Assessment of breast cancer awareness and detection of asymptomatic cases in Ngaoundere, Adamawa region of Cameroon.

Introduction: In Cameroon and most African countries, breast cancer (BC) is mainly diagnosed at an advanced stage, leading to worse prognosis and disease consequences. This is partly due to the delayed presentation of patients, which constitutes a significant barrier to the effective management of the disease. The aim of this descriptive, cross-sectional study is to identify the level of awareness of breast cancer and screening practice among women and health professionals in the city of Ngaoundere, Cameroon. Methods: Women and medical personnel were randomly recruited in two health institutions in the Adamawa region, Cameroon: the Ngaoundere Regional Hospital and the Ngaoundere Protestant Hospital. Two different questionnaires were prepared. The first was to collect sociodemographic data and assess participants' awareness of BC and related symptoms. The second was to collect information from the recommended screening methods for early detection of cases, including the frequency of screening practice among women and the daily practice of medical personnel. Results: Out of the women surveyed, 88.05 % have heard of breast cancer, but the majority were unaware of its clinical signs (47.1 %) and the means of treatment (22 %). In the studied population, 66.4 % were aware of the screening, but the practice was very low, as only 1.1 % of women had ever undergone screening by mammography and only 6 % often practiced breast self-examination (BSE). The levels of screening knowledge and practice were significantly associated with the level of education and employment status (P = 0.0001). In the group of 94 health personnel surveyed, 68.1 % had no knowledge of breast cancer screening methods, and only 30 % performed breast cancer screening in their daily practice. The practice of BSE during the study allowed a detection of 2 % of screened women with some suspicious clinical signs. Conclusion: This study revealed a lack of knowledge about BC and its screening methods and practice among women and health personnel in Ngaoundere. This lack of knowledge constitutes a significant barrier to early diagnosis of BC. There is a need to raise awareness and provide education and information about BC screening.

Association of hypertension in pregnancy with serum electrolyte disorders in late pregnancy among Cameroonian women.

Multiple electrolyte disorders, including sodium, potassium and calcium disorders, have been associated with hypertension in pregnancy. Most of these studies failed to evaluate the combined effect of low and high sodium, potassium, calcium and chloride ion concentrations on hypertension in pregnancy. This study evaluates the combined effect of these ion categories (low, normal, high) on hypertension in pregnancy. Biochemical ion assays and blood pressure measurements were carried out on 1074 apparently healthy pregnant women in late third trimester. Serum potassium, sodium, chloride, and ionised calcium were measured by ion-selective electrode potentiometry, while total plasma calcium was measured by absorption spectrophotometry. Hypertension in pregnancy was defined as systolic blood pressure ≥ 140 mmHg and/or diastolic blood pressure ≥ 90 mmHg. The prevalence of hyponatraemia, hypokalaemia, hypochloraemia, ionised hypocalcaemia and total hypocalcaemia in late pregnancy was 1.30 [0.78-2.18]%, 3.55 [2.60-4.84]%, 1.96 [1.28-2.97]%, 1.49 [0.92-2.21]% and 43.58 [40.64-46.56]%, respectively. Hypernatraemia, hyperkalaemia, hyperchloraemia, ionised hypercalcaemia and total hypercalcaemia were found in 1.49 [0.92-2.41]%, 2.34 [1.59-3.43]%, 4.38 [3.31-5.77]%, 39.94 [37.06-42.90]%, 2.79 [1.96-3.96]% of the participants, respectively. The prevalence of hypertension in pregnancy was 7.17 [5.77-8.87]%. When ion categories were considered in multiple logistic regression, only ionised and total calcium had significant associations with hypertension in pregnancy. Women with ionised hypercalcaemia had lower odds of hypertension in pregnancy (AOR = 0.50 [0.29-0.87], p-value = 0.015), and women with total hypocalcaemia had higher odds of hypertension in pregnancy (AOR = 1.99 [1.21-3.29], p-value = 0.007), compared to women with ionised and total normocalcaemia, respectively. Increasing kalaemia was associated significantly with higher odds of hypertension in pregnancy; however, kalaemia below and above the normal concentrations had no significant association with hypertension. Nonetheless, participants with kalaemia ≤ 3.98 mmol/L, had lower odds of hypertension in pregnancy compared with those with higher kalaemia (OR = 0.40 [0.24-0.66], p-value = 0.0003). Calcium disorders remain the most frequent electrolyte disorders in pregnancy. When normal cut-offs are considered for calcium and other ions, only ionised and total calcium influence the occurrence of hypertension in pregnancy. Kalaemia seems to affect hypertension in pregnancy but primarily within its normal concentrations. Serum electrolyte follow-up is indispensable for a proper pregnancy follow-up.

Calcium supplementation in pregnancy: An analysis of potential determinants in an under-resourced setting.

