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Mortality and Associated Risk Factors among In-Patients with Covid-19 in Douala, Cameroon: A Retrospective Cross-Sectional Study

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Advances in Infectious Diseases 2022年第1期12卷 1-19页

作者： Francois Adrien Bokalli Fru McWright Chi Ephesians Anutebeh Caven Ngoe mbachan takere Edwin Ewane Dieudonne Akanji Conrald Ekukole Marie-Solange Ndom Mireille-Laurent Endale David Mekolo Henry Luma Jacqueline Ze Minkande Marcelin Ngowe Ngowe Specialised COVID-19 Treatment Centre Yassa Douala Cameroon Department of Medicine Faculty of Health Sciences University of Buea Buea Cameroon Department of Medicine Laquintinie Hospital Douala Cameroon Intensive Care and Emergency Department Laquintinie Hospital Douala Cameroon Department of Internal Medicine Douala General Hospital Douala Cameroon Department of Surgery and Specialties Faculty of Medicine and Biomedical Sciences University of Yaounde Yaounde Cameroon Department of Surgery and Specialties Faculty of Medicine and Pharmaceutical Sciences University of Douala Douala Cameroon

Background: In March 2020, the World Health Organization declared the coronavirus disease 2019 a pandemic, this was caused by the Severe Acute Respiratory Syndrome Coronavirus 2. The overall mortality from this remains high, yet there are limited studies assessing the associated factors in Africa. Objective: To identify the factors associated with mortality in hospitalized COVID-19 patients in Douala, Cameroon. Method: We conducted a single-centre retrospective cross-sectional study by reviewing records of patients managed for COVID-19 between March and June 2020. Diagnosis was confirmed by real-time RT-PCR. Outcome of interest was mortality during hospitalization. We inputted and analyzed data using SPSS version 25.0, compared mortality between groups using the Chi’s squared test and the Fisher’s exact test where appropriately investigated for associations using the Logistic regression in a stepwise approach and alpha-value set at P = 0.05. Results: We analyzed 282 case files, 68% were males (M:F = 2:1) and a mean age of 52 (±15) years. We had an overall mortality of 31.5% (89/282 patients) and 54% (50/92 patients) admitted in the ICU died. Patients aged 0 - 39 years had a significantly lesser odds of mortality compared to those > 70 years (OR: 0.2 (0.1 - 0.5) P Conclusion: The in-hospital mortality in COVID-19 patients is very high and hospitalisation into the ICU is associated with even higher mortality. Advanced age, diffused lung involvement (particularly with alveolar consolidation), hemodynamic instability at presentation and altered level of consciousness favoured hospitalisation in the ICU. Once in the ICU, placement on mechanical ventilation did not reduce death discernibly.

关键词： COVID-19 Risk Factors Mortality Cameroon

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Helicobacter Pylori Infections in Peptic Ulcer Perforations: A Retrospective Analysis in Two Referral Hospitals in Douala, Cameroon

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Surgical Science 2020年第10期11卷 298-311页

作者： Francois Adrien Morel Bokalli Chi Fru McWright Jerry Brown Njoh Aseneh takere Maseoli mbachan Ngomba Divine Mokake Jules Clément Assob Nguedia Marcelin Ngowe Ngowe Department of Medicine Faculty of Health Sciences University of Buea Buea Cameroon Laquintinie Hospital Douala Cameroon Department of Surgery Faculty of Health Sciences University of Buea Buea Cameroon Department of Biomedical Sciences Faculty of Medicine and Pharmaceutical Sciences University of Douala Douala Cameroon Department of Surgery Faculty of Medicine and Pharmaceutical Sciences University of Douala Douala Cameroon

Background: Perforations are major complications of peptic ulcer disease and surgical emergencies with important mortality and morbidity. Helicobacter pylori (H. pylori) has been identified as one of the commonest factors associated with peptic ulcer disease. However, little is known about its implication in cases of perforations in Cameroon. We aimed to determine the frequency of Helicobacter pylori infections in cases of perforated peptic ulcers, describe clinical features and outcomes of these cases in Cameroon. Method: A hospital-based retrospective cross-sectional study was conducted through the review of patients’ records admitted for peptic ulcer perforations in Laquintinie and Douala General Hospitals over a period of 5 years (January 2014 - December 2018). We defined H. pylori infection as;positive result on tissue biopsy at time of surgery. We used SPSS version 23.0 to analyse data and set an alpha value at P = 0.05. Results: We reviewed 115 cases of peptic ulcer perforation, with a mean age of 40 years and sex ratio (M:F) of 5:1. All patients underwent emergency laparotomy, 48 (41%) cases had a biopsy report and the prevalence of H. pylori infection in these cases was 47.9 %. Smoking, alcohol consumption and Non-Steroidal Anti-inflammatory Drugs (NSAIDs) use, were not associated with peptic ulcer perforation. The morbidity was at 43.7% and mortality at 14%. Mortality was increasing with a higher Mannheim Peritonitis Index score (OR: 23.51, 95% CI: 4.197 - 143.003, P-value: 0.000). Conclusion: We observed a high prevalence of H. pylori infection in patients with peptic ulcer perforations. We recommend systematic H. pylori screening in cases of perforations and that larger studies should be carried out to evaluate the association of H. pylori infection with peptic ulcer perforation in Sub-Saharan Africa.

关键词： Perforated Peptic Ulcers Helicobacter pylori Infections Clinical Features Outcome

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