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Magnetic Resonance Imaging of the Spine at the douala General Hospital (Cameroon)

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Open Journal of Modern Neurosurgery 2019年第3期9卷 237-247页

作者： Mathurin Neossi Guena Florent Alapha Zilbinkai Antonia Djougnye Regine Gaelle Ngah Etoundi Edwige Vekoun Ngadjere Emmanuela Manka’a Wankie Narcisse Nwedjiwe Nana Celestine Nguemgne Wanko Woguep Laure Vanina Joseph Fotsin Gonsu Department of Biomedical Sciences Faculty of Sciences University of Ngaoundéré Ngaoundéré Cameroon Imaging service Ngaoundéré Regional Hospital Ngaoundéré Cameroon Imaging service Douala General Hospital Douala Cameroon Faculty of Medicine and Biomedical Sciences University of Yaounde I Yaounde Cameroon Yaounde Gynaecology Obstetrics and Pediatrics Hospital Yaounde Cameroon

Objectives: The objective of this study was to evaluate the interest of MRI in the diagnosis of spinal disorders in our area. Method: It was a cross-sectional, descriptive and retrospective study during a nine-month period from January to September 2015 involving all patients who performed a spine MRI in the Imaging Department of douala General Hospital. All the patients were scanned using an open-sided mid-field MRI APERTO LUCENT (0.4 T) using sagittal and axial slices in T1-weighted and T2-weighted FSE spin echo and STIR sagittal slices and T1 gado. Water-fat saturation (WFS) slices were obtained after injection of a contrast agent. All the data collected were analyzed using Microsoft Excel 2010 and Sphinx version 4.0. Results: 220 patients were recruited. The mean age was 46.34. There was male predominance with a sex ratio of 1.5. The main indication was lumbar spine pain (36.8%), followed by cervical spine pain, sensory and motor disorder. Neurosurgeon (33.6%), neurologist (23.1%) and rheumatologist (13.6%) were the main referring physicians. The lumbar spine was the most explored (53.2%). Discal hernia (46.6%), arthrosis (31.3%) and degenerative disc disease (25.5%) were the main observed lesion. Infectious disorders were mainly represented by spondylitis (5%);Traumatic disorders by spondylolisthesis (8.6%). Tumors were mainly metastasis (4%). 21.3% of MRI were normal. MRI-clinical concordance was 78.63%. Conclusion: MRI allows an accurate assessment of spinal and spinal cord pathologies without exposing patients to radiation. It helped to confirm or refute the diagnosis suspected by clinics. However, its availability is limited in our country.

关键词： Spine MRI Spinal Disorders douala General Hospital

Microbial Ecology and Antibiotic Susceptibility Profile of Germs Isolated from Hospital Surfaces and Medical Devices in a Reference Hospital in douala (Cameroon)

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Advances in Microbiology 2018年第2期8卷 125-137页

作者： Cécile Okalla Ebongue Chanceline Mayoudom Nguatcheussi Jean-Pierre Nda Mefo’o Joss Bollanga Dieudonné Adiogo Henry Namme Luma Laboratory of Clinical Biology General Hospital Douala Cameroon Department of Biological Sciences Faculty of Medicine and pharmaceutical Sciences University of Douala Douala Cameroon Committee for Hygiene and the Fight against Nosocomial Infections General Hospital Douala Cameroon

Background: The hospital environment is largely contaminated with pathogenic microorganisms. This colonization is a threat for hospitalized patients, especially in high-risk services. The purpose of this study was to identify the germs found on surfaces and medical devices in some departments of the General Hospital of douala, and to establish their susceptibility profile to most commonly used antibiotics in this health facility. Results: We collected 114 surface and medical device samples, and seeded different culture media for Gram-positive and Gram-negative aerobic bacteria. Of the total samples, 108 were positive and 137 bacterial strains were isolated. The colony count revealed a high rate of contamination. Enterobacter cloacae was the most represented specie (53.3%), followed by Pseudomonas aeruginosa (22.6%) and Klebsiella pneumoniae (6.6%). Various coagulase-negative Staphylococci have been isolated in some departments, as well as Cryptococcus laurentii and molds. The isolated strains showed low susceptibility to the antibiotics tested. Enterobacter cloacae showed low susceptibility for all tested molecules, except for carbapenems with rates ranging from 82% to over 94% in Maternity, Intensive Care and Neonatology units. The strains coming from the Haematology Protected Ward were resistant to all antibiotics, except fluoroquinolones with a susceptibility rate of 50% for ofloxacin. Conclusion: The hospital surfaces and medical devices are highly contaminated by environmental bacteria, with low susceptibility rates to antibiotics. Microbiological controls of the environment should be regular in critical areas in order to reinforce measures to prevent diffusion of multi-resistant bacteria.

