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A Public Health Model and Framework to Mitigate the Impact of Orphans and Vulnerable Children Due to HIV/AIDS in Cameroon

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World Journal of AIDS 2014年第1期4卷 27-37页

作者： Dickson Shey Nsagha ngowe ngowe marcelin Jules Clement Nguedia Assob Anna Longdoh Njundah Department of Biomedical Sciences Faculty of Health Sciences University of Buea Buea Cameroon Department of Medical Laboratory Sciences Faculty of Health Sciences University of Buea Buea Cameroon Department of Public Health and Hygiene Faculty of Health Sciences University of Buea Buea Cameroon Department of Surgery Obstetrics and Gynecology Faculty of Health Sciences University of Buea Buea Cameroon

UNICEF, UNAIDS and USAID developed a global strategic framework to guide responses to care and protect orphans and other vulnerable children in the context of HIV/AIDS. In the developing world, about 132 million people have lost one or both parents due to the AIDS pandemic and 25 million children have been orphaned by HIV/AIDS in 2010. The HIV prevalence in Cameroon is estimated at 5.1%. As of 2010, there were 304,000 deaths due to AIDS in Cameroon. Out of 1,200,000 orphans and vulnerable children in Cameroon in 2010, 300,000 were AIDS orphans. The HIV/AIDS burden impacts child survival, growth and development in the traditional African setting. With so many orphans in the population, along with many vulnerable children, strategies must be developed to respond more effectively to their critical needs. This study provides a model for OVC care and support in Cameroon. The model was developed out of extensive work using a participatory approach involving traditional, administrative and health stakeholders on OVC in Yaounde I and Yaounde VI Councils, Nanga Eboko Health District, Isangelle, Ekondo Titi, and Bafaka-Balue communities in Cameroon. Consultancy services with PLAN Cameroon, the Pan African Institute for Development-West Africa coupled with facilitation of many training workshops on OVC with Save the orphans Foundation, the Ministry of Social Affairs, and the Ministry of Public Health and working with the National AIDS Control Committee. The essential components of a holistic framework for the care of OVC have been identified. A public health model for the care of OVC and a mechanism for their identification and a referral system for testing OVC for HIV are proposed. Through this model, a mechanism for the effective holistic care of OVC and collaboration is enhanced.

关键词： Orphans Vulnerable Children HIV AIDS Public Health Model Cameroon

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Pronostic Factors and Survival of Colorectal Cancer in Cameroun: A Retrospective Hospital-Based Study

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Open Journal of Gastroenterology 2021年第3期11卷 53-66页

作者： Jean Paul Engbang Fabien Bekolo Fouda Ulrich Chanwa marcelin ngowe ngowe Faculty of Medicine and Pharmaceutical Sciences The University of Douala Douala Cameroon Douala Laquintinie Hospital Douala Cameroon Douala Military Hospital Douala Cameroon Faculty of Medicine and Biomedical Sciences The University de Yaounde I Yaoundé Cameroon

Background: Colorectal cancer represents a major health problem in the world today, the 3rd most common cancer and the 2nd in terms of mortality. Despite of the fact that the incidence rate remains the lowest in Africa, it is still a provider of a stronger lethality in most western countries. In Cameroon according to WHO 2018, 421 new cases (4.5% of all cancers) and 451 deaths (4.3% of all cancers) were registered. Objective: Determine the prognostics factors and the survival of patients suffering from colorectal cancer followed up in Douala. Patients and Method: This was a retrospective cohort study over a period from January 1st, 2009 to December 31st, 2018. All patients with histologically proven colorectal cancer, at the gastroenterological, oncological, anatomopathological, radiotherapy and surgery Department of Laquintinie and General Hospitals of Douala were included. The data collected were recorded and analyzed by SPSS version 25 and Excel 2016 statistical computer software. Survival was determined by the Kaplan Meier method and the search for prognostic factors was carried out using the Cox proportional hazards mod

关键词： Colorectal Cancer Prognosis Survival Douala

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Diagnosis and Treatment of Digestive Emergencies in Two Hospitals in Douala (Cameroon)

