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Co-Morbidities Associated with Prematurity in Two Referral Hospitals in Cameroon

Open Journal of Pediatrics 2024年第4期14卷 738-753页

作者： Diomede Noukeu Njinkui Dominique Enyama Yolande Djike Fokam Cyrelle O. Mefotse Saha Beatrice Moudze Kaptue charlotte eposse koube Annick A. Tchouamo Sime Christophe Akazong Adjahoung Marthe E. Barla Edgar Mandeng Ma Linwa Seraphin Nguefack Faculty of Medicine and Pharmaceutical Sciences of the University of Dschang Dschang Cameroon Faculty of Health Sciences University of Buea Buea Cameroon Faculty of Health Sciences University of Mountains Bangangte Cameroon Douala Laquintinie Hospital Douala Cameroon Faculty of Medicine and Pharmaceutical Sciences University of Douala Douala Cameroon Douala General Hospital Douala Cameroon Faculty of Medicine and Biomedical Sciences University of Yaound I Yaound Cameroon

Introduction: Prematurity is the leading cause of neonatal death in Africa. More than a million children die each year due to co-morbidities related to prematurity. In addition to being one of the causes of neonatal deaths, the health problems associated with prematurity can also lead to severe lifelong impairment in those who survive. Objectives: This paper aims to determine the epidemiology and identify co-morbidities of prematurity in the neonatology units of the Douala General Hospital (DGH) and the Laquintinie Hospital of Douala (LHD). Patients and Methodology: We conducted an analytical retrospective cohort study from January 2015 to January 2018 in the neonatology department of the GDH and the LHD, which are considered reference hospitals for the management of preterm babies in Cameroon. We included all newborns aged less than 37 weeks admitted to the neonatology units of the GDH and the LHD. The descriptive component was based on the analysis of quantitative variables using measures of central tendency. The analytical component was evaluated using Spearman correlations and the Chi-square and Fisher tests. Simple and multiple logistic regressions measured factors predictive of mortality. The Kaplan Meier survival curve used the Log Rank test and significance at p ≤ 0.05. Results: We recorded 908 preterm newborns in neonatal service and 1,124 preterm deliveries in maternity, representing an incidence of 32.5% in neonatal unit and 10.6% in maternity. 51% of whom were girls, given a sex ratio M/F of 0.9. Hypertension was the main prenatal pathology (9.1%), while premature rupture of membranes: PROM (35.5%) and eclampsia/pre-eclampsia (18.6%) were the most common obstetrical pathologies. 75.9% of deliveries were vaginal with 65.2% being performed in our referral hospitals. Gestational age ranged from 22 to 36 weeks, with a mean of 32.4 weeks. Late preterm birth rate was 53.7%, and birth weight varied between 590 and 3200 g with an average of 1747 ± 479 g. The per

关键词： Epidemiology Co-Morbidities Prematurity Douala

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Diabetes during COVID-19 Pneumonia in a 16-Year-Old Girl: A Case Report in Cameroon

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Open Journal of Pediatrics 2024年第4期14卷 712-718页

作者： Ritha Mbono Betoko charlotte eposse Suzanne Sap Betsy Bate Gaelle Ntsoli Hassanatou Iyawa Calixte Ida Penda Faculty of Medicine and Pharmaceutical Sciences University of Douala Douala Cameroon Laquintinie Douala Hospital Douala Cameroon Faculty of Medicine and Biomedical Sciences University of Yaounde I Yaound Cameroon

Background: Diabetes is a known risk factor for susceptibility and severity of COVID-19 infection. It may also be a complication of COVID-19. Many hypotheses have been proposed to explain this condition. It may be due to the effect of SARS-CoV-2 on β cells or drug-related side effects. In children, there is a paucity of data on the burden of this complication. Objective: We aimed to report a case of secondary diabetes during COVID-19 in a pediatric unit. Case Presentation: A 16-year-old girl presented with severe respiratory distress. She was treated for COVID-19 infection with antibiotics and corticosteroids. On day 6 of treatment, she developed polyuria and polydipsia. A random blood glucose test showed hyperglycaemia. The diagnosis of secondary diabetes was maintained. Conclusion: Covid-19 infection can be complicated by diabetes in children. It is essential to monitor blood glucose levels regularly.

