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Profile of Full-Term Births in Maternity Wards of Public Hospitals in Douala Cameroon

Open Journal of Obstetrics and Gynecology 2024年第5期14卷 705-720页

作者： Henri Essome Merlin Boten Bounyom Astrid Ndolo Kondo Ingrid Doriane Ofakem Ilick Fulbert Mangala Nkwele Irène Cyrielle Edjoa Mboe Michel Roger Ekono alphonse ngalame nyong Robert Tchounzou Moustapha Bilkissou Junie Ngaha Yaneu Marga Vanina Ngono Akam Gervais Mounchikpou Ngouhouo Grâce Tocki Toutou Théophile Nana Njamen Valère Mve Koh Pascal Foumane Faculty of Medicine and Pharmaceutical Sciences University of Douala Douala Cameroon Laquintinie Hospital Douala Cameroon Faculty of Health Sciences University of Bamenda Bamenda Cameroon Faculty of Health Sciences University of Buea Buea Cameroon Faculty of Medicine and Biomedical Sciences University of Yaound&#233 1 Yaound&#233 Cameroon Faculty of Medicine and Pharmaceutical Sciences of Sangmelima University of Ebolowa Ebolowa Cameroon

Introduction: Pregnancy as much as childbirth constitutes a risky situation, potentially fraught with sometimes dramatic complications: maternal death. Objective: We conducted this study with the aim of establishing the profile of those giving birth in our context with the aim to anticipate operationally in the future on morbidity but more on maternal deaths. Methodology: We conducted, using a structured questionnaire, a prospective descriptive study in representative maternity wards in the city of Douala;the study variables were socio-economic, anthropometric, obstetrical and clinical. Statistical analyses were carried out with CS Pro 7.3 and SPSS version 25.0 software. The Student, Chi-square and Fischer tests were used to compare the means of the variables and the percentages. Results: We recruited 305 births for our study. The average age of our births was 28.7 years ± 6.1 with an average height of 161.6 cm ± 5.06;an average body mass index at the start of pregnancy of 28.0 kilograms/square meter and 31.3 kilograms/square meter at delivery;the average weight gain was 8.4 g ± 5.37;an average gestation of 2.84±1.90;an average parity of 2.2 ± 2.1 with an average birth interval of 27.7 months ± 23.7. The average gestational age was 39.2 weeks ± 1.21 with pregnancy pathology dominated by malaria;85.9% began their prenatal follow-up before the 14th week of amenorrhea. Conclusion: The profile of childbirth in urban Cameroon does not seem potentially dystocic compared to that of the same regional and racial area.

关键词： Profile Delivery Term Malaria Douala

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Draft of an Anthropometric Reference System for Full-Term Cameroonian Newborns: Prospective Study with Analytical Aim in the Maternity Wards of Douala

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Open Journal of Obstetrics and Gynecology 2024年第3期14卷 435-450页

作者： Henri Essome Charlotte Epossè Ekoube Fulbert Mangala Nkwele Rita Carole Mbono Betoko Irène Cyrielle Edjoa Mboe Michel Roger Ekono alphonse ngalame nyong Robert Tchounzou Ingrid Doriane Ofakem Ilick Hassanatou Iyawa Moustapha Bilkissou Astrid Ndolo Kondo Junie Ngaha Yaneu Marga Vanina Ngono Akam Gervais Mounchikpou Ngouhouo Grâce Tocki Toutou Nelly Noubi Valère Mve Koh Théophile Nana Njamen Training Teaching and Research Unit in Gynecology Obstetrics and Reproduction Faculty of Medicine and Pharmaceutical Sciences University of Douala Douala Cameroon Department of Obstetrics and Gynecology Laquintinie Hospital Douala Cameroon Department of Pediatrics Laquintinie Hospital Douala Cameroon Faculty of Health Sciences of Buea University of Buea Buea Cameroon Pluridisciplinary Department Laquintinie Hospital Douala Cameroon Faculty of Medicine and Biomedical Sciences University of Yaounde 1 Yaounde Cameroon

