Stroke characteristics in elderly: a hospital-based study in Cameroon.

INTRODUCTION: Advanced age is an important nonmodifiable risk factor for stroke. Little data are available on stroke in older people in sub-Saharan Africa. This study aimed to determine the clinical features of stroke and identify the predictive factors for poor outcomes in this age group. METHODS: A 4-month retrospective study was conducted using the Stroke Registry of Douala General Hospital. The main outcomes were mortality, poor functional recovery at 3-month (modified Rankin Scale score ≥ 3), and recurrence at 1-year. Factors associated with poor outcomes were determined using binary logistic regression. Survival was estimated using the Kaplan-Meier method. The significance threshold was set at p <0.05. RESULTS: Elderly patients represented 38.6% of all stroke cases (n=1260). Male represented 48.6% of the old patients. The incidence of hypertension, diabetes, previous stroke, and cardiopathies was significantly higher in older patients (p<0.05). Ischemic stroke accounted for 73.1% of stroke types. Cardiopathies, GCS 8-12, GCS <8, hemorrhagic stroke, NIHSS >14, and Barthel index at one month were independently associated with mortality. Being divorced, a modified Rankin scale score ≥ 3 at one-month, and a Barthel index ≤60 at one-month were independently associated with poor functional recovery at 3 months. Old patients represented 50% of recurrent stroke cases. Age > 90 years (p <0.001) and NIHSS < 5 were independently associated to recurrence at 1-year. CONCLUSION: Approximately two out of five stroke cases were old. Cardiopathies, hemorrhagic stroke, and data related to stroke severity contribute to poor outcomes. A management approach that considers the particularities of this age group could contribute to improving the outcomes of these patients.

Epidemiological profile of occupational risks associated with artisanal burning of plastic materials in Parakou / Profil épidémiologique des risques professionnels associés au brûlage artisanal de matières plastiques à Parakou

Introduction: Burning plastic releases toxic fumes and gases. More and more people engage in the professional activity of welding plastic parts by fusion in Benin. Hence the need for this study. Purpose of research: To assess the frequency of the various occupational risks associated with the welding of plastic materials by burning in Parakou. A cross-sectional, descriptive, and analytical study focused on plastic welders in Parakou. The data was collected using a questionnaire. The variables studied were accidents at work, occupational diseases, and socio-professional characteristics. The data was analyzed by Epi info version 7.2.1.0. The significance level was set at p < 0.05. Results: A total of 137 subjects were surveyed. They were all male. Almost all of them were victims of accidents at work. The lesions were mainly on the fingers (99%) and feet (99%). The most expressed morbid manifestations were musculoskeletal disorders (98%), rhinitis (87%), cough (79%), tearing (98%) and conjunctival hyperemia (93%). Conclusions: Plastic welding in Parakou is a high health risk activity for craftsmen. It is urgent to take protective measures for these craftsmen.

Introduction: La combustion du plastique dégage des fumées et des gaz toxiques. De plus en plus de personnes se livrent à l'activité professionnelle de soudage de pièces en plastique par fusion au Bénin, d'où la nécessité de cette étude. But de l'étude: Évaluer la fréquence des différents risques professionnels associés au soudage de matières plastiques par brûlage à Parakou. Il s'agit d'une étude transversale, descriptive et à visée analytique qui a porté sur les soudeurs de plastiques à Parakou. Les données ont été collectées à l'aide d'un questionnaire. Les variables étudiées étaient l'accident du travail, les maladies professionnelles et les caractéristiques socioprofessionnelles. Les données ont été analysées par Épi info version 7.2.1.0. Le seuil de signification a été fixé à p < 0,05. Résultats: Au total 137 sujets ont été enquêtés. Ils étaient tous de sexe masculin. La quasi-totalité d'entre eux était victime d'accidents du travail. Les lésions siégeaient surtout aux doigts (99 %) et aux pieds (99 %). Les manifestations morbides les plus exprimées étaient les troubles musculo-squelettiques (98 %), la rhinite (87 %), la toux (79 %), le larmoiement (98 %) et l'hyperhémie conjonctivale (94 %). Conclusions: Le soudage de plastique à Parakou est une activité à risque sanitaire élevé pour les artisans. La prise de mesures protectrices pour ces artisans est urgente.

Association of acute COVID-19 with 24 hours-pulse wave velocity in cameroonian workers

Introduction. COVID-19appears to have a vascular tropism responsible for diffuse vasculitis-like cell damage. The aim of our study was to evaluate the impact of Sars-Cov-2 infection on arterial stiffness.Material and methods. This was a cross-sectional analytical case-controlstudy with 1:1 matching (1 case to 1 control) over a six-month period from January 1, 2021 to June 30, 2021 at the medical-social centerof the autonomous port of Douala. We measured the pulse wave velocity (PWV) in two groups of patients (group 1: COVID-19and group 2: non-COVID-19) using a MOBIL-O-GRAPH 24h PWA MonitorTM. A p-value < 0.05 was considered significant.Result. A total of 122 patients (61 COVID-19and 61 non-covid) were included in this study, among which 68 (55.7%) male. The mean age was 41±11 years. PWV as well as POV adjusted for age and mean BP were similar in both groups. The mean 24-hour, diurnal and nocturnal PWV were slightly higher in COVID-19patients than in controls by 0.1 m/s (p=0.67), 0.2m/s (p=0.37) and 0.2m/s (p=0.25) respectively. COVID-19infection was not significantly associated with PWV (p=0.082).Conclusion. PWV were slightly higher in COVID-19patients and increased arterial stiffness was not significantly associated with COVID-19status in the acute phase of infection.

Epidemiology of Musculoskeletal Disorders among the Teaching Staff of the University of Douala, Cameroon: Association with Physical Activity Practice.

