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Obstetrical and Perinatal Outcomes of Adolescent Pregnancies in Cameroon: A Retrospective Cohort Study at the YaoundéGeneral Hospital

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Open Journal of Obstetrics and Gynecology 2015年第2期5卷 88-93页

作者： Jean Dupont Kemfang Ngowa Jean Marie Kasia Walter Dobgima Pisoh anny ngassam Cyrille Noa Obstetrics and Gynecology Unit Yaoundé General Hospital Yaoundé Cameroon Department of Obstetrics and Gynecology Faculty of Medicine and Biomedical Sciences University of Yaoundé I Yaoundé Cameroon

Background: Adolescent pregnancy is a serious health and social problem worldwide as well as in Cameroon. The aim of this study was to determine the obstetrical and perinatal outcomes of nulliparous adolescent pregnancies in a reference hospital in Cameroon. Methods: A retrospective cohort study to compare the outcomes of nulliparous adolescent pregnancies to those of nulliparous women aged 20 to 25 years was carried out at the Yaoundé General Hospital between January 1993 and December 2012. Results: Adolescent deliveries represented 2.84% (331 deliveries) of all deliveries registered during the study period. The adolescent mothers had a significantly higher incidence of preeclampsia/eclampsia, preterm delivery and low birth weight babies (<2500 g) when compared to the control group (OR, 3.46;CI 95%, 1.46 - 8.18;OR, 1.94 CI 95%, 1.34 - 2.79;OR, 1.98, CI 95%, 1.39 - 2.46, respectively). However, placenta previa, abruptio placenta, episiotomy, cesarean section, vaginal instrumental delivery, perineal tears and post partum hemorrhage were not significantly different in the two groups. Furthermore, there was no statistically significant difference between the two groups regarding fetal distress, low Apgar score (st and 5th minutes), the rate of admission in the neonatal intensive care unit, stillbirth and neonatal death. Conclusion: Adolescent pregnancy is associated with an increased risk of preeclampsia/ eclampsia, preterm birth and low birth weight.

关键词： Adolescent Pregnancy Perinatal and Obstetrical Outcome Preterm Birth Low Birth Weight

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Contribution of Laparoscopy in the Management of Female Infertility in Low Resource Countries: A Review of 208 Cases at the YaoundéGeneral Hospital, Cameroon

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International Journal of Clinical Medicine 2015年第12期6卷 934-939页

作者： Jean Dupont Kemfang Ngowa Jean Marie Kasia Victorine Nkongo anny ngassam Jovanny Fouogue Tsuala Philemon Nsem Alexis Medou Department of Obstetrics and Gynaecology Faculty of Medicine and Biomedical Sciences University of Yaoundé I Yaoundé Cameroon Gynecological Endoscopic Surgery and Human Reproductive Teaching Hospital Yaoundé Cameroon Anesthesia Unit Yaoundé General Hospital Yaoundé Cameroon

Background: Infertility is a global problem, but the highest prevalence is in low resource countries, particularly in sub-Saharan Africa where tubal damage following pelvic infection is the commonest cause. Objectives: This study aimed to assess contribution of laparoscopy as a diagnostic and therapeutic tool in infertile women in our setting. Methods: A descriptive review of complete medical records of 208 women who underwent laparoscopy at the Gynaecology Unit of Yaoundé General Hospital from December 2007 to December 2012. Results: Two hundred and eight women were enrolled in this study. Mean age was 32.6 ± 11.25 years. Infertility was secondary in 71.6% of cases;125 (60.1%) women were married and 116 (55.8%) had a positive serology of Chlamydia trachomatis infection. The most frequent findings during diagnostic laparoscopy were: pelvic adhesions (83.7%), hydrosalpinx (21.6%), pyosalpinx (4.8%), perihepatic adhesions (25.5%), uterine fibromas (22.6%), pelvic endometriosis (13%) and ovarian abnormalities (10.1%). The surgical procedures during laparoscopy were: adhesiolysis (79.7%), tuboplasty (35.0%), salpingectomy (8.2%), ovarian cystectomy (5.8%) and myomectomy (1.9%). Three (1.4%) cases of uterine perforation and 1 (0.5%) case of laparoscopy conversion to laparotomy were observed. Conclusion: Diagnostic laparoscopy revealed that tubal lesions and pelvic adhesions were still the major causes of female infertility in developing countries. Adhesiolysis and tuboplasty were the most frequently performed surgical procedures during laparoscopy. Therefore, training in endoscopic surgery should be regarded as an important issue in developing countries.

