RISK FACTORS FOR SPONTANEOUS ABORTIONS IN TWO YAOUNDÉ DISTRICT HOSPITALS

Background. Abortion is the termination of a pregnancy before the age of fetal viability which, according to the WHO, is 22 weeks of pregnancy and/or with the fetus weigh less than 500 g. Spontaneous abortion is a public health problem. It's one of the most common complications of pregnancy. In order to contribute to the decrease of the morbidity and mortality linked to spontaneous abortions, we conducted this study, which the general objective was to study risk factors of spontaneous abortion. We carried out a cross-sectional case-control study in the District Hospitals of Biyem Methods. - Assi and Efoulan in Yaoundé. During six months, we collected 3774 records of pregnant women from January 1, 2020 to December 31.,2020. For each case (record of woman who had a spontaneous abortion), two controls (records of those who gave birth spontaneously at term) of the same age, were immediately recruited. Data were analyzed using IBM SPSS Version.23.0 software. Tools used to assess our results were: Fischer's exact test, frequency, odds ratio (OR) and P, with P signicant for any value less than 5%. We recruited 104 cases and 208 controls. Being unmarried, being from the littoral region, having a Results. history of stress, smoking, having started antenatal care and having had prenuptial check-up, independently increased the risk of spontaneous abortion with respectively aOR = 2.8 IC=1.24-6.31 aP= 0.013, aOR=4.31 IC= 1.09-17.02 aP= 0.037, aOR=11.86; CI=3.88-36.19; aP=<0.001, aOR=8.57; CI=3.41-21.54; aP=<0.001, aOR=10.4; CI=1.12-96.82; aP=0.04) and aOR=3.37; CI=1.67-6.79; aP<0.001). These risk factors being mostly modiable, should be sought and prevented Conclusion. in order to improve the prognosis of pregnancies in our context

Human and Environmental Reservoirs of Intestinal Parasites in the City of Yaoundé, Cameroon: An Update in the Context of COVID-19 Pandemic

Aims: Intestinal parasitic infections are persistent in Africa, and we questioned here whether prevention measures imposed by the occurrence of the COVID-19 pandemic in 2020 could alleviate this threat in lowlands of the city of Yaoundé, Cameroon. Study Design: We monitored the trend of intestinal parasites in human and environmental samples from the seven subdivisions of the city of Yaounde, before (November-December 2019) and during (July-August 2020, November-December 2020) the COVID-19 pandemic. Methodology: Parasitological analysis were performed to check for the presence of helminths and protozoans in stools from inhabitants as well as in water, soil and fresh vegetables, using standard Kato Katz and Formol Ether methods.The minimum effective sample size considered for the estimation of parasite richness, parasite infection and contamination indexeswas 30 for human and 30 for environmental samples (i.e. soils, water and vegetables) per location. Results: Of the 19 parasite species identified in human and the environments, twelve were helminths and seven protozoans. The overall parasite species richness reached 16 in 2019 (12 helminths and 4 protozoans) and 19 in 2020 (12 helminths and 7 protozoans), with about 62.5-68.4% of species shared by human and environments. The parasite frequencies in human (21.03%) and water/soils (32.3%) in 2019 did not differ statistically with those of 2020 (14.6-20.3% and 10.8-35.4%, respectively). The contamination rate of vegetables (i.e. carrots, lettuce, basil, celery, etc.) has increased from 2019 (6.1-9.1%) to 2020 (9.1-24.2%), and was frequently due to roundworms, hookworms, Entamoeba and Cryptosporidium cysts. The findings suggest persistent risk associated with intestinal parasite irrespective to measures imposed by COVID-19 in study locations. Conclusion: The current control approaches may therefore integrateecological epidemiology of the intestinal parasite infections as complementary strategy in African cities.

Profil clinique de la surdité de l'enfant à Yaoundé / Clinical profile of child deafness in Yaounde

In Cameroon, the prevalence of deafness in children is 3.6%. The aim of this study was to describe the clinical profile of these hearing impaired children at the time of diagnosis. Patients and methods.This was a descriptive cross-sectional study that took place between November 2020 and June 2021 and involved 127 hearing impaired children. Results.The mean age of these children was 9.2 ± 3.9 years, with extreme values of 1 and 15 years. The sex ratio was 1.3. The average number of children in the siblings was 3.5 ± 1.8 children and 30.7% occupied the 1st rank in their siblings. The average birth weight was 3269 ± 0.685g. The neonatal history was found in 11.81% of the cases while the postnatal history related to 32.28% of the cases. Maternal alcoholism and parental genital infections were found during pregnancy. Familial deafness was found in one of the mothers (0.4%) and in the siblings in 3.1% (n=4). At the time of diagnosis, the median age was between 0 and 24 months, the mode of onset was old and 96.9% of children had bilateral deafness. The absence of reaction to noise and the delay of language were the most found modes of revelation. Moderate and severe deafness were the most represented and were mostly sensory or mixed. Among these deaf children, 4%presented a handicap or an associated pathology. Conclusion.The causes of child deafness in Yaoundé are acquired in perinatal period. This deafness is diagnosed in the perilingual period and remains dominated by bilateral deafness, whether severe or profound

