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Epidemiological, Clinical, and Evolutionary Profile of Children Admitted to the Pediatric Emergency Department of the Maroua Regional Hospital, Cameroon

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Open Journal of Pediatrics 2024年第5期14卷 878-888页

作者： Soureya Haman Kamo Selangaï Héléne Enyama Dominique Abouame Palma Haoua Salihou Sadjo Mekone Nkwele isabelle Nguefack Félicitée Faculty of Medicine and Biomedical Sciences University of Garoua Garoua Cameroon Garoua General Hospital Garoua Cameroon Faculty of Medicine and Pharmaceutical Sciences University of Dschang Dschang Cameroon Faculty of Medicine and Biomedical Sciences University of Yaound Yaound Cameroon

Introduction: Pediatric emergencies in developing countries are associated with high morbidity and mortality. The Maroua Regional Hospital (MRH) is one of the referral centers for pediatric emergencies in the Far north region of Cameroon. Pediatric emergencies are frequent in Maroua and are associated with significant mortality. The aim of our study is to determine the epidemiological, clinical, and evolutionary profile of children admitted to the pediatric emergency department of the HRM. Methods: We conducted an observational, descriptive, and retrospective study over a period from April 10, 2023 to April 10, 2024, focusing on the records of patients admitted to the pediatric emergency department of the MRH. The variables studied included epidemiological, clinical, and evolutionary characteristics. Data analysis was performed using CSPro version 8.01 and SPSS version 27.0. Results: We included 1027 patients;the sex ratio was 1.2 infants under 2 years represented 54.33%. The main reasons for consultation were fever (62.22%) and seizures (30.18%). The most frequently prescribed additional test was the Complete Blood Count (CBC), performed in 97.37% of cases. The most common pathologies were severe malaria (45.18%), broncho-pulmonary infections (15.48%), and bacterial meningitis (12.26%). At admission, 32.9% were transfused. There were 68 deaths, representing 6.67%, and 86% of the deaths occurred within 24 hours of admission. The leading cause of death was severe malaria, with 28 (41.17%) cases. Conclusion: Febrile illnesses were the main reason for consultation, and mortality was linked to severe malaria. Therefore, in addition to the other preventive methods already used against malaria, it is recommended to consider the use of the malaria vaccine.

关键词： Pediatric Emergencies Malaria Cameroon

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Assessment of the Indirect Cost of Drug Resistant Tuberculosis Treatment to Patients in a High Burden, Low Income Setting in Mozambique

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Journal of Tuberculosis Research 2024年第2期12卷 91-104页

作者： Júlia Malache António Domingas Pacala isabelle Munyangaju Isaías Benzana Claudia Mutaquiha Dulce Osório Benedita José Edy Nacarapa Pereira Zindoga Faculdade de Cincias de Sade Universidade Catlica de Moambique Beira Moambique Programa Nacional de Controlo da Tuberculose Ministrio da Sade de Moambique Maputo Moambique ISGlobal Hospital Clnic Universitat de Barcelona Barcelona Spain Tinpswalo Association Vincentian Association to Fight AIDS and TB Chokwe Mozambique Centro de Estudos e Apoio Psicolgico (CEAP) Universidade Eduardo Mondlane Maputo Moambique

Introduction: Tuberculosis is closely linked to poverty, with patients facing significant indirect treatment costs. Treating drug-resistant tuberculosis further increases these expenses. Notably, there is a lack of published data on the indirect costs incurred by patients with drug-resistant tuberculosis in Mozambique. Objective: To assess the indirect costs, income reduction, and work productivity incurred by patients undergoing diagnosis and treatment for Drug-Resistant Tuberculosis (DRTB) in Mozambique during their TB treatment. Methods: As part of a comprehensive mixed-methods study conducted from January 2021 to April 2023, this research utilized a descriptive cross-sectional approach, incorporating both quantitative and qualitative methods. The primary goal was to evaluate the costs incurred by the national health system due to drug-resistant TB. Additionally, to explore the indirect costs experienced by patients and their families during treatment, semi-structured interviews were conducted with 27 individuals who had been undergoing treatment for over six months. Results: All survey participants unanimously reported a significant decline in labour productivity, with 70.3% experiencing a reduction in their monthly income. Before falling ill, the majority of respondents (33.3%) earned up to $76.92 monthly, representing the minimum earnings range, while 29.2% had a monthly income above $230.77, the maximum earnings range. Among those who experienced income loss, the majority (22.2%) reported a decrease of up to $76.92 per month, and 18.5% cited a loss exceeding $230.77 per month. Notably, patients with Drug-Resistant Tuberculosis (DRTB) have not incurred the direct costs of the disease, as these are covered by the government. Conclusion: The financial burden of treating Drug-Resistant Tuberculosis (DRTB), along with the income reduction it causes, is substantial. Implementing a patient-centred, multidisciplinary, and multisector approach, coupled with strong psy

