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Determinants of Early Survival of Breast Cancer Patients in Yaoundé-Cameroon

Open Journal of Obstetrics and Gynecology 2024年第3期14卷 487-501页

作者： Um Esther Meka Ngo Junie Annick Metogo Ntsama Kodoumé Motolouze Naomi Marie Laurene Ndtoungou Schouame Obalemba Etienne Atenguena Claude Cyrille Noa Ndoua robinson enow mbu Faculty of Medicine and Biomedical Sciences The University of Yaoundé 1 Yaoundé Cameroon Yaoundé Gyneco-Obstetric and Pediatric Hospital Yaoundé Cameroon Hospital Center for Research and Application in Endoscopic Surgery and Human Reproduction Yaoundé Cameroon Yaoundé General Hospital Yaoundé Cameroon

Introduction: Breast cancer is one of the leading causes of death worldwide. We carried out this study with the aim of evaluating the determinants of early survival of women with breast cancer in two hospitals in the city of Yaoundé. Methodology: This was an analytical cross-sectional study with retrospective and prospective data collection of breast cancer patients during 6 years in two Hospitals of Yaoundé from January 2017 to December 2022. We consulted the files in search of epidemiological, clinical, paraclinical, therapeutic and survival variables. We completed the survival data directly from the patients or their relatives after their consent. We analyzed the data using SPSS version 23.0 software. Survival analysis was done using the Kaplan-Meier method and survival curves were compared using the Log Rank test. Factors influencing survival were evaluated using the Cox model. The significance threshold (P value) was set at 0.05 at 95% confidence interval. The study was approved by the ethics committees. Results: We included 500 patients whose ages varied between 22 and 83 years with a mean age of 47.19 ± 11.61 years. The most represented age group was 30 to 45 years old (45.8%). Less than half (41.6%) were postmenopausal. The most frequent reason for consultation was a breast lump (79.9%). The most common clinical stage at presentation was stage-3 (47.6%). Infiltrating ductal carcinoma was the most represented histological type (84.7%). The most represented histological grade was grade 2 (40.2%). Immunohistochemistry was performed in 34.20% of cases. The most represented molecular subtype was triple negative (41.8%) followed by Luminal A (30%). Concerning treatment, 17.2% did not receive any, 45% had surgery, 79.4% had chemotherapy, 34.2% hormone therapy, and 14.6% radiotherapy. The survival of patients with breast cancer at 1, 2, 3, 4 and 5 years was respectively 90.6%;83.1%;74.2%;69.8% and 59.2%. The median survival was not reached;however, the first quartil

关键词： Determinants Early Survival Breast Cancer Yaoundé

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Determinants of Early Survival of Breast Cancer Patients in Yaoundé-Cameroon

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Open Journal of Obstetrics and Gynecology（妇产科期刊） 2024年第3期 487页

作者： Um Esther Meka Ngo Junie Annick Metogo Ntsama Kodoumé Motolouze Naomi Marie Laurene Ndtoungou Schouame Obalemba Etienne Atenguena Claude Cyrille Noa Ndoua robinson enow mbu

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Maternal and Foetal Outcome among Pregnant Women Infected with COVID-19 in Three Referral Hospitals in Cameroon

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Open Journal of Obstetrics and Gynecology 2023年第3期13卷 625-641页

作者： William Ako Takang Cho Joseline Nyuykighan Dobgima Walters Pisoh Dobgima Walters Pisoh robinson enow mbu Faculty of Health Sciences University of Bamenda Bamenda Cameroon Maternity Department Regional Hospital Bamenda Bamenda Cameroon Gynaeco-Obstetric and Pediatric Hospital Yaoundé Yaoundé Cameroon

