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Mortality and Associated Risk Factors among In-Patients with Covid-19 in douala, Cameroon: A Retrospective Cross-Sectional Study

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Advances in Infectious Diseases 2022年第1期12卷 1-19页

作者： Francois Adrien Bokalli Fru McWright Chi Ephesians Anutebeh Caven Ngoe Mbachan Takere Edwin Ewane Dieudonne Akanji Conrald Ekukole Marie-Solange Ndom Mireille-Laurent Endale David Mekolo Henry Luma Jacqueline Ze Minkande Marcelin Ngowe Ngowe Specialised COVID-19 Treatment Centre Yassa Douala Cameroon Department of Medicine Faculty of Health Sciences University of Buea Buea Cameroon Department of Medicine Laquintinie Hospital Douala Cameroon Intensive Care and Emergency Department Laquintinie Hospital Douala Cameroon Department of Internal Medicine Douala General Hospital Douala Cameroon Department of Surgery and Specialties Faculty of Medicine and Biomedical Sciences University of Yaounde Yaounde Cameroon Department of Surgery and Specialties Faculty of Medicine and Pharmaceutical Sciences University of Douala Douala Cameroon

Background: In March 2020, the World Health Organization declared the coronavirus disease 2019 a pandemic, this was caused by the Severe Acute Respiratory Syndrome Coronavirus 2. The overall mortality from this remains high, yet there are limited studies assessing the associated factors in Africa. Objective: To identify the factors associated with mortality in hospitalized COVID-19 patients in douala, Cameroon. Method: We conducted a single-centre retrospective cross-sectional study by reviewing records of patients managed for COVID-19 between March and June 2020. Diagnosis was confirmed by real-time RT-PCR. Outcome of interest was mortality during hospitalization. We inputted and analyzed data using SPSS version 25.0, compared mortality between groups using the Chi’s squared test and the Fisher’s exact test where appropriately investigated for associations using the Logistic regression in a stepwise approach and alpha-value set at P = 0.05. Results: We analyzed 282 case files, 68% were males (M:F = 2:1) and a mean age of 52 (±15) years. We had an overall mortality of 31.5% (89/282 patients) and 54% (50/92 patients) admitted in the ICU died. Patients aged 0 - 39 years had a significantly lesser odds of mortality compared to those > 70 years (OR: 0.2 (0.1 - 0.5) P Conclusion: The in-hospital mortality in COVID-19 patients is very high and hospitalisation into the ICU is associated with even higher mortality. Advanced age, diffused lung involvement (particularly with alveolar consolidation), hemodynamic instability at presentation and altered level of consciousness favoured hospitalisation in the ICU. Once in the ICU, placement on mechanical ventilation did not reduce death discernibly.

关键词： COVID-19 Risk Factors Mortality Cameroon

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Diagnostic Value of Leukocyte Count Abnormalities in Newly Diagnosed Tuberculosis Patients

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Open Journal of Respiratory Diseases 2020年第1期10卷 1-10页

作者： Bertrand Hugo Mbatchou Ngahane Abinkeng Tazifua Ebenezer Ngouadjeu Dongho Eveline Mafo Nzonteu Estelle Raissa Kemta Lekpa Fernando Che Vanessa Lum Namme Luma Henry douala General hospital Department of Internal MedicineDoualaCameroon Faculty of Medicine and Pharmaceutical Sciences University of DoualaDoualaCameroon Faculty of Medicine and Biomedical Sciences University of Yaounde 1YaoundeCameroon

Background: The diagnosis of tuberculosis (TB) is frequently challenging given that the clinical and radiographic features of TB are often nonspecific. Altered leukocyte count ratios could serve as new tools of diagnostic orientation of tuberculosis. The aim of this study was to assess the diagnostic value of the leukocyte count ratios for the diagnosis of TB. Methods: This was a cross-sectional study including cases of newly diagnosed TB patients from registers of the TB treatment center of the douala General hospital. Control subjects were healthy volunteers, age and sex matched, recruited at the blood bank. Sociodemographic, clinical data and peripheral blood parameters were collected. The diagnostic value of leukocyte counts was determined using receiver operating characteristics curve analysis. Results: In total, 204 TB patients and 204 control subjects were included in the study. The gender of the participants was equitably distributed in the 2 study groups (male 61.8%;female 38.2%). The median age of TB patients was 33 years while that of control patients was 32 years. The monocyte-lymphocyte count ratio (MLR) and neutrophil-lymphocyte count ratio (NLR) were significantly higher in the TB patients group compared to control group. A NLR >1.19 and MLR >0.29 were identified as cut-off values for discriminating TB patients. The areas under the curves (AUC) were 0.77 and 0.84 for the MLR and NLR respectively. Conclusion: A raised NLR > 1.19 and MLR > 0.29 are predictive of tuberculosis. The NLR has greater diagnostic ability as evidenced by its higher AUC. Further research is needed to confirm or refute our findings.

