Hospital Of Douala Research Articles

Cryoglobulin and factors associated with it in patient with anti-hepatitis-C antibodies living in resource-limited countries

IntroductionLe virus de l'hépatite C (VHC) a plusieurs manifestations extra hépatiques parmi lesquelles la cryoglubulinémie. La cryoglobulinémie se définit par la présence anormale dans le sang d'une ou plusieurs protéines (cryoglobuline) pouvant précipiter au froid.MéthodesNous avons mené une étude transversale et analytique dans le service du laboratoire de biologie et l'unité d'hépatologie de l'Hôpital Général de Douala (HGD) pendant une durée de 6 mois. Etaient inclus dans le travail tous les patients acceptant de participer et porteurs d'un anticorps anti VHC avec ou sans traitement. Les cryoglobulines étaient recherchées par la méthode de Biuret et la classification était réalisée par une immunoélectrophorèse de Brouet. Une analyse multivariée a été réalisée, des facteurs de confusion tels que l'âge, le sexe et la durée après dépistage du VHC ont été ajustés.RésultatsNous avons inclus 116 patients. L'âge moyen était de 58,47 ± 9,95 ans. Le sexe masculin représentait 50,86% des cas. L'arthralgie était présente dans 69,80% des cas. La cryoglubiline était présente chez 63,80% des cas. Apres ajustement, le sexe féminin (ORa =2,18; IC à 95% [0,97-4, 90]; p= 0,059), l'asthénie seule (ORa =2,45; IC à 95% [1,04-5,80]; p= 0,041), l'asthénie couplée à l'arthralgie (ORa =2,84; IC à 95% [1,13-7, 10]; p= 0,026) et la présence de l'ARN du VHC (ORa =2,84; IC à 95% [1,13-7, 10]; p= 0,028) étaient des facteurs indépendamment associés à la présence de cryoglobuline.ConclusionLa prévalence de la cryoglobubine est élevée chez les patients porteurs de l'Ac anti VHC à l'HGD. Elle est recherchée par les méthodes biologiques simples. La recherche de cryoglobuline chez les patients porteurs du VHC est essentielle dans un pays à ressources limitées.

Detection and serotyping of dengue viruses in febrile patients consulting at the New-Bell District Hospital in Douala, Cameroon

Arboviruses are a major public health problem worldwide and are predominantly present in intertropical areas. Chikungunya, dengue and zika viruses have been implicated in recent epidemics in Asia, America and Africa. In Cameroon, data on these viruses are fragmentary. The purpose of this study was to determine the frequency of detection of these three viruses in febrile patients in Douala, Cameroon. A cross-sectional and descriptive study was conducted from March to April 2017 at the New-Bell District Hospital in Douala. Blood samples were collected from febrile patients and tested for malaria infections using Rapid Diagnostic test. Plasma harvested was later analyzed for the presence of chikungunya, dengue and zika viruses by a Trioplex real-time RT-PCR at Centre Pasteur of Cameroon. A total of 114 participants were included, of which 63.2% were females, reflecting a sex ratio (female/male) of 1.7. The median age was 26 years, range [0.25–81]. Eight (7%) of the 114 participants were infected with Dengue virus (DENV) among which 5 were identified as serotype 1. No cases of infection by either Zika virus or Chikungunya virus were detected. Three cases of dengue-malaria co-infection (13%) were recorded. No association was found between socio-demographic factors and dengue infection. The phylogenetic analysis of the partial envelope E gene showed that all the five DENV serotype 1 samples belonged to subtype V, similarly to strains from West African countries, particularly those from Nigeria, Senegal and Côte d’Ivoire. This study showed the circulation of DENV serotype 1 in febrile patients and raises the alarm for the establishment of a sustained surveillance system to detect cases and prevent potential outbreaks in Cameroon. The existence of dengue-malaria co-infections suggests that surveillance of arboviruses should not be limited to febrile, non-malarial cases.

