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Epidemiological, Clinical and Therapeutic Patterns of Venous Thromboembolic Disease in Cancer Patients followed up in Two Reference Hospitals in Cameroon

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World Journal of Cardiovascular Diseases 2022年第4期12卷 250-257页

作者： Chris Nadège Nganou-Gnindjio Liliane Mfeukeu-Kuate Huguette Atangana Ekobo Dieudonné Danwe Etienne Atangana Okobalemba Ladé Viche Valérie Ndobo-Koé félicité kamdem Bâ Hamadou Alain Patrick Menanga faculty of Medicine and Biomedical Sciences University of Yaoundé I Yaoundé Cameroon Yaoundé Central Hospital Yaoundé Cameroon General Hospital of Yaoundé Yaoundé Cameroon Douala General Hospital Douala Cameroon faculty of Medicine and Biomedical Sciences University of Garoua Garoua Cameroon faculty of Medicine and Pharmaceuticals Sciences University of Douala Douala Cameroon

Background: Cancer increases the incidence of venous thromboembolic disease (VTE), which represents a significant cause of morbidity, mortality, and economic burden in cancer patients. Objective: We aimed to describe the epidemiologic, clinical, and therapeutic pattern of VTE in cancer patients followed-up in two reference hospitals in Cameroon over the past ten years. Methods: This was a cross-sectional retrospective study conducted in the oncology department of the General hospitals of Yaoundé and Douala. We included the medical records of all patients aged 18 years and above who had active cancer with a confirmed diagnosis of VTE from 2010 to 2021. Results: We analysed 408 patients’ medical records. The prevalence of VTE was 7.6%. All those having VTE had solid tumours. There were twenty (64.5%) cases of deep venous thrombosis, five (16.1%) cases of pulmonary embolism, and three (9.7%) cases of both. Poor performance status and chemotherapy were independently associated with the development of VTE. Most of the patients were treated with compression stockings and low molecular weight heparin. Conclusion: VTE prevalence is high among cancer patients in Cameroon. It is most frequent in solid tumours originating from the genitourinary system, the lung, the pancreas, and the brain.

关键词： Venous Thromboembolic Disease Cancer Cameroon

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Therapeutic Routes of a Group of Heart failure Patients followed in a Cameroonian Urban Setting

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World Journal of Cardiovascular Diseases 2023年第10期13卷 686-700页

作者： Chris Nadège Nganou-Gnindjio Bâ Hamadou Melissa Djuidje Djampouop Marie Ntep Gwet félicité kamdem Pierre Mintom Juliette Valerie Ndobo Siddikatou Djibrilla Guillaume Ebene Manon Joel Noutackdie Tochie Samuel Kingue faculty of Medicine and Biomedical Sciences University of Yaoundé 1 Yaoundé Cameroon Institut Supérieur des Sciences de la Santé Université des Montagnes Bangangte Cameroon faculty of Medicine and Pharmaceuticals Sciences University of Douala Douala Cameroon faculty of Health Sciences University of Buea Buea Cameroon

Background: Heart failure (Hf) is a rising global health problem. Patients with Hf tend to use several therapies obtained via different treatment routes to relieve their symptoms. It is rampant in sub-Saharan Africa (SSA), leading to poor health-seeking behaviours and worsened Hf health outcomes. We aimed to describe the different therapeutic routes of Hf patients from the onset of their first symptom until treatment in a specialised cardiology centre to identify and rebuke harmful therapeutic routes. Materials and Methods: This was a cross-sectional study at the Yaoundé Central Hospital in Cameroon between December 2018 to July 2019. Patients were recruited by consecutive convenient sampling. Adult patients aged above 18 years with confirmed Hf were included using the framingham criteria. Variables relating to socio-demographic and clinical data and the health-seeking behaviours of Hf patients were studied. Results: We included 132 patients with a mean age of 62.90 years (62.88% women). Very few patients (0.90%) followed an ideal route;60.71% of subjects had a pseudo-ideal route, 19.64% accessed a specialised facility directly, and 21.42% used an erratic route. At the arrival time in a cardiology unit, 49.24% and 35.61% of our subjects were in NYHA stage III and IV Hf compared to 15.15% for stage II. None of them was in Stage I. Conclusion: Most heart failure patients in Cameroon have resorted to non-specialised care, which worsens their clinical presentation. There is an urgent need for health education of Hf patients in our context.

