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Normal Range of Neutrophile to Lymphocyte Ratio in Healthy, Chronic Kidney Disease Stage 4 - 5 and Hemodialysis Participant in a Sub-Saharan African Context

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Open Journal of Nephrology 2024年第1期14卷 104-114页

作者： Fouda Menye Epse Ebana Hermine Danielle Elimby Lionel Thierry Sevele Deussi De Ngaha Bogne Takam Yvan Halle Marie-Patrice eveline ngouadjeu dongho Department of Medicine and Specialties General Hospital of Douala Douala Cameroon Department of Internal Medicine and specialties Faculty of Medicine and Biomedical Sciences of Yaounde Yaounde Cameroon Department of Internal Medicine and specialties Faculty of Medicine and Pharmaceutic Sciences of Douala Douala Cameroon

Background: Neutrophile to lymphocyte ratio (NLR) is a well-established marker of inflammation. It has been reported to be high in chronic kidney disease (CKD) and it is described as a prognosis factor in hemodialysis patients. However, limited data are available about the normal range of NLR in healthy adults as well as CKD patients including hemodialysis black Africans in Sub-Saharan countries. We sought to study NLR in healthy and advanced CKD in a single Cameroonian health facility. Methods: Blood samples were obtained from blood donors, CKD stage 4 and non-dialysis stage 5, and hemodialysis patients for more than 6 months. Patients with confounding factors such as positive CRP, infection, and recent use of steroids were excluded. RNL means standard deviations (SDs), and 95% confidence intervals (95% CI) were determined. RNL range was defined as percentiles P2.5 to P97.5. Results: A total of 102 participants were included. Mean age was 40.45 ± 9.97 years and 58.8% were male. Age and sex distribution were similar in the three groups. Leucopenia and neutropenia were common in all the groups. Means NLR was 1.29 ± 0.57 (95% CI 1.08 - 1.49) range between 0.55 to 2.67;2.31 ± 1.3 (95% CI 1.75 - 2.88) with range between 0.69 to 4.31 and 2.14 ± 0.98 (95% CI 1.85 - 2.44) with range between 0.77 to 4.32 respectively in controls, CKD, and hemodialysis participants. NLR was comparable in CKD and hemodialysis patients (p = 0.99). Compared to controls, NLR was significantly elevated in CKD (p = 0.043) and hemodialysis patients (p Conclusion: Our data suggest that the normal range for NLR in adult nongeriatric healthy and advanced CKD patients including those on chronic hemodialysis may vary between 0.55 to 2.67 and 0.69 to 4.32 respectively.

关键词： NLR CKD Hemodialysis Cameroon

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Normal Range of Neutrophile to Lymphocyte Ratio in Healthy, Chronic Kidney Disease Stage 4 - 5 and Hemodialysis Participant in a Sub-Saharan African Context

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Open Journal of Nephrology（肾脏病） 2024年第1期 104页

作者： Fouda Menye Epse Ebana Hermine Danielle Elimby Lionel Thierry Sevele Deussi De Ngaha Bogne Takam Yvan Halle Marie-Patrice eveline ngouadjeu dongho

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Factors Associated with Haemolytic Anaemia in the Internal Medicine Department of the Douala General Hospital in Cameroon

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Open Journal of Blood Diseases 2023年第2期13卷 83-91页

作者： eveline ngouadjeu dongho Brice Utrich Afana Clémence Olemba Jean Pierre Nda Mefo’o Cécile Ebongue Okalla Abdou Temfomo Jules Clement Nguedia Assob Henry Namme Luma Department of Internal Medicine Douala General Hospital Douala Cameroon Department of Biological Sciences Faculty of Medicine and Pharmaceutical Sciences University of Douala Douala Cameroon Department of Microbiology Virology and Immunology Faculty of Medicine and Biomedical Sciences University of Yaoundé 1 Yaounde Cameroon

Introduction: Haemolytic anaemia (HA) is defined as a decrease in haemoglobin (Hb) levels below baseline due to excessive and premature destruction of red blood cells (RBCs) in the periphery resulting in a shortened life span of less than 120 days. Haemolysis can be corpuscular or extra-corpuscular. The aim of our study was to investigate the factors associated with it for optimal management of patients hospitalised in internal medicine at the Douala General Hospital (DGH). Methodology: We conducted an analytical cross-sectional study, including all patients admitted to the internal medicine department of the DGH from 11 February to 20 May 2022, and excluding patients with non-compliant samples. The search for haemolytic anaemia was carried out by means of blood count, reticulocyte count, blood smear, unconjugated bilirubin, lactate dehydrogenase and direct Coombs test. Sociodemographic, clinical and biological parameters were collected and analysed. Correlation was defined for a p value 0.05. Results: This study included 147 patients, 50.34% of whom were men, for a sex ratio of 1.01. The mean age was 52 ± 17.9 years. The most represented age group was 56 - 70 years (n = 49;33%) with extremes from 15 to 90 years. We counted 29.3% cases of haemolytic anaemia (HA) and 13.9% cases of autoimmune haemolytic anaemia (AIHA). Haemolytic anaemia (HA) was present in 54.14% of men for a sex ratio of 1.38;the most represented age group was 40 - 55 years, 37.2%. HA was associated with jaundice (OR: 3.74, CI: [1.70 - 8.22], p = 0.001), HIV - AIDS (OR: 2.72, CI: [0.98 - 7.53], p = 0.05), thrombocytopaenia (OR: 3.53, CI: [1.58 - 7.89], p = 0.02). LDH was elevated (OR: 2.86, CI: [1.30 - 6.26], p = 0.00) as well as elevated reticulocyte count (OR: 3.84, CI: [1.75 - 8.44], p = 0.01). Unconjugated bilirubin was elevated in all these patients. In multivariate analysis, factors associated with HA were a history of HIV/AIDS, jaundice, thrombocytopaenia and elevated reticulocyte count. Con