Phenotypic Detection of Extended Spectrum β-Lactamase and AmpC producing Enterobacteriaceae Isolated in A General Hospital

Objective: The antibiotic resistance of Enterobacteriaceae is a worldwide preoccupation, and misuse
 antibiotics of beta-lactam group allowed the development of bacteria producing
 extended spectrum beta-lactamase and cephalosporinase AmpC enzymes type
 resistance. The aim of this study was to determine the frequency of these
 enzymes among strains isolated at the General Hospital in Douala, Cameroon.
 
 Methods: We
 conducted a cross-sectional study. For phenotypic detection of resistance
 enzymes, MASTDISCS™ test impregnated third and fourth generation
 cephalosporin’s was used by diffusion on Mueller Hinton agar. Measuring the
 inhibition areas and comparing the inhibition diameters determined the nature
 of the resistance mechanism.
 
 Results: This
 study included 195 strains of Enterobacteriaceae.
 The most frequent species were Escherichia
 coli and Klebsiella pneumoniae,
 with a frequency of 49.2% and 31.3% respectively. After determination of
 resistance phenotypes, 101 (51.8%) isolates were found to be producing
 resistance enzymes. The frequency of ESBL-producing Enterobacteriaceae was 19.5%; AmpC producing was 14.3% and both
 enzymes (AmpC + ESBL) 17.9%. E. coli
 and K. pneumoniae resistance rates
 were 90% and 83.7% for Cotrimoxazole, 82.5% and 78.3% for ciprofloxacin, 20%
 and 13.5% for Amikacin, respectively. Imipenem, Amikacin and Fosfomycin were
 the most active molecules with 4.9%, 19.8% and 33.6%, out of 101 resistant
 strains, respectively.
 
 Conclusion: This study showed a high frequency of resistance
 enzyme producing strains. This situation leads to resistance to antibiotics
 most commonly used. This finding justifies a change in prescription habits for
 protection of molecules that are still active. J Microbiol Infect Dis 2018; 8(3):113-119

Feasibility and utility of active case finding of HIV-infected children and adolescents by provider-initiated testing and counselling: evidence from the Laquintinie hospital in Douala, Cameroon

BackgroundUniversal HIV testing and treatment of infected children remain challenging in resource-limited settings (RLS), leading to undiagnosed children/adolescents and limited access to pediatric antiretroviral therapy (ART). Our objective was to evaluate the feasibility of active cases finding of HIV-infected children/adolescents by provider-initiated testing and counseling in a health facility.MethodsA cross-sectional prospective study was conducted from January through April 2016 at 6 entry-points (inpatient, outpatient, neonatology, immunization/family planning, tuberculosis, day-care units) at the Laquintinie Hospital of Douala (LHD), Cameroon. At each entry-point, following counseling with consenting parents, children/adolescents (0–19 years old) with unknown HIV status were tested using the Rapid Diagnostic Test (RDT) (Determine®) and confirmed with a second RDT (Oraquick®) according to national guidelines. For children less than 18 months, PCR was performed to confirm every positive RDT. Community health workers linked infected participants by accompanying them from the entry-point to the treatment centre for an immediate ART initiation following the « test and treat » strategy. Statistical analysis was performed, with p < 0.05 considered significant.ResultsOut of 3439 children seen at entry-points, 2107 had an unknown HIV status (61.3%) and HIV testing acceptance rate was 99.9% (2104). Their mean age was 2.1 (Sd = 2.96) years, with a sex ratio boy/girl of 6/5. HIV prevalence was 2.1% (44), without a significant difference between boys and girls (p = 0.081). High rates of HIV-infection were found among siblings/descendants (22.2%), TB treatment unit attendees (11.4%) and hospitalized children/adolescents (5.6%); p < 0.001. Up to 95.4% (42/44) of those infected children/adolescents were initiated on ART. Overall, 487 (23.2%) deaths were registered (122 per month) and among them, 7 (15.9%) were HIV-positive; mainly due to tuberculosis and malnutrition.ConclusionThe consistent rate of unknown HIV status among children/adolescents attending health facilities, the high acceptability rates of HIV testing and linkage to ART, underscore the feasibility and utility of an active case finding model, using multiple entry-points at the health facility, in achieving the 90–90-90 targets for paediatric HIV/AIDS in RLS.

