Diagnosis, Prevalence, Awareness, Treatment, Prevention, and Control of Hypertension in Cameroon: Protocol for a Systematic Review and Meta-Analysis of Clinic-Based and Community-Based Studies.

BACKGROUND: Hypertension holds a unique place in population health and health care because it is the leading cause of cardiovascular disease and the most common noncommunicable condition seen in primary care worldwide. Without effective prevention and control, raised blood pressure significantly increases the risk of stroke, myocardial infarction, chronic kidney disease, heart failure, dementia, renal failure, and blindness. There is an urgent need for stakeholders-including individuals and families-across the health system, researchers, and decision makers to work collaboratively for improving prevention, screening and detection, diagnosis and evaluation, awareness, treatment and medication adherence, management, and control for people with or at high risk for hypertension. Meeting this need will help reduce the burden of hypertension-related disease, prevent complications, and reduce the need for hospitalization, costly interventions, and premature deaths. OBJECTIVE: This review aims to synthesize evidence on the epidemiological landscape and control of hypertension in Cameroon, and to identify elements that could potentially inform interventions to combat hypertension in this setting and elsewhere in sub-Saharan Africa. METHODS: The full search process will involve several steps, including selecting relevant databases, keywords, and Medical Subject Headings (MeSH); searching for relevant studies from the selected databases; searching OpenGrey and the Grey Literature Report for gray literature; hand searching in Google Scholar; and soliciting missed publications (if any) from relevant authors. We will select qualitative, quantitative, or mixed-methods studies with data on the epidemiology and control of hypertension in Cameroon. We will include published literature in French or English from electronic databases up to December 31, 2016, and involving adults aged 18 years or older. Both facility and population-based studies on hypertension will be included. Two reviewers of the team will independently search, screen, extract data, and assess the quality of selected studies using suitable tools. Selected studies will be analyzed by narrative synthesis, meta-analysis, or both, depending on the nature of the data retrieved in line with the review objectives. RESULTS: This review is part of an ongoing research program on disease prevention and control in the context of the dual burden of communicable and noncommunicable diseases in Africa. The first results are expected in 2017. CONCLUSIONS: This review will provide a comprehensive assessment of the burden of hypertension and control measures that have been designed and implemented in Cameroon. Findings will form the knowledge base relevant to stakeholders across the health system and researchers who are involved in hypertension prevention and control in the community and clinic settings in Cameroon, as a yardstick for similar African countries. TRIAL REGISTRATION: PROSPERO registration number: CRD42017054950; http://www.crd.york.ac.uk/PROSPERO/ display_record.asp?ID=CRD42017054950 (Archived by WebCite at http://www.webcitation.org/6qYSjt9Jc).

Metabolic effects of quail eggs in diabetes-induced rats: comparison with chicken eggs.

BACKGROUND: Quail eggs as a food item have recently been introduced into the diet of some Cameroonians. These eggs are being sold in local markets, but with many unfounded health claims. One claim is that quail eggs can reduce blood glucose levels in diabetics. It was therefore necessary to evaluate the effect of consuming quail eggs on blood glucose levels, lipid profiles, and oxidative stress parameters in diabetes-induced rats. METHODS: Twenty Wistar rats weighing, on average, 250 g were divided into four groups of five rats each. Group 1 consisted of rats with normal blood glucose, and the other three groups (2, 3, and 4) consisted of diabetes-induced rats achieved by intravenous injection of streptozotocin. During 16 days, rats in groups 1 and 2 received distilled water; and rats in groups 3 and 4 received quail and chicken eggs, respectively, with gastroesophageal probe at a dose of 1 mL/200 g body weight. Fasting blood glucose levels were determined in all the groups on the 1st, 7th, 14th, and 17th days after induction of diabetes. On the 17th day, the fasting rats were sacrificed, and blood and liver samples were collected for biochemical analyses. RESULTS: In 17 days, the consumption of quail and chicken eggs had no effect on blood glucose levels of diabetic rats. Total cholesterol levels were higher in groups 3 (75.59 mg/dL) and 4 (59.41 mg/dL) compared to group 2 (55.67 mg/dl), although these differences were not significant (all p>0.05). Triglyceride levels were significantly higher (p<0.05) in groups 3 (106.52 mg/dL) and 4 (109.65 mg/dL) compared to group 2 (65.82 mg/dL). Quail eggs had no effect on oxidative stress parameters (malondialdehyde, hydroperoxides, and catalase). CONCLUSIONS: The consumption of quail eggs by diabetic rats at the tested dose had no effect on blood glucose level and oxidative stress parameters and may have a negative effect on lipid profile.

