The paucity of data regarding the relationship between atherogenic index of plasma (AIP) and risk... more The paucity of data regarding the relationship between atherogenic index of plasma (AIP) and risk of cardiovascular disease (CVD) in postmenopausal women living in sub-Saharan Africa prompted us to conduct this study which aimed at assessing the interplay between AIP and risk of CVD among Cameroonian postmenopausal women. This was a cross-sectional study conducted among 108 postmenopausal women in Yaoundé, Cameroon. Risk of CVD was calculated using the Framingham risk score, (FRS), and the AIP was derived as log (triglycerides/high-density lipoproteins cholesterol). Mean age of participants equaled 56.4 ± 6.9 years. AIP values ranged from -0.40 to 0.85 with a mean of 0.21 ± 0.27. There was a positive and significant correlation between AIP and body mass index (r = 0.234; p = 0.015), systolic blood pressure (r = 0.350; p < 0.001), diastolic blood pressure (r = 0.365; p < 0.001), fasting plasma glucose (r = 0.314; p = 0.001), uric acid (r = 0.374; p < 0.001), and total cholesterol (r = 0.374; p < 0.001), but not with age (r = -0.104; p = 0.284). The FRS varied between 1.2 % and >30 % with a mean of 13.4 ± 8.7 %. In univariable model, AIP significantly influenced the risk of CVD (β = 11.94; p < 0.001; R(2) = 0.136). But in the multivariable model, after adjusting for confounders, AIP did not impact the risk of CVD anymore (adjusted β = 1.98; p = 0.487; R(2) = 0.486). AIP may not be an independent factor impacting the risk of CVD among Cameroonian postmenopausal women. More studies are needed to better elucidate the interaction between AIP and risk of CVD in our setting.
Data on sexual behaviors in Cameroonian youths are needed to design and implement effective preve... more Data on sexual behaviors in Cameroonian youths are needed to design and implement effective preventive strategies against HIV/AIDS. This study aimed at assessing sociodemographic and religious factors associated with sexual behaviors among university students in Cameroon. In 2011, 411 university students were surveyed by a self-administered questionnaire at the Medical and Social Welfare Center of the University of Maroua. Logistic regression analyses were used to determine correlates of sexual behaviors. 80.8 % of students were sexually active. The mean age at sexual debut was 18.1 years (SD = 3.1). The frequency of premarital sex was 92.8 %. Pornography viewing [adjusted odds ratio (aOR): 4.0, 95 % CI 2.1-7.6; p < 0.0001] and an increased age of 1 year (aOR: 1.3, 95 % CI 2.0-7.6; p < 0.0001) were significantly associated with having previously had sex. The likelihood to have a lower (<18) age at sexual debut was increased by male gender (aOR: 2.5, 95 % CI 1.7-5; p < 0.001), and urban origin (aOR: 2.9, 95 % CI 1.5-5.7; p < 0.01). The probability to have a high number (#3) of lifetime sexual partners was increased by age (aOR: 1.1, 95 % CI 1.0-1.2; p < 0.001), pornography viewing (aOR: 4.3, 95 % CI 1.9-9.5; p < 0.001), an early sexual debut (aOR: 2.8, 95 % CI 1.6-5.0; p < 0.001), having had occasional sexual partners (aOR: 7.0, 95 % CI 3.7-13.1; p < 0.0001), and was decreased by Muslim religious affiliation (aOR: 0.2, 95 % CI 0.1-0.9; p < 0.05). Having had casual sexual partners was associated with less inconsistent condom use (aOR: 0.5, 95 % CI 0.2-0.9; p < 0.05). Our findings indicate that there is an alarming level of risky sexual behaviors among the study population. Strong and efficient measures should be undertaken to handle such harmful behaviors, this for the prevention and control of HIV/AIDS and other STIs in this vulnerable population.
Post-menopausal women may be at particular risk of developing cardiovascular disease due to metab... more Post-menopausal women may be at particular risk of developing cardiovascular disease due to metabolic changes occurring at menopause. The present study aimed to assess the 10-year cardiovascular risk (CVR) among a group of post-menopausal women and to determine associated factors. This was a cross-sectional study conducted among post-menopausal women in Yaoundé, Cameroon. CVR was calculated using the Framingham risk score. We enrolled 108 women, their ages ranging from 45 to 80 years, with a mean of 56.4 ± 6.9 years. CVR ranged between 1.2 and greater than 30% with a mean of 13.4 ± 8.7%. Forty three participants (39.8%) had a low CVR (< 10%), 39 women (36.1%) had a moderate CVR (10-20%), and 21 women (24.1%) had a high CVR (> 20%). Low-density lipoproteins cholesterol (LDL-C) (β = 3.27, p = 0.004), fasting plasma glucose (β = 5.40, p = 0.015), and diastolic blood pressure (DBP) (β = 3.49, p < 0.0001) were independently associated with CVR. Women not married (i.e. single, divorced or widowed) (adjusted odds ratio (aOR 4.66, p = 0.002), those with high titers of LDL-C (≥ 1.6 g/l) (aOR 5.07, p = 0.001), and those with elevated DBP (≥ 90 mmHg) (aOR 8.10, p < 0.0001) presented an increased likelihood to be at an advanced level of CVR. A significant number of post-menopausal women are at considerable risk of cardiovascular events in our setting. Therefore, they should be educated to adopt healthy lifestyles for substantial reduction in their CVR.
