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The SARS-CoV-2 pandemic has led to over 4.9 million deaths as of October 2021. One of the main challenges of creating vaccines, treatment, or diagnostic tools for the virus is its mutations and emerging variants. A couple of variants were declared as more virulent and infectious than others. Some approaches were used as nomenclature for SARS-CoV-2 variants and lineages. One of the most used is the Pangolin nomenclature. In our study, we enrolled 35 confirmed SARS-CoV-2 patients and sequenced the viral RNA in their samples. We also aimed to highlight the hallmark mutations in the most frequent lineage. We identified a seven-mutation signature for the SARS-CoV-2 C36 lineage, detected in 56 countries and an emerging lineage in Egypt. In addition, we identified one mutation which was highly negatively correlated with the lineage. On the other hand, we found no significant correlation between our clinical outcomes and the C36 lineage. In conclusion, the C36 lineage is an emerging SARS-CoV-2 variant that needs more investigation regarding its clinical outcomes compared to other strains. Our study paves the way for easier diagnosis of variants of concern using mutation signatures., Competing Interests: The authors declare that the research was conducted in the absence of any commercial or financial relationships that could be construed as a potential conflict of interest., (Copyright © 2022 Agwa, Elghazaly, El Meteini, Yahia, Khaled, Abd Elsamee, Darwish, Elsayed, Hafez, Mahmoud, EM and Matboli.)

Immunochromatographic tests (ICT) are diagnostics tools providing rapid results without the need for specialized equipment. Our aim was to evaluate retrospectively the rotavirus and adenovirus ICT routinely used in the virology laboratory serving the University Hospital of Marseille, France. From January 2017 to March 2020, 715 stool specimens from patients were screened using the Ridaquick Rotavirus/Adenovirus Combi ICT (RR/AC ICT) and a commercially available multiplex PCR detection kit. Rotavirus was detected in 9.2% of specimens by PCR and 7.7% of specimens by RR/AC ICT while adenovirus was detected in 8.5% of specimens by PCR and 2.4% of specimens by RR/AC ICT. The RR/AC ICT parameters for rotavirus were 75.8% sensitivity, 99.2% specificity, 90.9% positive predictive value (PPV) and 97.6% negative predictive value (NPV). The RR/AC ICT parameters for adenovirus were 6.6% sensitivity, 98.0% specificity, 23.5% PPV and 91.8% NPV. While the ICT test may be suitable for rotavirus detection, a PCR-based assay is better adapted for adenovirus detection in stools.

Bufavirus (BuV) and human parvovirus 4 (PARV4) belong to the Parvoviridae family. We assessed BuV and PARV4 DNA presence by real-time PCR analysis in stool, blood and respiratory samples collected in patients from Marseille and Nice, two large cities in the South-East of France. Bu-V DNA was detected in diarrheic stool samples from 92 patients (3.6% of 2583 patients), particularly men and adults, and patients from the nephrology and the infectious disease departments. Among the patients with a BuV-positive stool sample and for whom at least one blood sample was available ( n = 30 patients), BuV DNA was detected also in 3 blood samples. In contrast, BuV DNA was not detected in any of the respiratory samples from 23 patients with BuV-positive stool. BuV detection rate was comparable in stool samples from patients with and without diarrhea. We did not detect PARV4 DNA in any of the stool specimens ( n = 2583 patients). Our results suggest that PARV4 fecal-oral transmission is rare or non-existent in the South-East of France while BuV circulates with a relatively high rate in this area.

Official case counts suggest Africa has not seen the expected burden of COVID-19 as predicted by international health agencies, and the proportion of asymptomatic patients, disease severity, and mortality burden differ significantly in Africa from what has been observed elsewhere. Testing for SARS-CoV-2 was extremely limited early in the pandemic and likely led to under-reporting of cases leaving important gaps in our understanding of transmission and disease characteristics in the African context. SARS-CoV-2 antibody prevalence and serologic response data could help quantify the burden of COVID-19 disease in Africa to address this knowledge gap and guide future outbreak response, adapted to the local context. However, such data are widely lacking in Africa. We conducted a cross-sectional seroprevalence survey among 1,192 individuals seeking COVID-19 screening and testing in central Cameroon using the Innovita antibody-based rapid diagnostic. Overall immunoglobulin prevalence was 32%, IgM prevalence was 20%, and IgG prevalence was 24%. IgM positivity gradually increased, peaking around symptom day 20. IgG positivity was similar, gradually increasing over the first 10 days of symptoms, then increasing rapidly to 30 days and beyond. These findings highlight the importance of diagnostic testing and asymptomatic SARS-CoV-2 transmission in Cameroon, which likely resulted in artificially low case counts. Rapid antibody tests are a useful diagnostic modality for seroprevalence surveys and infection diagnosis starting 5-7 days after symptom onset. These results represent the first step towards better understanding the SARS-CoV-2 immunological response in African populations., Competing Interests: We declare no competing interests., (© 2021 The Authors.)

