Laquintinie Hospital Research Articles

The socio-clinical particularities of preeclampsia in a disadvantaged African black environment

Introduction: Pre-eclampsia is one of the major causes of maternal and neonatal morbidity and mortality in the world. The complexity of its etiopathogenesis involves, among other things, age, primi-gravidity, obesity, lack of sensitization to the partner's sperm. Objective: It was to describe the socio-clinical profile of the preeclampsia pregnant woman received in consultation in our service and to compare it with that of a control population. Methodology: We carried out a situational study of prospective descriptive and analytical type during 07 months from 01 November 2018 to May 31, 2019, in the obstetrics and gynecology department of the Laquintinie Hospital in Douala. We recruited in consultation a continuous series of 150 pregnant women including 50 preeclampsia that we matched to 100 non preeclampsia all at a gestational age greater than 20 weeks of amenorrhea. The variables of interest were age, pregnancy, parity, gestational age, marital status and body mass index. The statistical tests were considered significant for a value of p˂0.05. Results: The preeclampsia pregnant woman in our series had a mean age of 27.80±5.80, mostly in the 25-30years, pauci-gravid, nulliparous and obese grade 1 with a gestational age predominantly ≥37 weeks of amenorrhea. This profile was non-exposing and heterogeneous compared to the control group of the same racial strain and to data from the literature. Conclusion: Our preliminary study suggests the existence of certain socio-clinical peculiarities in the preeclampsia pregnant woman in the black African environment.

Cryptococcal antigen carriage among HIV infected children aged 6 months to 15 years at Laquintinie Hospital in Douala

Up to 15% of deaths of people living with HIV is attributable to meningeal cryptococcosis, with nearly 75% occuring in sub-Saharan Africa. Although rare in children, it is a major cause of morbidity and mortality in people living with HIV. A strong association between cryptococcal antigenemia and the development of meningeal cryptococcosis has been shown in adults. Thus, in 2018, the World Health Organization published an updated version of its guidelines for the diagnosis, prevention and management of cryptococcal infection in adults, adolescents and the HIV-infected child. To determine the prevalence of cryptococcal antigenemia and to identify its determinants in children infected with HIV. An analytical cross-sectional study was carried out at the approved treatment center of Laquintinie hospital in Douala over a period of 4 months. Children were recruited consecutively after informed parental consent. Cryptococcal antigenemia and CD4 assay were performed using a Cryptops® immunochromatographic rapid diagnostic test and flow cytometry, respectively. The data collected included the socio-demographic, clinical and paraclinical variables of the children, as well as their antecedents. Data analysis was performed using Epiinfo software version 3.1 and SPSS 21.0. The significance threshold was set at 5%. A total of 147 children were enrolled. The mean age was 9.8 ± 4.09 years. The majority were on antiretroviral therapy (142, 96.60%). Only 13 (8.80%) were in severe immunosuppression. No child showed signs of meningeal cryptococcosis. The prevalence of cryptococcal antigenemia was 6.12%. Severe immunosuppression [OR: 10.03 (1.52-65.91), p = 0.016] and contact with pigeons [OR: 9.76 (1.14-83.65), p = 0.037] were independent factors significantly associated with the carriage of the cryptococcal antigen. We recommend screening for cryptococcal antigenemia and routine treatment with fluconazole of all HIV positive children with cryptococcal antigen whether symptomatic or not.