关键词： Covid-19 Diabetes Adolescents

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Parent-Reported Reasons for Loss-to-Follow Up in Patients Hospitalized at the Neonatology Unit at Laquintinie

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Open Journal of Pediatrics 2024年第4期14卷 686-699页

作者： eposse Ekoube charlotte Puepi Djike Yolande Hassanatou Iyawa Mandeng Ma Linwa Edgar Epée Patricia Mbonjo Bitsie Dora Kedy Mangamba Koum Daniele-Christiane Faculty of Medicine and Pharmaceutical Sciences University of Douala Douala Cameroon Paediatric Unit Douala Laquintinie Hospital Douala Cameroon Faculty of Sciences University of Douala Douala Cameroon

Introduction: Despite the known benefits of newborn follow-up clinics, attendance has historically been difficult. Infants with reported follow-up difficulty have a greater incidence of severe sensorimotor and cognitive deficits and poorer access to early intervention programs. Our objective was to determine the parent-reported reasons for loss-to-follow up in patients hospitalised at the neonatology unit of Laquintinie Hospital. Methodology: We carried out a cross-sectional study through phone interviews with parents/caregivers of patients hospitalised at Laquintinie over a 2-year period from 1st January 2021 to 31st December 2022. A non-standardised structured interview guide was used for data collection. Loss-to-follow up referred to absence to at least one visit as recorded in the neonatal follow-up chart. All necessary administrative and ethical considerations were duly respected. Results: Most neonates were born through vaginal delivery (n = 313, 69.45%). The neonates were admitted at a median gestational age of 33 weeks (Q1-Q3;32 - 35) and the median duration of hospitalisation was 12 days (Q1 - Q3;8 - 18). A total of 23 neonates had died at the time of interview giving a mortality rate of 5.1%. The three most reported reasons for loss-to-follow-up was lack of money (n = 310, 68.13%), assumption that follow-up had ended (n = 37, 8.13%), and newborn that died (n = 23, 5.1%). Conclusion: This study highlights the significant impact of financial constraints and absence of a robust follow-up system on poor uptake of neonatal follow-up post-discharge in resource limited settings like Cameroon. Our results serve as advocacy for national health insurance especially in neonates.

关键词： Loss-to-Follow Up Cameroon Neonates

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“FISH VERTEBRA” about 3 Sickle Cell Patients Followed at Laquintinie Hospital, Douala

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Open Journal of Rheumatology and Autoimmune Diseases 2024年第1期14卷 20-25页

作者： Same Bebey Francine Mbono Betoko Ritha Eloundou Onomo Paul Mantho Fopa Pauline eposse Ekoube charlotte Megne Tamo Estelle Ebene Mbende Romain Singwe Ngandeu Madeleine Rheumatology Unit Laquintinie Hospital Douala Douala Cameroon Paediatric Unit Laquintinie Hospital Douala Douala Cameroon La Cite Verte Hospital Yaounde Yaounde Cameroon Paediatric Surgery Unit Laquintinie Hospital Douala Douala Cameroon La Cite des palmiers Hospital Douala Douala Cameroon Rheumatology Unit Central Hospital Yaounde Yaounde Cameroon

Vertebral involvement in particular is common in sickle cell patients. We report 3 cases of “fish vertebra” fractures in sickle cell patients aged 16, 18, and 24 years old respectively at Laquintinie Hospital, Douala. When the vertebral fractures were diagnosed, the 3 patients had back pain and kyphosis deformities of the dorsal spine. Treatment with an infusion of biphosphonates (zoledronic acid at a dose of 0.5 mg·per·kg) was offered to all three patients. Two out of three patients received treatment with biphosphonates with a successful outcome. Profound vitamin D deficiency is associated with increased bone remodeling and a history of fractures. In sickle cell anemia, vertebral fractures may also result from bone fragility, which is often overlooked as aseptic osteonecrosis and osteomyelitis, which are very often suspected.

关键词： Vertebral Fractures Sickle Cell Anemia Vertebral Bone Fragility

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Diagnosis of CAH in a Sub Saharan Country: Visible Part of Iceberg

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Open Journal of Pediatrics 2024年第2期14卷 227-233页

作者： Suzanne Sap Ritha Mbono Hélène Kamo Jocelyn Tony charlotte eposse Jeannette Epée Isabelle Mekone Adele Bodieu Gaelle Ntsoli Paul Olivier Koki Mother and Child Center of the Chantal Biya Foundation University of Yaoundé I Yaoundé Cameroon Laquintinie Hospital University of Douala Douala Cameroon Genral Hospital of Garoua University of Garoua Garoua Cameroon Human Reproductive Center and Research on Fertility of Yaoundé University of Yaoundé I Yaoundé Cameroon Yaounde General Hospital University of Yaoundé I Yaoundé Cameroon Yaounde Central Hospital Yaoundé Cameroon Laquintiinie Hospital Douala Cameroon

