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Epidemiological, Clinical Aspects and Outcome of Measles in a Low-Income Country in 2023

Open Journal of Pediatrics 2024年第1期14卷 139-148页

作者： Sime Tchouamo Arielle Annick Enyama Dominique noukeu diomède Atyam Ekotto Marie Christine Abouame Palma Haoua Epee Ngoue Jeannette Kago Tague Daniel Armand Touka Eric Brice Tasse Simo Nathalie Ines Nguéfack Félicité Faculty of Medicine and Pharmaceutical Sciences of University of Dschang Dschang Cameroon Gynaeco-Obstetric and Pediatric Hospital of Yaounde Yaounde Cameroon Gynaeco-Obstetric and Pediatric Hospital of Douala Douala Cameroon Regional Annex Hospital of Dschang Dschang Cameroon Faculty of Medicine and Biomedical Sciences of University of Garoua Garoua Cameroon Faculty of Medicine and Biomedical Sciences of University of Yaounde 1 Yaounde Cameroon West Regional delegation of Public Health Bafoussam Cameroon

Introduction: Measles remains a worrying health problem in sub-Saharan African countries. There have been measles outbreaks in Cameroon with the most recent occurring between October 2022 and September 2023. The Centre region of Cameroon was the most affected in the country and being at the frontline of the fight against this illness, we conducted this study in order to determine the epidemiological and clinical characteristics as well as the outcome of children who contracted the measles and were hospitalized at the Yaoundé Gynaeco-Obstetric and Pediatric Hospital. Methodology: We conducted a cross-sectional descriptive and prospective study for one year from October 2022 to November 2023 corresponding to the duration of the outbreak. We included all children admitted in the pediatric unit for measles and its complications during this period. Results: In total, 60 children were enrolled. Their caregivers were mostly their mothers who had a mean age of 34.71 ± 9.55 years living in significant precarious conditions for the majority. The median age of children was 16 months (09 - 30 months). Twenty six percent of children (16) were less than 9 months. Girls were predominant (55%). Most children were not up to date with their routine EPI vaccination (80%) and most did not receive the measles and Rubella vaccine (76.67%). Clinical manifestations, included fever, conjunctivitis, and cough. Skin rash and catarrh (98.33% and 86.67% respectively) are the case definition signs of measles. The outcome was unfavorable for 4 children. One had a neurological disorder: coma and three presented with pneumonia and severe respiratory distress (6.67%). Conclusion: Measles is still being a reality and claiming lives in our context, emphasis should be made on immunization coverage and if possible, advocacies should be formulated to decrease the age of measles vaccine administration.

关键词： Measles Complications Low-Income Countries

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Missed Opportunities for Vaccination and Associated Factors among Children Aged 12 - 23 Months in Cameroon: Further Analyses of 2018 Cameroon demographic and Health Survey

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Health 2022年第10期14卷 1081-1103页

作者： Solange Whegang Youdom diomède Njinkui noukeu Georges Nguefack-Tsague Jerôme Ateudjieu department of Public Health Faculty of Medicine and Pharmaceutical Sciences University of Dschang Dschang Cameroon department of Public Health Faculty of Medicine and Biomedical Sciences University of Yaoundé 1 Yaoundé Cameroon Division of Health Operations Research Ministry of Public Health Yaoundé Cameroon