关键词： Heart failure Therapeutic Care Route Cameroon

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Estimation of the Direct Cost of Management of Venous Thromboembolism in Three Reference Hospitals in the City of Yaoundé: A Retrospective Study over a Three-Year Period

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World Journal of Cardiovascular Diseases 2024年第2期14卷 99-114页

作者： Hamadou Ba Nganou-Ngnindjio Chris Nadège Tatchim Samuel Aimé kamdem félicité Tchoukoua Serge Honoré Ahmadou Jingi Danwe Dieudonne Kingue Samuel faculty of Medicine and Biomedical Sciences University of Yaoundé I Yaoundé Cameroon Department of Internal Medicine Garoua General Hospital Garoua Cameroon Cardiology Department Yaoundé Central Hospital Yaoundé Cameroon Higher Institute of Health Sciences University of the Mountains Bagangté Cameroon faculty of Medicine and Pharmaceutical Sciences University of Douala Douala Cameroon Department of Internal Medicine Douala General Hospital Douala Cameroon faculty of Health Sciences University of Bamenda Bamenda Cameroon Cardiology Department Yaoundé General Hospital Yaoundé Cameroon

Background: Venous thromboembolism (VTE) is a major public health problem due to its increasing frequency, mortality and management cost. This cost may require major financial efforts from patients, especially in developing countries like ours where less than 7% of the population has health insurance. This study aimed to estimate the direct cost of managing VTE in three reference hospitals in Yaoundé. Methods: This was a cross-sectional retrospective study over a three-year period (from January 1st 2018 to December 31 2020) carried out in the Cardiology departments of the Central and General Hospitals, and the Emergency Centre of the city of Yaoundé. All patients managed during the study period for deep vein thrombosis and pulmonary embolism confirmed by venous ultrasound coupled with Doppler and computed tomography pulmonary angiography respectively were included. for each patient, we collected sociodemographic and clinical data as well as data on the cost of consultation, hospital stay, workups and medications. These data were analysed using SPSS version 23.0. Results: A total of 92 patient’s records were analysed. The median age was 60 years [48 - 68] with a sex ratio of 0.53. The median direct cost of management of venous thromboembolism was 766,375 CfAf [536,455 - 1,029,745] or $1415 USD. Management of pulmonary embolism associated with deep vein thrombosis was more costly than isolated pulmonary embolism or deep vein thrombosis. factors influencing the direct cost of management of venous thromboembolism were: hospital structure (p = 0.015), health insurance (p 0.001), type of pulmonary embolism (p = 0.021), and length of hospital stay (p = 0.001). Conclusion: Management of VTE is a major financial burden for our patients and this burden is influenced by the hospital structure, health insurance, type of pulmonary embolism and length of hospital stay.

关键词： Cost Management Venous Thromboembolism Yaoundé

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Prevalence and Risk factors of Peripheral Artery Disease in a Group of Apparently Healthy Young Cameroonians: A Cross-Sectional Study

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World Journal of Cardiovascular Diseases 2018年第2期8卷 111-122页

作者： félicité kamdem Yacouba Njankouo Mapoure Ba Hamadou fanny Souksouna Ahmadou Musa Jingi Caroline Kenmegne fernando Kemta Lekpa Jaff fenkeu Kweban Gisèlei Mandy Jean Pierre Nda Mefo’o Henry Luma Marie Solange Doualla Internal Medicine Service Douala General Hospital Douala Cameroon faculty of Medicine and Pharmaceutical Sciences University of Douala Douala Cameroon faculty of Medicine and Biomedical Sciences University of Yaounde I Yaounde Cameroon Chemical Pathology Laboratory Douala General Hospital Douala Cameroon

Background: The?burden of peripheral artery disease (PAD) is not well known among apparently healthy people in Africa. Aim: To determine the prevalence and associated risk factors of PAD in a group of blood donors seen at the Douala General Hospital—Cameroon. Methods: Between 1st November 2015 and 30th April 2016, we carried out a cross-sectional study. Participants were consenting adults of both sexes, aged ≥ 21 years who presented for blood donation, and were tested HIV negative. We collected socio-demographic data and their past history. We carried out a physical examination and measured their Ankle-Brachial Index (ABI). We defined PAD as an ABI Results: We recruited 103 participants, 55.4% males. The mean age was 33 ± 10 years. The mean ABI on left and right leg was 1.04 ± 0.1 and 1.02 ± 0.1respectively. ABI was higher in males than females both legs (p 0.05). PAD was seen in 11 (10.7%) participants. This was higher in females than males (3.6% versus 19.2%, p = 0.026). Among those with PAD, 8 (72.7%) were asymptomatic (Males: 100% versus females: 66%, p = 0.9). After adjusting for age and gender, sedentary lifestyle (aOR: 7.14, [95% CI: 1.38 - 33.3], p = 0.019), and female gender (aOR: 6.2, [95% CI: 1.26 - 30.5], p = 0.025) were significantly associated with PAD. Conclusion: The prevalence of PAD was high in this group of HIV negative blood donors, most of whom were asymptomatic. This was associated with females, and a sedentary lifestyle.