INTRODUCTION: Despite the evidence that calcium supplementation in pregnancy improves maternofoetal outcomes, many women still do not take calcium supplements during pregnancy in Cameroon. This study identifies factors that influence calcium supplementation during pregnancy in a low resource setting. METHODS: We conducted a cross-sectional hospital-based study (from November 2020 to September 2021) targeting 1074 healthy women in late pregnancy at the maternities of four major health facilities in the Nkongsamba Health District, Cameroon. Data were collected using an interview-administered semi-structured questionnaire and analysed using Epi Info version 7.2.4.0, and the statistical threshold for significance set at p-value = 0.05. RESULTS: The mean age of the participants was 28.20±6.08 years, with a range of 15-47 years. The proportion of women who reported taking any calcium supplements in pregnancy was 72.62 [69.85-75.22]%. Only 12% of calcium-supplemented women took calcium supplements throughout pregnancy, while a majority (50%) took calcium supplements just for 4-5 months. Women believe that taking calcium supplements is more for foetal growth and development (37.12%) and prevention of cramps (38.86%), than for the prevention of hypertensive diseases in pregnancy (2.84%). About all pregnant women (97.65%) took iron and folic acid supplements during pregnancy, and 99.24% took these supplements at least once every two days. Upon control for multiple confounders, the onset of antenatal care before 4 months of pregnancy (AOR = 2.64 [1.84-3.78], p-value = 0.000), having had more than 3 antenatal care visits (AOR = 6.01 [3.84-9.34], p-value = 0.000) and support/reminder from a partner on the necessity to take supplements in pregnancy (AOR = 2.00 [1.34-2.99], p-value = 0.001) were significantly associated with higher odds of taking any calcium supplements in pregnancy. CONCLUSION: Calcium supplementation practices in pregnancy remain poor in this population and far from WHO recommendations. Early initiation of antenatal care, a high number of antenatal visits and reminders or support from the partner on supplement intake significantly increase the odds of taking any calcium supplements in pregnancy. In line with WHO recommendations, women of childbearing age should be sensitised to initiate antenatal care earlier and attain as many visits as possible. Male involvement in prenatal care might also boost the likelihood of these women taking calcium supplements.

Cervical Precancerous Lesions and Associated Factors Among Women Screened in Two Hospitals in the City of Douala, Cameroon.

INTRODUCTION: Cervical cancer remains the second leading cause of death among women in Cameroon despite the new strategies put in place. This study was conducted in order to determine the prevalence of precancerous cervical lesions and its associated factors in Douala (Cameroon). METHODS:  A cross-sectional study was conducted over a period of nine months in two hospitals of the city of Douala, Cameroon (Laquintinie Hospital and Gyneco-Ostetric and Pediatric Hospital). Cervico-vaginal and endocervical samples were taken from women attending the above-mentioned hospitals in order to identify and characterize precancerous lesions by cytological examination and to genotype for human papillomavirus (HPV) using the Abbott RealTime High-Risk (HR) HPV kit. Data of sociodemographic characteristics, clinical history, and knowledge about cervical cancer were collected using a questionnaire. RESULTS: Of the 196 women included in this study, 17% had precancerous lesions, including 1.53% for atypical glandular cells (AGC), 4.53% for atypical squamous cells (ASC), 4.53% for low-grade squamous intraepithelial lesion (LSIL), 5.61% for high-grade squamous intraepithelial lesion (HSIL), 0.51% for atypical squamous cells of undetermined significance (ASC-US), and 0.51% for atypical squamous cells cannot exclude HSIL (ASC-H). In addition, the prevalence of HPV infection was 18%, of which 2% was for HPV 16, 2% for HPV 18, and 14% for undetermined HPV. A positive association was recorded between the occurrence of precancerous lesions and HPV infection (P=0.01), age, and school level. Moreover, the occurrence of precancerous lesions was positively associated with the participants' level of knowledge (P=0.01). DISCUSSION: Precancerous lesions were predominantly HSIL, and the factor most associated with these lesions was HPV infection. CONCLUSION: This study demonstrates that diagnosis is made at a relatively late stage due to a low level of knowledge about cervical cancer in the population.

Adverse maternofoetal outcomes associated with ionised calcaemia, total calcaemia, albuminaemia, and calcium supplementation in pregnancy: Analysis from a resource-limited setting.

