Director of Publication’s Note

Dear Readers,

This is the first issue of the eigth volume of the African Journal of Integrated Health. It is the first publication of 2019. Our journal is a biannual publication and we have consolidated our visibility online (http: www. ajih. co) and once published all articles appear in Google scholar, Research gate and others.

This has so far contributed to the reputation of the authors who publish with us and to the dissemination of health information directly to our citizens and to researchers. Our effort to enlarge the auditory to Central and West African countries will continue as we publish articles coming from some of those countries.

 

We reiterate that peer Review is the key, and only papers with scientifically relevant information are accepted for publication. As a journal advocating for an integrated approach to improve the health condition of the people, the present issue reflects this diversity with articles dealing with clinical issues, health economics, and research outcomes from medical sciences/case studies and biotechnology of pharmaceutical interest.

We thank all those who have contributed to the publication of this volume including the authors, reviewers, and secretaries.

 

Marcelin Ngowe Ngowe

Professor of General Surgery,

Dean, Faculty of Health Sciences,

University of Buea

Volume 9.1a

 

1. Fatal Amniotic Fluid Embolism: a report of two cases

Elong FA1*, Mokake Ngomba DM2, Wambo AG2, Tchounzou R1, Fokam Puepi Y3, Halle Ekane G1, Egbe Obinchemti T1

1 Department of Obstetrics and Gynecology Faculty of health Sciences, University of Buea, Cameroon

2 Department of Surgery, Faculty of health Sciences, University of Buea, Cameroon

3 Department of internal medicine and pediatrics, Faculty of health Sciences, University of Buea, Cameroon

*Corresponding author: Elong Felix Adolphe, Department of Obstetrics and Gynecology, Faculty of health Sciences, University of Buea, Cameroon. e-mail: adolpheelong@yahoo. fr

ABSTRACT

Background: Amniotic fluid embolism (AFE) is a rare, unforeseeable, life-threatening pregnancy complication.

Cases presentation: In this paper, we report two fatal cases of AFE. In the first case, the death of a 36-year old apparently healthy parturient due to AFE is reported. She came in the active phase of labour. After artificial rupture of membranes, she developed features of AFE and died within 15 minutes of the onset of the symptoms. An immediate post mortem caesarian section was then performed with successful neonatal outcome. The second case concerns a 37- year old pregnant woman who developed AFE syndrome two hours after an uneventful elective cesarean section. Because of uncontrollable uterine atony and bleeding, a hysterectomy was performed. Despite intensive cardiopulmonary resuscitation the patient died 30 minutes after hysterectomy.

Conclusion: AFE is a catastrophic complication of pregnancy. It should be considered in the differential diagnosis of any condition that presents as acute cardiovascular collapse as well as respiratory failure, disseminated intravascular coagulation (DIC) or massive hemorrhage in the peripartum period. The treatment is supportive and should be immediately initiated. In developing countries, its management is a big challenge and its related mortality is unknown.

Keywords: Amniotic fluid embolism, coagulopathy, hypoxia, cardiac arrest, cesarian section

Elong FA, Mokake Ngomba DM, Simo Wambo AG, Tchounzou R, Fokam Puepi Y, Halle Ekane G, Egbe Obinchemti T. Fatal Amniotic Fluid Embolism: a report of two cases: Afr. J. of Integ. Health 2019,9 (1 a): 01-03

2. Connaissances des Maladies Tropicales Négligées et de leurs Stratégies de contrôle par les gestionnaires des services de santé publique de la région du Centre, Cameroun

Knowledge of Neglected Tropical Diseases and their control strategies by public health service managers in the Centre Region in Cameroon

Enoka P1 and Kamga Fouamno HL2*

1 Ministère de la Santé Publique, Yaoundé, Distant Production House University (DPHU)

2 Faculté des Sciences de la Santé, Université de Bamenda, Cameroun

*Correspondence: Henri Lucien Kamga. E-mail: henrikamga2002@yahoo. fr; Tel: +237 699 721 972

Résumé

Introduction: Les maladies tropicales négligées sont un groupe de maladies infectieuses de fréquence et de gravité variables touchant en premier lieu les populations rurales des pays pauvres situés en zone intertropicale, les populations urbaines vivant dans les marécages et les zones de conflit, avec une prédilection pour les enfants.

Objectif: Déterminer les connaissances que les gestionnaires des services de santé publique de la Région du Centre au Cameroun ont des maladies tropicales négligées (MTN) et de leurs stratégies de contrôle

Matériel et Méthodes: L'étude était transversale, exploratoire et descriptive. Les données ont été rassemblées utilisant des questionnaires distribués à 493 gestionnaires des services de santé publique de la région du Centre, basée sur un échantillon randomisé et stratifié. Les résultats obtenus étaient analysés utilisant le logiciel “Statistical Package for Social Sciences (SPSS)”.

Résultats: Au total 493 gestionnaires des services de santé publique ont participé à cette étude parmi lesquels 368 (67,6%) étaient de sexe masculin tandis que250 (50,7%) étaient âgés entre 35 et 50 ans. La moyenne générale de bonnes connaissances des MTN et sur leurs stratégies de contrôle était de 52,6%. La majorité (50,3%) de répondants ayant une bonne connaissance étaient employés dans les centres de santé intégrés, néanmoins n'y avait pas de relation significative entre les avis des répondants et le type de service employeur (X2 = 9,695; P > 0,05). Les MTN pour lesquelles les répondants avaient les meilleures connaissances étaient les helminthiases transmises par le sol (98,0%), l’onchocercose (77,7%) et la filariose lymphatique (62,5%), néanmoins, il n’y avait pas de relation significative entre les connaissances de MTN et stratégies de contrôle et le type de zone des répondants (X2 = 14.418 P> 0,05).

Conclusion: Les MTN et leurs stratégies de contrôle ne sont toujours pas bien connues par les gestionnaires des différents services de santé publics dans la Région de Centre du Cameroun, ceci souligne un besoin urgent d’éducation et de recyclage, ce qui devrait être adopté et impliqué dans les stratégies de la politique nationale de lutte contre les MTN.

Mots-Clés: Gestionnaires des services de Santé publics, Maladies Tropicales Négligées, Cameroun

Abstract

Introduction: Neglected tropical diseases are a group of infectious diseases of varying frequency and gravity affecting primarily rural populations of poor tropical countries, urban populations living in swampy areas or conflict zones, with a predilection for children.

Objective: to determine the knowledge that public health service managers in the centre region have on neglected tropical diseases (ntd) and their control strategies

Material and Methods: it was a cross-sectional, exploratory and descriptive study. Data were collected with the use of questionnaires distributed to public health service managers in the centre region, based on a randomized and stratified sampling. Results obtained were analysed using the “statistical package for social sciences (spss)” application.

Results: A total of 493 public health service managers took part in the study among which à 368 (67.6%) were males, while 250 (50.7%) were aged between 35 et 50 years. the average good knowledge of ntds and their control strategies was 52.6%. majority (50.3%) of respondents with good knowledge were those working in integrated health centres, nevertheless there was no significant relationship between respondents’ opinion and ­­the type of health service in which they worked (x2 = 9.695; p > 0.05). NTDs for which respondents had greater good knowledge were soil-transmitted helminth infections (98.0%), onchocercosis (77.7%) and lymphatic filariosis (62.5%), though there was no significant relationship between respondents’ knowledge and the type of setting in which they lived (x2 = 14.418 p> 0.05)

Conclusion: NTDs and their control strategies are not still well understood by those public health service managers in the centre region, outlining an urgent need for educational and training. This should be adopted and involved among the strategies of the national policy for fight against the ntds.