Although sub-Saharan Africa (SSA) is particularly affected by sickle cell disease (SCD), there is... more Although sub-Saharan Africa (SSA) is particularly affected by sickle cell disease (SCD), there is dearth of research on this topic in the region, specifically targeting the magnitude of SCD-related complications. We therefore conducted this study to determine the burden of acute chest syndrome (ACS) and describe its clinical and therapeutic aspects among SCD children in Cameroon, a SSA country. This was a retrospective study carried-out from September 2013 to June 2014 at the SCD unit of the Mother and Child Centre of the Chantal Biya Foundation, a pediatric reference centre in Yaoundé, Cameroon. We enrolled all SCD children with confirmed diagnosis of ACS, and recorded their clinical presentation at admission along with their evolution during hospitalization. Twenty one cases of ACS were identified during the study period, from 338 hospitalizations of children with SCD. Ages ranged from 11 months to 16 years with a mean (standard deviation) of 5.5 (3.4) years, and a male/female sex ratio of 3.2/1. We noticed relatively low levels of HbF, from 6.4 to 21.9% with a mean of 14.6% (6.0%). The three main symptoms at admission were fever (90.5%), cough (81%) and chest pains (28.6%). Two patients (9.5%) developed ACS 2 days after admission. The mean values of leukocytes, neutrophils, serum CRP, serum LDH and hemoglobin were respectively 32479.4 (17862.3)/mm(3), 23476 (11543.7)/mm(3), 228.2 (132.6) mg/l, 3452.3 (2916.3) IU/l and 6.5 (1.2) g/dl. The main localizations of radiological alveolar consolidations were the lower lobes (90.5%). Treatment associated broad-spectrum antibiotics (100%), hydration (100%), analgesics (43.2%), whole blood transfusion (66.7%), and oxygen supplementation (33.3%). Blood transfusion significantly improved hemoglobin level (p = 0.039). The duration of hospitalization, the mean of which was 6.8 (3.1) days, was influenced by none of the tested variables (all p values > 0.05). ACS is frequent among SCD children in our milieu. Its etiologies seem to be multifactorial. Patients' parents should be educated to recognize early signs and symptoms of the disease, and consult rapidly. Additionally, clinicians must be trained to diagnose ACS, and manage it promptly and efficiently to avoid its related catastrophic consequences.
Introduction: The African adult population is facing a growing epidemic of hypertension. Establis... more Introduction: The African adult population is facing a growing epidemic of hypertension. Establishment of accurate epidemiological data on hypertension in African children and adolescents may have important implications for hypertension preventive strategies in Africa.
CONTEXTE L’infection à hépatite B est un problème important de santé publique dans le monde [1] ;... more CONTEXTE L’infection à hépatite B est un problème important de santé publique dans le monde [1] ; et en Afrique en particulier où la prévalence varie de 7% à 20% [2, 3]. La transmission de la mère à l’enfant du virus de l’hépatite B (VHB) est responsable de plus d’un tiers des hépatites virales chroniques [4] et est le principal mode de transmission dans les pays à forte prévalence comme en Afrique [5]. Malgré le l’importance de la transmission du VHB de la mère à l’enfant, le test de diagnostic de l’infection par le VHB n’est pas fait en routine. Très peu de données épidémiologiques existent concernant l’infection par le VHB chez les femmes enceintes au Cameroun, surtout en milieu rural. OBJECTIFS Le but de l’étude était de déterminer la prévalence et les facteurs de risque (FDR) de l’infection par le VHB, et l’infectiosité des femmes enceintes en milieu rural au Cameroun. MÉTHODES Nous avons réalisé une étude transversale dans trois formations sanitaires en milieu rural au Camerou...
The persistent high prevalence of human scabies, especially in low- and middle-income countries p... more The persistent high prevalence of human scabies, especially in low- and middle-income countries prompted us to research the sociodemographic profile of patients suffering from it, and its spreading factors in Cameroon, a resource-poor setting. We conducted a cross-sectional survey from October 2011 to September 2012 in three hospitals located in Yaoundé, Cameroon, and enrolled patients diagnosed with human scabies during dermatologists' consultations who volunteered to take part in the study. We included 255 patients of whom 158 (62 %) were male. Age ranged from 0 to 80 years old with a median of 18 (Inter quartile range: 3-29) years. One to eight persons of our patients' entourage exhibited pruritus (mean = 2.1 ± 1.8). The number of persons per bed/room varied from 1 to 5 (mean = 2.1 ± 0.8). The first dermatologist's consultation occurred 4 to 720 days after the onset of symptoms (mean = 77.1 ± 63.7). The post-scabies pruritus (10.2 % of cases) was unrelated to the complications observed before correct treatment (all p values > 0.05), mainly impetiginization (7.1 %) and eczematization (5.9 %). Human scabies remains preponderant in our milieu. Populations should be educated on preventive measures in order to avoid this disease, and clinicians' knowledges must be strengthened for its proper diagnosis and management.
