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

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Health 2022年第10期14卷 1081-1103页

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

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

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

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

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

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

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

关键词： Perinatal Asphyxia Newborn Neurological Outcome Cameroon

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

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Health（健康） 2022年第10期

作者： solange whegang youdom diomède njinkui noukeu georges nguefack-tsague jerôme ateudjieu

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

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

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

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

关键词： Measles Complications Low-Income Countries

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

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

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Open Journal of Pediatrics（儿科学期刊） 2023年第6期

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

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Open Journal of Pediatrics（儿科学期刊） 2024年第1期

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

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Open Journal of Pediatrics（儿科学期刊） 2024年第4期 738页

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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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Level of Implementation of Seasonal Malaria Chemoprevention in Children Aged between 3 to 59 Months in Koza, Far North Region of Cameroon

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Open Journal of Pediatrics 2023年第5期13卷 707-718页

作者： Djike Puepi Fokam Yolande Kamo Selangai Helene noukeu njinkui diomede Missota Tchahe Mariane Gabrielle Wandji Yanelle Ganni Wele Wilfried Tedongfo Nicolas Verla Vincent Sisyi department of Internal Medicine and Pediatric Faculty of Health Sciences University of Buea Buea Cameroon department of Pediatric Faculty of Medicine and Biomedical Sciences University of Garoua Garoua Cameroon Faculty of Medicine and Pharmaceutical Sciences University of Dschang Dschang Cameroon Faculty of Health Sciences University of Buea Buea Cameroon department of Public Health Faculty of Health Sciences University of Buea Buea Cameroon

Background: Seasonal Malaria Chemoprevention (SMC) is a strategy put in place by World Health Organisation (WHO) to fight against malaria in zones of high seasonal malaria transmission since the year 2012. This strategy has been implemented in the Far North and North regions of Cameroon since the year 2016. despite the implementation of this program the number of cases and deaths from seasonal malaria among the under 5 seems to be rising in Koza health area. Objective: To determine the level of implementation of the SMC Program and its impact on the mortality of children aged 03 to 59 months during the season of high transmission. Methods: This was a community-based cross-sectional and 7-years retrospective study. Data was surveyed for 3 months in 3 health areas of Koza health area. Data were collected and typed in Kobo collect, cleaned in MS Excel and analyzed in SPSS version 25 to come out with descriptive statistics. Results: Among the 172 households, female children were mostly represented 99 (57%) The age group mostly represented was 2 years. The population knowledge on SMC’s overall score was above average. The overall coverage rate (4 cycles) was 84% from interviewed parents and 67.5% from SMC cards. More than 23% of children experienced at least one side effect with the most common being vomiting (72%). The population’s overall impression of the program was good at 85%. The trends SMC coverage showed a sinusoidal fluctuation from 2015 to 2021, 2016 to 2019 and 2020 to 2021. Conclusion: The coverage rate of SMC was high thus the program is well implemented.

关键词： Level of Implementation Children Parents/Tutors Seasonal Malaria Chemoprevention Koza

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