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Cardiac Surgery at Yaoundé General Hospital by a Local Team: Activity Report from September 2022 to January 2024

World Journal of Cardiovascular Surgery 2024年第6期14卷 87-94页

作者： Laurence Carole Ngo Yon Charles Mve Mvondo Hermann Nestor Tsague Kengni Zephanie Kobe Fokalbo Sépolin Lowe Mireille Dakleu alain Patrick menanga William Ngatchou Djomo Vincent De Paul Djientcheu Department of Cardiothoracic and Vascular Surgery Yaound General Hospital Yaound Cameroon Department of Surgery and Specialities Faculty of Medicine and Pharmaceutical Sciences University of Douala Douala Cameroon Department of Clinical Sciences Faculty of Medicine and Pharmaceutical Sciences University of Douala Douala Cameroon Department of Clinical Sciences Faculty of Medicine and Biomedical Sciences University of Yaound Yaound Cameroon Department of Surgery and Specialities Faculty of Medicine and Biomedical Sciences University of Yaound Yaound Cameroon

Introduction: The practice of cardiac surgery (CS) in sub-Saharan Africa faces a number of challenges. We report on the surgical activities of the first 17 months of the program launched at the Yaoundé General Hospital (YGH), describing the types of interventions and the early results. Patients and Methods: This was a descriptive cross-sectional study including patients who underwent CS from September 2022 to January 2024 at the YGH. Clinical, operative and postoperative data were collected and analysed retrospectively by R software. Results: A total of 37 patients underwent CS during the study period, divided into 23 (62.2%) open-heart and 14 (37.8%) closed-heart cases. Males predominated (sex ratio 1.17). The median age and interquartile range (IQR) were 36 years (9 - 51). Isolated valve surgery, in 15 (40.5%) cases, was the most common procedure in open-heart surgery cases. Closed-heart surgery involved closure of the patent ductus arteriosus in 9 (24.3%) cases, coronary artery bypass grafting in 3 (8.1%) cases, and pericardectomy in 2 (5.4%) cases. The median duration of extracorporeal circulation and aortic cross-clamping was 101 min (IQR 84 - 143) and 74 min (IQR 54 - 112) respectively. The median duration of mechanical ventilation was 2 hours (IQR 2 - 3). The median intensive care unit stay and median hospital stay were 2 days (IQR 2 - 3) and 7 days (IQR 5 - 8) respectively. Operative mortality was 2 (5.4%). Conclusion: Cardiac surgery remains a major challenge for African populations. The early results achieved by the local team are satisfactory. An increase in surgical activity should be strongly encouraged to facilitate local training and ensure the sustainability of the activity.

关键词： Cardiac Surgery Sub-Saharan Africa Cameroon

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Prevalence of Re-Hospitalization for Heart Failure in a Cameroonian Tertiary Hospital: A Cross-Sectional Study

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World Journal of Cardiovascular Diseases 2023年第6期13卷 333-340页

作者： Amalia Owona Ning Lom Bryan-Bill Ahmadou Musa Jingi Dieudonne Danwe alain Patrick menanga Faculty of Medicine and Biomedical Sciences University of Yaoundé I Yaoundé Cameroon Cardiology Unit Yaoundé General Hospital Yaoundé Cameroon Faculty of Health Sciences University of Bamenda Bamenda Cameroon

Aim: To determine the prevalence of re-hospitalization for heart failure in the cardiology unit of the Yaoundé General Hospital. Study Design: This was a retrospective cross-sectional study from January 2015 to December 2020. Patients and Methods: Patients aged at least 18 years who were hospitalized for heart failure during the study period were included. Data were collected using a predesigned form and were analyzed using Epi InfoTM version 7.2.2. Results: We included a total of 160 patients. The prevalence of re-hospitalization was 30.6%. Re-hospitalized patients had a mean age of 71.0 ± 13.9 years and a sex ratio of 1.6. The most common etiologies of HF were hypertensive heart disease (36.7%), followed by dilated cardiomyopathy (22.5%), and atrial fibrillation (16.3%). More than two third had class IV NYHA disease (77.6%). Most of them also had HFrEF (71.4%) and anemia (77.6%). Conclusion: There is a high rate of re-hospitalization in the cardiology unit of the Yaoundé General Hospital with most of these patients having old age and severe HF.