Fructosamine is a marker of glucose control reflecting the average glycaemic level over the prece... more Fructosamine is a marker of glucose control reflecting the average glycaemic level over the preceding 2-3 weeks. Fructosamine has not gained as much popularity as glycated haemoglobin (HbA1c) for diabetes mellitus (DM) control monitoring, and the related underlying reasons remain unclear. We aim to search for and summarise available evidence on the accuracy of fructosamine measurements to diagnose and monitor DM. This systematic review will include randomised control trials, controlled before-and-after studies, time series designs, cohort studies, case-control studies and cross-sectional surveys reporting the diagnosis and/or monitoring of DM (type 1 DM, type 2 DM and gestational DM) with fructosamine compared with other measures of glycaemia (fasting glucose, oral glucose tolerance test, random glucose, HbA1c), without any language restriction. We will perform electronic searches in PubMed, Scopus and other databases, supplemented with manual searches. Articles published from 1 Jan...
Background: Epidemiological data on hepatitis B virus (HBV) infection among pregnant women in Cam... more Background: Epidemiological data on hepatitis B virus (HBV) infection among pregnant women in Cameroon are very scarce, especially in the rural milieu. The purpose of this study was to determine the prevalence and factors associated with HBV infection, and the infectivity of rural pregnant women in the Far North Region of Cameroon. Methods: A cross-sectional study was conducted in three rural health facilities of the Guidiguis health district between December 2013 and March 2014. We consecutively recruited 325 pregnant women attending antenatal consultations. A pretested questionnaire was used to collect socio-demographic data and factors associated with HBV infection. The presence of hepatitis B surface antigen (HBsAg), hepatitis B e antigen (HBeAg) and human immunodeficiency virus (HIV) were determined using commercial test strips. Regression analyses were used to assess correlates of HBV infection. Results: The mean age was 24.4 (SD5.6) years. Most women were married (97.2%) and housewives (96.4%), with less than secondary education level (80%). Only 4 women (1.2%) had been vaccinated against HBV. Thirty-three women (10.2%) were HBsAg-positive, of whom 4 (12.1%) were positive to HBeAg. The prevalence of HIV infection was 2.5% (8/325). Overall, 5 (1.5%) women were co-infected with HIV and HBV. Independent correlates of HBV infection included history of blood transfusion (adjusted odd ratio 12.59, 95% CI 1.46-108.89; p = 0.021) and concurrent infection by HIV (adjusted odd ratio 22.53, 95% CI 4.76-106.71; p < 0.0001). Conclusion: The prevalence of HBV infection among pregnant women in this rural milieu is high. History of blood transfusion and HIV infection are highly associated with HBV infection. The relative low rate of women positive to both HBsAg and HBeAg suggests that perinatal transmission of HBV might not be the prevailing mode of HBV transmission in this area.
Background: Primary care physicians (PCPs) are the main providers of diabetes care especially in ... more Background: Primary care physicians (PCPs) are the main providers of diabetes care especially in resource-limited countries which experience extreme shortage of specialists. The present study aimed to evaluate PCPs' approach towards diabetes mellitus (DM) diagnosis, evaluation and management in Cameroon. Methods: We carried-out a cross-sectional survey in February 2012 in the West Region of Cameroon. Using a structured pretested questionnaire, we interviewed all PCPs working in the region who were present at their working place when the investigators visited, and volunteered to be enrolled in the study.
Background: "Vision 2020the right to sight" is a program which purpose is to eliminate avoidable ... more Background: "Vision 2020the right to sight" is a program which purpose is to eliminate avoidable blindness by the year 2020 through the implementation of concrete action plans at the national and district levels. Accordingly, baseline data are needed for the planning, monitoring, follow-up and evaluation of this program. The present study aimed to better characterize visual impairment and blindness in Cameroonian diabetics by providing with baseline data on the prevalence and main causes of these affections.
Hepatitis B virus (HBV) infection is one of the most serious occupational hazards faced by health... more Hepatitis B virus (HBV) infection is one of the most serious occupational hazards faced by healthcare workers. Surgical personnel are particularly at risk. HBV infection is preventable by vaccination, but no previous study has assessed HBV vaccination coverage among healthcare workers in Cameroon. We assessed knowledge of risk factors of HBV infection, awareness of HBV vaccine, and vaccination status of surgical residents in Cameroon. A structured pretested questionnaire was administered to 49 of the 70 surgical residents in Cameroon during the 2011-2012 academic year. Since the beginning of their residency program, 28 (57.1%) had had at least one accidental exposure to blood, with a median of 2 (range 1 to 25) exposures. Most of them had a good knowledge of risk factors for HBV infection. Although 98.0% (n = 48) were aware of the HBV vaccine, and 89.8% (n = 44) knew that they were at high risk of infection, only 24.5% (n = 12) had received a full course of at least three doses of t...