关键词： Leukocytes Diagnosis Tuberculosis Africa

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Pattern and Management of Neural Tube Defect in Cameroon

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Open Journal of Modern Neurosurgery 2017年第3期7卷 87-102页

作者： Mathieu Motah Mireille Moumi Aurélien Ndoumbe Clerence Ntieafac Vincent De Paul Djienctheu Department of Surgery Faculty of Medicine and pharmaceutical sciences University of Douala Douala Cameroon Neurosurgical Unit General Hospital of Douala Douala Cameroon Faculty of Medicine and Biomedical Sciences University of Yaoundé Yaounde Cameroon Service of Neurosurgery Central Hospital of Yaoundé Yaoundé Cameroon

Objectives: The aim of study was to determine the pattern and management of neural tube defects (NTD). Methodology: It was a hospital based descriptive cross-sectional retrospective study on patients who consulted and/or were admitted at the douala General hospital for neural tube defects from January 2005 to April 2015. Results: A total of forty-nine (49) patients were enrolled. Males constituted 59.8% and females 40.2% giving a sex ratio of 1.5 in favour of males. Most of the parents of the patients (71.5%) had a low socio-economic status. Myelomeningocele was the most common type (80.4%) followed by 17.4% cases of meningocele and 2.2% cases of lipomeningocele. Three cases (3) of encephaloceles were seen during this period. The commonest site of these defects was the lumbosacral region (47.8%). Other sites included lumbar (19;41.3%), sacral (3;6.5%) and thoracolumbar (2;4.3%) ones. About half of the patients (24;48.9%) presented with ruptured lesions. Hydrocephalus was also recorded in 65.3% of patients. Talipes equinovarus and talipes calcaneovalgus were the most common associated orthopedic birth defects found. Surgical closure was done for 44 (89.9%) patients. Ventriculoperitoneal shunting was done in 78.1% of those who presented with hydrocephalus. Post-operative complications were more frequent in patients with ruptured lesions (P = 0.001). The most common post-operative complications were wound infections (22;44.9%) and wound dehiscence (20;40.8%). Conclusion: Lumbosacral Myelomeningocele was the most common type of NTD in our region. Low socio-economic status was a common risk factor.

关键词： Neural Tube Defects Myelomeningocele Cameroon

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Endoscopic Third Ventriculostomy for Non-Tumor Obstructive Hydrocephalus in Children under Two Years of Age

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Open Journal of Modern Neurosurgery 2015年第3期5卷 100-105页

作者： Aurélien Ndoumbé Mathieu Motah Samuel Takongmo Faculty of Medicine & Pharmaceutical Sciences University of Douala Douala Cameroon Faculty of Medicine & Pharmaceutical Sciences University of Douala Neurosurgeon Service of Surgery General Hospital of Douala Douala Cameroon Faculty of Medicine & Biomedical Sciences University of Yaoundé I CHU of Yaoundé Yaoundé Cameroon

The goal of this work is to report on the efficacy of endoscopic third ventriculostomy (ETV) for non-tumor obstructive hydrocephalus in children aged two years and below. In the period between June 2007 and December 2014, we had performed ETV in 30 patients with hydrocephalus from diverse etiologies. Among them were eight children aged two years or below. Clinical, radiological and outcome data of these children were retrospectively reviewed to assess ETV efficiency in this age group. Eight children (6 boys, 2 girls) with age range from 6 to 24 months (mean 12.5 months, median 15 months) suffering from non-tumor obstructive hydrocephalus underwent ETV as primary treatment. Seven patients (87.5%) were under two years and 3 had less than one year of age at the time of surgery. Macro crania, suture diastasis, scalp vein bulging and sunset gaze were the most common findings on physical examination. Computed tomography scanning was done in all patients but none had magnetic resonance imaging. Hydrocephalus was due to primary (congenital) aqueductal stenosis in all cases and was associated with myelomeningocele in one. ETV was successful in 7 (87.50%) cases but failed in one. Operation time varied from 28 to 35 minutes (mean 31.12 minutes, median 31.5 minutes). No intraoperative complication occurred. The child in whom ETV failed had postoperative CSF leak. No death related to procedure occurred. hospital stay ranged from 2 to 4 days (mean, 2.87 days, median, 3 days). Follow up range was 5.5 to 86 months (0.46 to 7.16 years);mean, 59.14 months (4.92 years);median, 45.75 months (3.81 years).