Keywords: Neglected Tropical Diseases, Health Service Managers, Cameroon

Enoka P, Kamga FHL. Knowledge of Neglected Tropical Diseases and their control strategies by public health service managers in the Centre Region in Cameroon: Afr. J. of Integ. Health 2019,9 (1 a): 04-14

3. A comparative study on the predictive value of cervical cancer screening by imaging, visualization and Pap smear at the Regional Hospital Buea, Cameroon

Enow-Orock G1,2, 4*, Enow-Orock A2, Njouendou AJ1, Elong F2,3, Sando Z4, Essame-Oyono JL4

1 Department of Biomedical Sciences, Faculty of Health Sciences, University of Buea, P. O. Box 12, Buea Cameroon

2 Buea regional Hospital, Buea Cameroon

3 Department of Obstetrics and Gynecology, Faculty of Health Sciences, University of Buea, P. O. Box 12, Buea Cameroon

4 National Cancer Control Committee, Yaounde, Cameroon

*Corresponding author: Prof. George Enow-Orock, Anatomic and Forensic Pathologist, HOD Biomedical Sciences, Faculty of Health Sciences, University of Buea, Director Regional Hospital Buea, Director Yaounde Cancer Registry, Cameroon, e. mail: enowrock24@yahoo. com, Tel +237 77716045

ABSTRACT

Background: Cervical cancer remains the leading cause of cancer deaths in women in Low and Medium Resources Income Countries due to timid implementation of the recommended test and treat strategy of WHO. Implementation of accurate diagnostic tools may lead to significant reduction of mortality due to this cancer by ensuring early treatment of the disease, especially in our setting where late presentation of patients is common.

Aim: This study evaluated and compared the respective and collective accuracy of Imaging, visual inspection with acetic acid and Lugol’s iodine (VIA/VILI) and Pap smear as diagnostic methods for the detection of cervical lesions. The capacity of each method to detect a lesion (diagnosis) and to accurately grade this lesion (grading) was evaluated for all three methods individually and collectively.

Methods: This study was a combined (closed-vertical and open -horizontal) screening. For vertical screening, one screening method was sequentially examined without knowledge of results of the other methods for all cases. For horizontal screening, all 3 screening methods were examined simultaneously for each case. Histologic results of the cervical lesions were used as goal standard for determination of the diagnostic accuracy.

Results: Of 134 suspected cases examined, 8 lesions were found (6%); distributed as 2 invasive lesions SCC (25%), 1 CIN III (12.5%), 2 CIN II (25%), 3 CIN I (37.5%) and 1 ASCUS (12.5%). Following vertical-closed screening, 3 of the 8 lesions were accurately identified by imaging (37.5%), 5 by visual inspection (62.5%), while Pap smear detected 7 cases (87.5%). Images, visual and Pap smear respectively found 2,4 and 6 lesions. For Horizontal (combined-open) screening, overall diagnosis using a combined Images, VIA/VILI and Pap smear identified all the 8 cases (100%), out of which 7 (87.5%) were accurately graded. All methods combined provided maximum true positivity (8/8) and true negativity (126/126) as well as minimum false positivity (0/126) and false negativity (0/8). The values of Accuracy (ACC) were 0.91,0.96,0.98 and 1.0 while the Balanced Accuracy (BACC) were 0.66,0.80,0.89 and 1.0 respectively for the four methods.

Conclusion: This study confirmed the inability of Imaging to be recommended as a stand-alone method for cervical screening. It highlights the potential of Visual methods with above average capacity to suspect cervical lesions though with a low capacity for grading of the lesions. The high diagnostic and grading capacity of Pap smear as a screening procedure is reported. However, the improved accuracy to diagnose and grade cervical lesions by combined screening procedures is recommended.

Keywords: cervical cancer, screening, comparative, imaging, VIA/VILI, Pap smear

Enow-Orock G, , Enow-Orock A, Njouendou AJ, Elong F, , Sando Z, Essame-Oyono JL. A comparative study on the predictive value of cervical cancer screening by imaging, visualization and Pap smear at the Regional Hospital Buea, Cameroon: Afr. J. of Integ. Health 2019,9 (1 a): 15-20

4.

4. Microbiological profile of umbilical and peripherally inserted central catheters related infections and predictors of mortality in Neonatology at the Gyneco-Obstetrics and Paediatric Hospital of Douala, Cameroon

Kedy Koum D1,2, Ebongue Okalla C3, Penda CI1, Noukeu D2, Tagne LS1, Enyama D2, Kouemo FD2, Kojom LP4,5, Ngaba GP2,3, Mah E6, Chiabi A6, Adiogo D1,3, Wiyeh A7, Monebenimp F6

1 Department of Clinical Science, Faculty of Medicine and Pharmaceutical Science, The University of Douala, P. O. Box 24157, Douala, Cameroon

2 Gyneco-obstetric and paediatric Hospital, P. O. Box 2770, Douala, Cameroon

3 Department of Biological Science, Faculty of Medicine and Pharmaceutical Science, The University of Douala, P. O. Box 24157, Douala, Cameroon

4 Department of Animal Sciences, Faculty of Science, The University of Douala, P. O. Box 24157, Douala, Cameroon

5 Indian Council of Medical Research, Dwarka, Sector 8,110077, New Delhi, India

6 Department of Paediatrics, Faculty of Medicine and Biomedical Sciences, The University of Yaoundé I, P. O. Box 812, Douala, Cameroon

7 Cochrane South Africa, South African Medical Research Council, Cape Town, South Africa.

*Corresponding author: Dr Kedy Koum Daniele; P. O Box 24157; Douala; E-mail: dckedykoum@yahoo. fr

ABSTRACT

Background: Catheter related infections are one of the major causes of morbidity and mortality in Neonatology wards in developing countries. In this study we aimed to determine the incidence, outcomes, risk factors and etiologies of catheter related infections amongst newborns hospitalized at the Douala Gyneco-obstetric and Paediatric hospital, Cameroonian.

Methods: This was a retrospective review of medical records. Newborns under umbilical and/or peripherally inserted venous central catheter were included. Catheters were sent to laboratory for culture and a structured ad hoc investigation form was used to collect data of interest.

Results: A total of 81 catheters placed in 70 newborns were analysed. Of the 81,69 were umbilical venous catheters and 12 were peripherally inserted central catheter. The mean gestational age of participants was 32.4 ± 3.5 weeks. The overall incidence of catheter related infections was 57.9/1000 days under catheterization [36.4/1000 and 57.9/1000 days under peripherally inserted and umbilical venous catheter respectively]. Candida albicans (41.4%) and Staphylococcus aureus (20.7%) were the isolated pathogens mainly responsible for infections. C. albicans isolates were all sensitive to ketoconazole, itraconazole and fluconazole while S. aureus isolates were all sensitive to gentamycin. Overall mortality rate was 30% and significantly higher in infected newborns as showed by multivariate logistic (OR = 2.82; 95% CI: 1.14-6.96; P-value = 0.002) and Kaplan-Meier (HR = 2.823; P-value = 0.0024) models. Catheter infection was the only independent predictor for mortality.

Conclusion: This study outlined a high incidence rate of catheter-related infections. Prescriptions for placing these catheters should be strict and hospital staff trained on their maintenance in order to reduce neonatal morbidity and mortality.

Keywords: New-Borns; Catheter-Related Infection; Umbilical Venous Catheter; Peripherally Inserted Central Catheter; Douala, Cameroon

Kedy Koum D, Ebongue Okalla C, Penda CI, Noukeu D, Tagne LS, Enyama D, Kouemo FD, Kojom LP, Ngaba GP Mah E, Chiabi A, Adiogo D, , Wiyeh A, Monebenimp F. Microbiological profile of umbilical and peripherally inserted central catheters related infections and predictors of mortality in Neonatology at the Gyneco-Obstetrics and Paediatric Hospital of Douala, Cameroon: Afr. J. of Integ. Health 2019,9 (1 a): 21-32

5. Removed

6. Faible Poids de naissance: Epidémiologie et facteurs pronostiques au Gabon

Low birth weight: Epidemiology and prognostic factors in Gabon

Mouba JF1, Sima OB2, Ndjengue DC1, Mewie LA2, Vendiany J1, Tsamba E1, Murielle MM1

1 Département de Pédiatrie, Faculté de Médecine, Université des Sciences de la Santé, BP 4009, Libreville-Gabon.

2 Département de Gynécologie Obstétrique, Faculté de Médecine, Université des Sciences de la Santé, BP 4009, Libreville-Gabon

*Auteur correspondant: MOUBA John Florent, Département de Pédiatrie, Faculté de Médecine, Université des Sciences de la Santé, BP 4009, Libreville-Gabon. Tel: +241 06 62 20 19. Email: jfmouba@gmail. com

RESUME

Introduction: La prévalence mondiale de l’insuffisance pondérale est de 15,5% ce qui représentant environ 20 millions de naissance par année et dont 96,5% dans les pays en développement comme le Gabon. L’objectif de cette étude était d’évaluer l’incidence hospitalière et de rechercher les facteurs pronostiques pour améliorer la prise en charge notamment la prévention.

