Incidence and Predictors of Poor Outcome amongChildhood Tuberculosis in the North of Cameroon

Background. Childhood tuberculosis (TB) has been neglected by TB programs in Sub-Saharan Africa. The aim of this study was to determine the incidence and predictors of poor outcome in children with TB in the North region of Cameroon. Methods.It was a retrospective cohort study based on hospital TB registers and treatment TB forms, in all of the 18 functional diagnosis and therapeutic centers (DTC) in the North region. All children aged 0-15years, on anti-TB treatment between 2010-2016 were enrolled. Logistic regression was used to find independent factors associated to poor outcome. Results. Of the 668 children included [321 (48.1%) boys], the median (25th-75thpercentile) age was 11(6-14) years, with 75.9% children aged >5 years. Pulmonary TB was the most common (62.9%) with 34.3% smear-negative pulmonary TB. Extrapulmonary TB (62.1%) was mostly found in children aged 0-5years. HIV/TB coinfection was 10.3%. Incidence (95%CI) of poor outcome was 4.0 %( 2.5-5.5%). Predictors [OR (95%CI)] of poor outcome were: HIV positivechildren [3.995(1.131-14.112), p=0.031], management in peripheral DTC [32.451(4.211-250.099), p=0.001], and transferred in patients from a peripheral zone toward a 3rdor 4thDTC category [4.602(1.092-19.386), p=0.037]. Conclusion.Incidence of poor outcome of childhood TB was quite low in the North region of Cameroon. HIV, peripheral TDC and transferred in patients were predictors of poor outcome. A better management of HIV, retraining DTC personnel and early reference from peripheral DTC would reduce poor outcome among childhood TB.

Risk factors for neonatal mortality at the yaounde gynaeco-obstetric and pediatric hospital, cameroon

Neonatal mortality is a major health problem in sub-Saharan Africa and the risk factors are not well established. The objective of this study was to determine the risk factors for neonatal mortality at the Yaounde Gynaeco-Obstetric and Pediatric Hospital. We conducted a retrospective and analytic case-control study from the medical records of newborns admitted at the neonatal unit of this hospital between 1[st] March 2003 and 31[st] December 2012. 850 subjects were enrolled; that is 425 cases and 425 controls. The intra-hospital neonatal mortality rate was 9.83%. The main causes of neonatal mortality were in descending order: neonatal sepsis [60.2%], complications from prematurity [42.6%], birth asphyxia [37.4%], and congenital malformations [11.8%].The most prominent risk factors for neonatal mortality after multivariate analysis with logistic regression were: prolonged membrane rupture [OR: 3.8719, 95% CI: 2.3619-6.3471; P=0.0000], low birth weight [OR: 1.6240, 95% CI: 1.0108-2.6091; P=0.0450], Apgar score less than 7 at the 5th minute [OR: 6.8979, 95% CI: 4.0709-11.6883; P=0.0000], and congenital malformations [OR: 4.3307, 95% CI: 1.6120-11.6347; P=0.0037]. Delivery by cesarean section [OR: 0.2644, 95% CI: 0.1478-0.4732; P=0.0000] and being born in this hospital [OR: 0.4409;95% CI: 0.2566-0.7576; P=0.0030] were protective. Neonatal mortality was influenced by both maternal and neonatal factors. This could be reduced through sensitization of pregnant women on the need of good quality antenatal visits, and capacitating the health personnel on the adequate management of high risk neonates

The empiric use of palm kernel oil in neonatal skin care: justifiable or not? / 中国结合医学杂志

Palm kernel oil is a vegetable oil derived from Elaeis guineensis and widely used in neonatal settings for skin care. It is a good emollient with a beneficial effect in moisturizing the skin and preventing transdermal heat and water loss. However, it's putative roles in the prevention or treatment of fatty acid defificiency is still controversial. So is its function in the improvement of neurological development from its longchain polyunsaturated fatty acids? We set out in this review to verify whether its empiric use in this context has any scientific justification and is recommendable. Although there is evidence that it has emollient and moisturizing properties necessary for softening the skin and restoring elasticity, controversy subsists on its other nutritional and neurodevelopmental properties.

clinical and bacteriogical spectrum of neonatal sepsis in a tertiary hospital in Yaounde, Cameroon

Sepsis is an important cause of morbidity and mortality in neonates especially in developing countries where identification of the germs and treatment is often unsatisfactory. The aim of the study was to assess the clinical presentation, and bacteriological profile of neonatal infections, and the sensitivity of the causative germs to antibiotics. We carried out a prospective analytic study in the Yaounde Gynaeco-Obstetric and Pediatric Hospital in Cameroon over a 6 months period from 18[th] November 2008 to 18[th] May 2009. On the basis of history and/or clinical findings and paraclinical investigations, 218 neonates out of a total of 628 admissions were investigated and managed for neonatal infection. The most frequent symptoms were fever [44.95%], refusal to feed/irritability [32.11%], and respiratory distress/cough [28.90%]. Premature birth and prolonged rupture of membranes were the most frequent risk factors. Klebsiella spp, Escherichia coli and Enterobacter spp were the most frequent germs identified in respectively 28.6%, 21.4% and 14.3% of the positive samples. Overall sensitivity of the cultures to ampicillin, netilmicin and gentamycin was poor at 29.4%, 31.4% and 18.9% respectively, whereas imipenem, ofloxacin, ciprofloxacin and ceftazidime had the best sensitivities in 91.7%, 90%, 85.3% and 69.4% of the cultures respectively. The mortality rate was 22%, and low birth weight, premature birth and septicemia were significant risk factors for death. Mortality from neonatal sepsis in this context is still high and there is an upsurge of multi-resistant germs to currently used antibiotics, calling for the need for rational use of antibiotics in the management of these infections