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Djuicy DD, Bilounga CN, Esso L, Mouiche MMM, Yonga MGW, Essima GD, Nguidjol IME, Anya PJA, Dibongue EBN, Etoundi AGM, Eyangoh SI, Kazanji M, Njouom R. Evaluation of the mpox surveillance system in Cameroon from 2018 to 2022: a laboratory cross-sectional study. BMC Infect Dis 2024; 24:949. [PMID: 39256651 PMCID: PMC11385501 DOI: 10.1186/s12879-024-09802-2] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/06/2024] [Accepted: 08/22/2024] [Indexed: 09/12/2024] Open
Abstract
BACKGROUND Formal assessment of a surveillance system's features and its ability to achieve objectives is crucial for disease control and prevention. Since the implementation of the mpox surveillance system in Cameroon, no evaluation has been conducted. METHODS In a cross-sectional study, we assessed the performance of the mpox surveillance system in accordance with the Centers for Disease Control and Prevention (CDC) and World Health Organization (WHO) guidelines. We collected mpox surveillance data from 2018 to 2022 and conducted a survey with key stakeholders of the surveillance program. The survey results were summarized. The rates of complete reporting and mpox detection, as well as the time lag between the different stages of surveillance were analyzed using R version 4.1. RESULTS The mpox detection rate was 21.6% (29/134) over the five years under review. Surveillance indicators revealed that a combination of sample types, including vesicles, crust, and blood, was associated with higher case confirmation. Overall, the mpox surveillance system was effective. Weaknesses in terms of simplicity were identified. Most components of the assessed system failed to meet the timeliness and data quality goals, except for the laboratory component, which was commendable. The lack of a computerized shared database and the system's non-sustainability were a course of concern. CONCLUSIONS Despite all identified bottlenecks in the mpox surveillance system in Cameroon, it was found to meet it stipulated goals. Recommendations are made for training on surveillance system features, particularly at the facility/field level. Therefore, there is a crucial need to globally improve the mpox surveillance system in Cameroon for better disease control.
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Affiliation(s)
- Delia Delia Djuicy
- Virology Service, Centre Pasteur of Cameroon, 451 Rue 2005, P. O. Box 1274, Yaoundé, Cameroon
| | - Chanceline Ndongo Bilounga
- Department for the Control of Disease, Epidemics and Pandemics (DLMEP), Ministry of Public Health, Yaoundé, Cameroon
- Faculty of Medicine and Pharmaceutical Sciences, University of Douala, Douala, Cameroon
| | - Linda Esso
- Department for the Control of Disease, Epidemics and Pandemics (DLMEP), Ministry of Public Health, Yaoundé, Cameroon
- Faculty of Medicine and Biomedical Sciences, University of Yaoundé, Yaoundé, Cameroon
| | - Moctar Mohamed Moulioum Mouiche
- USAID's Infectious Disease Detection and Surveillance (IDDS) Program, ICF, Yaoundé, Cameroon
- School of Veterinary Medicine and Science, University of Ngaoundéré, Ngaoundéré, Cameroon
| | | | - Gael Dieudonné Essima
- Virology Service, Centre Pasteur of Cameroon, 451 Rue 2005, P. O. Box 1274, Yaoundé, Cameroon
| | - Inès Manda Emah Nguidjol
- Department for the Control of Disease, Epidemics and Pandemics (DLMEP), Ministry of Public Health, Yaoundé, Cameroon
| | - Pricilla Josephine Ambany Anya
- Department for the Control of Disease, Epidemics and Pandemics (DLMEP), Ministry of Public Health, Yaoundé, Cameroon
- USAID's Infectious Disease Detection and Surveillance (IDDS) Program, ICF, Yaoundé, Cameroon
| | - Elisabeth Betsi Noma Dibongue
- National Program for the Fighting Against Emerging and Re-emerging Zoonosis (PNLZER), Prime Ministry Office, Yaoundé, Cameroon
| | - Alain Georges Mballa Etoundi
- Department for the Control of Disease, Epidemics and Pandemics (DLMEP), Ministry of Public Health, Yaoundé, Cameroon
- Faculty of Medicine and Biomedical Sciences, University of Yaoundé, Yaoundé, Cameroon
| | - Sara Irène Eyangoh
- Virology Service, Centre Pasteur of Cameroon, 451 Rue 2005, P. O. Box 1274, Yaoundé, Cameroon
| | - Mirdad Kazanji
- Virology Service, Centre Pasteur of Cameroon, 451 Rue 2005, P. O. Box 1274, Yaoundé, Cameroon
| | - Richard Njouom
- Virology Service, Centre Pasteur of Cameroon, 451 Rue 2005, P. O. Box 1274, Yaoundé, Cameroon.
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Djuicy DD, Sadeuh-Mba SA, Bilounga CN, Yonga MG, Tchatchueng-Mbougua JB, Essima GD, Esso L, Nguidjol IME, Metomb SF, Chebo C, Agwe SM, Ankone PA, Ngonla FNN, Mossi HM, Etoundi AGM, Eyangoh SI, Kazanji M, Njouom R. Concurrent Clade I and Clade II Monkeypox Virus Circulation, Cameroon, 1979-2022. Emerg Infect Dis 2024; 30:432-443. [PMID: 38325363 PMCID: PMC10902553 DOI: 10.3201/eid3003.230861] [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] [Indexed: 02/09/2024] Open
Abstract
During 1979-2022, Cameroon recorded 32 laboratory-confirmed mpox cases among 137 suspected mpox cases identified by the national surveillance network. The highest positivity rate occurred in 2022, indicating potential mpox re-emergence in Cameroon. Both clade I (n = 12) and clade II (n = 18) monkeypox virus (MPXV) were reported, a unique feature of mpox in Cameroon. The overall case-fatality ratio of 2.2% was associated with clade II. We found mpox occurred only in the forested southern part of the country, and MPXV phylogeographic structure revealed a clear geographic separation among concurrent circulating clades. Clade I originated from eastern regions close to neighboring mpox-endemic countries in Central Africa; clade II was prevalent in western regions close to West Africa. Our findings suggest that MPXV re-emerged after a 30-year lapse and might arise from different viral reservoirs unique to ecosystems in eastern and western rainforests of Cameroon.