关键词： Laparoscopy Infertility Pelvic Adhesions Adhesiolysis Tuboplasty Myomectomy

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Management of Cervical Intra Epithelial Neoplasia by Loop Electrosurgical Excision Procedure in a Low Resource Country: An Experience from the YaoundéGeneral Hospital, Cameroon

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Open Journal of Obstetrics and Gynecology 2015年第9期5卷 481-486页

作者： Jean Dupont Kemfang Ngowa anny ngassam Jovanny Fouogue Tsuala Juny Metogo Zacharie Sando Angèle Kabeyene Jean Marie Kasia Obstetrics and Gynecology Unit Yaoundé General Hospital Yaoundé Cameroon Department of Obstetrics and Gynecology Faculty of Medicine and Biomedical Sciences University of Yaoundé I Yaoundé Cameroon Department of Pathology Faculty of Medicine and Biomedical Sciences University of Yaoundé I Yaoundé Cameroon

Background: Cervical cancer is the third most common cancer worldwide, and 80% of cases occur in the developing world. A critical component of effective cervical cancer screening programs is the ability to offer women appropriate and effective treatment for cervical intra epithelial neoplasia (CIN). Objectives: This study aimed at assessing the primary experience of management of CIN by Loop Electrosurgical Excision Procedure (LEEP) in a low resource country. Methods: We carried out a descriptive cross sectional study at the Yaoundé General Hospital in Cameroon. Results: Twenty three cases of CIN were treated by LEEP. Mean age of patients was 40.5 ± 9.9 years. Six (26.1%) patients were infected by the Human Immunodeficiency Virus (HIV). LEEP was indicated in 21 (91.30%) cases for CIN2 and CIN3. The mean duration of the surgical procedure was 10 ± 3 minutes. There was one (4.3%) complication (persistent cervical bleeding). Surgical margins were negative for dysplasia or invasive carcinoma in 18 (78.26%) cases and non-applicable in 5 (21.73%) cases (thermal artefacts of margins and cervicitis without CIN). One patient with micro invasive carcinoma on post-operative histology was treated by total hysterectomy. Cervical cytology was normal at 6 months post LEEP for 15 cases out of 16 (93.8%) patients who performed the test. One woman achieved pregnancy and delivered a term baby. Conclusion: Treatment of CIN by LEEP is feasible, safe and effective in our setting.

关键词： Cervical Cancer Cervical Intraepithelial Neoplasia LEEP Screening Cervical Cancer Low Resource Country

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Maternal and Perinatal Complications of Severe Preeclampsia in Three Referral Hospitals in Yaoundé, Cameroon

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Open Journal of Obstetrics and Gynecology 2015年第12期5卷 723-730页

作者： Jean Dupont Kemfang Ngowa Jean Marie Kasia Jean Alima Joel Fokom Domgue anny ngassam Jean Baptiste Bogne Sebastien Mba Obstetrics and Gynecology Unit Yaoundé General Hospital Yaoundé Cameroon Department of Obstetrics and Gynecology Faculty of Medicine and Biomedical Sciences University of Yaoundé I Yaoundé Cameroon Department of Pediatrics Faculty of Medicine and Biomedical Sciences University of Yaoundé I Yaoundé Cameroon Anesthesia and Intensive Care Unit Yaoundé General Hospital Yaoundé Cameroon

