The Pattern of Cervical Cancer according to HIV Status in Yaoundé, Cameroon.

OBJECTIVE: To analyze the epidemiological aspects of invasive cervical cancer according to HIV status. METHODS: This was an historical cohort study from January 2010 to April 2017 in three hospitals at the Yaoundé city Capital, Cameroon, after the National Ethics Committee' approval. We included invasive cervical cancers with documented HIV status. Odds ratios and 95% confidence interval were calculated to assess the association between the different variables and HIV status. Survival was analyzed using the Kaplan-Meier. The level of significance was set up at <5%. RESULTS: Among the overall 213 cervical cancer patients, 56 were HIV+ (24.67%). Factors associated with positive HIV status were age below 40 (OR: 2.03 (1.38-2.67)), celibacy (OR: 2.88 (1.58-4.17)), nonmenopausal status (OR: 2.56 (1.36-3.75)), low parity, primiparity (OR: 2.59 (1.43-3.74)), and for parity with 2-4 children (OR: 2.24 (1.35-3.12)). Concerning the HIV+ patients, tumor was diagnosed late (stages III-IV) (OR: 2.70 (1.43-5.08)), undifferentiated (grade III) (OR: 7.69 (5.80-9.57)), with low median survival (9.83 months vs. 20.10 months). CONCLUSION: HIV is frequent among cervical cancer patients. In the HIV+ patients, the diagnosis was made at the advanced stage, cells were poorly differentiated, and the prognosis was worse.

[Nonpalpable breast lesions: correlation of the BI-RADS classification and histologic findings]. / Corrélation radio-histologique des lésions mammaires infracliniques à partir de la classification BI-RADS (étude gabonaise).

UNLABELLED: Diagnosis of nonpalpable breast lesions too often requires a breast biopsy or tumorectomy. OBJECTIVE: To validate the American College of Radiology (ACR) classification and lexicon using a standardized description to improve the uniformity of management of abnormal mammographic lesions and reduce the number of unnecessary tumorectomies. MATERIAL AND METHODS: This prospective study was conducted in Libreville Hospital Center over a 4-year period and compared the histologic results of 150 nonpalpable masses identified by mammography and their ACR classification to assess the correlation between the radiographic and histologic findings. RESULTS: There were 90 cases (60%) of ACR2 lesions, 28 cases (18%) of ACR3, 6 cases (4%) of ACR4 and 26 cases (17%) of ACR5 lesions. Histologic results showed that 3% of the ACR2 lesions were malignant, 11% of the ACR3, 67% of the ACR4 and 92% of the ACR5 lesions. CONCLUSION: The correlations showed that the ACR classification was highly reliable for ACR2 and ACR5 lesions and makes it possible to optimize their treatment. ACR3 and ACR4 lesions must be watched carefully.

[Risk factors for eclampsia in Libreville (Gabon): a case-control study]. / Facteurs de risque de l'éclampsie à Libreville (Gabon): étude cas-témoins.

OBJECTIVES: To determine the current prevalence of eclampsia in our department, identify its risk factors and assess the prognosis of mother and child. MATERIAL AND METHODS: This retrospective case-control study took place from January 1, 2004, through December 31, 2005, in the gynecology-obstetrics and intensive care departments of the Libreville Hospital Center. Every case of eclampsia was compared with three control patients. We collected social, demographic and clinical variables and compared them between the two groups. Univariate analysis was conducted with Epi Info 6.0. The odds ratio (OR) and 95% confidence intervals (95% CI) were calculated for each variable and compared with the Chi 2 test (significance defined as a p value less than 0.05). RESULTS: The prevalence of eclampsia was 0.5%. The principal risk factors were: mother aged younger than 19 years (OR=3.38; CI= 1.77-6.47), nulliparity (2.21; 1.22-4.02) and one or no prenatal consultations (19.23; 6.45-61.40). Severe high blood pressure (>160/110 mmHg) was found in 52% of cases. There were 14 maternal deaths (21%) in the case group and none among the controls. CONCLUSION: Improvement in the quality and quantity of prenatal care should help reduce the incidence of eclampsia.