关键词： Re-Hospitalization Heart Failure Yaoundé Cameroon

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Electrocardiographic Analysis of Patients with Suspicion of Acute Coronary Syndrome in Yaounde, Cameroon

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Open Journal of Internal Medicine 2023年第4期13卷 436-446页

作者： Kong Derick Njikeh Ngongang Ouankou Christian Boombhi Jerome Ntep Gweth menanga alain Patrick Ngu Blackett Kathleen Faculty of Medicine and Biomedical Sciences University of Yaounde 1 Yaounde Cameroon Department of Internal Medicine University Teaching Hospital Yaounde Cameroon Department of Internal Medicine General Hospital Yaounde Cameroon

Background: Ischemic heart disease (IHD) is the leading cause of death worldwide. IHD was thought to be an extremely rare occurrence in Sub-Saharan Africa, but the increasing economic development with changes in lifestyle has led to an increase in IHD risk factors which has motivated the interest of our study. Objectives: The aim was to study a group of patients with suspicion of acute coronary syndrome (ACS), in order to determine those with and without electrocardiographic diagnosis of ACS. Methods: It was an observational cross-sectional descriptive study over a period of six months, which included concerned patients who presented with retrosternal or precordial chest pain of onset being less than two weeks with at least one cardiovascular risk factor, in the cardiology units of three reference hospitals in Yaounde. Ethical clearance and authorizations were obtained from the competent authorities. We used a preformed questionnaire to obtain information from the patients concerning the demographic data, clinical presentation and electrocardiographic findings. Results: We recruited 100 patients with suspicion of ACS. 56 patients presented with electrocardiographic diagnosis of ACS and 44 patients did not. The mean age was 60.6 ± 11.5 years with age limits of 32 - 85 years in patients with ACS and 55.3 ± 16.6 years with age limits of 19 - 90 years in patients without ACS. The predominant age group was 60 - 69 years in both groups. The sex ratio (male/female) was 0.6 in patients with ACS and 0.7 in patients without ACS. The main complaints presented in both groups were;chest pain, fatigue, dyspnea and palpitation. The frequent cardiovascular risk factors in both groups were hypertension, age and overweight/obesity. In patients with ACS, 55.4% presented with ST-segment elevated acute coronary syndrome (STE-ACS) and 44.6% presented with non-ST-segment elevated acute coronary syndrome (NSTE-ACS). The Antero-Septal territory represented 77.4% of patients with STE-ACS and

关键词： Chest Pain Cardiovascular Risk Factor Electrocardiogram Acute Coronary Syndrome

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Left Ventricular Diastolic Dysfunction and Silent Myocardial Ischemia amongst Asymptomatic Type 2 Diabetic Patients in Two Referral Hospitals in Cameroon

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World Journal of Cardiovascular Diseases 2022年第7期12卷 374-381页

作者： Joshua Njimbuc Walinjom Jerome Boombhi Martine Etoa Collins Chenwi Ambe Emerentia Eho alain menanga Samuel Kingue Faculty of Medicine and Biomedical Sciences (FMBS) University of Yaoundé I Yaoundé Cameroon Medical and Cardiology Unit General Hospital Yaoundé Yaoundé Cameroon Central Hospital Yaoundé Yaoundé Cameroon Mvangan District Hospital Mvangan Cameroon

Background: Cardiovascular events, the leading cause of death among diabetic patients, are usually under-diagnosed due to subclinical presentation. Methods: We conducted a cross-sectional study from March-2019 to September-2020, in two reference hospitals in Yaoundé, Cameroon, to assess the prevalence of asymptomatic Left Ventricular Diastolic Dysfunction (LVDD) and Silent Myocardial Infarction (SMI) and potentially associated factors. Results: Out of 95 participants (mean age ± SD: 43 ± 7 years;M/F sex-ratio 1.6), 22 (23.1%;95% CI: 15.8% - 32.6%) had LVDD and fewer (n = 13, 13.6%;95% CI: 8.2% - 22.0%) had SMI, p = 0.86. Though not statistically significant, patients with ≥5 years diabetes duration, as well as patients with HbA1C ≥ 7.5% had two-fold increased risk of LVDD (p = 0.22 and p = 0.15 respectively). LVDD was significantly higher in patients with SMI (29% vs 6.3%, p Conclusion: The significant presence of asymptomatic cardiovascular manifestations in this population entails mandatory preventive screening, especially, in patients with long standing diabetes and poor glycemic control, to allow timely detection and management.

