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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

Determinants of Sexual Activity among HIV-Infected Adolescents in Cameroon

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Open Journal of Pediatrics 2024年第5期14卷 921-936页

作者： Calixte Ida Penda Rachel Fotso Yogue Nelly Noubi Kamgaing Sena Mouna Penda Loïc Boupda Francis Atéba Ndongo Christian Eyoum Ritha Mbono Betoko Grace Dalle Ngondi Patricia Epee Eboumbou Francisca Monebenimp Essome Henri Faculty of Medicine and Pharmaceutical Sciences University of Douala Douala Cameroon General hospital of douala Douala Cameroon Faculty of Medicine and Biomedical Sciences University of Yaound 1 Yaound Cameroon University hospital Centre of Yaound Yaound Cameroon Mokolo Regional hospital Annex Mokolo Cameroon University of Garoua Garoua Cameroon Mother and Child Centre of the Chantal Biya Foundation in Yaound Yaound Cameroon douala Laquintinie hospital Douala Cameroon District hospital of Bonassama Douala Cameroon

Introduction: Adolescence is a period of transition to adulthood, including for HIV-infected adolescents (HIA), when sexual problems emerge. Few studies have been carried out on the sexuality of HIA. This study aimed to assess the sexual behavior of HIV-infected adolescents in Cameroon. Methodology: A cross-sectional study was conducted in three hospitals in the cities of Yaoundé and douala, from November 2019 to June 2020. All HIA aged 13 to 19 years followed in the study who knew their HIV status were included in the study after obtaining their assent and their parent’s consent. Socio-demographic and clinical characteristics were collected, as well as sexual practices and the determinants of their sexual activity. A multivariate analysis was performed to explore the relationship between the different variables studied and the sexual activity of these adolescents. Results: Of 204 HIA enrolled in the study, 64 (31.7%) were sexually active, the mean age at first sexual intercourse was 15.6 ± 2.8 years and the sex ratio was 0.94. Of the adolescents in the study, 75.7% of girls and 61.2% of boys had regular sexual activity, while 21.3% of girls and 35.4% of boys had multiple sexual relationships in the six months preceding the study. Nearly 16 (25.0%) of the sexually active HIA had more than 2 sexual encounters per month, 6 (9.3%) of these encounters had been paid for and 9 (27.2%) of the girls had already had at least one pregnancy. More than 7 out of 10 HIA (79.6%) had used a condom the last time they had sex. Age less than 18 years [OR = 11.1 (95% CI: 3.1 - 39.4), p = 0.001], lack of remuneration [OR = 9.8 (95% CI: 2.0 - 47.4), p = 0.001] and self-care were significantly associated with sexual activity in HIA, while school attendance was a protective factor. Self-funded HIAs were 21 times more likely to be sexually active [OR = 21.6 (95% CI: 2.3 - 179), p = 0.004]. Conclusion: More than a third of HIV-infected adolescents were sexually active and risky sexual practi

关键词： HIV Adolescent Sexual Behavior Cameroon

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

Radical Hysterectomy in Cervical Cancer: Patients’ Epidemiological and Clinical Profiles and Perioperative Outcome in Two Referral hospitals in Cameroon

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Open Journal of Obstetrics and Gynecology 2024年第3期14卷 466-479页

作者： Théophile Njamen Nana Robert Tchounzou Fulbert Nkwele Mangala Alphonse Ngalame Henri Essome Sedrick Tiokeng Sidonie Noa Ananga Andrew Tassang Humphry Tatah Neng Isaac Mboh Eyong Gaetan Andre Wambo Simo Felix Adolphe Elong Fidelia Kobenge Mbi Junior Cédric Nana Njamen Charlotte Tchente Nguefack Thomas Obinchemti Egbe Gregory Ekane Halle Emile Telesphore Mboudou Marcellin Ngowe Ngowe Department of Obstetrics and Gynaecology Douala General Hospital Douala Cameroon Department of Obstetrics and Gynaecology Faculty of Health Sciences University of Buea Buea Cameroon Department of Obstetrics and Gynaecology Douala Gynaeco-Obstetric and Pediatric Hospital Douala Cameroon Department of Surgery and Specialties Faculty of Medicine and Pharmaceutical Sciences University of Douala Douala Cameroon Department of Pathology Douala General Hospital Douala Cameroon Faculté Des Sciences De La Santé Université Joseph Kizerbo Ouagadougou Burkina Faso

Background: Cervical cancer (CC) is one of the most frequent cancers and the leading cause of death from gynecological cancer in Low and middle income countries, Cameroon inclusive. Surgery is the primary treatment modality when the disease is diagnosed at early stage. Radical hysterectomy in cervical cancer has not been evaluated in recent years in Cameroon. The purpose of this study is thus to evaluate the epidemiological and clinical features and short term outcomes of patients who underwent surgery. Patients and methods: This retrospective study was conducted at the douala Gynaeco-obstetric and Pediatric hospital and the douala General hospital. Cervical cancer patients who underwent Radical hysterectomy between January 2015 and December 2020 were included. A pre-established data collection tool was used to record socio-demographic, clinical and outcomes information from patients’ files;additional outcome information was obtained from phone calls. Descriptive analysis was done using the SPSS version 26. Bivariate analysis was used to determine associations between disease and patients characteristics and occurrence of adverse postoperative outcome. P value of 0.05 was considered. Results: Sixty one patients were enrolled. Their ages ranged from 33 to 74 years with a mean age of 51.95 ± 10.29 years. Over 85% of women were married, 65.57% were unemployed and 86.88% were multiparous. Only 28% had never done cervical cancer screening. Most patients had stage IB1 to IB2 stage disease (57.1%). Less than 9% underwent radical hysterectomy and 8 of those (13.11%) suffered intraoperative complications. Twenty-five patients (40.98%) presented immediate and short term complications. There was no significant association between the disease or patients’ characteristics and adverse outcomes. Conclusion: Cervical cancer patients are relatively young in our settings and only 9% of them reach the hospital at early stage. Postoperative adverse outcomes rate is higher than that rep

