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Parent-Reported Reasons for Loss-to-Follow Up in Patients Hospitalized at the Neonatology Unit at Laquintinie

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Open Journal of Pediatrics 2024年第4期14卷 686-699页

作者： eposse ekoube charlotte Puepi Djike Yolande Hassanatou Iyawa Mandeng Ma Linwa edgar epée Patricia Mbonjo Bitsie Dora Kedy Mangamba Koum Daniele-Christiane Faculty of Medicine and Pharmaceutical Sciences University of Douala Douala Cameroon Paediatric Unit Douala Laquintinie Hospital Douala Cameroon Faculty of Sciences University of Douala Douala Cameroon

Introduction: Despite the known benefits of newborn follow-up clinics, attendance has historically been difficult. Infants with reported follow-up difficulty have a greater incidence of severe sensorimotor and cognitive deficits and poorer access to early intervention programs. Our objective was to determine the parent-reported reasons for loss-to-follow up in patients hospitalised at the neonatology unit of Laquintinie Hospital. Methodology: We carried out a cross-sectional study through phone interviews with parents/caregivers of patients hospitalised at Laquintinie over a 2-year period from 1st January 2021 to 31st December 2022. A non-standardised structured interview guide was used for data collection. Loss-to-follow up referred to absence to at least one visit as recorded in the neonatal follow-up chart. All necessary administrative and ethical considerations were duly respected. Results: Most neonates were born through vaginal delivery (n = 313, 69.45%). The neonates were admitted at a median gestational age of 33 weeks (Q1-Q3;32 - 35) and the median duration of hospitalisation was 12 days (Q1 - Q3;8 - 18). A total of 23 neonates had died at the time of interview giving a mortality rate of 5.1%. The three most reported reasons for loss-to-follow-up was lack of money (n = 310, 68.13%), assumption that follow-up had ended (n = 37, 8.13%), and newborn that died (n = 23, 5.1%). Conclusion: This study highlights the significant impact of financial constraints and absence of a robust follow-up system on poor uptake of neonatal follow-up post-discharge in resource limited settings like Cameroon. Our results serve as advocacy for national health insurance especially in neonates.

关键词： Loss-to-Follow Up Cameroon Neonates

Diagnosis of CAH in a Sub Saharan Country: Visible Part of Iceberg

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Open Journal of Pediatrics 2024年第2期14卷 227-233页

作者： Suzanne Sap Ritha Mbono Hélène Kamo Jocelyn Tony charlotte eposse Jeannette epée Isabelle Mekone Adele Bodieu Gaelle Ntsoli Paul Olivier Koki Mother and Child Center of the Chantal Biya Foundation University of Yaoundé I Yaoundé Cameroon Laquintinie Hospital University of Douala Douala Cameroon Genral Hospital of Garoua University of Garoua Garoua Cameroon Human Reproductive Center and Research on Fertility of Yaoundé University of Yaoundé I Yaoundé Cameroon Yaounde General Hospital University of Yaoundé I Yaoundé Cameroon Yaounde Central Hospital Yaoundé Cameroon Laquintiinie Hospital Douala Cameroon

Introduction :Congenital adrenal hyperplasia (CAH) is the most common cause of primary adrenal insufficiency. It is a rare monogenic recessive disorder. In African setting in absence of neonatal screening, the diagnosis is still late, based on a clinical approach. During this clinical enquiry, information from past history or pedigree of the patient is of a huge importance and may revealed surprises. Patients and Methods: In this observational study, we retrospectively included all patients with a diagnosis of CAH. The diagnosis of CAH was retained based on a high 17 hydroxyprogesterone level in addition to clinical and morphological findings. From patients’ files, we extracted data on family history of disease, pedigree, clinical findings and genetics when available of 39 patients from two endocrinopeadiatric centers. Results: In 13 (30%) families, we found 20 reported deaths of infant less than 12 months. In these 13 families, half of the patients followed had 21 hydroxylase deficiencies and had 11 hydroxylase deficiencies. Unsurprisingly, we suspected adrenal insufficiency in these patients at verbal autopsy even in families with a patient with 11 hydroxylase deficiency. Other non DSD malformations or genetic disorders with apparently no link with CAH were reported in 3 families. The father of a patient reported to have hypospadias. Conclusion: each diagnosis of CAH made in our context is visible part of an iceberg. Behind a diagnosis of CAH made in our setting, is a long course of care, a dramatic past history revealing access to appropriate care disparity. Neonatal screening should thus be considered as an emergency.