INTRODUCTION: Disorders of total calcium (tCa) in pregnancy have been associated with adverse maternofoetal outcomes. However, studies evaluating this from the viewpoint of ionised calcaemia are practically inexistent. This study estimates the prevalence of some adverse maternal and foetal outcomes and the potential effect of ionised calcium (iCa), tCa, albumin and calcium supplementation on some maternofoetal outcomes. METHODS: A cross-sectional study was conducted among 1074 pregnant women in late pregnancy from four health facilities in the Nkongsamba Health District. Data were collected by interview, analysis of maternal blood samples and measurement of maternal and foetal parameters. Total calcaemia and albuminaemia were measured by atomic absorption spectrophotometry, while iCa and pH were measured using ion-selective potentiometry. Associations were measured using the odds ratio in simple and multiple logistic regression. RESULTS: The prevalence of low birth weight, macrosomia, and hypertension in pregnancy was 6.27 [4.97-7.89]%, 4.78 [3.65-7.89]%, 10.24 [8.57-12.20]%, respectively. Following multiple logistic regression, women with iCa levels ≤ 1.31mmol/L had significantly increased odds of hypertension in pregnancy (AOR = 2.47 [1.63-3.74], p-value = 0.000), having babies with low birth weight (AOR = 2.02[1.33-3.61], p-value = 0.002), low birth length (AOR = 2.00 [1.34-2.99], p-value = 0.001), low brachial circumference (AOR = 1.41[1.10-1.81], p-value = 0.007), first minute Apgar score < 7 (AOR = 3.08[1.70-5.59], p-value = 0.000) and fifth minute Apgar score < 7 (AOR = 2.86[1.32-6.16], p-value = 0.007). Ionised calcaemia had no significant association with maternal body mass index immediately after birth and the head circumference of the baby. Total calcaemia was found to have no significant association with any of the selected outcomes, while women with total albuminaemia ≤ 30mg/L had significantly higher odds of having babies with low birth weight (AOR = 3.40[1.96-5.91], p-value = 0.000), and Apgar scores < 7 at the first (AOR = 2.07[1.16-3.70], p-value = 0.013). Calcium supplementation showed no significant association with any of the selected outcomes except for the first (OR = 0.42[0.24-0.72], p-value = 0.002) and fifth minute Apgar score (OR = 0.25[0.12-0.50], p-value = 0.000). CONCLUSION: The prevalence of low birth weight, macrosomia, and hypertension in pregnancy was 6.27 [4.97-7.89]%, 4.78 [3.65-7.89]%, 10.24 [8.57-12.20]%, respectively. Maternal iCa levels ≤ 1.31mmol/L significantly increase the odds of having babies with low birth weight, low birth length, low brachial circumference at birth, low Apgar scores at the first and fifth minutes and maternal hypertension in pregnancy. Low maternal albuminaemia is significantly associated with low birth weight, and Apgar score < 7 at the first minute. None f the selected maternofoetal outcomes directly depend on total calcaemia, given that none of the associations was statistically significant. Even though iCa levels remain relatively normal in normal pregnancies, it remains the strongest predictor of foetal outcomes. Calcium supplementation significantly improves the Apgar scores at the first and fifth minute. Routine pregnancy follow-up should include evaluating maternal calcaemic states, particularly the ionised fraction, to detect the low-normal concentrations likely to impact maternal and foetal outcomes. Normal iCa levels for pregnant women need revisiting.

Ionised and total hypocalcaemia in pregnancy: An analysis of prevalence and risk factors in a resource-limited setting, Cameroon.

INTRODUCTION: Hypocalcaemia remains a prevalent laboratory finding in pregnancy, capable of inducing adverse maternofoetal outcomes. This study compares the prevalence of hypocalcaemia in apparently healthy pregnant women from the ionised, and total calcaemia viewpoints and further identifies factors associated with total crude and ionised hypocalcaemia in pregnancy. METHODS: A hospital-based cross-sectional study was conducted between November 2020 and September 2021, targeting apparently healthy pregnant women received in late pregnancy in four maternities in the Nkongsamba Health District, Cameroon. Blood samples were collected and analysed for serum ionised calcium concentrations and pH (by ion-selective electrode potentiometry), and for total calcium and albumin concentration (by atomic absorption spectrophotometry). Sociodemographic, obstetric and nutritional data were collected using an interviewer-administered questionnaire. RESULTS: The average age of the 1074 participants included in the study was 28.20±6.08 years. The prevalence of total crude and total albumin-corrected hypocalcaemia in this study was 61.64 [58.69-64.50]% and 56.70 [53.72-59.64]%, respectively (p-value = 0.000). The prevalence of ionised hypocalcaemia was very low (2.89 [2.04-4.07]%) compared with the prevalence of total hypocalcaemia (p-value = 0.000). Monthly income below 100.000FCFA (179 USD) (AOR = 0.73, p-value = 0.024), taking more than 2 meals daily (AOR = 0.68, p-value = 0.006) and taking desserts (AOR = 0.73, p-value = 0.046) reduced the odds of total crude hypocalcaemia, while having banana/plantain and tubers as the content of their most consumed meal significantly increased the odds of total crude hypocalcaemia (AOR = 1.37, p-value = 0.012). Single women (AOR = 2.54, p-value = 0.021), with a higher education (AOR = 3.27, p-value = 0.017), who initiated antenatal care before 4 months (AOR = 2.47, p-value = 0.029), had their odds of ionised hypocalcaemia significantly increased. On the other hand, women below 30 years (AOR = 0.44, p-value = 0.039), with occupations other than housewife (AOR = 0.34, p-value = 0.027), and women who took desserts between meals (AOR = 0.45, p-value = 0.034) had their odds of ionised hypocalcaemia significantly reduced. Taking calcium supplements simultaneously with other supplements also significantly reduced the odds of total hypocalcaemia in pregnancy (OR = 0.69, p-value = 0.027). CONCLUSION: Ionised hypocalcaemia in pregnancy is a rare finding. Only 2.89% of all apparently healthy pregnant women have ionised hypocalcaemia in late pregnancy, while 56.70% have total hypocalcaemia. Factors like the daily number of meals, taking of desserts, the content of the most consumed meal and monthly revenue significantly affect the prevalence of total hypocalcaemia in pregnancy. On the other hand, factors like age above 30 years, having a higher education, being single, having initiated antenatal care before 4 months of pregnancy, being a housewife and not taking desserts between meals have a significantly positive association with ionised hypocalcaemia.

