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Spontaneous Intracerebral Hemorrhage: Epidemiology, Clinical Profile and Short-Term Outcome in a Tertiary Hospital in Sub-Saharan Africa

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World Journal of Neuroscience 2020年第3期10卷 141-154页

作者： Jacques Doumbe Khadidja Abdouramani Daniel Massi Gams Chia Mark Ayeah caroline kenmegne Yacouba Njankouo Mapoure Department of Clinical Sciences University of Douala Douala Cameroon Department of Epidemiology School of Public Health University of Ghana Accra Ghana Department of Clinical Sciences University of Buea Buea Cameroon Neurological Unit Douala General Hospital Douala Cameroon

Background: Data on spontaneous intracerebral haemorrhagic (SICH) are scarce in Africa. Our objectives were to determine the prevalence of SICH, describe the clinical profile, aetiology and evaluate the prognosis (fatality case, functional outcome) of patients in a tertiary health care hospital in Cameroon. Methods: This was a hospital-based retrospective cohort which included patients with SICH and followed up for 6 months after stroke. Subarachnoid haemorrhage, cerebral venous thrombosis with bleeding or bleeding related with ischemic or brain tumour were excluded. Predictive factors were obtained using multiple logistic regression and survival by Kaplan Meier method. Results: The prevalence of SICH was 37% with male predominance (64.0%), a mean age of 55.6 ± 11.8 years. Deep coma was found in 30.3% on admission. The basal ganglion was the most frequent location of haemorrhage (85.1%) while intraventricular blood effusion, mass effect, cerebral oedema and herniation occurred in 31.4%, 25.7%, 8.8% and 5.0% respectively. Hypertension (57.5%) was the most common aetiology. The mean length of hospitalization was 9.0 ± 7.7 days and chest infection (30.7%) was the most frequent complication. The cumulative case fatality rate after 24 hours (day 1), during admission, month 1 and month 3 was 9.6%, 39.9%, 46.0%, 59.8% respectively. On multivariate analysis, GCS -month survival was 37.8%. Conclusion: About one-third of stroke patient were haemorrhagic. Hypertension is the leading CV

关键词： Spontaneous Intracerebral Haemorrhage Epidemiology Prognosis Africa

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Outcome between Diabetic versus Non-Diabetic Acute Stroke in a Black African Population: A Cohort Study

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World Journal of Neuroscience 2021年第3期11卷 231-245页

作者： Daniel Gams Massi Jacques Doumbe Raïmatou Ngouh Patouokoumche Chia Mark Ayeah caroline kenmegne Yacouba Njankouo Mapoure Neurological Unit Douala General Hospital Douala Cameroon Faculty of Health Sciences University of Buea Buea Cameroon Neurology department Douala Laquintinie Hospital Douala Cameroon Department of Clinical Sciences University of Douala Douala Cameroon Department of Epidemiology School of Public Health University of Ghana Accra Ghana

Background: Post-stroke outcomes are poorer in patients with diabetes mellitus (DM). The aim of this study was to determine the prevalence of DM in acute stroke and to compare the outcome in patients with or without diabetes in a tertiary care hospital in Douala, Cameroon. Methods: This was a hospital-based prospective cohort study included both diabetic and non-diabetic acute stroke patients (ASP). Demographic, clinical profile and outcome data was collected within 3 months of stroke onset. Descriptive statistics, t-test and chi square test used for comparisons while associations between DM and stroke outcomes, were analyzed using multiple logistic regression and survival analysis. Results: Of the 701 ASP included, the overall prevalence of diabetes in stroke was 34.2% (n = 240) while 9.4% (n = 66) had newly diagnosed diabetes. Mortality was significantly elevated amongst patients with diabetes during hospitalization (p = 0.034) and at 3 months post stroke onset (p = 0.004), but on multivariate analysis, diabetes was not an independent predictor of mortality [OR = 0.984;(95% CI: 0.506 - 1.913);p = 0.961)]. On Cox proportional hazards regression model, the risk of dying was about 1.5 times higher amongst the DM patients compared to non-diabetic patients [adjusted HR (95% CI) of 1.502 (1.128 - 2.000);p = 0.005]. Diabetes was not an independent predictor of poor functional outcome within 3 months post stroke. Conclusion: About 1 in 3 ASP had DM on admission. Survival is better in non-diabetes versus diabetes mellitus ASP. DM was associated with high mortality but does not influence the functional o

关键词： Diabetes Prevalence Mortality Functional Outcome Prognosis Africa

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Prevalence and Risk Factors of Peripheral Artery Disease in a Group of Apparently Healthy Young Cameroonians: A Cross-Sectional Study

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World Journal of Cardiovascular Diseases 2018年第2期8卷 111-122页

