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Radical Hysterectomy in Cervical Cancer: Patients’ Epidemiological and Clinical Profiles and Perioperative Outcome in Two Referral Hospitals in Cameroon

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Open Journal of Obstetrics and Gynecology 2024年第3期14卷 466-479页

作者： Théophile Njamen Nana Robert Tchounzou Fulbert Nkwele Mangala Alphonse Ngalame Henri Essome Sedrick Tiokeng Sidonie Noa Ananga Andrew Tassang Humphry Tatah Neng Isaac Mboh Eyong Gaetan Andre Wambo Simo Felix Adolphe Elong Fidelia Kobenge Mbi Junior Cédric Nana Njamen charlotte tchente nguefack Thomas Obinchemti Egbe Gregory Ekane Halle Emile Telesphore Mboudou Marcellin Ngowe Ngowe Department of Obstetrics and Gynaecology Douala General Hospital Douala Cameroon Department of Obstetrics and Gynaecology Faculty of Health Sciences University of Buea Buea Cameroon Department of Obstetrics and Gynaecology Douala Gynaeco-Obstetric and Pediatric Hospital Douala Cameroon Department of Surgery and Specialties Faculty of Medicine and Pharmaceutical Sciences University of Douala Douala Cameroon Department of Pathology Douala General Hospital Douala Cameroon Faculté Des Sciences De La Santé Université Joseph Kizerbo Ouagadougou Burkina Faso

Background: Cervical cancer (CC) is one of the most frequent cancers and the leading cause of death from gynecological cancer in Low and middle income countries, Cameroon inclusive. Surgery is the primary treatment modality when the disease is diagnosed at early stage. Radical hysterectomy in cervical cancer has not been evaluated in recent years in Cameroon. The purpose of this study is thus to evaluate the epidemiological and clinical features and short term outcomes of patients who underwent surgery. Patients and methods: This retrospective study was conducted at the Douala Gynaeco-obstetric and Pediatric Hospital and the Douala General Hospital. Cervical cancer patients who underwent Radical hysterectomy between January 2015 and December 2020 were included. A pre-established data collection tool was used to record socio-demographic, clinical and outcomes information from patients’ files;additional outcome information was obtained from phone calls. Descriptive analysis was done using the SPSS version 26. Bivariate analysis was used to determine associations between disease and patients characteristics and occurrence of adverse postoperative outcome. P value of 0.05 was considered. Results: Sixty one patients were enrolled. Their ages ranged from 33 to 74 years with a mean age of 51.95 ± 10.29 years. Over 85% of women were married, 65.57% were unemployed and 86.88% were multiparous. Only 28% had never done cervical cancer screening. Most patients had stage IB1 to IB2 stage disease (57.1%). Less than 9% underwent radical hysterectomy and 8 of those (13.11%) suffered intraoperative complications. Twenty-five patients (40.98%) presented immediate and short term complications. There was no significant association between the disease or patients’ characteristics and adverse outcomes. Conclusion: Cervical cancer patients are relatively young in our settings and only 9% of them reach the hospital at early stage. Postoperative adverse outcomes rate is higher than that reported in the literature. Sensitization on screen

关键词： Cervical Cancer Radical Hysterectomy Epidemiological and Clinical Profiles Outcomes Cameroon

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Antibiotics Resistance of Urogenital Mycoplasma in Sexually Active Women Attending Gynecologic Consultation in Douala (Cameroon)

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Advances in Microbiology 2023年第12期13卷 559-570页

作者： Jean Pierre Nda Mefo’o Rosa Fetue Notio Fulbert Mangala Nkwele Grace Dalle Ngondi Emmanuel Roddy Mengue Elodie Ngo Malabo charlotte tchente nguefack Cécile Okalla Ebongue Théophile Nana Njamen Laboratory of Clinical Biology Douala General Hospital Douala Cameroon Department of Biological Sciences Faculty of Medicine and Pharmaceutical Sciences The University of Douala Douala Cameroon Department of Surgery and Specialties Faculty of Medicine and Pharmaceutical Sciences The University of Douala Douala Cameroon Mother and Child Department Douala General Hospital Douala Cameroon Department of Obstetrics and Gynecology Faculty of Health Sciences University of Buea Buea Cameroon

