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

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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Follow Up of Hypertensive Patients at regional hospital of Bafoussam, West Cameroon: Biochemical Profiles in Naive and Hypotensive Drug Treated Patients

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World Journal of Cardiovascular Surgery 2020年第9期10卷 167-185页

作者： Vanessa Linda Nzesseu Charles Kouam Kouam Jean-de-Dieu Tamokou Jules-Roger Kuiate Department of Biochemistry Faculty of Science University of Dschang Dschang Cameroon Department of Internal Medicine Bafoussam Regional Hospital Bafoussam Cameroon

Objective: The aim of this work was to study the effects of antihypertensive therapies on certain metabolic parameters in hypertensive patients. Methods: A cross-sectional and analytical study conducted within the Bafoussam Re-gional hospital on 343 patients including 99 normotensives and 244 hyperten-sives distributed in 71 patients naive to treatment and 173 patients under treatment (84 under monotherapy, 67 under bitherapy and 21 under trithera-py). The antihypertensive medications were recorded from the medical records. A questionnaire survey was administered to study participants and potential risk factors for hypertension sought. Blood and urine samples were collected for lipid, renal and hepatic disorder analysis. Two blood pressure measure-ments enabled us to diagnose hypertensive patients. Measurements of bio-chemical parameters such as total cholesterol, HDL-cholesterol, LDL-cholesterol, triglycerides, creatinine, glucose, aspartate aminotransferase (ASAT), alanine aminotransferase (ALT), potassium, chloride and calcium were done in serum by methods resulting from commercial kits. Results: Cal-cium Channel Blockers were significantly associated with increases in blood potassium (odd-ratios (OR) = 8.63, p = 0.036) and sodium (OR = 0.20, p = 0.037). Angiotensin-converting enzyme/Angiotensin II receptor blockers were significantly associated with an increase in plasma activity of ASAT (OR = 0.12, p = 0.03) whereas Diuretics were significantly associated with an increase in ALAT plasma activity (OR = 0.003, p = 0.012). Dual therapies were associ-ated with highest frequencies of hypercreatininemia (41.8%) and hyperglyce-mia (44.8%) whereas hypocholesterolemia HDL (38.1%) was most observed in hypertensive patients on triple therapy. The different therapies resulted in very low frequencies of abnormal liver profiles (in general almost all below 10%). Tritherapy h

关键词： Antihypertensives Therapy Metabolic Abnormalities

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Therapeutic Strategies and Evolution in the Short Term: Fractures by Firearms in Civilian Practice about 35 Operated Lesions

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Surgical Science 2023年第10期14卷 618-625页

作者： Dikongue Dikongue Fred Mohamadou Guemse Hans Moevi Akue Bahebeck Jean Fondop Joseph Department of Surgery and Specialties Faculty of Medicine University of Dschang Dschang Cameroon Department of Surgery and Specialties Faculty of Medicine University of Yaoundé 1 Yaoundé Cameroon Faculty of Health Sciences of Cotonou University of Abomey Calavi National University Hospital Center of Cotonou Cotonou Benin Department of Morphological and Anatomopathological Sciences Faculty of Medicine University of Dschang Bafoussam Regional Hospital Dschang Cameroon

Fracture by firearms is a surgical emergency. The aim of our study was to report our experience in the management of open fractures by firearms and monitoring with a decline of 6 months the lesions observed in peacetime. This retrospective study over 3 years (January 2007-November 2010), supplemented by a prospective (December 2010-November 2011) is based on an analysis of operative reports and clinical records of patients admitted to the Yaoundé Central hospital. 29 cases were selected, including 35 lesions were observed. Our series consists of 27 men and 2 women, mean age 30 years. 40% of our patients were initially supported (debridement) before the 6th hour and 51.42% between the 6th and 24th hours. In terms of internal fixation, these figures were 66% between the 25th and 96th hours. The type of material was used as the external fixate (64.9%). Conversion processing by the establishment of an internal hardware, after 3 - 6 weeks and control NFS (numeration of blood count or blood count), VS (rate of sedimentation), CRP (C reactive protein). Unfortunately this has been possible only in two cases because of financial means. In 40% of cases, surgical outcome was simple, and complications to a type of osteomyelitis, shortening, suppuration in 42.7% of cases.