Introduction: Pregnancy is generally known to be an immune compromised state, thus placing pregnant women at risk of SARS-COV-2 infection. We therefore carried out this study to assess the maternal and foetal outcomes among pregnant women infected with COVID-19 in three referral hospitals in Cameroon. Methodology: This was a hospital-based retrospective case control study covering a two-year period. Data collection was done over a duration of four months at the Yaoundé Central Hospital, Douala Gynaeco-Obstetric and Paediatric Hospital and the Bamenda Regional Hospital. Cases were pregnant women who gave birth after a confirmed COVID-19 infection, matched 1:2 by age (±1 year) and parity (±1) to pregnant women not infected by COVID-19, who gave birth at the three hospitals within the same period. Results: The rate of caesarean section delivery among our cases was 52.4% as compared to 44.3% among controls (OR, 1.38, 95% CI, 0.74 - 2.60, P = 0.296). Maternal mortality rate in our cases was at 8.2% as compared to 6.6% in controls (OR, 1.60, 95% CI, 0.50 - 5.12, P = 0.422). The rate of preterm delivery in our cases was 24.6% as compared to 11.5% in the control group (OR, 2.39, 95% CI, 1.05 - 5.42, P = 0.025). Perinatal death rate in our study was recorded at 8.2% as compared to 3.4% in the controls (OR, 2.63, 95% CI, 0.68 - 10.18, PS = 0.162) Conclusion: Pregnant women infected with COVID-19 were found to have higher risks of preterm delivery and acute foetal distress as compared to pregnant women who were not infected. Caesarean section deliveries, maternal and foetal mortality were higher in COVID-19 infected pregnant women as compared to those not though these findings were not statistically significant.

关键词： COVID-19 Pregnancy Maternal Foetal Outcome

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Knowledge, Attitude and Practice of Breast Self-Examination amongst Women in Two Communities of Cameroon

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Open Journal of Obstetrics and Gynecology 2021年第6期11卷 773-793页

作者： Florent Ymele Fouelifack Rene Pierre Binyom Anyimbi Mosman Ofeh Jeanne Hortence Fouedjio robinson enow mbu Department of Obstetrics and Gynecology of Higher Institute of Medical Technology of Nkolondom Yaounde Cameroon Obstetrics and Gynecology Unit of Yaounde Central Hospital Yaounde Cameroon Research Education and Health Associative Group GARES-Falaise Dschang Cameroon Department of Surgery Higher Institute of Medical Technology of Nkolondom Yaounde Cameroon Department of Obstetrics and Gynecology Faculty of Medicine and Biomedical Sciences University of Yaounde I Yaounde Cameroon

Breast cancer is a major health problem in the world. It is the most common cancer in women and is equally the leading cause of cancer death in women. Though in controversy Breast self-examination (BSE) remains a useful tool in early diagnosis of breast cancer. The aim of this study was to evaluate the knowledge, attitude and practice of BSE amongst women in Yaoundé and Monatele. We carried out a cross sectional study in two communities of Cameron over a period of eight months, targeting females older than 15 years. After obtaining authorization, we randomly interviewed 402 consenting participants, using a pretested questionnaire. Data were entered using CS Pro 7.3 and analysed using SPSS 23. Of a total of 402 participants, 256 (63.7%) in Monatele and 146 (36.3%) in Yaoundé VI, the mean age was 26.55 ± 9.57 years. Exactly 50% (201) had earlier heard of BSE. Health personnel and media represented the main sources of information on BSE. Of the total, 46 (11.4%) knew BSE should be done monthly. Fifty-three percent had poor knowledge and 51.0% had a generally low attitude towards BSE. Out of 402 participants, 65.2% reported not practicing BSE. For those practicing, 71.6% had poor practices. The main reason for not practicing was lack of knowledge. Poor knowledge increased poor practice. In conclusion half of the women had heard about BSE even though the majority had a poor knowledge on BSE and very low overall attitude and practice. Health personnel and media played a key role in passing of information. Increasing the number of health campaigns, multiplying TV shows and health talks about breast self-examination will improve knowledge and hence attitude and practice.

关键词： Knowledge Attitude Practice Breast Self-Examination

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Outcomes of Twin Delivery at the Bamenda Health District, North West Region Cameroon

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Open Journal of Obstetrics and Gynecology 2022年第5期12卷 465-481页

作者： William Ako Takang Dobgima Walters Pisoh Tcheumbe Josiane Nyeumenou enow robinson mbu Mary Bi Shu Atanga Department of Obstetrics and Gynecology Faculty of Health Sciences University of Bamenda Bamenda Cameroon Department of Obstetrics and Gynecology Bamenda Regional Hospital North West Region Bamenda Cameroon Programs and Academic Affairs Faculty of Health Sciences University of Bamenda Bamenda Cameroon Department of Nursing and Midwifery Faculty of Health Sciences University of Bamenda Bamenda Cameroon