First delivery of a COVID-19 positive patient in Cameroon

Since its appearance in China in December 2019, COVID-19 which is caused by the SARS-CoV-2 virus has become a real global health problem. Pregnant women are not immune to this novel infection, which makes it difficult for proper management of pregnancy and childbirth. Authors present here the first case of childbirth in Cameroon of a 19-year-old adolescent tested positive for COVID-19.

Risk factors of intrauterine fetal death: a case control study at the maternity of Yaoundé Central Hospital

Background: Intrauterine fetal death (IUFD) is the death before the beginning of the work of the fetus from the 28th week of pregnancy or a fetus of weight greater than or equal to 1000g. It occurs in 98% in poor countries, particularly in sub-Saharan Africa. The aim of this study was to identify the risk factors for IUFD in low-income countries.Methods: All the women with preeclampsia from 30 weeks onwards were enrolled in the study. The umblical artery (UA) Systolic-diastolic (S/D) ratio >2 standard deviation (SD) or UA-pulsatility index (PI) and UA-resistive index (RI) >2 SD were taken as abnormal. The middle cerebral artery (MCA) was visualised and cerebroumblical PI ratio calculated. MCA-RI<2SD was taken as abnormal.Results: Independent risk factors for IUFD are age over 30 years (ORa = 2.1, P = 0.052), (ORa = 2.4497, p = 0.01), household occupation (ORa = 2.0097, p = 0.0282), hypertension disorders (ORa = 2.11, p = 0.0176), antepartal haemorrhage (ORa = 3.9635, p = 0.000), multiparity (ORa = 13.3089, p = 0.0056).Conclusions: The main risk factors for IUFD identified in our study are maternal age greater than 30 years, hypertension, antepartal haemorrhage, multiparity, and the household profession. Any pregnant woman who has one of these factors should be follow-up closely during pregnancy with a weekly assessment of fetal well-being by the 28th week.

Overweight and Obesity among School-Aged Adolescents in Yaounde (Cameroon)

@#Introduction Overweight and obesity are a major public health problem due to its association with serious chronic diseases. Concerning childhood overweight/obesity, its rise in developing countries is so that there is a need to provide more evidence on its burden and associated factors in order to set preventive measures. Methods This study was designed to know the prevalence and related factors of overweight and obesity amongst adolescents in Yaoundé- Cameroon, and to draw their epidemiological profile. Results The prevalence of overweight and obesity was 13.6% and 4.3% respectively. Results revealed that practices associated with overweight and obesity are increase in age (R = 0.42, p < 0.001), female gender (p < 0.001). In addition, the use of bikes, cars or buses to go to school compared to walking (OR: 0.26; CI: 0.14 – 0.64; p = 0.0026) increase the risk of being overweight or obese. After adjusting the multivariable logistic model for age and sex with our study variables, it reveals that the odds of being obese for those who consume alcohol once a week were nine fold higher than that of those who consumed 2-5 times a week (OR: 9.37; CI: 1.34 to 193.41). Conclusions This results show that there is a need for health education in schools so as to help in health promotion and prevention, therefore avoid chronic disease conditions at older ages.

Co-Infection of Hepatitis B Virus and Hepatitis Delta Virus in Yaounde-Cameroon.