Objective: The aim of this study was to determine maternal and perinatal complications of pregnancies complicated by severe preeclampsia in three tertiary care centers in Cameroon. Methods: We carried out a descriptive cross sectional study from the 1st of June 2012 to the 31th of June 2014, among pregnant women with severe preeclampsia followed up in three tertiary level hospitals in Yaoundé, Cameroon: the Yaoundé General Hospital, the Yaoundé Central Hospital, and the Yaoundé University Hospital. Statistical analysis was performed using EPI 3.5.5. Data were described as means ± standard deviation, percentages and numbers. Chi-square and Fisher exact tests were used where appropriate. Results: Of the 2500 deliveries registered during the study period, 111 cases (8.49%) were managed as severe preeclampsia. Four patients refused to participate and were excluded from the study. Most of these patients were non workers (58.0%), pauciparous (61.7%) and young (median age of 27.47 years ± 6.46). Eclampsia (12.14%), abruptio placentae (11.21%) and hypertensive retinopathy (7.47%) were the most frequent maternal complications. Two cases (1.86%) of maternal deaths occurred in patients who had eclampsia. Prematurity (48.6%), intra uterine fetal death (13.1%) and oligoamnios (11.2%) were the most frequent fetal complications. All four neonatal deaths occurred in women in whom the diagnosis of severe preeclampsia was done between 28 and 33 weeks of gestation. Conclusion: Pregnancies complicated by severe preeclampsia had significantly high maternal and perinatal morbidity and mortality in Cameroon. The complications of severe preeclampsia can be prevented by more widespread use of antenatal care, education of primary medical care personnel, prompt diagnosis of high-risk patients and timely referral to tertiary medical centers.

关键词： Pregnancy Hypertension Severe Preeclampsia Maternal and Perinatal Complications Cameroon

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Breast Cancer Survival in Cameroon: Analysis of a Cohort of 404 Patients at the YaoundéGeneral Hospital

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Advances in Breast Cancer Research 2015年第2期4卷 44-52页

作者： Jean Dupont Kemfang Ngowa Jean Marie Kasia Jean Yomi Achille Nkigoum Nana anny ngassam Irenée Domkam Zacharie Sando Paul Ndom Department of Gynecology and Obstetrics Yaoundé General Hospital Faculty of Medicine and Biomedical Sciences University of Yaounde I Yaoundé Cameroon Department of Radiation Therapy Yaoundé General Hospital Faculty of Medicine and Biomedical Sciences University of Yaoundé I Yaoundé Cameroon Chantal Biya International Reference Centre for Research on HIV/AIDS Prevention and Management Yaoundé Cameroon Department of Morphological Sciences Yaoundé General Hospital Faculty of Medicine and Biomedical Sciences University of Yaoundé I Yaoundé Cameroon Oncology Division Yaoundé General Hospital Yaoundé Cameroon

This study aimed to estimate the survival rate of breast cancer in a group of patients followed up at the Yaoundé General Hospital in Cameroon. A retrospective review of records of patients managed for breast cancer between 1995 and 2007 was carried out at the Yaoundé General Hospital. Survival analysis was carried out with survival defined as the time between the date of unequivocal diagnosis of cancer and the date of last follow-up or death. Survival curves were plotted in R.3.1.1 software. Mean age of the patients was 47.5 ± 12.36 years. Most of the patients (67.9%) presented with advanced breast cancer disease (stage III and IV). Overall patient survival rate was 30% at 5 years and 13.2% at 10 years. Median overall survival time was 2 (1.9 - 3) years. There was a correlation between survival and the stage of disease. The highest survival rates were recorded in stages I and II while the lowest rates were recorded in stage IV. There was no statistically significant difference in survival among the age groups (p = 0.15). Overall survival rates of breast cancer are 30% at 5 years and 13.2% at 10 years among Cameroonian patients and are lower compared with 90% and 82% respectively at 5 years and 10 years in some developed countries.