Introduction: Multiple gestations or multiple pregnancies occur when two or more fetuses are conceived at the same time in the same woman. Therefore, a twin pregnancy is defined as the simultaneous development of two fetuses in the same woman. It can either be a monozygotic or dizygotic pregnancy. Twin pregnancy is considered a high-risk pregnancy with variable incidence and outcomes worldwide. The adverse maternal and fetal outcomes of twin deliveries have not yet been investigated in our setting. Objectives: The main objective of this study was to evaluate the outcomes of twin deliveries at the Bamenda Health District. Methods: This was a hospital-based, cross-sectional analytic study done at the Bamenda Health District in three selected hospitals (Bamenda Regional Hospital, CMA Nkwen, and IHC Azire) from the 1st of January to the 10th of May 2018. 55 women with twin pregnancies and 55 women with singleton pregnancies at gestational ages of 28 completed weeks and above who came for delivery and who consented to the study were included. A face-to-face interview-administered questionnaire was used to obtain sociodemographic characteristics;a venous blood sample was collected from the mothers before and after delivery to determine the estimated blood loss based on haemoglobin level. The partogram was opened from 4 cm cervical dilatation for those who came in the first stage of labour and the mode of delivery was recorded. After delivery, outcome variables were 1st, 5th, and 10th min Apgar score, birth weight, and gestational age. Data were entered in CSPro 7.1 and exported to IBM SPSS version 23.0 for analysis. All variables with p < 0.05 were statistically significant, OR and 95% CI were calculated for all outcome variables to measure the association with twin deliveries. Results: During the study period, we included 110 participants (55 twin mothers and 55 singleton mothers). Women with twin gestations were mos

关键词： Outcomes Twin Singleton Pregnancies Deliveries Bamenda Health District

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Routine prenatal ultrasonography: The pregnant woman’s expectations and perspectives on safety in a Central African obstetric population

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Open Journal of Obstetrics and Gynecology 2013年第7期3卷 573-576页

作者： Joshua Tambe Boniface Moifo Odile Fernande Zeh Pascal Foumane Joseph Gonsu Fotsin robinson enow mbu Obstetrics and Gynecology Department Faculty of Medicine and Biomedical Sciences The University of Yaounde 1 Yaounde Cameroon Obstetrics and Gynecology Department Gyneco-Obstetric and Pediatric Hospital Yaounde Cameroon Radiology Department Gyneco-Obstetric and Pediatric Hospital Yaounde Cameroon

Background: Pregnant women are important stakeholders regarding prenatal ultrasound (US) scanning. Their specific needs and preferences have to be ascertained by healthcare providers to ameliorate service delivery. Objective: To assess the pregnant woman’s expectations during routine prenatal US scan and her perspective ofUSsafety during pregnancy in a Central African obstetric population. Methods: A cross-sectional descriptive survey of consenting pregnant women who reported for routine prenatal US scan using an anonymous questionnaire. A convenient sample of 200 participants was adopted. Results: Thirty-three (16.8%) respondents (on a total of 196) declared they had never done anUSscan. One hundred and eleven (58.4%) on a total of 190 stated that they had not received any information on what ultrasonography is all about. Before theUSscan the respondents would like to receive information on the aim or purpose of ultrasonography, possible inconveniences or risks, and on how to prepare before the scan. The most reported expectations were assurance of the wellbeing of the fetus (58%), gender determination (44.5%) and information on fetal position (20.5%). Thirty-four respondents considered ultrasonography as not perfectly safe for the mother or the “baby”, with the relevant reasons being the use or production of some potentially harmful “rays”. Conclusion: Pregnant women would want to be assured of the wellbeing of the fetus, the gender and position during routine prenatal US. They however need to be informed of its purpose and safety.

