Ethical and legal frameworks are important for ensuring that the goals of scientific research are realised while at the same time the rights and welfare of human participants are adequately ...protected. A balance in attaining these two goals can be achieved if such frameworks provide for legally binding structures and processes to oversee, regulate, and monitor research on human participants according to accepted norms and standards. From 2007 to 2009, an ethical/legal audit, sponsored by the WHO/UNAIDS Ethics, Law and Human Rights Working Group of the African AIDS Vaccine Programme (AAVP ELH), was conducted in regard to five African countries (Cameroon, Malawi, Nigeria, Rwanda and Zambia) to determine whether these countries have adequate laws, ethical guidelines and policies in place to regulate HIV-vaccine research. This article discusses the findings of the audit with a view to highlighting key lessons that can be learnt from these countries. The article provides the context of the audit by highlighting its rationale, aims and methods. We discuss the general findings of the audit and the complex issues arising from HIV-vaccine research, specifically. Lastly, we propose specific ways in which the ethical/legal frameworks guiding research with human participants in these countries can be improved.
Cameroon is a country with many languages interacting together. The languages have a complex history reflecting its complex culture. This paper focuses on some of these complexities and demonstrate ...how people belonging to different linguistic groups construct and deconstruct the concept of country using local languages. I will expand on the feeling of belonging to the country when a local language is used. The paper will set the context, provide a historical background of Cameroon, explain the language situation and settle on how the multiple languages spoken in Cameroon make village and ethnic entities countries within a country. It may not be possible to discuss the possible interactions between the multiple languages but levels of interaction of these languages will be established. The notion of country will be explained through the use of the languages and linked to the complexity in the governance process undermining the unity of the people of Cameroon.
Despite legal restriction, induced abortions and resulting
complications are common in Nigeria. Misoprostol administration for
incomplete abortion was introduced in 3 Nigerian hospitals. The
...feasibility of the hospitals, patient and provider acceptability were
assessed using questionnaire and interview guides administered to 205
women and 17 providers respectively. Amongst the women, 194 (95%) were
satisfied and very satisfied with misoprostol, 176 (86%) would choose
misoprostol again if another incomplete abortion occurred and 191 (93%)
would recommend it to another woman in a similar situation. Providers
were highly satisfied with misoprostol. The ease of use and ability to
redirect surgical resources to more complicated issues were positive
features cited by them. The providers agreed that integration of
misoprostol was straightforward and required few resources. Therefore,
misoprostol for incomplete abortion is safe, efficacious and acceptable
to providers and patients. In remote areas of Nigeria with limited
post-abortion care (PAC), misoprostol administration is an important
potential PAC treatment modality. Features of misoprostol-low cost,
room temperature stability, and ease of introduction-render it an
important treatment option, particularly in low resource and rural
settings (Afr J Reprod Health 2011; 154: 42-50).
Background and purpose. Asthma is an important health condition in sub-Saharan Africa, with major gaps in clinical care. The aim of this project was to implement nurse-led care for asthma in rural ...Cameroon. Methods: We set-up a nurse-led structured management program for asthma in Bafut rural health district in Cameroon from 1998 to 2000. After an initial phase of intensive medical supervision, nurses were offered to run the clinics independently. Patients were monitored for all-cause mortality, hospitalizations, and control of asthma attacks. Results. At the final evaluation, 87 (73.4% women) were registered in the two pilot clinics. They were 4 to 92 years of age (median 51) and had been diagnosed with asthma for 0 to 40 years. The median duration of follow-up was 5 months (range 1-20) and patients attended on average 3 visits (range 1 to 14). During follow-up, a 66-year-old participant died and 170 emergency hospital admissions/consultations were recorded in 34 participants, 82.3% of them being women. Overall there was a significant downward trend in the number of days/month with attacks with the duration of follow-up, and at the last visit most patients had improved compared with the initial visit. This trend was apparent in most subgroups of participants. Hospital admission before baseline visit was a predictor of hospital admission during follow-up, hazard ratio (95% confidence interval) 3.20 (1.30-7.91), p = 0.012. Conclusions. The program was well received by the community at large. A marked improvement was observed for most patients as substantiated by the reduction in the number of asthma attacks. Trained nurses are a good alternative for the management of asthma in a resource-limited context.