Méthodologie: Il s’agit d’une étude rétrospective réalisée au Centre Hospitalier Universitaire (CHU) d’Owendo durant la période du 01 Janvier 2015 au 31 Janvier 2017 (2 ans). Etaient inclus tous les nouveau-nés vivants ayant un poids à la naissance compris entre 800 et 2500 g. Les paramètres étudiés étaient socio-démographiques, les données maternelles et la grossesse, les données néonatales et les facteurs pronostiques.

Résultats: Au cours de la période de l’étude, 63/412 avaient un faible poids de naissance soit 15,29%. L’âge moyen des mères était de 26,95±1,762 ans [14 à 47 ans]. Le terme était < 28 SA chez 3 nouveau-nés (4,76%), compris entre 28 et 32 SA chez 21 (33,33%) et entre 33 et 37 SA chez 39 (61,91%). Le poids moyen était de 1927,825±160,87 g et 49 (77,77%) avaient un poids compris entre 800 et 2000 g. L’âge gestationnel est un facteur pronostic majeur car garant de la maturité viscérale et d’une bonne adaptation de la vie extra-utérine.

Conclusion: La prématurité et le faible poids de naissance reflètent le niveau de développement d’un pays. Un plateau technique et la disponibilité du personnel qualifié pourraient contribuer à l’amélioration de la prise en charge de ces nouveaux nés.

Mots clés: Epidémiologie; Pronostic, Faible-Poids, Naissance, Gabon.

Mouba JF, Sima OB, Ndjengue DC, Mewie LA, Vendiany J, Tsamba E, Murielle MM. Faible Poids de naissance: Epidémiologie et facteurs pronostiques au Gabon: Afr. J. of Integ. Health 2019,9 (1 a): 44-49

7. POST-OPERATIVE COMPLICATIONS IN HIV/AIDS PATIENTS FOLLOWING ABDOMINAL SURGERY IN BUEA AND LIMBE REGIONAL HOSPITALS, CAMEROON: A RETROSPECTIVE COHORT ANALYSIS COMPARING TWO GROUPS OF PATIENTS

Palle JN1, Halle EG3, Chichom AM3, Pallissa AM3, Eta VA1, Essoh NB1, Udoamka GN1, Mokake NDM3, Kemayim F1, Ngounou E2, Mewoabi DM3

1 Department of Nursing Sciences, Faculty of Health Sciences, University of Buea, SW Region Cameroon

2 Department of Biomedical Sciences, Faculty of Health Sciences, University of Buea, SW Region Cameroon

3 Department of Surgery and Obstetrc and Gynaecology, Faculty of Health Sciences, University of Buea, SW Region Cameroon

*Corresponding Author: Dr Palle John Ngunde, Faculty of Health Sciences, University of Buea, Cameroon. Email: ngunde_pal@yahoo. co. uk, Tel; (+237)677812384

ABSTRACT

Background: HIV-infected patients have been reported to be significantly more susceptible to post-operative complications. This higher risk is generally correlated to CD4 count and viral load. Consequently, surgeons are sometimes reluctant to perform surgical interventions on these patients. The aim of this study was to compare the complication rate between HIV-infected and non-infected undergoing abdominal surgery and correlate these complications to CD4 count.

Methods: This retrospective cross-sectional analysis study, comparing two groups of patients was conducted in Limbe and Buea Regional Hospitals, Cameroon. We included two groups of patients (HIV-infected and non-infected patients) matched for age, sex and types of procedures performed. We compared the complication rates between the two groups using the Chi-square test.

Results: 360 patients were included, 180 in each group. Most patients (66.7%) were female and the majority was between 15 and 45 years; surgery was most often performed as an emergency. We recorded 168 complications in 360 patients giving a complication rate of 46.7%. This complication rate was 27.3% in HIV-infected patients and 19.4% in HIV-non infected patients. This difference was statistically significant (p=0.04). This complication rate was significantly correlated to the CD4 count with the cut off value of 200 cells per milliliter. The use of antiretroviral therapy did not significantly influence the outcome (p=0.05).

Conclusion: HIV influenced the outcome of patients after surgery and CD4 count was a predictor of post-operative complications. Risk factors of postoperative complications were immunosuppression, age of the patients and major surgery.

Keywords: HIV, AIDS, Abdominal surgery, post-operative complications

Palle J N, Halle EG, Chichom AM, Pallissa AM, Eta VA, Essoh NB, Udoamka GN, Mokake NDM, Kemayim F, Ngounou E, Mewoabi DM. Post-operative complications in hiv/aids patients following abdominal surgery in Buea and Limbe Regional Hospitals, Cameroon: a retrospective cohort analysis comparing two groups of patients: Afr. J. of Integ. Health 2019,9 (1 a): 50-59

8. Gestion du programme du VIH pédiatrique au Cameroun

management of paediatric HIV care in Cameroon

Penda CI1,2*, Téjiokem MC3, Bilong SC4,5, Kedy Koum DC1, Monebenimp F4, Eboumbou Moukoko EC1,3, Ateba Ndongo F6,7, Sofeu CL3,8, Njock LR1,2, Zoung Kanyi Bissek AC4,6

1 Faculté de Médecine et des Sciences Pharmaceutiques, Université de Douala, Cameroun;

2 Hôpital Laquintinie de Douala, Cameroun;

3 Service d’Epidémiologie et de Santé Publique, Centre Pasteur du Cameroun, Membre du Réseau International des Instituts Pasteur, Yaoundé, Cameroun;

4 Faculté des Sciences Biomédicales, Université de Yaoundé 1, Yaoundé, Cameroun;

5 Groupe Technique Central du Comité National de lutte contre le VIH/SIDA (CNLS), Yaoundé, Cameroon

6 Division de la Recherche Opérationnelle en Santé, Ministère de la Santé Publique du Cameroun, Yaoundé, Cameroun;

7 Fondation Chantal Biya, Centre Mère et Enfant de Yaoundé, Yaoundé, Cameroon;

8 University of Bordeaux, INSERM Bordeaux Population health U1219 (Biostatistic), Bordeaux, France

*Auteur correspondant: Calixte Ida Penda, Pédiatre, MD, MPH, Département des Sciences Cliniques, Faculté de Médecine et des Sciences Pharmaceutiques (FMSP), Université de Douala; Département de Pédiatrie, Hôpital Laquintinie de Douala (HLD), Cameroun. BP 2701 Douala Cameroun Tel: +237677703155; Email: Calix. penda@gmail. com

Résumé

Introduction: Au Cameroun, la couverture des enfants éligibles au traitement antirétroviral (TARV) (15%) était l’une des plus faibles des 21 pays prioritaires du Fonds Mondial en 2012. Le but de cette étude était de faire une analyse situationnelle de la gestion des soins pour améliorer la prise en charge du VIH pédiatrique (PECP) au Cameroun.

thodes: Une étude transversale descriptive a été menée pendant 4 mois (avril à août 2014) dans 12 formations sanitaires de 7 régions du Cameroun sélectionnées par un sondage systématique. Les données recueillies à l’aide d’un auto-questionnaire administré aux personnels soignants et responsables administratifs inclus dans l’étude.

Résultats: Au total 142 personnels en charge du VIH pédiatrique ont été inclus dans cette étude: 115 du niveau opérationnel parmi lesquels 59 (51,2%) personnels de santé, 44 (38,3%) agents communautaires, 12 (10,4%) chefs de services, 19 responsables du niveau régional et 8 du niveau central. La grande majorité des personnels soignants impliqués dans la PECP étaient des infirmiers, nécessitant ainsi la délégation effective des tâches médicales institutionnalisée au Cameroun. Très peu de documents normatifs nationaux prenaient en compte la PECP. La faible vulgarisation de ces documents normatifs à tous les niveaux de la pyramide sanitaire pourrait justifier le non-respect des protocoles de prise en charge observé dans les formations sanitaires offrant la PECP.

Conclusion: La mise à jour et la diffusion à large échelle des documents nationaux normatifs, prenant en compte des spécificités de l’enfant infecté par le VIH, sont nécessaires pour améliorer l’application des directives de la PECP au niveau opérationnel.

