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Comparative Analysis of Community-Based Management of Anemia in Children before and during the COVID Pandemic

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Open Journal of Pediatrics 2022年第4期12卷 671-677页

作者： Kamo Sélangaï Doka Hélène Mekone Nkwele Isabelle Jeannette Epée ngoué Tony Nengom Jocelyn Zenabou Tena Zomene Franc ngo um sap suzanne Faculty of Medicine and Biomedical Sciences University of Garoua Garoua Cameroon Pediatric Unit of the Regional Hospital of Ngaoundere Ngaoundere Cameroon Faculty of Medicine and Biomedical Sciences University of Yaounde I Yaounde Cameroon

Introduction: In low-income countries, severe anemia represents a significant risk of mortality. It is generally the consequence of a lack of correct community-based management of mild and moderate anemia and its etiologies. Our study aimed to evaluate the community practice in confronting anemia by mothers of children aged 0 - 5 years old before and during the COVID-19 period. Methods: We conducted a descriptive cross-sectional study in two phases at the pediatric ward of the regional hospital of Ngaoundere in Cameroon;before the period of the COVID-19 pandemic from December 2018 to May 2019 and during the pandemic period from December 2020 to May 2021. It was a volunteer sample. Were included in this study all mothers of children aged 0 - 5 years present in the pediatric ward at the time of the survey who agreed to freely answer our questionnaire. Results: Of the 152 mothers surveyed in the “Before COVID-19” group, 69% went to a health facility when they suspected their children were anemic, 20% gave grenadine juice (Red colored soda), 7% went to marabous, 2% bought street medicines and 2% used other home-made potions. Of the 92 mothers included in the “During COVID-19” group, the majority did not go to a health facility: 36% gave grenadine juice and other potions, 26% went to marabouts, 23% bought medicines from the street and only 13% went to a health facility;2% did nothing. The average Group rank is not statistically significantly different between the before and during the COVID-19 periods (p = 0.89). Conclusion: Community behavior and practice in confronting anemia deteriorated during the COVID-19 pandemic, with the majority of mothers resorting to non-effective out-of-hospital solutions. The consequence can be an increase in infant mortality. While waiting for the end of the pandemic, it is judicious and urgent to review the whole health system in Africa and especially in countries with limited resources. We propose developing multiple advanced strategies t

关键词： Anemia COVID-19 Community Management

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

Congenital Lipodystrophy: A Case Series Report from Cameroon

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Open Journal of Pediatrics 2020年第1期10卷 231-235页

作者： suzanne sap ngo um Jocelyn Tony Ritha Mbono Yannick Tekel Isabelle Mekone Mesmin Dehayem Koki Ndombo Department of Paediatrics University of Yaounde I Yaounde Cameroon Mother and Child Center of the Chantal Biya Foundation Yaounde Cameroon University of Douala Douala Cameroon Yaounde Central Hospital Yaounde Cameroon

Congenital lipodystrophy is a group of rare syndrome characterized by the absence of subcutaneous tissue. Affecting less per million live birth, this condition associate metabolic disturbance including severe insulin resistance and progeroid appearance. Diagnosis may be fortuitous or related to complications as presented in the present case series. Lipodystrophy can be generalized or localized. Acquired lipodystrophy is associated with some drugs like antiretroviral. Thus, the condition is well described in African HIV patients but data on congenital forms from Sub Saharan Africa are sparse, justifying the present report. We present four cases, with peculiar appearance associated with increased blood triglycerides. Two on four of the patients presented diabetes mellitus. Genetic testing was not available, questioning the actual guidelines of diagnosis for our context.

关键词： Lipodystrophy Diabetes Children

Comparison of the Clinical Profile and Severity Factors of COVID-19 during the First 4 Waves in a Paediatric Population of Yaounde

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Open Journal of Pediatrics 2023年第1期13卷 125-137页

作者： Jocelyn Tony Nengom suzanne sap ngo um Louis Serge Tang Nlend Bonaventure Hollong Jeannette Epée ngoué Paul Olivier Koki Ndombo Faculty of Medicine and Biomedical Sciences Department of Pediatrics University of Yaounde I Yaounde Cameroon Mother and Child Center of Chantal Biya’s Foundation Yaounde Cameroon Specialized Center for COVID-19 Patients Annex Number II of the Yaounde Central Hospital (ORCA) Yaounde Cameroon

