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Estimation of the Direct Cost of Management of Venous Thromboembolism in Three Reference Hospitals in the City of Yaoundé: A Retrospective Study over a Three-Year Period

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World Journal of Cardiovascular Diseases 2024年第2期14卷 99-114页

作者： hamadou ba Nganou-Ngnindjio Chris Nadège Tatchim Samuel Aimé Kamdem Félicité Tchoukoua Serge Honoré Ahmadou Jingi Danwe Dieudonne Kingue Samuel Faculty of Medicine and Biomedical Sciences University of Yaoundé I Yaoundé Cameroon Department of Internal Medicine Garoua General Hospital Garoua Cameroon Cardiology Department Yaoundé Central Hospital Yaoundé Cameroon Higher Institute of Health Sciences University of the Mountains Bagangté Cameroon Faculty of Medicine and Pharmaceutical Sciences University of Douala Douala Cameroon Department of Internal Medicine Douala General Hospital Douala Cameroon Faculty of Health Sciences University of Bamenda Bamenda Cameroon Cardiology Department Yaoundé General Hospital Yaoundé Cameroon

background: Venous thromboembolism (VTE) is a major public health problem due to its increasing frequency, mortality and management cost. This cost may require major financial efforts from patients, especially in developing countries like ours where less than 7% of the population has health insurance. This study aimed to estimate the direct cost of managing VTE in three reference hospitals in Yaoundé. Methods: This was a cross-sectional retrospective study over a three-year period (from January 1st 2018 to December 31 2020) carried out in the Cardiology departments of the Central and General Hospitals, and the Emergency Centre of the city of Yaoundé. All patients managed during the study period for deep vein thrombosis and pulmonary embolism confirmed by venous ultrasound coupled with Doppler and computed tomography pulmonary angiography respectively were included. For each patient, we collected sociodemographic and clinical data as well as data on the cost of consultation, hospital stay, workups and medications. These data were analysed using SPSS version 23.0. Results: A total of 92 patient’s records were analysed. The median age was 60 years [48 - 68] with a sex ratio of 0.53. The median direct cost of management of venous thromboembolism was 766,375 CFAF [536,455 - 1,029,745] or $1415 USD. Management of pulmonary embolism associated with deep vein thrombosis was more costly than isolated pulmonary embolism or deep vein thrombosis. Factors influencing the direct cost of management of venous thromboembolism were: hospital structure (p = 0.015), health insurance (p 0.001), type of pulmonary embolism (p = 0.021), and length of hospital stay (p = 0.001). Conclusion: Management of VTE is a major financial burden for our patients and this burden is influenced by the hospital structure, health insurance, type of pulmonary embolism and length of hospital stay.

关键词： Cost Management Venous Thromboembolism Yaoundé

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Evaluation of the Functional Capacity of a Group of Patients Aged over 65 Years: A Cross-Sectional Study at the YaoundéCentral Hospital

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World Journal of Cardiovascular Diseases 2022年第12期12卷 527-543页

作者： Ndobo-Koe Valérie Nganou-Gnindjio Chris Nadège Kemnang Yemele Honoré Biatu Nestor ba hamadou Kingué Samuel Faculty of Medicine and Biomedical Sciences University of Yaoundé I Yaoundé Cameroon Yaoundé Central Hospital Yaoundé Cameroon Faculty of Medicine and Biomedical Sciences University of Garoua Garoua Cameroon

background: The functional capacity of elderly patients decreases with age due to a combination of age-related decline in physiologic functions and chronic diseases. A severe decrease leads to an inability to carry out activities of daily living leading to a loss of autonomy and increased dependence. The aim of this study was to evaluate the functional capacity of the elderly followed at the Yaoundé Central Hospital. Methods: We carried out a non-probabilistic consecutive sampling of elderly patients that consulted in Yaoundé Central Hospital during a five-month’ period. Data was taken concerning their chronic conditions, use of medication, and presence of depressive symptoms (evaluated using the Geriatric Depression Scale (GDS) questionnaire). The presence of any cognitive impairment was evaluated using the Mini-Mental State Examination (MMSE). Cardiac ultrasonography and electrocardiograms were done to evaluate the cardiac morphology and physiology. Their functional capacity was assessed with the WHO Global Physical Activity Questionnaire and the six-minute walk test. A self-paced step test was equally done to estimate the maximum oxygen consumption during aerobic exercise. We carried out aunivariate, and then multivariate analyses to identify factors associated with an altered functional status. Statistical analysis was performed using the SPSS software 23.0. The threshold of significance was set at 0.05. Results: 66 participants were included (35 women) with a median age of 70 (IQR: 67 - 75) years. Among them, 39.4% were found to have an altered functional capacity, about 87.8% had at least one chronic condition and 47% had two or more. The most prevalent chronic condition was hypertension (71.2%) followed by heart failure (24.2%) and osteoarthritis (12.1%). Mild depressive symptoms were present in 1.5% of our study population. The factors associated with an altered functional capacity include age ≥ 75 years (OR = 2.9 p heart failure (OR: 3.2, p ), osteoarthriti