关键词： Survival Breast Cancer Developing Countries

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Consultation, Diagnosis and Treatment Delays for Breast Cancer among Patients Followed up at the YaoundéGeneral Hospital, Cameroon

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Open Journal of Obstetrics and Gynecology 2020年第11期10卷 1580-1589页

作者： Jean Dupont Kemfang Ngowa Angèle Kabeyene Richard Ngarvounsia Etienne Atenguena Yvan Sinclair Ngaha Tchawe anny ngassam Christiane Nsahlai Junie Metogo Jovanny Fouogue Tsuala Pierre Marie Tebeu Department of Obstetrics/Gynecology Faculty of Medicine and Biomedical Sciences University of Yaoundé I Yaoundé Cameroon Yaoundé General Hospital Obstetrics/Gynecology Unit Yaoundé Cameroon Department of Pathology Faculty of Medicine and Biomedical Sciences University of Yaoundé I Yaoundé Cameroon Yaoundé General Hospital Medical Oncology Unit Yaoundé Cameroon Department of Obstetrics/Gynecology Faculty of Medicine and Pharmaceutical Sciences University of Dschang Dschang Cameroon

Introduction: Breast cancer is often diagnosed at an advanced stage in Cameroon. The objective was to analyse consultation, diagnosis and treatment delays for breast cancer among patients followed up at the Yaoundé General Hospital (YGH) in Cameroon. Materials and Methods: This was a cross-sectional study carried out from the files of patients followed up for breast cancer at the YGH from January 1, 2014 to April 30, 2018. A total of 183 patients were included. We measured time elapsed between the awareness of first signs of disease and the initial consultation (consultation delays), time lapse between the initial consultation and pathological diagnosis of breast cancer (diagnosis delays), interval between pathological diagnosis and treatment onset (treatment delays), time elapsed between the initial consultation and management (health system delays) and time elapsed from awareness of first signs of disease to treatment onset (overall delays). Results:

关键词： Breast Cancer Delay in Consultation Delay in Diagnosis Delay in Treatment

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Sexual Orientation and Associated Factors among Adolescents in Cameroonian Cities—Factors Associated with Sexual Orientation in Adolescents

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Open Journal of Pediatrics 2023年第6期13卷 749-762页

作者： Eboutou Ivan Nguefack Félicitée Meguieze Claude-Audrey ngassam Tchouamo Cindy Brenda Dongmo Tsopfack Félicie Cindy Mboringong Kwedi Fanny Danwe Danwang Welba Nseme Etouckey Eric Faculty of Medicine and Biomedical Sciences University of Yaoundé I Yaoundé Cameroon School of Health and Medical Sciences-CATUC-Kumbo Bamenda Cameroon

Introduction: Over time, new sexual practices other than the common ones are frequently described. This work aimed to determine the sexual orientation and its associated factors among adolescents attending school in two big cities in Cameroon. Methodology: A cross-sectional study with prospective data collection took place from November 2021 to April 2022 in eight secondary schools (four in Yaoundé and four in Douala). We conducted non-probability, consecutive sampling on school-going, sexually active adolescents between the ages of 14 and 19 years. A self-administered questionnaire to students was used to study their sexual orientations and practices. Univariate and multivariate analyses made it possible to find the associated factors using the chi-square test. Results: We included 1274 adolescents with an average age of 18 years;majority were boys (54.8%) for a sex ratio of 1.21. Most (49.7%) were from two-parent families. Cisgender was the most common self-gender identity (89.6%). The main sexual orientation was heterosexuality (82.3%), followed by bisexuality (9.7%) and homosexuality (8%). The average age at first sexual intercourse (coitarche) was 15 years and the coitarche was consenting in 84.1%. Sexual practices included: kissing (94.7%), fondling (93.4%), vaginal penetration (80.6%), oral sex (40.4%), masturbation (22.8%), fisting (18.4%), and anal penetrations (17.5%). The majority of sexual intercourse acts (55.8%) took place without protection;24.6% of adolescents practiced them with a person of the same sex and 18.4% with several others simultaneously. The factors associated with heterosexuality were age ≤17 years (aOR: 2.44 [1.36 - 4.40];p = 0.003), self-identification opposite to primary sexual characteristics (aOR: 12.05 [5.13 - 28.29];p 0.001), absence of consent during the first coitus (aOR: 7.09 [3.61 - 13.93];p 0.001) and a history of sexual intercourse with a person of the same sex (aOR: 94.17 [43.36 - 183.39];p 0.001). Conclusion: Although most adolescents are heterosexual in the school envi