A significant number of Baka Pygmies in Cameroon have been sedentarised in roadside villages, in contrast to their nomadic hunter-gatherer existence of the past. Although this change in lifestyle has had important consequences on health, most Baka villages still supplement their diets from forest products, especially wild meat. We used a combination of participatory methods and monitoring of individual hunters to map hunting territories in 10 Baka villages in southeastern Cameroon. From these, we determined whether wild meat extraction levels per village were related to the size of hunting territories, measured habitat use by hunters and finally defined the overlap between hunting territories and extractive industries in the region. Mapped village hunting areas averaged 205.2 ± 108.7 km 2 (range 76.8-352.0 km 2 ); all villages used a total of 2052 km 2 . From 295 tracks of 51 hunters, we showed that hunters travelled an average of 16.5 ± 13.5 km (range 0.9-89.8 km) from each village. Home ranges, derived from kernel utilization distributions, were correlated with village offtake levels, but hunter offtake and distance travelled were not significantly related, suggesting that enough prey was available even close to the villages. Hunters in all village areas exhibited a clear bias towards certain habitats, as indicated by positive Ivlev's index of selectivity values. We also showed that all village hunting territories and hunter home ranges fall within mining and logging concessions. Our results are important for local understanding of forest land uses and to reconcile these with the other land uses in the region to better inform decisions concerning land use policy and planning.

Intradialytic hypotension (IDH), one of the most frequent acute complications of hemodialysis (HD), is associated with increased patient's morbidity and mortality. The aim of this study was to determine its prevalence and associated factors among patients on maintenance HD in Cameroon. This was a prospective longitudinal study carried out from June 20, to July 30, 2016 (5 weeks), including adult patients on HD >3 months at a tertiary hospital in Douala. During this period, patients were followed up at each HD session, and their blood pressure and occurrence of clinical events possibly related to IDH were recorded. In this study, IDH was defined as a decrease in systolic BP by >20 mm Hg or a decrease in mean arterial pressure by >10 mm Hg, associated to a clinical event. Logistic regression analysis was used to determine associated factors. We included 104 patients (69 males) with a mean age of 50.74 ± 15.18 years and a median duration on HD of 30.5 (interquartile range: 12.25-58.75) years. Hypertension 99/104 (95.2%) and diabetes 32/104 (30.8%) were the main comorbidities encountered. A total of 1032 HD sessions were followed up with an average of 9.88 ± 1.57 sessions per patient. IDH occurred in 11.6% of HD sessions. Associated factors were age, female sex, HIV infection, feeding during dialysis, and use of antihypertensive drug during or within 2 h before dialysis. The prevalence of IDH in our study was low. Associated factors were mainly related to patient's characteristics and comorbidities.

Background: Late presentation (LP) of chronic kidney disease (CKD) patients to nephrologist is a serious problem worldwide with persistent high prevalence despite known benefits of early nephrology care., Objective: Determine the prevalence and factors associated with LP of CKD patients to nephrologists in Cameroon., Methods: A cross-sectional study from October 2015 to May 2016 at the nephrology units of the Douala General and Laquintinie hospitals, including all consenting incident CKD patients. Data collected were: socio-demographic, search of CKD diagnostic criteria during prior follow up, therapeutic itinerary, clinical and biological parameters at presentation, knowledge on CKD and attitude towards dialysis. LP was defined as eGFR < 30 ml/min/1.73 m 2 . It was physician-related whenever no CKD screening was done in the presence of risk factor or no referral to nephrologists at early stages; patient-related whenever patients did not have recourse to hospital care while symptomatic or disrespected a referral decision. p value <.05., Results: We included 130 patients, mean age 53.10 ± 14.66 years, 60.77% males, 58.70% were referred by internal medicine physicians and 10% had recourse to complementary and alternative medicine (CAM). At presentation, 70.80% were symptomatic, 53% had CKD stage five, 86.12% were poorly graded on knowledge and 49% had a negative attitude towards dialysis. The prevalence of LP was 73.90%, 50% was physician-related, 44.79% patient-related and 5.21% both. Being accompanied (p = .038), a low level of education (p = .025) and recourse to CAM (p = .008) were associated with LP., Conclusion: LP is high in Cameroon, attributed to physician's practical attitudes and patient's socio-cultural behaviors and economic conditions.