关键词： Open Fractures Firearm Treatment Surgery Trauma Orthopedics Public Health Africa

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The Effect of Requester Training on the Relevance of Lumbar Spine X-Ray Request for Low Back Pain in Adults at Yaounde

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Open Journal of Radiology 2022年第1期12卷 8-16页

作者： Moulion Tapouh Jean Roger Djomou Wandji Franck Arold Mbede Maggy Moifo Boniface Bafoussam regional hospital Center Bafoussam Cameroon Department of Radiology Biophysics and Medical Imaging Faculty of Medicine and Pharmaceutical Sciences University of Dschang Dschang Cameroon Department of Medical Imaging and Radiation Oncology Faculty of Medicine and Biomedical Sciences University of Yaounde I Yaounde Cameroon Yaounde Central hospital Yaounde Cameroon Gynaeco-Obstetric and Pediatric hospital of Yaounde Yaounde Cameroon

Background: Despite the availability of guidelines, the requests for medical imaging examinations for the exploration of low back pain remain irrelevant in the majority of cases. Objective: To assess the impact of requester training on the justification of lumbar spine X-rays for low back pain in adults in Yaounde. Materials and Methods: We carried out an interventional study from December 2017 to April 2018 in Yaounde (Cameroon). We analyzed the relevance of the prescription of X-rays for low back pain before and after an interactive training of the requesters. Results: Among the 16 requesters who were trained, the proportion of irrelevant requests dropped from 58.22% (46/79) before training to 44.44% (20/45) after training, representing a decrease of 13.78% (p = 0.012). The highest drop in the proportion of irrelevant requests was found among general practitioners (-21.98%) and requesters having less than 10 years of experience in medical practice (-31.8%). Conclusion: The training of requesters moderately reduces the rate of irrelevant examinations. Other factors of irrelevant prescription must be investigated and corrected for this decrease to be more significant.

关键词： Guidelines Low Back Pain Training Requesters Justification

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Biermer Disease in an Unusual Neurological Presentation without Anemia: A Case Report

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Open Journal of Gastroenterology 2022年第5期12卷 129-135页

作者： Nsenga Djapa Guy Roger Fogang Fogoum Yannick Ndjitoyap Ndam Antonin Wilson Kowo Pierre Mathurin Ankouane Andoulo Firmin Choukem Simon Pierre Department of Internal Medicine and Specialties Faculty of Medicine and Pharmaceutical Sciences University of Dschang Dschang Cameroon Gastroenterology Unit Internal Medicine Service Ebolowa Regional Hospital Ebolowa Cameroon Department of Internal Medicine and Specialties Faculty of Medicine and Biomedical Sciences University of Yaoundé I Ya-oundé Cameroon

Background: Biermer disease is a megaloblastic disease caused by vitamin B12 deficiency. It is a rare clinical entity especially in subsahara Africa. Case presentation: We report the case of a 45 years old female patient who consulted for a one month history of generalised muscle cramps, weakness and numbness of all four limbs. Physical examination was relevant for a poor gait, poor coordination of both upper and lower limbs, a positive Romberg sign, normal muscle tone in all four limbs, reduced pallesthesia and deep tendon reflexes, abolished plantar reflexes. Paraclinical investigations revealed macrocytosis without anemia, a low cyanocobalamin (vitamin B12) level with a normal folic acid level, an atrophic corporeofundic mucosa which upon pathological analysis revealed a chronic atrophic gastritis with no Helicobacter pylori infection. Anti-intrinsic factor antibodies were positive while anti parietal cells antibodies were negative. The diagnosis of Biermer disease was considered and the patient did well on vitamin B12 supplementation. Conclusion: Though a rare disease, Biermer disease should be considered in a patient who consults for polyneuropathy even in the absence of anemia.

关键词： Biermer Disease Pernicious Anemia Autoimmune Disease Atrophic Gastritis Vitamin B12 Deficiency Cameroon

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Circadian Rhythm of Childbirths and Maternal and Neonatal Prognosis at the YaoundéCentral hospital

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Advances in Reproductive Sciences 2023年第1期11卷 11-22页

作者： Florent Ymele Fouelifack Jufo Donkeng William Takang Edmond Mesumbe Loic Dongmo Fouelifa Mosman Anyimbi Ofeh Jackson Ndenkeh Jeanne Hortence Fouedjio Higher Institute of Medical Technology of Nkolondom Yaoundé Cameroon Obstetrics and Gynecology Unit of Yaoundé Central hospital Yaoundé Cameroon Research Education and Health Associative Group Dschang Cameroon Faculty of Medicine and Biomedical Sciences University of Yaoundé I Yaoundé Cameroon Faculty of Medicine University of Bamenda Bamenda Cameroon Bamenda regional hospital Bamenda Cameroon Faculty of Health Sciences University of Lomé Lomé Togo School of Armies Health Services of Lomé Lomé Togo Faculty of Medicine and Pharmaceutical Sciences University of Dschang Dschang Cameroon

