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Background: In November 2012, the 62nd session of the Regional Committee for Africa adopted a comprehensive 10-year regional strategy for health disaster risk management (DRM). This was intended to operationalize the World Health Organization's core commitments to health DRM and the Hyogo Framework for Action 2005-2015 in the health sectors of the 47 African member states. This study reported the formative evaluation of the strategy, including evaluation of the progress in achieving nine targets (expected to be achieved incrementally by 2014, 2017, and 2022). We proposed recommendations for accelerating the strategy's implementation within the Sendai Framework for Disaster Risk Reduction.Methods: This study used a mixed methods design. A cross-sectional quantitative survey was conducted along with a review of available reports and information on the implementation of the strategy. A review meeting to discuss and finalize the study findings was also conducted.Results: In total, 58 % of the countries assessed had established DRM coordination units within their Ministry of Health (MOH). Most had dedicated MOH DRM staff (88 %) and national-level DRM committees (71 %). Only 14 (58 %) of the countries had health DRM subcommittees using a multi-sectoral disaster risk reduction platform. Less than 40 % had conducted surveys such as disaster risk analysis, hospital safety index, and mapping of health resources availability. Key challenges in implementing the strategy were inadequate political will and commitment resulting in poor funding for health DRM, weak health systems, and a dearth of scientific evidence on mainstreaming DRM and disaster risk reduction in longer-term health system development programs.Conclusions: Implementation of the strategy was behind anticipated targets despite some positive outcomes, such as an increase in the number of countries with health DRM incorporated in their national health legislation, MOH DRM units, and functional health sub-committees within national DRM committees. Health system-based, multi-sectoral, and people-centred approaches are proposed to accelerate implementation of the strategy in the post-Hyogo Framework of Action era. [ABSTRACT FROM AUTHOR]

The linkages between human health, biodiversity, ecosystems, and the life-supporting services that they provide are varied and complex. The traditional neglect of this nexus by policy-makers perpetuates threats posed to ecosystems with potentially critical impacts on global health. The Convention on Biological Diversity and the World Health Organization recently co-convened two regional workshops on these intricate but vital linkages. From discussions held with policy-makers and experts in the biodiversity and health sectors, spanning some 50 countries in Africa and the Americas, we derive a broad framework for the development of national and regional public health and biodiversity strategies relevant to strategic planning processes in the emerging post-2015 development context. [ABSTRACT FROM AUTHOR]

Background: Malaria is a major public health problem in Cameroon. Unlike in the southern forested areas where the epidemiology of malaria has been better studied prior to the implementation of control activities, little is known about the distribution and role of anophelines in malaria transmission in the coastal areas. Methods: A 12-month longitudinal entomological survey was conducted in Tiko, Limbe and Idenau from August 2001 to July 2002. Mosquitoes captured indoors on human volunteers were identified morphologically. Species of the Anopheles gambiae complex were identified using the polymerase chain reaction (PCR). Mosquito infectivity was detected by the enzyme-linked immunosorbent assay and PCR. Malariometric indices (plasmodic index, gametocytic index, parasite species prevalence) were determined in three age groups (<5 yrs, 5-15 yrs, >15 yrs) and followed-up once every three months. Results: In all, 2,773 malaria vectors comprising Anopheles gambiae (78.2%), Anopheles funestus (17.4%) and Anopheles nili (7.4%) were captured. Anopheles melas was not anthropophagic. Anopheles gambiae had the highest infection rates. There were 287, 160 and 149 infective bites/person/year in Tiko, Limbe and Idenau, respectively. Anopheles gambiae accounted for 72.7%, An. funestus for 23% and An. nili for 4.3% of the transmission. The prevalence of malaria parasitaemia was 41.5% in children <5 years of age, 31.5% in those 5-15 years and 10.5% in those >15 years, and Plasmodium falciparum was the predominant parasite species. Conclusion: Malaria transmission is perennial, rainfall dependent and An. melas does not contribute to transmission. These findings are important in the planning and implementation of malaria control activities in coastal Cameroon and West Africa. [ABSTRACT FROM AUTHOR]

Background: Insecticide-treated nets (ITNs) are an integral component of malaria control programmes in Africa. How much pyrethroid resistance in malaria vectors will impact on the efficacy of ITNs is controversial. The purpose of this study was to evaluate knockdown and killing effects of ITNs on a metabolic-based resistant or tolerant malaria vector strain. Methods: Bio-efficacy of 500 mg/m2 permethrin EC treated bednets was assessed on the OCEAC laboratory (OC-Lab) strain of Anopheles gambiae s.s.. This strain is resistant to DDT and tolerant to pyrethroids, with elevated mixed function oxidases. The Kisumu reference susceptible strain of A. gambiae s.s. was used as control. Nets were impregnated in February 1998 and used by households of the Ebogo village. Then they were collected monthly over six months for Bio-assays (WHO cone test). Knockdown and mortality rates were compared between the OC-Lab and the Kisumu strains, by means of the Mantel-Haenszel chi-square test. Results: During the whole trial, permethrin EC knockdown rates were impressive (mostly higher than 97%). No significant difference was observed between the two strains. However, the mortality rates were significantly decreased in the OC-Lab strain (40-80%) compared with that of the Kisumu strain (75-100%). The decrease of killing effect on the OC-Lab strain was attributed to permethrin EC tolerance, due to the high oxidase metabolic activity. Conclusion: These data suggested an impact of pyrethroid tolerance on the residual activity of ITNs. More attention should be given to early detection of resistance using biochemical or molecular assays for better resistance management. [ABSTRACT FROM AUTHOR]