Hepatitis C virus (HCV) infection one of the most common blood-borne infections is endemic in Cameroon and a serious problem in hemodialysis (HD). We aimed to determine the annual incidence and factors associated with seroconversion to hepatitis C positivity amongst patients on maintenance HD after an exposition of two years in a center with a high prevalence of hepatitis C (20.6%) and where no isolation policy is practiced. This was a retrospective cohort study carried out in January 2015 in the HD unit of Douala General Hospital in Cameroon including 71 patients on maintenance HD who tested negative for HCV in January 2013. Socio-demographic characteristics and clinical data were recorded, while for each patient 10 mL of blood was collected and patients retested for HCV using a fourth-generation ELISA test (BIOREX R BXEO781A). Fisher's exact test was used for dichotomous variables and using Mann Whitney's test for quantitative variables. Statistical significance was set at P <0.05. Mean age was 47 ± 13 years with 60.6% male. Blood transfusion was the main means for anemia management (85.9%) with a median number of blood units received of 5 (1-44). Facility HCV prevalence was 19.3% in January 2015. Five out of the 71 patients developed anti-HCV antibodies giving us a seroconversion rate of 7.1% and an incidence of 3.6/100 patient years. There was no significant association between age (P = 0.4), number of blood units received (P = 0.8) origin of blood units (P = 0.8), scarifications (P = 0.09) and seroconversion. After two years of exposure seroconversion to HCV positivity was 7.1% in our center with no associated factors. In a setting with high prevalence of HCV, isolation of positive patient may help to reduce the rate of transmission., Competing Interests: None declared

This study aims to detect the antischistosomal properties of the plants' Chenopodium ambrosioides, Conyza dioscorides and Sesbania sesban methanol extract against Schistosoma mansoni in infected mice, including determination of total protein and albumin levels and the activities of alanine and aspartate transaminases (AlT, AsT) and acid and alkaline phosphatases (AcP and AkP) enzymes in the serum of infected treated mice. Male Swiss albino mice were infected with S. mansoni and orally treated with methanol extract of the plants C. ambrosioides (1250 mg/kg/day), C. dioscorides and S. sesban (1000 mg/kg/day from each) for 2 consecutive days 7 weeks post infection (PI). In addition, treatment of mice with the tested dose of each plant extract was successively done (i.e. the 1st extract followed by the 2nd and 3rd one with an hour interval). Parasitological and biochemical parameters were assessed. Nine weeks PI, the reduction rates of worm load/mouse treated with either C. dioscorides (1000 mg/kg), C. ambrosioides (1250 mg/kg) or S. sesban (1000 mg/kg) were 40.9%, 53.7% and 54.4%, respectively. Successive treatment raised the reduction rates of worm load/mouse to 66.3% and the ova/g tissue in liver to 76.9%. Moreover, serum total protein and albumin levels and activities of AlT, Ast, AcP and AkP enzymes of infected treated mice were improved in comparison with those of infected untreated ones. It is concluded that administration of C. dioscorides, C. ambrosioides and S. sesban methanol extract to infected mice exhibited a moderate antischistosomal effect. Successive treatment improved the antischistosomal properties of these plant species, hence ameliorated the liver functions of treated mice that may suggest degenerations of liver granulomas and regenerative changes., (Copyright © 2011 Elsevier Ireland Ltd. All rights reserved.)

Introduction: Despite the development of non-invasive ventilation there remain indications for domiciliary ventilation by tracheostomy (TDV). The principal complications are mechanical and infective. We report a case of chylous ascites secondary to compression of the thoracic duct by the tracheostomy cuff., Case Report: A man of 65 had had TDV for over one year. During hospitalisation for possible weening chylous ascites was discovered. The classical causes of this condition were excluded. CT scan of the neck and thorax showed evidence of significant dilatation (over 45 mm) of the upper part of the trachea in association with an over-inflated cuff, leading to compression of the thoracic duct. On reducing the inflation pressure of the cuff the chylous ascites has not recurred., Conclusion: The management of the tracheostomy tube cuff is an important matter for the personel involved in the management of TDV. Regular radiological surveillance is useful to ensure that there is no tracheal dilatation in association with the cuff.