关键词： Routine Prenatal US Expectations US Safety

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Clinical Presentation, Management and Materno-Fetal Outcome of Patients with HELLP Syndrome at the Yaoundé Gyneco-Obstetrics and Pediatric Hospital

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Open Journal of Obstetrics and Gynecology 2023年第8期13卷 1432-1451页

作者： Nzometia Crysantus Yimlefack Foumane Pascal Dohbit Julius Sama Kenn Chi Ndi Daniel Tarh Ketchen Claude Hector Mbia robinson enow mbu Faculty of Medicine and Biomedical Sciences University of Yaounde 1 Yaoundé Cameroon

Background: HELLP (Hemolysis, Elevated Liver enzymes and Low Platelets) syndrome is a common complication of severe preeclampsia, with a high maternal and perinatal mortality rate. Data on HELLP syndrome is scanty in our setting. We sought to study the clinical presentation, management, and materno-fetal outcome of patients with HELLP syndrome at the Yaoundé Gyneco-Obstetrics and Pediatric Hospital (YGOPH). Methods: This was a cross-sectional, analytical study with a retrospective data collection of patients, diagnosed with HELLP syndrome at the YGOPH between 1st January 2020 and 31st July 2021. Data were analyzed using the software R version 4.0.2. Results are presented as mean ± standard deviation, frequencies and percentages. P values < 0.05 were considered statistically significant. Results: Of 254 cases of severe preeclampsia, 17 developed HELLP syndrome, giving us a frequency of 6.7%. One patient who presented with hepatitis B was excluded. The mean age was 27.19 ± 6.44 years. Most patients (56.3%) had poor follow up during antenatal contacts. The most common symptom was headache (93.8%). Most cases (56.3%) were diagnosed during post-partum, prepartum (25.0%), and per partum (18.8%). Obstetrical management was done by cesarean section (62.5%) and vaginal delivery (37.5%). Post-partum management of HELLP syndrome consisted of antihypertensive medication, anticonvulsants, sedatives, transfusion of blood and blood products, and fluid resuscitation. Of the 50% of patients who presented with acute kidney injury, only 12.5% (1) were referred for dialysis. Over 50% of our study participants presented severe complications after delivery, but 43.8% recovered, while 56.2% finally died. The fetal outcome was: still birth (31.2%), intra-uterine growth restriction/low birth weight (12.5%), term delivery (≥37 weeks) (31.3%), and preterm deliveries (<37 weeks) (68.7%). Three (18.8%) of the neonates delivered alive presented with a poor Apgar score at the 5th minute. Conclusi

关键词： HELLP Syndrome Clinical Presentation Management Maternal and Fetal Outcomes

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Epidemiologic Profile of Maternal Deaths in Two Referral Hospitals in Cameroon

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Open Journal of Obstetrics and Gynecology 2016年第6期6卷 365-372页

作者： Philip Njotang Nana Felix Essiben Julius Dohbit Sama Elisabeth Medoua Koh Koh Morfaw Lifanji Filbert Eko Eko Jeanne Fouedjio Agnes Esiene robinson enow mbu Department of Obstetrics and Gynecology Faculty of Medicine and Biomedical Sciences (FMBS) The University of Yaoundé I Yaoundé Cameroon Department of Obstetrics and Gynecology Yaoundé Central Hospital Yaoundé Cameroon Department of Obstetrics and Gynecology Yaoundé Gyneco-Obstetric and Pediatric Hospital Yaoundé Cameroon Faculty of Medicine and Biomedical Sciences (FMBS) The University of Yaoundé I Yaoundé Cameroon Department of Obstetrics and Gynecology Bamenda Regional Hospital Bamenda Cameroon Department of Anesthesia and Reanimation Faculty of Medicine and Biomedical Sciences (FMBS) The University of Yaoundé I Yaoundé Cameroon

Introduction: Our objective was to compare the epidemiologic profile of maternal mortality in two structures serving as referral levels of care in Cameroon. Methodology: This cross-sectional, comparative study took place at the maternities of the Yaoundé Central Hospital (YCH) and the Bamenda Regional Hospital (BRH) from December 1st 2014 to May 31st 2015, a 6 months’ period. The medical records of deceased women over 5 years, from January 2010 to December 2014, were collected. We calculated the MMR (Maternal mortality rate) and studied the causes and risk factors associated with maternal death. The Epi info software 3.5.4 was used to analyze data with a significance level of P < 0.05. Results: The maternal mortality ratio (MMR) was 964 and 247 per 100,000 live births for YCH and BRH, respectively. More deaths occurred within the aged group range 20 to 34 years, 76.8% at YCH and 64.7% at BRH. At YCH, 70.7% of these patients were referrals versus 32.4% at BRH. Complication from abortion was often implicated at BRH (P = 0.007;OR = 0.31;CI = 0.13 - 0.74). Others causes were hemorrhage (YCH = 43.4%;BRH = 35.5%), hypertensive diseases (YCH = 17.2%;BRH = 14.7%) and infections (YCH = 8.1%;BRH = 17.6%). At YCH time elapsed from admission to death was <3 h (P = 0.005;OR = 6.63;CI = 1.49 - 29.5). Conclusion: Both hospitals have similar causes of maternal deaths, differing only in the context within which the deaths occurred. Improving access to good quality health care, satisfying unmet needs for family planning, availability of blood products and the establishment of health insurance could decrease the maternal mortality rate.