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Sandie AB, Tejiokem MC, Faye CM, Hamadou A, Abah AA, Mbah SS, Tagnouokam-Ngoupo PA, Njouom R, Eyangoh S, Abanda NK, Diarra M, Ben Miled S, Tchuente M, Tchatchueng-Mbougua JB, Tchatchueng-Mbougua JB. Observed versus estimated actual trend of COVID-19 case numbers in Cameroon: A data-driven modelling. Infect Dis Model 2023; 8:228-239. [PMID: 36776734 PMCID: PMC9905042 DOI: 10.1016/j.idm.2023.02.001] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/08/2022] [Revised: 02/02/2023] [Accepted: 02/02/2023] [Indexed: 02/10/2023] Open
Abstract
Controlling the COVID-19 outbreak remains a challenge for Cameroon, as it is for many other countries worldwide. The number of confirmed cases reported by health authorities in Cameroon is based on observational data, which is not nationally representative. The actual extent of the outbreak from the time when the first case was reported in the country to now remains unclear. This study aimed to estimate and model the actual trend in the number of COVID -19 new infections in Cameroon from March 05, 2020 to May 31, 2021 based on an observed disaggregated dataset. We used a large disaggregated dataset, and multilevel regression and poststratification model was applied prospectively for COVID-19 cases trend estimation in Cameroon from March 05, 2020 to May 31, 2021. Subsequently, seasonal autoregressive integrated moving average (SARIMA) modeling was used for forecasting purposes. Based on the prospective MRP modeling findings, a total of about 7450935 (30%) of COVID-19 cases was estimated from March 05, 2020 to May 31, 2021 in Cameroon. Generally, the reported number of COVID-19 infection cases in Cameroon during this period underestimated the estimated actual number by about 94 times. The forecasting indicated a succession of two waves of the outbreak in the next two years following May 31, 2021. If no action is taken, there could be many waves of the outbreak in the future. To avoid such situations which could be a threat to global health, public health authorities should effectively monitor compliance with preventive measures in the population and implement strategies to increase vaccination coverage in the population.
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Key Words
- ACF, Autocorrelation Function
- AIC, Akaike information criterion
- COVID-19
- COVID-19, Coronavirus Disease 2019
- Cameroon
- Forecasting
- MAE, Mean Absolute Error
- MAPE, Mean Absolute Percentage Error
- MASE, Mean Absolute Scaled Error
- ME, Mean Error
- MPE, Mean Percentage Error
- MRP, Multilevel Regression and Post-stratification
- Observed
- PACF, Partial Autocorrelation Function
- PLACARD, Platform for Collecting, Analyzing and Reporting Data
- Post-stratification
- SARIMA, Seasonal Autoregressive integrated moving average
- SARS-CoV-2, Severe Acute Respiratory Syndrome Coronavirus 2
- Underestimated
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Affiliation(s)
- Arsène Brunelle Sandie
- African Population and Health Research Center, West Africa Regional Office, Dakar, Senegal,Centre Pasteur du Cameroon, membre du Réseau International des Instituts Pasteur, Cameroon,Corresponding author. African Population and Health Research Center, West Africa Regional Office, Dakar, Senegal.
| | | | - Cheikh Mbacké Faye
- African Population and Health Research Center, West Africa Regional Office, Dakar, Senegal
| | - Achta Hamadou
- Centre Pasteur du Cameroon, membre du Réseau International des Instituts Pasteur, Cameroon
| | - Aristide Abah Abah
- Direction de la lutte contre les Maladies épidémiques et les pandémies, Ministère de la santé publique, Cameroon
| | - Serge Sadeuh Mbah
- Centre Pasteur du Cameroon, membre du Réseau International des Instituts Pasteur, Cameroon
| | | | - Richard Njouom
- Centre Pasteur du Cameroon, membre du Réseau International des Instituts Pasteur, Cameroon
| | - Sara Eyangoh
- Centre Pasteur du Cameroon, membre du Réseau International des Instituts Pasteur, Cameroon
| | - Ngu Karl Abanda
- Centre Pasteur du Cameroon, membre du Réseau International des Instituts Pasteur, Cameroon
| | | | | | - Maurice Tchuente
- Fondation pour la recherche l'ingénierie et l'innovation, Cameroon,IRD UMI 209 UMMISCO, University of Yaounde I, P.O. Box 337, Yaounde, Cameroon
| | - Jules Brice Tchatchueng-Mbougua
- Centre Pasteur du Cameroon, membre du Réseau International des Instituts Pasteur, Cameroon,IRD UMI 209 UMMISCO, University of Yaounde I, P.O. Box 337, Yaounde, Cameroon
| | - Jules Brice Tchatchueng-Mbougua
- Centre Pasteur du Cameroon, membre du Réseau International des Instituts Pasteur, Cameroon,IRD UMI 209 UMMISCO, University of Yaounde I, P.O. Box 337, Yaounde, Cameroon
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