Mots-clés: VIH; Prise en charge; Enfants infectés par le VIH; Traitements antirétroviraux.

 

Abstact

Bacground: In Cameroon, the proportion (15 %) of eligible children effectively on antiretroviral treatment (ART) was one of the lowest among the 21 priority countries of Global Fund in 2012. The aim of this study was to do a situational analysis of the management of care in order to improve care to pediatric HIV in Cameroon.

Methods: A descriptive cross-sectional study was conducted during a 4-months period (April to August 2014) in 12 healthcare facilities in 7 regions of Cameroon selected using systematic random sampling. The data were drawn from interviews with healthcare providers and managers, using standardized auto-questionnaires.

Results: In total, 142 staffs were included in this study, of whom 59 (51.2%) health workers and 44 (38.3%) community agents, 12 (10.4%) chiefs of services, 19 and 8 managers respectively of the intermediate and central levels of healthcare system. The majority of health workers in charge of HIV pediatric care were nurses, requiring effective medical tasks shifting which was institutionalized in Cameroon. The small extension of normative documents at all levels of the health system could justify non-compliance with care protocols observed in the healthcare facilities offering HIV pediatric care.

Conclusion: Updating and large-scale dissemination of normative national documents, taking into account the specificities of HIV-infected children, are required to improve implementation of the guidelines of HIV pediatric care at the operational level of healthcare system.

Keywords: HIV; Pediatric care; HIV-infected children; Antiretroviral therapy

Penda CI, Téjiokem MC, Bilong SC, Kedy Koum DC, Monebenimp F, Eboumbou Moukoko EC, , Ateba Ndongo F, , Sofeu CL, Njock LR, , Zoung Kanyi Bissek AC. Gestion du programme du VIH pédiatrique au Cameroun: Afr. J. of Integ. Health 2019,9 (1 a): 60-75

9. EVALUATION OF RISK FACTORS OF SURGICAL SITE INFECTIONS IN SPINE SURGERY AT THE CENTRAL HOSPITAL OF YAOUNDE (CHY)

Ngaroua1,2*, Dah’Ngwa D², Eloundou NJ3

1 Regional Hospital of Ngaoundéré-Cameroun

2 Faculty of Medicineand Biomedical Sciences of Garoua, University of Ngaoundéré-Cameroun

3 Faculty of Medicine and Biomedical Sciences, University of Yaoundé 1

*Corresponding author: Dr Ngaroua, tel: (237) 699 978 351; email: mdngaroua2007@yahoo. fr

ABSTRACT

Introduction: The surgery of the spine is an intervention on the backbone and/or its content so as to decompress the spinal cord and its nerve stems or stabilize the spine. Just as in any other surgery we may face a surgical site infection (SSI).

Methods: we carried out a cohort prospective design survey going from May 1 st 2016 to April 30 th 2017. Informations collected were patient’s background history, surgical intervention characteristics and patients follow-up for 30 days post-surgery.

Results: 119 had a backbone surgery amongst which 57.1% were male. The mean age of study sample was 51 years old. Prophylactic antibiotic was given to 99.2% of the sample. The mean surgical time was of 105 minutes. The most concerned region of the spine was the lumbar which concerned 57.1% of the patients. SSI global incidence was 10.9%. Additional stay period in the hospital attributable to the SSI was 15 days.

Conclusion: SSI are frequent in the backbone surgery at the Central Hospital of Yaoundé (CHY). SSI unexpected arrival increases hospital stay period by 15 days.

Keywords: SSI, Incidence, Risk factors

Ngaroua, Dah’Ngwa D, Eloundou NJ. Evaluation of risk factors of surgical site infections in spine surgery at the Central Hospital Of Yaounde (CHY): Afr. J. of Integ. Health 2019,9 (1 a): 76-82

10. Assessment of primary Health care facilities preparedness for cardiovascular diseases diagnosis and management in the North West Region of Cameroon: a cross-sectional study

Assessment of primary Health care facilities preparedness for cardiovascular diseases diagnosis and management in the North West Region of Cameroon: a cross-sectional study

Palle JN1, Halle EGE2, Choukem SP3, Nde Fon P4, Eta VA1, Essoh NB1, Udoamaka GN1, Fongang CL1, Ngounou E3, Mewaobi MD3

1 Department of Nursing Sciences, Faculty of Health Sciences, University of Buea, SW Region Cameroon

3 Department of Internal Medicine and Paediatrics, Faculty of Health Sciences, University of Buea, SW Region Cameroon

3 Department of Biomedical Sciences, Faculty of Health Sciences, University of Buea, SW Region Cameroon

6 Department of Surgery and Obstetrc and Gynaecology, Faculty of Health Sciences, University of Buea, SW Region Cameroon

4 Department of Public Health and Hygiene, Faculty of Health Sciences, University of Buea, SW Region Cameroon

*Corresponding author: Dr Palle John Ngunde, Faculty of Health Sciences, University of Buea. Email: ngunde_ pal@yahoo. co. uk

 

ABSTRACT

Background: Non-communicable diseases (NCDs) account for over 30% of global death annually and about 80% of the deaths occur in low and middle income countries. With the growingepidemicof cardiovasculardiseases (CVDs)globallyand in the Sub-SaharanAfrica (SSA) especially, thereis needfor veryaggressiveeffortsto ensurethe preparednessof countriesto manageCVDsat the Primaryhealthcare (PHC)level.

Objectives: to assessthe availabilityof Guidelinesand diagnosticequipmentas well as the availabilityand affordabilityof essentialmedicinesfor CVDsat PHClevel in the NorthWest Region (NW) of Cameroon.

Methods: A cross-sectional survey of PHC facilities in the NW Region including public, private and confessional facilities. A cluster and simple random sampling were used, a questionnaire was used to collect data on the availability of basic equipment, guidelines, essential CVDs medications and the cost of these medications. Data was analysed using Epi INFO version 7.0.

Results: A total of 40 PHC facilities were included with 53% rural, 22% semi-urban and25% urban. 55% were public, 18% private and 27% were confessional facilities. Guidelines for hypertension and diabetes were found in 20% and 22% of the health facilities respectively. There was a 100% availability of glucometers and stethoscopes, 97% availability of sphygmomanometer and a 25% availability of ECG machines. Spironolactone, statins, methyldopa, nitrites, digoxin and aspirin had less than 70% availability among the studied facilities. The income of lowest unskilledcivilservant was 36.270 frsmonthlywhile median (monthly)cost of spironolactone (1350 frs), methyldopa (1500 frs), captopril (1500 frs), digoxin (300 frs), nifedipine (900 frs) and aspirin (300 frs).

Conclusion: There wasan extremely low availability of guidelines, most of thePHCshadglucometer andBPmonitor, butonly1 in 4 hadanECGmachine. Essentialmedications were available in a majorityof PHCs, although not readilyaffordableto lowest paid unskilled worker. Much effort still needs to be made to ensure that the PHC facilities areadequately prepared for the challenges ofCVDs in the region.

Keywords: Preparedness, Essential Medications, Primary Health Care Facility

Palle JN, Halle EGE, Choukem SP, Nde Fon P, Eta VA, Essoh NB, Udoamaka GN, Fongang CL, Ngounou E, Mewaobi MD. Assessment of primary Health care facilities preparedness for cardiovascular diseases diagnosis and management in the North West Region of Cameroon: a cross-sectional study: Afr. J. of Integ. Health 2019,9 (1 a): 83-93

Volume 9.1b

11. Forgotten Foreign Body, still a reality and consequence of non-use of the WHO surgical safety check lists in tropical surgery

Mokake DM1*, Verla VS2, Palle NJ2, Elong FA1, Leku BA3, Ngowe NM1

1Department of Surgery and Specialties, Faculty of Health Sciences, University of Buea, Cameroon.

2Department of Internal Medicine and Pediatrics, Faculty of Health Sciences, University of Buea, Cameroon.

3Buea Regional Hospital, South West Region, Cameroon

*Corresponding author: Dr Mokake Divine; Tel: 00 237 676 41 34 08; E. Mail: divymoks2001@yahoo. com

ABSTRACT

Background: Adhesions are a major cause of acute abdomen in previously operated patients.

The presence of foreign bodies in the abdomen is a leading factor in the development of post-operative adhesion. It is therefore important to take all necessary measures to avoid foreign bodies in the abdomen, as this increases the risk of developing post-operative complications.