Ethnopharmacological Study of the Medicinal Plants Used in the Treatment of Sickle Cell Anemia in the West Region of Cameroon.

Background: Sickle cell anemia (SCA) or sickle cell disease (SCD) is a genetic disease associated with increased morbidity and mortality in Africa and other developing nations. Therefore, modern and traditional remedies are being introduced for use in the treatment and management of this disease. This is because safe, effective, and inexpensive therapeutic agents are urgently needed for the treatment of this disease in Africa and other developing nations. Objective: The purpose of this study is to identify medicinal plant species commonly used by traditional healers in the treatment of sickle cell patients across some localities in the west region of Cameroon. Material and Methods. The ethnopharmacological survey was carried out in several districts within some localities of the western region of Cameroon. The survey was based on a semistructured questionnaire that was administered to 17 traditional healers and 62 sickle cell patients. It took place between November 2018 and March 2019. Personal information of participants and plant therapy data were gathered. Plants were identified at the National Herbarium of Cameroon. Literature review determined pharmacological effects and phytochemical compounds of the identified plants. Data were generally analysed using Epi Info 7 software for Windows. Results: Twelve medicinal plant species belonging to 10 families are being used in the treatment of sickle cell anemia across the study sites. Euphorbiaceae is the dominant family with three plant species. Bark (39.3%) and seeds (35.7%) are the most used plant parts, which get administered through maceration, decoction, and chewing in water. According to the literature review, the identified plants have pharmacological effects and phytochemical compounds (especially polyphenols and alkaloids) that signify the presence of antioxidant compounds, which may possess an antisickling activity. There is therefore a need to conduct another study to scientifically validate (in vitro) antisickling properties of these plants. Conclusion: This study has revealed promising medicinal plants that are currently applied in the traditional treatment of sickle cell anemia. Although still inconclusive, the association of pharmacological effects and phytochemical compounds with these medicinal plants justifies their use in traditional pharmacopoeia.

Metabolic Syndrome During Pregnancy: Prevalence and Determinants Among Pregnant Women Followed-Up at the Dschang District Hospital, West Region of Cameroon.

Purpose: Metabolic syndrome (MS) during pregnancy constitutes a serious threat to the mother and child health that will shortly become a major public health issue, especially in developing countries. However, in Cameroon, epidemiological data on MS during pregnancy are still scarce. The aim of this study was to determine the prevalence and determinants of MS among pregnant women followed-up at the Dschang District Hospital (DDH), in the west region of Cameroon. Patients and Methods: This study was a hospital based cross-sectional study, carried out among pregnant women followed-up at the antenatal care unit of the DDH, from September 2019 to June 2020. Participants were assessed on sociodemographic, lifestyle parameters, and dietary habits using standardized and structured questionnaires. Anthropometric parameters, blood pressure, and biochemical markers were measured using standard procedures. Metabolic syndrome was diagnosed using the HNLBI/AHA definition, modified for pregnant women by Chatzi et al. A participant was recorded as having MS if presenting at least three of the following criteria: Pre-gestational BMI >30 kg/m2; triglycerides ≥150 mg/dl; HDL cholesterol <50 mg/dl; SBP ≥130/DBP ≥85 mm/Hg; and fasting blood glucose ≥100 mg/dl. Results: Six hundred and four (604) pregnant women were included in the study. The prevalence of MS was 17.88% (95% CI: 15.03-21.14) and its most frequent individual components were low levels of HDL-cholesterol (66.23% (95% CI: 62.36-69.88)) and hypertriglyceridemia (28% (95% CI: 54.31-62.15)). Grand multiparous shows a higher risk of presenting MS (OR:3.06, 95% CI: 1.24-7.12; p = 0.011) compared to nulliparous. Pregestational BMI appears to be the best predictor of MS during pregnancy even after adjustment on age, parity, lifestyle and dietary habits (OR: 46.46, 95% CI: 15.58-138.49; p ˂ 0.0001). Conclusion: The prevalence of MS on pregnant women in the Dschang health district is 17.88% (95% CI: 15.03-21.14) and its major determinant is pre-gestational obesity. This work provides quality preliminary data for the design and improvement of prevention strategies.

Prevalence of precancerous cervical lesions and high-risk human papillomavirus types in Yaounde, Cameroon.