The aim of this study was to assess the epidemiology of musculoskeletal disorders (MSDs) among the teaching staff of the University of Douala and determine their association with physical activity (PA) practice. The Nordic questionnaire was used to assess MSDs. Ricci-Gagnon questionnaire was used to determine the level of PA. We recruited 104 participants mean-aged 42 ± 8 years, 80% male. Previous 7 days and 12 months prevalence were 56.7% and 80.8%, respectively. The most affected body regions were neck, shoulders and lower back. No significant association was found between MSDs and PA. Celibacy was significantly associated with previous 7-days MSDs (p = 0.048) while age ≥ 45 years and job seniority ≥ 10 years were significantly associated with a reduced risk of previous 12-months MSDs (p = 0.039 and p = 0.016, respectively). The prevalence of MSDs among university of Douala teaching staff showed no significant effect with the practice of PA.

Performance based financing and job satisfaction in a semiurban health district in Cameroon

The performance based financing approach is being tested in four regions of Cameroon, including the Littoral region. Our study aimed to study the effects associated with the implementation of the performance based financing approach within the health facilities based in the health district of Edea in the Littoral region in Cameroon. We've carried out a cross sectional analytical study among 178 health personnel from 21 health facilities under PBF-contract within the health district of Edea. We have studied their sociodemographic characteristics, the individual and collective effects resulting from the performance based financing subsidies and the level of job satisfaction. Participants' job satisfaction was measured with the French version of the Minnesota satisfaction scale. The results were presented in a descriptive and analytical form at the alpha = 5% and the P-value 5%. We recruited 113 women and 65 men. The mean age was 39.19 ± 8.95 years. The individual results of the performance based financing were the regular collection of subsidies between F CFA 20-40.000 (42.1%), the improvement of working conditions (74.2%) and living conditions (67.4%) and the acquisition of new skills (69.7%). Collectively, participants confirmed the increase of the users attendance (65.7%), the improvement of the internal organization (79.8%), the purchase of new equipment (84.3%) and the improved quality of health care (86%). Satisfaction is influenced by age (P=0.016), gender (P=0.01), occupational category (P=0.04), type of health facility (P=0.02) and the amount of subsidies (P=0.03). The healthcare personnel's were satisfied with the improvement of their social conditions (66.67%), working conditions (62.88%), the transparency in health centers management (69%) and their involvement in the health centers' functioning (76.6%). Participants were dissatisfied with their salaries (70.2%) and the lack of opportunities for advancement (47.8%). The positive effects of the performance based financing approach contributed to the job satisfaction of the healthcare workers in the Edea health district. These results should prompt the government to extend the performance based financing approach to communities and other health districts in Cameroon

[Risky Sexual Behavior And Prevalence Of HIV In Sex Workers In Douala In 2011]. / Comportements Sexuels A Risque Et Seroprevalence Du VIH Chez Des Travailleuses De Sexe De Douala En 2011.

BACKGROUND: With an HIV seroprevalence of 14%, sex workers in Douala remain a population at high risk of viral infection. Many campaigns have been carried out with the objective of informing and helping to prevent the spread of infections. This study aims to identify the reoccurring and new risky sexual behaviors and to make recommendations concerning the observations. MATERIALS AND METHODS: A cross sectional study was carried out in the city of Douala. Screening tests were carried out and a questionnaire looked at information concerning different variables. The associations between these variables were evaluated by calculating odds ratios rough-and their confidence intervals at 95%. RESULTS: A seroprevalence of 12.5% was recorded. The average years worked were 25±3. We noted 89% of participants were on HIV medicine (P= 0.001). There was no significant correlation between the sex worker's age and her HIV status (P= 0.458), and no significant correlation between their age and educational level (P= 0.502). 89% of the participants reported using condoms during their paid sexual relations, among them 9% were HIV positive (P=0.04). 87.5% of HIV positive participants reported engaging in anal sex (P=0.007). CONCLUSION: Seroprevalence remains high in sex workers in Douala. They continue to engage in risky sexual behaviors, endangering themselves and their partners. We therefore suggest to increase informational campaigns to increase awareness in this at-risk population.

INTRODUCTION: Avec une séroprévalence au VIH estimée à 14%, les travailleuses du sexe constituent un groupe à risque élevé dans la ville de Douala. Afin de réduire les risques de contamination et de transmission au sein de cette frange de la population, de nombreuses campagnes de sensibilisation et de prévention ont été organisées à cet effet. La présente étude compte répertorier les comportements sexuels à risque résiduels et /ou nouveaux observés au cours leurs activités quotidiennes et d'en faire de recommandations. MATÉRIELS ET MÉTHODES: Une étude transversale a été menée pour cela dans la ville de Douala. Des tests de dépistage ont été effectués et un questionnaire prétexté renseignait sur différentes variables. Le test du khi carré a été utilisé pour la mesure des associations entre les variables. Le seuil de significativité était de 5%. RÉSULTATS: La séroprévalence était de 12,5%. L'âge moyen de travail était de 25±3 ans. On comptait 89% des consommatrices de drogue séropositives (P= 0,001). On ne notait pas d'association significative entre l'âge des sujets et leur statut sérologique (p= 0,458), encore moins avec leur niveau d'instruction (p= 0,502). Dans cette étude, 89% de sujets disaient utiliser des préservatifs pendant les rapports sexuels payant et parmi elles, 9% étaient séropositives (P=0,04). On comptait 87,5% de séropositives qui avaient des rapports anaux (P=0,007). CONCLUSION: La séroprévalence demeure importante chez les travailleuses de sexe à Douala. Elles pratiquent toujours des comportements sexuels à risque susceptibles de les exposer ainsi que leurs partenaires. Des efforts de sensibilisation sont donc recommander au profit de cette population à risque.