关键词： Haemolytic Anaemia Internal Medicine DGH

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Evaluation of Bleeding Risk by Hemostatic Parameters in Hemodialysis at the Douala General Hospital: Comparison between Patients on Hemodialysis before 3 Months and after 12 Months

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Open Journal of Nephrology 2023年第1期13卷 31-38页

作者： Fouda Menye Epouse Ebana Hermine Danielle Elimby Lionel Dongmo Tsague Elvire Ali Nasser Ngo Bitoungui Valentina Josiane Halle Marie Patrice ngouadjeu dongho eveline General Hospital of Douala Douala Cameroon Faculty of Medicine and Biomedical Sciences of Yaounde Yaounde Cameroon Faculty of Medicine and Pharmaceutical Sciences of Dschang Dschang Cameroon Faculty of Medicine and Pharmaceutical Sciences of Douala Douala Cameroon

Background: Bleeding disorders are common and may be a life-threating complication among patients with End Stage Kidney Disease (ESKD), especially for those in hemodialysis (HD). Bleeding risk can be evaluated by hemostatic parameter such as platelet count, prothrombine time (PT) or activated prothromplastin time (aPTT) and may be influenced by duration in HD. Objective: Evaluate bleeding risk in HD patients by analyzing some hemostatic parameters according to duration in dialysis. Patients and methods: We conducted a cross sectional study of 3 months (March to May 2022) in the HD center of the Douala General Hospital. All consenting adult patients with ESKD admitted in HD for less than 3 months or more than 12 months were included. Bleeding risk was evaluated by platelet count, PT, aPTT and fibrinogen. Chi-square test and logistic regression were used to compare data and evaluate association with hemostatic disorder. Results: A total of 80 (60% male) patients were included;30 patients were on HD for less than 3 months and 50 for more than 12 months. Median age was 45 [30 - 60] years in the first group and 43 [30 - 55] years in the second group. Increased bleeding risk was noted in 50% (n = 40) of patients and was similar in both groups. Thrombocytopenia was more common in patients on HD ≥ 12 months (20% (n = 6) vs 44% (n = 22), p = 0.02). Prolong aPTT was more common in HD patients ≥ 3 months (OR = 6.6 [1.88 - 23.5], p = 0.0013) and those with HD catheter (OR = 21.3 [4.6 - 45.7], p < 0.001). Fibrinogen and PT were comparable in both groups. HD catheter was associated with prolong PT (OR = 5.3 CI [1.5 - 8.9], p = 0.03). Conclusion: Increased bleeding risk is common in HD patients. Thrombocytopenia is common in HD patients ≥ 12 months, while prolong aPTT are mainly found in HD patients ≤ 3 months with catheter and may reflect heparin overdose.

关键词： Thrombocytopenia Prolongactivated Prothromplastin Time Hemodialysis Cameroon

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Diagnostic Value of Leukocyte Count Abnormalities in Newly Diagnosed Tuberculosis Patients

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Open Journal of Respiratory Diseases 2020年第1期10卷 1-10页

作者： Bertrand Hugo Mbatchou Ngahane Abinkeng Tazifua Ebenezer ngouadjeu dongho eveline Mafo Nzonteu Estelle Raissa Kemta Lekpa Fernando Che Vanessa Lum Namme Luma Henry Douala General Hospital Department of Internal MedicineDoualaCameroon Faculty of Medicine and Pharmaceutical Sciences University of DoualaDoualaCameroon Faculty of Medicine and Biomedical Sciences University of Yaounde 1YaoundeCameroon

Background: The diagnosis of tuberculosis (TB) is frequently challenging given that the clinical and radiographic features of TB are often nonspecific. Altered leukocyte count ratios could serve as new tools of diagnostic orientation of tuberculosis. The aim of this study was to assess the diagnostic value of the leukocyte count ratios for the diagnosis of TB. Methods: This was a cross-sectional study including cases of newly diagnosed TB patients from registers of the TB treatment center of the Douala General Hospital. Control subjects were healthy volunteers, age and sex matched, recruited at the blood bank. Sociodemographic, clinical data and peripheral blood parameters were collected. The diagnostic value of leukocyte counts was determined using receiver operating characteristics curve analysis. Results: In total, 204 TB patients and 204 control subjects were included in the study. The gender of the participants was equitably distributed in the 2 study groups (male 61.8%;female 38.2%). The median age of TB patients was 33 years while that of control patients was 32 years. The monocyte-lymphocyte count ratio (MLR) and neutrophil-lymphocyte count ratio (NLR) were significantly higher in the TB patients group compared to control group. A NLR >1.19 and MLR >0.29 were identified as cut-off values for discriminating TB patients. The areas under the curves (AUC) were 0.77 and 0.84 for the MLR and NLR respectively. Conclusion: A raised NLR > 1.19 and MLR > 0.29 are predictive of tuberculosis. The NLR has greater diagnostic ability as evidenced by its higher AUC. Further research is needed to confirm or refute our findings.

关键词： Leukocytes Diagnosis Tuberculosis Africa

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Evaluation of Bleeding Risk by Hemostatic Parameters in Hemodialysis at the Douala General Hospital: Comparison between Patients on Hemodialysis before 3 Months and after 12 Months

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Open Journal of Nephrology（肾脏病） 2023年第1期

作者： Fouda Menye Epouse Ebana Hermine Danielle Elimby Lionel Dongmo Tsague Elvire Ali Nasser Ngo Bitoungui Valentina Josiane Halle Marie Patrice ngouadjeu dongho eveline

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