A multi-centre study of community-directed ivermectin distributors' (CDDs') involvement in other healthcare and development programme activities in Cameroon, Togo, Sudan, Nigeria and Uganda

A multi-centre study to determine whether community-directed distributors (CDDs) are capable of carrying out additional healthcare and developmental activities in their communities was carried out in Cameroon, Nigeria, Sudan, Uganda and Togo to ascertain the potential effects of their involvement on the implementation of community-directed treatment with ivermectin (CDTI). Both quantitative and qualitative methods were used to collect data from households, community-directed distributors, community leaders, and health workers. The results showed no major decrease in the CDDs' performance in CDTI: on the contrary, the involvement of CDDs in other health and development activities motivated them to perform their CDTI functions better. However, the results did not show any significant increase in therapeutic coverage of ivermectin distribution. The expansion of the CDDs' experience to include additional healthcare and development related activities would be of interest to onchocerciasis control programmes--it will strengthen CDTI sustainability through greater integration.

Comparison of Edmonston-Zagreb, Connaught and Schwarz measles vaccines in Cameroonian infants aged 3-8 months

Eighty-five Cameroonian infants aged between 3 and 8 months were vaccinated with a high-dose Edmonston-Zagreb (EZ) strain (10(5.6) TDIC50), 81 with a low-dose Connaught strain (10(3) TCID50) and 74 with a medium-dose Schwarz strain (10(4) TCID50). Side-effects were mild (less than 32% of infants) and were not significantly different among the groups, nor were postvaccination anti-measles antibody levels. Postvaccination seropositivity and seroconversion rates were respectively 91.6% and 69% for EZ, 85.3% and 67.7% for Connaught and 75.6% and 62.2% for Schwarz. In the light of concerns regarding high-titre measles vaccines, the overall performance of the Connaught strain warrants its wider evaluation in young infants.

Water contact and schistosomiasis infection in Kumba, south-western Cameroon

Kumba, a town with a population of mixed background and socio-economic status, is a new and intense focus of schistosomiasis. Although fountains provide clean water, the population still uses the river and streams which cross the town for most of its bathing, laundry and swimming. A multivariate analysis indicated that a local subject's age, ethnic group, knowledge about schistosomiasis and the intensity of his or her contact with the river and/or streams were all significantly associated with schistosome infection. Surprisingly, a high level of knowledge about schistosomiasis was positively associated with the infection.

Ascariasis and trichuriasis in Cameroon

A national survey of Ascaris lumbricoides and Trichuris trichuria was carried out in Cameroon on more than 22,000 children from a random sample of 512 schools. Prevalence rates of both A. lumbricoides and T. trichuria infection were very low in the tropical zone (below 5%). They increased markedly in the equatorial zone, Guinea-type climate, to 60-85% for A. lumbricoides and 85-95% for T. trichuria. In the equatorial zone with Cameroon-type climate, prevalences were slightly lower: 50-70% for A. lumbricoides and 70-90% for T. trichuria infections. Environmental conditions are the main factors explaining these differences. Other factors (altitude, population density and urbanization) were not important. The entire population of villages selected from distinct climatic zones of Cameroon were also examined. The age group distribution of A. lumbricoides and T. trichuria infections indicated acquisition early in life, reaching a peak in early childhood, followed by a stable prevalence rate.