INTRODUCTION: Various Human papillomavirus (HPV) types cause cervical cancer, and represent the primary cause of cancer death in Africa and the second cause of most common cancers in Cameroon. Herein, we determined the prevalence of high-risk HPV types in women and associated cervical cytologic abnormalities in Yaounde, Cameroon. METHODOLOGY: A cross-sectional study targeting HPV-positive women aged 20 and over was conducted between March and June 2020 at the Saint Martin de Porres' Health Centre in Yaounde. HPV tests were performed by PCR for detection of HPVs 16, 18, 33, and 45. The test was performed on 616 women using exfoliated cell specimens; then, we processed on cytological diagnosis with Pap smears on HPV positive specimens. RESULTS: The HPV types tested were detected in 137 participants, of which 38.7% with multiple HPV infections, and the remaining part with single HPV infections of type HPV 16 (28.5%), HPV 18 (17.5%), HPV 33 (10.2%), and HPV 45 (5.1%). Cervical cytologic abnormalities were found in 69.34% of participants including: LSIL (49.63%), HSIL (15.32%), ASC-US (3.66%) and AGC (0.73%). Co-infections with HPV 16 and HPV 18 were significantly associated with HSIL (p = 0.001) lesions, while HPV 45 was more common in participants with normal cytology (p = 0.001). Cervical lesion occurrence was significantly associated with the number of sexual partners (p = 0.02) and history of oral contraceptive pill use (p = 0.001). CONCLUSIONS: Our results suggest that HPV 16 and 18 are predominant in Yaounde, and are associated with more severe precancerous lesions.

Breast cancer awareness and screening practice amongst health personnel and general population of the littoral region of Cameroon.

Introduction: Late diagnosis has been observed as the hallmark of breast cancer in Cameroonian women where over 70% of patients report with either stage III or IV of the disease, with high mortality and dire socioeconomic consequences. The present study was undertaken to assess the awareness of breast cancer, warning signs and screening methods among Health professionals and general population of Douala. Methods: Participants included in this study were health practitioners and women randomly selected and enrolled in six health facilities in the city of Douala, Littoral Region, Cameroon. A self-administered questionnaire was designed for each group and aimed at assessing their knowledge about breast cancer, warning signs and screening practices. Then, 616 women underwent breast palpation, followed by fine needle aspiration (FNA) when a nodule was found. Results: Out of a total of 737 participants (121 health personnel and 616 women) interviewed, a majority (96.3%) were aware of the disease with the main source of information being the hospital (76.0%), media (47.1%) and vocational training schools (45.4%) for health personnel; medias (39.9%), health professionals (26.1%) and their entourage (21.9%) for the population. Health workforce presented suitable awareness of the risk factors for breast cancer and its clinical signs even though 37.1% of them had misconceptions and myth-based ideas on the origin of the disease. Both the population and health personnel were aware of the possibility of early screening for breast cancer and cited breast self-examination, clinical breast examination and mammography as screening techniques. Nonetheless, screening practice amongst all women is very poor and mainly due to ignorance, high cost of mammography, together with a lack of mastery of the BSE technique and the fear of actually discovering signs of the disease. Conclusion: Our findings show lack of awareness and low practice of breast cancer screening amongst women in Douala and highlight the need to raise awareness and provide the right information to the public for early detection of breast cancer.

Awareness of Breast Cancer Screening among the Medical and General Population of the North Region of Cameroon.

Breast cancer has become a real public health problem in Cameroon, particularly in rural areas due to late diagnosis, resulting partly from the absence of national screening programs. This work is aimed at assessing breast cancer awareness in the North Region of Cameroon. Participants were selected in six health centers surrounding the rural area of Garoua, North Region, Cameroon, and administered a questionnaire aimed at assessing their awareness about breast cancer risk factors and screening. Out of the 475 women (including 37 medical personnel) interviewed, 45.5% attended at least secondary school; 91.3% were aware of the disease with the main sources of information from those around them (64.8%), media (46.5%), and health professionals in health facilities (42.7%). 23.3% had misconceptions and myth-based ideas on the origin of the disease. Ignorance was the main reason preventing the performance of breast self-examination, and the high cost prevents individuals from going for mammography. The highest awareness rate was observed in employed women with higher level of education. Our study highlights the need to raise awareness among the populations in North Region, Cameroon, about the risk factors and clinical signs of breast cancer and the importance of screening practice for early diagnosis of breast cancer.

Effects of the aqueous extract of Dicliptera verticillata on fertility and different stages of gestation in female rats.

