural identity within a hegemonic Francophone republic. By applauding the activities of female political elites, they directly advocated for Anglophone Cameroonian political identity and autonomy. Yet through all of this they emphasized they were mere housewives, strategically suppressing their roles as public intellectuals and thereby making themselves less politically threatening to their readers, communities, and the patriarchal state.

Quantifying local community voices in the decision-making process: insights from the Mount Cameroon National Park REDD+ project

ABSTRACTOne key component in community development is the ability to negotiate and make contentious environmental decisions that have sustainable environmental and livelihoods benefits. This study examines the community voice during the consultation and decision-making process to evaluate if the inclusion of community delegates is meant to legitimise REDD+ or leads to community development. Likert-scale questionnaire, focus-group discussions and interviews were used to collect data from 259 respondents located in 12 villages around Mount Cameroon National Park (MCNP). Results show that the level of local participation in the MCNP-REDD+ project directly relates to both standing and influence granted to the local stakeholders. Although MCNP managers understood community concerns, these concerns are not being addressed. Local community delegates are granted access to discussion forums, but they are not influencing the decision-making process or the design of REDD+ within MCNP. The voice of all stakeholders must be heard to ensure equitable development and socio-environmental legitimacy of projects. A decision-making process that is transparent and familiar to local communities will enhance their confidence to engage in debates as equal stakeholders and ensure that decisions reflect community consent. Capacity building in the decision-making process will empower the community to efficiently engage in consultation, dialogue and transparent forest management decisions.

Foliar nutrient and metal levels of crops in the Mount Cameroon area—reference values for plant nutrition and environmental monitoring

The growing population number and traffic loads, increasing environmental pressures, agricultural intensification, and the establishment of Mount Cameroon National Park demand farsighted environmental management in the region and the definition of a favorable ecological status. Since plants grow in the interface between soils and the atmosphere they can be used as passive biomonitors for the environmental quality. At the same time, the accumulation of nutrients and pollutants in crops is linked to human health, so that foliar elemental levels can be used as an integrative measure for environmental pollution and impact assessment. In the present study, we collected leaf samples of plantain, cassava, cocoyam, and maize on 28 sites at the southern flanks of Mt. Cameroon and determined 20 chemical elements. Air pollution in the study area comes from biomass and waste burning mainly, but emissions from traffic and a large refinery were believed to also play a significant role. However, spatial patterns in foliar elemental concentrations reflected the geochemistry rather than specific sources of pollution. Significant differences in foliar metal and nutrient levels were observed between the four species, indicating a different demand and uptake of specific elements. The results were compared to published data on nutrient concentrations in the tested species and the so-called reference plant. The data can be used as a baseline for future studies in plant nutrition and the environmental monitoring in inner tropical regions where these crops are grown.

Evaluation of Customer Behaviour Irregularities in Cameroon Electricity Network using Support Vector Machine

Non-Technical Losses (NTLs) in the Cameroonians electricity network are approximately 30 to 40% of production and are estimated at several billion CFA francs per year for National Electricity Company (ENEO); Hence the importance of finding effective solutions to fight against these losses. The purpose of this work was to develop a tool for the fraud detection for Cameroon National Electricity Company (ENEO) using support vector machines which consisted in data preprocessing base on the load profile, development of a model for classification, parameter optimization and detection of customers irregularities and prediction.

The Role of Traditional Taboos and Custom as Complementary Tools in Wildlife Conservation Within Mount Cameroon National Park Buea

This study was carried out to examine the use of traditional taboos and custom in wildlife conservation in the Mount Cameroon National Park. A purposive sampling technique was used in selecting 13 villages from the 41 villages surrounding the park. A total number of 130 respondents were randomly selected for the study and data collected was analyzed using descriptive statistics. From the results, majorities (76.67%) of the respondents were male and, fall within the age range of 50–59 years (62.5%), attained secondary education and 80.83% were Christians. As the results reveal, a good percentage of the respondents were conversant with cultural practices and its impact in wild animal conservation as 70.83% and 20.83% of the respondents strongly agree and agree respectively that cultural practices are used for conserving wildlife species. Religion, migration and westernization were found to be responsible for the decline of cultural practices in wildlife conservation within the study area. One animal, the African forest elephant is reverenced as a deity throughout the study area, although there were taboos forbidding indigenes/residents from killing or eating some particular wildlife species (Chimpanzee, Western bush pig, African python, Preuss monkey, Blue duiker, Drill, African civet, African wild dog, Black kite, White-face owl and snail spp). Illegal communal hunting is still practiced in the area. It is recommended that new and holistic wildlife conservation policies that will blend traditional systems of regulation, myths, rituals, and perceptions with existing wildlife legislation in the country be implemented to enhance conservation in this area.

Modern Contraceptive Choice Among Patients Seen at the "Cameroon National Planning Association for Family Welfare" Clinic Yaoundé.