Aims: To determine the seroprevalence of HDV as well as the virological and clinical characteristics of HBV mono-infected and HBV/HDV co-infected patients. Study Design: The few studies on HDV in Cameroon have reported a high prevalence of this viral infection. This is a first step in describing the virological and clinical profile of HBV mono-infected and of HBV/HDV co-infected patients. Place and Duration of Study: Blood collection was carried out in the Gastroenterology Unit of the Yaounde University Hospital Centre, Yaounde General Hospital and “Centre Médical la Cathédrale”, from August 2012 to May 2013. Methodology: We included into this study treatment-naïve HBV-infected patients from Yaounde irrespective of age and gender free of HIV and HCV infection. Blood samples were collected from each patient for laboratory analysis. Detection of HDV antibodies (Diasorin, Germany) was performed by ELISA and viral load for HBV and HDV was determined using real-time PCR (Abbott Molecular Diagnostics). Patients were classified clinically into low replicative hepatitis, immune tolerance and chronic active hepatitis. Moreover, ultrasound and liver histological data were collected. Results: The population comprised 128 chronic HBV-infected patients of which 77 (60.16%) were male and 51 (39.84%) were female. We found 29 HDV-positive patients representing 22.66% of the population. In the HBV/HDV co-infected group, the mean viral load for HBV was significantly low compared to patients with HBV mono-infection (P = .01). These patients also presented with higher liver cytolysis compared to HBV monoinfected patients (P<.001). Chronic active hepatitis was significantly more prevalent in HBV/HDV co-infected patients (68.96%) compared to HBV mono-infected patients (20.20%). Conclusion: We found that HBV/HDV co-infection results in suppression of HBV replication and such patients show broader sequelae of liver disease. The prevalence of HBV and HDV co-infection is high in this population. Routine screening of HBV-positive individuals for HDV should be implemented in the health services nationwide.

An Assessment of Hygiene Practices and Health Status of Street-food Vendors in Yaoundé, Cameroon.

Background: From 1993, civil servants in Cameroon were subjected to a new working schedule, according to which, work starts every working day from 7.30am to 3.30pm with a short lunch break from 12 noon to 1.00pm. However, this new regulation was not accompanied by effective measures such as the creation of formal eating houses or canteens to ensure the provision of services that could satisfy the food needs of workers. Consequently, there has been a development and concentration of informal food vendors around public offices. While street foods are an important source of ready-to-eat nutritious, low-cost meals for the urban poor, the health risk posed by such foods may outweigh their benefits. Objective: This study aims at assessing personal hygiene and health status of vendors involved in informal sales of food in Yaoundé. Methods: In this cross-sectional epidemiological design, 837 food vendors were investigated through medical examinations notably stools analysis for ova and cysts of parasites. Questionnaires were also administered to the vendors. The vendors were selected from within the three main places in the city where people congregate: schools, market places, and government ministries/office. Results: The personal hygiene of a majority of street-food vendors in Yaoundé (87, 1%) is of low and this is reflected on their health status because among the 837 food vendors enrolled in the study, 379 were found infected with one or more faeco-orally transmissible parasites, a 45% prevalence rate. Conclusion: There is the need to improve the personal hygiene of food vendors in Cameroon in order to reduce the prevalence of food-related diseases. This can be done through adequate sensitization programmes on personal and food hygiene and the development of food handling policies.

Comparative Analysis for Estimating Hydraulic Conductivity Values to Improve the Estimation of Groundwater Recharge in Yaoundé-Cameroon.

Climate change will deeply affect the precipitation and evapotranspiration around the world. The sustainability of groundwater resources is crucial for regional and local communities, which is intimately tied to the changing recharge rate. To accurately assess the recharge rate, different methods were used to estimate hydraulic conductivity of an unconfined aquifer in this study. Particle size method with four empirical formulae, together with in-situ aquifer tests and the inverse modelling techniques were integrated to evaluate their potential for the determination of hydraulic conductivity of unconsolidated aquifer materials in order to improve groundwater recharge estimation. Results showed a wide disparity between the granulometric estimates of the hydraulic conductivity and the in-situ and modelling techniques. Slug test values range from 5.13 x 10-6 m/s to 4.96 x 10-5 m/s whereas the infiltration test (Porchet method) results vary from 1.91 x 10-7 m/s to 1.16 x 10-6 m/s. The simulated hydraulic conductivity values range from 2.54 x 10-7 m/s to 6.36 x 10-7 m/s, with a decreasing trend in the northeast-southwest (NE-SW) direction. The infiltration method appeared to be better than the granulometric one in the estimation of the vertical hydraulic conductivity within the unsaturated zone of porous formations. This study also pointed out that within an anisotropic formation, the hydraulic conductivity ratio (Kv/Kh) should not always be taken as equal to 10. Specific tests should be implemented to access this value in a given aquifer.The inverse modelling results showed the net recharge values varying from 68.5 mm/yr to 180 mm/yr. The modelling technique appears to be consistent with the in-situ estimates. Therefore, the application of groundwater modelling tool in this study has shown excellent promise for characterizing the spatial distribution of hydraulic conductivity and net recharge values within the targeted aquifer system.