关键词： Asymptomatic Cardiovascular Manifestations Left ventricular Diastolic Dysfunction Silent Myocardial Ischemia Type 2 Diabetes Cameroon

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Relation between Obstructive Sleep Apnea-Hypopnea Syndrome and Glaucoma in a Sub-Saharan African Population

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Open Journal of Ophthalmology 2021年第3期11卷 191-202页

作者： Christelle Domngang Ngambi Ferdinand Nanfack Chantal Mekieje Tumchou Pamela Kapche Diane menanga alain Parick Kagmeni Giles Faculty of Health Sciences Université des Montagnes Bangangté Cameroon Faculty of Medicine and Biomedical Sciences Université of Yaoundé 1 Yaounde Cameroon

Introduction: Obstructive sleep apnea-hypopnea syndrome (OSAHS) is a frequent pathology worldwide whose main mechanism is a complete or partial obstruction of the upper airway. One of the pathophysiological mechanisms described in primary open-angle glaucoma is that hypoxia in the optic nerve progressively destroys the retinal cells leading to the onset and/or aggravation of glaucoma. The aim of the study was to evaluate the risk of OSA in patients with primary open-angle glaucoma. Methodology: An analytical study was conducted from January to May 2020 at the UHC. After obtaining ethical clearance, 112 patients including 50 glaucoma patients (44.64%) and 62 in the control group were enrolled. Sociodemographic and clinical data were collected from the medical records of the participants, with or without glaucoma, and a questionnaire was administered and a clinical examination performed. The STOP BANG score was used to determine the risk level of OSAHS. Statistical analyses were performed using Epi Info version 7.2. Results: A female predominance was found (60%) in the glaucoma group with a mean age of 55 ± 17 years against 49 ± 18 years in the control group. The high risk of OSAHS was more associated with glaucoma patients. In glaucoma patients, an association was found between high risk of OSAHS and snoring (OR = [1.43 - 849.53];p = 0.029) as well as insomnia (OR = [1.36 - 482.86];p = 0.030). Conclusion: High risk of OSAHS was found in participants with chronic open-angle glaucoma. Signs of OSAHS should be sought in chronic open-angle glaucoma as it may be a factor in its progression.

关键词： Obstructive Sleep Apnea-Hypopnea Syndrome Glaucoma Risk Factor Subsaharan Africa

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Stroke Associated with Covid-19 at the YaoundéGeneral Hospital, Cameroon: Series of 10 Cases

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World Journal of Neuroscience 2021年第3期11卷 221-230页

作者： Paul-Cédric Mbonda Victor Sini Jose Kamgang Hadja Cherif alain menanga Victor Eyenga Callixte Kuate Vincent de Paul Djientcheu Faculty of Medicine and Biomedical Sciences University of Yaoundé 1 Yaoundé Cameroon Neurology Department Yaoundé General Hospital Yaoundé Cameroon Emergencies Department Yaoundé General Hospital Yaoundé Cameroon Infectious diseases Department Yaoundé General Hospital Yaoundé Cameroon

Background: The Covid-19 pandemic, which is an infection due to the SARS Cov-2 virus, mainly causes severe damage to the respiratory system, but several studies have reported neurological damage with different manifestations including headaches, seizures, encephalopathies, and stroke. We report a series of 10 patients infected with Covid-19 who had an ischemic stroke at the Yaoundé General Hospital, Cameroon. Patients and Methods: We carried out a prospective study for 12 months between April 2020 and March 2021 by collecting data from patients admitted for Covid-19 at the Yaoundé general hospital. Were included all patients with a diagnosis of stroke confirmed by brain imaging (CT/MRI) following a focal neurological deficit of sudden onset and whose test (nasopharyngeal swab confirmed by PCR) for Covid-19 was positive. Patients diagnosed with a stroke more than 2 weeks (14 days) after the positive Covid-19 PCR test were excluded. Results: The prevalence of ischemic stroke in this hospital-based series was 1.46%. These were six men and four women. The mean NIHSS score was 13.57. The average age of our patients was 58 years. Brain imaging was performed in each patient revealing hypodense lesion in a large arterial territory in 8 of them, for two patients we found multilacunar infarcts. All patients had negative HIV serology and D-dimers greater than 500 μg/L. Conclusion: This work on strokes in Covid-19 infected patients shows that it is a fairly frequent neurological complication, which can occur even in young subjects without known risk factors, the symptoms of viral infection are not systematically present before the onset of stroke.