Introduction :Congenital adrenal hyperplasia (CAH) is the most common cause of primary adrenal insufficiency. It is a rare monogenic recessive disorder. In African setting in absence of neonatal screening, the diagnosis is still late, based on a clinical approach. During this clinical enquiry, information from past history or pedigree of the patient is of a huge importance and may revealed surprises. Patients and Methods: In this observational study, we retrospectively included all patients with a diagnosis of CAH. The diagnosis of CAH was retained based on a high 17 hydroxyprogesterone level in addition to clinical and morphological findings. From patients’ files, we extracted data on family history of disease, pedigree, clinical findings and genetics when available of 39 patients from two endocrinopeadiatric centers. Results: In 13 (30%) families, we found 20 reported deaths of infant less than 12 months. In these 13 families, half of the patients followed had 21 hydroxylase deficiencies and had 11 hydroxylase deficiencies. Unsurprisingly, we suspected adrenal insufficiency in these patients at verbal autopsy even in families with a patient with 11 hydroxylase deficiency. Other non DSD malformations or genetic disorders with apparently no link with CAH were reported in 3 families. The father of a patient reported to have hypospadias. Conclusion: Each diagnosis of CAH made in our context is visible part of an iceberg. Behind a diagnosis of CAH made in our setting, is a long course of care, a dramatic past history revealing access to appropriate care disparity. Neonatal screening should thus be considered as an emergency.

关键词： Congenital Adrenal Hyperplasia

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Suicidal Behaviours in Sickle Cell Patients at the Douala Sickle Cell Care Centre in Cameroon

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Open Journal of Psychiatry 2024年第3期14卷 265-281页

作者： Christian Eyoum Léonce Kengno Kologne charlotte eposse Ekoube Annick Mélanie Magnerou Joséphine Manga Befolo Cindy Laura Ndepa Daniel Gams Massi Aurore Nzesseu Djomo Guy Jonas Basseguin Atchou Guy Calvin Mbongo’O Rihta Mbono Mbekoto Iyawa Hassanatou Fabiola Tchouankeu Kounga Christiane Medi Sike Josiane Essola Jacques Narcisse Doumbe Erero Njiengwe Callixte Kuate Tegueu Faculty of Medicine and Pharmaceutical Sciences University of Douala Douala Cameroon Laquintinie Hospital Douala Cameroon Faculty of Health Sciences University of Buea Buea Cameroon Faculty of Medicine and Biomedical Sciences University of Yaound&#233 1 Yaound&#233 Cameroon

Introduction: Sickle cell anaemia is a hereditary disease that combines physical and psychological manifestations, including suicidal tendencies. So far, to our knowledge, no study has been conducted on suicidal behaviours among people with sickle cell disease in Cameroon. This is what justifies our study on the prevalence and factors related to suicidal behaviors in our study population. Methods: We conducted a cross-sectional, analytical study of 171 sickle cell patients aged from 12 years upwards who came to the sickle cell disease care service of the Laquintinie Hospital in Douala, over a period of 6 months, that is, from 1 January to 31 June 2022. Data were collected using a structured questionnaire with questions on suicidal behaviours based on the “MINI” (Mini International Neuropsychiatric Interview). The data were processed using the SPSS 26.0 software. The related factors were studied in both a bivariate and multivariate analysis. Results: Female sickle cell patients accounted for 60.2% of the sample. The mean age was 23.36 ± 8.42 years. Suicidal ideation was prevalent in 56% of cases and 13% attempted suicide. The factors most associated with suicidal ideation were: primary level of education (OR = 0.08 (0.09 - 0.79);p = 0.03), feeling unworthy of life (OR = 0.40 (0.08 - 1.96);p = 0.02), not often being considered by those around them (OR = 2.97 (1.26 - 6.99);p = 0.01), lack of family support (OR = 0.34 (0.15 - 0.77);p = 0.01). Meanwhile, the factors associated with suicide attempts were: the fact of being rarely exposed to suicide-related media (OR = 4.17 (1.40 - 71.80);p = 0.03), and a constant feeling of sadness when returning home (OR = 18.02 (1.59 - 20.55);p = 0.01). Conclusion: More than half of sickle cell patients had had suicidal thoughts and 1/6 had made at least one suicide attempt, women and young adults being the most concerned. It is therefore necessary to ensure optimum psychological care for patients with sickle cell disease.