关键词： Functional Capacity Elderly Physical Activity Cameroon

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Clinical Presentations and Outcome of Cardiovascular Emergencies in Yaounde: A Cross-Sectional Study

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World Journal of Cardiovascular Diseases 2018年第2期8卷 133-142页

作者： ba hamadou Yaya Toure Kalissou Ahmadou Musa Jingi Sylvie Ndongo Amougou Sandrine Edie Dikosso Rodrigue Njouoguep Samuel Kingue Department of Internal Medicine and Specialties Faculty of Medicine and Biomedical Sciences University of Yaounde 1 Yaounde Cameroon Internal Medicine Service Cardiology Unit Yaounde Central Hospital Yaounde Cameroon Yaounde Emergency Center Yaounde Cameroon

background: Cardiovascular emergencies have become a public health problem with a high burden in low-income settings. This is due to the high rates of cardiovascular risk factors that are fast reaching epidemic?proportions. There is paucity of data on cardiovascular emergencies to guide repost strategies in our setting. Our aim was to determine the clinical presentation and outcome of cardiovascular emergencies at Yaounde Emergency Center.?Methods: We carried out this cross-sectional study between June 2015 and May 2017. We included all patients with confirmed cardiovascular emergency. We consecutively collected data on socio-demography, symptoms on admission, past history, clinical findings, and final diagnosis at discharge or in the event of death. Results: Of the 8285 patients admitted for medical emergencies, 388 (4.7%) were cardiovascular emergencies. Their mean age was 59.5 ± 13.8 years, and 59% were males. The Medical Emergency Aid Service was the means of transporting 4% of patients. The median time of arrival at the hospital was 48 hours. Symptoms on admission were mainly weakness of a limb (43.8%), and altered consciousness (33.5%). The most common cardiovascular emergencies were ischemic stroke (30.9%), hypertensive emergency (21.4%), and hemorrhagic stroke (16.5%). The most common comorbidity was diabetes (21.9%). The death rate in the 24 - 72 hours was 14.4%. The causes of death were hypertensive emergency (35.7%), and hemorrhagic stroke (30.3%). Conclusion: Stroke and hypertensive emergency were the most frequent cardiovascular emergencies. The early mortality was high. Hemorrhagic stroke and hypertensive emergencies accounted for most cases of death.

关键词： Cardiovascular Emergencies Ischemic Stroke Hemorrhagic Stroke Cameroon

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Patterns of Mortality Occurrence in a Cardiology Unit of a Low-Income Country: A Critical Analysis at the YaoundéCentral Hospital

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World Journal of Cardiovascular Diseases 2021年第2期11卷 126-134页

作者： Liliane Mfeukeu Kuaté Mazou Ngou Temgoua hamadou ba Chris Nadège Nganou Doriane Mbono Bidias Ndongo Joel Nouktadie Tochie Eugene Sobngwi Faculty of Medicine and Biomedical Sciences University of Yaoundé 1 Yaoundé Cameroon Cardiology Unit Central Hospital of Yaoundé Yaoundé Cameroon