关键词： Microbial Ecology Hospital Environment Susceptibility to Antibiotics douala

Kaolin Clay Consumption and Pregnancy:Prevalence,Hematological Consequences and Outcome of Labour in the douala

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Open Journal of Obstetrics and Gynecology 2017年第12期7卷 1166-1173页

作者： Henri Essome Jean Paul Engbang Gaella Penda Ndedi Mve Koh Valere Merlin Boten Pascal Foumane DieudonnéAdiogo douala Laquintinie Hospital DoualaCameroon Faculty of Medicine and Pharmaceutical Sciences The University of DoualaDoualaCameroon Yaounde University Health Center YaoundéCameroon Faculty of Medicine and Biomedical Sciences The University of Yaoundé IYaoundéCameroon Gynecological-Obstetric and Pediatric Hospital of Yaoundé YaoundéCameroon

Objective: To determine the prevalence, haematological repercussions and prognosis of childbirth in the event of consumption of kaolin during pregnancy. Materials and Methods: It was a study over a period of 3 months at the Laquintinie Hospital douala. It compared two groups of women, one of whom had consumed kaolin during pregnancy (exposed group) and the other had not consumed it (non-exposed group). Results: A total of 342 women were included in our study, 121 (35.4%) of whom had consumed kaolin during pregnancy. Women exposed to this consumption (P < 0.05) after univariate analysis were those of pregnant women from the Far North (OR = 3.37, CI: 1.29 - 8.79, P = 0.013), single (OR = 1.65, CI = 1.05 - 2.59, P = 0.029), those with primary education (OR = 2.25, CI = 1.06 - 4.79, P = 0.035) and those with HIV (OR = 2.75, IC = 1.02-7.43, P = 0.045). Consumption was more frequent in the first trimester of pregnancy (37%) and in the third quarter (34%), at a predominantly weekly rate (47.9%). The most frequently cited reasons were envy (82%), and nausea (45%). This consumption was associated with a risk of premature delivery (RR = 2.26, IC = 1.27 - 4.05, P = 0.001), yellowish amniotic fluid (RR = 4.66, IC = 1.81 - 11, P = 0.001), birth weight < 2500 g in newborns (RR = 1.72, IC = 3.36 - 9.56, P = 0.025), but increased the probability of delivery (RR = 1.94, IC = 0.96 - 3.90, P = 0.039). For the hematological aspect, the occurrence of anemia (RR = 1.55, IC = 0.97 - 2.31, P = 0.003) and a decrease in mean hemoglobin concentration (RR = 1.29, IC = 0.83 - 2.03, P = 0.041) were associated with kaolin in pregnancy. After multivariate logistic regression, the complications included premature delivery, yellowish colour of the amniotic fluid and decreased hemoglobin. Conclusion: The use of kaolin is a frequent feeding behavior in pregnancy, mainly motivated by envy, which nevertheless presents serious maternal and fetal complications.

关键词： Kaolin Pregnancy Anemia Prognosis Childbirth douala

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

Antibiotics Susceptibility Profile of Staphylococcus aureus Clinical Isolates Collected in Hospitals in the City of douala (Cameroon)

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Journal of Biosciences and Medicines 2022年第8期10卷 188-200页

作者： Jean Pierre Nda Mefo’o Yanne Sabekob Grace Dalle Ngondi Emmanuel Roddy Mengue Elodie Ngo Malabo Nancy Handa Guy Pascal Ngaba Dieudonné Adiogo Cécile Okalla Ebongue Laboratory of Clinical Biology Douala General Hospital Douala Cameroon Department of Biological Sciences Faculty of Medicine and Pharmaceutical Sciences University of Douala Douala Cameroon Laboratory Laquintinie Hospital Douala Cameroon Kansas City University of Medicine and Biosciences Kansas City MO USA Laboratory Unit of the Gyneco-Obstetric Douala Pediatric Hospital Douala Cameroon