关键词： Cervical Cancer Radical Hysterectomy Epidemiological and Clinical Profiles Outcomes Cameroon

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

Cervical Myelopathy: Diagnostic Aspects, Surgical Treatment and Evolution of Patients Operated upon in Yaounde

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Open Journal of Modern Neurosurgery 2024年第1期14卷 72-82页

作者： Bello Figuim Djoubairou Ben Ousmanou Oumarou Haman Nassourou Ndome Toto Orlande Amadou Tidjani Djientcheu Vincent de Paul Yaounde Central hospital Faculty of Medicine and Biomedical Sciences of the University of Yaounde 1 Yaounde Cameroon Yaounde Military hospital Faculty of Medicine and Pharmaceutical Sciences of the University of Douala Douala Cameroon douala General hospital Faculty of Medicine and Pharmaceutical Sciences of the University of Douala Douala Cameroon Higher Institute of Health Sciences Université des Montagnes Bangangté Cameroon

Introduction: Although cervical myelopathy is the most common degenerative cervical spine pathology in adults, the indications and approaches of surgical treatment have not yet been clearly defined in the literature. Very few studies exist regarding these aspects in our setting, and they are mostly outdated. This study aimed to describe the diagnostic aspects, current surgical treatment with technical improvements, and progression in patients. Patients and Methods: We conducted a multicentre retrospective descriptive study over a 10-year period between January 2011 and January 2020 in three referral centres in Yaoundé. All patients who underwent surgery for cervical myelopathy were included. Results: Fifty-two patients were recruited. The rate of operated cervical myelopathies among all degenerative spinal pathologies was 14.05%. The M/F sex ratio was 3/1, and the average age was 52 ± 10 years. All included patients had gait problems, 90.38% demonstrated motor deficiency, and 67.30% experienced at least three levels of compression. Surgery was decided based on the Nurick grade;a posterior approach was applied to 86.54% of patients. Postoperative progression showed a neurological improvement of 82% with an average follow-up of 4 years. Conclusion: In this study, the patients who underwent surgery were relatively young, their clinical presentations were mostly advanced, and surgical management showed good results in well-selected cases.

关键词： Cervical Myelopathy Diagnosis Treatment Evolution Cameroon

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

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

Normal Range of Neutrophile to Lymphocyte Ratio in Healthy, Chronic Kidney Disease Stage 4 - 5 and Hemodialysis Participant in a Sub-Saharan African Context

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Open Journal of Nephrology 2024年第1期14卷 104-114页

作者： Fouda Menye Epse Ebana Hermine Danielle Elimby Lionel Thierry Sevele Deussi De Ngaha Bogne Takam Yvan Halle Marie-Patrice Eveline Ngouadjeu Dongho Department of Medicine and Specialties General Hospital of Douala Douala Cameroon Department of Internal Medicine and specialties Faculty of Medicine and Biomedical Sciences of Yaounde Yaounde Cameroon Department of Internal Medicine and specialties Faculty of Medicine and Pharmaceutic Sciences of Douala Douala Cameroon

Background: Neutrophile to lymphocyte ratio (NLR) is a well-established marker of inflammation. It has been reported to be high in chronic kidney disease (CKD) and it is described as a prognosis factor in hemodialysis patients. However, limited data are available about the normal range of NLR in healthy adults as well as CKD patients including hemodialysis black Africans in Sub-Saharan countries. We sought to study NLR in healthy and advanced CKD in a single Cameroonian health facility. Methods: Blood samples were obtained from blood donors, CKD stage 4 and non-dialysis stage 5, and hemodialysis patients for more than 6 months. Patients with confounding factors such as positive CRP, infection, and recent use of steroids were excluded. RNL means standard deviations (SDs), and 95% confidence intervals (95% CI) were determined. RNL range was defined as percentiles P2.5 to P97.5. Results: A total of 102 participants were included. Mean age was 40.45 ± 9.97 years and 58.8% were male. Age and sex distribution were similar in the three groups. Leucopenia and neutropenia were common in all the groups. Means NLR was 1.29 ± 0.57 (95% CI 1.08 - 1.49) range between 0.55 to 2.67;2.31 ± 1.3 (95% CI 1.75 - 2.88) with range between 0.69 to 4.31 and 2.14 ± 0.98 (95% CI 1.85 - 2.44) with range between 0.77 to 4.32 respectively in controls, CKD, and hemodialysis participants. NLR was comparable in CKD and hemodialysis patients (p = 0.99). Compared to controls, NLR was significantly elevated in CKD (p = 0.043) and hemodialysis patients (p Conclusion: Our data suggest that the normal range for NLR in adult nongeriatric healthy and advanced CKD patients including those on chronic hemodialysis may vary between 0.55 to 2.67 and 0.69 to 4.32 respectively.

关键词： NLR CKD Hemodialysis Cameroon