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Assessment of Knowledge, Attitudes and Practices (KAP) on Rheumatic Heart Disease among Senior Medical Students in Cameroon

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World Journal of Cardiovascular Diseases 2020年第6期10卷 363-378页

作者： David Chelo Leslie Mbapah Tasha Anastase Dzudie Tamdja Clovis Nkoke denis georges tewafeu Nelson Njedock Samuel Kingue Mother and Child Center Chantal BIYA Foundation Yaoundé Cameroon Department of Pediatrics Faculty of Medicine and Biomedical Sciences University of Yaoundé 1 Yaoundé Cameroon Department of Internal Medicine University of Buea Buea Cameroon Department of Internal Medicine Faculty of Medicine and Biomedical Sciences University of Yaoundé 1 Yaoundé Cameroun

Background: Rheumatic heart disease (RHD) is the commonest cause of valvular heart disease in low and middle-income countries (LMICs). The low cardiologist to patient ratio leaves a big challenge of RHD prevention and management to general practitioners in Cameroon. This makes it important to assess the aptitude of senior medical students who are doctors-to-be on RHD. This could thus give a base on which to increase awareness and decrease the burden of the disease. Therefore, we sort to evaluate the knowledge, attitudes, and practices (KAP) of senior medical students on rheumatic heart disease. General objective: To determine the level of knowledge, attitudes on rheumatic heart disease, and assess practices towards RHD and its prevention. Methodology: A cross-sectional study was conducted in four medical schools in Cameroon for a period of 3 months (from January 1st to April 1st, 2019). The senior medical students were recruited using a structured self-administered questionnaire and electronic forms. Data were entered into an excel spreadsheet and analysed with IBM SPSS version 25.0 for windows. The knowledge level was divided into tertiles (poor, moderate and good) while the attitudes and practices were divided into poor

关键词： Senior Medical Students Rheumatic Heart Disease Cameroon Attitude Knowledge and Practice General Practitioners

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Predictors of Fatal Outcome in Hospitalised Adult Patients with Acute Kidney Injury at Two Tertiary Hospitals in Sub-Saharan Africa

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Open Journal of Nephrology 2024年第1期14卷 86-103页

作者： denis georges Teuwafeu Fombo Enjeh Jabbossung Maimouna Mahamat Eric Aristide Nono Tomta Mbapah Leslie Tasha Francois Kaze Folefack Gloria Ashuntantang Faculty of Health Sciences University of Buea Buea Cameroon Triad Research Fundation Buea Cameroon Faculty of Medicine and Biomedical Sciences University of Yaounde I Yaounde Cameroon Department of nephrology Yaounde General Hospital Yaounde Cameroon Departement of Nephrology Yauonde Teaching Hospital Yaounde Cameroon

Introduction: Data on mortality in acute kidney injury (AKI) derives from high-income countries where AKI is hospital-acquired and occurs in elderly patients with a high burden of cardiovascular disease. In sub-Saharan Africa (SSA), AKI is community-acquired occurring in healthy young adults. We aimed to identify predictors of fatal outcomes in patients with AKI in two tertiary hospitals in Cameroon. Methods: Medical records of adults with confirmed AKI, from January 2018 to March 2020 were retrieved. The outcomes of interest were in-hospital deaths and presumed causes of death. We used multiple logistic regressions modeling to identify predictors of death. The study was approved by the ethics boards of both hospitals. Values were considered significant for a p-value of 0.05. Results: We included 285 patient records (37.2% females). The mean (SD) age was 50.1 (19.0) years. Hypertension (n = 97, 34.0%), organ failure (n = 88, 30.9%), and diabetes (n = 60, 21.1%) were the main comorbidities. The majority of patients had community-acquired AKI (78.6%, n = 224), were KDIGO stage 3 (88.8%, n = 253), and needed dialysis (52.6%, n = 150). Up to 16.7% (n = 25) did not receive what was needed. The in-hospital mortality rate was 29.1% (n = 83). Lack of access to dialysis (OR = 27.8;CI: 5.2 - 149.3, p = 0.001), hypotension (OR = 11.8;CI: 1.3 - 24.8;p = 0.001) and ICU admission (OR = 5.7;CI: 1.3 - 24.8, p = 0.001) were predictors of mortality. The presence of co-morbidities or underlying diseases (n = 46, 55%) were the main causes of death. Conclusions: In-hospital AKI mortality is high, as in other low- and middle-income economies. Lack of access to dialysis and the severity of the underlying illness are major predictors of death.