Prevalence and Risk Factors of Work Related Stress in the Medical Emergency Services in Douala, Cameroon

Background: Healthcare workers are exposed to work related stress in the course of their activities. We conducted this study to determine the prevalence of work-related stress and search for its associated factors among healthcare workers assigned to the emergency medical services of public hospitals in Douala. Methods: The cross-sectional and analytical study was carried out from March 27th to June 30th, 2017 in 8 public hospitals in Douala. The sampling method was non-random, consisting of consecutive recruitment of volunteer healthcare staff working in the emergency departments of public hospitals who provided the framework for the study. The level of stress was measured using the French version of KARASEK’s psychometric scale. The analysis was performed with SPSS 20.0 software. The study was authorized and obtained an clearance was granted. Results: The sample consists of 51 men (33.55%) and 101 women (66.44%). The average age is 34.6 ± 5.4 years. Nurses (54.6%) and healthcare staff aged 30 to 39 years (61.2%) predominates in the sample. Day / night shift work is the main form of work done by ¾ staff (75.6%). The prevalence of stress is 78.9% and the associated risk factors are the following: belonging to a 4th category hospital (p = 0.008), medical professions (p = 0.001), nurses (p = 0.0002), work experience of less than 10 years (p = 0.04) and exclusive night shifts (p = 0.02). Conclusion: Continuous improvement of the working conditions must be implemented inside the various facilities to mitigate the consequences of work related stress among the healthcare workers.

Microbial Ecology and Antibiotic Susceptibility Profile of Germs Isolated from Hospital Surfaces and Medical Devices in a Reference Hospital in 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.

Characterization of pharmaceutical medication without a medical prescription in children before hospitalization in a resource-limited setting, Cameroon.

IntroductionThe use of different therapeutic approaches is common among sick children in Cameroon. The main objective of this study was to characterize the use of non-prescription drugs and describe the therapeutic itineraries of sick children before admission to the hospital.MethodsA cross-sectional and prospective study was conducted from January to May 2017. A closed-ended questionnaire (CEQ) consisting of one or several response options was administered to the parents/guardians of the children on admission to the hospital in the pediatric ward of the Laquintinie Hospital in Douala (LHD) and the Cité des Palmiers District Hospital (CPDH) of the city of Douala. Inclusion of participants was made consecutively for adolescents who gave their consent and parents or guardians who signed the informed consent for all children. The confidentiality of the data was ensured by the replacement of the names by codes.ResultsOverall, 295 hospitalized children were included with an average age of 3.1 (SD: 3.3) years in the study. More than half of these children (58.6%) came from LHD. More than 90% of parents had at least one therapeutic recourse (TR). The ratio of boys to girls 3/1. Self-medication (74.1%) and medical consultation (16.9%) were the main therapeutic paths in 1st recourse. The medical consultation (80.2%) and the pharmaceutical advice (16.9%) were used frequently in 2nd recourse. The mean lapse time to see a medical professional was 2.7 days (min-max: 0-14 days). The main symptoms associated with TR were fever (76.6%), vomiting (24.7%) and diarrhea (22.7%). The most frequently used drugs were Analgesics/antipyretics (47.6%), antimalarials (15.0%) and antibiotics (10.2%) and the family medicine box was the highest source of drugs.ConclusionSelf medication remains the first therapeutic path, followed by medical consultation as second therapeutic path taken when the disease is perceived as serious.

