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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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Suicidal Behaviours in Sickle Cell Patients at the Douala Sickle Cell Care Centre in Cameroon

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Open Journal of Psychiatry 2024年第3期14卷 265-281页

作者： Christian Eyoum Léonce Kengno Kologne Charlotte Eposse Ekoube Annick Mélanie Magnerou Joséphine Manga Befolo Cindy Laura Ndepa daniel gams massi Aurore Nzesseu Djomo Guy Jonas Basseguin Atchou Guy Calvin Mbongo’O Rihta Mbono Mbekoto Iyawa Hassanatou Fabiola Tchouankeu Kounga Christiane Medi Sike Josiane Essola Jacques Narcisse Doumbe Erero Njiengwe Callixte Kuate Tegueu Faculty of Medicine and Pharmaceutical Sciences University of Douala Douala Cameroon Laquintinie Hospital Douala Cameroon Faculty of Health Sciences University of Buea Buea Cameroon Faculty of Medicine and Biomedical Sciences University of Yaound&#233 1 Yaound&#233 Cameroon

Introduction: Sickle cell anaemia is a hereditary disease that combines physical and psychological manifestations, including suicidal tendencies. So far, to our knowledge, no study has been conducted on suicidal behaviours among people with sickle cell disease in Cameroon. This is what justifies our study on the prevalence and factors related to suicidal behaviors in our study population. Methods: We conducted a cross-sectional, analytical study of 171 sickle cell patients aged from 12 years upwards who came to the sickle cell disease care service of the Laquintinie Hospital in Douala, over a period of 6 months, that is, from 1 January to 31 June 2022. Data were collected using a structured questionnaire with questions on suicidal behaviours based on the “MINI” (Mini International Neuropsychiatric Interview). The data were processed using the SPSS 26.0 software. The related factors were studied in both a bivariate and multivariate analysis. Results: Female sickle cell patients accounted for 60.2% of the sample. The mean age was 23.36 ± 8.42 years. Suicidal ideation was prevalent in 56% of cases and 13% attempted suicide. The factors most associated with suicidal ideation were: primary level of education (OR = 0.08 (0.09 - 0.79);p = 0.03), feeling unworthy of life (OR = 0.40 (0.08 - 1.96);p = 0.02), not often being considered by those around them (OR = 2.97 (1.26 - 6.99);p = 0.01), lack of family support (OR = 0.34 (0.15 - 0.77);p = 0.01). Meanwhile, the factors associated with suicide attempts were: the fact of being rarely exposed to suicide-related media (OR = 4.17 (1.40 - 71.80);p = 0.03), and a constant feeling of sadness when returning home (OR = 18.02 (1.59 - 20.55);p = 0.01). Conclusion: More than half of sickle cell patients had had suicidal thoughts and 1/6 had made at least one suicide attempt, women and young adults being the most concerned. It is therefore necessary to ensure optimum psychological care for patients with sickle cell disease.

关键词： Sickle Cell Disease Suicidal Behaviours Self-Harm

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Spontaneous Intracerebral Hemorrhage: Epidemiology, Clinical Profile and Short-Term Outcome in a Tertiary Hospital in Sub-Saharan Africa

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World Journal of Neuroscience 2020年第3期10卷 141-154页

作者： Jacques Doumbe Khadidja Abdouramani daniel massi gams Chia Mark Ayeah Caroline Kenmegne Yacouba Njankouo Mapoure Department of Clinical Sciences University of Douala Douala Cameroon Department of Epidemiology School of Public Health University of Ghana Accra Ghana Department of Clinical Sciences University of Buea Buea Cameroon Neurological Unit Douala General Hospital Douala Cameroon

Background: Data on spontaneous intracerebral haemorrhagic (SICH) are scarce in Africa. Our objectives were to determine the prevalence of SICH, describe the clinical profile, aetiology and evaluate the prognosis (fatality case, functional outcome) of patients in a tertiary health care hospital in Cameroon. Methods: This was a hospital-based retrospective cohort which included patients with SICH and followed up for 6 months after stroke. Subarachnoid haemorrhage, cerebral venous thrombosis with bleeding or bleeding related with ischemic or brain tumour were excluded. Predictive factors were obtained using multiple logistic regression and survival by Kaplan Meier method. Results: The prevalence of SICH was 37% with male predominance (64.0%), a mean age of 55.6 ± 11.8 years. Deep coma was found in 30.3% on admission. The basal ganglion was the most frequent location of haemorrhage (85.1%) while intraventricular blood effusion, mass effect, cerebral oedema and herniation occurred in 31.4%, 25.7%, 8.8% and 5.0% respectively. Hypertension (57.5%) was the most common aetiology. The mean length of hospitalization was 9.0 ± 7.7 days and chest infection (30.7%) was the most frequent complication. The cumulative case fatality rate after 24 hours (day 1), during admission, month 1 and month 3 was 9.6%, 39.9%, 46.0%, 59.8% respectively. On multivariate analysis, GCS -month survival was 37.8%. Conclusion: About one-third of stroke patient were haemorrhagic. Hypertension is the leading CV

关键词： Spontaneous Intracerebral Haemorrhage Epidemiology Prognosis Africa

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Outcome between Diabetic versus Non-Diabetic Acute Stroke in a Black African Population: A Cohort Study

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World Journal of Neuroscience 2021年第3期11卷 231-245页

作者： daniel gams massi Jacques Doumbe Raïmatou Ngouh Patouokoumche Chia Mark Ayeah Caroline Kenmegne Yacouba Njankouo Mapoure Neurological Unit Douala General Hospital Douala Cameroon Faculty of Health Sciences University of Buea Buea Cameroon Neurology department Douala Laquintinie Hospital Douala Cameroon Department of Clinical Sciences University of Douala Douala Cameroon Department of Epidemiology School of Public Health University of Ghana Accra Ghana

Background: Post-stroke outcomes are poorer in patients with diabetes mellitus (DM). The aim of this study was to determine the prevalence of DM in acute stroke and to compare the outcome in patients with or without diabetes in a tertiary care hospital in Douala, Cameroon. Methods: This was a hospital-based prospective cohort study included both diabetic and non-diabetic acute stroke patients (ASP). Demographic, clinical profile and outcome data was collected within 3 months of stroke onset. Descriptive statistics, t-test and chi square test used for comparisons while associations between DM and stroke outcomes, were analyzed using multiple logistic regression and survival analysis. Results: Of the 701 ASP included, the overall prevalence of diabetes in stroke was 34.2% (n = 240) while 9.4% (n = 66) had newly diagnosed diabetes. Mortality was significantly elevated amongst patients with diabetes during hospitalization (p = 0.034) and at 3 months post stroke onset (p = 0.004), but on multivariate analysis, diabetes was not an independent predictor of mortality [OR = 0.984;(95% CI: 0.506 - 1.913);p = 0.961)]. On Cox proportional hazards regression model, the risk of dying was about 1.5 times higher amongst the DM patients compared to non-diabetic patients [adjusted HR (95% CI) of 1.502 (1.128 - 2.000);p = 0.005]. Diabetes was not an independent predictor of poor functional outcome within 3 months post stroke. Conclusion: About 1 in 3 ASP had DM on admission. Survival is better in non-diabetes versus diabetes mellitus ASP. DM was associated with high mortality but does not influence the functional o

关键词： Diabetes Prevalence Mortality Functional Outcome Prognosis Africa

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