关键词： Predictors Fatal Outcome Acute Kidney Injury Tertiary Hospital

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Spectrum of Neurological Disorders amongst Patients on Maintenance Haemodialysis in Douala, Cameroon: A Cross-Sectional Study

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Open Journal of Nephrology 2022年第1期12卷 112-123页

作者： Halle Marie Patrice Tchouamou Tchouamou Eric Gildas Fouda Hermine Gams Massi Daniel Ngamby Vincent Ebenezer tewafeu denis Kaze Folefack Francois Mapoure Njankouo Yacouba Faculty of Medicine and Pharmaceutical Sciences University of Douala Douala Cameroon Department of Internal Medicine Douala General Hospital Douala Cameroon Faculty of Medicine and Biomedical Sciences University of Yaounde I Yaounde Cameroon Faculty of Health Sciences University of Buea Buea Cameroon Department of Internal Medicine Douala Laquintinie Hospital Douala Cameroon Department of Internal Medicine Regional Hospital of Buea Buea Cameroon Yaounde Teaching Hospital Yaounde Cameroon

Context: Neurologic disorders are common in patients on maintenance haemodialysis (MHD). Data in Sub-Saharan Africa are scarce. Aim: To determine the prevalence and associated factors of neurological disorders amongst patients on MHD in Cameroon. Settings and Design: This was a four-month cross-sectional study carried out at the Douala General Hospital (DGH) a tertiary referral hospital in Cameroon. Methods: The diagnosis of neuropathy was made using the Michigan Neuropathy Screening Instrument (MNSI), neuropathic pain with the DN4 score, Restless Legs Syndrome (RLS) with the International Restless Legs Syndrome Study Group questionnaire (IRLSSG) and cognitive disorders with the Mini-Mental State Examination test (MMS). Student T and Chi-square tests were used to compare qualitative and quantitative variables. The level of significance was set at p Results: A total of 157 patients were included with 65% being males. The mean age was 48.8 ± 13.7 years. The main comorbidities were hypertension (90.4%), diabetes (19.1%), hepatitis C (10.5%) and HIV infection (10.8%). The median dialysis vintage was 36 (1 - 178) months. The overall prevalence of neurological disorders was 85.4%. The leading type was sensory polyneuropathy (57.3%), cognitive dysfunction (52.9%), neuropathic pain (23%), and restless legs syndrome (17.8%). Male gender was statistically associated with neuropathic pain, while age ≥ 40 years and diabetes were associated with sensory neuropathy and RLS. Conclusions: The burden of neurological disorders is high among patients on MHD as up to 4/5 of them had neurological involvement dominated by sensory polyneuropathy and cognitive dysfunction.

关键词： Neurological Disorder Haemodialysis Prevalence Cameroon

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Epidemiological and Clinical Profiles of Chronic Kidney Disease Patients Presenting for Emergency Hemodialysis: A Five-Year Retrospective Study in Two Dialysis Centres in Cameroon

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Open Journal of Nephrology 2022年第1期12卷 75-86页

作者： denis georges Teuwafeu Nlend Bah Joseph Maimouna Mahamat Nono Aristide Kaze Folefack Francois Ashuntantang Gloria Faculty of Health Sciences University of Buea Buea Cameroon General Hospital Yaoundé Yaoundé Cameroon Yaoundé University Teaching Hospital Yaoundé Cameroon Faculty of Medicine and Biomedical Sciences University of Yaoundé 1 Yaoundé Cameroon Faculty of Health Sciences University of Bamenda Bamenda Cameroon