Objective: To assess the availability and affordability of medicines and routine tests for cardio... more Objective: To assess the availability and affordability of medicines and routine tests for cardiovascular disease (CVD) and diabetes in the West region of Cameroon, a low-income setting.
d i a b e t e s r e s e a r c h a n d c l i n i c a l p r a c t i c e 1 0 7 ( 2 0 1 5 ) 1 2 3 -1 ... more d i a b e t e s r e s e a r c h a n d c l i n i c a l p r a c t i c e 1 0 7 ( 2 0 1 5 ) 1 2 3 -1 2 9 a b s t r a c t Background and purpose: Fructosamine provides an estimate of diabetes control over a shorter period than HbA 1c , and has been proposed as a suitable parameter to monitor glycemic control in low-income countries. The aim of this study was to investigate determinants of fructosamine levels in an urban non-diabetic population of Cameroon.
The transmission of malaria by blood transfusion was one of the first recorded incidents of trans... more The transmission of malaria by blood transfusion was one of the first recorded incidents of transfusion-transmitted infections (TTIs). Although the World Health Organization (WHO) recommends that blood for transfusion should be screened for TTIs, malaria screening is not performed in most malaria-endemic countries in sub-Saharan Africa (SSA). The transfusion of infected red blood cells may lead to severe post-transfusion clinical manifestations of malaria, which could be rapidly fatal. Ensuring that blood supply in endemic countries is free from malaria is highly problematical, as most of the donors may potentially harbour low levels of malaria parasites. Pre-transfusion screening within endemic settings has been identified as a cost-effective option for prevention of transfusion-transmitted malaria (TTM). But currently, there is no screening method that is practical, affordable and suitably sensitive for use by blood banks in SSA. Even if this method was available, rejection of malaria-positive donors would considerably jeopardize the blood supply and increase morbidity and mortality, especially among pregnant women and children who top the scale of blood transfusion users in SSA. In this context, the systematic prophylaxis of recipients with anti-malarials could constitute a good alternative, as it prevents any deferral of donor units as well as the occurrence of TTM. With the on-going programme, namely the Affordable Medicine Facility -Malaria, there is an increase in the availability of low-priced artemisinin-based combination therapy that can be used for systematic prophylaxis. It appears nonetheless an urgent need to conduct cost-benefit studies in order to evaluate each of the TTM preventive methods. This approach could permit the design and implementation of an evidence-based measure of TTM prevention in SSA, advocating thereby its widespread use in the region.
International Journal of Infectious Diseases, 2013
Background: Blood safety remains an issue of major concern in transfusion medicine in sub-Saharan... more Background: Blood safety remains an issue of major concern in transfusion medicine in sub-Saharan Africa. Blood-borne agents such as the human immunodeficiency virus (HIV), hepatitis B virus (HBV), hepatitis C virus (HCV), and Treponema pallidum are among the greatest threats to blood safety for the recipient. This study aimed to determine the seroprevalence and risk factors of HIV, HCV, HBV, and syphilis infections among first-time blood donors at the new hospital-based blood bank in Edé a, Cameroon. Methods: We carried out a retrospective analysis of blood donor data recorded between December 2011 and May 2012 at the blood bank of the Edé a Regional Hospital. Antibodies to HIV types 1 and 2 were screened with the Determine and ImmunoComb tests. Hepatitis B surface antigen and antibodies to HCV were detected using DIASpot test strips. Syphilis was diagnosed using the Venereal Disease Research Laboratory (VDRL) test and the Treponema pallidum hemagglutination assay (TPHA). Results: A total of 543 blood donors were included, among whom 349 (64.3%) were family replacement donors. One hundred and fifteen donors (21.2%) were infected with at least one pathogen. The overall seroprevalence rates of HIV, HBV, HCV, and syphilis were 4.1%, 10.1%, 4.8%, and 5.7%, respectively. We found a total of 26 dual infections. The most common combinations were HBV-HCV and HBV-HIV. There was a significant association between HIV and HBV infections (adjusted odds ratio (aOR) 3.46, 95% CI 1.29-9.39; p = 0.014), and between HBV and HCV infections (aOR 2.81, 95% CI 1.02-10.12; p = 0.036). Compared to voluntary donors, family replacement donors were significantly more infected by at least one screened pathogen (aOR 1.81, 95% CI 1.14-2.88; p = 0.013), and more infected specifically by HIV (aOR 3.66, 95% CI 1.07-12.55; p = 0.039) and syphilis (aOR 2.81, 95% CI 1.05-7.46; p = 0.039). Conclusions: Our findings indicate that blood safety remains a major problem in Cameroon where hospital-based blood banks and family replacement donors are predominant. There is an urgent need for a national blood transfusion program in Cameroon that will establish a nationally coordinated blood transfusion service based on the principles of voluntary regular non-remunerated blood donation. ß
The paucity of data regarding the relationship between atherogenic index of plasma (AIP) and risk... more The paucity of data regarding the relationship between atherogenic index of plasma (AIP) and risk of cardiovascular disease (CVD) in postmenopausal women living in sub-Saharan Africa prompted us to conduct this study which aimed at assessing the interplay between AIP and risk of CVD among Cameroonian postmenopausal women. This was a cross-sectional study conducted among 108 postmenopausal women in Yaoundé, Cameroon. Risk of CVD was calculated using the Framingham risk score, (FRS), and the AIP was derived as log (triglycerides/high-density lipoproteins cholesterol). Mean age of participants equaled 56.4 ± 6.9 years. AIP values ranged from -0.40 to 0.85 with a mean of 0.21 ± 0.27. There was a positive and significant correlation between AIP and body mass index (r = 0.234; p = 0.015), systolic blood pressure (r = 0.350; p &amp;amp;lt; 0.001), diastolic blood pressure (r = 0.365; p &amp;amp;lt; 0.001), fasting plasma glucose (r = 0.314; p = 0.001), uric acid (r = 0.374; p &amp;amp;lt; 0.001), and total cholesterol (r = 0.374; p &amp;amp;lt; 0.001), but not with age (r = -0.104; p = 0.284). The FRS varied between 1.2 % and &amp;amp;gt;30 % with a mean of 13.4 ± 8.7 %. In univariable model, AIP significantly influenced the risk of CVD (β = 11.94; p &amp;amp;lt; 0.001; R(2) = 0.136). But in the multivariable model, after adjusting for confounders, AIP did not impact the risk of CVD anymore (adjusted β = 1.98; p = 0.487; R(2) = 0.486). AIP may not be an independent factor impacting the risk of CVD among Cameroonian postmenopausal women. More studies are needed to better elucidate the interaction between AIP and risk of CVD in our setting.