Case presentation: A 32 yr old female with a relevant past surgical history of an emergency laparotomy indicated for a ruptured ectopic pregnancy, presented as an emergency 3 months after the above surgery with signs of generalized peritonism, following a brief history of sudden onset of lower abdominal pains. An erect plain abdominal x-ray revealed distended loops of bowel with air fluid levels. After fluid and electrolyte resuscitation was done, an emergency laparatomywas carried onunder general anesthesia. It revealed the presence of a foreign body (gauze), surrounded by multiple adhesion around the ileo-cecal junction with 2 meters of ischemic small bowel. Adhesionolysis was done, foreign body extracted and an end to end anastomosis performed after resection of the ischemic portion of the bowel using Lamberts technique.

Conclusion: Forgotten foreign body increases the risk of developing post-operative adhesions. Taking appropriate measures in the operating room like the effective use of the WHO surgical check lists before incision and before closing the abdomen, will prevent foreign body retention.

Keywords: Foreign bodies, Abdominal Surgery, WHO guideline, Checklist

Mokake DM, Verla VS, Palle NJ, Elong FA, Leku BA, Ngowe NM. Forgotten Foreign Body, still a reality and consequence of non-use of the WHO surgical safety check lists in tropical surgery: Afr. J. of Integ. Health 2019,9 (1 b): 94-102

12. Scrotal Elephantiasis: A case report from the Buea Regional Hospital and review of the literature

Eyongeta DE1,2*, Kamadjou C3, Moby H4, Weledji Eloy P1,2, Ngowe Ngowe M2, Angwafo III FF5

1 Regional Hospitals Limbe and Buea, Limbe, South West Region, Cameroon

2 Department of Surgery, Faculty of Health Sciences, University of Buea, Buea, Cameroon

3 Centre Medico-Chirurgical d’Urologie de Douala, Douala, Cameroon

4 Regional Hospital Annex Nkongsamba, Nkongsamba, Littoral Region, Cameroon

5 Coordinator, Urology Residency Program, Faculty of Medicine and Biomedical Sciences, University of Yaounde I, Yaounde, Cameroon

*Corresponding author: Dr. Divine Enoru Eyongeta, Department of Surgery, Faculty of Health Sciences, University of Buea, Cameroon. Tel (237) 679 27 04 21. E-mail eyongeta@yahoo. com

ABSTRACT

Scrotal Elephantiasis is characterized by lymphedema and thickening of the subcutaneous tissues of the scrotum. There are multiple causes, which may be difficult to identify. It is a source of both psychological and physical distress for the patient. Reconstructive surgery is often the only way to restore cosmetic and functional aspects of the external genitalia. We report the case of a 51-year-old man with giant scrotal elephantiasis who underwent excision and scrotal reconstruction at the Buea Regional Hospital, South West Region of Cameroon.

Keywords: Scrotal elephantiasis, physical distress, Scrotoplasty

Eyongeta DE, Kamadjou C, Moby H, Weledji Eloy P, Ngowe Ngowe M, Angwafo III FF. Scrotal Elephantiasis: A case report from the Buea Regional Hospital and review of the literature: Afr. J. of Integ. Health 2019,9 (1 b): 103-106

13. The impact of community-directed health education on the prevalence of urinary schistosomiasis among school children in some rural communities in the Littoral Region of Cameroon

L̓΄impact de l’éducation sanitaire sous directive communau-taire sur la prévalence de la schistosomiase urinaire chez les élèves de certaines communautés rurales de la région du Littoral du Cameroun

Fankep DAB1*, Tamdjo F1, Njunda AL1 and Kamga FHL2*

1 Department of Medical Laboratory Sciences, Faculty of Health Sciences, University of Buea, Cameroon

2 Department of Medical Laboratory Sciences, Faculty of Health Sciences, University of Bamenda, Cameroon

*Corresponding author: Henri Lucien Kamga Fouamno, Email: henrikamga2002@yahoo. fr

ABSTRACT

Background: Urinary Schistosomiasis is the most prevalent of water-borne diseases and a great health risk in rural areas of developing countries including Cameroon.

Objective: To determine the impact of programme-designed and community-directed health education interventions on the prevalence of urinary schistosomiasis among school schildren in three rural communities in the Littoral Region of Cameroon, namely Lelem Mangouete, Lelem Mouaton and Bere-Bakem.

Material and Methods: It was a prospective cross-sectional study conducted in two phases. The target population was the primary school children aged between 5-15 years living in 3 villages in the Littoral Region of Cameroon. During the first phase, urine specimen was then filtered and examined for schistosome ova using optic microscope. In Lelem Mouaton (experiment1) children who received health education were asked to participate by proposing a method of control which they felt could be applied to their village, and under the supervision of the investigator, one of these methods was choosen for implementation. In Lelem Mangouete (experiment 2) pupils also received health education and were trained on procedures for implementation of schistosomiasis control. Bare-Bakem was used as control in which no health education was carried out. The second phase was conducted 5 months after the end of the first intervention and consisted of urine specimen collection and ova detection. Statistical analyses of data were done using Chi-square and student-t-test for the significance of the results obtained.

Results: There was a significant drop in the prevalence in Lelem Mouaton (53.8% vs 32.3%, p<0.001) and Lelem Mangouete (57.8% vs 43.5%, p<0.001) and but not in Bere-Bakem (49.4% vs 51.4%, p>0,10), with a greater drop in Lelem Mouaton (21.5% vs 14.3%, p = 0.001).

Conclusion: A significant reduction of prevalence of urinary schistosomiasis can be obtained if community-directed health education strategies are implemented among youths living in endemic villages.

Keywords: Urinary schistosomiasis, Cameroon, community-directed health education, Primary school children

Résumé

Contexte: La schistosomiase est la plus répandue des maladies transmises par l’eau et represente un grand risque sanitaire pour les populations vivant dans les régions rurales des pays en développement, y compris le Cameroun.

Objectif: Déterminer L̓΄impact des interventions d’éducation sanitaire programméeset sous directive communautaire sur la prévalence de la schistosomiase urinaire chez les élèves de certaines communautés rurales de la région du Littoral du Cameroun à savoir Lelem Mangouete, Lelem Mouaton et Bere-Bakem.

Matériel and Methodes: Il s’agissait d’une étude transversale prospective menée en deux phases. La population cible était les enfants du primaire âgés de 5-15 ans vivant dans 3 villages de la Région du Littorale du Cameroun. Au cours de la première phase, les échantillons d’urine ont été filtrés et examinés microscopiquement pour détecter les œufs de schistosomes. L’éducation sanitaire a été utilisée à Lelem Mouaton et Lelem Mangouete. À Lelem Mouaton (village expérimental 1), les enfants ont été invités à participer en proposant une méthode de contrôle qu’ils estimaient pouvoir être appliquée à leur village et, sous la supervision de l’enquêteur, l’une de ces méthodes a été choisie pour la mise en œuvre. À Lelem Mangouete (village expérimental 2), les élèves ont reçu une formation sur les procédures de mise en œuvre de la lutte contre la schistosomiase. A Bare-Bakem (village contrôle) aucune éducation sanitaire n’a été donnée. La deuxième phase a été menée 5 mois après la fin de la première intervention et consistait à recueillir des échantillons d’urine et à détecter les œufs. Les analyses statistiques des données ont été effectuées à l’aide du test de Ki-carré et du test t- de Student pour déterminer l’importance des résultats obtenus.

Résultats: Il y avait une baisse importante de la prévalence à Lelem Mouaton (53,8 % contre 32,3 %, p=0,001) et a Lelem Mangouete (57,8 % contre 43,5 %, p=0,001) et mais pas a Bere-Bakem (49,4 % contre 51,4 %, p>0,10), avec une baisse plus importante à Lelem Mouaton (21,5 % contre 14,3 %, p = 0,001).

Conclusion: Il y a eu une réduction significative de la prévalence de la schistosomiase urinaire dans les villages où l’éducation sanitaire a été effectuée, mais pas dans le contrôle. L’éducation sanitaire sous directive communautaire a toutefois entraîné une baisse plus importante de la prévalence que celle programmée. Cette méthode a été recommandée comme méthode de lutte contre la schistosomiase urinaire dans les pays endémiques.