Introduction: COVID-19 is an infectious disease that has been causing a global pandemic since 2019. Although clinical forms are generally less severe in children than in adults, children nevertheless present polymorphous clinical forms and severe cases that can lead to death. Objective: To describe the clinical presentations found in the different waves of COVID-19, and to highlight the different factors of severity. Materials and Methods: We conducted a cross-sectional study with retrospective and prospective data collection which lasted 7 months (from November 2021 to June 2022) and covered a study period from 6 March 2020 to 22 June 2022, i.e. 27 months. All patients aged 0 to 18 years, suspected of having COVID-19, confirmed by real-time RT-PCR or an antigenic Rapid Diagnostic Test or antibody were included. These patients were to be managed in the Mother and Child Centre of the Chantal Biya Foundation, as well as in the Specialised Centre for the Management of COVID patients, annex number II of the Yaoundé Central Hospital. The results were analysed using IBM SPSS.23 software. Results: We included 163 patients in our study. No paediatric patients were registered during the 3rd wave. The mean age of the patients in the study population was 13 ± 5 years with extremes from 15 days to 18 years. We had a female predominance with a sex ratio of 0.83. The most common comorbidity was asthma. The first wave presented mainly with respiratory symptoms such as dry cough and signs of respiratory distress. The second wave presented mainly with digestive symptoms such as diarrhoea, abdominal pain and vomiting. The fourth wave presented with ENT signs such as sore throat, and rhinorrhea. Factors associated with severity were mainly age less than five years (OR = 17.69), vomiting (OR = 6.50), presence of comorbidities (OR = 3.39), and alteration of vital parameters such as bradypnoea (OR = 19.68), bradycardia (OR = 6.34), tachycardia (OR = 3.73), oxygen saturation Co

关键词： COVID-19 Children Waves Clinical Profile Severity Cameroon

Pediatric COVID-19 in Sub-Saharan Africa: A Series of Cases Report in Cameroon

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Open Journal of Pediatrics 2020年第2期10卷 363-368页

作者： Mekone Nkwele Isabelle Chelo David Eloundou Odi Eugene sap ngo um suzanne Meli Josephine Hadja Hamsatou Balla Nkonda Alain Minka Basilice Djientcheu Vincent de Paul Faculty of Medicine and Biomedical Sciences Department of Pediatrics University of Yaoundé I Yaoundé Cameroon Yaoundé General Hospital Yaoundé Cameroon Jordan Medical Service Yaoundé Cameroon

Background: Infection with the new Coronavirus 2019 SARS-CoV-2, COVID-19, is a global pandemic that does not spare children. Pediatric forms of COVID-19 are increasingly described in the literature with less severe clinical forms and lower mortality as compared to adults. We do not have data on the epidemiologic characteristics of SARS-CoV-2 infection in children in sub-Saharan Africa where the pandemic is less severe. Aim: We present four cases of pediatric COVID-19 in Cameroun. Case Presentation: These cases of COVID-19 concern children aged 12 weeks to 13 years. We discuss the diagnostic difficulties and the issues of effective management in the context of a resource-constrained country. Conclusion: COVID-19 affects children in sub-Saharan Africa. There are different clinical presentations with favorable outcomes, but there is a need for greater vigilance in the pediatric population.

关键词： COVID-19 Children Cameroon Sub-Saharan Africa

Factors Associated with Antibody Levels among Children Aged 15 to 59 Months Vaccinated against Hepatitis B during the Expanded Program on Immunization in Cameroon

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Open Journal of Gastroenterology 2023年第2期13卷 91-98页

作者： Antonin Wilson Ndjitoyap Ndam Alpha Hamed Béchir Ndam Mefire Winnie Bekolo Guy Roger Nsenga Djapa suzanne ngo um sap Paul Koki Ndombo Elie Claude Ndjitoyap Ndam Department of Internal Medicine and Specialities Faculty of Medicine and Biomedical Sciences University of Yaoundé 1 Yaoundé Cameroon Department of Clinical Sciences Faculty of Medicine and Pharmaceutical Sciences University of Douala Douala Cameroon Department of Internal Medicine and Specialities Faculty of Medicine and Biomedical Sciences University of Dschang Dschang Cameroun Department of Paediatrics Faculty of Medicine and Biomedical Sciences University of Yaoundé 1 Yaoundé Cameroon