关键词： Sexual Orientation Practice Identity Factors Teenager Cameroon

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Clinical, Psycho-Social and Metabolic Profile of Women with Hirsutism in Yaounde

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Open Journal of Endocrine and Metabolic Diseases 2022年第11期12卷 225-237页

作者： Francine Mendane Ekobena Martine Claude Etoa Etoga Laurence Carole Ngo Yon Mesmin Dehayem Sandrine Ongnesseck Nengom Eliane ngassam Vanessa Balla Eugène Sobngwi Jean Claude Mbanya Internal Medicine Essos Hospital Centre Yaoundé Cameroon Department of Internal Medicine and Specialties Faculty of Medicine and Biomedical Sciences University of Yaoundé I Yaoundé Cameroon National Obesity Centre Diabetes and Metabolic Diseases Unit Yaoundé Central Hospital Yaoundé Cameroon Faculty of Medicine and pharmaceutical Sciences University of Douala Douala Cameroon Regional Hospital of Nkongsamba Nkongsamba Cameroon

Background: Hirsutism is a clinical situation in Cameroon which is poorly elucidated due to a paucity of clinical and biological data;hence our interest in this study. The aim of this work was to describe the clinical, psycho-social and metabolic profile of women with hirsutism in Yaoundé. Materials and Methods: This was a descriptive cross-sectional study carried out from May 2013 to December 2013. Participants were recruited by announcement through social media. Our study included women at least 18 years old, not in menopausal, not pregnant, not breastfeeding, with hirsutism regardless of severity. They were assessed through an interrogation, anthropometric parameters, a physical examination using the modified Ferriman and Gallwey score, the measurement of fasting capillary blood glucose and a lipid profile. The psycho-social assessment was carried out using a pre-designed questionnaire on the participant’s perception and daily experience with hirsutism. The metabolic syndrome was established according to the criteria of the International Diabetes Federation of 2005 and the National Cholesterol Education Program-third adult treatment panel of 2001. Results: We recruited 60 women aged 27.6 ± 7.0 years. The median Ferriman and Gallwey score was 12. The mean duration of evolution was 9 years. A family history of hirsutism was found in 88.8% of the participants, especially in the mother. Signs of virilization were found in 3.3% of the participants. Association was found between menstrual cycle abnormalities and severity of hirsutism (p = 0.023). Psycho-socially, 58.8% of women found hirsutism normal. The metabolic syndrome was found in 21.7% and 18.3% according to the IDF and NCEP-ATP III, respectively. Conclusion: Hirsutism in our context seems normal to most of our participants. It is, however, associated with menstrual irregularities, signs of virilization and metabolic syndrome. As a result, hirsutism merits further study on a large-scale with emphasis on etiology.

关键词： Hirsutism hyperandrogenism Yaoundé Ferriman and Gallwey

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Short-Term Outcomes of Neonatal Resuscitation

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Open Journal of Pediatrics 2022年第3期12卷 507-513页

作者： Claude-Audrey Meguieze Eric Nseme Etouckey Isabelle Mekone Nkwele Félicité Nguefack Jocelyn Tony Nengom Dominique Enyama Cindy Brenda ngassam Ivan Eboutou Rose Andréa Yaka Jules Thierry Elong Evelyn Mah Paul Koki Ndombo Paediatric Department Faculty of Medicine and Biomedical Sciences University of Yaoundé I Yaoundé Cameroon Department of Morphological Sciences and Anatomopathology Faculty of Medicine and Biomedical Sciences University of Yaoundé I Yaoundé Cameroon Paediatric Department Faculty of Medicine and Pharmaceutical Sciences University of Dschang Dschang Cameroon