关键词： Economic Costs Drug Resistance Tuberculosis Catastrophic Costs

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An Analysis of the Accounting Costs Associated with 20-Month DR TB Regimens in Maputo City, Mozambique

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Journal of Tuberculosis Research 2024年第2期12卷 73-90页

作者： Júlia Malache António Isaías Benzana isabelle Munyangaju Benedita José Dulce Osório Edy Nacarapa Claudia Mutaquiha Simeão Nhabinde Pereira Zindoga Universidade Catlica de Moambique Beira Moambique Centro de Estudos e Apoio Psicolgico (CEAP) Universidade Eduardo Mondlane Maputo Moambique ISGlobal Hospital Clnic Universitat de Barcelona Barcelona Spain Tinpswalo Association Vincentian Association to Fight AIDS and TB Chokwe Mozambique Programa Nacional de Controlo da Tuberculose Ministrio da Sade de Moambique Maputo Mozambique Faculdade de Economia Universidade Eduardo Mondlane Maputo Moambique

Introduction: Socioeconomic and demographic conditions in a country can influence tuberculosis incidence and mortality, with nearly 95% of tuberculosis-related deaths occurring in poorer countries. Mozambique is among the 30 countries with the highest TB burden. Objective: The study aimed to estimate the average direct medical cost of treating drug-resistant tuberculosis in 19 health centers in Maputo City, Mozambique. Methods: A retrospective analysis of direct medical costs was conducted on patients aged 18 and older who completed 20-month drug-resistant tuberculosis treatment regimens in Maputo City in 2019. Results: This analysis covered 140 patients who completed a 20-month treatment regimen, with 64.3% (78) being male and 35.7% (62) female. Approximately 50% of the participants were aged between 29 and 47. The average direct medical cost of DRTB treatment was $4789.43, reaching up to $6568.00, with a standard deviation of $753.26, including clinical interventions and treatment. Conclusion: The direct medical costs for a basic treatment package for a patient with drug-resistant TB in Mozambique equal 36 minimum wages. Developing alternative and innovative funding mechanisms and identifying ways to mitigate costs through the use of generic medicines would be beneficial.

关键词： Antitubercular Agents Multidrug-Resistant Healthcare Costs Tuberculosis Mozambique

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Diagnosis of CAH in a Sub Saharan Country: Visible Part of Iceberg

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Open Journal of Pediatrics 2024年第2期14卷 227-233页

作者： Suzanne Sap Ritha Mbono Hélène Kamo Jocelyn Tony Charlotte Eposse Jeannette Epée isabelle Mekone Adele Bodieu Gaelle Ntsoli Paul Olivier Koki Mother and Child Center of the Chantal Biya Foundation University of Yaoundé I Yaoundé Cameroon Laquintinie Hospital University of Douala Douala Cameroon Genral Hospital of Garoua University of Garoua Garoua Cameroon Human Reproductive Center and Research on Fertility of Yaoundé University of Yaoundé I Yaoundé Cameroon Yaounde General Hospital University of Yaoundé I Yaoundé Cameroon Yaounde Central Hospital Yaoundé Cameroon Laquintiinie Hospital Douala Cameroon