Medical radiation exposure of pregnant patients: case study of the gynaeco obstetric and paediatric hospital of douala, cameroon

Medical radiation exposure of pregnant patients: case study of the gynaeco obstetric and paediatric hospital of douala, cameroon

Cerebral Gliomas Patterns at the General Hospital of Douala, Cameroon

The diagnosis and management of cerebral gliomas are challenging. The goal of this study was to evaluate the pattern of cerebral gliomas at the General Hospital Douala, Cameroon. A retrospective study was carried out over a period of 10 years. Non-glial lesions were not included. Data were analyzed with Epi info version 7.2.2.6 (Microsoft, Seattle, USA). 220 cases of brain tumors, comprising 56 gliomas (25.46% of all brain tumors) were managed during the study period. The mean age of the patients was 42.93 ± 16.90 years. 35 cases (62.5%) were males. Patients over 15 years of age represented 91.07% (n = 51) of the cases. The most frequent presenting complaints were headache and vomiting with 52 cases (92.86%) and 47 cases (83.93%) respectively. Brain computed tomography was done for all patients. The most frequent histological type was astrocytoma with 22 cases (39.29%) followed by glioblastoma with 20 cases (35.71%). The most performed surgical technique was partial removal with 33 cases (58.93%), followed by open biopsy with 14 cases (25.00%). Radiotherapy was administered to 54 patients (96.43%). The outcome ranged from full recovery in 8 cases (14.29%), recovery with persisting symptoms, in 15 cases (26.79%) and death in 26 cases (46.43%). Seven patients (12.50%) were lost to view. In this series, cerebral gliomas affected most often adult males. Most of them presented with signs of raised intracranial pressure. The outcome was poor with 46.43% of patients dying before 2 years after diagnosis.

Management of blood pressure in acute stroke: Comparison of current prescribing patterns with AHA/ASA guidelines in a Sub-Saharan African referral hospital

BackgroundHigh blood pressure (HBP) is common at acute phase of stroke. It may reflect untreated or uncontrolled hypertension before stroke, or it may relate to stress response. The present study was designed to compare current American Stroke Association (ASA) guidelines with actual prescribing patterns for management of HBP at the acute phase of stroke, in a tertiary care Hospital in Douala, Cameroon. MethodsThis cross-sectional study was conducted in the Cardiology and Neurology department of the Douala Laquintinie Hospital. Consenting patients with sign of stroke, confirmed by a brain CT-scan, who consented to participate in the study were recruited from March to July 2012. The use of antihypertensive medications (type, dose, routes of administration, BP recordings) in the first three days after admission was noted. ResultsOne hundred and eleven patients were recruited including 59 men (53.1%). The mean age of patients was 60.9±12.3years, 70 patients (63%) had ischemic stroke and 41 (37%) hemorrhagic. Sixty two (55.8%) patients had hypertension severe enough to warrant treatment upon arrival. There was an overtreatment rate of 46.9% and undertreatment rate of 9.7%. ConclusionThe ASA guidelines were broadly respected by practitioners for patients who required treatment, but those who do not need treatment were overtreated. These findings support the need for more research to improve treatment guidelines as well as patient management.

Cardiac surgery in sub-Saharan Africa: a report of 3-year experience at the Douala General Hospital

Background: Cardiac surgery was started at the Douala General Hospital since 2012 as a result of a North-South collaboration between Cameroon and Belgium. Five cardiac surgery missions have been carried out since then. This work aimed at assessing three years of this initial experience. Methods: We carried out a cross-sectional descriptive study between November 2012 and March 2016. We reviewed the case records of all patients with heart disease, and with an indication for surgery. Results: A total of 45 patients with heart diseases who had an indication for surgery were retained for this study. There were 23 women and 22 men. Of these, 27 patients benefited from surgical intervention. Their mean age was 41±18 years (range, 14 to 85 years). The most common physical sign was heart murmur in 29 (64.4%) patients. Valvular Heart diseases were the most frequent in 32 (71.1%) patients, which were predominantly rheumatic heart diseases (RHD) in 25 (55.6%) patients. The most frequent surgical procedures were valve replacement with prosthesis, followed by repairs of congenital abnormalities. Mechanical prosthesis were mostly used (8/12 cases). Short-term intra-hospital mortality was 7.4%. The main cause of death was acute ventricular failure. Conclusions: The pilot phase of the cardiac surgery program at the General Hospital of Douala (DGH) was successful. Patients could be operated at a lower cost locally. Efforts must be made for the creation of an autonomous local team.