Background: Late referral of Chronic Kidney Disease (CKD) patients requiring emergency hemodialysis (HD) for survival poses a serious threat to global health particularly in sub-Saharan Africa (SSA). Objective: Describe the epidemiological and clinical profiles of CKD patients starting HD in emergency. Methodology: This was a retrospective cross-sectional study. Files of patient files of CKD patients who underwent dialysis from January 1st, 2016 to December 31st, 2020 were reviewed at the HD centres of the two main hospitals of the Cameroon city capital, Yaoundé. We included all emergency HD for End Stage Renal Disease (ESRD). Socio-demographic and clinical data including past medical history, signs and symptoms at presentation and indications for emergency HD were recorded. Emergency HD was defined as a dialysis session performed in ESRD with a temporary vascular access. Data were analyzed using Statistical Package for Social Sciences (SPSS) software version 26 for Windows. Results: Out of 700 recorded CKD patients who started HD, 570 underwent an emergency HD, thus a prevalence of 81.43%. We included 311 patients, 63.7% were males. The mean age was 47.05 ± 15.60 years ranging from 8 to 83 years with a modal age group of 40 - 59 years. The most prevalent co morbidities were hypertension (66.2%), diabetes mellitus (28.6%) and HIV infection (10%). The commonest presenting symptoms were asthenia (68.2%), lower limbs swelling (52.1%) and anorexia (41.8%) and the main clinical signs were high blood pressure (74.92%), and pallor (60.5%) and altered general state (55%). The indications for emergency HD were dominated by uremic encephalopathy (33.4%) and pulmonary oedema (25.7%). Conclusion: More than eight out of ten CKD patients start emergency HD. Patients are mostly middle-aged adults with a male predominance. Hypertension and diabetes mellitus remain the most common co morbidities and uremic encephalopathy is by far the first indication for emerg

关键词： Epidemiology Clinical Profile Chronic Kidney Disease Emergency Hemodialysis Cameroon

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Impacts of Field Harvesting and Conservation Practices on the Physical Quality of Yam “Kponan” (Dioscorea cayenensis-rotundata) of Côte D’Ivoire

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Open Journal of Applied Sciences 2022年第12期12卷 1979-1994页

作者： Yapo Hypolithe Kouadio Kouakou Nestor Kouassi Daouda Nimaga Yao denis N’dri N’Guessan georges Amani Laboratory of Food Biochemistry and Technology of Tropical Products Department of Food Science and Technology NANGUI ABROGOUA University Abidjan C&ocirc te D’Ivoire Swiss Center for Scientific Research in Cô te d’Ivoire (CSRS-CI) Abidjan C&ocirc te D’Ivoire Agronomic Forestry and Environmental Engineering Department University of Man Man C&ocirc te D’Ivoire

Yam “Kponan” (Dioscorea cayenensis-rotundata) is a popular staple food in Côte d’Ivoire. However, its rapid decay during conservation prevents regular supply of markets. The objective of this study was therefore to assess the impact of field cultivation and conservation practices on some physical quality parameters of “Kponan”. To this end, “Kponan” yam from three production areas (Bondoukou, Bouna, Kouassi-Kouassikro) was cultivated in each area. At maturity, physical parameters of yams at harvest and after 3 months of storage in field were analyzed. The results showed that injury was the most significant deterioration in yam harvest. The rate of injured yams was highest for hoe-harvested in Kouassi-Kouassikro area (16.67% - 22.22%) regardless of the origin of the cuttings. The main damage observed after the 3 months of storage was rots (22.86% - 60.00%) and weight loss (8.57% - 42.86%). However, yams stored in pits in Bouna zone had less damage (40% - 48.87%) than those stored under straw huts in Bondoukou locality (100%) and at shade under a tree in Kouassi-Kouassikro area (100%). In conclusion, the physical quality of “Kponan” in field is most affected by abusive use of herbicides during weeding and clearing, hoe harvesting and storage in the shade under a tree.