Risk Factors of Prostate Cancer in Douala (Cameroon): A Case-Control Study

Background: Generally, cancers are among the principal causes of Morbidity and Mortality given their increase rate, with prostate cancer being the most frequent neoplasm in men and the second leading cause of cancer death after bronchopulmonary cancers. We decided to carry out this study to highlight its risk factors and create awareness on the need for regular check-ups to avoid complications of late diagnosis. The aim of this study is to assess the impact of Prostate Cancer risk recognition, and therapeutic attitudes towards the patients. Material and Methods: We conducted a cross sectional and analytical study in the surgical and oncology consultation units of the Douala general hospital (HGD) and Douala laquintinie hospital (HLD) within a period of four months. Patients diagnosed of Prostate cancer were eligible to our study. The patients responded to a questionnaire containing data on socio-demographic conditions and lifestyle data. Risk factor exposure and complications of late diagnosis. Anthropometric parameters were measured and recorded. Data was analyzed using SPSS 17.0 software. Determinants were identified using multiple logistic regressions. Statistical significance was set at P< 0.05. Results: Two Hundred and Fifty patients were surveyed during this period. The median age was 62.5 ± 9.51, with ages ranging from 43-60years. The age group with the largest number of patients that is 89 cases with 35.6% was those from 60-69 years. Age greater than 50years was also known to be associated with Prostate Cancer. (CI=0.11-0.24, OR: 6.12, p value=<0.0001). Other factors significantly associated with Prostate Cancer were, Hypertension (CI=5.49-10.6, OR: 7.43, p value=<0.0001), Diabetes (CI=3.22-9.12, OR: 4,1, p value=<0.0001), Tobacco (CI 3.93-7.26, OR 5.33, p value= 0.001). Also, the consumption of Carbohydrates (CI= 1.86-4.19, OR 2.78, p value=<0.0001) and sexual activity less than 5 times a month (CI: 2.67-4.85, OR: 3.6) were significantly associated with Prostate Cancer. Conclusions: Many factors are significantly associated with prostate cancer (Age˃50 years, hypertension, diabetes, tobacco and carbohydrates consumption, sexual activity less than 5 times a month). Therefore, early diagnosis and multiple check-ups are necessary. Especially as men grow older given that age is a great risk factor.

Recurrence of Strokes and Associated Factors at Laquintinie Hospital in Douala

OVERVIEW: Stroke is the second leading cause of death in the world and the leading cause of non-traumatic disability in adults. Although the incidence of stroke has steadily declined in developed countries, the incidence in low- and middle-income countries like Cameroon continues to grow, accounting for 85% of the global burden of stroke. Whenever a stroke occurs, the patient, the patient's family and the physician want to know the risk of recurrence, its severity and the possibility of prevention. Few studies have focused on stroke recurrences and factors associated with Cameroon. OBJECTIVE: To determine the prevalence of recurrent stroke and the factors associated with Laquintinie Hospital in Douala. METHODOLOGY: We conducted a two-year retrospective study from January 1, 2016 to December 31, 2017 and five-month cross-sectional prospective from January 1, 2018 to May 31, 2018 at Laquintinie Hospital in Douala. Included were all patients hospitalized for stroke. RESULTS: We recruited 528 stroke patients, including 75 recidivists with a recurrence prevalence of 14.20%. The average age of recidivism was 65.82±12.75 years and 70.6% female. Factors statistically associated with recurrence were an antecedent of hypertension (OR=038 [0.152-0.98], P=0.045), the ischemic type of first stroke (OR=2.32 [1.04-5.17] P=0.04); females (OR=2.052 [1.20-3.4921]; P=0.007) and poor treatment compliance after first stroke (OR=0.399 [0.160-0.99] P=0.042). CONCLUSION: About 1 out of 6 (14.2%) survivors of a first stroke have recurrent stroke over the next 2 years at Laquintinie Hospital in Douala. The predictive factors for recurrence in this study were a history of hypertension, the ischemic type of stroke, female gender, and poor adherence to secondary prevention measures.

Bacterial Ecology of Otorrhea at the Laquintinie Hospital in Douala, Cameroon

Background: Otitis media is an inflammation of the lining of the middle ear, involving the eardrum, ancillary cavities and the auditory tube. Prolonged, it can be suppurative. The etiology can be bacterial, fungal or viral. The observation of this disease led us to do this study to look for possible treatment alternatives. Method: We conducted a prospective, descriptive and cross-sectional study, from February 1 to May 3, 2013 at Laquintinie hospital in Douala. The samples taken were cultured, the identification of the strains made by the galleries API (20E ™, STAPH, 20 STREP), the study of the sensitivity to antibiotics and antifungals by the method of diffusion of discs on agar. Results: 38.3% of patients had infected left ear, 53.2% right ear and 8.5% had bilateral otitis. In 50.5% of pus, at least 2 germs were isolated. 95.7% of samples were culture positive and 4.3% negative. 79.1% of bacteria were isolated against 20.9% of fungals. Pseudomonas aeruginosa was mostly isolated (50.9%) followed by staphylococcus aureus (15.1%). We had better susceptibility of Pseudomonas aeruginosa to imipenem (88.5%), piperacillin (80.8%), ciprofloxacin (76.2%) and significant resistance to ticarcillin (7.7%). The best sensitivity of Candida is that of ketoconazole (92.9%). Conclusion: The bacterial profile is different from that encountered in most Western countries. The main etiologies are: Pseudomonas aeruginosa and Staphylococcus aureus. Fungals were also present. Imipenem and ketoconazole are the antibiotic and antifungal of choice, respectively.