关键词： Maternal Mortality Causes Maternal Death Referral Hospital Cameroon

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Morbi-Mortality Linked to Unsafe Abortions—Difficulties in Accessing Safe Abortions in Cameroon: Meta-Analysis and Systematic Review

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Open Journal of Obstetrics and Gynecology 2023年第2期13卷 342-359页

作者： Florent Ymele Fouelifack Mosman Anyimbi Ofeh Jenny Ornella Manewoun Nsen Abeng Christophe Saha Lontsi Mvong Vendeline Amaelle Goretti Guy Sadeu Wafeu robinson enow mbu Department of Surgery and Specialties at the Higher Institute of Medical Technology of Nkolondom Yaoundé Cameroon Gynecology and Obstetrics Unit of the Yaoundé Central Hospital Yaoundé Cameroon Maga District Hospital Maga Cameroon Public Health of Higher Institute of Medical Technology of Nkolondom Yaoundé Cameroon CIVITAS Cameroon Human Rights and Humanitarian Action Yaoundé Cameroon Public Health Option Epidemiology Yaoundé Cameroon Information Communication and Technology American University Yaoundé Cameroon Centre for the Development of Best Practices in Health (CDBPSH) National Coordinator of Building Medical Research in Africa (BMR Africa) Yaoundé Cameroon Family Health Ministry of Public Health Yaoundé Cameroon

Background: Unsafe abortions are one of the leading causes of maternal mortality, especially in developing countries. In Cameroon, the maternal mortality rate remains high, and the scarcity of data on abortions leads to a lack of solid evidence to advocate on the extent of the abortions related complications. Our objective was to evaluate the unsafe abortions related complications, and to assess the difficulties of accessing safe abortions in our setting. Methods: We carried out a meta-analytic and systematic review in the biomedical databases MEDLINE (Pubmed), Google Scholar and African Journal Online concerning unsafe abortions and/or difficulties in accessing safe abortions in Cameroon. The keywords used for the search are seen in table I. Selection of studies was simultaneously done by two authors. Data were extracted through a form designed on Google Form. We used a random-effect model for proportion estimation, and The I2 and Q statistics to assess the extent of heterogeneity. Results: A total of 430 studies were identified, from which 28 were included and analysed. About 5% (95% CI: 3 - 7) of unsafe abortions leads to death. The contribution of unsafe abortions in maternal deaths was 23% (95% CI: 20 - 27). The rate of severe bleeding and/or anemia were 40% (95% CI: 18 - 63) and the rate of infection was 17% (95% CI: 7 - 28), dominated by pelvic infections, pelviperitonitis, severe sepsis, and septic shock. Case reports described uterine perforations, uterine rupture during the following pregnancy. Abortion was performed in the practitioner’s or patient’s home in 41.4% of cases, in a health center in 35.1% of cases, in a private clinic in 21.2% of cases, drugs selling places and in traditional healer clinics. The restriction of abortion laws, the stigma surrounding abortion and its consequences at any level of the society, lead to the underreporting of unsafe abortions and a deep reluctance to advocate for safe abortion services. Conclusion: The str

关键词： Morbi-Mortality Unsafe Difficulties Access Safe Abortion Cameroon

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Maternal and Foetal Outcome among Pregnant Women Infected with COVID-19 in Three Referral Hospitals in Cameroon

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Open Journal of Obstetrics and Gynecology（妇产科期刊） 2023年第3期

作者： William Ako Takang Cho Joseline Nyuykighan Dobgima Walters Pisoh robinson enow mbu

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