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Morbidity and Mortality Linked to Unsafe Abortions in Cameroon—Difficulties in Accessing Safe Abortions: Systematic Review and Meta-Analysis. A Study Proposal

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Open Journal of Obstetrics and Gynecology 2022年第10期12卷 1102-1112页

作者： Florent Ymele Fouelifack Ako William Takang Mosman Anyimbi Ofeh Jenny Ornella Manewoun Nsen Abeng Guy Sadeu Wafeu Christophe Lontsi Saha Department of Surgery and Specialties Higher Institute of Medical Technology of Nkolondom-Yaoundé Yaoundé Cameroon Gynecology and Obstetrics Unit Yaoundé Central Hospital Yaoundé Cameroon Faculty of Health Sciences University of Bamenda Bamenda Cameroon Monatélé District Hospital Monatélé Cameroon Higher Institute of Medical Technology of Nkolondom Yaoundé Cameroon Human Rights and Humanitarian Action National Coordinator of CIVITAS Cameroon Yaoundé Cameroon Systematic Reviews and Meta-Analysis Coordinator of Cochrane Cameroon Yaoundé Cameroon Public Health Option Epidemiology Faculty of Health Sciences Catholic University of Central Africa Yaoundé Cameroon

Unsafe abortions constitute a public health problem. It is one of the causes of maternal mortality in the world and particularly in developing countries. Despite the progress made, maternal mortality remains high in Cameroon. The scarcity and disparity of data on abortions lead to a lack of strong evidence to advocate to decision-makers on the extent of the problems associated with abortions in Cameroon. Our objective is to estimate the rates of mortalities and complications related to unsafe abortions, as well as the difficulties of accessing safe abortions in Cameroon. We will carry out a systematic and meta-analytical review in the biomedical databases MEDLINE (Pubmed), Google Scholar and African Journal Online (AJOL) concerning unsafe abortions and/or difficulties in accessing safe abortions in Cameroon, without date or language restriction. Gray literature will be also consulted. Two authors will simultaneously select the studies and data extraction will be done using a Google Form. Proportions will be estimated on a random-effect model. The I2 and Q statistics will be used to assess the extent of heterogeneity across the studies. The outcome of both the quantitative and qualitative parts of the study will be commented. Death and morbidity due to abortions can be prevented. A concerted multidisciplinary and multicentric action would be essential.

关键词： Mortality Morbidity Difficulties Access Unsafe Abortion Cameroon

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Morbi-Mortality Linked to Unsafe Abortions—Difficulties in Accessing Safe Abortions in Cameroon: Meta-Analysis and Systematic Review

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Open Journal of Obstetrics and Gynecology 2023年第2期13卷 342-359页

作者： Florent Ymele Fouelifack Mosman Anyimbi Ofeh Jenny Ornella Manewoun Nsen Abeng Christophe Saha Lontsi Mvong Vendeline Amaelle Goretti Guy Sadeu Wafeu Robinson Enow Mbu Department of Surgery and Specialties at the Higher Institute of Medical Technology of Nkolondom Yaoundé Cameroon Gynecology and Obstetrics Unit of the Yaoundé Central Hospital Yaoundé Cameroon Maga District Hospital Maga Cameroon Public Health of Higher Institute of Medical Technology of Nkolondom Yaoundé Cameroon CIVITAS Cameroon Human Rights and Humanitarian Action Yaoundé Cameroon Public Health Option Epidemiology Yaoundé Cameroon Information Communication and Technology American University Yaoundé Cameroon Centre for the Development of Best Practices in Health (CDBPSH) National Coordinator of Building Medical Research in Africa (BMR Africa) Yaoundé Cameroon Family Health Ministry of Public Health Yaoundé Cameroon

Background: Unsafe abortions are one of the leading causes of maternal mortality, especially in developing countries. In Cameroon, the maternal mortality rate remains high, and the scarcity of data on abortions leads to a lack of solid evidence to advocate on the extent of the abortions related complications. Our objective was to evaluate the unsafe abortions related complications, and to assess the difficulties of accessing safe abortions in our setting. Methods: We carried out a meta-analytic and systematic review in the biomedical databases MEDLINE (Pubmed), Google Scholar and African Journal Online concerning unsafe abortions and/or difficulties in accessing safe abortions in Cameroon. The keywords used for the search are seen in table I. Selection of studies was simultaneously done by two authors. Data were extracted through a form designed on Google Form. We used a random-effect model for proportion estimation, and The I2 and Q statistics to assess the extent of heterogeneity. Results: A total of 430 studies were identified, from which 28 were included and analysed. About 5% (95% CI: 3 - 7) of unsafe abortions leads to death. The contribution of unsafe abortions in maternal deaths was 23% (95% CI: 20 - 27). The rate of severe bleeding and/or anemia were 40% (95% CI: 18 - 63) and the rate of infection was 17% (95% CI: 7 - 28), dominated by pelvic infections, pelviperitonitis, severe sepsis, and septic shock. Case reports described uterine perforations, uterine rupture during the following pregnancy. Abortion was performed in the practitioner’s or patient’s home in 41.4% of cases, in a health center in 35.1% of cases, in a private clinic in 21.2% of cases, drugs selling places and in traditional healer clinics. The restriction of abortion laws, the stigma surrounding abortion and its consequences at any level of the society, lead to the underreporting of unsafe abortions and a deep reluctance to advocate for safe abortion services. Conclusion: The strengthening of awareness campaigns for provider b