关键词： Covid-19 Stroke Ischemia

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Cardiovascular Disease Risk Associated to Chronic Inflammatory Rheumatic Diseases in Patients Seen in Rheumatology Unit in Yaounde, Cameroon

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Open Journal of Rheumatology and Autoimmune Diseases 2016年第1期6卷 13-21页

作者： Madeleine Singwe-Ngandeu Mickael Essouma alain Patrick menanga Vicky Jocelyne Ama Moor Caroline Ngoufack Sandrine Sa’a Lontsi Yolande Vanessa Ayi Efoua Thierry Ntandzi Faculty of Medicine and Biomedical Sciences University of Yaounde I Yaounde Cameroon Rheumatology Unit Yaounde Central Hospital Yaounde Cameroon Cardiology Unit Yaounde General Hospital Yaounde Cameroon Biochemistry Laboratory Yaounde University Teaching Hospital Yaounde Cameroun

Introduction: Even though there is a huge burden of both chronic inflammatory rheumatic diseases (CIRD) and cardiovascular diseases in Sub-Saharan Africa, no published study from this region has yet addressed the issue of cardiovascular diseases in a group including different CIRD to the best of our knowledge. Objective: We conducted this research with the aim to explore the association between CIRD and cardiovascular risk in a Cameroonian population based on the World Health Organization (WHO) and International Society for Hypertension (ISH) risk charts. Methods: This cross-sectional study included CIRD patients, followed at the rheumatology unit of the Yaounde Central Hospital, and, who were matched to non-CIRD subjects for sex, age and race. Cardiovascular risk factors were studied and subsequently the cardiovascular risk was estimated using the WHO/ISH risk charts. Analyses were performed in Epi-info and SPSS software and results were considered statistically significant for a p-value less than 0.05. Results: In total, 109 CIRD patients and 111 non-CIRD subjects were included. Their respective mean ages were 44.4 ± 15.2 years and 44.2 ± 15.1 years. Odds ratio 2.09, 95% confidence interval (CI) (1.07 - 4.08);high BMI OR 1.89, 95% CI (1.1 - 3.24);diabetes mellitus (p = 0.03) and physical inactivity (p < 0.001) were all markedly found in CIRD patients compared with controls. Ten (9.2%) CIRD patients had a past history of atherosclerotic cardiovascular events compared with no control (p < 0.001). The cardiovascular risk estimated with the WHO/ISH risk charts was low in 43 (79.6%) patients with CIRD versus 52 (88.1%) non-CIRD subjects. Conclusions: CIRD were associated with hypertension, excess overall adiposity, diabetes mellitus, and physical inactivity. A substantially increased proportion of CIRD patients with a past history of atherosclerotic cardiovascular events were noted. But the WHO/ISH risk charts broadly found a similar and globally decremented cardiovasc

关键词： Chronic Inflammatory Rheumatic Diseases Cardiovascular Risk Cardiovascular Risk Factors Cardiovascular Disease WHO/ISH Risk Charts Sub-Saharan Africa

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Parasympathetic Dysfunction in Black African Patients with Heart Failure:A Cross-Sectional Study in Sub-Saharan Africa

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World Journal of Cardiovascular Diseases 2020年第4期10卷 178-187页

作者： Ba Hamadou Sylvie Ndongo Amougou Ismaila Daouda Chris Nadege Nganou-Gnindjio Liliane Mfeukeu-Kuate Jerome Boombhi Ahmadou Musa Jingi alain menanga Samuel Kingue Department of Medicine and Specialties Faculty of Medicine and Biomedical SciencesUniversity of Yaounde IYaoundeCameroon Cardiology Unit Central Hospital of YaoundeYaoundeCameroon Cardiology Unit University Teaching Hospital of YaoundeYaoundeCameroon Faculty of Medicine and Biomedical Sciences University of Yaounde IYaoundeCameroon Cardiology Unit Medicine BGeneral Hospital of YaoundeYaoundeCameroon

Background: Heart Failure (HF) is a major public health problem worldwide. Neurohormonal changes associated with HF are current therapeutic targets. The parasympathetic system in HF has not been well studied especially in black Africans. Aim: This study aimed to report on the prevalence and determinants of parasympathetic dysfunction in patients with heart failure in sub-Saharan Africa. Methods: We conducted a cross-sectional study between December 2017 and April 2018 in the outpatient and inpatient departments in two teaching hospitals in Yaounde-Cameroon. Cases were patients with HF matched with controls without HF according to age, sex, and risk factors (hypertension, diabetes, and obesity). We assessed the parasympathetic function via the Deep Breathing Test using an electrocardiograph. Results: We recruited 35 patients in each group. The mean age was 57 ± 11.68 years. Vagal dysfunction was seen in 51.4% of cases and 11.4% of controls (aOR: 10.1 [95% CI: 2.7 - 38.3], p = 0.001). This risk increased with the severity of HF-aOR: 11.8, [95% CI: 1.8 - 77.9], p = 0.01 for dyspnea stage III-IV, and aOR: 9.27, [95% CI: 1.3 - 65.3], p = 0.025) for HF with reduced Ejection fraction. This risk was not associated with the classic cardiovascular risk factors. Conclusion: Parasympathetic dysfunction as assessed with the Deep Breathing Test was seen in over half of the patients with HF and this was associated with the severity and type of HF.