Introduction: Staphylococcus aureus is one of the most important agents involved in community and hospital-acquired infections. Due to the multi-drug resistance of strains to antibiotics, treatment to eradicate it is becoming more difficult and poses a global public health problem. Methodology: This was a cross-sectional study conducted from March to August 2020 in hospitals in the city of douala, including all S. aureus isolates from diagnostic samples. Strain identification and antibiotic susceptibility testing were performed using the Vitek2 CompactTM (BioMerieux). Results: During the study period, 136 non-repetitive S. aureus strains were identified with a high frequency of methicillin-resistant S. aureus of 78.7%. The majority of the strains originated from the douala General Hospital (66.9%) and was most frequently isolated from blood culture samples (55.1%). The study of biochemical characteristics showed that most of the strains identified had between 87% and 99% homology with the reference strain. The most active antibiotics were Quinupristin/Dalfopristin (94.2%), Linezolid (87.8%) and Vancomycin (84.2%). Methicillin resistance was associated with decreased susceptibility of S. aureus to other antibiotics such as Gentamycin (44.9%), Erythromycin (38.2%), Tetracycline (38.3%), Trimethoprim (21.4%), Ciprofloxacin (19.1%) and Levofloxacin (24.0%). Inducible MLSb and constitutive resistance phenotypes were identified with 26.7% and 22.8% respectively. Conclusion: The sensitivity of S. aureus strains differs from one antibiotic family to another, and remains good for molecules that are not available in our context. The high frequency of Methicillin-Resistant S. aureus shows the continuous progression of multi-resistant strains of S. aureus and their decreased sensitivity to usual antibiotics becomes more and more alarming.

关键词： Staphylococcus aureus Multidrug Resistance MRSA douala

Antibiotics Resistance of Urogenital Mycoplasma in Sexually Active Women Attending Gynecologic Consultation in douala (Cameroon)

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Advances in Microbiology 2023年第12期13卷 559-570页

作者： Jean Pierre Nda Mefo’o Rosa Fetue Notio Fulbert Mangala Nkwele Grace Dalle Ngondi Emmanuel Roddy Mengue Elodie Ngo Malabo Charlotte Tchente Nguefack Cécile Okalla Ebongue Théophile Nana Njamen Laboratory of Clinical Biology Douala General Hospital Douala Cameroon Department of Biological Sciences Faculty of Medicine and Pharmaceutical Sciences The University of Douala Douala Cameroon Department of Surgery and Specialties Faculty of Medicine and Pharmaceutical Sciences The University of Douala Douala Cameroon Mother and Child Department Douala General Hospital Douala Cameroon Department of Obstetrics and Gynecology Faculty of Health Sciences University of Buea Buea Cameroon

Introduction: Mycoplasmas are bacteria commonly found in the commensal flora of humans and can occasionally be pathogenic. The population and the geographical area determine their susceptibility to various antibiotics. Methodology: We carried out a cross-sectional study from January to June 2022 at the douala General Hospital. All women who were sexually active and willing to participate were included. Endo-cervical swabbing was used to collect the samples. Culture and antibiotic susceptibility testing were performed in a liquid medium using Mycoplasma-SystemPlus Gallery (Liofilchem). All samples that degraded urea (threshold > 103 for Ureaplasma urealyticum) and arginine (threshold > 104 for Mycoplasma hominis) were deemed positive. Results: A total of 107 women with a median age of 33 ± 8.3 years and a predominance of 30-40 years (41.1%) were included. The frequency of mycoplasma infection was 73.8% with 34.1%, 11.4% and 54.4% for Ureaplasma urealyticum, Mycoplasma hominis and co-infection respectively. Resistance rates to Minocycline were low, 1.3% for Ureaplasma urealyticum and 3.7% for co-infection;for Pefloxacin the resistance rates were 3.7% (Ureaplasma urealyticum, Mycoplasma hominis) and 22.8% (co-infection). Ureaplasma urealyticum had a resistance rate of 3.7% for Erythromycin, 1.3% for Clarithromycin and 5% for Azithromycin. There was no significant correlation between risk factors and infection. Vaginal cleansing and the development of resistance in mycoplasma infection were found to be significantly correlated (OR = 6.915 [1.52 - 31.55];(p = 0.013)). Conclusion: Minocycline was the most active antibiotic and Ureaplasma urealyticum was the species with the lowest rate of resistance. Antibiotic resistance was more common in co-infected people than mono-infected. Antibiotic resistance was independently correlated with vaginal douching.