Objective: To provide the current burden of high blood pressure and
related risk factors in urban setting in Cameroon. Methods:We used the
WHO STEPS approach for Surveillance of non-communicable ...diseases and
their risk factors to collect data from 2,559 adults aged 15-99 years,
residing at Cite des Palmiers in Douala, Cameroon. Results: The level
of education was low with up to 60% of participants totalizing less
than primary school. Smoking habits were 6 times more frequent in men
(p<0.001) and 85% of participants reported alcohol consumption.
Sedentary lifestyles at work and at leisure time were prevalent.Women
displayed high prevalence of obesity in general.The mean blood pressure
and the prevalence of hypertension increased with age in men and
women.The prevalence of hypertension was 20.8%, and the risk of
hypertension significantly increased with clustering of risk factors in
the general population (p=0.001) and in men (p=0.008). Conclusions:
This study provides additional evidence on the growing problem of
hypertension and related risk factors in urban Cameroon; and confirms
the feasibility of using the WHO STEPS approach for the surveillance of
NCDs in Africa. There is a need for rapid implementation of preventive
strategies in the country.
Despite legal restriction, induced abortions and resulting complications are common in Nigeria. Misoprostol administration for incomplete abortion was introduced in 3 Nigerian hospitals. The ...feasibility of the hospitals, patient and provider acceptability were assessed using questionnaire and interview guides administered to 205 women and 17 providers respectively. Amongst the women, 194 (95%) were satisfied and very satisfied with misoprostol, 176 (86%) would choose misoprostol again if another incomplete abortion occurred and 191 (93%) would recommend it to another woman in a similar situation. Providers were highly satisfied with misoprostol. The ease of use and ability to redirect surgical resources to more complicated issues were positive features cited by them. The providers agreed that integration of misoprostol was straightforward and required few resources. Therefore, misoprostol for incomplete abortion is safe, efficacious and acceptable to providers and patients. In remote areas of Nigeria with limited post-abortion care (PAC), misoprostol administration is an important potential PAC treatment modality. Features of misoprostol-low cost, room temperature stability, and ease of introduction-render it an important treatment option, particularly in low resource and rural settings. Introduction de Misoprostol pour le traitement de l'avortement inachevé au Nigéria Malgré la limitation judiciaire, les avortements provoqués et les implications éventuelles sont communs au Nigéria. L'administration de Misoprostol pour l'avortement inachevé a été introduite dans trois hôpitaux nigérians. Nous avons évalué la faisabilité des hôpitaux, l'acceptabilité des patientes et des dispensateurs é l'aide des questionnaires et des interviews auprès des 205 femmes et 17 dispensateurs respectivement. Parmi les femmes, 194 (95%) ont été satisfaites et très satisfaites de Misoprostol. 176 (86%) choisiraient Misoprostol encore si elles subissent un autre avortement inachevé et 191 (93%) le proposeraient aux autres femmes qui se trouvent dans une situation pareille. Les dispensateurs étaient hautement satisfaits de Misoprostol. La facilité de l'utilisation et la capacité de réorienter les ressources chirurgicales vers les problèmes plus compliqués constituent des qu'elles ont citées. Les dispensateurs étaient d'accord que l'intégration de Misoprostol est facile et ne demande que peu de ressources. En conséquence, Misoprostol n'est pas dangereux pour le traitement de l'avortement inachevé, il est efficace et acceptable aux dispensateurs et aux patientes. Dans les régions rurales isolées au Nigéria, qui ne disposent que très peu de soins du post-avortement (SPA) limités, l'administration de Misoprostol est une modalité de traitement du SPA potentiel important. Les caractéristiques de Misoprostol : bon marché, stabilité à la température ordinaire et la facilité de l'introduction, le rend une option de traitement importante, surtout dans les milieux é faibles revenus et dans les régions rurales.
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