Data on sexual behaviors in Cameroonian youths are needed to design and implement effective preve... more Data on sexual behaviors in Cameroonian youths are needed to design and implement effective preventive strategies against HIV/AIDS. This study aimed at assessing sociodemographic and religious factors associated with sexual behaviors among university students in Cameroon. In 2011, 411 university students were surveyed by a self-administered questionnaire at the Medical and Social Welfare Center of the University of Maroua. Logistic regression analyses were used to determine correlates of sexual behaviors. 80.8 % of students were sexually active. The mean age at sexual debut was 18.1 years (SD = 3.1). The frequency of premarital sex was 92.8 %. Pornography viewing [adjusted odds ratio (aOR): 4.0, 95 % CI 2.1-7.6; p &amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;lt; 0.0001] and an increased age of 1 year (aOR: 1.3, 95 % CI 2.0-7.6; p &amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;lt; 0.0001) were significantly associated with having previously had sex. The likelihood to have a lower (&amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;lt;18) age at sexual debut was increased by male gender (aOR: 2.5, 95 % CI 1.7-5; p &amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;lt; 0.001), and urban origin (aOR: 2.9, 95 % CI 1.5-5.7; p &amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;lt; 0.01). The probability to have a high number (#3) of lifetime sexual partners was increased by age (aOR: 1.1, 95 % CI 1.0-1.2; p &amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;lt; 0.001), pornography viewing (aOR: 4.3, 95 % CI 1.9-9.5; p &amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;lt; 0.001), an early sexual debut (aOR: 2.8, 95 % CI 1.6-5.0; p &amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;lt; 0.001), having had occasional sexual partners (aOR: 7.0, 95 % CI 3.7-13.1; p &amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;lt; 0.0001), and was decreased by Muslim religious affiliation (aOR: 0.2, 95 % CI 0.1-0.9; p &amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;lt; 0.05). Having had casual sexual partners was associated with less inconsistent condom use (aOR: 0.5, 95 % CI 0.2-0.9; p &amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;lt; 0.05). Our findings indicate that there is an alarming level of risky sexual behaviors among the study population. Strong and efficient measures should be undertaken to handle such harmful behaviors, this for the prevention and control of HIV/AIDS and other STIs in this vulnerable population.
Post-menopausal women may be at particular risk of developing cardiovascular disease due to metab... more Post-menopausal women may be at particular risk of developing cardiovascular disease due to metabolic changes occurring at menopause. The present study aimed to assess the 10-year cardiovascular risk (CVR) among a group of post-menopausal women and to determine associated factors. This was a cross-sectional study conducted among post-menopausal women in Yaoundé, Cameroon. CVR was calculated using the Framingham risk score. We enrolled 108 women, their ages ranging from 45 to 80 years, with a mean of 56.4 ± 6.9 years. CVR ranged between 1.2 and greater than 30% with a mean of 13.4 ± 8.7%. Forty three participants (39.8%) had a low CVR (&amp;amp;amp;amp;lt; 10%), 39 women (36.1%) had a moderate CVR (10-20%), and 21 women (24.1%) had a high CVR (&amp;amp;amp;amp;gt; 20%). Low-density lipoproteins cholesterol (LDL-C) (β = 3.27, p = 0.004), fasting plasma glucose (β = 5.40, p = 0.015), and diastolic blood pressure (DBP) (β = 3.49, p &amp;amp;amp;amp;lt; 0.0001) were independently associated with CVR. Women not married (i.e. single, divorced or widowed) (adjusted odds ratio (aOR 4.66, p = 0.002), those with high titers of LDL-C (≥ 1.6 g/l) (aOR 5.07, p = 0.001), and those with elevated DBP (≥ 90 mmHg) (aOR 8.10, p &amp;amp;amp;amp;lt; 0.0001) presented an increased likelihood to be at an advanced level of CVR. A significant number of post-menopausal women are at considerable risk of cardiovascular events in our setting. Therefore, they should be educated to adopt healthy lifestyles for substantial reduction in their CVR.