关键词： Non-Tumor Obstructive Hydrocephalus Aqueductal Stenosis Children under Two Years Endoscopic Third Ventriculostomy Cameroon

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Facial and Periorbital Emphysemas Following a Violent Sneezing: An Atypical Clinical Situation

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International Journal of Otolaryngology and Head & Neck Surgery 2022年第3期11卷 136-142页

作者： Adèle-Rose Ngo Nyeki Caroline Mvilongo Esthelle Minka Ngom Valentin Fokouo Roger Meva’a Léonel Atanga Yannick Mossus Claudine Nkidiaka Luc Meka Abakar Taimou Serge Abogo David Mindja Olive Ngaba Godefroy Koki Francois Djomou Richard Njock ENT Ophthalmology and Stomatology Department Faculty of Medicine and Biomedical Sciences University of Yaoundé I Yaoundé Cameroon Essos hospital Center Yaoundé Cameroon Central hospital of Yaoundé Yaoundé Cameroon ENT Department Faculty of Medicine and Pharmaceutical Sciences University of Douala Douala Cameroon douala General hospital Douala Cameroon Bertoua Regional hospital Bertoua Cameroon

Introduction: Facial emphysema is the presence of air in the subcutaneous tissues of the facial region. They can be clinically recognized by the crackling sensation felt when the affected area is palpated. Observation: The authors describe left orbito-facial emphysema that occurred after a violent sneezing episode in a 36-year-old patient. He had significant edema of the left facial and ipsilateral periorbital region associated with major emphysema and complete closure of the left eye. Nasal cavities endoscopy revealed inflammation of the distal orifice of the nasolacrimal duct. The clinical ophthalmologic examination performed in emergency showed left chemosis, slight ocular hypertonia of mechanical origin, and a slight decrease in visual acuity. Pupillary reflexes and retinography were normal. A craniofacial computed tomography (CT) revealed a significant left orbital emphysema, a fracture of the left medial orbital wall (ethmoidal lamina papyracea) with intraconal fat incarceration without entrapment of the medial rectus and significant air infiltration of all the left hemifacial soft tissues. A broad-spectrum antibiotic and anti-inflammatory treatment were instituted, as well as practical advice to prevent a recurrence. We observed progressive resorption of the edema with a return to the normal of the soft tissues and the palpebral cleft in 15 days. Conclusion: These atypical cases can be serious. It is essential to exclude signs of visual deficit and ocular compression. Multidisciplinary management is important.

关键词： Sneezing Orbital Fracture Emphysema Pneumorbitia

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Evaluation of Bleeding Risk by Hemostatic Parameters in Hemodialysis at the douala General hospital: Comparison between Patients on Hemodialysis before 3 Months and after 12 Months

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Open Journal of Nephrology 2023年第1期13卷 31-38页

作者： Fouda Menye Epouse Ebana Hermine Danielle Elimby Lionel Dongmo Tsague Elvire Ali Nasser Ngo Bitoungui Valentina Josiane Halle Marie Patrice Ngouadjeu Dongho Eveline General hospital of douala Douala Cameroon Faculty of Medicine and Biomedical Sciences of Yaounde Yaounde Cameroon Faculty of Medicine and Pharmaceutical Sciences of Dschang Dschang Cameroon Faculty of Medicine and Pharmaceutical Sciences of douala Douala Cameroon

Background: Bleeding disorders are common and may be a life-threating complication among patients with End Stage Kidney Disease (ESKD), especially for those in hemodialysis (HD). Bleeding risk can be evaluated by hemostatic parameter such as platelet count, prothrombine time (PT) or activated prothromplastin time (aPTT) and may be influenced by duration in HD. Objective: Evaluate bleeding risk in HD patients by analyzing some hemostatic parameters according to duration in dialysis. Patients and methods: We conducted a cross sectional study of 3 months (March to May 2022) in the HD center of the douala General hospital. All consenting adult patients with ESKD admitted in HD for less than 3 months or more than 12 months were included. Bleeding risk was evaluated by platelet count, PT, aPTT and fibrinogen. Chi-square test and logistic regression were used to compare data and evaluate association with hemostatic disorder. Results: A total of 80 (60% male) patients were included;30 patients were on HD for less than 3 months and 50 for more than 12 months. Median age was 45 [30 - 60] years in the first group and 43 [30 - 55] years in the second group. Increased bleeding risk was noted in 50% (n = 40) of patients and was similar in both groups. Thrombocytopenia was more common in patients on HD ≥ 12 months (20% (n = 6) vs 44% (n = 22), p = 0.02). Prolong aPTT was more common in HD patients ≥ 3 months (OR = 6.6 [1.88 - 23.5], p = 0.0013) and those with HD catheter (OR = 21.3 [4.6 - 45.7], p < 0.001). Fibrinogen and PT were comparable in both groups. HD catheter was associated with prolong PT (OR = 5.3 CI [1.5 - 8.9], p = 0.03). Conclusion: Increased bleeding risk is common in HD patients. Thrombocytopenia is common in HD patients ≥ 12 months, while prolong aPTT are mainly found in HD patients ≤ 3 months with catheter and may reflect heparin overdose.

