Persistance des pathologies tropicales et maladies culturelles au Cameroun : cas de l’onchocercose chez les Bamoun à l’ouest

Abstract

This work is entitled « Persistance des pathologies tropicales et maladies culturelles au Cameroun : Cas de l’onchocercose chez les Bamoun à l’Ouest ». As part of the fight against onchocerciasis, this work raises the problem of the persistence of this disease in the districts of Kouoptamo, Massangam and Fosset. In fact, for several years now, Cameroon, with the support of its development partners, has been mobilising human, material and economic resources to eliminate onchocerciasis through the implementation of several strategies, including the CDTI strategy initiated by APOC. Despite these efforts and the effectiveness of geographic coverage, therapeutic coverage has come up against numerous difficulties and the disease continues to be rampant. The main research question is what are the explanatory factors for the persistence of onchocerciasis among the Bamoun in Kouoptamo, Fosset and Massangam in the Noun department, West Cameroon Region? To answer this question, we put forward the hypothesis that environmental, socio-cultural, economic, behavioural and organisational factors linked to the chemoprevention campaigns favour the persistence of onchocerciasis among the Bamoun in kouoptamo, Fosset and Massangam. The main objective is to understand the factors that explain the persistence of onchocerciasis among the Bamoun in Kouoptamo, Fosset and Massangam in the Noun department, West Cameroon Region. The qualitative method was used to collect secondary and primary data using specific techniques and tools. The data collected was analysed using the content analysis technique, and the results were interpreted using a theoretical framework based on Harold Garfinkel's ethnomethodology (1967), Ann Mc Elroy and Patricia K. Townsend's ecological approach (1985), and Arthur Kleinman's interpretative cultural approach to medical anthropology (1970) and Byron Good (1990). This methodological approach has produced a number of results, the most relevant of which are as follows: Socio-economic activities and cultural practices constantly expose populations to vectors and lead to the persistence of the disease; fear of side effects, representations of the disease and the perception that the drug is free reinforce people's refusal to take ivermectin; cultural practices lead to the use of the drug for inappropriate reasons; poor application of the principles of Community-Directed Treatment with Ivermectin (CDTI) by field workers; the failure to take charge of DCs, resulting in the diversion of medicines and their resignation; the discrepancy between actual data and official data due to the fictitious filling in of distribution registers.