Introduction: Anthropometry applied to newborns is a reliable indicator of the quality of fetal growth. The latter is influenced by genetic, racial and nutritional factors varying from one population to another, explaining why a standard cannot be applied to all populations. Research question: should the Caucasian frame of reference be dogmatically applied in our African context? Multicenter studies are therefore necessary;hence the interest of this work, the main objective of which was to describe the anthropometric profile of full-term newborns in the city of Douala. Methodology: We carried out a cross-sectional study with an analytical aim and prospective data collection in the maternity wards of the Douala General Hospital, Laquintinie Hospital, District hospitals of Deido, Nylon and Bonassama over a period of 4 months (January to April 2020). We were interested in any newborn, born alive, vaginally or by cesarean section, seen in the first 24 hours from a full-term single-fetal pregnancy whose mother had given consent. We excluded newborns whose term was unclear and those with congenital malformations or signs of embryo-foetopathy. Data collection was done using structured and pre-tested survey sheets. The study variables were obstetric and anthropometric. Statistical analyzes were carried out with CS Pro 7.3 and SPSS version 25.0 software. The Student, Chi-square and Fischer tests were used to compare the means of the variables, the percentages with a significance threshold P value Results: During the study period, 305 full-term newborns were included, divided into 172 boys and 133 girls. The average anthropometric parameters of the full-term newborn in the city of Douala were: average weight: 3305 grams, average height: 49.8 centimeters, average head circumference: 34.6 centimeters, average upper arm circumference: 11.3 centimeters, circumference average thoracic: 32.8 centimeters. The percentile distribution showed a 10th percentile at 2656 grams and a 90th

关键词： Anthropometry Full-Term Newborn Douala

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Low Birth Weight in Cameroon: Research and Analysis of Factors Associated with Their Occurrence in Douala Maternity Wards

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Open Journal of Obstetrics and Gynecology 2024年第5期14卷 758-778页

作者： Henri Essome Merlin Boten Bounyom Astrid Ndolo Kondo Ingrid Doriane Ofakem Ilick Charlotte Epossè Ekoube Rita Bono Betoko Hassanatou Iyawa Fulbert Mangala Nkwele Théophile Nana Njamen Robert Tchounzou alphonse ngalame nyong Charlotte Irène Cyrielle Edjoa Mboe Moustapha Bilkissou Junie Ngaha Yaneu Marga Vanina Ngono Akam Gervais Mounchikpou Ngouhouo Grâce Tocki Toutou Michel Roger Ekono Nelly Noubi Pascal Foumane Training Teaching and Research Unit in Gynecology Obstetrics and Reproduction Faculty of Medicine and Pharmaceutical Sciences University of Douala Douala Cameroon Laquintinie Hospital Douala Cameroon Faculty of Health Sciences University of Bamenda Bamenda Cameroon Faculty of Health Sciences University of Buea Buea Cameroon Faculty of Medicine and Biomedical Sciences University of Yaound&#233 1 Yaound&#233 Cameroon Faculty of Medicine and Pharmaceutical Sciences University of Ebolowa Ebolowa Cameroon

Introduction: Low birth weight (LBW) is defined by the World Health Organization (WHO) as a birth weight strictly below 2500 g, whatever the term of pregnancy. It constitutes a major public health problem, both in developed and developing countries, due to its magnitude and its strong association with infant morbidity and mortality. Main objective was to study the factors associated with the occurrence of small-for-gestational-age newborns in Douala. Methodology: We carried out a cross-sectional analytical study with prospective data collection using a technical pretested sheet in the maternity wards of the Douala General Hospital, the Laquintinie Hospital, and the District hospitals of Deido, Nylon and Bonassama over a period of 4 months (January to April 2020). We were interested in any newborn, born alive, vaginally or by cesarean section, of low weight, seen in the first 24 hours from a full-term single-fetal pregnancy whose mother had given her consent. Our sampling was consecutive and non-exhaustive. We excluded newborns whose term was unclear and those with congenital malformations or signs of embryo-foetopathy. Data collection was done using survey sheets. Statistical analyzes were carried out with CS Pro 7.3 and SPSS version 25.0 software. The Student, Chi-square and Fischer tests were used to compare the means of the variables, the percentages with a significance threshold P value Results: During the study period, 305 full-term newborns were included, divided into 172 boys and 133 girls. The percentage of small-for-gestational-age newborns was 9.8%;after multivariate analysis by logistic regression to eliminate confounding factors, we found maternal factors associated with small for gestational age newborns;maternal age less than 20 years, primiparity, gestational age (37 - 38), a delay in prenatal visits greater than 14 weeks, anemia in pregnancy, positive toxoplasmosis serology in pregnancy, a body mass index of Conclusion: Our study revealed the potenti