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Surgical Science 2021年第6期12卷 174-186页

作者： Jean Paul Engbang Basile Essola Thomas Jim-Kevin Moukoury Christian Beugheum Chasim Gertrude Massom Toumaleu Mathieu Motah marcelin ngowe ngowe Faculty of Medicine and Pharmaceutical Sciences The University of Douala Douala Cameroon Douala Laquintinie Hospital Douala Cameroon Douala General Hospital Douala Cameroon Faculty of Medicine and Biomedical Sciences The University de Yaounde I Yaounde Cameroon

Background: Gastrointestinal tract (GIT) surgical emergencies represent a significant amount within surgical pathologies, in Africa and throughout the world. Our study was aimed to assess the etiological, therapeutic and prognostic aspects of GIT surgical emergencies in patients from two hospitals in Douala, Cameroon. Patients and Method: A longitudinal prospective study was conducted from December 2018 to May 2019, including 203 patients of all ages and both sexes who presented with a GIT surgical emergency in any clinical form, and who underwent surgery within one of our hospitals. We collected patients’ parameters through a survey, from complete history to clinical examination, then followed them up from surgery to post-operative time. Gathered information was analyzed by IBM Statistical Package for Social Science (SPSS) 23.0 software version. Results: GIT surgical emergencies accounted for 27.5% of all surgical emergencies. Our target population included 55.2% (n = 112) of men, and 44.8% (n = 91) of women, observing a sex-ratio of 1.23. The mean age of the patients was 36.3 ± 17.1 years, with extreme values of 6 months and 86 years. Abdominal pain was the most common symptom, vomiting and lack of bowel movement or gas pass, were the main associated symptoms in 27.6% and 16.7% of cases, respectively. Etiologically, leading pathologies were intestinal obstruction (32.0%, 64 cases), acute appendicitis (24.6%, 50 cases), then came peritononitis and abdominal trauma with respectively 22.7% (46 cases) and 21.7% (43 cases). Most patients underwent surgery within 24 hour. Laparotomy was the primary method used in 90.6%, and laparoscopy (9.4%). Post-operative suture breakage and parietal suppuration were the most common complications post-operatively. Totally, the overall morbidity and mortality rates were respectively 8.9% and 0.98% among our patients. Conclusion: Acute surgical abdomens occupy an impor

关键词： Emergency Digestive Surgery Etiologies Management Douala (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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Socio-Demographic Profiles of Naive HIV Pregnant Women and Retention to the Prevention of Mother-to-Child Transmission (PMTCT) Interventions in the East Region of Cameroon

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World Journal of AIDS 2020年第1期10卷 36-45页

作者： Ottop F. Manyi Assob N. Jules Clement Mbu R. Enow ngowe N. marcelin Department of Medical Laboratory Sciences Faculty of Health Sciences University of Buea Buea Cameroon Department of Obstetrics and Gynecology Faculty of Medicine and Biomedical Sciences University of Yaoundé 1 Yaoundé Cameroon Department of Family Health Ministry of Public Health Yaoundé Cameroon Department of Surgery Faculty of Medicine and Biomedical Sciences University of Yaoundé 1 Yaoundé Cameroon Faculty of Health Sciences University of Buea Buea Cameroon

Background: At enrolment into antenatal care, socio-demographic data of HIV infected pregnant women and lactating mothers are usually collected with little or no analysis done on them. This study was aimed to describe the socio-demographic profiles of naive to antiretroviral therapy (ART) HIV-infected pregnant women in the East region of Cameroon and to link this to retention in order to optimize the implementation of the prevention of mother-to-child transmission (PMTCT) interventions. Methods: A descriptive prospective study that lasted from February 2018 until February 2019 in three catchment health facilities in the East region for the recruitment and follow-up of participants who were consented HIV-infected pregnant women naive to ART. Socio-demographic, treatment compliance and adherence data were obtained by healthcare providers who were trained using a standard questionnaire that was conceived, tested and adapted for the study. Data were analyzed using Graph Prism (Graph pad 6.0, San Diego, USA). The Fisher exact and Chi-squared tests were used to establish the associations and independence between different variables at statistical significance level of p Results: A total of seventy (70) women were enrolled with age range varying between 15 and 40 years with a mean age of 26.5 ± 6.2 years. Loss-to-follow-up (LTFU) was observed among 17 women (24.29%). The Muslim religion, education below secondary level and the profession of housewife were significantly associated with LTFU at p = 0.01, p p = 0.0053, respectively. For participants who were retained until study endpoint, having secondary level of education or above and a profession other than housewife had a significant association (p = 0.0063), as well as being a Christian. Conclusion: Loss to follow-up in PMTCT program was associated with Muslim religion, primary level of education and the housewife occupation.