Knowledge and Attitudes of Pregnant Mothers towards Maternal Dietary Practices During Pregnancy at the Etoug-Ebe Baptist Hospital Yaounde

BACKGROUND AND PURPOSE. Poor dietary practices have been observed among the pregnant mothers receiving antenatal care services (ANC) at the Etoug-Ebe Baptist Hospital Yauonde (EBHY); despite routine nutrition education provided to these mothers and their apparent knowledge and approval of the importance of nutrition in pregnancy. We explored the nutritional knowledge and dietary practices of pregnant mothers receiving ANC at the EBHY in order to identify the correlation between their nutrition knowledge and dietary practices.MATERIALS AND METHODS. A cross sectional descriptive survey was done on 100 randomly selected pregnant mothers. An interviewer-administered structured questionnaire was used to collect data. Statistical analysis was done using the SPSS computer package (Version 19.) Data comparison was done by Chi Square (?2) test with P 0.05 considered statistically significant and a 95 % confidence level (CI) computed.RESULTS. Sixty seven percent of mothers were married. Seventy one percent were literate; 51% had no stable jobs and 39% of their husbands were unemployed. Seventy one percent of respondents belonged to families with monthly income of less than 100;000FCFA and 56% of them had 5 or more household members. Ninety two percent of mothers had knowledge on good maternal nutrition before pregnancy. Seventy three percent of mothers cited the correct components of a balanced diet and their food sources (81%); however; 29% had aversion towards foods rich in protein and other important nutrients. Thirty eight percent of mothers knew that they should eat 3 main meals a day; but only 22% of them practiced it. Sixty five percent of mothers were aware that 'calaba chalk' (dry clay) was harmful and prohibited in pregnancy; yet 85% consumed it. Sixty eight percent did not have Knowledge about the risk of overfeeding in pregnancy. Sixty five percent had awareness that some foods items are potentially harmful in pregnancy but did not know what to avoid. Advanced maternal age; education level; parity and monthly family income were apparently positively associated with nutrition knowledge but there was no significant difference (p0.05).Cultures and taboos exempted mothers from eating meat from wild animals; chicken; sea fish; sweet things; food partly eaten by animals; sugar cane; mud fish and 'porrished' cocoyam.CONCLUSION. Pregnant mothers in Yaounde have satisfactory knowledge on adequate nutrition in pregnancy; but with significant gaps and difficulty in translating knowledge into practice. Maternal dietary habits are greatly influenced by hormonal changes in pregnancy; socio- economic status; food taboos and cultural beliefs; thus making it difficult to practice the nutrition advice they receive. Adequate multiple dietary supplementation should accompany nutrition advice as an integral part of ANC. Health policies that address cultural taboos should be instituted in favour of pregnancy nutrition

Situational analysis and expert evaluation of the nutrition and health status of infants and young children in five countries in sub-Saharan Africa.

BACKGROUND: The poor feeding practices of pregnant women, infants, and young children contribute to the burden of malnutrition and subsequently to childhood morbidity and mortality in sub-Saharan Africa. Gaining insight into the nutritional and health status of infants and young children will help to focus future nutrition programs and actions. OBJECTIVE: To assess the nutrition and health status of infants and young children in five sub-Saharan African countries: Ivory Coast, Senegal, Cameroon, Kenya, and Nigeria. METHODS: Published and gray literature was critically reviewed and enriched with the views of local experts from academia, hospitals, and institutions to assess infants' and children's diet and health in the five sub-Saharan African countries. Subsequently, the Africa Nutriday Conference was held in Senegal in November 2011 to further discuss key challenges, action plans, and recommendations for future research. RESULTS: This review highlighted the need for education of parents and healthcare professionals in order to increase their knowledge of breastfeeding, vaccination programs, and over- and undernutrition. An integrated health and nutrition surveillance is needed both to identify micronutrient deficiencies and to recognize early signs of overweight. These data will help to adapt nutrition education and food fortification programs to the target populations. CONCLUSIONS: Different countries in sub-Saharan Africa face similar nutrition and health issues and are currently not sharing best practices, nutrition programs, and scientific studies optimally. There is a need for closer collaboration among scientists within and between countries.