关键词： Heart Failure Parasympathetic Dysfunction Heart Rate Variability Deep Breathing Test

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Evaluation of Sub Clinical Myocardial Systolic Dysfunction Using 2D Global Longitudinal Strain Assessment in Type 2 Diabetes Patients in Sub-Saharan Africa

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World Journal of Cardiovascular Diseases 2020年第10期10卷 707-715页

作者： alain Patrick menanga Chris Nadège Nganou-Gnindjio Ladé Viché André Jules Ahinaga Franck Ngowa Guy Sadeu Wafeu Donald Paulin Tchapmi Njeunje Hamadou Bâ Samuel Kingue Internal Medicine and Specialities Department Faculty of Medicine and Biomedical Sciences University of Yaoundé Yaoundé Cameroon Internal Medicine Department Yaoundé General Hospital Yaoundé Cameroon Cardiology Department Yaoundé Central Hospital Yaoundé Cameroon Internal Medicine Department Douala General Hospital Douala Cameroon Efoulan District Hospital Yaoundé Cameroon

Background: Heart failure is the commonest cardiovascular complication in type 2 diabetes mellitus. However, subclinical left ventricular dysfunction can’t be detected using 2D echocardiography which is routinely used for cardiac evaluation of diabetic patients. We aimed to determine the prevalence and factors associated to left ventricular global longitudinal strain (LV GLS) impairment in type 2 diabetes Cameroonians patients. Methods: We conducted a cross-sectional study from January 2019 to June 2019, including type 2 diabetes patients with preserved left ventricle ejection fraction. Clinical and echocardiographic data were collected, and LV GLS was assessed using speckle tracking technique, a value ≤ -16% been considered as normal value. Results: We recruited 95 patients, with a mean age of 57.4 ± 11.8 years old and median diabetes duration of 5 [2 - 12] years. Echocardiographic evaluation found 56.3% of left ventricle remodelling, 51.6% of left ventricle diastolic dysfunction and mean left ventricle ejection of 63.3% ± 6.6%. LV GLS impairment was present in 43.2% (95% CI: 32.6 - 53.7) of the participants. After adjustment to all significantly associated factors, Obesity (aOR: 4;95% CI: 1.5 -

关键词： 2D Echocardiography Myocardial Strain Left Ventricle Function Diabetes Mellitus Cameroon

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Venous Thromboembolic Disease and Thrombolysis at the YaoundéEmergency Center during the Past Five Years, Cameroon

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World Journal of Cardiovascular Diseases 2022年第4期12卷 199-208页

作者： Chris Nadège Nganou-Gnindjio Bâ Hamadou Ludovic Kadji Jules Thierry Elong Daryl Tcheutchoua Nzokou Honoré Kemnang Yemele alain Patrick menanga Samuel Kingue Jacqueline Ze Minkande Faculty of Medicine and Biomedical Sciences University of Yaoundé I Yaoundé Cameroon

Background: Venous thromboembolic disease (VTE) is a clinical entity whose two clinical manifestations are deep vein thrombosis (DVT) and pulmonary embolism (PE). It is a frequent and severe disease in Cameroon, thus constituting a significant public health problem. We aimed to describe VTE management in the Yaoundé Emergency Center, in particular the use of thrombolysis. Methods: This was a retrospective study on patients hospitalized at the Yaoundé Emergency Center for DVT and/or PE from January 1, 2015, to December 31, 2020. We collected clinical signs, paraclinical signs, risk factors of VTE, and management methods from each patient. Results: We recruited 106 participants. Dyspnea was the most frequent symptom;PE was the most common form of VTE in eight patients on 10. Obesity and high blood pressure were the main cardiovascular risk factors. The main clinical signs were oedema and pain in the limb for DVT, dyspnea, and tachycardia for PE. Heparinotherapy was the most commonly used management modality. Thrombolysis was performed in 7.5% of participants, especially in the case of hypotension or massive PE. Conclusion: In VTE management, thrombolysis remains the least used therapeutic modality in our context. Heparinotherapy remains the basis of the therapy.

关键词： Venous Thromboembolic Disease Thrombolysis Yaoundé-Cameroon

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