ABSTRACT
Comorbidity of diabetes mellitus and hypertension is common, with both diseases and their treatment being able to cause liver function abnormalities, which can lead to liver failure. This study aims to access the effect of drugs used in the management of these diseases on liver function. A cross sectional study will be conducted, followed by a case-control design. Ethical clearance will be obtained from the Faculty of Health Sciences Institutional Review Board and administrative authorization from the various hospital directorates. The sampling procedure adopted will be consecutive and shall include all consenting patients aged 21 years and above, treated for hypertension, diabetes mellitus, or both. Pregnant women, patients with liver disease, viral hepatitis, as well as those on known hepatotoxic drugs will be excluded. Clinical, lifestyle, anthropometric data as well as venous blood samples will be collected and analyzed for liver enzymes (aspartate transaminase, alanine transaminase, and gamma glutamyl transferase) total or conjugated bilirubin, hepatitis B surface antigen and hepatitis C virus antibodies. Student T-test will be used to compare means and chi-square to test for proportion. Associated factors will also be determined using odds ratios. A p-value of <0.05 will be considered significant. The prevalence of liver function abnormalities shall be determined. Determinants of liver function abnormalities shall also be identified.
Subject(s)
Humans , Male , Female , Liver Failure , Hepacivirus , Hypertension , Liver Function Tests , Diabetes Mellitus , LiverABSTRACT
Depression is a debilitating mood and mental disorder affecting approximately 13% of postpartum mothers worldwide with a prevalence of 25%-60% in low and middle income countries. The prevalence is yet to be published in Cameroon. Aim: This study was carried out to determine the prevalence, severity and risk factors of depression among postpartum mothers in Limbe Health District (LHD), Cameroon. Study Design: It was a cross-sectional, analytic community-based survey. A non- probability convenient sampling method was used to recruit four hundred participants in eight communities in the LHD. Postpartum mothers with infants aged 1-12 months constituted the study population. Data collected using the Patient Health Questionnaire-9 (PHQ-9) and a structured questionnaire was analyzed using Epi-Info version 3.5.4. A p-value of less than 0.05 was considered statistically significant for variables. Results: The prevalence of depression among participants was 61.8% based on PHQ-9 depression scale. The severity of depression varied from mild 54.7%, moderate 43.3% to severe2.0%. Socio-demographic factors associated with depression were: unemployment [OR=2.02;95% CI:(1.35-3.86), p=0.002], unsatisfactory support or assistance for care of baby [OR = 4.89; 95% CI: 2.25-10.612), p = < 0.001], marital conflict [OR = 0.44; 95%CI: (0.23-0.82), p = 0.009] and serious financial problems [OR = 0.31; 95% CI: (0.18-0.54), p =0.002]. Unplanned pregnancy was the only obstetric factor associated with depression [OR=2.02; 95% CI: (1.24-3.29), p= 0.004]. Conclusion: The prevalence of depression among postpartum mothers in the LHD was high. Unemployment, unsatisfactory assistance for child care, marital conflicts, financial difficulties and unplanned pregnancy were risk factors for postpartum depression.
ABSTRACT
Objective: This study was aimed at determining the prevalence of Hepatitis B and associated risk factors such as CD4+ counts variation and liver enzymes among HIV co– infected patients and those with HIV mono-infections only. Design and Methods: Three hundred and fourteen (314) HIV patients took part in this cross sectional case control study. Socio-demographic information and history of exposure to risk factors such as scarification, blood transfusion, and unprotected sexual intercourse and alcohol consumption, were obtained through a well-structured questionnaire. Serological tests were done to determine the presence of Hepatitis B (HB) surface Antigen, liver enzymes’ activities were estimated and CD4+ cell counts evaluated using standard laboratory methods. Results: Out of the 314 HIV patients, 20 (6.4%) tested positive for hepatitis B surface antigen (HBsAg) while 294 (93.6%) were negative. Most HIV patients co–infected with HBV were in the age group 31 to 45 years. There was no significant variation when co-infection and mono-infection groups were compared based on age and sex (p=0.7405 and p=0.3361). More males, 7 (2.23%) against 2 (0.64%) females (P=0.02) co–infected with HBsAg had a CD4+ cell counts in the range 201-350cells/µL. No significant difference of liver transaminases (SGPT and SGOT) levels between mono and co-infection groups (P>0.05) was observed. No association of HBsAg with observed risk factors among HIV patients was noted. Conclusion: The study concluded that the prevalence of hepatitis B among HIV patients was 6.4% with majority of the patients having CD4+ cell counts within 201-350. The liver function parameters (transaminases) were not affected with HIV/HBV co-infection.
ABSTRACT
Intestinal parasitic infections (IPIs) are among the most prevalent infections in humans in developing countries and are responsible for considerable morbidity and mortality. Most of them are transmitted by the faecal-oral route. In general; situations involving unhygienic conditions promote transmission [1]. These infections are globally endemic and have been described as constituting the greatest single worldwide cause of illness and disease [2]. They are associated with poor hygiene and lack of access to safe water [3]. Food handlers play an important role in their transmission [4]. Ignorance is also a contributing factor to transmission especially among people living in rural areas where level of awareness is relatively low [5]. Like the majority of the parasitic diseases; these infections are influenced by human behaviour especially their hygienic practices; and failure to take advantage of available screening services or comply with treatment [6]. In Cameroon; IPIs are recognized by the Ministry of Public Health to be an important public healthproblem ranking second to malaria [7]. There has been periodic de-worming in most endemic areas in the country; but studies suggest that there is a high rate of re-infection [8]. A change in hygienic behaviour is advocated to reduce these infections. Health education; especially in rural communities where the level of awareness is quite low and sanitary conditions poor [9] could contribute to the reduction of the prevalence of infection: This issue is addressed in this study. Methods : Ten villages in the South-West Region of Cameroon were grouped in pairs. The grouping was based on the fact that each pair was made of 2 rural communities sharing the same social; geographical and climatic features. The pair comprising Kake II and Barombi-Kang was randomly selected among five. An intervention study was conducted from January 2010 to July 2010 in two primary schools in the 2 selected villages (Kake II and Barombi-kang). They are separated by a distance of about 30 Km. Theformer village served as the experimental school; whilst the latter served as the control (random selection). The two villages are typical African rural communities. There is no pipe-borne water; electricity; or drainage system. Each of the villages has a government primary school; but no secondary school. The inhabitants are farmers practicing peasant farming and petty trading. Prior to the start of this study; permission was sought from the school authorities and parents were informed about the purpose; objectives and benefits of the study; as their involvement was a key factorfor its success. They were made to understand that it was not a school obligation to take part in the study; neither was it a prerequisite for accessing publicly available health facilities. Written informed parental consent forms were distributed one week prior to the beginning of sample collection. An ethical clearance was obtained from the Regional Delegation of Health of the South West Region in Buea (Ref.R11/MPH/SWP/RDPH/FP-R/5341/94)