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Siewe Fodjo JN, Ekome SRE, Njamnshi JNT, Njamnshi WY, Njamnshi KG, Ngarka L, Njamnshi AK. Community Perceptions of Blackfly Nuisance and Acceptability of the "Slash and Clear" Vector Control Approach in the Ntui Health District of Cameroon: A Qualitative Study. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2024; 21:658. [PMID: 38928904 PMCID: PMC11204025 DOI: 10.3390/ijerph21060658] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 04/22/2024] [Revised: 05/15/2024] [Accepted: 05/19/2024] [Indexed: 06/28/2024]
Abstract
Besides being vectors of the onchocerciasis parasite, blackflies are a source of nuisance in onchocerciasis-endemic communities. We investigated the experience of residents in the Ntui Health District (Cameroon) regarding blackfly nuisance and assessed their perceptions of a novel "Slash and Clear" (S&C) intervention for blackfly control. Focus group discussions were conducted before and after S&C implementation (respectively, in February 2022 and December 2023). Blackflies were known to emerge from the river areas and cause disease. To prevent blackfly bites, the population often covered their body with protective clothing and applied various substances (kerosene, oil, or lemon) to their skin. Post-intervention data showed reduced blackfly nuisance, and the willingness to sustain blackfly control in the long-term was unanimous among community leaders and members, including the village volunteers who implemented the S&C intervention. In conclusion, blackfly nuisance is evident in the Ntui onchocerciasis focus of Cameroon and led to a panoply of coping practices, some of which could be detrimental to their health. Implementing S&C for blackfly control is well accepted and could sustainably alleviate the nuisance caused by blackflies while simultaneously breaking the onchocerciasis transmission cycle.
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Affiliation(s)
- Joseph Nelson Siewe Fodjo
- Brain Research Africa Initiative (BRAIN), Yaoundé P.O. Box 25625, Cameroon; (S.R.E.E.); (J.N.T.N.); (W.Y.N.); (K.G.N.); (L.N.)
- Global Health Institute, University of Antwerp, Doornstraat 331, 2610 Antwerp, Belgium
| | - Serge Raoul Ekukole Ekome
- Brain Research Africa Initiative (BRAIN), Yaoundé P.O. Box 25625, Cameroon; (S.R.E.E.); (J.N.T.N.); (W.Y.N.); (K.G.N.); (L.N.)
| | - Julius Ndi Taryunyu Njamnshi
- Brain Research Africa Initiative (BRAIN), Yaoundé P.O. Box 25625, Cameroon; (S.R.E.E.); (J.N.T.N.); (W.Y.N.); (K.G.N.); (L.N.)
| | - Wepnyu Yembe Njamnshi
- Brain Research Africa Initiative (BRAIN), Yaoundé P.O. Box 25625, Cameroon; (S.R.E.E.); (J.N.T.N.); (W.Y.N.); (K.G.N.); (L.N.)
- Division of Operational Research in Health, Ministry of Public Health, N°8 Rue 3038 quartier du Lac (Yaoundé III), Yaoundé P.O. Box 3595, Cameroon
| | - Kongnyu G. Njamnshi
- Brain Research Africa Initiative (BRAIN), Yaoundé P.O. Box 25625, Cameroon; (S.R.E.E.); (J.N.T.N.); (W.Y.N.); (K.G.N.); (L.N.)
| | - Leonard Ngarka
- Brain Research Africa Initiative (BRAIN), Yaoundé P.O. Box 25625, Cameroon; (S.R.E.E.); (J.N.T.N.); (W.Y.N.); (K.G.N.); (L.N.)
- Neuroscience Lab, Faculty of Medicine and Biomedical Sciences, The University of Yaoundé 1, Yaoundé P.O. Box 1364, Cameroon
- Neurology & Clinical Neuroscience Department, Yaoundé Central Hospital, Yaoundé P.O. Box 87, Cameroon
| | - Alfred K. Njamnshi
- Brain Research Africa Initiative (BRAIN), Yaoundé P.O. Box 25625, Cameroon; (S.R.E.E.); (J.N.T.N.); (W.Y.N.); (K.G.N.); (L.N.)