Knowledge of Nursing Staff on Postoperative Pain: The Case of the Laquintinie Hospital in Douala, Cameroon

Background and objective: Pain is a major concern in the surgical environment, but its management remains insufficient due to several factors related to the nursing staff, the organization of the structure or the patient himself. The objective of this study was to assess the knowledge of the nursing staff on postoperative pain at the Laquintinie Hospital in Douala. Methodology: This was a cross-sectional study carried out at the Laquintinie Hospital in Douala from September to December 2018. Participants were consecutively selected among members of nursing staff in charge of operated patients in the visceral surgery, trauma surgery, surgical reanimation, gynaecology and obstetrics services. Socio-professional data and data related to knowledge of postoperative pain were collected from this personnel using a pre-tested semi-structured questionnaire. Results: With regard to knowledge of postoperative pain, the proportion of correct answers to the knowledge questions was 61.4%. This proportion varied significantly with the specific training received on pain and the specialization of the nursing staff (p < 0.001). Conclusion: The results of the study reveal knowledge in this population that deserves to be improved with a view to better management of patients undergoing surgery.

Epidemiological Profile of Pediatric Vital Emergencies at Laquintinie Hospital of Douala, Cameroon

Introduction: In the absence of health coverage in resource limited-settings, life-saving pediatric emergencies remain a challenge. The objective of our study was to describe the epidemiological profile of life-threatening pediatric emergencies at Laquintinie Hospital in Douala (HLD). Methods: A cross-sectional study was carried out for a period of 3 months, from March to May 2017 in the pediatric emergency unit of HLD enrolling all children presenting a life-threatening emergency on admission. Local emergency kits and an internal deferred cost recovery voucher or “green voucher” were used to facilitate access to care for children on admission. The socio-demographic, clinical, therapeutic and evolutionary characteristics were collected and analyzed using SPSS software version 20.0. Results: A total of 135 children were enrolled and the sex ratio was 1.54. The mean age was 3.8 years ± 4.05 and 80.7% of the children were under 5 years old. The majority of children (82.9%) admitted to the emergency room came from peripheral health structures. The hospital prevalence of life-saving emergencies was 42.4%. The mean time to consultation after the onset of symptoms was 5.9 days and 66.0% of admissions were made during the 3 p.m. to 8 a.m. time slot. More than 4/5 of emergencies were neurological, respiratory and cardio-circulatory emergencies representing 35.6% and 18.5% respectively. Severe malaria accounted 31.9% of the etiologies, bronchopneumopathies and meningo-encephalitis were involved in 18.5% and 17.8% of cases respectively. Patients were managed within 30 minutes of admission in 75.6% of cases and 52.6% of them received a “green voucher”. The average length of stay in the emergency room was 6 days. The death rate from life-threatening emergencies was 17.8% and represented 61.5% of total deaths recorded in pediatric emergencies. Conclusion: The profile of life-threatening emergencies at the HLD was that of a child under 5 years old, coming from a peripheral health facility and presenting a neurological emergency.

Exhibitors to Bleeding Disorders in the Context of Pre-Eclampsia: Analytical Preliminary Study About 50 Cases at Laquintinie Hospital (Douala, Cameroon)

Introduction: Pre-eclampsia is one of the major causes of maternal and neonatal morbidity and mortality in the world. The complexity of its etiopathogenesis involves, among other things, age, primi-gravidity, obesity, lack of sensitization to the partner's sperm. Our objective was to describe the socio-clinical profile of the preeclampsia pregnant woman received in consultation in our department and to investigate its influence on certain coagulation parameters (prothrombin level, activated partial thromboplastin time). Methodology: We carried out an analytical cross-sectional study from 01st November 2018 to 31st May 2019, in the gynecology and obstetrics department of the Laquintinie Hospital in Douala. We recruited 150 pregnant women including 50 preeclampsia matched to 100 non-preeclampsia all with a gestational age greater than 20 weeks of amenorrhea. The variables of interest were age, pregnancy, parity, gestational age, marital status and body mass index, Prothrombin Level (PL), and Activated Cephalin Time (ACT). Statistical tests were considered significant for a p-value <0.05. Results: The majority age group in both groups was that of 25-30 years with a mean age of 27.80 ± 5.80 in the pregnant preeclampsia; the latter was predominantly pauci-gravid, nulliparous, and grade 1 obese with a gestational age predominantly ≥ 37 weeks of amenorrhea. In linear regression analysis and unvaried regression analysis, we did not find any socio-clinical factors exposing to coagulation disorders in preeclampsia. Conclusion: Our preliminary study reveals the non-existence of socio-clinical factors exposing to coagulation disorders in preeclampsia in our setting.