关键词： “Kponan” Yam Post-Harvest Loss Cultivation Practices Conservation Practices Physical Quality

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Early Mortality (120 Days) amongst Incident Hemodialysis with End Stage Kidney Disease: A 5-Year Retrospective Study

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Open Journal of Nephrology 2022年第3期12卷 332-346页

作者： denis georges Teuwafeu Dianna Fontania Mafouk Fopa Halle Marie Patrice Ronald Gobina Hermine Fouda Kaze Folefack Francois Faculty of Health Sciences University of Buea Buea Cameroon

Background: End stage kidney failure (ESKF) is a major public health problem worldwide. Haemodialysis is the principal method in its management, and is associated with high mortality mostly owing to cardiovascular disease (CVD). In Cameroon, data on its predictors is lacking. Objectives: This study aimed at determining the 120 day mortality, causes of death and its predictors and amongst incident haemodialysis patients with end stage kidney disease in Cameroon. Methods: We retrospectively reviewed medical records of patients admitted for ESKF who started haemodialysis between January 2016 and December 2020 (5 years) and who died within 120 days. For these patients, the variables collected were: age, gender, comorbidities, dialysis parameters, para-clinical parameters, cause of death. The causes of death were registered as stated by the attending physician. Data were analysed using SPSS 20. A p-value Results: Out of 1012 incident patients, 258 died giving a mortality rate of 25.5%. Of these, 59.7% were males. The mean age (SD) was 46.52 (15.6) years. The main causes of death included sepsis (45.61%), CVD (12.86%), and severe anaemia (9.94%);and were comparable between males and females except for anaemia which was more prevalent in females (p = 0.003). Catheters related infections (77.9%), and chest infections (9.0%) were the main sources of sepsis while sudden death (76.2%), myocardial infarction (9.5%), and heart failure (9.5%) were the main cardiovascular causes of death. Hypertension (65%), CVD (35.6%), and diabetes (9.19%) were the main comorbidities associated to death. The main vascular access was central venous catheter 96%. CVD (p = 0016, aOR;4.107), Albumin ≤ 3.5 g/dl (p = 0.015, aOR;23.083), and Creatinine > 20 mg/dl (p = 0.024, aOR;5.649) were independent predictors of mortality. Conclusion: One in four patients on haemodialysis died early. CVD, hypoalbuminemia and late initiation were predictors of mortality. Majority of patients die from preventable cau

关键词： Early Mortality Predictors Causes of Death Haemodialysis Cameroon

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Role of Lung Ultrasound in the Assessment of Hydration Status of Chronic Haemodialysis Patients

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Open Journal of Radiology 2023年第1期13卷 1-16页

作者： Sylviane Fomekong Dongmo Jean-Roger Tapouh Moulion denis georges Teuwafeu Samory Guedje Chuangueu François Jérôme Folefack Kaze Boniface Moifo Department of Internal Medicine and Paediatrics Faculty of Health Sciences University of Buea Buea Cameroon Department of Radiology Faculty of Medicine and Pharmaceutical Sciences University of Dschang Dschang Cameroon Department of Internal Medicine and Specialties Faculty of Medicine and Biomedical Sciences University of Yaoundé 1 Yaoundé Cameroon Department of Radiology and Medical Imaging Faculty of Medicine and Biomedical Sciences University of Yaoundé 1 Yaoundé Cameroon