Risk factors for mortality in patients with tuberculosis and HIV in Douala (Cameroon)

Despite prevention efforts, and free treatment, TB-HIV co-infection still occurs in Cameroon. The objective of this work is to present the risk factors for mortality in patients co-infected with TB and HIV in Douala from 2009 to 2014. This transversal, analytic, and retrospective study took place from November 2014 to May 2015 in the Laquintinie Hospital in Douala. A review of our records identified patients aged at least 15years, with this co-infection who received TB treatment, with or without antiretroviral agents. The bivariate analysis compared qualitative variables with Pearson's Chi2 test. In the multivariate analysis, we determined the risk factors for mortality by backward stepwise logistic regression. Model fit was tested with the Hosmer-Lemeshow test. The study identified 394 patients, 213 (54.1%) of whom were women (sex ratio 0.84). The mean age was 39 ± 10 years. All patients received drugs to treat tuberculosis drugs; 351 (89%) also received antiretroviral drugs, 78.2% of them including efavirenz; and 320 (81.2%) received cotrimoxazole prophylaxis. During the study period, 67.3% were cured of tuberculosis and 15.7% died. The multivariate regression results show that hepatitis B (P <0.0009), absence of cotrimoxazole prophylaxis (P <0.005), poor treatment adherence (P <0.0001), and a CD4 count <50 (P <0.0001) were risk factors for mortality. The cure rate for patients co-infected with TB and HIV in Cameroon remains low, and their mortality high. Comorbidities and the presence of opportunistic diseases are risk factors for death. Appropriate measures to prevent this co-infection and the systematic use of cotrimoxazole should reduce this mortality rate.

Early treated HIV-infected children remain at risk of growth retardation during the first five years of live: Results from the ANRS-Pediacam cohort in Cameroon

Introduction Little is known about the long-term outcome of growth in early treated infants in resources limited countries. Here, we compared growth parameters over the first 5 years of life of early treated HIV-infected and uninfected children and identified factors associated with growth retardation, taking into account informative censorship. Methods Data used in this study were obtained from the ANRS-Pediacam cohort based in three referral hospitals in Cameroon (The Maternity of the Central hospital/Mother and Child Center of the Chantal Biya Foundation in Yaounde, the Essos Hospital Center in Yaounde and the Laquintinie Hospital in Douala). Anthropometric indices [weight-for-age (WAZ), weight-for-length (WLZ), and length-for-age (LAZ) Z-scores] were calculated using data from this observational study. Of the four groups included, three were followed from the first week of life: HIV-infected (HI, n = 69), HIV-exposed uninfected (HEU, n = 205) and HIV-unexposed uninfected (HUU, n = 196), and the last group constituted of HIV-infected infants not followed from first week of life but diagnosed before 7 months of age (HIL, n = 141). We performed under the Missing At Random hypothesis a multiple imputation by a conditional approach of missing data on different covariates, except the anthropometric parameters. To take account of informative censorship, recurrent events and interval censoring, we used markov multi-state model for panel data to describe the incidence of growth retardation (defined as WAZ or WLZ or LAZ Results During the first 5 years, 27.5% of children experienced underweight (WAZ P P = 0.01 respectively) and stunting for HIL (aHR = 8.4 (95%CI: 2.4–29.7). HEU and HUU infants were not different according to stunting and wasting. However, the risk of underweight was higher in HEU compared to HUU children (aHR = 5.0 (CI: 1.4–10.0), P = 0.001). Others associated factors were younger age, chronic pathologies, small size at birth, diarrhea, CD4 Conclusions Despite early antiretroviral treatment HIV-infected children are at high risk of wasting and stunting within the first 5 years period of follow up. Nutritional status of HIV infected children should be closely monitored even in the context of early treatment.