Prognostic Factors and Survival of Laryngeal Cancer in Cameroon

Background: Laryngeal cancer is a major cause of morbidity and mortality worldwide. It is ranked worldwide as the second ENT cancer with 238,000 new cases and 106,000 deaths each year. In Africa, data on the prognostic factors and the survival of this pathology remain quite limited. Objective: To study the prognostic factors of laryngeal cancer and the survival of patients with laryngeal cancer in Yaoundé and Douala. Methods and Materials: We performed an analytical, longitudinal (retrospective) study over a period from January 1, 2009 to December 31, 2018 including all patients with histologically proven laryngeal cancer, at the ENT, oncological, anatomopathological, radiotherapy and surgery Department of three reference health structures in the cities of Douala and Yaoundé (Laquintinie Hospital and General Hospital of Douala, General Hospital of Yaounde). The data collected were recorded and analyzed by SPSS version 25 and Excel 2013 statistical computer software. Survival was determined by the Kaplan Meier method and the search for prognostic factors was carried out using the Cox proportional hazards model. The significance level was p = 0.05. Results: We selected 80 patients whose vital status we knew and who had been followed up after histological evidence. The sex ratio was 5.66. The median age at cancer diagnosis was 62 years old. 60 (75%) were exposed to tobacco, 52 (65%) had alcohol-tobacco poisoning. The Center and Littoral regions were the most represented with 37.5% and 48.8% respectively. Dysphonia was present in 98.8% of patients. The histological type encountered was squamous cell carcinoma in 78 patients; in the majority of cases the cancer was diagnosed at stage IV and the glottis was the most frequent site (86.2%). The median overall survival was 1.41 with 95% CI [1.08 - 1.74]. The overall survival rates at 1 year, 3 years, 5 years and 8 years were 70%, 18%, 3% and 1.5%, respectively. The poor prognosis factor found was: age greater than or equal to 70 years. Conclusion: Present study showed that survival in laryngeal cancer in Cameroon is very low with a median overall survival of 1.41 years. The overall survival rates at 1 year, 3 years, 5 years and 8 years are 70%, 18%, 3% and 1.5%, respectively. The age greater than or equal to 70 years is the poor prognosis factor, while receiving surgery in combination with neoadjuvant chemotherapy or surgery in combination with adjuvant radiotherapy is the factor of good prognosis.

Imaging of Degenerative Pathologies of the Lumbar Spine: Professional Habits in Some Hospitals in Cameroon

Background: The lumbar spine is the portion most frequently involved in degenerative pathologies. Everyone will suffer one day from “low back pain”. These pathologies are very frequent: epidemiological studies have shown that 65% to 90% of the general population could be affected by low back pain (lumbago) which could become chronic at acertain stage or could be complicated (2% to 4%) of cases could end up affecting nerve roots. Chronic low back pain causes a major public health problem in terms of morbidity and socioeconomic repercussions. Purpose: The overall purpose of this study is to evaluate the professional habits of exam applicants in case of degenerative pathologies of the lumbar spine, to Appreciate the knowledge of clinicians on the usefulness of medical imaging techniques in the event of suspicion of a degenerative pathology of the lumbar spine and finally to evaluate if the professional habits of requesting examinations in Cameroon comply with the Recommendations for Clinical Practice. Methods: A cross-sectional and descriptive study was used and was based on questionnaires distributed to those practitioners who requested for these diagnostic medical imaging studies and procedures at Yaounde General Hospital (HGY), Yaounde Central Hospital, La Cathedrale Medical Center, Yaounde University Teaching Hospital, the Douala General Hospital, the Laquintinie Hospital of Douala, the Military Hospital of Douala, the Daniel Muna Memorial Clinic of Douala, the International Center for Clinical and Medicine Imaging, the Ngaoundere Regional Hospital and the Protestant Hospital of Ngaoundere (HPN), from April 2020 to March 2021. Data collected was processed and analyzed via Epi Info version 12.0 and the statistical test used for correlation was Chi2. Results: 137 practitioners were retained among whom, 90 were male and 47 females, their average age being 46 years with working experience less than 5 years (35.8%). The results obtained show that parameters such as availability and accessibility of the required diagnostic medical imaging modalities could greatly influence the examination prescription. On the contrary, few prescribers were less interested in the costs and secondary effects due to irradiation and the invasiveness of these examinations. Professional habits of those who requested these examinations were in majority closer in line with the recommended clinical practices. However, an average of 43.78% of prescribers never followed recommendations nor applied them. On the other hand, knowledge and the application of these recommendations increased as the prescriber’s working experience too increased. Up to 54.47% of prescribers were not aware of those recommendations about requesting these examinations. Conclusion: Our results indicate that Medical Diagnostic Imaging techniques are not judiciously and optimally exploited in the diagnosis of degenerative pathologies of the lumbar spine and it would be necessary to establish recommendations for clinical practice adapted to Cameroonian realities.