Background: The circadian variation of childbirths has been described by several authors around the globe. De Graaf showed that hospital childbirths at night were associated with increased perinatal mortality and adverse perinatal outcome. To improve obstetric care, we carried out this study to evaluate the circadian rhythm of childbirths and to assess the outcome following variations in the time of childbirths during the day. Methods: It was a cross-sectional descriptive study at the Yaoundé Central hospital (YCH), over a two years period. We collected data from files of women who delivered from the 1st of January 2017 to 31st December 2018. We included files of women who delivered at least at 28 weeks of pregnancy. We excluded files of those who delivered by elective caesarean section, those whose hour of delivery was not noted and those who delivered before reaching the hospital. Sociodemographic, obstetrical characteristics, and immediate prognosis were recorded. Data were entered into excel, then analysed with SPSS v23 software. Tools used to appreciate our results were means, median, number, percentage, P, and OR with its 95% confidence interval. The difference in p is significant if p is less than 5%. Results: We analyzed 6041 files bearing the time of birth. Childbirths took place at all hours of the day, but the times of the day where the highest numbers of births were recorded were 10, 11, 12, 13 (that’s 1pm), 14 (that’s 2 pm), 15 (that’s 3 pm), 16 (that’s 4 pm), 17 (that’s 5 pm) and 23 (that’s 11 pm) hours, with respectively 224 (3.7%), 277 (4.6%), 256 (4.2%), 265 (4.4%), 207 (3.4%), 255 (4.2%), 228 (3.8%), 216 (3.6%) and 226 (3.7%) births. The peak of births was at 11 am while the time of day where the lowest number of births was recorded was 6 pm, with 175 (2.9%) births. The mean age of participants was 27.34 ± 6.03 years with extremes of 13 and 49, with 87.6% between 20 to 39 years. Sociodemographic characteristics of participants, prematurity and blee

关键词： Circadian Rhythm Childbirth Maternal Neonatal Prognosis

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Clinical and Evolutive Aspects of Severe Acute Malnutrition in Children Aged 0 - 59 Months at Maroua regional hospital in Cameroon’s Far North Region

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Open Journal of Pediatrics 2024年第4期14卷 700-711页

作者： Palma Haoua Abouame Selangai Hélène Kamo Sime Tchouamo Arielle Annick Fernando Kemta Lepka Daniel Nemsi Sadjo Salihou Aminou Haman Soureya Yolande Feudjo Ulrich Dama Félicitée Nguefack Faculty of Medicine and Biomedical Sciences University of Garoua Garoua Cameroon Maroua regional hospital Maroua Cameroon Garoua General hospital Garoua Cameroon Yaounde Gynaeco-Obstetrics hospital Yaounde Cameroon Faculty of Medicine and Pharmaceutical Sciences University of Dschang Dschang Cameroon Douala General hospital Douala Cameroon Department of Health Sciences Catholic University of Central Africa Yaounde Cameroon University of Lisala Lisala Democratic Republic of the Congo Faculty of Medicine and Biomedical Sciences University of Yaound I Yaounde Cameroon

Introduction: Severe acute malnutrition remains one of the most important causes of under-five mortality. In Cameroon, the northern regions have the highest prevalence, with 1.4% in the Far North in 2021. These children are managed at the Internal therapeutic and Nutrional Centre, one of which is located at Maroua regional hospital, the third level referral hospital. We therefore proposed to carry out a study on the clinical and evolutive aspects of these children. Materials and Methods: it was a descriptive, cross-sectional study from January 2020 to December 2022, at the ITNC (CNTI) of Maroua regional hospital. The sample size was obtained from the Lorentz formula. Patient records were used for data collection. We excluded all incomplete records and patients with less than 24 hours of admission. Results: Out of the 873 patients we recruited, the prevalence of severe malnutrition was estimated at 18 %. The average age was 14 months, with a male predominance. The main reasons for consultation were fever (42%) and diarrhoea (35%). Marasmus was the predominant clinical form. The major medical complications were sepsis (32.9%) and malaria (16.8%). HIV prevalence was 2.5% and tuberculosis was 4.9%. Most patients had haemoglobin levels between 7 and 10g/dl. 79.3% were cured and 6.5% died. The main causes of death were sepsis and malaria. Conclusion: Severe acute malnutrition remains a major problem in the Far North region. Several joint actions are needed to break this cycle.