Mots-clés: Schistosomiase urinaire, Cameroun, éducation sanitaire sous directive communautaire, Elèves du primaire

Fankep DAB, Tamdjo F, Njunda AL and Kamga FHL. The impact of community-directed health education on the prevalence of urinary schistosomiasis among school children in some rural communities in the Littoral Region of Cameroon: Afr. J. of Integ. Health 2019,9 (1 b): 107-115

14. Prevalence of onchocerciasis in the Menchum valley in Cameroon after fifteen years of annual mass treatment with ivermectin

La prévalence de l’onchocercose dans la vallée de la Menchum au Cameroun après quinze années de traitement de masse par l΄ivermectin

Kanjo Shiynsa F1, Kamga FHL2*, Assob NJCet Njunda AL1

1 Department of Medical Laboratory Science, Faculty of Health Sciences, University of Buea, Cameroon

2 Department of Medical Laboratory Science, Faculty of Health Sciences, University of Bamenda, Cameroon

*Corresponding author: Henri Lucien Kamga, Email: henrikamga2002@yahoo. fr

ABSTRACT

Background: Onchocerciasis is a parasitic disease caused by the filarial nematode Onchocerca volvulus. It is one of the leading causes of infectious blindness in Africa and is transmitted by the black fly Simulium damnosum.

Objective: To report the prevalence of microfilaredermia in individuals following 15 years of community directed treatment with ivermectin

Materials and Methods: It was a prospective and cross sectional analytic study. Four localities in the Menchum valley were randomly selected. Questionnaires were used to obtain bio data from participants. Skin snip specimens were collected from selected participants and analyzed for the presence of microfilaria. Epi-Info 6.04 (CDC, 2007) and SPSS version 17.0 were used to analyze the results obtained

Results: A total of 348 adults from 116 households took part in this study. Of these, there were 13 (3.7%) subjects with microfilaredermia. The highest percentage of infected subjects (23.1%) was among those aged between15-25 years. Females had a significantly higher percentage of infection than males (84.6.1% vs 15.3% P˂0.005). The highest prevalence of microfilaredermia was observed amongst farmers (2.5%) on one hand, and among participants with no formal education (2.0%) on the other hand, though there was no significant relationship between prevalence of microfilaredermia and the occupation (X2=6.22, P=0.1), or level of education (X2=5.966, P=0.1)

Conclusion: Ivermectin treatment for fifteen years in the Menchum valley has not interrupted onchocerciasis transmission, but has transformed the area from a hyper-/meso-endemic to a hypo-endemic level, far below the African programme for onchocerciasis control recommended baseline threshold.

Keywords: Prevalence of onchocerciasis, Menchum valley, ivermectin

 

Kanjo Shiynsa F, Kamga FHL, Assob NJC et Njunda AL. Prevalence of onchocerciasis in the Menchum valley in Cameroon after fifteen years of annual mass treatment with ivermectin: Afr. J. of Integ. Health 2019,9 (1 b): 116-122

15. THE QUALITY OF LIFE AND ECONOMIC BURDEN OF CHRONIC LEG ULCERS AMONG PATIENTS IN THE KUMBA AND MUYUKA HEALTH DISTRICTS, CAMEROON

Palle JN1, Halle EG2, Fokam P2, Udoamaka GN1, Njouendou AJ3, Mokake NDM2, Sombong EN1, Eta VA1, Essoh NB1, Kemayin F1, Ngounou E3, Mewoabi DM1

1 Department of Nursing Sciences, Faculty of Health Sciences, University of Buea, SW Region Cameroon

2 Department of Surgery and Obstetrc and Gynaecology, Faculty of Health Sciences, University of Buea, SW Region Cameroon

3 Department of Biomedical Sciences, Faculty of Health Sciences, University of Buea, SW Region Cameroon

*Corresponding author: Dr Palle John Ngunde, Faculty of health sciences, University of Buea; Email: ngunde_pal@yahoo. co. uk; Tel: +237677812384

 

ABSTRACT

Background: Chronic leg ulcers have an impact on all aspects of life. Treatment is expensive and time consuming. They significantly reduce the quality of life of patients while placing a huge strain on their financial resources. In Cameroon little is known about the hardships that these patients go through.

Objective: The aim of this study was to bring to light the quality of life and economic burden among patients with chronic leg ulcers.

Method: We conducted a cross-sectional study in 4 health facilities. All consenting patients with chronic leg ulcers were included. Using a convenient sampling method, relevant socio-demographic, clinical and average monthly earnings information was obtained through patient interviews, a physical examination and from medical records. Data was analyzed using Epi-info 7.

Results: We included 190 patients: 75 had venous ulcers, 41 traumatic ulcers, 40 infectious ulcers, 14 pressure ulcers, 10 arterial, 9 diabetic and 1 ulcer caused by gout. 85% of the participants had pain at rest while 96% experienced pain during wound dressing. Itching of the ulcer and surrounding area was reported in 59% of patients. Walking difficulty was found in 167 of the 190 patients. 92 (48.8%) reported completely abstaining from social gatherings. Perceived depression was identified in 29.47% of the participants. We saw that 51.58% of our participants spent more money on regular wound dressing, and treatment of ulcer related complications than their average monthly income.

Conclusion: Chronic leg ulcer is a major public health problem in Kumba and Muyuka health districts; it results in considerable reduction in quality of life. Despite many people with this problem, little is known about the extent of their hardships.

Keywords: Chronic leg ulcers, Quality of life, Economic burden

Palle JN, Halle EG, Fokam P, Udoamaka GN, Njouendou AJ, Mokake NDM, Sombong EN, Eta VA, Essoh NB, Kemayin F, Ngounou E, Mewoabi DM. The quality of life and economic burden of chronic leg ulcers among patients in the Kumba and Muyuka Health Districts, Cameroon: Afr. J. of Integ. Health 2019,9 (1 b): 123-131

16. Respiratory distress and predictors of mortality among term newborns hospitalised at a reference hospital in Douala, Cameroon

Kedy Koum DC1,2*, Noukeu Njinkui D2, Enyama D2, Tagne LS1, Penda CI1, Kouemo FD3, Kojom LP4, Wiyeh AB5, Mah E6, Chiabi C6, Koki Ndombo PO6, andPfister R7

1 Department of Clinical Sciences, Faculty of Medicine and Pharmaceutical Sciences, The University of Douala, P. O. Box 2701, Douala, Cameroon

2 Gyneco Obstetrics and Pediatric Hospital of Douala, Cameroon, P. O. Box 7270, Douala, Cameroon

3 Department of Medical Laboratory Science, Faculty of Health Sciences, University of Buea, P. O. Box 63, Buea, Cameroon

4 Department of Animal Sciences, Faculty of Science, The University of Douala, P. O. Box 24157, Douala, Cameroon

5 Cochrane South Africa, South African Medical Research Council, 7501 Cape Town, South Africa

6 Department of paediatrics, Faculty of Medicine and Biomedical Sciences; University of Yaoundé P. O. Box 1364, Yaoundé, Cameroon

7 Department of Children and Adolescence, University hospital of Geneva, Rue Willy-Donze 6. CH-1205 Geneva, Switzerland

*Corresponding author: Dr Kedy Koum Daniele Christiane, Department of clinical sciences, Faculty of Medicine and Pharmaceutical Sciences, The University of Douala, P. O. Box 24157, Douala, Cameroon. Phone: +237 678396536 E-mail: dckedykoum@yahoo. fr

 

ABSTRACT

Background: Respiratory distress in newborns at term is strongly associated with high mortality rates in resource constrained countries. This study aimed at studying the prevalence, clinical profile and predictors of mortality among term newborns admitted at the neonatal unit of the Gyneco-Obstetrics and Paediatrics Hospital in Douala, Cameroon.

Methods: A 28-month medical record review was conducted from August 2015 to December 2017. Socio-demographic, clinical data as well as predictors of mortality were documented from the medical records of term newborn hospitalised in this health facility with respiratory distress during the study period. Multivariate analysis was performed using SPSS 23 software and a p value of less than 0.05 was considered statistically significant.