关键词： Pregnant Women Intervention Profile Education Religion

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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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Management and Outcome of Urethral Strictures at Two Tertiary Health Facilities in Cameroon

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Open Journal of Urology 2024年第8期14卷 435-446页

作者： Martin Divine Mokake Divine Enoru Eyongeta Ekani Mahamat Ekani Diana Nunga Theophile Chunteng Nana Ntungwetape Ngwane Mwambo Nalova Elroy Patrick Weledji Chichom Alain Mefire Marcellin ngowe ngowe Department of Surgery and Specialties Faculty of Health Sciences University of Buea Buea Cameroon Department of Surgery Regional Hospital Buea Buea Cameroon Department of Surgery Regional Hospital Limbe Limbe Cameroon Department of Surgery Douala General Hospital Douala Cameroon

Introduction and Objectives: Urethral stricture is a reduction in the caliber of the urethral lumen impeding the outflow of urine. It predominantly affects males. The disease burden is severe in our milieu where access to specialized care is limited. Our goal was therefore to assess the management and outcome of male urethral stricture at two tertiary hospitals in Douala, Cameroon. Materials and Methods: This was a hospital-based retrospective study of patients managed for urethral stricture over 5 years (January 1st, 2017 to December 31st, 2021) at the Douala General and Laquintinie Hospitals. Data on sociodemographic, clinical, paraclinical, and treatment options were extracted using pre-structured forms. Data was analyzed using Statistical Package for Social Sciences (SPSS) version 28. Statistical significance was set at p-value Results: We exploited 130 medical records. The mean age of patients was 46.5 years. Dysuria and weak urine stream were the major presenting complaints (63.8% and 23.8% respectively). The etiology of urethral stricture was iatrogenic in 42.3% of cases. The strictures were mostly single (89.8%), and the bulbar urethra was most affected (46.9%). 28 patients had urinary tract infections and the most frequently isolated germ was E. coli in 29.6%. Direct visual internal urethrotomy (DVIU) was performed in 42.3% of cases. Surgery, especially excision and primary anastomosis (EPA) was done in 28.5% of cases. Major complications were wound infection, acute kidney injury (AKI), and urethrocutaneous fistulae affecting 3.1, 2.3, and 1.5% of cases respectively. The recurrence rate was 17% with a mortality rate of 0.08%. Conclusion: Urethral stricture is common in our adult male population. The cause is mainly iatrogenic and the bulbar urethra is most affected. Minimally invasive and open reconstruction are frequently used treatment options with significant recurrence rates in the long term.

关键词： Urethral Stricture Management Outcomes

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Prevalence, Management and Outcomes of Enterocutaneous Fistulas in Buea Regional Hospital and Laquintinie Hospital of Douala. A Five Years Retrospective Study

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Surgical Science 2023年第1期14卷 17-29页

作者： Yannick Mahamat Ekani Boukar Divine Mokake Ousmana Oumarou Chimene Cecile Biiga II Moussa Adam Adami Eric Patrick Savom Anutebeh Verdo Zisuh Guy Aristide Bang Alain Chichom Mefire Arthur Essomba Marcellin ngowe ngowe Maurice Aurelien Sosso Faculty of Health Sciences University of Buea Buea Cameroon Surgery unit Buea Regional Hospital Buea Cameroon Faculty of Medicine and Biomedical Sciences University of Garoua Garoua Cameroon Faculty of Human Health Sciences University of N’Djamena N’Djamena Tchad Faculty of Medicine and Biomedical Sciences University of Yaounde 1 Yaounde Cameroon Faculty of Medicine and Pharmaceutical Sciences University of Douala Douala Cameroon