Introduction: Mycoplasmas are bacteria commonly found in the commensal flora of humans and can occasionally be pathogenic. The population and the geographical area determine their susceptibility to various antibiotics. Methodology: We carried out a cross-sectional study from January to June 2022 at the Douala General Hospital. All women who were sexually active and willing to participate were included. Endo-cervical swabbing was used to collect the samples. Culture and antibiotic susceptibility testing were performed in a liquid medium using Mycoplasma-SystemPlus Gallery (Liofilchem). All samples that degraded urea (threshold > 103 for Ureaplasma urealyticum) and arginine (threshold > 104 for Mycoplasma hominis) were deemed positive. Results: A total of 107 women with a median age of 33 ± 8.3 years and a predominance of 30-40 years (41.1%) were included. The frequency of mycoplasma infection was 73.8% with 34.1%, 11.4% and 54.4% for Ureaplasma urealyticum, Mycoplasma hominis and co-infection respectively. Resistance rates to Minocycline were low, 1.3% for Ureaplasma urealyticum and 3.7% for co-infection;for Pefloxacin the resistance rates were 3.7% (Ureaplasma urealyticum, Mycoplasma hominis) and 22.8% (co-infection). Ureaplasma urealyticum had a resistance rate of 3.7% for Erythromycin, 1.3% for Clarithromycin and 5% for Azithromycin. There was no significant correlation between risk factors and infection. Vaginal cleansing and the development of resistance in mycoplasma infection were found to be significantly correlated (OR = 6.915 [1.52 - 31.55];(p = 0.013)). Conclusion: Minocycline was the most active antibiotic and Ureaplasma urealyticum was the species with the lowest rate of resistance. Antibiotic resistance was more common in co-infected people than mono-infected. Antibiotic resistance was independently correlated with vaginal douching.

关键词： Urogenital Mycoplasma Sexually Active Women Douala Cameroon

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Knowledge, Attitudes and Practices of Infertile Women on Child Adoption in Douala (Cameroon)

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Open Journal of Obstetrics and Gynecology 2014年第16期4卷 1065-1071页

作者： charlotte tchente nguefack Clovis Ourtching Halle Ekane Gregory Eugène Belley Priso Obstetrics and Gynecology Unit Douala General Hospital Douala Cameroon Department of Obstetrics and Gynecology Faculty of Medicine and Pharmaceutics Science University of Douala Douala Cameroon Department of Obstetrics and Gynecology Faculty of Health Sciences University of Buea Buea Cameroon Department of Obstetrics and Gynecology Faculty of Medicine and Biomedical Science University of Yaoundé Yaoundé Cameroon

Background: The aim of the study was to evaluate the knowledge, attitude and practices on child adoption among infertile women in Douala (Cameroon). Methods: It was a prospective descriptive study of six months duration at the General Hospital and the Dawn Medical Foundation Clinic. Patients of the gynecologic unit presenting with infertility were included. A questioner was administer to each patient with the following variables: Age, marital status, profession, level of education, past gynecologic history, number of children, type and the duration of infertility. Their knowledge, attitude and practice toward child adoption were investigated. Data collected was analyzed using the statistical software EPI-INFO 6.04 and R. p value < 0.05 was considered to be statistically significant. Results: Among the 300 women included, 269 (89.7%) had already heard about adoption, 62.1% through the media. Seventeen percent knew who to meet in order to adopt a child in Cameroon. Two hundred and thirty patients (76.7%) were in favor of adoption but 48.7% of them didn’t want to adopt a child. One percent of patient had adopted a child. The attitude towards adoption was significantly influenced by the duration of infertility of more than 10 years (p = 0.0014). Among women who have at least one child 9.4% wanted adoption against 21.4% who did not want adoption (p = 0.0305). Among women aged between 25 and 30 years, 28.2% wanted to adopt a child against 79.1% who did not want it (p = 0.000). Eighty five percent of women who had secondary infertility did not want to adopt against 44.7% who wanted it (p = 0.0003). Conclusion: The level of knowledge is high in educated patient. However, many women don’t know the right procedure and the structures in charge of adoption. Their attitude is favorable but the practice of adoption remains low.

