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National levels of personal health-care access and quality can be approximated by measuring mortality rates from causes that should not be fatal in the presence of effective medical care (ie, amenable mortality). Previous analyses of mortality amenable to health care only focused on high-income countries and faced several methodological challenges. In the present analysis, we use the highly standardised cause of death and risk factor estimates generated through the Global Burden of Diseases, Injuries, and Risk Factors Study (GBD) to improve and expand the quantification of personal health-care access and quality for 195 countries and territories from 1990 to 2015. We mapped the most widely used list of causes amenable to personal health care developed by Nolte and McKee to 32 GBD causes. We accounted for variations in cause of death certification and misclassifications through the extensive data standardisation processes and redistribution algorithms developed for GBD. To isolate the effects of personal health-care access and quality, we risk-standardised cause-specific mortality rates for each geography-year by removing the joint effects of local environmental and behavioural risks, and adding back the global levels of risk exposure as estimated for GBD 2015. We employed principal component analysis to create a single, interpretable summary measure–the Healthcare Quality and Access (HAQ) Index–on a scale of 0 to 100. The HAQ Index showed strong convergence validity as compared with other health-system indicators, including health expenditure per capita (r=0·88), an index of 11 universal health coverage interventions (r=0·83), and human resources for health per 1000 (r=0·77). We used free disposal hull analysis with bootstrapping to produce a frontier based on the relationship between the HAQ Index and the Socio-demographic Index (SDI), a measure of overall development consisting of income per capita, average years of education, and total fertility rates. This frontier allowed us to better quantify the maximum levels of personal health-care access and quality achieved across the development spectrum, and pinpoint geographies where gaps between observed and potential levels have narrowed or widened over time. Between 1990 and 2015, nearly all countries and territories saw their HAQ Index values improve; nonetheless, the difference between the highest and lowest observed HAQ Index was larger in 2015 than in 1990, ranging from 28·6 to 94·6. Of 195 geographies, 167 had statistically significant increases in HAQ Index levels since 1990, with South Korea, Turkey, Peru, China, and the Maldives recording among the largest gains by 2015. Performance on the HAQ Index and individual causes showed distinct patterns by region and level of development, yet substantial heterogeneities emerged for several causes, including cancers in highest-SDI countries; chronic kidney disease, diabetes, diarrhoeal diseases, and lower respiratory infections among middle-SDI countries; and measles and tetanus among lowest-SDI countries. While the global HAQ Index average rose from 40·7 (95% uncertainty interval, 39·0–42·8) in 1990 to 53·7 (52·2–55·4) in 2015, far less progress occurred in narrowing the gap between observed HAQ Index values and maximum levels achieved; at the global level, the difference between the observed and frontier HAQ Index only decreased from 21·2 in 1990 to 20·1 in 2015. If every country and territory had achieved the highest observed HAQ Index by their corresponding level of SDI, the global average would have been 73·8 in 2015. Several countries, particularly in eastern and western sub-Saharan Africa, reached HAQ Index values similar to or beyond their development levels, whereas others, namely in southern sub-Saharan Africa, the Middle East, and south Asia, lagged behind what geographies of similar development attained between 1990 and 2015. This novel extension of the GBD Study shows the untapped potential for personal health-care access and quality improvement across the development spectrum. Amid substantive advances in personal health care at the national level, heterogeneous patterns for individual causes in given countries or territories suggest that few places have consistently achieved optimal health-care access and quality across health-system functions and therapeutic areas. This is especially evident in middle-SDI countries, many of which have recently undergone or are currently experiencing epidemiological transitions. The HAQ Index, if paired with other measures of health-system characteristics such as intervention coverage, could provide a robust avenue for tracking progress on universal health coverage and identifying local priorities for strengthening personal health-care quality and access throughout the world. Bill & Melinda Gates Foundation.