Background: Fluid overload is frequent in Haemodialysis (HD) and is one of the major factors of cardiovascular morbidity and mortality for chronic HD patients. The main challenge with chronic haemodialysis patients is indeed the maintenance of a normal extracellular volume through dry weight determination. Our study aimed at assessing the role of lung ultrasound in the detection of B-lines for the determination of hydration status in chronic HD patients. Methods: We conducted a cross-sectional study including 31 patients undergoing chronic HD treatment for at least 3 months, in the Yaounde University Teaching Hospital dialysis unit. Lung ultrasonography and clinical examinations were performed immediately before dialysis, and 30 minutes after dialysis. Differences between clinical and ultrasound variables before and after dialysis were measured to assess the effects of dialysis. Association between categorical variables was assessed with the Chi-squared test or Fischer test, and Rho’s Spearman coefficient for quantitative variables. Results: There was a reduction in the median of B-lines score after dialysis [12 (7 - 26) versus 8 (5 - 13)], clinical score [2 (1 - 3) versus 0 (-1 - 2)], mean of systolic blood pressure (164.74 ± 26.50 versus 158.48 ± 27.89), frequency of dyspnoea in patients (32.3% versus 6.5%);and raising of the frequency of cramps in patients (0% versus 19.4%) and all statistically significant (p ≤ 0.031). B-lines score before and after dialysis was associated with dyspnoea and raised jugular venous pressure (p Conclusion: Lung ultrasound for the detection of B-lines reflects the variation of extracellular volume during dialysis and can even capture pulmonary oedema at a pre-clinical stage. It is then a reliable and sensible method for assessing extravascular lung water and thus hydration status of haemodialysis patients. It could constitute a better alternative for an objective and accurate definition of dry weight, specifically in the African and

关键词： Haemodialysis Lung Ultrasound B-Lines Hydration Status Clinical Score

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A new hemostatic agent composed of Zn^(2+)-enriched Ca^(2+)alginate activates vascular endothelial cells in vitro and promotes tissue repair in vivo

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Bioactive Materials 2022年第12期7卷 368-382页

作者： Anne-Charlotte Ponsen Richard Proust Sabrina Soave Françoise Mercier-Nom´e Isabelle Garcin Laurent Combettes Jean-Jacques Lataillade georges Uzan INSERM UMRS-MD 1197 Universit´e Paris-SaclayInstitut Andr´e LwoffHˆopital Paul BrousseVillejuifFrance Plateforme d’Histologie Immunopathologie de Clamart(PHIC) Universit´e Paris-SaclayINSERMCNRSInstitut Paris Saclay d’Innovation Th´erapeutiqueChˆatenay-MalabryFrance Universit´e Paris-Saclay INSERMInflammationMicrobiome and ImmunosurveillanceClamartFrance INSERM UMRS 1174 Universit´e Paris-SaclayOrsayFrance Centre de Transfusion Sanguine des Arm´ees ClamartFrance

To control capillary bleeding, surgeons may use absorbable hemostatic agents, such as Surgicel® and TachoSil®. Due to their slow resorption, their persistence in situ can have a negative impact on tissue repair in the resected organ. To avoid complications and obtain a hemostatic agent that promotes tissue repair, a zinc-supplemented calcium alginate compress was developed: HEMO-IONIC®. This compress is non-absorbable and is therefore removed once hemostasis has been achieved. After demonstrating the hemostatic efficacy and stability of the blood clot obtained with HEMO-IONIC, the impact of Surgicel, TachoSil, and HEMO-IONIC on cell activation and tissue repair were compared (i) in vitro on endothelial cells, which are essential to tissue repair, and (ii) in vivo in a mouse skin excision model. In vitro, only HEMO-IONIC maintained the phenotypic and functional properties of endothelial cells and induced their migration. In comparison, Surgicel was found to be highly cytotoxic, and TachoSil inhibited endothelial cell migration. In vivo, only HEMO-IONIC increased angiogenesis, the recruitment of cells essential to tissue repair (macrophages, fibroblasts, and epithelial cells), and accelerated maturation of the extracellular matrix. These results demonstrate that a zinc-supplemented calcium alginate, HEMO-IONIC, applied for 10 min at the end of surgery and then removed has a long-term positive effect on all phases of tissue repair.