作者： Félicité Kamdem Yacouba Njankouo Mapoure Ba Hamadou Fanny Souksouna Ahmadou Musa Jingi caroline kenmegne Fernando Kemta Lekpa Jaff Fenkeu Kweban Gisèlei Mandy Jean Pierre Nda Mefo’o Henry Luma Marie Solange Doualla Internal Medicine Service Douala General Hospital Douala Cameroon Faculty of Medicine and Pharmaceutical Sciences University of Douala Douala Cameroon Faculty of Medicine and Biomedical Sciences University of Yaounde I Yaounde Cameroon Chemical Pathology Laboratory Douala General Hospital Douala Cameroon

Background: The?burden of peripheral artery disease (PAD) is not well known among apparently healthy people in Africa. Aim: To determine the prevalence and associated risk factors of PAD in a group of blood donors seen at the Douala General Hospital—Cameroon. Methods: Between 1st November 2015 and 30th April 2016, we carried out a cross-sectional study. Participants were consenting adults of both sexes, aged ≥ 21 years who presented for blood donation, and were tested HIV negative. We collected socio-demographic data and their past history. We carried out a physical examination and measured their Ankle-Brachial Index (ABI). We defined PAD as an ABI Results: We recruited 103 participants, 55.4% males. The mean age was 33 ± 10 years. The mean ABI on left and right leg was 1.04 ± 0.1 and 1.02 ± 0.1respectively. ABI was higher in males than females both legs (p 0.05). PAD was seen in 11 (10.7%) participants. This was higher in females than males (3.6% versus 19.2%, p = 0.026). Among those with PAD, 8 (72.7%) were asymptomatic (Males: 100% versus Females: 66%, p = 0.9). After adjusting for age and gender, sedentary lifestyle (aOR: 7.14, [95% CI: 1.38 - 33.3], p = 0.019), and female gender (aOR: 6.2, [95% CI: 1.26 - 30.5], p = 0.025) were significantly associated with PAD. Conclusion: The prevalence of PAD was high in this group of HIV negative blood donors, most of whom were asymptomatic. This was associated with females, and a sedentary lifestyle.

关键词： Peripheral Artery Disease ABI Prevalence Risk Factors Douala

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An Assessment of Cardiovascular Functional Capacity of a Group of Chronic Heart Failure Patients Using the 6-Minute Walk Test in a Cameroonian Urban Setting

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World Journal of Cardiovascular Diseases 2023年第6期13卷 275-282页

作者： Félicité Kamdem Chris Nadège Nganou-Gnindjio Dieudonné Danwe Franc Christ-Roi Soemessabot Elysée Claude Bika Léle Ba Hamadou Sidick Mouliom Lade Viché Henri Ngoté caroline kenmegne Marie Solange Ndom Ebongue Siddikatou Djibrilla William Ngatchou Department of Internal Medicine Douala General Hospital Douala Cameroon Faculty of Medicine and Pharmaceutical Sciences University of Douala Douala Cameroon Faculty of Medicine and Biomedical Sciences University of Yaoundé I Yaoundé Cameroon Faculty of Sciences University of Douala Douala Cameroon Faculty of Medicine and Biomedical Sciences University of Garoua Garoua Cameroon Faculty of Health Sciences University of Buea Cameroon

Background: Chronic heart failure is a public health problem worldwide. It has a high mortality rate and is accompanied by a decreased functional capacity and alteration of the quality of life. Objective: This study aimed to assess the cardiovascular functional capacity of a group of patients suffering from heart failure using the 6-minute walk test (6 MWT). Methods: This was a cross-sectional study carried out in the cardiology unit of Douala’s general hospital for 4 months. We included all eligible patients aged 18 years or more who had stable chronic heart failure and gave informed consent. Those who had an acute coronary syndrome (≤1 month), tachycardia (HR ≥ 120 bpm), high blood pressure (SBP ≥ 180 mmHg and/or DBP ≥ 100 mmHg) and reduced mobility due to orthopaedic reasons were excluded. A 6 MWT was done according to the American Thoracic Society guidelines. The 6 MWT result was considered poor for - 450 m and good for >450 m. Results: We recruited a total of 81 patients (61.7% women) with a mean age of 65.9 ± 10.6 years. The most frequent risk factor for heart failure was high blood pressure (77.8%), alcohol consumption(69.1%) and a sedentary lifestyle (53.1%). The left ventricular ejection fraction was mostly preserved (42.0%) or mildly altered (46.9). The 6 MWT results were poor in 55.6% of cases, average in 19.8% of cases and good in only 24.7% of cases. More than half (59.3%) of the participants perceived the effort as being difficult. The cardiovascular functional capacity was significantly associated with age, heart failure stage and physical activity (p Conclusion: Most patients suffering from chronic stable heart failure in the general hospital of Douala have poor cardiovascular functional capacity.