关键词： Congenital Adrenal Hyperplasia

Prevalence of Children Vaccinated against Viral Hepatitis B in Brazzaville

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Open Journal of Pediatrics 2024年第2期14卷 426-434页

作者： Lucie charlotte Ollandzobo Ikobo Farrèche Colombe Missidi Hostaud Bienvenu Atipo-Ibara Arnaud Mongo Onkouo Clausina Philestine Ahoui Apendi Jile Florent Mimiesse Blaise Irénée Atipo Ibara Faculty of Health Sciences Marien Ngouabi University Brazzaville Republic of the Congo Infant Paediatrics Department Brazzaville University Hospital Brazzaville Republic of the Congo Gastroenterology and Internal Medicine Department Brazzaville University Hospital Brazzaville Republic of the Congo

Introduction: Viral hepatitis B (VHL) is a public health problem, particularly in sub-Sahara Africa. The aim of this study was to assess vaccination coverage against HBV in children in Brazzaville. Patients and Methods: This was a cross-sectional analytical study conducted in Brazzaville health centres from January to September 2019. It involved children aged between six months and six years who received a vaccination against HBV. Sampling was exhaustive and based on stratified sampling. Results: The overall prevalence of children vaccinated against HBV in Brazzaville was 96.2%. It was insufficient in the Talangai health district (79%). The pentavalent vaccine was administered to 97.7% of children, 85% of whom had received all three doses. The reasons for incomplete vaccination were parents’ ignorance of HVB (85.6%) and of vaccination (14.3%). Conclusion: Although the prevalence of vaccinated children is high in Brazzaville, it is still insufficient in some health districts, particularly Talangai, because parents are unaware of the disease and of vaccination. Pentavalent is the only vaccine available in the national vaccination programme, which is why an effective national vaccination policy needs to be put in place. .

关键词： Prevalence Vaccination Viral Hepatitis B Child Brazzaville

Co-Morbidities Associated with Prematurity in Two Referral Hospitals in Cameroon

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Open Journal of Pediatrics 2024年第4期14卷 738-753页

作者： Diomede Noukeu Njinkui Dominique enyama Yolande Djike Fokam Cyrelle O. Mefotse Saha Beatrice Moudze Kaptue charlotte eposse Koube Annick A. Tchouamo Sime Christophe Akazong Adjahoung Marthe e. Barla edgar Mandeng Ma Linwa Seraphin Nguefack Faculty of Medicine and Pharmaceutical Sciences of the University of Dschang Dschang Cameroon Faculty of Health Sciences University of Buea Buea Cameroon Faculty of Health Sciences University of Mountains Bangangte Cameroon Douala Laquintinie Hospital Douala Cameroon Faculty of Medicine and Pharmaceutical Sciences University of Douala Douala Cameroon Douala General Hospital Douala Cameroon Faculty of Medicine and Biomedical Sciences University of Yaound I Yaound Cameroon