关键词： Newborn Low Birth Weight Gestational Age Douala

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Covid-19 in Pregnancy: Cases of Women Managed in the City of Douala-Cameroon

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Open Journal of Obstetrics and Gynecology 2022年第10期12卷 1019-1030页

作者： Bilkissou Moustapha alphonse nyong ngalame Charlotte Nguefack Tchente Frederic Victor Okala Kingsley Ombaku Humphry Tatah Neng Diane Kamdem Ngo Batta Julie Nkendo Sandrine Darolles Mwadjie Emile Telesphore Mboudou Douala Gynaeco-Obstetric and Pediatric Hospital Douala Cameroon Faculty of Medicine and Pharmaceutical Sciences University of Douala Douala Cameroon Faculty of Health Sciences University of Buea Buea Cameroon Douala General Hospital Douala Cameroon Faculty of Medicine and Biomedical Sciences University of Yaounde I Yaounde Cameroon

Introduction: The SARS-COV-2 virus has been responsible for a health crisis in pregnancy, causing severe acute respiratory distress syndrome. Materno-foetal complications can be observed. Taking into account the materno-foetal risks associated with COVID-19 infection in pregnant women and the low sample size of the first publication in Cameroon, we considered it necessary to conduct an in-depth study on the maternal and foetal prognosis of this condition in pregnant women in three hospitals in Douala. Materials and Methods: We conducted a cross-sectional survey with retrospective data collection in the three state tertiary and reference hospitals in Douala (DGOPH, DGH and DLH) from November 1, 2021 to April 30 2022 after obtaining ethical and administrative clearances. All records of COVID-19 pregnant women confirmed by reverse transcription polymerase chain reaction (RT PCR) or COVID-19 rapid diagnostic test (COVID RDT) were included. The survey form contained socio-demographic data, clinical and para-clinical characteristics, management and materno-foetal outcome. SPSS.26 and Microsoft Excel 2016 software were used to analyze the data, and a logistic regression model was used to look for associations between the variables. Results: We found in total 96 files that met our inclusion criteria. The most represented sector of activity was the unemployed (44.46%). Patients with a secondary level of education constituted the majority with 47% (45). The main comorbidity found was diabetes (27.2%). The most frequent symptom was fever, found in 87 patients (90.1%). In our series, a chest CT scan was performed in 50 patients. Caesarean section was the most common mode of delivery (58.3%). We recorded 15.6% of maternal deaths, mainly in patients admitted to intensive care. Factors associated with maternal death were: Maternal diabetes, high LDH and D-dimer levels, and 75% lung involvement on chest CT scan. Oxygen saturation > 94% on admission was a protective factor. Regardin

关键词： COVID-19 Clinical Para-Clinical Materno-Foetal Outcomes Pregnant Women

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Contribution of Colposcopy in the Diagnosis of Precancerous Lesions of the Uterine Cervix at the Douala Gynaeco-Obstetric and Pediatric Hospital, Cameroon

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Open Journal of Obstetrics and Gynecology 2022年第10期12卷 1031-1041页

作者： Diane Estelle Modjo Kamdem alphonse nyong ngalame Inna Rakya Robert Tchounzou Darolles Wekam Mwadjie Humphry Tatah Neng Bilkissou Moustapha Julie Batta Patricia Metouom Kamdem Charlotte Nguefack Tchente Emile Mboudou Douala Gynaeco-Obstetric and Pediatric Hospital Douala Cameroon Faculty of Health Sciences University of Buea Buea Cameroon Faculty of Medicine and Biomedical Sciences University of Garoua Garoua Cameroon Faculty of Medicine and Pharmaceutical Sciences University of Douala Douala Cameroon University of Pittsburg Medical Center-Mckeesport Pittsburg USA Faculty of Medicine and Biomedical Sciences University of Yaounde I Yaounde Cameroon