Correlates of diabetic polyneuropathy of the elderly in Sub-Saharan Africa.

BackgroundDiabetic polyneuropathy is associated with significant physical disability among older adults. However, their frequency and correlates are not well known in the older adults in Sub-Saharan-Africa. The objectives were to evaluate the hospital-based prevalence of diabetic polyneuropathy and identify its correlates in older adults.MethodsOver a period of 5 months, a cross-sectional survey was carried out at Douala Laquintinie Hospital (DLH), a main reference hospital in Douala, the economic capital of Cameroon. Participants in our study group comprised all patients with type 2 diabetes, whatever the reason for their reporting to the hospital. Diabetic Polyneuropathy was defined according to a Diabetic Neuropathy Examination score > 3/16.ResultsA total of 159 older adults with diabetes were examined during this recruitment period, among whom 106 (66.7%) were women. The mean age was 68.3 ± 6.5 years. Diabetes median duration was 108 months. For all patients assessed using the Diabetic Neuropathy Examination score, polyneuropathy was reported in 31.4%; among them, polyneuropathy proved symptomatic in 78% of them. Correlates of polyneuropathy were glycated hemoglobin (p = 0.049), HIV infection (p = 0.031) and albuminuria (p< 0.001), even after adjustment for age, gender and duration of diabetes.ConclusionA third of older adults with diabetes who visited our hospital were diagnosed with prevalent diabetes-related polyneuropathy. It shows that early detection is required through routine screening and regular follow-up examinations in order to reduce the risk of disability and improve the quality of life in elderly diabetics.

Prevalence of anti-measles antibodies in infants from 0 to 9 months: case of three hospitals in the city of Douala (Cameroon)

Background: is an acute infection, usually occurring in childhood, caused by a virus of the Paramyxoviridae family. Infants born to mothers immunized against measles benefit from the transplacental transfer of anti-measles antibodies of the IgG type, and are in principle protected against infection in the first months of life. Methods: A cross-sectional study was carried out on infants born at term and not vaccinated against measles, in three hospitals in the city of Douala (General Hospital, Gynaecologic Obstetrics and Pediatrics Hospital and Laquintinie Hospital). The qualitative and quantitative research of type G immunoglobulins in serum or plasma was carried out by the ELISA technique using the Measles Virus IgGTM kits, followed by a colorimetric reading. Sociodemographic and biological data were collected and analyzed. Results: A total of 178 infants were recruited of which 54.5% were male. The average age was 3 months ± 2.6 and the most common age group was 0 to 1 month. Antibody levels ranged from 8 to 5,700 mIU/ml and 39.9% of infants had protective levels against measles. The presence of antibodies based on age was 81.1% in 0-1 months infants, 51.1% 1-3 months, and 8.2% 3-6 months, respectively. Only one of them was protected in the 6 to 9 month age group. We observed a significant association between infant age, maternal history of measles and the rate of protected infants. Conclusion: The frequency of maternal antibodies in infants was low. Strategies should be put in place to strengthen the fight against this resurgent disease.