关键词： Knowledge Attitudes Practices Child’s Adoption Douala

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Fight against Breast Cancer in Cameroon: Cross-Views of the Knowledge of the Female Population of Douala Hospitals

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Open Journal of Obstetrics and Gynecology 2023年第7期13卷 1196-1209页

作者： Henri Essome Astrid Ndolo Kondo Ingrid Doriane Ofakem Ilick Christelle Enama Olinga Moukouri Gertrude Junie Ngaha Yaneu Marga Vanina Ngono Akam Gervais Mounchikpou Ngouhouo Grâce Tocki Toutou Fulbert Mangala Nkwele Michel Roger Ekono Jean Paul Engbang Ndamba Theophille Nana Njamen charlotte tchente nguefack Pascal Foumane Faculty of Medicine and Pharmaceutical Sciences University of Douala Douala Cameroon Laquintinie Hospital Douala Cameroon Faculty of Health Sciences University of Buea BueaCameroon Faculty of Medicine of Sangmelima Sangmelima Cameroon

Introduction: Breast cancer in women is a global scourge due to its frequency and high fatality rate. If screening has made it possible to considerably reduce its incidence and its mortality in developed countries, in our developing countries, it remains frequent with a still high mortality due to ignorance, late and non-systematized screening. Research Question: Can female health caregivers be incorporated into a breast cancer screening awareness team? Objective: It aimed at evaluating the knowledge of female health caregivers in Douala hospitals, added to that of female users on breast cancer screening for their efficient operationalization in this procedure. Methodology: This was a comparative cross-sectional study for analytical purposes for a period of 07 months from January 15 to July 15, 2020 conducted by means of a structured and pre-tested questionnaire after informed consent obtained from the participants received in the consultation units of these hospitals. The study variables were socio-demographic and cognitive. The data collected were entered and analyzed using SPSS 23.0 software (statistical package for social sciences) with a significance level established for a value of p Results: We retained 1000 women fulfilling our inclusion criteria, including 818 users and 182 health caregivers, i.e. an average ratio of 4 users for 1 caregiver. The average age of the users was 31.03 ± 11.31 years and that of the caregiver was 29.54 ± 8.14 years (with extremes of 15 and 67 years identical in the two groups) with a respective median of 29 and 28 years old. Good knowledge was significantly associated with level of education (secondary OR = 0.38, p = 0.03 and University OR = 0.22, p = 0.001) with a predominance of good knowledge among care givers (83.5%) against 56.2% among users. The association between caregiver and good knowledge appeared to be statistically significant (OR = 0.25;p < 0.0001). In general, the association of users and poor knowledge carried a 4 times higher risk (OR: 3.94 (2.6 - 5.97) p Concl

关键词： Screening Breast Cancer Knowledge Attitudes Practices Carer Users

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Hystererectomy in a Tertiary Hospital in a Sub-Saharan Setting: A 20-Year Retrospective Review of the Indications, Types and Analysis of Technical Index

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Open Journal of Obstetrics and Gynecology 2021年第7期11卷 885-897页

作者： Théophile Njamen Nana Robert Tchounzou Fulbert Nkwele Mangala Henri Essome Fidelia Mbi Kobenge Bongoe Adamo Gregory Ekane Halle Thomas Obinchemti Egbe charlotte tchente nguefack Department of Obstetrics and Gynecology Douala General Hospital Douala Cameroon Department of Obstetrics and Gynecology Faculty of Health Sciences University of Buea Buea Cameroon Department of Obstetrics and Gynecology Douala Gynaeco-Obstetrics and Paediatric Hospital Douala Cameroon Department of Surgery and Specialities Faculty of Medicine and Pharmaceutical Sciences University of Douala Douala Came-roon Department of Obstetrics and Gynecology Douala Laquintinie Hospital Douala Cameroon