Introduction: Cervical cancer is a public health problem in Cameroon, due to low screening and late diagnosis. We sought to assess practice of colposcopy at the Douala Gyneco-Obstetric and Pediatric Hospital (DGOPH) in Cameroon and its contribution to the fight against cervical cancer in our context. Method: This is a retrospective cross-sectional study of 99 colposcopies after which 71 exploitable biopsies were retained at the Douala for a period of 1year (December 1, 2019-December 1, 2020). The nomenclature of the French Society of Colposcopy and Cervico-Vaginal Pathology (SFCPCV) was used. Results: Mean age of the participants was 44 years, mostly multiparous (80%). Cytological abnormalities were the main reference pattern. During the examination 22% of colposcopies were found to be normal, 37% of TAG 1-2A, 31% of TAG 2B-C, and 5% suspected of cancer. After histological analysis of biopsies guided by colposcopy, we found 42% (30/71) of Cervical Intraepithelial Neoplasia (CIN) 1, 15.5% (11/71) of CIN 2 - 3, and 24% (17/71) cancer. Upon analysis of the diagnosed CIN1/CIN2-3/Cancers, we noted a concordance with colposcopy in 62% (23/37), 37% (10/27) and 85% (6/7) respectively. Colposcopic performance in the detection of high-grade lesions and above was 36% (26/71), with a sensitivity of 92.86%, specificity 83.33%, PPV 78.79% and NPV 94.59%. Conclusion: Despite the difficult socioeconomic context, colposcopy retains all its importance in the diagnosis of precancerous lesions of the uterine cervix. With the imminent putting in place of a national health policy, the goals 90-70-90 by 2030 of the World Health Organization for the fight against cervical cancer can be achieved in our sub-Saharan African countries.

关键词： Colposcopy Cervix Dysplasia Cancer DGOPH

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Prevalence, Indications and Morbidity of Caesarean Sections in a Referral Hospital of the Health Voucher Program: The Case of Garoua Regional Hospital in the Northern Region of Cameroon

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Open Journal of Obstetrics and Gynecology 2023年第12期13卷 1949-1964页

作者： Mbarnjuk Aoudi Stéphane Kabko Mbargang Georges ngalame alphonse nyong Ourtchingh Clovis Mangala Nkwele Fulbert Anicet Gakdang Ladibe Tameh Theodore Yangsi Neng Humphry Tatah Koudjou Blaise Halle-Ekane Gregory Edie Department of Gynecology & Obstetrics Faculty of Medicine and Biomedical Sciences University of Garoua Garoua Cameroon Gynecology & Obstetrics Unit Garoua General Hospital Garoua Cameroon Department of Surgery and Specialties Faculty of Health Sciences University of Buea Buea Cameroon Douala Gyneco-Obstetric and Pediatric Hospital Faculty of Health Sciences (FHS) University of Buea Buea Cameroon Gynecology & Obstetrics Unit Maroua Regional Hospital Maroua Cameroon Nkongsamba Regional Hospital Faculty of Medicine and Pharmaceutical Sciences University of Douala Douala Cameroon Faculty of Medicine and Biomedical Sciences University of Yaoundé 1 Yaoundé Cameroon Nkongsamba Regional Hospital Faculty of Health Sciences University of Bamenda Bamenda Cameroon Douala General Hospital Dean Faculty of Health Sciences (FHS) University of Buea Buea Cameroon

Caesarean section (CS) is a surgical procedure performed to remove a fetus from the mother’s uterus through an incision on the abdominal wall, then on the uterine wall. The indications of CS vary not only between countries, but also from one hospital to another and from one team to another within the same hospital. Despite advances in asepsis and anesthesia/resuscitation technics, there are still complications of varying severity inherent to the gravid-puerperal state on one hand and the technics used on the other, irrespective of the operative indication. Thus, the present study was carried out with the objectives of determining the prevalence, identifying the indications, and evaluating the morbidity linked to caesarean sections in our environment. Cameroon has also set up a health voucher program in its northern region, aimed at reducing maternal and fetus morbidity and mortality. The program aims to improve financial access in antenatal care and deliveries, including caesarean sections, in this low-income region of the country. We conducted a descriptive cross-sectional study with retrospective data collection, from February 1, 2022, to May 31, 2022. We included all women who gave birth by caesarean section. In our study series, out of 905 parturient admissions into the Department of Obstetrics and Gynecology, 226 were caesarian cases. The overall frequency of CS during our study period was 25%. Fetal indications were dominated by cephalopelvic disproportion and non-reassuring fetal heart in 17.3% and 13.7% of cases respectively. Intraoperative complications were dominated by hemorrhage (15.5%). In our study, we noted an 11.1% of prevalence perinatal mortality. Cameroon is a low-income country with limited financial resources, especially in the Northern region. The health voucher program has improved financial access to caesarean sections for parturient in northern Cameroon, and consequently to emergency obstetric and neonatal care.