Introduction: Neonatal resuscitation is a means to restore life to a baby from the state of asphyxia. It can end in either survival or death. Survivors may develop short-term complications in the immediate postnatal period. Objective: Determine the short-term outcomes following neonatal resuscitation. Materials and Methods: A retrospective cross-sectional study was conducted for seven months running from November 2021 to June 2022 in two hospitals in Yaounde. Admission files of newborns who benefited from neonatal resuscitation at birth from the year 2019 to 2022 were included. We recorded the clinical characteristics of newborns (gestational age, gender, and birth weight), the frequency of transfers, the duration of admission, the rate and types of complications in an operating sheet The results were analysed using IBM SPSS 23.0 software and the data expressed as frequencies, percentages, and means. The threshold of significance was set at 5%. Results: A total of 245 files of newborns who benefited from neonatal resuscitation were included. The mean gestational age at delivery was 36.7 ± 3.6 weeks with a minimum and maximum of 25 weeks and 46 weeks respectively. 61.6% of newborns were born at term and were of the male sex (55.5%, sex ratio of 1.25). The average birth weight was 2748.4 ± 794.3 g (range: 800 - 5600 g) with 62.4% of newborns weighing between 2500 and 4000 g. 97.1% of the newborns were transferred to the neonatology unit with a median length of hospitalization of 5 days. The frequency of short-term complications during the study was 26.9% and hypoxic-ischemic encephalopathy was the most common (97%). Newborns resuscitated for more than 5 minutes were more likely to develop a short-term complication. Conclusion: Hypoxic-ischaemic encephalopathy was the most frequent complication post-resuscitation and a prolonged duration of resuscitation favoured the development of short-term complications.

关键词： Complications Neonatal Resuscitation Hypoxic Ischaemic Encephalopathy Cameroon

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Peritoneovaginal Duct and Nück’s Duct Persistence in Children at Campus Teaching Hospital in Lomé(Togo)

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Open Journal of Pediatrics 2022年第1期12卷 137-147页

作者： Missoki Azanlédji Boume Kwami Edem Edoh Bikor Oswaldo Enatonta Ayidedji Wandote Yawa Sesime Sanni Dédé Virginie Teko Telly Bailo Kante Yvon Arnold ngassam Gamédzi Komlatsè Akakpo-Numado Pediatric Surgery Department Kara Teaching Hospital Kara Togo Pediatric Surgery Department Campus Teaching Hospital Lomé Togo

Introduction: Peritoneovaginal duct (PVD) and Nück duct (ND) include several abnormalities with many clinical entities that are at the cause of a variety of symptoms. These are frequent in pediatric surgeon practice and could lead to serious complications. The aim of our work was to describe the epidemiological, diagnostic and therapeutic aspects of pathologies of PVD or ND in our conditions after the first five years of surgical activities of our pediatric department. Material and Methods: This was a retrospective and descriptive study, carried out on the files of children, aged zero to 15 years, presenting PVD or ND pathology, operated in the service, over a period of 4 years (2016 to 2019). Results were classified good, medium or bad. Results: During the study period, among the 865 children operated in pediatric surgery, 164 children were found for PVD and ND pathologies (18.95%). The average age was 5.3 years old. There were 152 boys (92.68%) and 12 girls (7.32%). The reason for consultation was inguinal or inguino-scrotal swelling in 99.3% of the children. The right side was affected in 58.5% of cases. In boys, there were inguinal hernias (27.5%), inguinoscrotal hernias (30.3%), hydroceles (36.9%) and cysts (5.3%). In girls, there were inguinal hernias (91.7%) and 1 ovarian hernia (8.3%). The umbilical hernia was associated with these pathologies in 39 cases. Treatment was conventional closure of the PVD or ND. With an average follow-up of 2.5 years (range 3 months and 3.5 years), the results were good in all cases. Conclusion: Pathologies of PVD or ND took an important place in the activities of the pediatric surgery department. Management by conventional surgery has given good results in all cases. Early treatment of these pathologies helps prevent complications.

关键词： Peritoneovaginal Duct Nück Duct Hernia Hydrocele Cord Cyst Pediatric Surgery

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