Evaluating the Necessity of a Poison Control Center in Cameroon: The Knowledge and Perception of Health Care Professionals in the Laquintinie Hospital and the Bonassama District Hospital in Douala

Introduction: A cross sectional study was carry out on the necessity of creating a poison control center in Cameroon, by evaluating the knowledge and perception of health care professionals in the Laquintinie hospital and the Bonassama District hospital in Douala, based on a 2 years (2014 to 2015) record files reviewed of poison victims. Materials: A4 white sheets, Respiratory mask, Disposable gloves, A data analyzing tool (Microsoft Excel 2010), ruler and pens, Questionnaire. Method: A Questionnaire was used in data collection to access the knowledge of health care professionals on poisoning and poison control center in regard to proper poison management (group I). To further evaluate group I, a 2 years poison victims files (records) were reviewed at the level of the emergency and paediatric units. The data obtained were analyzed using Microsoft Excel 2010 and the results were displaced on frequency tables, and in percentages and figures. Results: The perception and knowledge of the 66 Health care professionals accessed in the study; revealed that none of the participants had a formal training on poison management and none of the hospitals involved, had established poison management guidelines. 23,182 patients’ files were reviewed; of which 245 files were recorded as poison victims: 62% (152) as voluntary, 38% (93) as involuntary, 4% (10) death case recorded inclusive; with a prevalence of 1% been observed for poisoning from the sorted hospitals. Conclusion: The relative low knowledge of health care professionals on poisoning and the absence of poison management guidelines in hospitals still make poison management in Cameroon a complex issue. Cameroon is therefore highly in need for policies on poison management.

Les traumatismes oculo-orbitaires dus aux accidents de motos taxis à Douala au Cameroun

A prospective and longitudinal study was carried from January 2 to December 31, 2013 in which victims of commercial motor bike accidents presenting to the Laquintinie Hospital in Douala were examined in search of oculo-orbital injuries with the double goal of identifying and evaluating the physical impact of the observed oculo-orbital lesions. We included 88cases with oculo-orbital trauma due to commercial motor bike accident. There were 71males (80.7%) and 17females (19.3%). The mean age was 32.8±10.6years. Collision between two motorbikes was the most frequent mechanism and accounted for 42% of cases of oculo-orbital trauma (n=37). None of the 81patients on a motor bike reported wearing a helmet at the time of the accident (7pedestrians were victims). Injuries of the globe were present in 16.5% of eyes (n=29); while orbital injuries were present in 22% of eyes (n=39). The most frequent orbital injury was orbital wall fracture, occurring in 31eyes (17.6%). Lesions of the eyelids were found in 50cases (28.4%). ENT lesions were associated in 27cases (30.7%), cranial trauma in 3cases (3.4%). Orbital dystopia, oculomotor palsy, ptosis, ectropion and unilateral blindness (rate of 9%) were sequelae recorded after six months of follow-up. The existing rules and regulations on driving licenses, vehicle code and compulsory use of helmets in the area of commercial motorbike activity should be strictly applied in Douala to avoid these preventable oculo-orbital trauma which lead to unsightly scars and blindness.

In-vitro fertilization and spontaneous pregnancies: matching outcomes in Douala, Cameroon.

BackgroundCouples are considered infertile if they do not conceive over a 12-month period of unprotected intercourse. Studies have shown that female causes accounted for between 25 to 37 percent of infertility worldwide (with larger proportions in sub-Saharan Africa and Southeast Asia) and male causes accounted for between 8 to 22 percent. Both male and female causes accounted for between 21 to 38 percent. Although the majority of ART children are normal, there are concerns about the increased risk for adverse pregnancy outcomes. More than 30 % of ART pregnancies are twins or higher-order multiple gestations (triplets or greater) and more than one half of all ART neonates are the products of multifetal gestations, with an attendant increase in prematurity complications. The aim of this study was to evaiuate the outcome of pregnancies conceived by In-vitro fertilisation compared to those conceived naturally in two hospitals in Douala, Cameroon.MethodsThis was a prospective study carried out from October 1, 2011 to September 30, 2012. Participants were recruited from two hospitals: the Douala General Hospital (DGH) and the Clinique de l’ Aéroport (CDA), also in Douala. A total of 102 women were recruited for study: 51 who conceived by IVF (cases) and 51 who conceived naturally (controls). Of the 102 women, 52.9 % were between 31 – 39 years of age, while 21.6 % were above 40.ResultsParticipants who conceived through IVF-ET were 4.1 times more likely to undergo cesarean delivery than those who conceived naturally [OR 4.10, 95 % CI 1.78–9.42]. Similarly, a higher percentage of patients in the IVF group than those in the control group have never given birth (33.3 % vs 2.0 %) (P < 0.0001). The percentage of multiple pregnancies was 7.5 times higher in the IVF group than in the control group (14.7 % vs.1.96 %) (P = 0.000).The leading indication for cesarean delivery was advanced maternal age (27.3 %) followed by IVF or precious pregnancy (18.2 %).ConclusionsCesarean delivery was more frequent amongst the IVF group than in the control group. The leading indications for cesarean delivery were advanced maternal age and IVF or precious pregnancy.The long-term neonatal outcomes of IVF babies beyond 5-min Apgar scores should be studied in Cameroon and follow-up beyond 1 year encouraged.