Maternal Mortality in Cameroon: Prevalence survey and Epidemiological Aspects at the Laquintinie Hospital in Douala From 2011 to 2016

Introduction: Maternal mortality is the death of a woman occurring during pregnancy or within 42 days after its termination, whatever its duration and location for any cause determined or aggravated by pregnancy or the care it motivated. All countries of the world are affected by maternal mortality. Objective: The objective of this study was to study the epidemiology of maternal mortality at the Laquintinie hospital in Douala. Methodology: This was a cross-sectional study with retrospective collection of data on maternal deaths at the Laquintinie Hospital in Douala from January 1, 2011 to December 31, 2016. All cases of maternal death conform to the WHO definition were included. The data collected was entered and analyzed respectively by Cspro 6.3 and IBM SPSS 23 software according to age, marital status, type of occupation, parity, quality of prenatal consultation, level of education, patient's place of origin, time of arrival at the hospital and causes of death. Results: Two hundred and fifty-four (254) maternal deaths were identified during the study period for fifteen thousand four hundred and ninety-eight (15,498) live births, representing a maternal mortality rate of one thousand six hundred and thirty-eight per one hundred thousand live births (1638/100000 NV). The 25-30 age group was the most affected (33.1%) by death, with an average age of 29.26 ± 6.1 years. Housewives (51.6%), Singles (73.6%) women with primary education 54.3% were mostly affected. Hemorrhage was the leading direct cause of death (67%) followed by complications from hypertensive disease (14.1). Malaria and HIV infection were the main indirect causes. The majority (53.93%) of the women in our series died within an hour of admission. Conclusion: The maternal mortality rate at Laquintinie Hospital in Douala is 1,638 /100,000 Live Births. The 25-30 age group was the most affected. Singles, housewives, women referred from health centers, women with a primary education level constituted the mask and the majority of women died less than an hour after admission

Clinical predictors of significant intracranial computed tomography scan findings in adults experiencing headache disorder.

IntroductionRadiological assessments for adult headache disorder show significant intracranial findings in 2.5% to 10% of performed computed tomography scans (CT-scans), leading to an overuse consideration for CT-scan requests by physicians in headache-experiencing patients. Therefore, we undertook this study in order to determine predictors of significant intracranial CT-scan findings in adults experiencing headache disorder; in order to help physicians better select patients who need imaging, which would subsequently decrease the costs of headache disorder management and the useless irradiation rates.MethodsWe carried out a cross-sectional study in the medical imaging departments of Yaounde Central Hospital and Douala Laquintinie Hospital, which are two teaching hospitals in Cameroon, over a period of five months. We consecutively and non-exhaustively included all consenting patients aged eighteen years and above, referred to the radiology department to perform a head CT-scan as aetiological workup of headache disorder, from either a traumatic or non-traumatic mechanism. Patients having a known brain lesion and those with a Glasgow coma scale less than thirteen were excluded. The clinical history of patients was taken and a complete physical examination was performed. Demographic data, clinical characteristics of the headache, results of neurological and physical examinations were collected and correlated to the results of head CT-scan.ResultsWe enrolled 169 patients in the study, 56.2% were males, with a sex ratio of 1.3; sudden onset of headache increased by two the risk of discovering significant intracranial pathology (p = 0.032). Occipital and cervical location of headache, headache evolving by crisis, and recurrent paroxysmal headache were rather significantly correlated to no structural brain finding. An abnormal neurological examination with specifically abnormal stretch reflexes, aphasia, loss of consciousness, raised intracranial signs, weakness, and meningeal signs were predictive of structural intracranial pathology. Otorrhagia, epistaxis, and periorbital ecchymosis in addition were predictive in post-traumatic headaches.ConclusionAbnormal results from neurological examination are the best clinical parameters to predict structural intracranial pathology on CT-scan in adult patients experiencing headache disorder. In case of post-traumatic headaches, in addition, otorrhagia, epistaxis, and periorbital ecchymosis are too highly predictive.

HIV infection and Mycoplasma co-infection: case-control study in a female population of Douala (Cameroon)