background: In-hospital mortality is high in low-income countries. Currently, little is known in Cameroon concerning the characteristics of patients who die in cardiology units. Our objectives were to determine the in-hospital mortality rate;describe the general characteristics of death patients, and factors associated with mortality. Material and Methods: We conducted a retrospective cross-sectional study by reviewing the medical records of all patients admitted to the cardiology unit of the Yaoundé Central Hospital (CHY) between January 2018 andJanuary 2019. The files of all death patients were studied for socio-demographical, clinical and therapeutical variables. Bivariate analysis was conducted to order to check the association between independents variables and time of death. A p-value 0.05 was considered statistically significant. Results: A total number of 860 patients were admitted in the cardiology unit of CHY during the study period. Amongst the 860 patients admitted 78 had a fatal outcome, hence, an in-hospital mortality rate of 9.06%. The male gender was predominant amongst the deceased patients (n = 45). The mean age at death was 69 ± 15.19 years. The median time before death was 6 days and they ranged between 1 to 25 days. Hypertension was the most frequent comorbidity (65.4%). Stroke was the principal cause of admission (40.3%), whereas the main presenting complaint was dyspnea (26.9%). Before being a

关键词： Mortality Occurrence Low Income Country Yaoundé Central Hospital Criti-cal Analysis

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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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Effect of Therapeutic Group Education on Adherence and Blood Pressure Control among Uncontrolled Hypertensive Patients in Sub Saharan Africa

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World Journal of Cardiovascular Diseases 2018年第3期8卷 183-195页

作者： Chris Nadege Nganou-Gnindjio Heloise Guidelle Kenmogne Domning Liliane Mfeukeu-Kuate ba hamadou Felicite Kamdem Georges Bediang Aurel T.Tankeu Alain Patrick Menanga Samuel Kingue Faculty of Medicine and Biomedical Sciences University of Yaounde IYaoundeCameroon Cardiology Unit Yaounde Central HospitalYaoundeCameroon Faculty of Health Sciences Universite des MontagnesBangangteCameroon Faculty of Medicine and Pharmaceutical Sciences University of DoualaDoualaCameroon Internal Medicine Department Douala General HospitalDoualaCameroon Internal Medicine Department Yaounde General HospitalYaoundeCameroon

background: Hypertension is the leading cardiovascular risk factor worldwide, with the greatest burden in low-income settings. Blood pressure (BP) control is usually low resulting in high rates of uncontrolled patients and complications. Low awareness resulting in poor therapeutic adherence represents an important factor for insufficient blood pressure control in developing countries. Methods: This was a three months non-randomized control trial at the cardiology clinic of the Yaoundé Central Hospital. We included adults with essential and uncontrolled hypertension. The intervention consisted of group educative sessions every week focusing on knowledge of hypertension risk factors, complications, treatment, comorbidities, home self-monitoring of BP. Home blood pressure figures, drug compliance, and knowledge regarding hypertension were evaluated before and after. Results: 17 participants (8 women) with a mean age 56.2 ± 8.1 years. During intervention, mean SBP decreased by 30 mmHg while mean DBP drooped by 11 mmHg using home BP measures. Knowledge regarding hypertension, adherence and drug compliance increased by 36.5%, 88.2% and 81.4% respectively. Conclusion: Therapeutic group education resulted in a significant improvement in BP control amongst uncontrolled hypertensive patients in sub Saharan Africa.

关键词： Therapeutic Group Education Hypertension Adherence Knowledge

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Hygienic and Dietary Measures in Cameroonian Hypertensive Patients Followed at the Douala General Hospital: Knowledge, Compliance and Effect on Blood Pressure Control

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World Journal of Cardiovascular Diseases 2023年第1期13卷 21-31页

作者： Félicité Kamdem Grace Eugénie Makota Ndongo Christelle Noche Domngang hamadou ba Jaff Fenkeu Kweban Glwadys Ngono Atéba Sidick Mouliom Henri Ngoté Lade Viché Caroline Kenmegne Marie Solange Ndom Ebongue Siddikatou Djibrilla Elysée Claude Bika Léle Samuel Kingue Department of Internal Medicine Douala General Hospital Douala Cameroon Faculty of Medicine and Pharmaceutical Sciences University of Douala Douala Cameroon Institut Supérieur des Sciences de la Santé Université des Montagnes Bangangté Cameroon Faculty of Medicine and Biomedical Sciences University of Yaoundé I Yaoundé Cameroon Intensive Care Unit Douala General Hospital Douala Cameroon Faculty of Medicine and Biomedical Sciences University of N’Gaoundéré N’Gaoundéré Cameroon Faculty of Health Sciences University of Buea Buea Cameroon Physiology and Medicine of Physical Activities and Sports Unit University of Douala Douala Cameroon