Dicliptera verticillata is a medicinal plant traditionally used in western Cameroon to cure female infertility. This experiment was designed to assess the effects of the aqueous extract of Dicliptera verticillata (AEDv) on fertility and gestation in female rats. Oral increasing doses of AEDv were administered to immature female rats over 20 d. After this time, some animals were mated with fertile males and some fertility parameters were assayed; the other animals were euthanized for preliminary toxicity parameters analysis. The effects of AEDv on the different stages of gestation were assayed on selected animals previously controlled for estrous cycle regularity and mated. AEDv led to an increase in serum, uterine and ovarian proteins as well as in ovarian and uterine weights (P < 0.05) in immature female rats. Hepatic proteins significantly decreased (P < 0.01) in high dose-treated animals (50 and 100 mg/kg) compared with controls. The number of implantation sites and the fertility rate were significantly lower (P < 0.05), while the antifertility activity increased significantly (P < 0.05) in treated rats compared with controls. When administered from the 1st to the 5th day of pregnancy, AEDv led to a decrease of more than 60% in the implantation rate in high dose-treated rats (50, 100, and 400 mg/kg). From the 6th to the 9th day, the implantation, gestation rates and the number of fetuses decreased significantly in all treated groups. From the 11th to the 20th day, a 50% resorption and decrease in gestation rate were reported in 50 mg/kg dose-treated animals. AEDv possesses weak contraceptive and abortifacient effects during pregnancy.

Clinical Manifestations and Changes of Haematological Markers among Active People Living in Polluted City: The Case of Douala, Cameroon.

Urban air pollution, despite its dangerous health impact, is poorly studied in sub-Saharan Africa (sSA). Epidemiological data on this silent killer are almost non-existent for cities of Cameroon, which seems to be one of the sSA countries where populations are highly exposed to air pollutants. Objective: The present study was conducted in Douala city, and aimed at determining the association of urban air quality degradation with respiratory and systemic health in active populations exposed to air pollutants on a daily basis. Methods: A cross-sectional study was conducted from 2017 to 2019 in 1182 active people consisting of motorbikes drivers (MD), outdoor urban workers (UW), and fuel station sellers (FSS). A standardized questionnaire was used to document participants' data. One hundred and twenty-six (126) motorbike drivers were selected to evaluate the relationship between haematological (white blood cells, platelets) and inflammatory (C-reactive protein-CRP) biomarkers, and air pollution; compared with those of a sixty-five (65) motorbike drivers' control group enrolled in Dschang, another town situated at about 216.3 km from Douala. Results: Among those recruited in urban Douala, some respiratory disorders such as running nostrils, colds, common fever, sore throats, dry cough, wheezing, chest pain, shortness of breath and systemic symptoms such as headaches, eye irritation, conjunctivitis, watery eyes and general tiredness were very common among MD, UW, and FSS. Regarding biological data, blood monocytes, lymphocytes and CRP were found to be significantly increased among selected MD in Douala, compared to control groups in Dschang. Conversely, a more significant decrease in blood neutrophil level was observed among MD in Douala than control groups in Dschang. These changes of haematological markers were significantly associated with place of residence, site of activity, and daily duration. Conclusion: Our results suggest the risk of suffering from respiratory impairments and systemic symptoms with exposure to urban air pollution among active people working near highways in Douala.

Hypocalcaemia and calcium intake in pregnancy: A research protocol for critical analysis of risk factors, maternofoetal outcomes and evaluation of diagnostic methods in a third-category health facility, Cameroon.

INTRODUCTION: Hypocalcaemia in pregnancy remains a major health issue, particularly in the developing world where daily calcium intakes are suboptimal. This electrolyte imbalance can lead to severe maternofoetal and childhood consequences. Calcium supplementation, amongst others, contributes significantly to meeting calcium demands in pregnancy. With ionised calcaemia as the gold standard for diagnosis, total calcaemia and albumin-corrected calcaemia in other pathological states have been found to overestimate the burden of hypocalcaemia. The main objectives of this study are to describe the blood calcium level (total, albumin corrected, and ionised calcaemia) and associated maternofoetal outcomes while identifying determinants of calcium supplementation and ionised hypocalcaemia. This study will also evaluate the sensitivity and specificity of albumin corrected calcaemia as a diagnostic tool for hypocalcaemia (ionised calcaemia as the gold standard) among pregnant women in the Nkongsamba Regional Hospital, Cameroon. METHODS: Our study will target a total of 1067 term pregnant women who shall be included consecutively into the study as they arrive the maternity of the Nkongsamba Regional Hospital for their last antenatal care visit. Data shall be collected using a semi-structured interview-administered questionnaire and blood samples collected for total plasma calcium, albumin and serum ionized calcium assays. Additional data will be collected at birth (maternal and foetal variables; foetal outcomes evaluated as secondary outcomes). Total calcaemia and albuminemia shall be measured by atomic absorption spectrophotometry, while ionised calcaemia will be measured by ion-selective electrode potentiometry(using MSLEA15-H electrolyte analyzer) per standard BIOLABO and MSLEA15 protocols, respectively. Data will be analysed using the statistical softwares epi-Info version 7.2.2.16 and STATA version 16. EXPECTED RESEARCH OUTCOME: This study will present a more precise estimate of the burden of hypocalcaemia in late pregnancy as well as identify and analyse the different factors associated with calcium supplementation and ionised hypocalcaemia among term pregnant women in a developing world setting. Maternofoetal outcomes associated with hypocalcaemia will be determined as well as the sensitivity and specificity of total and albumin-corrected calcaemia in diagnosing hypocalcaemia. Our findings will contribute significantly to designing or strengthening interventions to control this electrolyte imbalance.