关键词： Caesarean Section Health Voucher Cephalon-Pelvic Disproportion Hemorrhage

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Improving Post Abortion Care (PAC) Delivery in Sub-Saharan Africa: A Literature Review

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Open Journal of Obstetrics and Gynecology 2020年第9期10卷 1295-1306页

作者： alphonse nyong ngalame Robert Tchounzou Humphry Tatah Neng Fulbert George Nkwele Mangala Rakya Inna Diane Modjo Kamdem Bilkissou Moustapha Julius Sama Dohbit Eugene Justine Kongnyuy Claude Ndoua Noa Benova Lenka Gregory Ekane Halle Darolles Wekam Mwadjie Therese Delvaux Emile Telesphore Mboudou Gynecology & Obstetrics Unit Douala Gyneco-Obstetric and Pediatric Hospital (DGOPH) Douala Cameroon Faculty of Health Sciences (FHS) University of Buea Buea Cameroon Faculty of Medicine and Pharmaceutical Sciences University of Douala Douala Cameroon Faculty of Medicine and Biomedical Sciences (FMBS) University of Ngaoundere Ngaoundere Cameroon Faculty of Medicine and Biomedical Sciences (FMBS) University of Yaounde I Yaounde Cameroon United Nations Population Fund (UNFPA) Bamako Mali Institute of Tropical Medicine (ITM) Antwerpen Belgium

Saharan Africa (SSA) contributes 29% of the global unsafe abortions with 62% of abortion-related deaths. This is due to restrictive abortion laws, low quality post abortion care (PAC) and inadequate access to effective modern contraception. The overall objective was to review current literature on PAC in SSA and make recommendations for improvement especially in Cameroon. A literature review was conducted on PAC in SSA published during 2000-2018. The following databases were searched: MEDLINE, POPLINE, COCHRANE Library, African Index Medicus and GOOGLE Scholar. Thirty articles were reviewed from 16 countries ranging from observational studies to systematic reviews with meta-analysis. Major outcomes: 1) Manual vacuum aspiration (MVA) and misoprostol are equally safe and effective. 2) There is comparable effectiveness between physicians and trained mid-level cadres in PAC management. 3) PAC contraception uptake was increased when offered immediately before patient leaves the facility. 4) Gaps to PAC service use include inadequate access, low quality care and less adolescent-friendly environment. Task shifting of PAC to trained mid-level staff, decentralization of medical PAC using misoprostol, offering post abortion counselling and contraception to clients before leaving the health facility, encouraging linkage and provider-community partnership in PAC and reinforcement of advocacy for less restrictive abortion laws in Cameroon are recommended.

关键词： Post Abortion Care (PAC) Misoprostol Contraception Midlevel Cadres Sub-Saharan Africa

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Management of Obstetric Emergencies in a Tertiary Hospital in Cameroon: A Milestone for End of Preventable Maternal Deaths

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Open Journal of Obstetrics and Gynecology 2020年第12期10卷 1749-1762页

作者： Robert Tchounzou Theophile Nana Njamen alphonse nyong ngalame Vanessa Baleba Inna Rakya Darolles Mwadjie Wekam André Gaetan Simo Wambo Humphry Neng Tatah Diane Estelle Kamdem Moustapha Bilkissou Félix Adolphe Elong Dominique Djomo Tamchom Julie Ngo Batta Emile T. Mboudou Douala Gynaeco-Obstetric and Paediatric Hospital Douala Cameroon Faculty of Health Sciences University Buea Buea Cameroon Douala General Hospital Douala Cameroon Faculty of Medicine and Biomedical Sciences of Ngaoundere Garoua Cameroon Regional Hospital Limbe Limbe Cameroon Regional Hospital Buea Buea Cameroon Faculty of Medicine and Biomedical Sciences University of Yaounde I Yaounde Cameroon