Background: An Enterocutaneous fistula (ECF) is an abnormal connection between the intestinal tracts or stomach and the skin. They are a major catastrophe to the patient and surgeons and still have a high incidence of morbidity and mortality which varies between 6% - 33%;their management remains a big challenge. These patients frequently face complications, and a well-organized multidisciplinary approach must be implemented in their management to improve outcomes. Objectives: Our study aims to assess the prevalence, management and outcomes of enterocutaneous fistulas in Buea regional hospital and Laquintinie hospital of Douala over the past 5 years. Methods: This was a hospital-based retrospective study in Buea regional hospital and Laquintinie hospital of Douala. Records of patients who had enterocutaneous fistulas within the period of 1st January 2017 to 31st December 2020 in the surgical departments. Data included demographics, pre-operative diagnosis, comorbidities, type of fistula, management modality and means, the indication of operative treatment, length of stay in the hospital and outcomes. Data was analysed using SPSSv26. Results: The study constituted 1343 medical records of which 83 medical records of patients with enterocutaneous fistulas, giving a prevalence of 6.2%, female predominance at 59% (n = 49), 42.2% (n = 35) were referred cases from the periphery for better management. A vast majority (96.4%) occurred as post-operative complications with appendectomy the most common indication (18.8%). High output fistulas were predominant (43.4%). 59% (n = 47) were managed medically, 6% (n = 5) received both conservative and surgical modalities while 35% (n = 5) were managed surgically. 64.1% (n = 50) were placed on enteral nutrition while 35.9% (n = 28) were placed on parenteral nutrition. Peritonitis/infection 50% (n = 18) was the commonest indication of surgical treatment, followed by failure of medical treatment 25% (n = 9) then hig

关键词： Enterocutaneous Fistula Prevalence Management Outcomes

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Prevalence, Aetiology, and Clinical Profile of Acute Abdomen in Pregnancy in Southwest Cameroon: A 5-Year Retrospective Study

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Surgical Science 2023年第1期14卷 1-9页

作者： Yannick Mahamat Ekani Boukar Divine Mokake Felix Adolphe Elong Terence Dze Enah Moussa Adam Adami Eric Patrick Savom Anutebeh Verdo Zisuh Guy Aristide Bang Alain Chichom Mefire Arthur Essomba Marcellin ngowe ngowe Maurice Aurelien Sosso Faculty of Health Sciences University of Buea Buea Cameroon Surgery Unit Buea Regional Hospital Buea Cameroon Gynaecology Unit Buea Regional Hospital Buea Cameroon Faculty of Human Health Sciences University of N’Djamena N’Djamena Tchad Faculty of Medicine and Biomedical Sciences University of Yaounde 1 Yaounde Cameroon Faculty of Medicine and Pharmaceutical Sciences University of Douala Douala Cameroon

Background: Acute abdomen is one of the commonest reasons for presentation at the emergency department. The physiologic changes of pregnancy increase the chances of developing acute abdomen. The global incidence of acute abdomen in pregnancy range from 1 in 500 to 1 in 635 pregnant women. In 2018, a study in Azerbaijan reported a prevalence of 25%. However, to the best of our knowledge, very few studies have been carried out on this subject in Cameroon. Objectives: To determine the prevalence, assess the aetiologies, and review clinical profile of acute abdomen in pregnancy in the Southwest Cameroon. Methods: We conducted a 5-year retrospective study at the Obst/Gyn and Surgical units of Kumba, Buea, and Limbe Regional Hospitals. We included all files of pregnant women that were admitted for acute abdomen within the study period (1st Jan 2017 to 31st Dec 2021). Data was collected using a structured checklist adapted from previous studies. Descriptive statistics and statistical testing was done using SPSS version 25.0. Chi-square was used to compare categorical variables. p Results: Over 14,106 pregnant women were admitted to the aforementioned hospitals within the study period. 335 (2.4%) met our inclusion criteria. The patients’ age ranged from 17 to 43 years. The mean age was 27 years. Acute abdomen was more frequent (65%) in the first trimester. Ectopic pregnancy was the commonest obstetric aetiology while appendicitis was the commonest non obstetric surgical aetiology. Abdominal pain and tenderness were the most common presentation. Conclusion: The prevalence of acute abdomen in pregnancy in the Southwest Cameroon is 10 times higher than the global prevalence. Our study also confirmed the numerous aetiologies and varied clinical presentations of acute abdomen in pregnancy. Hence a wake-up call for primary care physicians.