Eremomastax speciosa potentializes the PMSG-inducing effect on some physiological and biochemical parameters in PMSG-primed immature rats.

The present study evaluated the effect of the aqueous extract from leaves of E. speciosa on some physiological and biochemical parameters of reproduction and the onset of puberty in pregnant mare serum gonadotropin (PMSG)-primed immature female rats. High pressure liquid chromatography (HPLC) was used to quantify the phenolic compounds in the methanol/methylene chloride (1:1) extract, the ethanolic and ethyl acetate fractions and the aqueous residue of E. speciosa. E. speciosa (0, 8, 32 or 64 mg/kg) were administered for 15 days to 24 non-PMSG-primed and 24 primed rats with 0.01 IU of PMSG. At the end of the treatment period, animal were sacrificed and their body, ovarian, uterine weight, ovarian protein or cholesterol level, as well as data on puberty onset were recorded. Of the 16 polyphenolic compounds quantitatively revealed in the extracts and fractions of E. speciosa after HPLC analysis, quercetin, rutin, apigenin and eugenol were the most abundant. Non-primed rats showed a significant increase (P < 0.05) in the uterine relative weight at the dose of 8 mg/kg when compared with the other treatments. The uterine proteins and the ovarian cholesterol (P < 0.05), respectively, showed a reduction at doses of 64 mg/kg and 32 mg/kg in non-primed rats. However in PMSG-primed rats, a significant decrease (P < 0.05) was observed in ovarian cholesterol at 64 mg/kg. In conclusion, E. speciosa potentializes the PMSG-inducing effect on folliculogenesis in PMSG-primed rats.

Evaluation of the Effects of Agro Pesticides Use on Liver and Kidney Function in Farmers from Buea, Cameroon.

Agro pesticides are increasingly used worldwide to increase crop production. However, health hazards resulting from human exposure to these chemicals, especially from agricultural areas of developing countries have been a growing concern. The objective of this study was to evaluate the impact of occupational exposure to agro pesticides on the health of farmers in the Buea subdivision, which is one of the major agrarian areas in Cameroon. The study was transversal and involved 90 participants including 58 farmers using pesticides and a reference population of 32 men not involved in occupational use of agro pesticides. The participants were interviewed on agro pesticide use and their health status. Thereafter, blood samples were collected from the participants and used for the assessment of biochemical markers of the liver (alanine aminotransferase and aspartate aminotransferase) and the kidney (creatinine and uric acid) function. Results revealed that farmers frequently used insecticides, fungicides, and herbicides in their farming activities. Farmers reported several acute health symptoms related to pesticides use with the common ones being skin rash, eye irritation, and face burn. When compared to the reference population, the farmers showed significantly elevated (p < 0.01) alanine aminotransferase activity. However, other parameters investigated were not affected significantly. These results suggested that farmers were exposed to 3 different classes of agro pesticides, which induced eye and skin affections. Pesticides exposure resulted in alterations of the liver function hence the increased serum alanine aminotransferase activity. Therefore, there is a need to sensitize the farmers on toxicity and liver alteration potential of agro pesticides and the importance of appropriate protective equipment that may minimize exposure.

Prevalence and correlates of low serum calcium in late pregnancy: A cross sectional study in the Nkongsamba Regional Hospital; Littoral Region of Cameroon.

INTRODUCTION: Women from low and middle income countries are generally more likely to have sub-optimal calcium intake. The objective of this study was to assess serum calcium disorders and correlates in late pregnancy. METHODS: We conducted from December 2018 to April 2019, a cross-sectional hospital-based study targeting pregnant women in late pregnancy in the Nkongsamba Regional Hospital. Data were collected by measurement of parameters (weight, height, blood pressure and foetal birthweight), administration of a semi-structured questionnaire and analysis of blood samples collected from each participant. Absorption spectrophotometry was used to measure serum calcium and albumin concentrations and corrected serum calcium calculated from the Payne's equation. With a statistical significant threshold set at p-value = 0.05, the odds ratio was used as a measure of the strength of association between hypocalcaemia and maternofoetal variables. RESULTS: We enrolled a total of 354 consenting participants with a mean age of 27.41±5.84 years. The prevalence of hypocalcaemia in late pregnancy was 58.76 [53.42-63.90]%. The rate of calcium supplementation in pregnancy was 57.63[52.28-62.80]% with a mean duration of supplementation of 3.69±1.47 months. When controlled for marital status, age, level of education, and gestational age at delivery, pregnant women with systolic blood pressures below 130 mmHg were significantly less likely to have hypocalcaemia than their counterparts with higher systolic blood pressures (Adjusted Odds Ratio = 0.41[0.18-0.89], p-value = 0.020). No statistically significant associations were found between diastolic blood pressure, body mass index, foetal birth weight and hypocalcaemia. CONCLUSION: Hypocalcaemia in late pregnancy is highly prevalent (59%) among women accessing reproductive services at the Nkongsamba Regional Hospital. There is also a wide gap in calcium supplementation compared to World Health Organization recommendations. Hypocalcaemia is significantly associated to higher systolic blood pressure in pregnancy. Systematic calcium supplementation and consumption of high calcium containing locally available meals should be encouraged.