Background: Hysterectomy is one of the most performed surgeries through the world, even in Sub Saharan setting where indications are not rare. Objective: To study the frequency, indications, surgical methods, and complications of hysterectomies at the Douala General Hospital. Patients and methods: We carried out a cross-sectional study over a 20-year period, from the 1st January 2000 to 31st December 2019, in the department of Gynaecology and Obstetrics of the Douala General Hospital, a tertiary health facility in Cameroon, central Africa. All patients who underwent hysterectomies for gynaecological or obstetrical indications and whose files were complete were retained. Results: Out of a total of 7126 gynaecological and obstetrical surgical cases 1007 were hysterectomies, giving a frequency of 14.21%. Meanwhile, 968 files fulfilled the inclusion criteria. The average age of the pati

关键词： Hysterectomy Indications Surgical Methods Complications Douala General Hospital-Cameroon

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Primary Post-Partum Haemorrhage Following Vaginal Deliveries at the Douala General Hospital: Prevalence, Causes and Risk Factors

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Open Journal of Obstetrics and Gynecology 2021年第6期11卷 742-752页

作者： Théophile Njamen Nana Robert Tchounzou Fulbert Nkwele Mangala Henri Essome Javorez Thibaut Demgne Fidelia Mbi Kobenge Bongoe Adamo Thomas Obinchemti Egbe charlotte tchente nguefack Gregory Ekane Halle Department of Obstetrics and Gynecology Douala General Hospital Douala Cameroon Department of Obstetrics and Gynecology Faculty of Health Sciences University of Buea Buea Cameroon Department of Surgery and Specialities Faculty of Medicine and Pharmaceutical Sciences University of Douala Douala Came-roon Institut Supérieur des Sciences de la Santé Université des Montagnes Bangangte Cameroun

Background: Postpartum haemorrhage is one of the leading causes of maternal morbidity and mortality worldwide. It occurs predominantly in developing countries due to poorly developed infrastructures and lack of skilled birth attendants. Objective: To identify the prevalence, causes and risk factors of primary postpartum haemorrhage following vaginal deliveries in a referral hospital (Douala General Hospital-Cameroon). Methods: This was a descriptive and analytical study carried in the Douala General Hospital (DGH) for which socio-demographic, clinical, obstetric and post-partum data were collected using a pre-tested questionnaire. Descriptive statistics, multivariate analysis and logistic regression allowed us to present and discuss our results, with a 95% confidence interval (CI) and p value 0.05. <

关键词： Primary Postpartum Haemorrhage Prevalence Causes Risk Factors

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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. Regarding fetal and neonatal outcomes, we registered 30.

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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Attainment of the Fifth Millennium Development Goal: Utopia or Reality Based on Trends in Maternal Mortality in 12 Years in Two Regional Hospitals in Fako Division, Cameroon? A Retrospective Study

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Open Journal of Obstetrics and Gynecology 2014年第13期4卷 771-781页

作者： Gregory Edie Halle Ekane Thomas Egbe Obinchemti charlotte nguefack tchente Lydia Kahgomia Fokunang Theophile Nana Njamen Ndamezie Nkafu Bechem Martin Mafany Njie Daniel Latum Department of Surgery and Gynecology/Obstetrics Faculty of Health Sciences University of BueaBuea Cameroon Department of Obstetrics and Gynecology Douala General Hospital Douala Cameroon Department of Gynecology and Obstetrics Regional Hospital Buea Buea Cameroon Department of Obstetrics and Gynecology Limbe Regional Hospital Limbe Cameroon Department of Public and Community Health University of Yaoundé 1 Yaoundé Cameroon

