Markers and risk factors for chronic kidney disease in sub-Saharan Africans: baseline levels and 12-month trajectories in newly referred patients in Cameroon.

BACKGROUND: Little is known about the changes in disease makers and risk factors in patients with chronic kidney disease (CKD) under nephrological care in Africa. This study aimed to evaluate the baseline level of markers of CKD and their 12-month time-trend in newly referred patients in a tertiary hospital in Cameroon. METHODS: This was a retrospective cohort study including 420 patients referred for CKD between 2006 and 2012 to the nephrology unit of the Douala General Hospital in the littoral region of Cameroon. Their disease and risk profile was assessed at baseline and every 3 months for 1 year. Estimated glomerular filtration rate (eGFR) was based on MDRD and Schwartz equations. CKD was diagnosed in the presence of eGFR< 60 ml/min/1.73 m2 and/or proteinuria> 1+ and/or abnormal renal ultrasound persisting for ≥3 months. Data analysis used mixed linear regressions. RESULTS: Of the 420 patients included, 66.9% were men and mean age was 53.8 (15.1) years. At referral, 37.5% of the participants were at CKD Stage 3, 30.8% at stage 4 and 26.8% at stage 5. There was 168 (40%) diabetic and 319 (75.9%) hypertensive patients. After some improvement during the first 3 months, eGFR steadily decreased during the first year of follow-up, and this pattern was robust to adjustment for many confounders. Systolic and diastolic blood pressure levels significantly fluctuated during the first twelve months of follow-up. Changes in the levels of other risk factors and markers of disease severity over time were either borderline or non-significant. CONCLUSION: Patients with CKD in African settings are referred to the nephrologist at advanced stages. This likely translates into a less beneficial effects of specialised care on the course of the disease.

Prevalence and determinants of abnormal glucose metabolism in urban and rural secondary schools in Cameroon: A cross-sectional study in a sub-Saharan Africa setting.

INTRODUCTION: The incidence of Diabetes in children and teenagers increased by 30.2% between 2001 and 2009, with the main cause being an increase in the prevalence of overweight and obesity. Despite its high morbidity and mortality, few studies in Cameroon have focused on the study of abnormal glucose metabolism in schools. METHODOLOGY: This cross-sectional study was carried out in three schools institutions of two health districts selected from a three-stage cluster sampling survey-which consisted of a simple draw without discount for department selection, a simple random survey for the choice of health districts, and finally a simple random survey for the choice of schools institutions. RESULTS: Among the 815 participants, the prevalence of impaired fasting glucose and diabetes was 34.1% and 1.8% respectively. Glucose metabolism abnormalities were significantly higher in rural area than in urban areas (40% vs. 31.6%, p=0.016), and were significantly associated with abdominal obesity (p=0.027). Overweight and obesity were significantly higher in rural areas (p=0.0002), as well as abdominal obesity (p=0.0004). CONCLUSION: Abnormalities of glucose metabolism are a major health problem in schools in Cameroon. Thus, it is urgent to develop a health policy involving teachers and parents in the fight against overweight and obesity in schools.