Introduction: Prematurity is the leading cause of neonatal death in Africa. More than a million children die each year due to co-morbidities related to prematurity. In addition to being one of the causes of neonatal deaths, the health problems associated with prematurity can also lead to severe lifelong impairment in those who survive. Objectives: This paper aims to determine the epidemiology and identify co-morbidities of prematurity in the neonatology units of the Douala General Hospital (DGH) and the Laquintinie Hospital of Douala (LHD). Patients and Methodology: We conducted an analytical retrospective cohort study from January 2015 to January 2018 in the neonatology department of the GDH and the LHD, which are considered reference hospitals for the management of preterm babies in Cameroon. We included all newborns aged less than 37 weeks admitted to the neonatology units of the GDH and the LHD. The descriptive component was based on the analysis of quantitative variables using measures of central tendency. The analytical component was evaluated using Spearman correlations and the Chi-square and Fisher tests. Simple and multiple logistic regressions measured factors predictive of mortality. The Kaplan Meier survival curve used the Log Rank test and significance at p ≤ 0.05. Results: We recorded 908 preterm newborns in neonatal service and 1,124 preterm deliveries in maternity, representing an incidence of 32.5% in neonatal unit and 10.6% in maternity. 51% of whom were girls, given a sex ratio M/F of 0.9. Hypertension was the main prenatal pathology (9.1%), while premature rupture of membranes: PROM (35.5%) and eclampsia/pre-eclampsia (18.6%) were the most common obstetrical pathologies. 75.9% of deliveries were vaginal with 65.2% being performed in our referral hospitals. Gestational age ranged from 22 to 36 weeks, with a mean of 32.4 weeks. Late preterm birth rate was 53.7%, and birth weight varied between 590 and 3200 g with an average of 1747 ± 479 g. The per

关键词： epidemiology Co-Morbidities Prematurity Douala

evolution in the treatment of metastatic colorectal carcinoma of the liver

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World Journal of Gastroenterology 2006年第20期12卷 3253-3258页

作者： charlotte e Ariyan Ronald R Salem Department of Surgery Section of Surgical Oncology Yale University School of MedicineTompkins 202333 Cedar StreetNew HavenCT 06520United States

Metastatic colorectal cancer to the liver is associated with a uniform poor prognosis without treatment. Advances in therapy over the past decades have now allowed surgical resections of the liver to occur with a low morbidity and mortality. Improvements in chemotherapy regimes have paralleled technical improvements and now allow a new group of patients to become eligible for surgical resection. This chapter will review the recent advances in surgical and chemotherapeutic regimes in metastatic colorectal cancer to the liver.

关键词： ethical tensions Metastatic Colorectal Carcinoma Liver

Nuclear mechanics during constricted migration

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Acta Mechanica Sinica 2019年第2期35卷 299-308页

作者： Yuntao Xia charlotte R. Pfeifer Dennis e. Discher Physical Sciences Oncology Center at Pennsylvania (PSOC@Penn) University of Pennsylvania PhiladelphiaPA 19104USA Molecular and Cell Biophysics Lab University of PennsylvaniaPhiladelphiaPA 19104 USA Department of Physics and Astronomy University of Pennsylvania Philadelphia PA 19104USA

Cell migration through narrow interstitial space in tissues is commonly seen in both physiological and pathological conditions. For example, immune cells have to squeeze through vasculature and extracellular matrix to reach the wound or diseased sites, and similarly cancer cells need to crawl through porous space in tissues to invade surrounding tumor-free regions. Therefore, the bulky stiff nucleus in the cell becomes a barrier during constricted migration making such process pore-size dependent with smaller pores exponentially alleviate the passage capability. However, in some cases, cells can actively deform their nuclei to squeeze through constrictions although some price needs to be paid. In this review, we focus on:(1) nuclear structures and morphological regulations,(2) proposed mechanisms that drive constricted migration,(3) short-term consequences such as nuclear envelope (Ne) rupture and DNA damage during such process,(4) biophysical factors that facilitate Ne rupture, and (5) long term consequences such as genomic variation caused by repetitive Ne rupture. Both experimental results and modeling are provided with the intention to better understand the constricted migration.