Although sub-Saharan Africa (SSA) is particularly affected by sickle cell disease (SCD), there is... more Although sub-Saharan Africa (SSA) is particularly affected by sickle cell disease (SCD), there is dearth of research on this topic in the region, specifically targeting the magnitude of SCD-related complications. We therefore conducted this study to determine the burden of acute chest syndrome (ACS) and describe its clinical and therapeutic aspects among SCD children in Cameroon, a SSA country. This was a retrospective study carried-out from September 2013 to June 2014 at the SCD unit of the Mother and Child Centre of the Chantal Biya Foundation, a pediatric reference centre in Yaoundé, Cameroon. We enrolled all SCD children with confirmed diagnosis of ACS, and recorded their clinical presentation at admission along with their evolution during hospitalization. Twenty one cases of ACS were identified during the study period, from 338 hospitalizations of children with SCD. Ages ranged from 11 months to 16 years with a mean (standard deviation) of 5.5 (3.4) years, and a male/female sex ratio of 3.2/1. We noticed relatively low levels of HbF, from 6.4 to 21.9% with a mean of 14.6% (6.0%). The three main symptoms at admission were fever (90.5%), cough (81%) and chest pains (28.6%). Two patients (9.5%) developed ACS 2 days after admission. The mean values of leukocytes, neutrophils, serum CRP, serum LDH and hemoglobin were respectively 32479.4 (17862.3)/mm(3), 23476 (11543.7)/mm(3), 228.2 (132.6) mg/l, 3452.3 (2916.3) IU/l and 6.5 (1.2) g/dl. The main localizations of radiological alveolar consolidations were the lower lobes (90.5%). Treatment associated broad-spectrum antibiotics (100%), hydration (100%), analgesics (43.2%), whole blood transfusion (66.7%), and oxygen supplementation (33.3%). Blood transfusion significantly improved hemoglobin level (p = 0.039). The duration of hospitalization, the mean of which was 6.8 (3.1) days, was influenced by none of the tested variables (all p values &amp;amp;gt; 0.05). ACS is frequent among SCD children in our milieu. Its etiologies seem to be multifactorial. Patients&amp;amp;#39; parents should be educated to recognize early signs and symptoms of the disease, and consult rapidly. Additionally, clinicians must be trained to diagnose ACS, and manage it promptly and efficiently to avoid its related catastrophic consequences.
Introduction: The African adult population is facing a growing epidemic of hypertension. Establis... more Introduction: The African adult population is facing a growing epidemic of hypertension. Establishment of accurate epidemiological data on hypertension in African children and adolescents may have important implications for hypertension preventive strategies in Africa.
CONTEXTE L’infection à hépatite B est un problème important de santé publique dans le monde [1] ;... more CONTEXTE L’infection à hépatite B est un problème important de santé publique dans le monde [1] ; et en Afrique en particulier où la prévalence varie de 7% à 20% [2, 3]. La transmission de la mère à l’enfant du virus de l’hépatite B (VHB) est responsable de plus d’un tiers des hépatites virales chroniques [4] et est le principal mode de transmission dans les pays à forte prévalence comme en Afrique [5]. Malgré le l’importance de la transmission du VHB de la mère à l’enfant, le test de diagnostic de l’infection par le VHB n’est pas fait en routine. Très peu de données épidémiologiques existent concernant l’infection par le VHB chez les femmes enceintes au Cameroun, surtout en milieu rural. OBJECTIFS Le but de l’étude était de déterminer la prévalence et les facteurs de risque (FDR) de l’infection par le VHB, et l’infectiosité des femmes enceintes en milieu rural au Cameroun. MÉTHODES Nous avons réalisé une étude transversale dans trois formations sanitaires en milieu rural au Camerou...
The persistent high prevalence of human scabies, especially in low- and middle-income countries p... more The persistent high prevalence of human scabies, especially in low- and middle-income countries prompted us to research the sociodemographic profile of patients suffering from it, and its spreading factors in Cameroon, a resource-poor setting. We conducted a cross-sectional survey from October 2011 to September 2012 in three hospitals located in Yaoundé, Cameroon, and enrolled patients diagnosed with human scabies during dermatologists&amp;amp;amp;amp;amp;amp;#39; consultations who volunteered to take part in the study. We included 255 patients of whom 158 (62 %) were male. Age ranged from 0 to 80 years old with a median of 18 (Inter quartile range: 3-29) years. One to eight persons of our patients&amp;amp;amp;amp;amp;amp;#39; entourage exhibited pruritus (mean = 2.1 ± 1.8). The number of persons per bed/room varied from 1 to 5 (mean = 2.1 ± 0.8). The first dermatologist&amp;amp;amp;amp;amp;amp;#39;s consultation occurred 4 to 720 days after the onset of symptoms (mean = 77.1 ± 63.7). The post-scabies pruritus (10.2 % of cases) was unrelated to the complications observed before correct treatment (all p values &amp;amp;amp;amp;amp;amp;gt; 0.05), mainly impetiginization (7.1 %) and eczematization (5.9 %). Human scabies remains preponderant in our milieu. Populations should be educated on preventive measures in order to avoid this disease, and clinicians&amp;amp;amp;amp;amp;amp;#39; knowledges must be strengthened for its proper diagnosis and management.