关键词： Peripheral Artery Disease ABI Prevalence Risk factors Douala

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Epidemiology, Clinical and Paraclinical Presentations of Pulmonary Embolism: A Cross-Sectional Study in a Sub-Saharan Africa Setting

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Open Journal of Respiratory Diseases 2019年第3期9卷 89-99页

作者： Bertrand Hugo Mbatchou Ngahane félicité kamdem Silvain Raoul Simeni Njonnou Nina Chebou Anastase Dzudie Serge Arnold Ebongue Bruno Tengang fernando Kemta Lekpa Yacouba Mapoure Njankouo Sidick Mouliom Henri Roger Ngote Henry Luma Namme Douala General Hospital Douala Cameroon faculty of Medicine and Pharmaceutical Sciences University of Douala Douala Cameroon faculty of Medicine and Biomedical Sciences University of Yaounde 1 Yaounde Cameroon Military Hospital Douala Cameroon Centre des Maladies Respiratoires Douala Cameroon

Background: Venous thromboembolic (VTE) disease burden is increasing worldwide, representing a major cause of cardiovascular death and public health problem. Pulmonary embolism (PE) is the most serious clinical presentation of VTE. Epidemiological and clinical data on PE are still lacking in Africa, particularly in Cameroon. This study aimed at determining the clinical features as well as imaging presentation and outcome of pulmonary embolism. Methods: A cross-sectional study was carried out in three hospitals in Douala. We retrospectively reviewed patient records admitted for PE from January 2009 to May 2017. We collected data on epidemiology, clinical presentation, venous Doppler/pulmonary computed tomographic angiography (CTA), and outcome. Results: We included 103 patients (56 males) with PE. Their median age was 52 years. The main risk factors were obesity (49.5%), hypertension (35.0%), long trip (24.3%) and cancer (18.4%). The most frequent clinical presentations were dyspnoea (83.4%), chest pain (78.6%), and cough (40.8%). Additionally, pleural effusion (32.8%), atelectasis (25.7%) and pulmonary hyperlucency (20.0%) were the most frequent findings on chest X-ray. The main abnormalities found in electrocardiogram were sinus tachycardia (63.4%), S1Q3T3 aspect (37.6%) and right axial deviation (28.7%). Moreover, right cavities dilatation (26.0%), pulmonary artery hypertension (35.0%) and pulmonary artery dilatation (21.0%) were the main echocardiographic findings. Low-molecular-weight heparin (LMWH) was the initial anticoagulant in all cases. There were 19 (18.4%) in-hospital deaths, and the mean hospital stay was 8.5 ± 5 days. Conclusion: PE is not rare in our setting. Obesity, long trip and cancer are the main risk factors, while dyspnoea, chest pain and respiratory distress are the main clinical presentation for PE. LMWH remains the therapeutic agent of choice. Lastly, in-hospital mortality is very high.

关键词： Epidemiology Africa Venous Thromboembolism Symptoms

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An Assessment of Cardiovascular functional Capacity of a Group of Chronic Heart failure Patients Using the 6-Minute Walk Test in a Cameroonian Urban Setting

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World Journal of Cardiovascular Diseases 2023年第6期13卷 275-282页

作者： félicité kamdem Chris Nadège Nganou-Gnindjio Dieudonné Danwe franc Christ-Roi Soemessabot Elysée Claude Bika Léle Ba Hamadou Sidick Mouliom Lade Viché Henri Ngoté Caroline Kenmegne Marie Solange Ndom Ebongue Siddikatou Djibrilla William Ngatchou Department of Internal Medicine Douala General Hospital Douala Cameroon faculty of Medicine and Pharmaceutical Sciences University of Douala Douala Cameroon faculty of Medicine and Biomedical Sciences University of Yaoundé I Yaoundé Cameroon faculty of Sciences University of Douala Douala Cameroon faculty of Medicine and Biomedical Sciences University of Garoua Garoua Cameroon faculty of Health Sciences University of Buea Cameroon