Background: the hepatitis B virus infection remains a major public health problem worldwide. It can lead to a liver cirrhosis and/or hepatocellular carcinoma. The World Health Organisation (WHO) has recommended the implementation of generalised vaccination programs against hepatitis B. In Cameroon, this vaccine was introduced in the expanded program on immunization (EPI) in 2005, but few studies have assessed the immune response. Objective: the general objective of this study was to identify factors associated with antibody levels among children aged from 15 to 59 months vaccinated against hepatitis B during the EPI in Cameroon. Method: this was a cross-sectional study carried out from December 2021 to June 2022 in a paediatric centre of Yaoundé (Cameroon). We analysed the antibody level in children vaccinated against hepatitis B within the framework of the EPI. We enrolled children who had received a series of 3 intramuscular doses of hepatitis B vaccine at 6, 10 and 14 weeks after birth. Some children could receive a 4th booster dose between 12 months. The antibody level was assessed by measuring the anti-HBs in such children, aged 15 - 59 months. A good immunization was defined as a serum level of anti-HBs antibody level above 100 IU/mL;a poor immunization, for an anti-HBs antibody level between 10 and 100 IU/mL;and a non-immunization, for an anti-HBs antibody level < 10 IU/mL. Association between explored factors and poor or non-immunization was evaluated through the Chi square test. The significance threshold was defined at p < 0.05. Results: sixty subjects were included in the study with a slight female majority: 31 cases (52%). The average age was 38.5 ± 15.7 months (range 15 - 59 months). We found 32 (53%) cases of good immunization;21 (35%) of poor immunization;and 7 children (12%) with a non-immunization. The only factor associated with poor or non-immunization was the age between 37 - 59 months (p = 0.016). Conclusion: Anti HBs Antibody levels

关键词： Hepatitis B Vaccination Children Antibody Levels Immunization Cameroon

Insulin Sensitivity of Term Newborns Exposed in Utero to HIV and Antiretrovirals in Yaoundé

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Open Journal of Endocrine and Metabolic Diseases 2023年第9期13卷 161-172页

作者： Francine Mendane Ekobena Audrey Christance Donfack Hortence Fouedjio suzanne ngo um sap Martine Claude Etoa Etoga Mesmin Dehayem Anne Boli Ongmeb Gabriel Loni Ekali Jean Claude Mbanya Eugène Sobngwi Internal Medicine Unit Essos Hospital Center Yaoundé Cameroon Faculty of Medicine and Biomedical Sciences University of Yaoundé 1 Yaoundé Cameroon Obstetrics and Gynecology Unit Yaoundé Central Hospital Yaoundé Cameroon Mother and Child Center Chantal Biya Foundation Yaoundé Cameroon Endocrinology and Metabolic Diseases Unit Yaoundé Central Hospital Yaoundé Cameroon Faculty of Health Sciences of Bamenda Bamenda Cameroon Biotechnology Center University of Yaoundé 1 Yaoundé Cameroon

Introduction: Antiretrovirals (ARVs) and the human immunodeficiency virus (HIV) are implicated in the onset of insulin resistance. They cross the placental barrier thereby inducing early modifications of the fetal environment. The aim of our study was to assess insulin sensitivity in full-term newborns exposed in utero to HIV and ARVs in Yaoundé. Materials and Methods: We conducted an analytical cross-sectional study in 2 maternities in the city of Yaoundé from November 2021 to June 2022. We generated two groups of newborns (NBs): one group born to HIV positive mothers on ARVs and the other control group born to HIV negative mothers. Clinical data from mothers and NBs were collected. A homeostatic model assessment of insulin resistance (HOMA-IR) like index with C peptide served to assess insulin sensitivity. We used the Spearman correlation to measure the strength of association between insulin sensitivity and the different variables. A p-value Results: Of 70 neonates included, 35 were born to HIV positive mothers on ARVs and 35 to HIV negative mothers. The median age of HIV positive and negative mothers was 30 (27 - 32) and 34 (24 - 47) years, respectively (p = 0.791). The body mass index before pregnancy as well as the average newborn weights were comparable in both groups. The ARV protocol associating Tenofovir, Lamivudine, Efavirenz was used by 97.1% of HIV positive mothers. In the exposed NBs group, C peptide was significantly lower (p < 0.001) and blood glucose significantly higher (p < 0.001). The median values of HOMA-IR were 1.4 (0.8 - 1.9) and 2 (1.4 - 2.6) (p = 0.001) for exposed and unexposed NBs, respectively. Conclusion: Newborns exposed to HIV and ARVs had lower C peptide levels and were more sensitive to insulin. Close metabolic monitoring of these newborns would allow early diagnosis and management of any glucose regulation disorder.

关键词： Insulin Sensitivity Newborns Antiretrovirals HIV C Peptide HOMA-IR