关键词： Morbi-Mortality Unsafe Difficulties Access Safe Abortion Cameroon

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Evaluation of Sub Clinical Myocardial Systolic Dysfunction Using 2D Global Longitudinal Strain Assessment in Type 2 Diabetes Patients in Sub-Saharan Africa

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World Journal of Cardiovascular Diseases 2020年第10期10卷 707-715页

作者： Alain Patrick Menanga Chris Nadège Nganou-Gnindjio Ladé Viché André Jules Ahinaga Franck Ngowa Guy Sadeu Wafeu Donald Paulin Tchapmi Njeunje Hamadou Bâ Samuel Kingue Internal Medicine and Specialities Department Faculty of Medicine and Biomedical Sciences University of Yaoundé Yaoundé Cameroon Internal Medicine Department Yaoundé General Hospital Yaoundé Cameroon Cardiology Department Yaoundé Central Hospital Yaoundé Cameroon Internal Medicine Department Douala General Hospital Douala Cameroon Efoulan District Hospital Yaoundé Cameroon

Background: Heart failure is the commonest cardiovascular complication in type 2 diabetes mellitus. However, subclinical left ventricular dysfunction can’t be detected using 2D echocardiography which is routinely used for cardiac evaluation of diabetic patients. We aimed to determine the prevalence and factors associated to left ventricular global longitudinal strain (LV GLS) impairment in type 2 diabetes Cameroonians patients. Methods: We conducted a cross-sectional study from January 2019 to June 2019, including type 2 diabetes patients with preserved left ventricle ejection fraction. Clinical and echocardiographic data were collected, and LV GLS was assessed using speckle tracking technique, a value ≤ -16% been considered as normal value. Results: We recruited 95 patients, with a mean age of 57.4 ± 11.8 years old and median diabetes duration of 5 [2 - 12] years. Echocardiographic evaluation found 56.3% of left ventricle remodelling, 51.6% of left ventricle diastolic dysfunction and mean left ventricle ejection of 63.3% ± 6.6%. LV GLS impairment was present in 43.2% (95% CI: 32.6 - 53.7) of the participants. After adjustment to all significantly associated factors, Obesity (aOR: 4;95% CI: 1.5 - 10.6) and dias

关键词： 2D Echocardiography Myocardial Strain Left Ventricle Function Diabetes Mellitus Cameroon

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Indications, Yield and Outcome of Colonoscopy: A 7-Year Retrospective Study in a Resource-Limited Setting

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Open Journal of Gastroenterology 2019年第3期9卷 49-58页

作者： Gabin Ulrich Kenfack Servais Albert Fiacre Bagnaka Eloumou Winnie Tatiana Bekolo Nga Guy Sadeu Wafeu Paul Nkemtendong Tolefac Agnès Malongue Mathurin Pierre Kowo Christian Tzeuton Firmin Ankouane Andoulo Oudou Njoya Henry Namme Luma Dominique Noah Noah Faculty of Medicine and Biomedical Sciences The University of Yaoundé I Yaoundé Cameroon Research Laboratory on Viral Hepatitis and Health Communication Yaoundé Cameroon Faculty of Medicine and Pharmaceutical Sciences The University of Douala Douala Cameroon Internal Medicine Unit Douala General Hospital Douala Cameroon “Les Capucines” Medical Center Douala Cameroon Deido District Hospital Douala Cameroon

Background and Aims: Diagnostic colonoscopy allows exploration of the colonic mucosa. Indications are multiple. The purpose of this work was to describe the indications and to report the lesions observed during colonoscopy at the General Hospital of Douala. Methods: This was a cross-sectional study with retrospective data collection over a period of 7 years (January 1, 2010 to January 31, 2017). The data collected from the reports were socio-demographic characteristics, indications and lesions observed at colonoscopy. Binary logistic regression allowed us to identify the independent risk factors associated with the presence of tumors and polyps. Results: We included 719 exams. The main indications were rectorrhagia (29.5%), abdominal pain (25.9%) and constipation (17.8%). A colonic lesion was found in 60.1% of cases. A colorectal tumor accounted for 10.3% of cases. Factors independently associated with colonic tumor were complete colonoscopy (aOR: 0.167 95% CI [0.096 - 0.289], p Conclusion: The presence of weight loss, abdominal or rectal mass should motivate the realization of a complete colonoscopy in search of a colorectal tumor. The most observed lesions remain hemorrhoids, polyps and diverticulosis of the colon.