Nutrient intakes and dysglycaemia in populations of West African origin.

Examining the relationship between glucose intolerance and dietary intake in genetically similar populations with different dietary patterns and rates of type 2 diabetes may provide important insights into the role of diet in the pathogenesis of this disease. The objective of the present study was to assess the relationship between dietary variables and dysglycaemia/type 2 diabetes among three populations of African origin. The study design consists of a cross-sectional study of men and women of African descent aged 24-74 years from Cameroon (n 1790), Jamaica (n 857) and Manchester, UK (n 258) who were not known to have diabetes. Each participant had anthropometric measurements and underwent a 2 h 75 g oral glucose tolerance test. Habitual dietary intake was estimated with quantitative FFQ, developed specifically for each country. The age-adjusted prevalence of undiagnosed type 2 diabetes in Cameroon was low (1·1 %), but it was higher in Jamaica (11·6 %) and the UK (12·6 %). Adjusted generalised linear and latent mixed models used to obtain OR indicated that each 1·0 % increment in energy from protein, total fat and saturated fats significantly increased the odds of type 2 diabetes by 9 (95 % CI 1·02, 1·16) %, 5 (95 % CI, 1·01, 1·08) % and 16 (95 % CI 1·08, 1·25) %, respectively. A 1 % increase in energy from carbohydrates and a 0·1 unit increment in the PUFA:SFA ratio were associated with significantly reduced odds of type 2 diabetes. The results show independent effects of dietary factors on hyperglycaemia in African origin populations. Whether modifying intake of specific macronutrients helps diabetes prevention needs testing in randomised trials.

Nutritional composition of commonly consumed composite dishes from the Central Province of Cameroon.

PRIMARY OBJECTIVE: To provide nutritional composition of 34 composite dishes commonly consumed in Cameroon, in order to enable dietary intake to be calculated from a Quantitative Food Frequency Questionnaire developed specifically for this population to determine associations between diet and diabetes. METHODS AND PROCEDURES: A total of 197 recipes were collected for 34 composite dishes. Multiple samples of each dish were collected from a range of 2-16 households in the villages of Evadoula and in the city of Yaounde. MAIN OUTCOMES AND RESULTS: The average nutritional composition for these composite dishes was calculated using the US Department of Agriculture National Nutrient Database. We provide the energy, macronutrient and micronutrient content of these foods. CONCLUSIONS: We provide, for the first time, the macronutrient and micronutrient content of 34 commonly consumed composite dishes in the Central Province of Cameroon. Such data are essential for calculating nutrient intake and determining associations between diet and diabetes and other chronic diseases. These data may also be used for nutrition interventions aimed at modifying commonly consumed composite dishes to improve dietary intake.

Nutrient content of complementary foods based on processed and fermented sorghum, groundnut, spinach, and mango.

BACKGROUND: Many African mothers use gruels made of maize and sorghum as complementary foods for their infants because they cannot afford the cost of nutritionally superior commercial weaning foods. OBJECTIVE: To improve the nutritional quality of traditional sorghum gruels used as complementary foods for children between six months and five years in the northern part of Cameroon. METHODS: Sorghum grains were processed by dehulling, sprouting, dehulling and cooking, and sprouting and cooking, then fermented using Saccharomyces cerevisae and tested for nutritional quality. The processed samples were analyzed for their nutrient composition and the digestibility of proteins and carbohydrates. RESULTS: The resulting products showed a significant reduction in antinutritional factors (e.g., phenolic compounds and phytates). In addition, germination improved the in vitro digestibility of proteins and carbohydrates. These effects were enhanced by fermentation of the resulting sorghum flour, regardless of how grains were pretreated, although the protein and mineral content remained low. Use of a composite flour made from pretreated sorghum, groundnut, spinach, and mango improved the protein, mineral, and vitamin A and C content of the gruels. Fermentation of composite flours resulted in an improvement in the protein content. CONCLUSIONS: This study, conducted under local conditions and using local technology, describes an opportunity for improving the quality of complementary foods using local ingredients.