关键词： Sickle Cell Disease Suicidal Behaviours Self-Harm

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Pregnancy Preferences in Females of Reproductive Age with Sickle Cell Disease at Laquintinie Hospital: A Cross-Sectional Analysis

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Open Journal of Obstetrics and Gynecology 2024年第5期14卷 744-757页

作者： eposse Ekoube charlotte Jeannette Disso Massako Mangala Fulbert Nkwele Mandeng Ma Linwa Edgar Puepi Djike Yolande Merlin Boten Bounyom Erero F. Njiengwe Épée Patricia Hassanatou Iyawa Dora Mbonjo Bitsie Emmanuel Heles Nsang Soumaiyatou Abba Ngo Linwa Esther Eleonore Ndolo Kondo Astrid Grâce Tocki Toutou Moustapha Bilkissou Essome Henri Faculty of Medicine and Pharmaceutical Sciences University of Douala Douala Cameroon Paediatric Unit Douala Laquintinie Hospital Douala Cameroon Faculty of Health Sciences University of Bamenda Bamenda Cameroon

Introduction: Females with sickle cell disease (SCD), despite having a delayed pubertal development, are subject to many worries relating to their abilities to conceive, their capacity to maintain a maternofetal-risk-free pregnancy till term and give birth to healthy children without sickle cell disease. Knowing that unplanned pregnancies are more likely to increase maternofetal morbidity and mortality, we sought out to explore the pregnancy preferences in female patients with sickle cell disease to promote healthy conception and childbirth in this vulnerable population. Methodology: We conducted a cross-sectional study involving female patients of child-bearing age with sickle cell disease followed at Laquintinie Hospital Douala or who were members of a local sickle cell association. Pregnancy preferences were determined using the Desire to Avoid Pregnancy (DAP) scale. Factors associated with pregnancy preferences were determined using multivariable linear regression model. Threshold for significance was set at p Results: Seventy-seven patients were included with a mean age of 24.71 ± 5.53 years. Forty patients (51.95%) had one sexual partner and thirteen women (32.5%) used contraceptive methods. Most patients (46.0%) responded “Strongly Agree” or “Agree” to the statement “it would be a good thing for me if I became pregnant in the next 3 months”. The mean DAP score was 1.63 ± 0.91 [1.28 ± 0.82 in those who had a sexual partner and 1.99 ± 0.86 in those who had no sexual partner]. Factors that were positively associated with DAP score were students (b = 0.32, 95% CI [0.21, 0.95], p = 0.003), monthly income ≥ 100,000 FCFA (b = 0.24, 95% CI [0.07, 0.81], p = 0.022), and not having a sexual partner (b = 0.26, 95% CI [0.11, 0.85], p = 0.012). Conclusion: Most female patients with SCD have a low desire to avoid pregnancy. This is especially true for patients who are not students, have a partner and have a low monthly income.

关键词： Pregnancy Preferences Sickle Cell Disease Laquintinie Hospital Cameroun

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Cryptoccocal Neuromeningitis in Immunocompetent Infant in Bonassama District Hospital, Douala: A Case Report

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Open Journal of Pediatrics 2021年第4期11卷 810-815页

作者： Patricia Epée Eboumbou Yanelle Wandji Ritha Mbono Betoko Hassanatou Iyawa charlotte eposse Danielle Kedy Koum Calixte Ida Penda Clinical Sciences Department Faculty of Medicine and Pharmaceutical Sciences of Douala Douala Cameroun Pediatric Service Bonassama District Hospital Douala Cameroun Clinical Sciences Department Faculty of Health Sciences University of Buea Buea Cameroun Pediatric Service Laquintinie Hospital Douala Douala Cameroun Deido District Hospital Douala Cameroun General Hospital Douala Douala Cameroun

Cryptococcosis is rare in children. We report a case of cryptococcal meningitis in an infant whose mother works as a poultry farmer (chicken farm). The infant was received in the context of fever with convulsions. We performed a lumbar puncture and started antibiotic treatment. Cerebrospinal fluid (CSF) analysis was performed including Indian ink staining. CSF results showed the presence of yeast and we replaced antibiotics with fluconazol-based treatment. After the loss of sight and the appearance of a motor deficit, a brain scan was performed showing cerebral edema. Several lumbar punctures were performed for 02 weeks until partial recovery of visual acuity and motor deficit. This case highlights the importance of taking into account the patient’s history when making the diagnosis. In our case, the working conditions and the employment of the mother guided the realization of the Indian ink coloring of the CSF. Treatment with fluconazol continued for 22 weeks with a completely regained visual acuity and gradual improvement in motor deficit despite limited resources.