关键词： Cardiovascular Functional Capacity Chronic Heart Failure 6-Minute Walk Test Cameroon

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Epidemiology, Clinical Presentations and In-Hospital Mortality of Venous Thromboembolism at the Douala General Hospital: A Cross-Sectional Study in Cameroon, Sub-Saharan Africa

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World Journal of Cardiovascular Diseases 2018年第2期8卷 123-132页

作者： Félicité Kamdem Bertrand Hugo Mbatchou Ngahane Ba Hamadou Agborbessong Mongyui Marie Solange Doualla Ahmadou Musa Jingi Anastase Dzudie Yves Monkam Henri Ngote Sidick Mouliom caroline kenmegne Jaff Kweban Fenkeu Romuald Hentchoya Albert Kana Aminata Coulibaly Henry Luma Internal Medicine Service Douala General Hospital Douala Cameroon Faculty of Medicine and Pharmaceutical Sciences University of Douala Douala Cameroon Faculty of Medicine and Biomedical Sciences University of Yaounde I Yaounde Cameroon Intensive Care Unit Douala General Hospital Douala Cameroon

Background: Venous thromboembolism (VTE) is a major cause of morbidity and mortality worldwide. It is also the most common complication in hospitalized patients. Aims:?To?study the in-hospital prevalence of VTE, describe the socio-demographic characteristics of patients, determine the frequency of risk factors, describe the clinical presentations, and determine the short term outcome of VTE in hospitalized patients in a low-income tertiary hospital setting.?Methods: We carried out a cross-sectional descriptive retrospective study over a period of 6 years and 4 months (January 2008 to April 2014) in the Douala General Hospital—Cameroon. Patients were cases of confirmed venous thromboembolic disease (VTE).?Results: A total of 78 case files were retained for this study, giving an in-hospital prevalence of 4.4 per 1000 admissions. There were 42 (53.8%) males and 36 (46.1%) females. Their ages ranged from 18 to 89 years (median: 53 years, [IQR: 40?-?61]).?There were 37 (47.4%) cases of Deep Vein Thrombosis (DVT), 31 (39.7%) cases of Pulmonary Embolism (PE), and 10 (12.8%) cases of PE associated with DVT (12.8%). The main risk factors were obesity (44.9%), hypertension (37.2%), immobility (20.5%), and long-haul travel (17.9%). The most frequent clinical presentations in PE were dyspnea (80.5%) and chest pain (65.9%). There were 8 (10%) in-hospital deaths. Conclusion: About twelve cases of VTE are seen yearly at the DGH, with an in-hospital mortality of ten percent. Obesity and hypertension were the main risk factors, with dyspnea and chest pain being the main clinical manifestations in PE, and lower limb swelling the main symptom in DVT.

关键词： Epidemiology Clinical Presentation Mortality Venous Thromboembolism Cameroon Sub-Saharan Africa

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Hygienic and Dietary Measures in Cameroonian Hypertensive Patients Followed at the Douala General Hospital: Knowledge, Compliance and Effect on Blood Pressure Control

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World Journal of Cardiovascular Diseases 2023年第1期13卷 21-31页

作者： Félicité Kamdem Grace Eugénie Makota Ndongo Christelle Noche Domngang Hamadou Ba Jaff Fenkeu Kweban Glwadys Ngono Atéba Sidick Mouliom Henri Ngoté Lade Viché caroline kenmegne Marie Solange Ndom Ebongue Siddikatou Djibrilla Elysée Claude Bika Léle Samuel Kingue Department of Internal Medicine Douala General Hospital Douala Cameroon Faculty of Medicine and Pharmaceutical Sciences University of Douala Douala Cameroon Institut Supérieur des Sciences de la Santé Université des Montagnes Bangangté Cameroon Faculty of Medicine and Biomedical Sciences University of Yaoundé I Yaoundé Cameroon Intensive Care Unit Douala General Hospital Douala Cameroon Faculty of Medicine and Biomedical Sciences University of N’Gaoundéré N’Gaoundéré Cameroon Faculty of Health Sciences University of Buea Buea Cameroon Physiology and Medicine of Physical Activities and Sports Unit University of Douala Douala Cameroon

Introduction: The management of hypertension is mostly based on pharmacotherapy and hygienic and dietary measures (HDMs) for which little data is available in Cameroon. The concern to improve the quality of life of hypertensive patients led us to study the knowledge, compliance and effect of HDMs among Cameroonian hypertensive patients. Methods: This was a cross-sectional study carried out at the Douala General Hospital;the census of patients was carried out from 05 March to 10 May 2018. The data evaluated were knowledge and compliance with HDMs with an inference of their effect on blood pressure control. Results: We recruited 330 participants at mean age of 60 ± 11 years, 37.9% men;57.3% with blood pressure (BP) controlled. Out of 330 subjects, 308 (93.3%) who had been educated about dietary health measures for hypertension were assessed on knowledge, compliance and effect of these measures against 22 (6.7%) who had never heard about them. Around 85.7% of participants had good knowledge of HDMs and 78.9% had good compliance with them. There was no statistically significant influence of knowledge and compliance with HDMs on blood pressure control. Conclusion: The level of knowledge and adherence to HDMs of hypertensive patients at the Douala General Hospital was appreciable. It is however appropriate for physicians to intensify patient education on HDMs and BP control.

关键词： Hypertension Hygienic and Dietary Measures Blood Pressure Control Knowledge Compliance

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