- Neuroscience Lab, Faculty of Medicine and Biomedical Sciences, The University of Yaoundé 1, Yaoundé P.O. Box 1364, Cameroon
- Neurology & Clinical Neuroscience Department, Yaoundé Central Hospital, Yaoundé P.O. Box 87, Cameroon
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Hildebrandt TR, Davi SD, Kabwende AL, Endamne LR, Mehmel E, Rakotonirinalalao M, Alabi A, Manego RZ, Kremsner PG, Lell B, Adegnika AA, Mombo-Ngoma G, Mischlinger J, Agnandji ST, Ramharter M. Evaluation of knowledge, attitude and practices towards loiasis in the rural community of Sindara, in central African Gabon. PLoS Negl Trop Dis 2024; 18:e0012109. [PMID: 38781277 PMCID: PMC11265652 DOI: 10.1371/journal.pntd.0012109] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/21/2023] [Revised: 07/23/2024] [Accepted: 03/27/2024] [Indexed: 05/25/2024] Open
Abstract
BACKGROUND More than 20 million people are infected with L. loa, and around 40 million live in high or intermediate-risk areas in West- and Central Africa. Although loiasis is associated with significant morbidity and excess mortality, little is known about the perception of loiasis by affected communities. This study assessed the knowledge, attitudes, and practices in the rural population of Sindara, Gabon, a region characterized by high loiasis prevalence. METHODS A community-based cross-sectional survey was conducted in Gabon between January and June 2022. During systematic door-to-door visits, randomly selected inhabitants were invited to participate in this questionnaire based survey. Venous blood was collected at midday from all participants for microscopic detection of filarial infection and clinical signs of loiasis were assessed. RESULTS A total of 150 participants were recruited, of which 66% were infected by L. loa. While almost everyone had some knowledge about L. loa, 72% of the participants understood that L. loa is a parasitic worm. The transmission of L. loa via the deer fly was known to only 21% of participants. The most frequently mentioned clinical symptoms attributed to loiasis were itching (84%), eye worm migration (59%), and conjunctivitis-like symptoms (53%). Participants who experienced migratory loiasis had better knowledge of loiasis and considered it as more serious. Traditional and herbal medicine was reported most often as an available treatment option (72%). While the formal healthcare sector was mentioned as the preferred treatment provider, 60% of the reported infections were treated by traditional medical practitioners. CONCLUSION Loiasis is in general well known by this community residing in a region of high L. loa transmission. Important gaps in knowledge were discovered foremost regarding the mode of transmission. The available healthcare system does not seem to provide adequate management for loiasis.
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Affiliation(s)
- Teite Rebecca Hildebrandt
- Center for Tropical Medicine, Bernhard-Nocht Institute for Tropical Medicine and I. Department of Medicine University Medical Centre Hamburg-Eppendorf, Hamburg, Germany
- Centre de Recherches Médicales de Lambaréné, Lambaréné, Gabon
- German Center for Infection Research, Partner Sites Hamburg-Lübeck-Borstel-Riems, Hamburg, Germany
| | - Saskia Dede Davi
- Center for Tropical Medicine, Bernhard-Nocht Institute for Tropical Medicine and I. Department of Medicine University Medical Centre Hamburg-Eppendorf, Hamburg, Germany
- Centre de Recherches Médicales de Lambaréné, Lambaréné, Gabon
- German Center for Infection Research, Partner Sites Hamburg-Lübeck-Borstel-Riems, Hamburg, Germany
| | | | - Lilian Rene Endamne
- Center for Tropical Medicine, Bernhard-Nocht Institute for Tropical Medicine and I. Department of Medicine University Medical Centre Hamburg-Eppendorf, Hamburg, Germany
- Centre de Recherches Médicales de Lambaréné, Lambaréné, Gabon
| | - Esther Mehmel
- Center for Tropical Medicine, Bernhard-Nocht Institute for Tropical Medicine and I. Department of Medicine University Medical Centre Hamburg-Eppendorf, Hamburg, Germany
- Centre de Recherches Médicales de Lambaréné, Lambaréné, Gabon
- German Center for Infection Research, Partner Sites Hamburg-Lübeck-Borstel-Riems, Hamburg, Germany
| | - Maximilian Rakotonirinalalao
- Center for Tropical Medicine, Bernhard-Nocht Institute for Tropical Medicine and I. Department of Medicine University Medical Centre Hamburg-Eppendorf, Hamburg, Germany
- German Center for Infection Research, Partner Sites Hamburg-Lübeck-Borstel-Riems, Hamburg, Germany
| | - Ayodele Alabi
- Centre de Recherches Médicales de Lambaréné, Lambaréné, Gabon
- Institut für Tropenmedizin, Eberhard-Karls-Universität Tübingen, Tübingen, Germany
- Department of Parasitology, Leiden University Medical Center, Leiden, The Netherlands
| | - Rella Zoleko Manego
- Center for Tropical Medicine, Bernhard-Nocht Institute for Tropical Medicine and I. Department of Medicine University Medical Centre Hamburg-Eppendorf, Hamburg, Germany
- Centre de Recherches Médicales de Lambaréné, Lambaréné, Gabon
- German Center for Infection Research, Partner Sites Hamburg-Lübeck-Borstel-Riems, Hamburg, Germany