关键词： Thrombocytopenia Prolongactivated Prothromplastin Time Hemodialysis Cameroon

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Epidemiological and Histological Profile of Cervical Cancer in Cameroon: About 2078 Cases

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Open Journal of Obstetrics and Gynecology 2016年第4期6卷 232-239页

作者： Engbang Ndamba Jean Paul Tchente Nguefack Charlotte Owona Manga Léon Jules Simo Godefroy Essam Sime Jean Daniel Elono Fouda Andrée Michelle Essame Oyono Jean Louis Hasigov Alan Faculty of Medicine and Pharmaceutical Sciences The University of Douala Douala Cameroon Laquintinie hospital of douala Douala Cameroon North-Ossetian State Medical Academy Vladikavkaz Russia douala General hospital Douala Cameroon Bio-Medical and Cancer Center of Bafoussam Bafoussam Cameroon Maroua Regional hospital Maroua Cameroon Faculty of Medicine and Biomedical Sciences The University of Yaoundé I Yaoundé Cameroon Yaounde University Health Center Yaoundé Cameroon

Objective: To describe the epidemiological and histological aspects of cervical cancer in Cameroon. Materials and Methods: It was a descriptive retrospective study carried out over a period of 10 years (2005-2014), on malignant tumors of the cervix observed at the laboratory of Anatomic Pathology in four regions (Center, Littoral, West, South-west). The studied parameters were frequency, age, sex, localization, histological type and the immuno-histochemical aspects. Results: A total of 2078 cases with an annual frequency of 20.78 cases were registered;the peak was reached in 2010 with 304 cases (14.62%). Cervical cancer was the main genital cancer affecting women with a percentage of 82.26%. The average age of the patients was 52.33 ± 12. 80 years old, with extremes from 22 to 93 years old. The age group from 40 to 59 had more than half of the cases, with 1094 cases (52.65%). The major histological types recorded were squamous cell cancer with 1687 cases (81.51%) and adenocarcinoma with 269 cases (12.95%). Conclusion: Cervical cancer is the chief genital cancer affecting female genital organs. The predominant histological types are squamous cell cancers.

关键词： Cancer Cervix Epidemiology Histopathology Cameroon

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Indications, Yield and Outcome of Colonoscopy: A 7-Year Retrospective Study in a Resource-Limited Setting

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Open Journal of Gastroenterology 2019年第3期9卷 49-58页

作者： Gabin Ulrich Kenfack Servais Albert Fiacre Bagnaka Eloumou Winnie Tatiana Bekolo Nga Guy Sadeu Wafeu Paul Nkemtendong Tolefac Agnès Malongue Mathurin Pierre Kowo Christian Tzeuton Firmin Ankouane Andoulo Oudou Njoya Henry Namme Luma Dominique Noah Noah Faculty of Medicine and Biomedical Sciences The University of Yaoundé I Yaoundé Cameroon Research Laboratory on Viral Hepatitis and Health Communication Yaoundé Cameroon Faculty of Medicine and Pharmaceutical Sciences The University of Douala Douala Cameroon Internal Medicine Unit Douala General Hospital Douala Cameroon “Les Capucines” Medical Center Douala Cameroon Deido District hospital Douala Cameroon

Background and Aims: Diagnostic colonoscopy allows exploration of the colonic mucosa. Indications are multiple. The purpose of this work was to describe the indications and to report the lesions observed during colonoscopy at the General hospital of douala. Methods: This was a cross-sectional study with retrospective data collection over a period of 7 years (January 1, 2010 to January 31, 2017). The data collected from the reports were socio-demographic characteristics, indications and lesions observed at colonoscopy. Binary logistic regression allowed us to identify the independent risk factors associated with the presence of tumors and polyps. Results: We included 719 exams. The main indications were rectorrhagia (29.5%), abdominal pain (25.9%) and constipation (17.8%). A colonic lesion was found in 60.1% of cases. A colorectal tumor accounted for 10.3% of cases. Factors independently associated with colonic tumor were complete colonoscopy (aOR: 0.167 95% CI [0.096 - 0.289], p Conclusion: The presence of weight loss, abdominal or rectal mass should motivate the realization of a complete colonoscopy in search of a colorectal tumor. The most observed lesions remain hemorrhoids, polyps and diverticulosis of the colon.