BACKGROUNDTo understand the low modern contraceptive prevalence in Cameroon, we reviewed the methods chosen and determined their side effects among patients in an urban setting.METHODSWe conducted a cross-sectional study at the “Cameroon National Planning Association for Family Welfare (CAMNAFAW) Clinic” in Yaoundé. Data were processed by SPSS software version 20.0 for Windows, and all tests were considered statistically significant at P < .05.RESULTSOf the 1180 women sampled, the most chosen methods were as follows: depot medroxy progesterone acetate: 72.1% (787 of 1091), followed by oral combined contraceptives: 21.3% (232 of 1091), subcutaneous implants: 3.2% (35 of 1091), and intrauterine contraceptive devices: 1.9% (21 of 1091). A hundred and forty two (14.5%) of the 977 women received at least once (revisits) at the Center, reported at least one side effect. Irregular vaginal bleeding was the most frequent side effect: 44.6% (84 of 188 total documented side effects). Side effects were most common among users of subcutaneous implants: 28% (7 of the 25 implant users).CONCLUSIONSPrescription of contraceptives should reflect not only the desire of couples but also the side effects associated with each method. This would optimize observance and adherence, consequently decreasing the failure rate.

Investigating the Role of the Local Community as Co-Managers of the Mount Cameroon National Park Conservation Project

Local forest management is essential for enhancing the sustainability of both communities’ livelihoods and Reducing Emissions from Deforestation and Land Degradation (REDD+) projects. However, few studies have examined the impact of forest ownership and control on community engagement and the functioning of communities in a co-managing conservation initiative. This paper examines the influence of forest management on local participation and identifies the roles/functions of local communities in the Mount Cameroon National Park REDD+ conservation project. Cluster multi-stage random sampling was used to collect data from 259 respondents that were analysed using the chi-square, Mann–Whitney, t-test, Kruskal–Wallis, Jonckheere–Terpstra tests and NVivo. Results show that local communities have been involved in forest management practices before the establishment of the park. Communities support the establishment of a strict conservation zone and hope to promote local participation with a high expectation of benefits. Insecure tenure reduces project support and local engagement. Though communities massively support the initiative, engagement is low, and participants are not carrying out any tangible roles. They function mainly as manual labourers or mere committee members who only enforce rules/regulations within communities. Community-based natural resource management and integrated conservation and development projects have often not realised local expectations due to problems of application and impracticable legislation. Projects’ failure may be avoided by involving communities in tangible roles/functions and developing an effective co-management approach or establishing community-owned and -managed forest projects. This paper examines the progress of REDD+ from an early stage to help inform proponents in adapting strategies that are geared towards appropriate satisfactory outcomes, especially for local communities, to prevent the early failure of the initiative.

The Conservation and Management Challenges of the Rainforest of Idenau in Mount Cameroon National Park, Southwest Region, Cameroon

The Conservation and Management Challenges of the Rainforest of Idenau in Mount Cameroon National Park, Southwest Region, Cameroon

Nation of Outlaws, State of Violence: Nationalism, Grassfields Tradition, and State Building in Cameroon by Meredith Terretta

<i>Nation of Outlaws, State of Violence: Nationalism, Grassfields Tradition, and State Building in Cameroon</i> by Meredith Terretta

The Ecological Distribution of Wild Prunus africana in Mount Cameroon National Park, Cameroon

Tropical montane forests contain some of the world’s richest plant communities but knowledge of the population and distribution of their diversity is still fragmentary. Among such species is Prunus africana which is of great economic and health value to forest communities and the world at large. The aim of the study was to evaluate the abundance, pattern of distribution, bark thickness and health status of Prunus Africana along elevational gradient on the slopes of mount Cameroon. In this study, three classes of elevations (1700 -2000m, 2000-3000m and 3000m and above) were selected using a digitized map of mount Cameroon and a global positioning receptor (Garmin GPSMAP 60CX). Sampling plots were selected in three different blocks of the mountain using management inventory method under adaptive cluster sampling technique. Five square plots measuring 100m by 100m were examined in three different classes of elevation. In each plot, record of all Prunus trees, diameter at breast height, bark thickness and health status were examined. ANOVA, Correlation, and Chi-square were the statistical models used in the data analysis. The result showed that a total number of 177 trees were recorded from the entire national park surface area (450,000m2). The height density (6.2 stem/ha) was recorded at the lowest class of elevation while the least density (1.2 stem/ha) was recorded at the highest class of elevation. It also revealed that variations in elevation accounted for 0.001cm change in bark thickness. The highest mean bark thickness (1.12cm) was recorded at the highest class of elevation while the least mean bark thickness (0.86cm) was recorded at the least elevation. The highest mean diameter at breast height (51.22cm) was registered at the highest class of elevation while the least mean diameter at breast height (36.57cm) was recorded at the lowest class of elevation. Healthy trees had the highest population (83.87%) at the lowest class of elevation while the least population (61.11%) was found at the highest class of elevation.