关键词： Hemostatic agent Alginate Surgery Hemostasis Endothelial cells Tissue repair

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Intradialytic Hypertension and Associated Factors among Chronic Haemodialysed Patients in Sub-Saharan Africa: An Example from Cameroon

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Open Journal of Nephrology 2018年第4期8卷 105-116页

作者： Halle Marie Patrice Bana Eric Loic Fouda Hermine Nda Mefo’o Jean Pierre tewafeu denis Kaze Folefack Francois Ashuntantang Enow Gloria Faculty of Medicine and Pharmaceutical Sciences University of DoualaCameroon Faculty of Medicine and Biomedical Sciences University of Yaounde IYaoundeCameroon Faculty of Health Sciences University of BueaBueaCameroon

Background: Hemodialysis (HD) is a therapy during which complications such as intradialytic hypertension (IDH) are frequent. We aimed to determine the incidence of IDH and associated factors amongst patients on maintenance hemodialysis in Cameroon. Method: It was a prospective cohort study including end stage kidney disease patients on HD. Data collected were: socio-demographic, comorbidities, current medication, weight, heart rate ultrafiltration rate (UF), albuminemia and electrocardiogram. The first blood pressure (BP) measurement was obtained at the beginning of the session and the last at the end. IDH was defined as an increase in systolic BP ≥ 10 mmHg between the first and the last measurement. Logistic regression was used to look for associated factors, p-value Results: Mean age was 49.06 ± 13.97 years with 64.2% males. Mean number of dialysis session was 11.26 ± 2.49. Incidence of IDH was 48.36%. The median number of IDH episodes was 5 (Range 0 - 12). Factors increasing the risk were hypertension (p = 0.003), number of antihypertensive drugs ≥ 2 (p Conclusion: IDH is frequent amongst patients on maintenance hemodialysis in our setting, with various patients related factors associated.

关键词： Hemodialysis Intradialytic Hypertension Incidence Associated Factors Cameroon

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Glycemic Index and Glycemic Load of Selected Staples Based on Rice,Yam and Cassava Commonly Consumed in Cote d’Ivoire

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Food and Nutrition Sciences 2014年第4期5卷 308-315页

作者： Camille Adam Kouamé Nestor Kouakou Kouassi Aissatou Coulibaly denis Yao N’dri georges Gnomblesson Tiahou Lokrou Adrien georges N’guessan Amani Laboratory of Food Biochemistry and Tropical Products Technology Nutrition and Food Safety SectionDepartment of Food Sci-ence and TechnologyNangui Abrogoua UniversityAbidjanCote d’Ivoire Laboratory of Food Biochemistry and Tropical Prod-ucts Technology Biochemistry SectionDepartment of Food Science and TechnologyNangui Abrogoua UniversityAbidjanCote d’Ivoire Laboratory of Nutrition and Food Safety Department of Food Science and TechnologyNangui Abrogoua UniversityAbidjanCote d’Ivoire Laboratory of Medical Biochemical Faculty of Medical SciencesFelix Houphouet-Boigny UniversityAbidjanCote d’Ivoire Endocrinology and Metabolic Diseases Department Centre Hospitalier Universitaire(CHU)de YopougonAbidjanCote d’Ivoire

Integrating information on the glycemic index (GI) and the glycemic load (GL) of diet is limited in C?te d’Ivoire because of the lack of data. Thus, this study was undertaking for the local management and prevention of diabetes mellitus and its complications based on nutritional data (GI and GL values). The study included ten healthy subjects with 7 males, 3 females (28 ± 2 years on average age and 20.5 ± 1.7 on average BMI). Participants tested three different meals with equal carbohydrate load (50 g). Blood samples were obtained at 0, 15, 30, 45, 60, 90 and 120 min before and after consumption for glucose levels determination. GIs were determined using a standard method with glucose as reference food and data were used for GLs calculating. Data showed that GIs value of pounded yam with eggplant sauce and cassava paste with granulates palm nut sauce were high ranging to 94 to 86 respectively while rice with groundnut sauce, have a low GI (GI = 45). Nevertheless, the GLs of the all the test foods are high with the values of 47, 43 and 23 (g) for pounded yam with eggplant sauce, cassava paste with granulates palm nut sauce and rice with groundnut sauce respectively. According to GIs and GLs data, the three test foods must be consumed moderately in a diet. So, it is important to associate GL data to GI data of Ivorian traditional foods for the management and the prevention of diabetes mellitus in C?te d’Ivoire and in others countries sharing the same food tradition.

关键词： Diabetes Mellitus Management Prevention Glycemic Index Glycemic Load Ivorian Traditional Foods

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