Fructosamine is a marker of glucose control reflecting the average glycaemic level over the prece... more Fructosamine is a marker of glucose control reflecting the average glycaemic level over the preceding 2-3 weeks. Fructosamine has not gained as much popularity as glycated haemoglobin (HbA1c) for diabetes mellitus (DM) control monitoring, and the related underlying reasons remain unclear. We aim to search for and summarise available evidence on the accuracy of fructosamine measurements to diagnose and monitor DM. This systematic review will include randomised control trials, controlled before-and-after studies, time series designs, cohort studies, case-control studies and cross-sectional surveys reporting the diagnosis and/or monitoring of DM (type 1 DM, type 2 DM and gestational DM) with fructosamine compared with other measures of glycaemia (fasting glucose, oral glucose tolerance test, random glucose, HbA1c), without any language restriction. We will perform electronic searches in PubMed, Scopus and other databases, supplemented with manual searches. Articles published from 1 Jan...
Background: Epidemiological data on hepatitis B virus (HBV) infection among pregnant women in Cam... more Background: Epidemiological data on hepatitis B virus (HBV) infection among pregnant women in Cameroon are very scarce, especially in the rural milieu. The purpose of this study was to determine the prevalence and factors associated with HBV infection, and the infectivity of rural pregnant women in the Far North Region of Cameroon. Methods: A cross-sectional study was conducted in three rural health facilities of the Guidiguis health district between December 2013 and March 2014. We consecutively recruited 325 pregnant women attending antenatal consultations. A pretested questionnaire was used to collect socio-demographic data and factors associated with HBV infection. The presence of hepatitis B surface antigen (HBsAg), hepatitis B e antigen (HBeAg) and human immunodeficiency virus (HIV) were determined using commercial test strips. Regression analyses were used to assess correlates of HBV infection. Results: The mean age was 24.4 (SD5.6) years. Most women were married (97.2%) and housewives (96.4%), with less than secondary education level (80%). Only 4 women (1.2%) had been vaccinated against HBV. Thirty-three women (10.2%) were HBsAg-positive, of whom 4 (12.1%) were positive to HBeAg. The prevalence of HIV infection was 2.5% (8/325). Overall, 5 (1.5%) women were co-infected with HIV and HBV. Independent correlates of HBV infection included history of blood transfusion (adjusted odd ratio 12.59, 95% CI 1.46-108.89; p = 0.021) and concurrent infection by HIV (adjusted odd ratio 22.53, 95% CI 4.76-106.71; p < 0.0001). Conclusion: The prevalence of HBV infection among pregnant women in this rural milieu is high. History of blood transfusion and HIV infection are highly associated with HBV infection. The relative low rate of women positive to both HBsAg and HBeAg suggests that perinatal transmission of HBV might not be the prevailing mode of HBV transmission in this area.
Background: Primary care physicians (PCPs) are the main providers of diabetes care especially in ... more Background: Primary care physicians (PCPs) are the main providers of diabetes care especially in resource-limited countries which experience extreme shortage of specialists. The present study aimed to evaluate PCPs' approach towards diabetes mellitus (DM) diagnosis, evaluation and management in Cameroon. Methods: We carried-out a cross-sectional survey in February 2012 in the West Region of Cameroon. Using a structured pretested questionnaire, we interviewed all PCPs working in the region who were present at their working place when the investigators visited, and volunteered to be enrolled in the study.
Background: "Vision 2020the right to sight" is a program which purpose is to eliminate avoidable ... more Background: "Vision 2020the right to sight" is a program which purpose is to eliminate avoidable blindness by the year 2020 through the implementation of concrete action plans at the national and district levels. Accordingly, baseline data are needed for the planning, monitoring, follow-up and evaluation of this program. The present study aimed to better characterize visual impairment and blindness in Cameroonian diabetics by providing with baseline data on the prevalence and main causes of these affections.
Hepatitis B virus (HBV) infection is one of the most serious occupational hazards faced by health... more Hepatitis B virus (HBV) infection is one of the most serious occupational hazards faced by healthcare workers. Surgical personnel are particularly at risk. HBV infection is preventable by vaccination, but no previous study has assessed HBV vaccination coverage among healthcare workers in Cameroon. We assessed knowledge of risk factors of HBV infection, awareness of HBV vaccine, and vaccination status of surgical residents in Cameroon. A structured pretested questionnaire was administered to 49 of the 70 surgical residents in Cameroon during the 2011-2012 academic year. Since the beginning of their residency program, 28 (57.1%) had had at least one accidental exposure to blood, with a median of 2 (range 1 to 25) exposures. Most of them had a good knowledge of risk factors for HBV infection. Although 98.0% (n = 48) were aware of the HBV vaccine, and 89.8% (n = 44) knew that they were at high risk of infection, only 24.5% (n = 12) had received a full course of at least three doses of t...
