Knowledge, Attitude, and Practice on Breast Cancer among Health Professionals in Douala References Hospitals, Cameroon.

In Cameroon, patients with breast cancer are more often diagnosed at stage III and IV, hence the need of preventives actions. Knowledge and attitude of medical personnel may influence their practice with regards to screening and early detection of breast cancer. Very few is known about this subject in Cameroon. The objective was to describe the knowledge, attitude, and practice of health care professionals on breast cancer risk factors, diagnostic methods, and screening. This was a cross-sectional study conducted during a 6-month period, among health professionals of Douala General Hospital and Laquintinie Hospital, Cameroon.Data were collected using a self-administered questionnaire which included demographic characteristics, questions on breast cancer risk factors, screening, and diagnostic methods. Marks were attributed to each question and calculated for each section. Participants fell in four categories of knowledge, attitude, and practice: very weak, weak, good, and excellent. The software XLStat7.5.2 was used for data analysis. Overall, 445 health professionals were interviewed. The average age was 39 ± 9 years. The level of knowledge, attitude, and practice was accessed respectively as weak (50.1%), very good (64.5%), and poor (36.4%). The personal practice of female workers was poor (43.0%). Compared to participants with very weak to weak knowledge, those with good to excellent knowledge had 1.55-fold odds of excellent attitude p < 0.0001. After multivariate analysis, the factor associated with good to excellent knowledge was the participant qualification (academic degree). These results suggest the need for training of health professionals in Douala references hospitals on breast cancer risks factors, diagnostic, and screening methods.

Evaluation of the offer of family planning services in a rural area of the Bamboutos division in the west region of Cameroon: a cross sectional study

Background and aim. The rate of utilization of contraceptive methods in Cameroon is low. The western region has a high fecundicity index and among the women in union using any contraception (30.2%), only 32.5% of them are using a modern method. This study aimed at improving the offer of family planning (FP) services by identifying factors limiting its expansion. Methods. We conducted a descriptive cross-sectional study from 1st January to 31st December 2011 in the Bamboutous health district of the West region of Cameroon. We included exhaustively public and private health institutions. The characteristics of health institutions, providers and various FP services offered were obtained from registers and interview of health care providers. Data was analyzed using Epi info software version 3.5.1. Results. Of the 68 health facilities in the Bamboutous health district, 25 (36.8%) offered FP services. Among them, 18 were public (72%), 21(84%) had been existing for over 5-years period and the service offer was integrated (88%). There was often no pipe-borne water (72%). Eighteen of 25 FP institutions had no personnel who had ever received any formal training in FP (72%). Unmet contraceptive need was estimated at 34.7%. The different contraceptive methods received by women were more often injectables (37.3%) and implants (12.6%). Male condom represents 30.8%. Conclusion. The health services in the Bamboutous division are poorly furnished with FP activities in spite of met-needs of 65.3%. Improving on the service offer for FP as well as the training of health care providers is highly recommended

[Changes of Von Willebrand factor concentration during pregnancy]. / Variations de la concentration du facteur Von Willebrand au cours de la grossesse.

The multimeric glycoprotein Von Willebrand factor (vWF), is produced by vascular endothelium and platelet. If some constitutionals deficiencies leading to hemorrhagic syndrome have been explored in the literature, increased production of vWF observed during cellular distress and pregnancy have not been explored in our milieu. The aim of this study was to determine vWF changes during pregnancy in a group of Cameroonian women and find out the possibility of using it as a marker of fetal distress. Serum was collected from 46 women in the second and third trimesters of pregnancy. The determination of vWF concentration was performed using the Asserachrom vWF reagent: Ag (Diagnostica Stago, France). The average concentrations of vWF in the second and third trimester samples were respectively 215.47 ± 9.38% (UI/dL) and 264.09 ± 11.58% (UI/dL). The difference between (i) concentrations of vWF during the second and third trimester of pregnancy was statistically significant (P-value<0.0001); (ii) concentrations of vWF according to mother's ages was not significant; (iii) concentrations of vWF in blood group O and B women was statistically significant (P-value<0.05). We observed a difference between vWF values in women whose babies had Apgar score 4 to 6 compared to those with Apgar score between 7 and 10. The different was not statistically significant probably due to low effective. In conclusion, vWF production during the pregnancy varies with gestational age and maternal blood group. It may increases during fetal distress.

Postpartum hemoperitoneum due to rupture of a blood vessel on a uterine pseudo tumor: a case report.

We are reporting a case of hemoperitoneum followed by early post partum collapse due to bleeding from a ruptured vessel on the surface of an undiagnosed uterine pseudo tumor. There are literature reports of spontaneous hemoperitoneum from bleeding of superficial vessels over lying myomas during pregnancy but a case of rupture of a blood vessel on a uterine pseudo tumor leading to isolated hemoperitoneum in the immediate postpartum period is a rare event. We are presenting the literature review and some aspects of the management of this case. The importance of having a high index of suspicion in cases of hemoperitoeum occurring immediately after delivery especially in a low income setting where radiologic imaging techniques like magnetic resonance imaging (MRI); which is the most sensitive diagnostic tool in cases of ruptured vessels are rare is highlighted.

Epidemiology and surgical management of breast cancer in gynecological department of Douala General Hospital.

INTRODUCTION: Breast cancer is one of the most common gynecological cancers in our environment. Douala General Hospital (DGH) is one of the two main centers in Cameroon, where the cancerous patient can receive multidisciplinary management including radiotherapy. METHODS: The aim of our study was to describe the epidemiological, clinical profile and surgical management of patients with breast cancer in gynecological department of DGH. RESULTS: A total of 42 patients were recruited in our department within a period of 3 years (from November 2006 to October 2009). The mean age was 46 years (range: 29-73 years). Characteristics of our study group were as followed: female sex (100%); breast feeding (95.245%); familial history of breast cancer (7.14%); 14.29% of patients were nulliparous and 19.05% primiparous. The main mode of discovering the disease was auto examination (92.86%). The clinical tumor size ranges from 2cm to 20cm with a mean of 6.83cm. Patients were then mostly diagnosed at stage III (54.76%) of the WHO classification. Only 2.38% were diagnosed at stage I. The main method of diagnosis was breast fine needle aspiration. Neo adjuvant treatment was administered in 78.57% of patients and the main surgical treatment was mastectomy (92.86%). Many patients are still followed up (59.52%), but we already had a mortality rate of 14.29% at the end of December 2010. We had no feedback for 26.19% of the study group. CONCLUSION: Breast cancer is generally diagnosed in advanced stage in our milieu; there is therefore a need for generalized sensitization of the population.