Objective: To determine the impact of Human Immuno-Deficiency Virus (HIV) on co-infection with Mycoplasma hominis and Ureaplasma urealyticum in HIV-infected women. Methodology: A case-control analytical study based on standardized questionnaire interview and cervical sample collection after informed consent obtained among HIV-positive and HIV-negative women from January 2nd, 2017 to June 30th, 2017 received at the laboratory of Laquintinie Hospital in Douala. Samples collected were used for mycoplasma research, quantification, and antibiogram using the mycoplasma IES kits. Socio-demographic, clinical and biological variables of interest were entered and analyzed on Microsoft Office Excel 2013 and Statistical Package for Social Sciences (SSPS) software version 20 and the chi-square correlation test was used with significance at the threshold of P &lt;5%. Results: We analysed 136 samples of women aged 18-65years, among which 96 HIV+(cases) matched with 40 HIV-(controls). The mean age of the case group was 39.08±10.22 years and that of the control group was 33.28±8.68 years. Genital mycoplasmas were found in 58.3% of cases, with a high frequency for U. urealyticum (19.8%) against 2.1% for M. hominis and the two germs were associated in 32.3% of cases. In the control group, the carrier rate was 62.5%, with a frequency of 17.5% for Ureaplasma alone and no carrier for M. hominis alone. Co-infection with the two germs in this group was 40%. The majority of HIV+women had a CD4 count above 200, and no significant association was found between CD4 count and the presence of mycoplasma in these women (P=0.094). Conclusion: Mycoplasma infection is common in HIV+ women. However, there is no significant association between the CD4 count and the presence of these mycoplasmas.

Malaria in patients with sickle cell anaemia: burden, risk factors and outcome at the Laquintinie hospital, Cameroon

BackgroundIt is believed that the current prevalence of malaria in endemic areas reflects selection for the carrier form of sickle cell trait through a survival advantage. Malaria has been incriminated as a great cause of mortality in people with sickle cell disease (SCD). However, people with SCD, a high-risk group, do not benefit from free or subsisized malaria prevention and treatment in Cameroon unlike other vulnerable groups which may be due to insufficient evidence to guide policy makers. This study aimed at describing clinical and socio-demographic characteristics of patients with malaria, determining the prevalence of malaria in hospitalized children and in those with SCD and without, compare frequency of presentation of malaria related complications (using clinical and laboratory elements that define severe malaria) between children admitted for malaria with SCD and those without and finally, determing the risk factors for death in children admitted for malaria.MethodsThis was a retrospective analysis of admission records of children age 1 to 18 years with a confirmed malaria diagnosis admitted at the Laquintinie Hospital during January 2015 through December 2018. Clinical features, laboratory characteristics and outcome of malarial infections, stratified by SCD status were studied. Patients with HIV infection, malnutrition, renal failure and discharged against medical advice were excluded from the study. Data were analysed using Epi-info 7 software and analysis done. Chi square test, Odds ratios, CI and student’s t test were used to determine association between variables. Statistical significance was set at p-value ≤0.05.ResultsThe prevalence of malaria was lower among children with SCD than it was among children without SCD (23.5% vs 44.9%). Similarly, among those with a positive microscopy, the mean parasite density was significantly lower among children with SCD than it was among children without SCD (22,875.6 vs 57,053.6 parasites/ μl with t-value − 3.2, p-value 0.002). The mean hemoglobin concentration was lower in SCD as compared to non SCD (5.7 g/l vs 7.4 g/l, t-value − 12.5, p-value < 0.001). Overall mortality in SCD was 3.4% and malaria was reponsible for 20.4% of these deaths as compared to the 35.4% in non SCD patients. Convulsion and impaired consciousness were significantly lower in SCD group (OR:0.1, CI: 0.1–0.3, p value < 0.01 and OR:0.1, CI:0.1–0.2, p-value < 0.001 respectively). Death was significantly higher in SCD patients with malaria as compared to SCD patients admitted for other pathologies (3.2% vs 1.5%., OR:2.2, CI:1–5, p-value 0.050).ConclusionThe SCD population has a lower mortality related to malaria compared to the non-SCD population. Meanwhile, within the SCD population, those admitted with malaria are twice more likely to die than those admitted for other pathologies. Jaundice, hepatomegaly and splenomegaly were common in SCD with malaria, however no risk factors for malaria severity or malaria related death was identified.

Personal Control in Newly Diagnosed Essential Hypertensive Patients and Health Behavior Adherence: Case Study at the Laquintinie Hospital

Personal Control in Newly Diagnosed Essential Hypertensive Patients and Health Behavior Adherence: Case Study at the Laquintinie Hospital

Hypercoagulability in the Context of Pre-Eclampsia: Case-Control Study at the Laquintinie Douala Hospital (Cameroon)