Objective: To assess the availability and affordability of medicines and routine tests for cardio... more Objective: To assess the availability and affordability of medicines and routine tests for cardiovascular disease (CVD) and diabetes in the West region of Cameroon, a low-income setting.
d i a b e t e s r e s e a r c h a n d c l i n i c a l p r a c t i c e 1 0 7 ( 2 0 1 5 ) 1 2 3 -1 ... more d i a b e t e s r e s e a r c h a n d c l i n i c a l p r a c t i c e 1 0 7 ( 2 0 1 5 ) 1 2 3 -1 2 9 a b s t r a c t Background and purpose: Fructosamine provides an estimate of diabetes control over a shorter period than HbA 1c , and has been proposed as a suitable parameter to monitor glycemic control in low-income countries. The aim of this study was to investigate determinants of fructosamine levels in an urban non-diabetic population of Cameroon.
The transmission of malaria by blood transfusion was one of the first recorded incidents of trans... more The transmission of malaria by blood transfusion was one of the first recorded incidents of transfusion-transmitted infections (TTIs). Although the World Health Organization (WHO) recommends that blood for transfusion should be screened for TTIs, malaria screening is not performed in most malaria-endemic countries in sub-Saharan Africa (SSA). The transfusion of infected red blood cells may lead to severe post-transfusion clinical manifestations of malaria, which could be rapidly fatal. Ensuring that blood supply in endemic countries is free from malaria is highly problematical, as most of the donors may potentially harbour low levels of malaria parasites. Pre-transfusion screening within endemic settings has been identified as a cost-effective option for prevention of transfusion-transmitted malaria (TTM). But currently, there is no screening method that is practical, affordable and suitably sensitive for use by blood banks in SSA. Even if this method was available, rejection of malaria-positive donors would considerably jeopardize the blood supply and increase morbidity and mortality, especially among pregnant women and children who top the scale of blood transfusion users in SSA. In this context, the systematic prophylaxis of recipients with anti-malarials could constitute a good alternative, as it prevents any deferral of donor units as well as the occurrence of TTM. With the on-going programme, namely the Affordable Medicine Facility -Malaria, there is an increase in the availability of low-priced artemisinin-based combination therapy that can be used for systematic prophylaxis. It appears nonetheless an urgent need to conduct cost-benefit studies in order to evaluate each of the TTM preventive methods. This approach could permit the design and implementation of an evidence-based measure of TTM prevention in SSA, advocating thereby its widespread use in the region.
International Journal of Infectious Diseases, 2013
Background: Blood safety remains an issue of major concern in transfusion medicine in sub-Saharan... more Background: Blood safety remains an issue of major concern in transfusion medicine in sub-Saharan Africa. Blood-borne agents such as the human immunodeficiency virus (HIV), hepatitis B virus (HBV), hepatitis C virus (HCV), and Treponema pallidum are among the greatest threats to blood safety for the recipient. This study aimed to determine the seroprevalence and risk factors of HIV, HCV, HBV, and syphilis infections among first-time blood donors at the new hospital-based blood bank in Edé a, Cameroon. Methods: We carried out a retrospective analysis of blood donor data recorded between December 2011 and May 2012 at the blood bank of the Edé a Regional Hospital. Antibodies to HIV types 1 and 2 were screened with the Determine and ImmunoComb tests. Hepatitis B surface antigen and antibodies to HCV were detected using DIASpot test strips. Syphilis was diagnosed using the Venereal Disease Research Laboratory (VDRL) test and the Treponema pallidum hemagglutination assay (TPHA). Results: A total of 543 blood donors were included, among whom 349 (64.3%) were family replacement donors. One hundred and fifteen donors (21.2%) were infected with at least one pathogen. The overall seroprevalence rates of HIV, HBV, HCV, and syphilis were 4.1%, 10.1%, 4.8%, and 5.7%, respectively. We found a total of 26 dual infections. The most common combinations were HBV-HCV and HBV-HIV. There was a significant association between HIV and HBV infections (adjusted odds ratio (aOR) 3.46, 95% CI 1.29-9.39; p = 0.014), and between HBV and HCV infections (aOR 2.81, 95% CI 1.02-10.12; p = 0.036). Compared to voluntary donors, family replacement donors were significantly more infected by at least one screened pathogen (aOR 1.81, 95% CI 1.14-2.88; p = 0.013), and more infected specifically by HIV (aOR 3.66, 95% CI 1.07-12.55; p = 0.039) and syphilis (aOR 2.81, 95% CI 1.05-7.46; p = 0.039). Conclusions: Our findings indicate that blood safety remains a major problem in Cameroon where hospital-based blood banks and family replacement donors are predominant. There is an urgent need for a national blood transfusion program in Cameroon that will establish a nationally coordinated blood transfusion service based on the principles of voluntary regular non-remunerated blood donation. ß
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Papers by Jobert Nansseu