Introduction: According to WHO, globally an estimated 585,000 women die each year from complications of pregnancy and childbirth. One of the targets of Millennium Development Goal 5 (MDG 5) is to reduce maternal mortality by three quarters of the 1999 value by the year 2015. However, three years to 2015, very little is known on the trends in maternal mortality ratio, causes of maternal deaths and their associated factors in the Tiko Cottage Hospital (TCH) and Limbe Regional Hospital (LRH) in the South-West Region, Cameroon. Methods: This was a retrospective, analytical cross-sectional study that was carried out from 1st January 2000 to December 2012. After obtaining ethical clearance, the records of cases of maternal deaths and a reference group of women who survived after a pregnancy during the same period were carefully reviewed. The data were analyzed with SPSS 10 and EPI 3.5.1. Results: There were 14,480 live births and 132 maternal deaths during the study period, giving an adjusted Maternal Mortality Ratio (MMR) of 892/100,000 live births. Patients’ age ranged from 15 - 40 years (SD 2.3). We observed a downwards trend of Maternal Mortality Ratio (MMR). Seventy-eight percent of the maternal deaths were due to direct causes. The triad of hemorrhage (54.5%), abortions (17.4%), and eclampsia (10.6%) was the leading cause of death. HIV-related complications and hepatitis constituted the main indirect causes of maternal death. In 85.4% of cases, maternal deaths were avoidable. Lack of blood for transfusion and late referral of cases were the main avoidable factors. Patients less than 35 years (p = 0.01), no antenatal care (ANC) (p = 0.001), unemployment [OR = 1.52;95% CI: (1.38 - 48.28);p = 0.02] were significantly associated with maternal deaths while grand multiparity [OR = 1.20;95% CI (0.30 - 4.86);p = 0.79], marital status [OR = 1.20;95% CI: (0.70 - 2.07);p = 0.51] and education level were not significantly associated with maternal deaths. Conclusion: The trend shows that there was no appreciable decline in ma

关键词： Maternal Mortality Ratio Causes Trends MDG 5 South West Region

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Immuno-Histochemical Profile of Breast Cancers at the General Hospital of Douala-Cameroon

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Open Journal of Obstetrics and Gynecology 2023年第8期13卷 1377-1388页

作者： Ekono Michel Roger Guy Ngaha Yaneu Junie Neng Humphry Tatah Messakop Yannick Azoumbou Mefant Thérèse Ze Ngbwa Mimi Flore Essome Henri Essola Basile Engbang Jean-Paul tchente nguefack charlotte Faculty of Medicine and Pharmaceutical Sciences University of Douala Douala Cameroon Department of Obstetrics and Gynecology Ebolowa Regional Hospital Ebolowa Cameroon Faculty of Health Sciences University of Buea Buea Cameroon

Introduction: The aim of the study was to describe the immunohistochemical aspects of breast cancers at Douala General Hospital, Cameroon. Methodology: This was a descriptive study with retrospective data collection, conducted from January 1st 2010 and December 31st 2019. It was focused on histologically proven breast cancers followed up at Douala General Hospital. Results: We collected 285 cases of breast cancer, all female, representing an annual frequency of 28.5 cases. The mean age of the patients was 48 ± 13 years. The most frequent histological form was infiltrating ductal carcinoma (83.9%), with grade II predominating (38.6%). Immunohistochemical analyses were performed on 89 patients (31.23%). The triple-negative subtype was the most common class (35.95%), followed by Luminal A (32.60);Human Epidermal Receptor 2-class and Luminal B tumors were observed at a frequency of 13.48% each. Treatment consisted mainly of surgery (78.60%) combined with chemotherapy (65.97%) and/or radiotherapy (63.16%). Hormonal treatment was used in only 10.18% of patients. Targeted therapy was exceptional (4%). Conclusion: Triple-negative phenotype is the most common. However, potentially hormone-sensitive tumors account for almost half of all patients, who are relatively young. Individualized treatments are rare. It is important to systematize these analyses for all breast cancers, with a view to appropriate management in our environment.

关键词： Breast Cancer Immunohistochemistry Douala General Hospital of Cameroon

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