Background: Chronic heart failure is a public health problem worldwide. It has a high mortality rate and is accompanied by a decreased functional capacity and alteration of the quality of life. Objective: This study aimed to assess the cardiovascular functional capacity of a group of patients suffering from heart failure using the 6-minute walk test (6 MWT). Methods: This was a cross-sectional study carried out in the cardiology unit of Douala’s general hospital for 4 months. We included all eligible patients aged 18 years or more who had stable chronic heart failure and gave informed consent. Those who had an acute coronary syndrome (≤1 month), tachycardia (HR ≥ 120 bpm), high blood pressure (SBP ≥ 180 mmHg and/or DBP ≥ 100 mmHg) and reduced mobility due to orthopaedic reasons were excluded. A 6 MWT was done according to the American Thoracic Society guidelines. The 6 MWT result was considered poor for - 450 m and good for >450 m. Results: We recruited a total of 81 patients (61.7% women) with a mean age of 65.9 ± 10.6 years. The most frequent risk factor for heart failure was high blood pressure (77.8%), alcohol consumption(69.1%) and a sedentary lifestyle (53.1%). The left ventricular ejection fraction was mostly preserved (42.0%) or mildly altered (46.9). The 6 MWT results were poor in 55.6% of cases, average in 19.8% of cases and good in only 24.7% of cases. More than half (59.3%) of the participants perceived the effort as being difficult. The cardiovascular functional capacity was significantly associated with age, heart failure stage and physical activity (p Conclusion: Most patients suffering from chronic stable heart failure in the general hospital of Douala have poor cardiovascular functional capacity.

关键词： Cardiovascular functional Capacity Chronic Heart failure 6-Minute Walk Test Cameroon

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Hygienic and Dietary Measures in Cameroonian Hypertensive Patients followed at the Douala General Hospital: Knowledge, Compliance and Effect on Blood Pressure Control

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World Journal of Cardiovascular Diseases 2023年第1期13卷 21-31页

作者： félicité kamdem Grace Eugénie Makota Ndongo Christelle Noche Domngang Hamadou Ba Jaff fenkeu Kweban Glwadys Ngono Atéba Sidick Mouliom Henri Ngoté Lade Viché Caroline Kenmegne Marie Solange Ndom Ebongue Siddikatou Djibrilla Elysée Claude Bika Léle Samuel Kingue Department of Internal Medicine Douala General Hospital Douala Cameroon faculty of Medicine and Pharmaceutical Sciences University of Douala Douala Cameroon Institut Supérieur des Sciences de la Santé Université des Montagnes Bangangté Cameroon faculty of Medicine and Biomedical Sciences University of Yaoundé I Yaoundé Cameroon Intensive Care Unit Douala General Hospital Douala Cameroon faculty of Medicine and Biomedical Sciences University of N’Gaoundéré N’Gaoundéré Cameroon faculty of Health Sciences University of Buea Buea Cameroon Physiology and Medicine of Physical Activities and Sports Unit University of Douala Douala Cameroon

Introduction: The management of hypertension is mostly based on pharmacotherapy and hygienic and dietary measures (HDMs) for which little data is available in Cameroon. The concern to improve the quality of life of hypertensive patients led us to study the knowledge, compliance and effect of HDMs among Cameroonian hypertensive patients. Methods: This was a cross-sectional study carried out at the Douala General Hospital;the census of patients was carried out from 05 March to 10 May 2018. The data evaluated were knowledge and compliance with HDMs with an inference of their effect on blood pressure control. Results: We recruited 330 participants at mean age of 60 ± 11 years, 37.9% men;57.3% with blood pressure (BP) controlled. Out of 330 subjects, 308 (93.3%) who had been educated about dietary health measures for hypertension were assessed on knowledge, compliance and effect of these measures against 22 (6.7%) who had never heard about them. Around 85.7% of participants had good knowledge of HDMs and 78.9% had good compliance with them. There was no statistically significant influence of knowledge and compliance with HDMs on blood pressure control. Conclusion: The level of knowledge and adherence to HDMs of hypertensive patients at the Douala General Hospital was appreciable. It is however appropriate for physicians to intensify patient education on HDMs and BP control.