关键词： Colonoscopy Indications Colorectal Tumor Limited Resources Cameroon

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Prevalence of HBs Antigen, and HCV and HIV Antibodies in a Young Male Population in Cameroon

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Open Journal of Gastroenterology 2015年第12期5卷 185-190页

作者： Dominique Noah Noah Firmin Ankouane Andoulo Brice Valery Moussima Essoh Georges Nko’O Ayissi Servais Albert Fiacre Eloumou Bagnaka Magloire Biwole Sida Faculty of Medicine and Pharmaceutical Sciences University of Douala Douala Cameroon Gastroenterology Service of the Yaounde Central hospital Yaounde Cameroon Faculty of Medicine and Biomedical Sciences University of Yaounde 1 Yaounde Cameroon Hepatology and Gastroenterology Department Yaounde University Teaching Hospital (CHU) Yaounde Cameroon douala General hospital Douala Cameroon

Introduction: According to WHO estimates, 57% of cases of liver cirrhosis and 78% of primary liver carcinoma are caused by a hepatitis B or C virus. This study aimed to assess the prevalence of these diseases and HIV among a young male population, according to region. Methods: This was a descriptive cross-sectional study conducted from 17 February to 31 March 2014 in the ten administrative regions of Cameroon. The study included male subjects of Cameroonian nationality aged at least 18 and at most 23, and living in the regions concerned. It excluded subjects that did not match the age, gender, and nationality criteria. For each subject, 10 ml of blood was collected in a dry tube. After centrifugation at 3000 RPM for 5 minutes, the serum was collected for the detection of viral infections. For subjects that tested positive, a confirmatory test was conducted. Results: In total, 4367 subjects were selected, with an average age of 20.46 (+/- 1.17) years. The prevalence of hepatitis B virus stood at 13.01% (with 95% CI: 12.03% - 14.05%). That of viral hepatitis C was 0.30% (95% CI: 0.17% - 0.52%). Co-infection with hepatitis B and C viruses was 0.05% (95% CI: 0.01% - 0.18%). The prevalence of HIV infection was 1.01% (95% CI: 0.74% - 1.36%). Conclusion: The overall prevalence of HBsAg in the population of young males is high. It tallies with the early vertical and horizontal modes of transmission that prevail in our environment.

关键词： Hepatitis B Virus Hepatitis C Virus HIV Infection Young Male Population Cameroon

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Uropathogens of Urinary Tract Infection in Pregnancy and Maternal-Fetal Outcomes at the douala Referral hospital, Cameroon: A Case-Control Study

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Open Journal of Obstetrics and Gynecology 2020年第7期10卷 914-929页

作者： Thomas Obinchemti Egbe Njimanted Omarine Essome Henri Wague Wague Christiane Dayas Francine Doretta Nzele Egbe George Enonchong Enow-Orock Faculty of Health Sciences University of Buea Buea Cameroon Department of Obstetrics and Gynecology Douala Referral Hospital Douala Cameroon Faculty of Health Sciences University of Bamenda Bamenda Cameroon Faculty of Medicine and Pharmaceutical Sciences University of Douala Douala Cameroon Department of Obstetrics and Gynecology Laquintinie Hospital Douala Douala Cameroon Department of Pathology Faculty of Health Sciences University of Buea Buea Cameroon

Background: Urinary tract infection (UTI) is common in pregnancy and accounts for a high burden of maternal and perinatal morbidity/mortality and health expenditure. The burden of this condition has been understudied in Cameroon. We aimed to determine the uropathogens of urinary tract infection in pregnancy, and the maternal-fetal outcomes of UTI at the Douala Referral Hospital. Methods: We conducted an analytic matched case-control study of 206 pregnant women with evidence of urinary tract infection (103 cases) and those without (103 controls) who underwent antenatal care and gave birth at the DRH from January 2019 to April 2019. Socio-demographic, laboratory and maternal-fetal outcome data were collected using a pre-tested structured questionnaire and analyzed with SPSS version 23. Statistical significance was set at p Results: Escherichia coli (51.5%), Proteus mirabilis (15.5%),

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