| | - Peter G. Kremsner
- Centre de Recherches Médicales de Lambaréné, Lambaréné, Gabon
- Institut für Tropenmedizin, Eberhard-Karls-Universität Tübingen, Tübingen, Germany
| | - Bertrand Lell
- Centre de Recherches Médicales de Lambaréné, Lambaréné, Gabon
- Medical University of Vienna, Vienna, Austria
| | - Ayôla Akim Adegnika
- Centre de Recherches Médicales de Lambaréné, Lambaréné, Gabon
- Institut für Tropenmedizin, Eberhard-Karls-Universität Tübingen, Tübingen, Germany
- Department of Parasitology, Leiden University Medical Center, Leiden, The Netherlands
- German Center for Infection Research, Partner Site Tübingen, Germany
| | - Ghyslain Mombo-Ngoma
- Centre de Recherches Médicales de Lambaréné, Lambaréné, Gabon
- German Center for Infection Research, Partner Sites Hamburg-Lübeck-Borstel-Riems, Hamburg, Germany
- Department of Implementation Research, Bernhard Nocht Institute for Tropical Medicine, Hamburg, Germany
| | - Johannes Mischlinger
- Center for Tropical Medicine, Bernhard-Nocht Institute for Tropical Medicine and I. Department of Medicine University Medical Centre Hamburg-Eppendorf, Hamburg, Germany
- German Center for Infection Research, Partner Sites Hamburg-Lübeck-Borstel-Riems, Hamburg, Germany
| | - Selidji Todagbe Agnandji
- Centre de Recherches Médicales de Lambaréné, Lambaréné, Gabon
- Institut für Tropenmedizin, Eberhard-Karls-Universität Tübingen, Tübingen, Germany
| | - Michael Ramharter
- Center for Tropical Medicine, Bernhard-Nocht Institute for Tropical Medicine and I. Department of Medicine University Medical Centre Hamburg-Eppendorf, Hamburg, Germany
- Centre de Recherches Médicales de Lambaréné, Lambaréné, Gabon
- German Center for Infection Research, Partner Sites Hamburg-Lübeck-Borstel-Riems, Hamburg, Germany
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Domche A, Nana Djeunga HC, Nwane PB, Njitchouang GR, Nono Fesuh B, Njiokou F, Jacob B, Pion SD, Kamgno J. Significant reduction of blackfly densities in persistent onchocerciasis area following pilot implementation of an environment friendly approach (Slash and Clear). Sci Rep 2024; 14:408. [PMID: 38172522 PMCID: PMC10764779 DOI: 10.1038/s41598-023-50747-4] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/10/2023] [Accepted: 12/24/2023] [Indexed: 01/05/2024] Open
Abstract
The effectiveness of the "Slash and Clear" method in reducing blackfly populations in low transmission areas is established, but its impact in high transmission settings with large rivers and dense vectors is yet to be proven. A community-based intervention study was conducted in the Mbam Valley, Centre Cameroon, involving two sites: Bayomen (control) and Biatsota (intervention). In each arm, baseline blackfly densities were collected over one year using the human landing method. The intervention consisted of destroying the trailing vegetation where blackflies breed. Blackfly densities were collected post-intervention to assess the impact of the intervention. Post-intervention data showed a 50.8% reduction in blackfly density in Biatsota (mean number of collected blackflies from 1936 to 953), while a reduction of 26.7% was observed in Bayomen (mean number of collected blackflies from 2418 to 1774). The reduction rate attributable to the intervention was 32.9%. Statistical analysis confirmed that the reduction in blackfly density was significantly greater in the intervention site. This study demonstrates the feasibility and significant impact of the "Slash and Clear" method in high transmission areas. However, further research is required to assess its long-term effects and determine how this strategy can be scaled up and sustained until onchocerciasis elimination is achieved.
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Affiliation(s)
- André Domche
- Higher Institute of Scientific and Medical Research (ISM), Yaoundé, Cameroon.
- Parasitology and Ecology Laboratory, Department of Animal Biology and Physiology, Faculty of Science, University of Yaoundé 1, Yaoundé, Cameroon.
| | | | - Philippe B Nwane
- Higher Institute of Scientific and Medical Research (ISM), Yaoundé, Cameroon
- Parasitology and Ecology Laboratory, Department of Animal Biology and Physiology, Faculty of Science, University of Yaoundé 1, Yaoundé, Cameroon
| | - Guy R Njitchouang
- Higher Institute of Scientific and Medical Research (ISM), Yaoundé, Cameroon
| | - Betrand Nono Fesuh
- Higher Institute of Scientific and Medical Research (ISM), Yaoundé, Cameroon
| | - Flobert Njiokou
- Parasitology and Ecology Laboratory, Department of Animal Biology and Physiology, Faculty of Science, University of Yaoundé 1, Yaoundé, Cameroon
| | - Benjamin Jacob
- Department of Global Health, College of Public Health, University of South Florida, Tampa, FL, USA
| | - Sébastien D Pion
- UMI 233 TransVIH MI, University of Montpellier, Institut de Recherche pour le Développement (IRD), Institut National de la Santé et de la Recherche Médicale (INSERM), Montpellier, France
| | - Joseph Kamgno
- Higher Institute of Scientific and Medical Research (ISM), Yaoundé, Cameroon
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