Results: A total of 499 files were reviewed out of which 172 were cases of respiratory distress giving a prevalence of 34.5% (172/499). The male-to-female ratio was 1.5: 1 and the mean (SD) age of newborns was 2.5 ± 0.3 days (range: 0-28). The onset of respiratory distress was early (less than 24 hours) and severe forms diagnosed in 85.4% and 7.6% patients respectively. Neonatal infections (88.5%), neonatal asphyxia (39.0%), transient respiratory distress (35.5%) and anaemia (34.3%) were the commonest associated disorders. Most newborns (91.3%) were under oxygen therapy and etiological treatment relied mostly on antibiotic therapy (88.4%). The mean (SD) hospitalization duration was 6.7 ± 0.5 (1-33) days with a mortality rate of 22.1%. Predictors of mortality include: Silverman score > 4 (OR 29.9 CI: 1.601-559.932), convulsion (OR 20.7 CI: 1.259 - 341.616) and being referred from an external health facility (OR 10.4 CI: 1.207-91.238).

Conclusion: Respiratory distress amongst term newborns is a common finding amongst hospitalised newborns at the Gyneco-Obstetrics and Paediatrics Hospital in Douala, Cameroon and mortality rates remains very high. There is an urgent need for the strengthening of the neonatology unit of DGOPH with equipment required to manage this condition. Capacity building of peripheral health facilities on neonatal resuscitation techniques is also critical.

Keywords: Cameroon, Douala, Respiratory distress, Term newborn

Kedy Koum DC, Noukeu Njinkui D, Enyama D, Tagne LS, Penda CI, Kouemo FD, Kojom LP, Wiyeh AB, Mah E, Chiabi C, Koki Ndombo PO, and Pfister R. Respiratory distress and predictors of mortality among term newborns hospitalised at a reference hospital in Douala, Cameroon: Afr. J. of Integ. Health 2019,9 (1 b): 132-142

17. ASPECTS EPIDEMIOLOGIQUES ET PRONOSTIQUES DES GROSSESSES ET ACCOUCHEMENTS CHEZ LES ADOLESCENTES AU CHU DE LIBREVILLE

EPIDEMIOLOGICAL AND PROGNOSTIC ASPECTS OF PREGNANCY AND DELIVERY IN ADOLESCENTS AT LIBREVILLE CHU

Ngou Mve Ngou JP1, Mouba JF2, Ndoba E1, Ngou Mve Ngou K1, Ambounda N1, Djengue C2, Sima Ole B1, Meye JF1

1Département de Gynécologie Obstétrique, Faculté de Médecine, Université des Sciences de la Santé, BP 4009, Libreville-Gabon

2Département de Pédiatrie, Faculté de Médecine, Université des Sciences de la Santé, BP 4009, Libreville-Gabon.

*Auteur correspondant: Mouba JF; Tel: +241 06 21 90 70. Email: jfmouba@gmail. com

Résumé

Introduction: Le monde compte un milliard d’adolescents dont 85% vivent dans les pays en voie de développement. La grossesse chez l’adolescente est considérée comme une grossesse à haut risque et peu d’étude traitent de près les complications survenant pendant ces grossesses et accouchements chez cette catégorie de jeunes mères.

L’objectif de cette étude était d’évaluer les aspects épidémiologiques et pronostiques des grossesses et accouchements chez les adolescentes au CHU de Libreville.

Méthodologie: Il s’agissait d’une étude rétrospective et descriptive menée sur une période de 05 ans allant de janvier 2010 à janvier 2015 incluant toutes les parturientes âgées de 15 ans au plus et ayant accouchées à la maternité du centre hospitalier universitaire de Libreville.

Résultats: La fréquence des accouchements chez les adolescentes âgée de 15 ans au plus durent la période d’étude était de 0,6% (307). L’âge moyen des adolescentes était de 14,7 plus ou moins 0,6 ans avec un niveau d’étude secondaire retrouvé chez 72,9% des parturientes et 51 % d’entre elles qui provenaient de milieux défavorisés. La majorité des adolescentes avaient accouché par voie basse (92%) et concernant ces accouchements par voie basse, il a été noté 77,3% de complications obstétricales maternelles. Aucun cas de décès maternels n’avait été noté par contre il y’avait eu trois décès fœtaux. Le poids moyen des nouveau-nés était de 2907,8 g plus ou moins 530,1 g et juste 3,3 % ont présenté une asphyxie.

Conclusion: Bien qu’il n’ait pas été noté un risque élevé de décès maternels et néonatals dans notre série, Les grossesses chez les adolescentes restent une préoccupation majeure du fait des complications non négligeables qu’elle engendre, nécessitant une prise en charge pluridisciplinaire.

Mots clés: Grossesse- accouchement - adolescentes - Libreville, Gabon

Ngou Mve Ngou JP, Mouba JF, Ndoba E, Ngou Mve Ngou K, Ambounda N, Djengue C, Sima Ole B, Meye JF. Aspects épidémiologiques et pronostiques des grossesses et accouchements chez les adolescentes au CHU de Libreville: Afr. J. of Integ. Health 2019,9 (1 b): 143-147

18. Effectivness of haemodialysis treatment in removal some substances on patient on maintenance at the haemodialysis Centre of Buea Regional Hospital

Njenou Njeumen RT1, Teuwafeu DG2*, Asongalem AE3, Nia R4, Aya F5, Youmbi S5, Nana Njamen T6, Assob Nguedia JC1

1 Department of Medical Laboratory Sciences, Faculty of Health Sciences, University of Buea, SW Region Cameroon

3 Department of Internal Medicine, Faculty of Health Sciences, University of Buea, SW Region Cameroon

3 Department of Biomedical Sciences, Faculty of Health Sciences, University of Buea, SW Region Cameroon

6 Department of Surgery and Obstetrc and Gynaecology, Faculty of Health Sciences, University of Buea, SW Region Cameroon

4 Department of Botany Faculty of Sciences, University of Buea, SW Region Cameroon

5 Buea Regional Hospital, SW Region Cameroon

*Corresponding author: Teuwafeu DG. d.teuwafeu@yahoo. com. Tel.: 00237 699961884

ABSTRACT

Background: Haemodialysis effectiveness and adequacy are important factors in identifying the level of reduction of various uremic complications experienced by haemodialysis patients. This study aims at evaluating the effectiveness of hemodialysis in removal of some substances through the analysis of biochemical parameters from patients on maintenance.

Method: This hospital based, cross sectional study enrolled 54 patients on maintenance haemodialysis. Data were collected using a questionnaire and haemodialysis effectiveness was assessed by evaluating the clearance of some solutes (urea, creatinine, uric acid, potassium, sodium and phosphorus), formulae such as the urea reduction ratio (URR), creatinine reduction ratio (CRR), urea kinetic modelling (Kt/V) and their clearance difference or proportion. Blood specimen was collected from patients before and after haemodialysis treatment. Data analysis was conducted using Statistical Package for Social Sciences (IBM SPSS, version 20). The level of significance considered was fixed at < 0.05.

Result: Using urea reduction ratio (URR), 54.7% of participants had near optimal or optimal urea removal (54.51±12.94%). and with creatinine reduction ratio (CRR), 67.92% of patients had an optimal creatinine removal (55.03±10.64%). The Daugirdas Kt/V found that only 16.0% had adequate haemodialysis (0.99±0.35). The proportion of clearance of phosphorus (2.46±2.32), sodium (4.02±21.81), uric acid (6.48±3.16), and potassium (2.08±1.34) varied from 29.6%, 81.5%, 94.4% and 100% respectively. The duration of haemodialysis less than 04 hours (p=0.012) was significantly associated to less optimal removal of urea. The Vascular access (catheter) use (P=0.006) and the duration of haemodialysis session less than 04 hours (P=0.018, r=0.140) were significantly associated with poor phosphorus removal.

Conclusion: Though only 16.0% of participants had adequate dialysis, the hemodialysis is effective in removal of some product (potassium, uric acid, phosphorus) at the near optimal and optimal level. The vascular access (catheter) and duration of the session (less than four hours) are associated with poor removal of phosphorus.