Background: Low vaccination coverage has been attributed to missed opportunities for vaccination (MOV). This study examines the prevalence of MOV, and its associated factors among children in Cameroon. Methods: Data from the 2018 demographic and Health Survey (DHS) was analyzed for children with at least one vaccination date in the home-based record (HBR). Immunization performances such as accessibility, drop-out, and timeliness, were assessed. Service quality was assessed using MOV. Multiple logistic regression examined the effect of DHS variables on MOV outcomes, and a decision tree approach was used to study their interaction. Results: Overall, 1824 children aged 12 to 23 months were surveyed;1285 (70.45%) had cards seen with vaccination dates leading to 85.03% of immunization activities. A proportion of 46.5% of children were not completely vaccinated. There was 27% of drop-out between BCG and MCV1, and less than 10% with the specific antigens. Vaccination timeliness proportions ranged from 42.18% for BGC to less than 70% for PENTA1-3. The national prevalence of MOV for simultaneous vaccines was 75.1% (95% confidence interval (CI) = 72;79). Among those who experienced MOV, 67.4% (95% CI = 60 - 73) were uncorrected MOV. MOV was an issue in all regions and comparable in rural areas that urban areas (p = 0.2). Dose-specific MOV ranged from 2.66% (for the third dose of the pneumococcal conjugate vaccine) to 91.12 (for the yellow fever vaccine). Second birth order children experienced more MOV than first born children (adjusted odds ratio (aOR) = 1.67, 95% CI: 1.11 - 2.47). Children born to non-educated/primary level mothers had increased odds of experiencing a MOV than those born to educated mothers (aOR = 1.48, 95% CI = 1.007 - 2.19/aOR = 1.55, 95% CI = 1.12 - 2.09). Children from poorest households were at high risk of experiencing MOV for any vaccine than richest households (aOR = 2.04, 95% CI = 1.11 - 3.76). Conclusion: There is a burden of MOV and under immuniz

关键词： Missed Opportunity Cameroon demographic and Health Survey Global Health Vaccination Date MOV Simultaneous Vaccines

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Neurodevelopmental Outcome of Newborns Aged More than 34 Weeks Gestational Age Managed for Birth Asphyxia in Douala (Cameroon): A Single Hospital-Based Study

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Open Journal of Pediatrics 2023年第6期13卷 838-851页

作者： diomède noukeu Njinkui Dominique Enyama Yolande Djike Fokam Danie L. Nanga Mewolo Christelle Annick Ngo Kana Sylvain Raoul Simeni Njonnou Charlotte Eposse Ekoube Arielle Annick Sime Tchouamo Paul Olivier Koki Ndombo Danièle-Christiane Kedy Koum Faculty of Medicine and Pharmaceutical Sciences University of Dschang Dschang Cameroon Douala Gynaeco-Obstetric and Pediatric Hospital Douala Cameroon Faculty of Health Sciences University of Buea Buea Cameroon Faculty of Medicine and Pharmaceutical Sciences University of Douala Douala Cameroon Yaoundé Gynaeco-Obstetric and Pediatric Hospital Yaoundé Cameroon Faculty of Medicine and Biomedical Sciences University of Yaoundé I Yaoundé Cameroon

Background: Perinatal asphyxia is a common cause of mortality and of morbidity including motor and neurodevelopmental abnormalities. The aim of this study was to evaluate the post-hospital outcome of neonates treated for perinatal asphyxia at the Douala Gynaeco-Obstetric and Pediatric Hospital (DGOPH) in Cameroon. Patients and Methods: We conducted a hospital-based cross-sectional study with both a retrospective and prospective data collection, conducted over a period of 3 months and involving neonates above 34 weeks of gestational age who were managed for perinatal asphyxia at DGOPH from August 2015 to February 2020. Socio-demographic, perinatal, motor, nutritional and neuro-developmental out-of-hospital data were recorded. The assessment of the child’s psychomotor development was evaluated through gross motor skills, fine motor skills, language and social contact. We calculated the development quotient (DQ) by dividing the developmental age (DA) by the actual age (RA) of the patient. The data were entered and analyzed using excel and Stata version 15 software. Results: Among the 58 newborns included in our study, males were the most represented (59%). The mean age was 36.5 ± 14.16 months (Extremes: 12 months and 66 months). The majority of patients were born at term (79%), had a birth weight between 2500 and 4000 grams (69%), were resuscitated (95%), and had an Apgar score th minute of life (67%). SARNAT stages II and III counted for 48%. Neurodevelopmental abnormalities were found in 25.5% of patients with gross motor delay (mainly tetraparesis) representing 23.5%, fine motor delay 27.5%, impairment in social contact 31% language speech delay. The majority of the children had a normal development quotient (78.4%). Conclusion: The short-term and long-term outcome of newborns who experienced perinatal asphyxia in our setting is marked by numerous impairments in developmental milestones leading to disability.

关键词： Perinatal Asphyxia Newborn Neurological Outcome Cameroon

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