Shallow groundwater resources, especially in hard rock environment, constitute an important part of urban water supply in developing countries, appropriate to the low level of economic development. However, increasing urban population and dependence on shallow groundwater systems make it imperative to evaluate the availability and the contamination of these resources, and define new strategies of water exploitation taking into accounts these findings and constrains. This study has been carried out on the shallow groundwater of Yaounde, Central Africa. Based on head slug-in tests, chemical and isotope analyses, we demonstrate the importance of geomorphological settings that constrain hydrogeology, urban occupation and therefore, water exploitation and contamination. Slug test results show spatial variability of well recovery rates with higher values recorded in the valleys compare to the hills, presenting saturated hydraulic conductivity of 10–6–10–8 m/s. Groundwater evolves from recharge zone as Ca–HCO3 in the hillside lateritic system to discharge zone in the slope/valley colluvium/alluvium system as NaK–NO3. The groundwater composition dominated by silicates/water interaction in the hillside lateritic system, and anthropogenic processes in the slopes and valleys. δ15N and δ18O of nitrates indicates that nitrate pollution of groundwater is mainly from sewage and human waste. Shallow groundwater resources in the hillside/new urban districts and to a lesser extent slopes should therefore be protected and prioritised for usability and sustainability. The proposed conceptual scheme for Yaounde can then be used as a guide in the development, exploitation and management of local wells in hard rocks system of Africa.

Despite the good prognosis of surgical treatment of chronic subdural hematomas, there are some early deaths, recurrences and post-operative complications. The objective of this study is to analyze the prognostic factors of chronic subdural hematomas in two reference university teaching hospitals in the city of Yaounde. Three hundred and ten cases of chronic subdural hematomas were diagnosed on 3788 patients hospitalized in the neurosurgery departments of two reference university teaching hospitals in the city of Yaounde from January 1st, 2015 to December 31st, 2021 (7 years). The authors collected data from patients in whom surgical treatment was performed and assessed their prognosis with regard to the rate of early and late recurrence, mortality rate and postoperative complications and associated factors. Data from 284 patients were analyzed. The mortality rate was 6.7 % and the recurrence rate was 3.2 % in early postoperative period and 4.5 % after a follow-up of 3–24 months. Prognostic factors for death were age greater than or equal to 80 years (p value = 0.034) and presence of cortico-subcortical atrophy (p value = 0.003). The main recurrence factors were age greater than or equal to 70 years and compartmentalization of the hematoma. Chronic subdural hematomas are generally of good prognosis when the Glasgow coma score on admission is good and adequate management is carried out as soon as possible. Advanced age, lesions such as cortico-subcortical atrophy and compartmentalization of the hematoma are all factors that predispose to recurrence or early mortality. Those groups of patients should therefore benefit from a closer follow-up in post-operative period. •The prognosis of chronic subdural hematomas is dependent of the age, the Glasgow coma scale on admission, the association of comorbidities.•The recurrence of chronic subdural hematoma is most often observed when it is associated with age greater than 70 and compartmentalization of the hematoma.

In this paper, hydrological properties generally needed to improve all over the world the policy and then the sustainability of groundwater resources are also presented in the Neoproterozoic terrane of Yaoundé Cameroon. For this purpose, data collected from 150 boreholes realized in the study area were analysed statistically. The transmissivity (T) and the specific flow (Q/S) have been deduced from the pumping tests interpretation using the Jacob recovery method. The average transmissivity is equal to 2.9 × 10−5 m2/s, and the specific flow is equal to 0.26 m2/s. Wells depth (D) in general ranges from 41 to 80 m with an average of 57 m. The empirical relationship between T and Q/S is T = 0.0158(Q/S)1.01 with the determination coefficient R2 = 0.64. The weathered layer has a thickness (H) ranged from 2.6 to 63.3 m with an average of 16.8 m. Compared to other areas of the crystalline basement, although in the middle of the equatorial forest, the mean specific flow and the mean transmissivity in the Neoproterozoic terrane of Yaoundé represent barely half values. Those parameters are of paramount importance in the groundwater management policy.