Keywords: Haemodialysis, adequacy, biochemical parameters

Njenou Njeumen RT, Teuwafeu DG, Asongalem AE, Nia R, Aya F, Youmbi S, Nana Njamen T, Assob Nguedia JC. Effectivness of haemodialysis treatment in removal some substances on patient on maintenance at the haemodialysis Centre of Buea Regional Hospital: Afr. J. of Integ. Health 2019,9 (1 b): 148-158

19. Prévalence des Dysfonctionnements Erectiles et des facteurs y associés chez les patients diabétiques de l’Hôpital de District de Dschang

Prevalence of erectile dysfunction and associated factors in diabetic patients at the Dschang District Hospital

Nguefo Kana RS1,2, Simo Gounoue C2, Dabou S3, Kamga Fouamno HL4*

1 Service de diabétologie, Hôpital de district de Dschang

2 Institut Universitaire de l’Estuaire/INSAM, Douala

3 Faculté des Sciences, Université de Dschang.

4 Faculté des Sciences de la Santé, Université de Bamenda, Cameroun

*Correspondance: E-mail: henrikamga2002@yahoo. fr; Tel: +237 699 721 972

ABSTRACT

Résumé 

Contexte: Le Dysfonctionnement Erectile (DE) est l’incapacité à obtenir et à maintenir une érection suffisamment rigide et durable pour une relation sexuelle satisfaisante. Le DE est un sujet presque tabou, sous-diagnostiqué et reste une complication chronique neurologique et vasculaire du diabète.

Objectif: L’objectif de cette étude était de déterminer la prévalence des DE et les facteurs y associés chez les diabétiques.

Matériel et Méthodes: Une étude de type transversal et analytique a inclut 51 diabétiques âgés de 25 à 65 ans du 13 Avril au 13 Juin 2018 à l’hôpital de district de Dschang. Un questionnaire avec l’index international de la fonction érectile a été utilisé pendant les interviews confidentielles. Les résultats obtenus ont été saisis, codifiés puis analysés grâce au logiciel SPSS version 16.0. Le seuil de significativité a été fixé à p <0,05.

Résultats: L’âge moyen des patients était de 53,6 ans Les rétinopathies, cardiopathies, néphropathies et neuropathies étaient respectivement de 49%, 15,70%, 3,9% et 43,10%. La durée moyenne de la maladie était de 4,8 ans chez les malades contre 1,91 chez les non malades. La prévalence des DE était de 76,47%. Les facteurs associés rapportés à la régression logistique étaient l’âge, les neuropathies et la concentration sérique des triglycérides avec respectivement les valeurs: OR=7,2 (IC: 1,01 – 49,82; p=0,04); OR=11,5 (IC: 1,2 – 94,6; p=0,02) et OR=0,35 (IC 0,14 - 0,84; p=0,02).

Conclusion: La prévalence des dysfonctionnements érectiles est de 76,47%. Elle est plus élevée dans la population des diabétiques que dans le reste de la population. L’âge avancé, les neuropathies et les triglycérides étaient des facteurs indépendamment associés à la survenue des dysfonctionnements érectiles.

Mots clés: Dysfonctionnement Erectile, Diabète, Prévalence, Index International de la Fonction Erectile.

Nguefo Kana RS, Simo Gounoue C, Dabou S et Kamga FHL. Prévalence des Dysfonctionnements Erectiles et des facteurs y associés chez les patients diabétiques de l’Hôpital de District de Dschang: Afr. J. of Integ. Health 2019,9 (1 b): 159-168

20. POST-OPERATIVE INFECTION AND THE COST OF MANAGEMENTIN THE SURGICAL WARD OF THE BUEA REGIONAL HOSPITAL, CAMEROON

Palle JN1*, Halle EG3, Fokam P3, Akoachere JF4, Bassah NE1, Eta VA1, Kemayim F1, Eko S2, Mewoabi DM1, Mokake NDM4, Udoamaka GN1, Andigema SN1

1 Department of Nursing Sciences, Faculty of Health Sciences, University of Buea, SW Region Cameroon

2 Department of Biomedical Sciences, Faculty of Health Sciences, University of Buea, SW Region Cameroon

3 Department of Surgery and Obstetrc and Gynaecology, Faculty of Health Sciences, University of Buea, SW Region Cameroon

4 Department of Microbiology and Parasitology, Faculty of Sciences, University of Buea, SW Region Cameroon

*CorrespondingAuthor: DrPalle John Ngunde, Faculty of Health Sciences, University of Buea. Email: Ngunde_pal@yahoo. co. uk; Tel: (+273)677812384

ABSTRACT

Background: Postoperative infections are a real problem in surgery. The management of an infected surgical wound is more expensive than a comparable non-infected wound Prevention of these infections is the only safe way out of the dilemma they cause both to the patient and the surgical team.

Objective: The main objective of the study was to find out the extra cost of management of post-operative infections in terms of money spent and length of hospital stay.

Methods: The research design was a prospective descriptive study, where patients upon operation were followed up until discharged during which an assessment of occurrence of postoperative infection, extra days spent and how much money was spent due to the infection was done. This information was obtained using a well-designed self-administered questionnaire.

Results: A 14.9% prevalence rate of post-operative infection was observed. At least 1000 CFA and 2 days additional were spent by patients who developed post-operative infection.

Conclusion: Postoperative infection increases cost of surgical management as well as prolongs length of hospital stay. We thus recommend that the surgical team should take all appropriatemeasures to prevent rather than wait to treat post-operative infections.

Keywords: Surgery, Post-Operative Infection, Hospital Stay

Palle JN, Halle EG, Fokam P, Akoachere JF, Bassah NE, Eta VA, Kemayim F, , Eko S, Mewoabi DM, Mokake NDM, Udoamaka GN, Andigema SN. Post-operative infection and the cost of managementin the surgical ward of the Buea Regional Hospital, Cameroon: Afr. J. of Integ. Health 2019,9 (1 b): 169-177

21. Ocular bacterial flora and antimicrobial Susceptibility profile in newborns in 2 hospital facilities in western Cameroon

Domngang Noche C1,2*, Fotsing Kwetche PR1,2, Youte O1, Tchatchouang B1, Djuikoue I, Bella AL3

1 Faculty of Health Sciences, Université des Montagnes, Bangangté, Cameroun

2 Cliniques Universitaires des Montagnes, Bangangté, Cameroun

3 Faculty of Medicine and Biomedical Sciences, Université de Yaounde 1, Cameroun.

*Corresponding author: Christelle Domngang Noche [MD; MSc], Faculty of Health Sciences, Université des Montagnes, Bangangté, Cameroun Tel: +237 699 936 709; E-mail: dockrystlnoche@gmail. com

 

ABSTRACT

Objective: To investigate bacteria types of the conjunctival flora and strain susceptibility profile to antibiotics.

Methods: A prospective descriptive study was conducted between July 1 to October 30,2017 at the Bangangté District Hospital and the Université des Montagnes [UdM] Teaching Hospital. The study population consisted of all children born in these two health facilities. Sample collection was performed by swabbing the surface of each eye before face washing. The swabbed material was immediately conveyed to the Laboratory of Infectious Diseases of the UdM Teaching Hospital for analyses. Culture, identification and susceptibility tests were conducted according to the standard protocols.

Results: Out of 31 newborns fulfilling the inclusion criteria, 23 were delivered by genital way and 8 by cesarean. Analyses resulted in positive culture for 30 out of 31 (96.7%). From these, 63 bacteria isolates were recovered (50 from infants delivered by genital way and 13 by cesarean). In decreasing order of frequency, major bacteria categories included: Gram-positive organisms (61.9%) including coagulase-negative Staphylococci representing 47.6% and Gram-positive Bacilli 26.9%. Bacterial polymorphism was highest birth, with up to 52.3% pathogenic isolates recovered. The susceptibility rates to rifampicin were 50%, 11.1% and 16.7% in Gram positive cocci, Gram-positive bacilli and Gram-negative bacilli respectively. Looking at gentamycin, and norfloxacin susceptibility, the respective sensitivivity rates stood at 76.9%, 77.8%, 83.3% and 80.8%, 66.7%, 16.7%.

Conclusion: Gentamycin and norfloxacin should be considered as the most effective antibiotics in ophthalmia infection prevention at birth in the setting.

Keywords: Eye, Conjunctiva, bacterial flora, antimicrobial susceptibility, antibiotics

Domngang Noche C, Fotsing Kwetche PR, Youte O, Tchatchouang B, Djuikoue I, Bella AL. Ocular bacterial flora and antimicrobial Susceptibility profile in newborns in 2 hospital facilities in western Cameroon: Afr. J. of Integ. Health 2019,9 (1 b): 178-186