Introduction: The management of hypertension is mostly based on pharmacotherapy and hygienic and dietary measures (HDMs) for which little data is available in Cameroon. The concern to improve the quality of life of hypertensive patients led us to study the knowledge, compliance and effect of HDMs among Cameroonian hypertensive patients. Methods: This was a cross-sectional study carried out at the Douala General Hospital;the census of patients was carried out from 05 March to 10 May 2018. The data evaluated were knowledge and compliance with HDMs with an inference of their effect on blood pressure control. Results: We recruited 330 participants at mean age of 60 ± 11 years, 37.9% men;57.3% with blood pressure (BP) controlled. Out of 330 subjects, 308 (93.3%) who had been educated about dietary health measures for hypertension were assessed on knowledge, compliance and effect of these measures against 22 (6.7%) who had never heard about them. Around 85.7% of participants had good knowledge of HDMs and 78.9% had good compliance with them. There was no statistically significant influence of knowledge and compliance with HDMs on blood pressure control. Conclusion: The level of knowledge and adherence to HDMs of hypertensive patients at the Douala General Hospital was appreciable. It is however appropriate for physicians to intensify patient education on HDMs and BP control.

关键词： Hypertension Hygienic and Dietary Measures Blood Pressure Control Knowledge Compliance

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Contribution of MRI in Extension Assessment of Cervical Cancer in Yaoundé(Cameroon)

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Open Journal of Radiology 2021年第4期11卷 151-159页

作者： Mbozo’o Mvondo Samuel Yannick Onana Aminou Mohamadou Jérémie Mbo Amvene David Ngaroua Genesis Eric Secvou Mathurin Neossi Guena Obi Fidelis Ayuk Ekobena Fouda Odile Fernade Zeh Boniface Moifo hamadou ba Samuel Nko’o Amvene Departement of Radiology and Medical Imaging Faculty of Medicine and Biomedical Sciences of Garoua University of Ngaoundéré Ngaoundéré Cameroon Department of Biomedical Sciences Faculty of Sciences University of Ngaoundéré Ngaoundéré Cameroon Department of Radiology Yaoundé Military Hospital Yaoundé Cameroon Faculty of Medicine and Biomedical Sciences University of Yaoundé Cameroon

background: Cervical cancer is one of the most common cancers, requiring a precise complementary assessment. The aim of this study was to contribute to the improvement of the management of cervical cancer by describing the MRI aspects of cervical cancer according to the IFOG-MRI classification. Material and Methods: This was a cross-sectional study, conducted in patients who came for clinical suspicion, extension assessment of histologically confirmed cervical cancer, from October 2020 to March 2021, in Yaoundé (Cameroon). Results: 54 patients were selected, with an average age of 50.4 years. Genital hemorrhage was the most frequent symptom (92%). The mean tumor size was 52.9 mm. According to IFOG staging, stages Ia, Ib, IIa, IIb, IIIa, IIIb, and IV accounted for 9.10%, 10.20%, 12.50%, 29.50%, 5.70%, 12.50%, and 20% respectively. No patient had known metastasis at the time of examination. Conclusion: MRI allows non-invasive, satisfactory tumor staging examination by providing information on tumor size, parametrium invasion, adjacent organ involvement, and the presence of lymph node metastasis.

关键词： Cervical Cancer Magnetic Resonance Imaging International Federation of Obstetricians and Gynecologists

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Prevalence and Risk Factors of Peripheral Artery Disease in a Group of Apparently Healthy Young Cameroonians: A Cross-Sectional Study

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World Journal of Cardiovascular Diseases 2018年第2期8卷 111-122页

作者： Félicité Kamdem Yacouba Njankouo Mapoure ba hamadou Fanny Souksouna Ahmadou Musa Jingi Caroline Kenmegne Fernando Kemta Lekpa Jaff Fenkeu Kweban Gisèlei Mandy Jean Pierre Nda Mefo’o Henry Luma Marie Solange Doualla Internal Medicine Service Douala General Hospital Douala Cameroon Faculty of Medicine and Pharmaceutical Sciences University of Douala Douala Cameroon Faculty of Medicine and Biomedical Sciences University of Yaounde I Yaounde Cameroon Chemical Pathology Laboratory Douala General Hospital Douala Cameroon