关键词： Cryptococcis Meningitis Immunocompetent Infant

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Neonatal Transfer Situation Following Implementation of a Perinatal Network: An Analysis in Douala, Cameroon

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Open Journal of Pediatrics 2022年第1期12卷 148-161页

作者： Daniele Kedy Koum Diomede Noukeu Njinkui Monique Carole Magnibou Loick Pradel Kojom Foko charlotte eposse Rhita Mbono Patricia Epée Eboumbou Calixte Ida Penda Department of Clinical Science Faculty of Medicine and Pharmaceutical Sciences The University of Douala Douala Cameroon Department of Pediatrics Deido District Hospital Douala Cameroon Department of Pediatrics Douala Gyneco-Obstetrics and Pediatrics Hospital Douala Cameroon Faculty of Medicine and Pharmaceutical Sciences University of Dschang Dschang Cameroon Department of Animal Organisms Faculty of Science The University of Douala Douala Cameroon Department of Pediatrics Douala General Hospital Douala Cameroon

Background: Postnatal transfer (PT) is interhospital transport of care-needing newborns. In 2016, a perinatal network was implemented to facilitate PT in the town of Douala, Cameroon. The network was supposed to improve PT-related care standards. This study aimed at determining characteristics of PT five years following the implementation of this network. Methods: A cross-sectional study was carried out from February to May 2021 at neonatology wards of six hospitals in Douala. Medical records of newborns transferred to the hospitals were scrutinized to document their characteristics. Parents were contacted to obtain information on PT route and itinerary. Data were analyzed using Epi Info software and summarized as percentages, mean and odds ratio. Results: In total, 234 of the 1159 newborns admitted were transferred, giving a PT prevalence of 20.2% (95% CI 17.9% - 22.6%). Male-to-female ratio of the transferred newborns was 1.3. Neonatal infection (26.5%), prematurity (23.5%) and respiratory distress (15.4%) were the main reasons for transfer. Only 3% of the PT was medicalized while only 2% of the newborns were transferred through perinatal network. On admission, hypothermia and respiratory distress were found in 31% and 35% of the newborns, respectively. The mortality rate among babies was 20% and these had a two-fold risk of dying (95% CI 1.58 - 3.44, p Conclusion: PT and the perinatal network are lowly organized and implemented in Douala. Sensitization of medical staff on in utero transfer, creating center for coordination of the network, and implementation of neonatal transport system could improve the quality of PT.

关键词： Postnatal Transfer Perinatal Network Characterization Douala

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Epidemiological Profile of Pediatric Vital Emergencies at Laquintinie Hospital of Douala, Cameroon

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Open Journal of Pediatrics 2021年第1期11卷 148-160页

作者： Penda Calixte Ida Endalè Mangamba Mireille-Laurent Samè Bebey Francine Maledje Kamgang Kiliane Lariale eposse Ekoubè charlotte Eyoum Bilè Bertrand Kedy Koum Danièle Department of Clinical Sciences Faculty of Medicine and Pharmaceutical Sciences University of Douala Douala Cameroon Department of Pediatrics Douala Laquintinie Hospital Douala Cameroon Department of Pediatrics Douala General Hospital Douala Cameroon Department of Pediatrics Faculty of Medical Sciences University of Buea Buea Cameroon Department of Medicine Douala Laquintinie Hospital Douala Cameroon Pediatrics Unit District Hospital of Déido Douala Cameroon

Introduction: In the absence of health coverage in resource limited-settings, life-saving pediatric emergencies remain a challenge. The objective of our study was to describe the epidemiological profile of life-threatening pediatric emergencies at Laquintinie Hospital in Douala (HLD). Methods: A cross-sectional study was carried out for a period of 3 months, from March to May 2017 in the pediatric emergency unit of HLD enrolling all children presenting a life-threatening emergency on admission. Local emergency kits and an internal deferred cost recovery voucher or “green voucher” were used to facilitate access to care for children on admission. The socio-demographic, clinical, therapeutic and evolutionary characteristics were collected and analyzed using SPSS software version 20.0. Results: A total of 135 children were enrolled and the sex ratio was 1.54. The mean age was 3.8 years ± 4.05 and 80.7% of the children were under 5 years old. The majority of children (82.9%) a

关键词： Vital Emergencies Pediatrics Douala Laquintinie Hospital Cameroon

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