Acute and sub-acute toxicity of the aqueous extract from the stem bark of Tetrapleura tetrapteura Taub. (Fabaceae) in mice and rats.

ETHNOPHARMACOLOGICAL RELEVANCE: Tetrapleura tetrapteura Taub. is a leguminous multipurpose tree (Fabaceae) indigenous to tropical Africa. Fruits, seeds and stem bark infusions or decoctions of Tetrapleura tetrapteura Taub. are used to treat many diseases, such as gastric ulcer, rheumatism, malaria, hypertension and hyperlipidemia. AIM OF THE STUDY: This work was conducted to evaluate the acute and sub-acute toxicity of the aqueous extract of Tetrapleura tetrapteura Taub. (AETT) stem barks. MATERIALS AND METHODS: For the study of acute toxicity, single oral doses of 2000 mg/kg and 5000 mg/kg of AETT were administrated to male and female Balb/c mice, followed by observation of mice for 14 days. In the study of sub-acute toxicity, 48 albino wistar rats of both genders were randomly divided into six groups of 8 animals and they were daily and orally administrated for twenty eight days. The animal's test groups and satellite test group were administrated with the extract (AETT) at the doses of 100, 200 and 400 mg/kg and 400 mg/kg respectively. On the 29th day, the satellite group (control 2 and satellite 400 mg/kg) were observed during two more weeks. General behavior changes, mortality, body weight of animal, water and food intake were recorded during the study period. At the end of each treatment period, biochemical and hematological parameters were measured and histological examinations of liver and kidneys sections performed. RESULTS: Up to 5000 mg/kg single dose administration of AETT for fourteen days registered no death animal. In sub-acute study, no mortality was recorded in various experimental groups. Significant reductions in body weight, water and food intake were recorded in all treated animals. Relative weights of liver, kidneys, stomach, spleen, lungs, and heart of treated animals remained unchanged. Significant increases in the number of platelets as well as in serum ALAT level were recorded in rats, treated with 400 mg/kg of AETT. Female rat liver histology showed, at a higher dose of AETT, a slight congestion of portal vein. CONCLUSION: AETT is safe after therapeutic (200 mg/kg) or acute administration. Higher dose (400 mg/kg) administered for longer period showed signs of liver toxicity.

Risk assessment of hepatotoxicity among tuberculosis and human immunodeficiency virus/AIDS-coinfected patients under tuberculosis treatment.

OBJECTIVE/BACKGROUND: Tuberculosis (TB) is a worldwide public health problem. It is a contagious and grave disease caused by Mycobacterium tuberculosis. Current drugs such as isoniazid, pyrazinamide, and rifampicin used for the treatment of tuberculosis are potentially hepatotoxic and can lead to drug hepatitis. In order to improve the follow-up of TB patients in Cameroon, we carried out a study which aimed to evaluate the hepatotoxicity risk factors associated with anti-TB drugs. METHODS: The studies were performed on 75 participants who had visited the Loum District Hospital located in the littoral region of Cameroon for their routine consultation. Participants have been selected based on pre-established criteria of inclusion and exclusion. Prior to the informed consent signature, patients were given compelling information about the objective and the result output of the study. They were questioned about antioxidant food and alcohol consumption as well as some clinical signs of hepatotoxicity such as fever, nausea, vomiting, and tiredness. The collected blood was tested for the determination of biochemical markers (transaminases and C-reactive protein) using standard spectrophotometric methods. RESULTS: Biochemical analysis of samples showed a significant increase (p<.05) of aspartate aminotransferase and alanine aminotransferase values in TB patients coinfected with human immunodeficiency virus/AIDS (33.28±16.58UI/L and 30.84±17.17UI/L, respectively) compared with the respective values of the controls (16.35±5.31UI/L and 16.45±4.83UI/L). Taking individually, the liver injury patient percentage of TB patients was significant compared to TBC when considering alanine aminotransferase and aspartate aminotransferase parameters. When considering risk factors, antioxidant food consumption significantly reduced the liver injury patient percentage for the above parameters, whereas an opposite situation was observed with alcohol consumption between TB-coinfection and TB patients. Regarding the C-reactive protein results, the percentage of positive tests was very high among coinfected patients (40%) compared with the control (15%). The interactions between parameters related to alcohol consumption and intake of antioxidant foods showed a slight decrease in activity compared with interactions without food. CONCLUSION: The results showed that human immunodeficiency virus status and alcohol consumption constitutes aggravating factors for the occurrence of hepatic toxicity. In addition, the consumption of antioxidant foods simultaneously with TB drugs help in reducing the hepatotoxic effects of these drugs.