background: The?burden of peripheral artery disease (PAD) is not well known among apparently healthy people in Africa. Aim: To determine the prevalence and associated risk factors of PAD in a group of blood donors seen at the Douala General Hospital—Cameroon. Methods: Between 1st November 2015 and 30th April 2016, we carried out a cross-sectional study. Participants were consenting adults of both sexes, aged ≥ 21 years who presented for blood donation, and were tested HIV negative. We collected socio-demographic data and their past history. We carried out a physical examination and measured their Ankle-Brachial Index (ABI). We defined PAD as an ABI Results: We recruited 103 participants, 55.4% males. The mean age was 33 ± 10 years. The mean ABI on left and right leg was 1.04 ± 0.1 and 1.02 ± 0.1respectively. ABI was higher in males than females both legs (p 0.05). PAD was seen in 11 (10.7%) participants. This was higher in females than males (3.6% versus 19.2%, p = 0.026). Among those with PAD, 8 (72.7%) were asymptomatic (Males: 100% versus Females: 66%, p = 0.9). After adjusting for age and gender, sedentary lifestyle (aOR: 7.14, [95% CI: 1.38 - 33.3], p = 0.019), and female gender (aOR: 6.2, [95% CI: 1.26 - 30.5], p = 0.025) were significantly associated with PAD. Conclusion: The prevalence of PAD was high in this group of HIV negative blood donors, most of whom were asymptomatic. This was associated with females, and a sedentary lifestyle.

关键词： Peripheral Artery Disease ABI Prevalence Risk Factors Douala

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An Assessment of Cardiovascular Functional Capacity of a Group of Chronic Heart Failure Patients Using the 6-Minute Walk Test in a Cameroonian Urban Setting

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World Journal of Cardiovascular Diseases 2023年第6期13卷 275-282页

作者： Félicité Kamdem Chris Nadège Nganou-Gnindjio Dieudonné Danwe Franc Christ-Roi Soemessabot Elysée Claude Bika Léle ba hamadou Sidick Mouliom Lade Viché Henri Ngoté Caroline Kenmegne Marie Solange Ndom Ebongue Siddikatou Djibrilla William Ngatchou Department of Internal Medicine Douala General Hospital Douala Cameroon Faculty of Medicine and Pharmaceutical Sciences University of Douala Douala Cameroon Faculty of Medicine and Biomedical Sciences University of Yaoundé I Yaoundé Cameroon Faculty of Sciences University of Douala Douala Cameroon Faculty of Medicine and Biomedical Sciences University of Garoua Garoua Cameroon Faculty of Health Sciences University of Buea Cameroon

background: Chronic heart failure is a public health problem worldwide. It has a high mortality rate and is accompanied by a decreased functional capacity and alteration of the quality of life. Objective: This study aimed to assess the cardiovascular functional capacity of a group of patients suffering from heart failure using the 6-minute walk test (6 MWT). Methods: This was a cross-sectional study carried out in the cardiology unit of Douala’s general hospital for 4 months. We included all eligible patients aged 18 years or more who had stable chronic heart failure and gave informed consent. Those who had an acute coronary syndrome (≤1 month), tachycardia (HR ≥ 120 bpm), high blood pressure (SBP ≥ 180 mmHg and/or DBP ≥ 100 mmHg) and reduced mobility due to orthopaedic reasons were excluded. A 6 MWT was done according to the American Thoracic Society guidelines. The 6 MWT result was considered poor for - 450 m and good for >450 m. Results: We recruited a total of 81 patients (61.7% women) with a mean age of 65.9 ± 10.6 years. The most frequent risk factor for heart failure was high blood pressure (77.8%), alcohol consumption(69.1%) and a sedentary lifestyle (53.1%). The left ventricular ejection fraction was mostly preserved (42.0%) or mildly altered (46.9). The 6 MWT results were poor in 55.6% of cases, average in 19.8% of cases and good in only 24.7% of cases. More than half (59.3%) of the participants perceived the effort as being difficult. The cardiovascular functional capacity was significantly associated with age, heart failure stage and physical activity (p Conclusion: Most patients suffering from chronic stable heart failure in the general hospital of Douala have poor cardiovascular functional capacity.

关键词： Cardiovascular Functional Capacity Chronic Heart Failure 6-Minute Walk Test Cameroon

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