关键词： Constricted migration Nuclear envelope rupture DNA damage

Maternal Burnout: Prevalence and Associated Factors in Northern Benin (2023)

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Open Journal of Psychiatry 2024年第1期14卷 29-44页

作者： Ireti Nethania elie Ataigba Guy Gérard Aza Gnandji David Sinet Koivogui Owèrè charlotte Dagan Coovi Ignace Tokpanoude Kwamé Abdias Adoufou Anselme Djidonou Francis Tognon Tchegnonsi Prosper Gandaho Institut de Formation en Soins Infirmiers et Obstétricaux Faculté de Médecine Université de Parakou Parakou Bénin Service de Psychiatrie Centre Hospitalier Universitaire Départemental du Borgou Alibori Parakou Bénin Organisation Non Gouvernementale de Soutien Réhabilitation Insertion et Réinsertion (SouRIR ONG) Parakou Bénin Faculté des Sciences de la Santé Université d’Abomey-Calavi Cotonou Bénin Service de Psychiatrie Centre National Hospitalier Universitaire Hubert Koutoucou Maga de Cotonou Cotonou Bénin Faculté des Sciences et Techniques de la Santé Université Gamal Abdel Nasser de Conakry Conakry Guinée

Introduction: Also known as maternal burnout syndrome, maternal burnout is a state of physical, emotional and mental exhaustion generated by prolonged stress in the family environment. It is experienced by women in their role as mothers. Those affected can develop psychological disorders, sleep disturbances, etc., all of which impair their day-to-day lives, and thus their maternal role. The repercussions affect both the child and other family members. Objective: The aim of the present study was to investigate maternal burnout among female users of public and private health facilities in the commune of Parakou in 2023. Methods: Descriptive cross-sectional study was conducted from December 2022 to July 2023 among all mothers using public and private health facilities in the commune of Parakou. All healthy mothers with at least one biological or adoptive child fully dependent on them and living at home, who came for a consultation in one of the health facilities or for an appointment at the expanded Program on Immunization (ePI) and gave their free and informed consent. Sampling was done for non-exhaustive convenience were included in the study. Burnout was assessed using the Parental Burnout Assessment (PBA) scale. Results: A total of 888 mothers meeting the inclusion criteria were surveyed. The prevalence of burnout calculated using the Parental Burnout Assessment (PBA) scale was 6.19%. The risk factors for maternal burnout were poor relationships with family and friends (OR = 8.90;p = 0.045), moderate (OR = 11.71;p = 0.020) and severe depression (OR = 40.85;p = 0.001), followed by the presence of repeated nocturnal awakening (OR = 5.14;p = 0.014). Conclusion: This is a subject that is almost never discussed in African society, but whose reality is revealed by the present study, which provided statistical data on maternal burnout. From now on, the risk of burnout will no longer be discussed solely in the family context. It will also need to be explored within the fam

关键词： Burnout Maternal Benin 2023

Pregnancy Preferences in Females of Reproductive Age with Sickle Cell Disease at Laquintinie Hospital: A Cross-Sectional Analysis

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Open Journal of Obstetrics and Gynecology 2024年第5期14卷 744-757页

作者： eposse ekoube charlotte Jeannette Disso Massako Mangala Fulbert Nkwele Mandeng Ma Linwa edgar Puepi Djike Yolande Merlin Boten Bounyom erero F. Njiengwe Épée Patricia Hassanatou Iyawa Dora Mbonjo Bitsie emmanuel Heles Nsang Soumaiyatou Abba Ngo Linwa esther eleonore Ndolo Kondo Astrid Grâce Tocki Toutou Moustapha Bilkissou essome Henri Faculty of Medicine and Pharmaceutical Sciences University of Douala Douala Cameroon Paediatric Unit Douala Laquintinie Hospital Douala Cameroon Faculty of Health Sciences University of Bamenda Bamenda Cameroon