Prevalence and factors associated with anemia in pregnant women attending the General Hospital in Douala

IntroductionL’anémie est un problème de santé publique, prédominant chez les enfants et les femmes en âge de procréer. L’objectif de l’étude était de déterminer la prévalence et les facteurs associés à l’anémie chez les femmes enceintes à l’Hôpital Général de Douala.MéthodesIl s’agissait d’une étude transversale qui s’est déroulée de juillet 2012 à juillet 2013. Toutes les femmes enceintes consentantes se présentant pour consultation prénatale et ayant réalisées une numération formule sanguine (NFS) étaient incluses. Les caractéristiques sociodémographiques, les antécédents obstétricaux et les résultats de la NFS étaient enregistrés sur une fiche technique pré-testée. L’anémie était définie selon les critères de l’OMS. Après quelques statistiques descriptives, nous avons effectué une analyse bivariée à l’aide du test de Chi 2 et la probabilité exacte de Fisher pour rechercher les facteurs associés à l’anémie. Une valeur de p< 0,05 était considérée significative.RésultatsAu total 415 gestantes ont été recrutées. La prévalence de l’anémie était de 39,8%. L’âge moyen était de 29,89±4,835ans. Le taux moyen d’hémoglobine était de 10,93±1,23.L’anémie normochrome normocytaire (53,3%) était prédominante. L’anémie était sévère dans 2,4% des cas. L’anémie en grossesse était significativement associée aux antécédents de pathologies chroniques (P=0,02) et d’anémie gravidique antérieure (P=0,003). L’anémie était plus observée au 3ème trimestre (P=0,04) et l’allaitement maternel était protecteur (P=0,02).ConclusionLa prévalence de l’anémie chez la femme enceinte reste élevée. Un accent doit être mis sur une meilleureprise en charge des pathologies chroniques chez les gestantes et sur leur suivi en post natal afin de corriger l’anémie avant la grossesse ultérieure.

In-Appropriate Physiotherapy: An Unusual Factor of Implant Failure in Douala

Introduction: Osteosynthesis has well defined principles. When the surgeon does not follow these principles, implant failure is likely to happen. The purpose of this study was to study this issue in our service and to search for underlining factors. Methodology: It was a descriptive study done from September 2009 to September 2012, in the orthopaedics and traumatology service of the Laquintinie hospital of Douala in Cameroon. Were enrolled, all patients operated or referred in the service and presenting an implant failure (folding, breakage, migration, disassembly bone fixation loosening). Results: We had 58 cases (after 330 Osteosynthesis that is 17.58%), 45 men and 13 women. Sex ratio: 3.46. Mean age 25 years. The initial condition was: a close fracture in 29 (50%) of cases, an open fracture in 21 (36.21)%, a pseudarthrosis in 4 (6.90%), an osteomyelitis in 3 (5.17%), and a limb deformation in 1 (1.72%). Plating was the most involved procedure: 36 (62.07%) of failed implants were stainless steel plates; and 21(56.33%) of these were broken. In 13 (22.41%) of cases, there was a fall preceding implant failure. In 8 cases (14%), the physiotherapy was inappropriately done by a traditional healer. Conclusion: Implant failure is a real problem in our environment. Factors include- surgeon failure, implant failure and patient related failure. Good indications, surgical technique and appropriate physiotherapy can reduce implant failure in our milieu. We did not carry out mechanical studies on failed implants.