Introduction :Congenital adrenal hyperplasia (CAH) is the most common cause of primary adrenal insufficiency. It is a rare monogenic recessive disorder. In African setting in absence of neonatal screening, the diagnosis is still late, based on a clinical approach. During this clinical enquiry, information from past history or pedigree of the patient is of a huge importance and may revealed surprises. Patients and Methods: In this observational study, we retrospectively included all patients with a diagnosis of CAH. The diagnosis of CAH was retained based on a high 17 hydroxyprogesterone level in addition to clinical and morphological findings. From patients’ files, we extracted data on family history of disease, pedigree, clinical findings and genetics when available of 39 patients from two endocrinopeadiatric centers. Results: In 13 (30%) families, we found 20 reported deaths of infant less than 12 months. In these 13 families, half of the patients followed had 21 hydroxylase deficiencies and had 11 hydroxylase deficiencies. Unsurprisingly, we suspected adrenal insufficiency in these patients at verbal autopsy even in families with a patient with 11 hydroxylase deficiency. Other non DSD malformations or genetic disorders with apparently no link with CAH were reported in 3 families. The father of a patient reported to have hypospadias. Conclusion: Each diagnosis of CAH made in our context is visible part of an iceberg. Behind a diagnosis of CAH made in our setting, is a long course of care, a dramatic past history revealing access to appropriate care disparity. Neonatal screening should thus be considered as an emergency.

关键词： Congenital Adrenal Hyperplasia

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Factors Associated with Renal Impairment in Patients on Tenofovir for Chronic Hepatitis B in Yaoundé (Cameroon)

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Open Journal of Gastroenterology 2024年第1期14卷 18-30页

作者： Antonin Wilson Ndjitoyap Ndam Sonia Charlsia Ewuo Shu Mahamat Maimouna Winnie Bekolo Nga isabelle Dang Babagna Paul Talla Mathurin Kowo Firmin Ankouane Andoulo Gloria Enow Ashuntantang Hepato Gastroenterologist Service Yaoundé General Hospital Yaoundé Cameroon Internal Medicine Department Faculty of Medicine and Biomedical Sciences University of Yaoundé 1 Yaoundé Cameroon Department of Clinical Sciences Faculty of Health Sciences University of Bamenda Bamenda Cameroon Nephrologist Service Yaoundé General Hospital Yaoundé Cameroon Department of Clinical Sciences Faculty of Medicine and Pharmaceutical Sciences University of Douala Douala Cameroon Hepato Gastroenterologist Service Centre Medical la Cathedrale Yaoundé Cameroon

Background: Tenofovir (TFV) is widely used to treat patients with hepatitis B virus (HBV) infection. But kidney abnormalities are the main concern using this drug. Few studies have described the renal impairment due to the TFV in chronic hepatitis B (CHB) in Sub-Saharan Africa. The objective was to evaluate factors associated with renal impairment observed in patients on TFV for CHB. Method: It was a hospital based cross sectional prospective study carried out from June 2023 to July 2023 in Yaoundé (Cameroon) and included any patient treated with TFV for CHB during at least a period of 6 months. For each participant, we collected in the medical report socio-demographic data, clinical data, baseline creatinine, treatment information (type of TFV which was Disoproxil Fumarate (TDF) or Alafenamide (TAF), duration). Then, we collected blood samples to measure serum creatinine and phosphate levels and urine dipstick analysis. Factors associated with renal impairment were assessed with the Odds Ratio. A p value of Results: A total of 60 participants were included. The median age was 44 years [36-55] and median duration of TFV therapy was 17.5 months [11.7-25.7]. The prevalence of reduced eGFR (Conclusion: Kidney function was impaired in some patients receiving TFV for CHB. It should be monitored, particularly after 36 months and for those receiving TDF prodrug.