关键词： Acute Abdomen Pregnancy Southwest Cameroon

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Radical Hysterectomy in Cervical Cancer: Patients’ Epidemiological and Clinical Profiles and Perioperative Outcome in Two Referral Hospitals in Cameroon

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Open Journal of Obstetrics and Gynecology 2024年第3期14卷 466-479页

作者： Théophile Njamen Nana Robert Tchounzou Fulbert Nkwele Mangala Alphonse Ngalame Henri Essome Sedrick Tiokeng Sidonie Noa Ananga Andrew Tassang Humphry Tatah Neng Isaac Mboh Eyong Gaetan Andre Wambo Simo Felix Adolphe Elong Fidelia Kobenge Mbi Junior Cédric Nana Njamen Charlotte Tchente Nguefack Thomas Obinchemti Egbe Gregory Ekane Halle Emile Telesphore Mboudou Marcellin ngowe ngowe Department of Obstetrics and Gynaecology Douala General Hospital Douala Cameroon Department of Obstetrics and Gynaecology Faculty of Health Sciences University of Buea Buea Cameroon Department of Obstetrics and Gynaecology Douala Gynaeco-Obstetric and Pediatric Hospital Douala Cameroon Department of Surgery and Specialties Faculty of Medicine and Pharmaceutical Sciences University of Douala Douala Cameroon Department of Pathology Douala General Hospital Douala Cameroon Faculté Des Sciences De La Santé Université Joseph Kizerbo Ouagadougou Burkina Faso

Background: Cervical cancer (CC) is one of the most frequent cancers and the leading cause of death from gynecological cancer in Low and middle income countries, Cameroon inclusive. Surgery is the primary treatment modality when the disease is diagnosed at early stage. Radical hysterectomy in cervical cancer has not been evaluated in recent years in Cameroon. The purpose of this study is thus to evaluate the epidemiological and clinical features and short term outcomes of patients who underwent surgery. Patients and methods: This retrospective study was conducted at the Douala Gynaeco-obstetric and Pediatric Hospital and the Douala General Hospital. Cervical cancer patients who underwent Radical hysterectomy between January 2015 and December 2020 were included. A pre-established data collection tool was used to record socio-demographic, clinical and outcomes information from patients’ files;additional outcome information was obtained from phone calls. Descriptive analysis was done using the SPSS version 26. Bivariate analysis was used to determine associations between disease and patients characteristics and occurrence of adverse postoperative outcome. P value of 0.05 was considered. Results: Sixty one patients were enrolled. Their ages ranged from 33 to 74 years with a mean age of 51.95 ± 10.29 years. Over 85% of women were married, 65.57% were unemployed and 86.88% were multiparous. Only 28% had never done cervical cancer screening. Most patients had stage IB1 to IB2 stage disease (57.1%). Less than 9% underwent radical hysterectomy and 8 of those (13.11%) suffered intraoperative complications. Twenty-five patients (40.98%) presented immediate and short term complications. There was no significant association between the disease or patients’ characteristics and adverse outcomes. Conclusion: Cervical cancer patients are relatively young in our settings and only 9% of them reach the hospital at early stage. Postoperative adverse outcomes rate is higher than that rep

关键词： Cervical Cancer Radical Hysterectomy Epidemiological and Clinical Profiles Outcomes Cameroon

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