Seroprevalence and Factors Associated with Herpes Simplex Virus Type 2 and Chlamydia trachomatis among Women Attending AIDS Care Unit at the Bonassama District Hospital

Background: Infections with Herpes Simplex Virus Type-2 (HSV-2) and Chlamydia trachomatis is the most common cause of genital ulcer disease and cervicitis worldwide. There is little information on the prevalence of these sexually transmitted infections (STIs) in Cameroon. The aim of this Original Research Article Luther et al.; BJMMR, 7(3): 224-230, 2015; Article no. BJMMR.2015.327 225 study was to evaluate the seroprevalence and behavior factors associated with Chlamydia trachomatis and HSV-2 seropositvity among women attending AIDS care unit in the district hospital in Douala. Methodology: One hundred and fifty seven consenting women (80 HIV-1 positive and 77 HIV-1 negative) were invited to participate in this study. A structured questionnaire was used for each woman to obtain informations about socio-demographic characteristics and sexual risk behavior. Peripheral venous blood sample were collected, labeled and sent to the laboratory, where the presence of IgG antibody against HSV-2 and Chlamydia trachomatis was detected, using ELISA test. Data management was carried out using the SPSS 16.0 statistical software. Results: The mean age of women was 37.22±9.13 years (range, 20 to 74 years). Of the 157 women tested, 122 (77.7%) were HSV-2 positive and 60 (38.2%) were positive for chlamydial infection. The prevalence of HSV-2 and chlamydial infections in HIV positive patients were 73.7% and 43.7% respectively versus 81.8% and 32.5% in HIV negative individuals. Women with multiple infections were those belonging to the group aged 30-39 years old, single and having had more than three sexual partners during the six months preceding the study. Conclusion: HIV status appears tobe a factor in the acquisition of chlamydial infection in our population. These results suggest the need for extension and expansion of the current study in Cameroon.

Factors associated with non-adherence of adults infected with HIV on antiretroviral therapy in a referral hospital in Douala

IntroductionLe succès du traitement antirétroviral repose sur l'observance. Elle est nécessaire pour réduire la mortalité, diminuer le risque de résistance et restaurer l'immunité. Cette étude a pour but d'identifier et analyser les différents facteurs associés à la non observance thérapeutique des patients infectés par le VIH sous traitement antirétroviraux à l'hôpital de référence Laquintinie de Douala.MéthodesIl s'agit d'une étude transversale et analytique effectuée de mars à juin 2014. La non observance est mesurée à travers les déclarations du patient et sur consultation des registres de renouvellement des ordonnances. Etaient non observant, ceux ayant consommé moins de 95% de médicaments et ceux ne s’étant pas présentés pour le renouvellement de l'ordonnance. L'analyse bivariée et le modèle de régression logistique ont été utilisés pour la détermination des facteurs associés à la non observance.RésultatsAu total, 524 patients ont été enrôlés dans l’étude;l’âge moyen était de 43,0 ± 10,7 ans et le sexe ratio H/F de 0,54. De ces patients, 49,0% étaient non observant, majoritairement des femmes (61,9%). Les principales raisons avancées de la non observance sont: l'oubli (32,9%), la rupture de médicaments (14,0%), les occupations (12,8%). Les personnes veuves(IC 95% OR= 1,31-5,22, p= 0,006), la consommation des excitants (IC 95%, OR= 2,30-6,90, p= 0,0001) et la présence d'infection opportuniste (IC 95%, OR= 1,41-17,54, p= 0,01) ont fortement été associés à la non observance.ConclusionLe taux d'observance était faible, lié à plusieurs facteurs. Des mesures sont nécessaires pour résoudre ce problème, y compris des stratégies tendant à l'amélioration du soutien psycho-social, et la limitation des ruptures de stock de médicaments. La recherche qualitative est souhaitée pour comprendre les raisons de la non observance afin de mettre au point des interventions fondées sur des données probantes.