Introduction: Females with sickle cell disease (SCD), despite having a delayed pubertal development, are subject to many worries relating to their abilities to conceive, their capacity to maintain a maternofetal-risk-free pregnancy till term and give birth to healthy children without sickle cell disease. Knowing that unplanned pregnancies are more likely to increase maternofetal morbidity and mortality, we sought out to explore the pregnancy preferences in female patients with sickle cell disease to promote healthy conception and childbirth in this vulnerable population. Methodology: We conducted a cross-sectional study involving female patients of child-bearing age with sickle cell disease followed at Laquintinie Hospital Douala or who were members of a local sickle cell association. Pregnancy preferences were determined using the Desire to Avoid Pregnancy (DAP) scale. Factors associated with pregnancy preferences were determined using multivariable linear regression model. Threshold for significance was set at p Results: Seventy-seven patients were included with a mean age of 24.71 ± 5.53 years. Forty patients (51.95%) had one sexual partner and thirteen women (32.5%) used contraceptive methods. Most patients (46.0%) responded “Strongly Agree” or “Agree” to the statement “it would be a good thing for me if I became pregnant in the next 3 months”. The mean DAP score was 1.63 ± 0.91 [1.28 ± 0.82 in those who had a sexual partner and 1.99 ± 0.86 in those who had no sexual partner]. Factors that were positively associated with DAP score were students (b = 0.32, 95% CI [0.21, 0.95], p = 0.003), monthly income ≥ 100,000 FCFA (b = 0.24, 95% CI [0.07, 0.81], p = 0.022), and not having a sexual partner (b = 0.26, 95% CI [0.11, 0.85], p = 0.012). Conclusion: Most female patients with SCD have a low desire to avoid pregnancy. This is especially true for patients who are not students, have a partner and have a low monthly income.

关键词： Pregnancy Preferences Sickle Cell Disease Laquintinie Hospital Cameroun

exercise-based real-time telerehabilitation for older patients recently discharged after transcatheter aortic valve implantation: An extended feasibility study

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Journal of Geriatric Cardiology 2023年第11期20卷 767-778页

作者： Barbara Cristina Brocki Jan Jesper Andreasen Jens Aarøe Jane Andreasen charlotte B Thorup Department of Physiotherapy and Occupational Therapy Aalborg University HospitalDenmark Department of Cardiothoracic Surgery Aalborg University Hospital and Clinical InstituteAalborg UniversityDenmark Department of Cardiology Aalborg University HospitalDenmark Public Health and epidemiology Group HealthScience and TechnologyAalborg UniversityDenmark Research Center of Health and Applied Technology University College Northern DenmarkDenmark

OBJeCTIVeS To assess the extended feasibility of a telerehabilitation program and its effects on physical performance in older adults who have recently undergone transcatheter aortic valve implantation(TAVI).MeTHODS In this single-center feasibility study, patients underwent an eight-week telerehabilitation program, involving webbased home exercise training twice weekly, an activity tracker, access to an informative website, and one online session with a nurse, starting one-week postoperative. Data collection was performed before surgery and three months postoperative. The feasibility of the intervention was based on recruitment and adherence to the program. As a secondary outcome, we evaluated the change in six-minute walk distance from before surgery to three months *** Forty-one patients scheduled for TAVI were assessed for eligibility;15 patients(37%) were enrolled. Of these, eight were excluded after surgery due to tiredness(n = 2), non-cardiac related hospital readmission(n = 2), fluctuating health(n = 1),death during hospital stay(n = 1), and reduced cognition(n = 2). Seven patients completed the eight-week web-based intervention and were evaluated three months postoperative. Their median(IQR) age was 83 [81, 87] years, and the sample comprised three men and four women. Their walked distance improved from median(IQR) 262 [199, 463] before surgery, to 381 [267, 521]meters three months postoperative. No adverse events were *** Web-based telerehabilitation, including supervised exercise training, in older adults who have recently undergone TAVI was feasible for a small number of patients who completed the eight-week intervention. This was reflected in an improvement in their walked distance three months after the surgery. However, the low recruitment and retention rates do question the overall feasibility of this intervention in a frail, older population of post-TAVI patients.

关键词： patients nurse implantation