Background: Improper maintenance of water used for hemodialysis poses a serious risk for patients by allowing the growth of biological contaminants like Candida species in the water system. These contaminants can be transmitted to patients through hemodialysis, exposing them to an increased risk of candidiasis. The objective of this study was to determine the antifungal susceptibility profile of Candida species isolated from water treatment units and urine from patients undergoing hemodialysis at GHY and UTHY in Yaounde, Cameroon. Methods: This cross‐sectional descriptive study was conducted from February 2024 to May 2024. Urine samples were collected from 132 consenting hemodialysis patients using a questionnaire, cultured on Sabouraud plus chloramphenicol agar. Water samples were collected every two days from different sites in the hemodialysis circuits; input, pretreatment, reverse osmosis (RO), RO output of both hospitals, filtered through membranes deposited on SC, and incubated at 35°C–37°C. Positive samples were cultured on CHROMagarTM to identify Candida species, which were tested against antifungals. SPSS V29.0.1.0 and Excel 2019 were used for statistics. Results: Of the patients, 17 (12.88%) had candiduria with C. auris (35.30%) most prevalent. Of 180 water samples, C. tropicalis (44.4%) was isolated from input water, while C. glabrata (22.2%) and C. parapsilosis (22.2%) were found in input and pretreated water. C. albicans (11.1%) was isolated at the RO output. Antifungal susceptibility testing of 35 Candida isolates showed that water isolates of C. glabrata , C. parapsilosis , and C. albicans were 100% susceptible to fluconazole and ketoconazole. C. tropicalis from water exhibited resistance to fluconazole. C. auris from urine was resistant to all antifungals tested. None were susceptible to itraconazole or amphotericin B. Conclusion: This study emphasizes the critical need for rigorous maintenance and monitoring of water used in hemodialysis to prevent transmission of antifungal‐resistant Candida to vulnerable patients.

Regular access to pipe-borne water remains a challenge to urban dwellers in Cameroon in general and those in Yaounde in particular. From that backdrop, this paper estimates the quantity of water used in car washing in the city of Yaounde as a representation of some of the numerous irrational water uses in the city in spite of its scarcity. It argues that the amount of water lost in car washing in the absence of water conservation and recycling techniques can offset the domestic water shortages experienced in many neighbourhoods of Yaounde significantly. To achieve this, both qualitative and quantitative methods were applied. An exhaustive enumeration of car washing points was undertaken in the Yaounde VI subdivision of the city of Yaounde. Water sources were determined and the water quantities used on a daily basis estimated from water bills paid and volumetric capacities of water reservoirs in the washing stations. Car washing was observed to be a streetside activity in dominantly outlying residential areas where some vacant undeveloped land still existed with the CDE being the major water supplier notwithstanding the emergence of alternative sources. Over 198.122 m³ of water (0.2 % of daily water use in the city of Yaounde) was estimated to be consumed by car washing in Yaounde VI. With a huge water supply deficit, of 200,000 m³ on its estimated daily water needs of 311,000 m³, water losses via spillouts from car washing points represents a significant withdrawal from the system that could reduce the daily shortages experienced by numerous households in Yaounde. There is the strong need for a water use policy that internalizes micro water recycling schemes in public water use as a means of reducing water demand, harvesting and wastage.

Cameroon faced several waves of COVID-19 epidemics between 2020 and 2022. The epidemic peaks were characterized by variations in the number of positive cases and major variants. The aim of this study was to determine the frequency of COVID-19 in Cameroon during the different epidemic waves. nasopharyngeal samples were collected in different regions of Cameroon between 2020 and 2022. The Daan Gene kit (DaAn Gene, Guangzhou, Guangdong Province, China) was used to detect SARS-CoV-2 in the samples by RT-PCR assay. Excel 2013 software was used to record participants´ sociodemographic characteristics (age, sex, sampling date) and SARS-CoV-2 test results. Statistical analyses were performed using IBM SPSS version 25 software. from 16 March 2020 to 31 December 2022, 142,850 samples were tested. Participants ranged in age from 1 to 99 years with a M/F sex ratio of 1.32. Of the participants tested, 17,463 (12.2%) were positive for SARS-CoV-2. The SARS-CoV-2 detection rate decreased over time and was highest in 2020 (15.6%; 7255/46466) as opposed to 2021 (12.7%; 8859/69867) and 2022 (5.1%; 1349/26383). Four peaks of COVID-19 circulation were identified: May 2020, March 2021, September 2021 and December 2021. Risk factors for increased detection of SARS-CoV-2 were being older than 65 years and being from the Littoral region. the SARS-CoV-2 positivity rate in Cameroon decreased over the years, probably due to compliance with the barrier measures implemented by the Cameroonian government to reduce transmission rates.