关键词： Urogenital Mycoplasma Sexually Active Women douala Cameroon

Spatio-Temporal Assessment of Water Quality in douala IV Municipality, Cameroon

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Journal of Water Resource and Protection 2019年第12期11卷 1441-1461页

作者： Mary Lum Fonteh Niba Theophile Fonkou Cornelius Mbifung Lambi Department of Geography Higher Teacher Training College The University of Bamenda Bambili Cameroon Department of Plant Biology Faculty of Science University of Dschang Dschang Cameroon Department of Geography Faculty of Social and Management Sciences University of Buea Buea Cameroon.

The study analysed the spatial and temporal contamination levels of fresh water resources by saline intrusion in the douala coastal area. Water samples were collected from 19 stations. 3 stations were selected from the mangrove area and 16 stations were selected from the rest of the area partitioned into four transects (coastal transect, inner transect 1, inner transect 2 and inner transect 3). Sampling was done repeatedly during the wet and dry seasons. They were analyzed for physico-chemical parameters according to the American Public Health Association methods. Geostatistical analysis was used in mapping the water properties. Considerable levels of actual electrical conductivity values (208.91 to 660.63 and 45 to 7540 μS/cm for the wet and dry seasons, respectively);calcium (0.06 to 85 and 4 to 256 mg/L for the wet and dry seasons, respectively);sulphate (0 to 103 and 0 to 99 mg/L for the wet and dry seasons) and total dissolved solids (15.79 to 1467 and 20 to 3750 mg/L for the wet and dry seasons, respectively) were observed for ground water in the study area based on spatio-temporal assessment. From the output grid, it could be deduced that the south eastern region had a hint of salt water intrusion (SWI) contamination of fresh water resources with actual value highs of electrical conductivity (1790 and 820 μS/cm) for the dry and wet seasons, respectively. Calcium highs (140 and 16 mg/L) for the dry and wet seasons were obtained at the central part of the study area. The spatial distribution of calcium highs extends from the central zone of the study area in the dry season and the south eastern zone in the wet season. The southern region is more vulnerable to contamination by calcium ions during this season. An up to date scope for surveillance monitoring and forecasting regarding the deterioration of coastal aquifers is recommended. Modelling of aquifers shifts for the coastal zone should be instituted as a means of ensuring efficient fresh water resources eva

关键词： Spatio-Temporal Assessment Fresh Water Resources Water Quality Geostatistics douala IV Municipality Cameroon

Draft of an Anthropometric Reference System for Full-Term Cameroonian Newborns: Prospective Study with Analytical Aim in the Maternity Wards of douala

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Open Journal of Obstetrics and Gynecology 2024年第3期14卷 435-450页

作者： Henri Essome Charlotte Epossè Ekoube Fulbert Mangala Nkwele Rita Carole Mbono Betoko Irène Cyrielle Edjoa Mboe Michel Roger Ekono Alphonse Ngalame Nyong Robert Tchounzou Ingrid Doriane Ofakem Ilick Hassanatou Iyawa Moustapha Bilkissou Astrid Ndolo Kondo Junie Ngaha Yaneu Marga Vanina Ngono Akam Gervais Mounchikpou Ngouhouo Grâce Tocki Toutou Nelly Noubi Valère Mve Koh Théophile Nana Njamen Training Teaching and Research Unit in Gynecology Obstetrics and Reproduction Faculty of Medicine and Pharmaceutical Sciences University of Douala Douala Cameroon Department of Obstetrics and Gynecology Laquintinie Hospital Douala Cameroon Department of Pediatrics Laquintinie Hospital Douala Cameroon Faculty of Health Sciences of Buea University of Buea Buea Cameroon Pluridisciplinary Department Laquintinie Hospital Douala Cameroon Faculty of Medicine and Biomedical Sciences University of Yaounde 1 Yaounde Cameroon

