[Screening of cardiac autonomic neuropathy in a group of adolescents and young adult Cameroonians with type 1 diabetes]. / Étude de la fréquence et des caractéristiques de la neuropathie autonome cardiaque chez un groupe d'adolescents et de jeunes adultes diabétiques de type 1 camerounais.

AIM: We aimed to describe cardiac autonomic neuropathy in a group of young Cameroonians type 1 diabetic patients. PATIENTS AND METHODS: We conducted a descriptive cross-sectional study including consenting patients with type 1 diabetes and without any other comorbidity, who were followed-up at the type 1 diabetic children's clinic at the Yaoundé central hospital. Cardiac autonomic neuropathy was diagnosed and stage using the five functional tests described by Ewang et al., and the heart rate variability assessment. RESULTS: We included 60 with a mean age of 18.6±4.9 years, 38.3% of female and a mean duration of diabetes of 5.9±5.1 years. Cardiac autonomic neuropathy was present in 96.7% of participants. Early, confirmed and severe cardiac autonomic neuropathy were found respectively in 8.3%, 86.7% and 1.7% of the patients. The most frequent clinical signs were exercise intolerance, alternating constipation and diarrhea and resting tachycardia. CONCLUSION: Cardiac autonomic neuropathy is common in young patients with type 1 diabetes. It is important to integrate the assessment of cardiac autonomic reflexes in type 1 diabetic patients' follow-up.

[Niveau d'activité physique et déconditionnement des patients insuffisants cardiaques suivis dans deux hôpitaux de la ville de Yaoundé : étude observationnelle au Cameroun]. / Physical activity and deconditioning of heart failure's patients followed at two Yaoundé's hospitals settings : A cross-sectional study in Cameroon.

OBJECTIVE: To assess the basic physical condition of chronic heart failure's Cameroonian patients. PATIENTS AND METHODS: We carried out a cross-sectional study from February to June 2020 at the Yaoundé Central and General Hospitals, including all consenting adults with stage I or II chronic heart failure of the New York Heart Association without sign of decompensation and received in outpatient consultation. Socio-demographic data and the level of physical activity assessed according to the International Questionnaire on PhysicalActivity were recorded. Quality of Life was evaluated using the "Minnesota Living with Heart Failure Questionnaire". Associated factors were analysed using the Chi-square test, the strength of association expressed by the odds ratio, and its 95% confidence interval. The significance level was 0.05. RESULTS: We recruited 102 participants, including 60 women with a median age of 64 [56,68]. Daily physical activity was moderate in 54% of participants and low in 45%, with no significant difference between the sexes (p = 0.3). About 39.2% of patients had an altered physical condition, and the most effective associated factors were obesity (p = 0.01), low daily physical activity (p = 0.002) and non-compliance to the treatment (p = 0.03). The mean Quality of Life score was low (36.7 ± 22.4), and the deterioration in physical condition harmed it (p < 0.001). CONCLUSION: More than a third of the study population had a poor physical condition, which negatively affected their Quality of Life. Therefore, we can suggest that prescribing appropriate physical activity should be an integral part of heart failure management in our context.

Seasonal variation of decompensated heart failure admissions and mortality rates in sub-Saharan Africa, Cameroon.

BACKGROUND: Epidemiological data of heart failure (HF) decompensation from the northern hemisphere suggests higher rates during winter. OBJECTIVES: We aimed to explore the seasonal variation in decompensated HF admission and mortality rates in a country with equatorial climate. METHODS: We conducted a retrospective cross-sectional study by chart review of the admission, discharge registries and patient files from 2016 to 2018 in the cardiology unit of the Yaoundé Central Hospital, Cameroon. Data was collected on HF morbidity and mortality from the registers and patients' files. Corresponding seasonal climatic data was obtained from the meteorology office of the Cameroonian ministry of transports. Analysis of variance and Chi-square test were respectively used to compare the continuous and categorical data between across seasons. Correlation between continuous data was assess with the Spearman correlation. RESULTS: Decompensated HF accounted for 636 (36.2%) out 1755 cardiology unit admission and an 18% lethality rate. Decompensated HF admission, mortality and lethality rates were respectively 38.2%, 6.7% and 17.9% higher during the long rainy season (all P values>0.05). We observed a borderline-to-significant inverse linear continuous correlation between monthly temperatures and admission rate (r=-0.301; P=0.070), lethality rate (r=-0.361; P=0.030) and mortality rate (r=-0.385; P=0.020). There was no significant difference of the distribution of precipitating factors between seasons. CONCLUSION: Although statistically insignificant, decompensated HF admissions and mortality increase in rainy season where the temperature is lower in an equatorial climate.