关键词： Hypertension Hygienic and Dietary Measures Blood Pressure Control Knowledge Compliance

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Epidemiology, Clinical Presentations and In-Hospital Mortality of Venous Thromboembolism at the Douala General Hospital: A Cross-Sectional Study in Cameroon, Sub-Saharan Africa

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World Journal of Cardiovascular Diseases 2018年第2期8卷 123-132页

作者： félicité kamdem Bertrand Hugo Mbatchou Ngahane Ba Hamadou Agborbessong Mongyui Marie Solange Doualla Ahmadou Musa Jingi Anastase Dzudie Yves Monkam Henri Ngote Sidick Mouliom Caroline Kenmegne Jaff Kweban fenkeu Romuald Hentchoya Albert Kana Aminata Coulibaly Henry Luma Internal Medicine Service Douala General Hospital Douala Cameroon faculty of Medicine and Pharmaceutical Sciences University of Douala Douala Cameroon faculty of Medicine and Biomedical Sciences University of Yaounde I Yaounde Cameroon Intensive Care Unit Douala General Hospital Douala Cameroon

Background: Venous thromboembolism (VTE) is a major cause of morbidity and mortality worldwide. It is also the most common complication in hospitalized patients. Aims:?To?study the in-hospital prevalence of VTE, describe the socio-demographic characteristics of patients, determine the frequency of risk factors, describe the clinical presentations, and determine the short term outcome of VTE in hospitalized patients in a low-income tertiary hospital setting.?Methods: We carried out a cross-sectional descriptive retrospective study over a period of 6 years and 4 months (January 2008 to April 2014) in the Douala General Hospital—Cameroon. Patients were cases of confirmed venous thromboembolic disease (VTE).?Results: A total of 78 case files were retained for this study, giving an in-hospital prevalence of 4.4 per 1000 admissions. There were 42 (53.8%) males and 36 (46.1%) females. Their ages ranged from 18 to 89 years (median: 53 years, [IQR: 40?-?61]).?There were 37 (47.4%) cases of Deep Vein Thrombosis (DVT), 31 (39.7%) cases of Pulmonary Embolism (PE), and 10 (12.8%) cases of PE associated with DVT (12.8%). The main risk factors were obesity (44.9%), hypertension (37.2%), immobility (20.5%), and long-haul travel (17.9%). The most frequent clinical presentations in PE were dyspnea (80.5%) and chest pain (65.9%). There were 8 (10%) in-hospital deaths. Conclusion: About twelve cases of VTE are seen yearly at the DGH, with an in-hospital mortality of ten percent. Obesity and hypertension were the main risk factors, with dyspnea and chest pain being the main clinical manifestations in PE, and lower limb swelling the main symptom in DVT.

关键词： Epidemiology Clinical Presentation Mortality Venous Thromboembolism Cameroon Sub-Saharan Africa

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Cyber Deception Using NLP

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Journal of Information Security 2024年第2期15卷 279-297页

作者： Igor Godefroy Kouam kamdem Marcellin Nkenlifack Department of Mathematics and Computer Science URIFIA Laboratory Faculty of Science University of Dschang Dschang Cameroon

Cyber security addresses the protection of information systems in cyberspace. These systems face multiple attacks on a daily basis, with the level of complication getting increasingly challenging. Despite the existence of multiple solutions, attackers are still quite successful at identifying vulnerabilities to exploit. This is why cyber deception is increasingly being used to divert attackers’ attention and, therefore, enhance the security of information systems. To be effective, deception environments need fake data. This is where Natural Language (NLP) Processing comes in. Many cyber security models have used NLP for vulnerability detection in information systems, email classification, fake citation detection, and many others. Although it is used for text generation, existing models seem to be unsuitable for data generation in a deception environment. Our goal is to use text generation in NLP to generate data in the deception context that will be used to build multi-level deception in information systems. Our model consists of three (3) components, including the connection component, the deception component, composed of several states in which an attacker may be, depending on whether he is malicious or not, and the text generation component. The text generation component considers as input the real data of the information system and allows the production of several texts as output, which are usable at different deception levels.

关键词： Cyber Deception Cybersecurity Natural Language Processing Text Generation

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Therapeutic Routes of a Group of Heart failure Patients followed in a Cameroonian Urban Setting

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World Journal of Cardiovascular Diseases（心血管病） 2023年第10期

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