关键词： Chronic Hepatitis B Tenofovir Factors Associated Renal Impairment Cameroon

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Risk Factors for Geo-Helminthiasis in Children Aged 6 - 36 Months in a Rural Health District in Cameroon

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Open Journal of Pediatrics 2024年第2期14卷 391-400页

作者： isabelle Mekone Nkwele Monono Naiza Gervais Talla Kamga Hugues Nana Djeunga Jeannette Epée Ngoue Patricia Epée Eboumbou Suzanne Ngo Um Sap Evelyn Mah Mungeh Joseph Kamgno Department of Pediatrics Faculty of Medicine and Biomedical Sciences University of Yaoundé I Yaoundé Cameroon Department of Internal Medicine and Paediatrics Faculty of Health Sciences University of Buea Buea Cameroon Centre de Recherche sur les Filarioses et autres Maladies Tropicales (CRFilMT) Yaoundé Cameroon Department of Clinical Sciences Faculty of Medicine and Pharmaceutical Sciences University of Douala Douala Cameroon Department of Public Health Faculty of Medicine and Biomedical Sciences University of Yaoundé I Yaoundé Cameroon

Introduction and Objectives: Soil-Transmitted-Helminthiasis (STH) is a public health problem in Cameroon. The control strategies currently in place, particularly chemoprevention, has shortcomings linked to the target population, which are school-age children. The objective was to determine the prevalence and the risk factors associated with geo-helminthiasis in children aged 0 to 3 years in a rural health district. Method: From December 2020 to May 2021, a descriptive and analytical cross-sectional study of 376 children between 6 and 36 months was carried out in the Akonolinga health district. This was a cluster sampling in 4 health areas. Stool samples were collected and analysed using the mini-FLOTAC method. The results expressed as the number of eggs per gram of stool. A questionnaire on socio-demographic and lifestyle data was administered to the parents. The Chi-squared test was used to measure the association between geo-helminth infection and the data collected. A multivariate analysis using logistic regression was performed (p 0.05). Results: The prevalence of STH was 19.4% (Ascaris lumbricoides: 16% and Trichuris trichiura: 8%). Risk factors were: consumption of contaminated water (AOR = 1.93 [1.03 - 3.6];p = 0.040), early contact of the child with the ground (before age of 4 months) (AOR = 4.9 [2.1 - 11.37];p .001), habit of walking barefoot (AOR = 2.91 [1.1 - 7.97];p = 0.038), and living in a habitat with unpaved ground (AOR = 7.4 [1.55 - 35.7];p = 0.012). Conclusion: The prevalence of STHs in infants was high. Preventive chemotherapy should be extended to this age-group, and other measures intensified.

关键词： Akonolinga Soil-Transmitted-Helminths Children Aged 0 - 3 Years Risk Factors

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Detailed Analysis of the Flow in the Inducer of a Transonic Centrifugal Compressor

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Journal of Thermal Science 2012年第1期21卷 1-12页

作者： Nicolas Buffaz isabelle Trébinjac Laboratoire de Mécanique des Fluides et d'Acoustique Ecole Centrale de Lyon 36 av. Guy de Collongue

Numerical and experimental investigations were conducted in a transonic centrifugal compressor stage composed of a backswept splittered unshrouded impeller and a vaned diffuser. A detailed analysis of the flow in the inducer (i.e. the entry zone of the impeller between the main blade leading edge and the splitter blade leading edge) is proposed from choke to surge. Steady and unsteady simulations were performed using the code elsA, which uses a multi-domain approach on structured meshes and solves the compressible RANS equations, associated with a two-equation turbulence model k-l in the rotating frame of reference. The 1MW LMFA-ECL test rig was used for carrying out the tests in the compressor stage. Unsteady pressure measurements up to 150 kHz and Laser Doppler Anemometry measurements were performed in the inducer. A good agreement is obtained between the experimental and numerical data even if an over dissipation is noticed in the numerical results. The change in flow pattern from choke to surge is mainly due to a change in the tip leakage flow trajectory which straightens, leading to a flow blockage of an individual passage near shroud. A spectral analysis shows that only the blade passing frequency and its harmonics compose the various spectra obtained from choke to surge.