Background: Maternal mortality was insufficiently reduced in Cameroon in 2015 despite the adoption of Millennium development goals. To tackle the situation and meet the sustainable Millennium goals target of 140/100,000 live births by 2030, the Government adopted the strategies of building reference hospitals where high quality obstetric care, timely and optimal management of obstetric emergencies will be offered. The objective of this study was to describe the patterns of obstetric emergencies in Douala Gynaeco-obstetric and Paediatric Hospital, evaluate the outcomes of their management and the contribution to maternal mortality. Patients and Methods: 418 patients with obstetric emergencies were included in a two-phase cross-sectional study. Data were retrieved from patients’ case notes during the retrospective phase and a questionnaire filled for each case received during the prospective phase. Patterns of obstetric emergencies were determined and for each, the following were analysed: patient managed in this hospital or referred from other hospitals, management according to hospital guidelines, timi

关键词： Obstetric Emergencies Tertiary Hospital Maternal Outcome Maternal Death

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Comparison of Chest Computed Tomography Findings between Pregnant and Non-Pregnant Women with COVID-19 Infection in Douala Gyneco-Obstetric and Pediatric Hospital, Cameroon

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Open Journal of Medical Imaging 2021年第4期11卷 132-144页

作者： Yannick Onana Joshua Tambe Adamou Dodo Balkissou Mohamadou Aminou Samuel Mbozo’o Mvondo Dominique Tamchom Djomo alphonse nyong ngalame Rakya Inna Bilkissou Moustapha Francis Ateba Ndongo Robert Tchounzou Jean Claude Mballa Amougou Jérémie Mbo Amvene Mathurin Neossi Guena Emile Telesphore Mboudou Douala Gyneco-Obstetric and Pediatric Hospital Douala Cameroon Faculty of Medicine and Biomedical Sciences of Garoua University of Ngaoundere Garoua Cameroon Faculty of Health Sciences University of Buea Buea Cameroon Faculty of Medicine and Pharmaceutical Sciences University of Douala Douala Cameroon Faculty of Sciences University of Ngaoundere Ngaoundere Cameroon Faculty of Medicine and Biomedical Sciences University of Yaoundé 1 Yaoundé Cameroon

Introduction: Pregnancy is a physiologic state associated with decreased immunity, and the use of medical imaging modalities with ionizing radiation must be justified as potential benefits must outweigh the risk of any harm. However, in the wake of SARS-CoV-2 virus pandemic, chest computed tomography (CT) is necessary to assess the severity of the disease. The objective of this study was to compare the chest CT findings of pregnant and non-pregnant women with SARS-CoV-2 viral pneumonia at a tertiary hospital setting. Materials and Methods: This was a cross-sectional, retrospective, descriptive study of admission records of pregnant and non-pregnant patients aged 15 - 49 years during a three (3) months period (April-July 2020) in DGOPH. Logistic regression was used to search for predictors of lung involvement during COVID-19. Results: A total of 31 patient files were studied of which 9 (29%) were those of pregnant women. The pregnant women mostly had a combination of lung ground-glass opacities and consolidation on CT compared to the non-pregnant women (7 out of 9 cases, 77.8%, vs. 6 out of 22 cases, 22.7%;p = 0.01). The group of pregnant women had more than 3 affected lobes (50.0% vs. 22.7%, p = 0.04) with a middle lobe predilection (77.8% vs. 31.8%, p = 0.02). CT predictors of COVID-19 pneumonia in the group of pregnant women after the multivariable logistic regression analysis were the presence of nodules (aOR = 13.9;95% CI: 1.25 - 134.2;p = 0.032) and linear bands of interlobular septal thickening (aOR = 17.8;95% CI: 1.46 - 217.6;p = 0.024). Conclusion: In this study, the chest CT of pregnant women with COVID-19 pneumonia revealed mostly a combination of findings compared to non-pregnant women, with more affected lobes. These findings suggest the likelihood of a greater CT severity of COVID-19 pneumonia among pregnant women and therefore the need for timely and appropriate management.

关键词： COVID-19 Pneumonia Pregnancy Computed Tomography

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Contribution of Colposcopy in the Diagnosis of Precancerous Lesions of the Uterine Cervix at the Douala Gynaeco-Obstetric and Pediatric Hospital, Cameroon

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Open Journal of Obstetrics and Gynecology（妇产科期刊） 2022年第10期

作者： diane estelle modjo kamdem alphonse nyong ngalame inna rakya robert tchounzou darolles wekam mwadjie humphry tatah neng bilkissou moustapha julie batta patricia metouom kamdem charlotte nguefack tchente emile mboudou

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