Determinants and aetiologies of postpartum pyrexia; a retrospective analysis in a tertiary health facility in the Littoral Region of Cameroon.

BACKGROUND: Postpartum febrile morbidity is relatively common, occurring in approximately 5-7% of births. Differentiating between potentially serious and benign causes of postpartum pyrexia (PP) is fundamental in curbing the mortality rate from sinister causes such as sepsis. The paucity of data on PP in Cameroon makes it difficult to access its actual burden. This study was aimed at determining the prevalence, risk factors and aetiologies of PP at a tertiary hospital in Douala, Cameroon. METHODS: This was a 2 - year hospital - based retrospective cohort study carried out at the Douala General Hospital (DGH), during which medical records of all postpartum admissions between January 1st 2017 and December 31st 2018 were reviewed. The review consisted of collecting data on socio-demographic characteristics, clinical profile, investigations and final diagnoses. The collected data was analysed in SPSS 23.0. Chi-squared test was used to test the association between variables and a logistic regression analysis was fitted to identify risk factors associated to PP. RESULTS: A total of 1520 postpartum files were reviewed. The prevalence of PP was 8.82%. The most frequent causes of PP were: malaria (46.7%), urinary tract infections (18.7%), puerperal sepsis (17.9%) and pneumonia (8.7%). E. coli was the most (49.3%) cultured germ isolated in positive cultures. Onset of PP was more common (85%) within the first 3 days postpartum and malaria (60%) was the leading aetiology within this period. Five or more vaginal examinations prior to delivery (OR 59.151, 95% CI: 21.463-163.019; p < 0.001), perineal tears (OR 45.157, 95% CI: 2.266-899.722; p < 0.001), and duration of labour > 18 h (OR 26.760, 95% CI: 7.100-100.862; p < 0.001) were the most significant risk factors associated with PP. CONCLUSION: Approximately 1 in every 12 postpartum cases in the DGH presents with PP. Malaria was the leading cause of PP at DGH especially for cases registered within 3 days postpartum. The risk factors identified were mostly associated to perinatal events, such as frequent vaginal examinations, perineal tears and prolonged labour. Efforts towards preventing identified risk factors thus becomes paramount in order to curb this high rate of PP in the DGH.

Cervical Cancer Screening Beliefs and Prevalence of LSIL/HSIL Among a University-Based Population in Cameroon.

OBJECTIVE: The aim of the study was to determine beliefs and utilization of cervical cancer screening and prevalence of low-grade squamous intraepithelial lesion/high-grade squamous intraepithelial lesion among a university-based population in the Southwest region of Cameroon. MATERIALS AND METHODS: A public-private partnership was established between the University of Arizona, University of Buea, and the Cameroon Baptist Convention Health Services. A single-day screening clinic using visual inspection with acetic acid and Lugol's iodine solution (VILI) was provided at the University of Buea. Screening results were documented as negative, low-grade, high-grade, or suspicious for cancer. Thermocoagulation and loop electrosurgical excisional procedure was available for low- and high-grade lesions, respectively. A survey was conducted before screening and factors associated with screening practices were evaluated. RESULTS: Of 120 clinic participants, 107 (89.2%) believed that treatment of precancerous lesions helped prevent cervical cancer, but most (67.5%) had never been screened. Eighty women (66.7%) were aware of the human papillomavirus (HPV) vaccine, and only 2 had received vaccination. Among 115 patients screened, the prevalence of abnormal screening was 6.09%. Low-grade lesions were treated with thermocoagulation and high-grade lesions were treated with loop electrosurgical excisional procedure. CONCLUSIONS: Despite knowledge of cervical cancer screening benefits, the majority had not been screened or vaccinated. This study suggests a desire for additional screening services in this population and validates the utility of public-private partnerships in low-income regions.