关键词： transonic centrifugal compressor inducer unsteady pressure measurements

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Twists and turns of the genetic story of mevalonate kinase-associated diseases:A review

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Genes & Diseases 2022年第4期9卷 1000-1007页

作者： isabelle Touitou IRMB Univ MontpellierINSERMMontpellier 34090France Department of Medical Genetics Rare Diseases and Personalized MedicineRare and Autoinflammatory Diseases UnitCeRéMAIACHUMontpellier 34000France

Mevalonate kinase (MK)-associated diseases encompass a broad spectrum of rare auto-inflammatory conditions, all resulting from pathogenic variants in the mevalonate kinase gene (MVK). Their clinical manifestations are highly variable, ranging from more or less serious systemic disorders, such as hereditary recurrent fevers, to purely localized pathologies such as porokeratosis. The oldest condition identified as linked to this gene is a metabolic disease called mevalonic aciduria, and the most recent is disseminated superficial actinic porokeratosis, a disease limited to the skin. The modes of inheritance of MK-associated diseases also diverge among the different subtypes: recessive for the systemic subtypes and dominant with a post-zygotic somatic genetic alteration for MVK-associated porokeratosis. This review quickly retraces the historical steps that led to the description of the various MK-associated disease phenotypes and to a better understanding of their pathophysiology, then summarizes and compares the different genetic mechanisms involved in this group of disorders, and finally discusses the diverse causes that could underlie this phenotypic heterogeneity.

关键词： Autoinflammatory disease Genetic disease Meval onate kinase deficiency Porokeratosis Subtypes

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Acceptance and Experience of HIV-Infected Adolescents in Two Hospitals in Yaoundé

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Open Journal of Pediatrics 2024年第2期14卷 435-443页

作者： isabelle Mekone Nkwele Nelly Kamgaing Pierrette Amanda Emah Manga Jeannette Épée Ngoué Hélène Kamo Sélangai Claude Audrey Meguieze Nsoh Ndeh-Fofang Serge Tchoukoua Jean-Baptiste Fotso Djemo Paul Koki Ndombo Department of Pediatrics Faculty of Medicine and Biomedical Sciences University of Yaoundé I Yaoundé Cameroon Institut Supérieur des Sciences de la Santé de Bangangté Université des Montagnes Bangangté Cameroon Faculty of Medicine and Biomedical Sciences University of Garoua Garoua Cameroon

Introduction: Access to antiretroviral drugs has improved the survival of children infected with the Human Immunodeficiency Virus (HIV). As they reach adolescence, they are confronted with various constraints related to the infection and its treatment, in addition to those of the growth period they are going through. The main aim of the study was to assess the acceptance and describe the experience of HIV infection by infected adolescents but also to investigate the factors associated with good acceptance and a positive experience. Methodology: The cross-sectional analytic study concerned HIV-infected adolescents aged 15 to 19 followed up at the Chantal Biya Foundation-Mother and Child Centre (CME-FCB) and the Yaoundé University Hospital Centre (CHUY) between February 2020 and June 2020. The study saw participants complete a questionnaire containing socio-demographic data and assessing acceptance and experience with the infection. Data analysis was accomplished using Epi info software version 7.***.2.6. Results: One hundred and thirteen HIV-infected adolescents were included in the study. The sex ratio was 0.68 and the mean age was 17 years. More than half of the adolescents had a good acceptance and positive experience with the infection. Related factors were the adolescent’s perception of good health and participation in an association with other infected adolescents. Conclusion: Emphasizing the psychological and educational follow-up of infected adolescents and encouraging their participation in associations for adolescents living with HIV could reduce the consequences of poor acceptance and ensure a better transition to adulthood. .

关键词： HIV Adolescent Acceptance Experience

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The therapeutic potential of nerve growth factor combined with blood-brain barrier modulation by focused ultrasound for neurodegenerative disorders

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Neural Regeneration Research 2021年第9期16卷 1783-1785页

作者： Kristiana Xhima isabelle Aubert Department of Laboratory Medicine and Pathobiology University of TorontoTorontoONCanada Hurvitz Brain Sciences Research Program Sunnybrook Research InstituteTorontoONCanada Biological Sciences Sunnybrook Research InstituteTorontoONCanada

Nerve growth factor(NGF) is a neurotrophic factor critical for cholinergic neuronal survival, phenotypic maintenance and plasticity in the mammalian brain. NGF has been implicated in the pathogenesis of neurodegenerat... 详细信息

关键词： degenerative disorders therapeutic

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