关键词： Colonoscopy Indications Colorectal Tumor Limited Resources Cameroon

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Functional Capacity of Patients with Venous Thromboembolic Disease Six to Twelve Months after Treatment

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World Journal of Cardiovascular Diseases 2024年第2期14卷 88-98页

作者： Hamadou Bâ Chris-Nadège Nganou-Gnindjio Alexis Noé S. Guiakam Kemnang Yemele Honore Danwe Dieudonné guy S. wafeu Faculty of Medicine and Biomedical Sciences University of Yaoundé I Yaoundé Cameroon Cardiology Department Yaoundé Central Hospital Yaoundé Cameroon Centre for Research on Filariasis and Other Tropical Diseases Yaoundé Cameroon

Background: Venous thromboembolism (VTE) is among the leading causes of hospital-related disability-adjusted life years lost. We aimed to determine the prevalence and determinants of functional capacity impairment six to twelve months after an acute VTE event. Methods: This was a cross-sectional study conducted between January and April 2021 in two referral hospitals of Yaoundé, including consenting adult patients admitted to these hospitals six to twelve months ago for VTE. We excluded dead patients and those with any comorbidity or symptoms limiting physical activity. The functional outcome was assessed with the six-minute walk test. Functional capacity impairment was defined as walking distance lower than the expected value. Results: We included 27 cases in this study with a mean age of 53.2 ± 14.4 years. The prevalence of functional capacity impairment was 29.6% (95% CI: 14.8 - 48.1). Factors associated with poor functional outcome were obesity (OR: 59.5;95% CI: 4.6 - 767.2;p - 207.4;p = 0.017), massive PE (OR: 30;95% CI: 2.5 - 354;p = 0.004), and poor adherence to treatment (OR: 30.3;95% CI: 2.5 - 333.3;p = 0.004). Conclusion: Functional capacity impairment is common in the medium-term after VTE and factors associated with this poor outcome are obesity, the severity of the VTE, and poor adherence to treatment.

关键词： Functional Capacity Venous Thromboembolism Six-Minute Walk Test Cameroon

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Reasons for Delayed Breastfeeding Initiation among Newly Delivered Women in Two First-Category Hospitals in Yaoundé, Cameroon

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Open Journal of Pediatrics 2020年第3期10卷 474-485页

作者： Félicitée Nguefack Dany Hermann Ngwanou Georges Pius Kamsu Moyo Louise Ejake Evelyn Mungyeh Mah guy wafeu Danny Stève Fodoung Wamba Andreas Chiabi Faculty of Medicine and Biomedicals Sciences University of Yaoundé 1 Yaoundé Cameroon Yaoundé Gynaeco-Obstetric and Pediatric Hospital Yaoundé Cameroon Faculty of Health Sciences University of Bamenda Bamenda Cameroon

Introduction: Exclusive breastfeeding is fundamental for the good health and development of the mother and the child. According to the World Health Organization (WHO), breastfeeding after childbirth should be initiated within 30 minutes. For a number of reasons, WHO recommendations on guiding principles for infants and young children feeding are often not followed. Objective: To determine the reasons for the delayed initiation of breastfeeding in newly delivered women. Means and Method: We carried out a mixed cross-sectional study over a period of six months from December 1st 2018 to May 31st 2019, at the Yaoundé Gynaeco-Obstetric and Pediatric Hospital. We included all mothers with full-term or premature babies weighing ≥ 2000 grams and those whom initiated breastfeeding more than one hour after delivery. The mother’s reasons for delaying breastfeeding initiation were recorded using a dictaphone and data were accurately extracted for analysis. Results: We interviewed 153 mothers. Their mean age was 27.9 ± 6.2 years. The main reasons for delaying breastfeeding initiation were caesarean delivery (22%), the belief in “spoiled milk” (21%), lack of knowledge about the time to initiate breastfeeding (21%), baby asleep (18%), and lack of instruction given to the mother by the health staff (2%). Conclusion: Delayed breastfeeding was common in our context. Improving the quality of breastfeeding invo

关键词： Childbirth Breastfeeding Delay Reasons Yaoundé

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