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Hospital Outcome of Newborns with a Health Cheque System in Comparison to Those Without

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Open Journal of Pediatrics 2023年第2期13卷 164-169页

作者： Kamo Sélangaï Doka Hélène Tony Nengom Jocelyn Naiza Monono Epée Jeannette Mekone Nkwele Isabelle Mbardjouk aoudi Stephane Sap Suzanne Faculty of Medicine and Biomedical Sciences of Garoua University of Ngaoundéré Ngaoundéré Cameroon Faculty of Medicine and Biomedical Sciences of the University of Yaoundé I Yaoundé Cameroon Department of Internal Medicine and Paediatrics Faculty of Health Sciences University of Buea Buea Cameroon

Introduction: The health cheque system is a prepayment mechanism aimed at reducing neonatal and maternal mortality through improving the management of pregnant women. The pregnant woman with the health cheque system that she pays at six thousand francs XAF (African financial community) is covered free of charge for all the care provided by the cheque system in the health facilities accredited to the health cheque project. We did a study, with objective to determine the hospital outcome of newborns with a health cheque system (HCS) compared to those without health cheque system. Method: A descriptive cross-sectional study with retrospective data collection was carried out at the Ngaoundere Regional Hospital from January 2018 to September 2021. Results: During our study period, 2985 newborns were received. We saw an increase in admissions over the years, particularly in the group of newborns with the health cheque system. Comparatively, the percentage of newborns cured in the health cheque system group was 76.73% (n = 1643) versus 77.72% (n = 656) those in the non-health cheque system group. Those who died were 8.96% (n = 192) in the health cheque system group compared to 6.27% (n = 53) in the non-health cheque system group. Conclusions and Recommendations: Most patients admitted to our service have the health cheque system. We notice an increase in hospital attendance with the health cheque project. The outcome of the newborn under the health cheque system is not different from that without health cheque system. The health cheque system was successful in getting the larger number of newborns into care. The next step is to put strategies in place to keep these patients in care for the duration of hospitalization.

关键词： Outcome Newborns Health Cheque System

Prevalence, Indications and Morbidity of Caesarean Sections in a Referral Hospital of the Health Voucher Program: The Case of Garoua Regional Hospital in the Northern Region of Cameroon

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Open Journal of Obstetrics and Gynecology 2023年第12期13卷 1949-1964页

作者： Mbarnjuk aoudi Stéphane Kabko Mbargang Georges Ngalame Alphonse Nyong Ourtchingh Clovis Mangala Nkwele Fulbert Anicet Gakdang Ladibe Tameh Theodore Yangsi Neng Humphry Tatah Koudjou Blaise Halle-Ekane Gregory Edie Department of Gynecology & Obstetrics Faculty of Medicine and Biomedical Sciences University of Garoua Garoua Cameroon Gynecology & Obstetrics Unit Garoua General Hospital Garoua Cameroon Department of Surgery and Specialties Faculty of Health Sciences University of Buea Buea Cameroon Douala Gyneco-Obstetric and Pediatric Hospital Faculty of Health Sciences (FHS) University of Buea Buea Cameroon Gynecology & Obstetrics Unit Maroua Regional Hospital Maroua Cameroon Nkongsamba Regional Hospital Faculty of Medicine and Pharmaceutical Sciences University of Douala Douala Cameroon Faculty of Medicine and Biomedical Sciences University of Yaoundé 1 Yaoundé Cameroon Nkongsamba Regional Hospital Faculty of Health Sciences University of Bamenda Bamenda Cameroon Douala General Hospital Dean Faculty of Health Sciences (FHS) University of Buea Buea Cameroon

Caesarean section (CS) is a surgical procedure performed to remove a fetus from the mother’s uterus through an incision on the abdominal wall, then on the uterine wall. The indications of CS vary not only between countries, but also from one hospital to another and from one team to another within the same hospital. Despite advances in asepsis and anesthesia/resuscitation technics, there are still complications of varying severity inherent to the gravid-puerperal state on one hand and the technics used on the other, irrespective of the operative indication. Thus, the present study was carried out with the objectives of determining the prevalence, identifying the indications, and evaluating the morbidity linked to caesarean sections in our environment. Cameroon has also set up a health voucher program in its northern region, aimed at reducing maternal and fetus morbidity and mortality. The program aims to improve financial access in antenatal care and deliveries, including caesarean sections, in this low-income region of the country. We conducted a descriptive cross-sectional study with retrospective data collection, from February 1, 2022, to May 31, 2022. We included all women who gave birth by caesarean section. In our study series, out of 905 parturient admissions into the Department of Obstetrics and Gynecology, 226 were caesarian cases. The overall frequency of CS during our study period was 25%. Fetal indications were dominated by cephalopelvic disproportion and non-reassuring fetal heart in 17.3% and 13.7% of cases respectively. Intraoperative complications were dominated by hemorrhage (15.5%). In our study, we noted an 11.1% of prevalence perinatal mortality. Cameroon is a low-income country with limited financial resources, especially in the Northern region. The health voucher program has improved financial access to caesarean sections for parturient in northern Cameroon, and consequently to emergency obstetric and neonatal care.

关键词： Caesarean Section Health Voucher Cephalon-Pelvic Disproportion Hemorrhage

Hepatitis B Surface Antigen Serum Level Is Correlated with Fibrosis Severity in Treatment-Naïve, Chronic Hepatitis B Patients in Côte d’Ivoire (West Africa)?