Introduction: Preeclampsia is one of the major causes of maternal and neonatal morbidity and mortality in the world. The complexity of its etio-pathogenesis involves, among other things, hypercoagulability, which alone accounts for about 15% of his deaths. Our objective was to study the parameters of coagulation (prothrombin level, activated cephalin time) in pregnant women with preeclampsia and non-preeclampsia at Laquintinie Hospital in Douala. Methodology: We carried out an analytical cross-sectional case-control study from November 01st, 2018 to May 31st, 2019, in the gynecology and obstetrics department of Laquintinie Hospital in Douala. We included preeclampsia and non-preeclampsia pregnant women with a gestational age greater than or equal to 20 weeks amenorrhea. The variables of interest were age, pregnancy, parity, gestational age, marital status and body mass index, prothrombin level (PL) and activated cephalin time (ACT). Hypercoagulability was defined by the presence of at least one of the following abnormalities: PL > 100%, ACT 25 seconds. Statistical tests were considered significant for a p-value 0.05. Results: We recruited 150 pregnant women including 50 preeclampsia matched with 100 non-preeclampsia. The majority age group in both groups was 25 - 30 years (32% versus 37%). We found a high PL in 58% of preeclampsia versus 22% of non-preeclampsia patients (p = - 10.20; p = Conclusion: Our study confirms the existence of hypercoagulability associated with preeclampsia, in particular in relation to an increase in the level of prothrombin.

HIV Infection Testing and Service Delivery of One Accredited Treatment Center in Cameroon

Effectiveness of Anonymous and free Voluntary Counseling and Testing (AVCT) Centers in the HIV prevention and care can be threatened by a low use of its service delivery, especially in developing countries. This study was designed to obtain reliable data on the current state of the quality of the services and, evaluate the factors that are associated with use of one Accredited HIV/AIDS Treatment Center (AHTC). A cross-sectional and prospective study was conducted among adults attending the AHTC of the Douala Laquintinie Hospital (DLH), Cameroon. Anonymous interviews including both open and closed ended questions were conducted in participants selected by convenience sampling. Descriptive and logistic regression analyses were performed using StataSE11 software (version 11 SE) in data analysis. Overall 80 (64%) of 125 adult volunteers for HIV testing reported that the reception at AHTC was excellent and 69.6% (80/115) of those who underwent the pre-test and among them, 49.6% were satisfied with the pre-test. Less than half of the participants were explained the merits of HIV testing. The interview was conducted in a confidential framework in 60% of those who underwent the pre-test and, 41.7% explained the merits of HIV testing. Among the 10 evaluated minimal items that the provider should have addressed, less than 6 items were done in 66.9% of the participants and between 9 and 10 items for 11.3%. Informed consent agreement was obtained in 89.60% of volunteers. Knowledge of HIV status was more reported among men than women who reported more requesting the HIV testing for prevention strategies for an exclusive sexual relation (p=0.038). The prevalence of HIV infection was 25.6% and, primary education remained significantly associated with higher risk of HIV infection in multivariate analysis (OR=0.11; IC95%=0.015-0.72; p=0.022). These results highlight the important of the appropriate sensibilization for the responsible implementation of the pretest counseling steps by health care providers in the AHTC of the DLH.

Knowledge and Contribution of Nurses in the Prevention of Bedsore Decubitus in the Surgical Ward

Bed sore commonly known as pressure sore, skin ulcers or decubitus are cuts, lesions or swelling caused due to prolonged pressure on any part of the body and usually affects part of the body over bony areas. Bedsore commonly occur among handicapped, disabled, paralyzed or bedridden patients as they are unable to change their position frequently and continuous pressure on specific part of body lead to bed sores. This disorder can be treated effectively if found early but can become a life-threatening condition as it cuts off blood circulation to parts of the body (Darke Smith et al.,2010). Most prominence are the buttocks, tailbone and shoulder blades. This can be caused by friction, pressure etc. Bedsore has 4 stages if not well managed. Some of the early nursing intervention should be turning the patient every 2hrs cushioning, preventing moist and inspecting the patient’s body daily. Some complication like cellulitis, bone and joint infection, cancer are some of the possible complication. This study aimed at assessing the knowledge and contribution of nurses in the prevention of bedsore decubitus in the Laquintinie Hospital of Douala. From October 2019- April 2020. A cross sectional hospital base study was used 30 questionnaires, closed and open questionnaire was shared to nurses in the in the surgical services. Regarding my research, it is concluded that nurses are aware of the prevention of bedsore; they had a positive attitude and practices toward it. Even though the result is fair i found some areas of lapse and think they can be solved by creating awareness through educational techniques.