Shallow weathered hard rock aquifers are an important source of water supply, particularly in areas where water supply systems are deficient. The efficient use of water resources in these environments, therefore, requires additional knowledge of the hydrogeological processes of these aquifers. On the basis of statistical analysis of the piezometric data and hydraulic conductivity of the soil, this study permitted us to determine the hydrodynamic properties of the most superficial part of the hard rock aquifers of the Olézoa watershed in Cameroon. The vertical evolution of permeability at a depth of about 13 m was investigated by considering an exponential decay of permeability throughout the portion of the weathering profile overlying the coarse saprolite. The model was applied by simulating a range of exponential (α coefficient) relationships defining hydraulic conductivity versus depth. In this aquifer, piezometry generally follows the topography and the hydraulic conductivities are relatively weak and have a heterogeneous distribution which can nevertheless be related to morphopedological features. The hierarchical cluster analysis of hydraulic conductivity data and piezometric levels revealed links between these two parameters. This study made it possible to identify a variability in hydrogeological environments as a function of the value of α, the investigated depth in the field (piezometric level or bottom of the well) and the considered hydraulic conductivity (variable, Ks; estimated, Km and identical, Ke). It also made it possible to understand the dynamics of groundwater and to specify the groundwater table conditions which is useful for the sustainable management of groundwater. Understanding the effect of exponential decay of hydraulic conductivity on piezometric levels may be useful in future modeling efforts of shallow weathered hard rock aquifers.

The Yaounde Group (YG), representing the southern edge of the North Equatorial Pan-African Belt, consists of quartzites, schists, micaschists, amphibolites, gneisses and migmatites. Tectonism has formed a landscape characterized by the development of linear and folded valleys and ridges, fault scarps, V-shaped valleys, incised rivers and knickpoints. These landforms constitute important markers of the regional tectonic activity, which have been computed from spatial sources such as SRTM, DEM, hydrographical networks and geomorphic indices such as AF, T, Smf, Vf, Bs, Hi, U, SI and Li. The results highlighted a mature relief consisting of asymmetric basins generated by tilting and uplift phenomena. The relative index of active tectonics (RIAT) has been estimated from an average of eight geomorphic indices evaluated on 24 sub-basins, in the study area. Four classes have been defined: class 1 (1.38), very high active (1.0 ≤ RIAT < 1.5); class 2 (1.50–1.88), high active (1.5 ≤ RIAT < 2.0); and class 3 (2.00–2.13) moderate active (2.0 ≤ RIAT < 2.5). These three classes, respectively covering 10.20% (458 km 2 ), 80.10% (3595 km 2 ) and 9.69% (435 km 2 ) of the study area, have shown a highly active tectonic zone, and imply the existence of a neotectonic event in the YG. This tectonic unit (YG) was also affected by the dextral NW-SE strike-slip faulting, which cross-cut the Sanaga Shear Zone (SSZ) at Ebebda and the foliation oriented NW-SE. The tilting and uplift of rocks related to Moho ascending are responsible for crustal thinning in the Cameroon basement, more important to the Adamawa Plateau from the Cretaceous age and the reactivation of existing tectonic accidents. The presence of hills, fault scarps, reverse faults, knickpoints, V and U shaped valleys and rounded mountains testify to the interaction between tectonic uplift, lithology, climate, weathering and erosion.

A study of environmental chloride and groundwater balance has been carried out in order to estimate their relative value for measuring average groundwater recharge under a humid climatic environment with a relatively shallow water table. The hybrid water fluctuation method allowed the split of the hydrologic year into two seasons of recharge (wet season) and no recharge (dry season) to appraise specific yield during the dry season and, second, to estimate recharge from the water table rise during the wet season. This well elaborated and suitable method has then been used as a standard to assess the effectiveness of the chloride method under forest humid climatic environment. Effective specific yield of 0.08 was obtained for the study area. It reflects an effective basin-wide process and is insensitive to local heterogeneities in the aquifer system. The hybrid water fluctuation method gives an average recharge value of 87.14 mm/year at the basin scale, which represents 5.7% of the annual rainfall. Recharge value estimated based on the chloride method varies between 16.24 and 236.95 mm/year with an average value of 108.45 mm/year. It represents 7% of the mean annual precipitation. The discrepancy observed between recharge value estimated by the hybrid water fluctuation and the chloride mass balance methods appears to be very important, which could imply the ineffectiveness of the chloride mass balance method for this present humid environment.