关键词： Severe Acute Malnutrition Children Far North Cameroon

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Epidemiological, Clinical, and Evolutionary Profile of Children Admitted to the Pediatric Emergency Department of the Maroua regional hospital, Cameroon

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Open Journal of Pediatrics 2024年第5期14卷 878-888页

作者： Soureya Haman Kamo Selangaï Héléne Enyama Dominique Abouame Palma Haoua Salihou Sadjo Mekone Nkwele Isabelle Nguefack Félicitée Faculty of Medicine and Biomedical Sciences University of Garoua Garoua Cameroon Garoua General hospital Garoua Cameroon Faculty of Medicine and Pharmaceutical Sciences University of Dschang Dschang Cameroon Faculty of Medicine and Biomedical Sciences University of Yaound Yaound Cameroon

Introduction: Pediatric emergencies in developing countries are associated with high morbidity and mortality. The Maroua regional hospital (MRH) is one of the referral centers for pediatric emergencies in the Far north region of Cameroon. Pediatric emergencies are frequent in Maroua and are associated with significant mortality. The aim of our study is to determine the epidemiological, clinical, and evolutionary profile of children admitted to the pediatric emergency department of the HRM. Methods: We conducted an observational, descriptive, and retrospective study over a period from April 10, 2023 to April 10, 2024, focusing on the records of patients admitted to the pediatric emergency department of the MRH. The variables studied included epidemiological, clinical, and evolutionary characteristics. Data analysis was performed using CSPro version 8.01 and SPSS version 27.0. Results: We included 1027 patients;the sex ratio was 1.2 infants under 2 years represented 54.33%. The main reasons for consultation were fever (62.22%) and seizures (30.18%). The most frequently prescribed additional test was the Complete Blood Count (CBC), performed in 97.37% of cases. The most common pathologies were severe malaria (45.18%), broncho-pulmonary infections (15.48%), and bacterial meningitis (12.26%). At admission, 32.9% were transfused. There were 68 deaths, representing 6.67%, and 86% of the deaths occurred within 24 hours of admission. The leading cause of death was severe malaria, with 28 (41.17%) cases. Conclusion: Febrile illnesses were the main reason for consultation, and mortality was linked to severe malaria. Therefore, in addition to the other preventive methods already used against malaria, it is recommended to consider the use of the malaria vaccine.

关键词： Pediatric Emergencies Malaria Cameroon

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Prevalence of Hepatitis B and Associated Factors in the Garoua Central Prison, Cameroon: A Cross-Sectional Study

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Open Journal of Gastroenterology 2024年第5期14卷 174-183页

作者： Mohamadou Abdou Galdima Adamou Dodo Balkissou Guy Roger Nsenga Djapa Winnie Tatiana Bekolo Nga Gilles Aghoagni Antonin Wilson Ndjitoyap Ndam Ali Abas Mathurin Pierre Kowo Firmin Ankouane Andoulo Dominique Noah Noah Oudou Njoya Servais Albert Fiacre Eloumou Bagnaka Faculty of Medicine and Biomedical Sciences University of Garoua Garoua Cameroon Garoua regional hospital Garoua Cameroon Faculty of Medicine and Pharmaceutical Sciences University of Dschang Dschang Cameroon Faculty de Medicine and Pharmaceutical Sciences University of Douala 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: Hepatitis B virus (HBV) infection is a major public health problem in Cameroon. Garoua city is the headquarters of the North Region of Cameroon, where the HBV prevalence is among the highest of the country. The aim of this study was to determine the prevalence of HBsAg carriage and associated factors among persons incarcerated in the Garoua Central Prison. Methods: It was a cross-sectional study conducted from July 1 to July 31, 2023 at the Garoua Central prison. We included all prisoners willing to participate in the study and who gave their verbal consent. We collected data using a pre-established data entry form and we used rapid test for blood screening for HBV surface antigen (HBs Ag) with ELISA confirmation. Data were analyzed using the R® software for Windows. After the univariate analysis, we selected associated variables to HBV infection with p-value p-value was set at 5%. Results: We included 1389 prisoners out of which 97.6% were male. The median age (IQR) of the study population was 28 (23 - 35) years. The median (IQR) duration of incarceration was 12 (6 - 26) months and the mean (±sd) number of incarcerations was 1.24 (±0.6). HBV prevalence was estimated at 14.8% (95% CI: 13.0 - 16.7). Upon uni- and multivariate analysis, no risk factor was significantly associated with viral hepatitis B infection in our study population. Conclusion: The prevalence of Hepatitis B was high in the Garoua Central Prison, but there were no additional risk factors for HBV infection. There is a need to include the Garoua Central Prison and by the way other prisons in the country in the chronic viral hepatitis care program.

关键词： Hepatitis B Prison Associated factors Cameroon

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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

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