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Stigma and epilepsy in onchocerciasisendemic regions in Africa:a review and recommendations from the onchocerciasisassociated epilepsy working group

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Infectious Diseases of Poverty 2019年第3期8卷 21-31页

作者： Sarah O'Neill Julia Irani Joseph Nelson Siewe Fodjo denis nono Catherine Abbo Yasuaki Sato Augustine Mugarura Housseini Dolo Maya Ronse Alfred K.Njamnshi Robert Colebunders CRISS-School of Public Health Universite Libre de Bruxelles and LAMC Faculte de Philosophie et de Sciences Sociales Universite Libre de BruxellesBrusselsBelgium Department of Public health Institute o f Tropical MedicineAntwerpBelgium Global Health Institute University of AntwerpAntwerpBelgium Department of Mental Health Austrian Partnership Programme in Higher Education and Research for Developm ent(APPEAR)Project&AVSI FoundationGulu UniversityGuluUganda Department of Psychiatry Makerere UniversityKampalaUganda Department of Environmental Science and Technology Osaka Sangyo UniversityOsakaJapan Epilepsy Support Association of Uganda WakisoUganda Department of Neurology Yaounde Central Hospital/FMBSThe University of Yaounde IBrain Research Africa Initiative(BRAIN)YaoundeCameroon

Background:In onchocerciasis-endemic areas,particularly in those with a sub-optimal onchocerciasis control programme,a high prevalence of epilepsy is *** onchocerciasis and epilepsy are stigmatizing *** first international workshop on onchocerciasis-associated epilepsy(OAE)was held in Antwerp,Belgium(12-14 October 2017)and during this meeting,an OAE alliance was *** this paper,we review what is known about epilepsy-associated stigma in onchocerciasis-endemic regions,and present the recommendations of the OAE alliance working group on *** body:For this scoping review,literature searches were performed on the electronic databases PubMed,Scopus and Science Direct using the search terms"epilepsy AND onchocerciasis AND stigma".Hand searches were also undertaken using Google Scholar,and in total seven papers were identified that addressed epilepsy-related stigma in an onchocercisasis-endemic *** to the limited number of published research papers on epilepsyassociated stigma in onchocerciasis-endemic areas,other relevant literature that describes important aspects related to stigma is *** thematic presentation of this scoping review follows key insights on the barriers to alleviating the social consequences of stigma in highly affected onchocerciasis-endemic areas,which were established by experts during the working group on stigma and discrimination at the first international workshop on *** themes are:knowledge gaps,perceived disease aetiology,access to education,marriage restrictions,psycho-social well-being,burden on the care-giver and treatment seeking *** on the literature and expert discussions during the OAE working group on stigma,this paper describes important issues regarding epilepsy-related stigma in onchocerciasis-endemic regions and recommends interventions that are needed to reduce stigma and discrimination for the improvement of the psycho-social well-being of persons with ***

关键词： Epilepsy Onchocerciasis Stigma,Anti-epileptic treatment Nodding syndrome Discrimination Misconception,Africa

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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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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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