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Open Journal of Gastroenterology 2015年第11期5卷 164-172页

作者： Mamert Fulgence Yao Bathaix Dramane Soro Aboubacar Demba Bangoura Adjéka Stanislas Doffou Siaka Koné Ya Henriette Kissy Dimitri Hartrydt Kouamé aoudi Ousmane Dé Mahassadi Kouamé Alassane Attia Koffi Alain Aya Thérèse N’dri Yoman Department of Hepatology and Gastroenterology of the Centre Hospitalier Universitaire de Yopougon (CHU-Y) Abidjan Cote d’Ivoire Department of Hepatology and Gastroenterology of the Centre Hospitalier Universitaire de Cocody (CHU-C) Abidjan Cote d’Ivoire

HBsAg serum level (quantification) may be useful for managing hepatitis B virus (HBV) infection patients. However few studies especially in Africa have evaluated the association between HBsAg serum level and liver fibrosis severity. The objective of this study was to estimate the correlation between HBsAg serum level and liver fibrosis severity with treatment naive chronic hepatitis B patients in Cote d’Ivoire. Methodology: It is a prospective study covering from February 1st, 2014 to April 30st, 2015 at Centre Hospitalier et Universitaire de Yopougon and a private medical office in Abidjan, Cote d’Ivoire. Inclusion criteria for patients were: HBsAg positive, known HBeAg status, serum HBsAg levels, serum HBV DNA levels, complex serum markers and absence of HCV, HDV, or HIV co-infection, drinking more than 30 g/day for men and 20 g/day in women over 10 years, metabolic disease and/or hepatic overload. Pearson’s Chi-square test (r2), Anova, Spearman, T-Student, Pearson’s (r) correlations and Mann Withney’s Test were carried out as appropriate. A p value < 0.05 was taken as significant. Results: We recruited, 105 patients (77 men) of whom the medium age was 39.01 ± 9.72 years. Predominant hepatitis B viral genotype was E (93%). Less than 10% patients had an inactive HBV in HBeAg-negative. Patients had an average high HBsAg serum level (mean 12111.2 ± 10617.4 IU/ml) as well as the one viral load (mean 4.4 e7 ± 7.5 e7). Serum ALAT levels averaged at the upper limit of normal value. The average liver fibrosis score was 0.34 ± 0.22 and the degree of viral activity was 0.19 ± 0.20. Half of our patients had no fibrosis (35.24%) or had mild fibrosis (20.95%). No significant association was observed between HBsAg serum level and patient age (p = 0.3994), genre (p = 0.8075) or serum ALT levels (p = 0, 0787). In multivariate analysis, there’s a significant correlation (r = 0.239, p = 0.014) between HBV DNA levels and HBsAg serum level. There’s a significant correlation (r = 0.92

关键词： Hepatitis B Surface Antigen Serum Level Liver Fibrosis Chronic Hepatitis B Viral Africa

Prognostic Factors for Cirrhosis Hospital in Abidjan (Cote d’Ivoire)

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Open Journal of Gastroenterology 2015年第7期5卷 103-109页

作者： Mamert Fulgence Yao Bathaix Akelesso Bagny Kouamé Alassane Mahassadi Anassé Jean-Baptiste Okon Ya Henriette Kissi-Anzouan Stanislas Doffou Aboubacar Demba Bangoura Hatrydt Dimitri Kouamé Kadiatou Diallo Antonin N’Dam aoudi Ousman De Koffi Alain Attia Aya Thérèse N’dri Yoman Department of Hepatology and Gastroenterology of the Centre Hospitalier Universitaire de Yopougon (CHU-Y) Abidjan Cote d’Ivoire

Cirrhosis is the cause of a high rate of death in hospitals. The aim of this research was to estimate the incidence of mortality and identify the risk factors associated with cirrhosis patients in hospital in Cote d’Ivoire. Methodology: It is a retrospective study covering from January 1st, 2002 to December 31st, 2011 at Centre Hospitalier et Universitaire de Yopougon in Abidjan. We concerned the cirrhosis patients that have been followed at the hepatology and gastroenterology department. Survival was estimated by the Kaplan-Meier curve and comparison of survival curves by the log-rank test. The multi-varied analysis of the survivals has been achieved with the Cox proportional Hazard regression. A p value < 0.05 was taken as significant. Results: We recruited, 221 patients (135 men) of whom the medium age was 59 ± 15.12 years. Among those patients, 34.5% were classified as Child Pugh C and 52.94% Child Pugh B, 19.45% suffered from digestive hemorrhage, 26.5% suffered from renal deficiency, 47% suffered from hepatic encephalopathy and 10.7% from hyponatremia. The median overall survival of patients was 0.50 person-months. The variables that were significantly associated to a reduction of survival were hepatic encephalopathy (p = 0.0029), spontaneous ascitesfluid infection (p = 0.0208), hyponatremia (p = 0.0434) and stage Cof Child- Pugh score (p = 0.046). Conclusion: The incidence of mortality in cirrhotic patients hospitalized in Abidjan is high. Pejorative prognostic factors were essentially hepatic encephalopathy, spontaneous ascites fluid infection, hyponatremia and stage C of Child-Pugh score.

关键词： Cirrhosis Portal Hypertension Child-Pugh Encephalopathy Prognostic Cote d’Ivoire