Introduction: Anthropometry applied to newborns is a reliable indicator of the quality of fetal growth. The latter is influenced by genetic, racial and nutritional factors varying from one population to another, explaining why a standard cannot be applied to all populations. Research question: should the Caucasian frame of reference be dogmatically applied in our African context? Multicenter studies are therefore necessary;hence the interest of this work, the main objective of which was to describe the anthropometric profile of full-term newborns in the city of douala. Methodology: We carried out a cross-sectional study with an analytical aim and prospective data collection in the maternity wards of the douala General Hospital, Laquintinie Hospital, District hospitals of Deido, Nylon and Bonassama over a period of 4 months (January to April 2020). We were interested in any newborn, born alive, vaginally or by cesarean section, seen in the first 24 hours from a full-term single-fetal pregnancy whose mother had given consent. We excluded newborns whose term was unclear and those with congenital malformations or signs of embryo-foetopathy. Data collection was done using structured and pre-tested survey sheets. The study variables were obstetric and anthropometric. Statistical analyzes were carried out with CS Pro 7.3 and SPSS version 25.0 software. The Student, Chi-square and Fischer tests were used to compare the means of the variables, the percentages with a significance threshold P value Results: During the study period, 305 full-term newborns were included, divided into 172 boys and 133 girls. The average anthropometric parameters of the full-term newborn in the city of douala were: average weight: 3305 grams, average height: 49.8 centimeters, average head circumference: 34.6 centimeters, average upper arm circumference: 11.3 centimeters, circumference average thoracic: 32.8 centimeters. The percentile distribution showed a 10th percentile at 2656 grams and a 90th

关键词： Anthropometry Full-Term Newborn douala

Stroke Epidemiology in douala: Three Years Prospective Study in a Teaching Hospital in Cameroon

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World Journal of Neuroscience 2014年第5期4卷 406-414页

作者： Yacouba N. Mapoure C. Kuate Clet B. Tchaleu Hugo B. Mbatchou Ngahane Gérard N. Mounjouopou Hamadou Ba Salomon Mbahe Julius Y. Fonsah Gérard Beyiha Henry N. Luma Albert S. Mouelle Philomène K. Ndouongo Alfred K. Njamnshi Department of Clinical Sciences University of Douala Douala Cameroon Department of Internal Medicine Douala General Hospital Douala Cameroon Department of Internal Medicine University of Yaoundé I Douala Cameroon Department of Neurology Yaoundé Central Hospital Yaoundé Cameroon Department of Surgery University of Douala Douala Cameroon Department of Neurology University of Health Sciences Libreville Gabon

Background and Objectives: Cerebro-vascular accident or stroke constitutes a major challenge in sub-Saharan Africa. In Cameroon, basic epidemiologic data are not routinely available. Aims: The aim of this study was to determine the type, the associated risk factors, time to admission, the clinical presentation and the case fatality of stroke at the douala General Hospital (DGH) in Cameroon. Methods: A cross-sectional study was performed from January 1, 2010 to December 31, 2012 at the neurology and intensive care units of the DGH. All patients above 15 years of age with a diagnosis of established stroke were enrolled. For each patient, socio-demographic, clinical and paraclinical data were recorded as well as the duration of hospitalization and the case fatality. Results: In all, 325 patients were enrolled with males constituting 68.1% and general mean age of 58.66 ± 13.6 years. The mean initial consultation delay was 47.36 ± 18.48 hours. The majors cerebro-vascular risk factors were hypertension (81.15%), chronic alcohol consumption (28.3%), diabetes mellitus (20.61%), obesity (18.15%), cigarette smoking (16%), dyslipidemia (8.9%) and atrial fibrillation (3.07%). Ischemic stroke accounted for 52% of cases while 48% were hemorrhagic. The mean duration of hospitalization was 8.58 ± 6.35 days with a case fatality rate of 26.8%. Septic conditions appeared to be the leading cause of death accounting for 35.6% of cases. Conclusion: Stroke in the DGH is associated with a high case fatality rate and hypertension remains the number one risk factor. There is a clear and urgent need for public health authorities to reinforce measures for the control of modifiable stroke risk factors.

关键词： Stroke Epidemiology Risk Factors Case Fatality douala Cameroon