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Ngatchou W, Barche B, Temgoua M, Metouguena SE, Jutcha I, Mvondo CM, Kamdem F, Dzudie A, Ndjoh S, Johne M, Metogo J, Ndom MS, Sango J, Ngo Yon C, Moulium S, Lade V, Kuaté LM, Menanga AP, Sobngwi E, Njock R, Blazquez SB, Ngowe Ngowe M. Prevalence, clinical presentation, and risk factors of chronic venous disease in Cameroon: A general population-based study. Phlebology 2024; 39:259-266. [PMID: 38158837 DOI: 10.1177/02683555231224111] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/03/2024]
Abstract
INTRODUCTION Chronic venous disease is a global public health problem, with high morbidity and economic distress. There is scarcity of data on this disease in sub-Saharan Africa. METHODS We conducted the first population-based study over a period of 20 months from 1st February 2020 to 30th September 2021 in the 10 regions of Cameroon. A stratify sampling method was chose to select study site. Socio-demographic data, personal and family history, anthropometric parameters, clinical signs, illustrative images, CEAP (Clinical-Etiological-Anatomical-Pathophysiological) classification revised in 2004, VCSS (venous Clinical Severity Score) and risk factor assessment score were used to construct the survey form. Chi-squared test and Fischer exact test were used to compare the prevalence of chronic venous disease across different potential risk factors (sex, age category, previous history of deep vein thrombosis, hypertension, diabetes, smoking status, obesity). Simple and multiple logistic regression models were used to obtain crude and adjusted odds ratio for risk factors associated with chronic venous insufficiency. Statistical analyses were done with R version 4.2 for Linux and the threshold for statistical significance was 0.05. RESULTS A total of 6578 participants were included in the study, with a mean age of 41.09 ± 16.02 years with female predominance (54.3%). The prevalence of chronic venous disease was 21.8% (95% CI: 20.8-22.9) and the prevalence of chronic venous insufficiency (C3-C6) was 7.02% (n = 462). Night cramps (43.2%), oedema (21.7%), lower limbs pain (20.4%) mostly worsens by walking and heavy legs (16.2%) were more common symptoms. The mean total venous clinical severity score was 0.69 ± 1.76 and this score had a significant positive correlation with C classification (p < .001). In the multivariate analysis, the following factors were independently associated with CVD: Male gender (aOR: 1.27; 95%CI: 1.04-1.56; p = .021), retired people (aOR: 46.9; 95% CI: 12.6-174.5; p < .001), hypertension (aOR: 289.5; 95%CI: 169.69-493.1; p < .001), diabetes (aOR: 2.19; 95% CI: 1.21-3.96; p = .009), obesity (aOR: 10.22; 95%CI: 7.67-13.62; p < .001). Smoking appears as a protective factor (aOR: 0.18; 95%CI: 0.10-0.30; p < .001). CONCLUSION Chronic venous disease is frequent in Cameroon and main traditional cardiovascular risk factors are associated to this condition. Systematic screening of the CVD in these specific groups could reduce the burden of the disease and its economic impact.
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Affiliation(s)
- William Ngatchou
- Department of Surgery and Specialities, Faculty of Medicine and Pharmaceutical Sciences, University of Douala, Douala, Cameroon
| | - Blaise Barche
- Clinical Research Education Networking and Consultancy, Douala, Cameroon
| | - Mazou Temgoua
- Department of Cardiology, Faculty of Medicine, University of Toulouse-Rangueil, Toulouse, France
| | - Serge Erwich Metouguena
- Department of Surgery and Specialities, Faculty of Medicine and Pharmaceutical Sciences, University of Douala, Douala, Cameroon
| | - Ivan Jutcha
- Department of Surgery and Specialities, Faculty of Medicine and Pharmaceutical Sciences, University of Douala, Douala, Cameroon
| | - Charles Mve Mvondo
- Department of Surgery and Specialities, Faculty of Medicine and Pharmaceutical Sciences, University of Douala, Douala, Cameroon
| | - Félicité Kamdem
- Department of Cardiology General Hospital, Douala, Cameroon
- Department of Medicine and Specialities, Faculty of Medicine and Pharmaceutical Sciences, University of Douala, Douala, Cameroon
| | - Anastase Dzudie
- Clinical Research Education Networking and Consultancy, Douala, Cameroon
- Department of Cardiology General Hospital, Douala, Cameroon
| | - Samuel Ndjoh
- Department of Surgery and Specialities, Faculty of Medicine and Pharmaceutical Sciences, University of Douala, Douala, Cameroon
| | - Marcel Johne
- Department of Surgery and Specialities, Faculty of Medicine and Pharmaceutical Sciences, University of Douala, Douala, Cameroon
| | - Junette Metogo
- Department of Surgery and Specialities, Faculty of Medicine and Pharmaceutical Sciences, University of Douala, Douala, Cameroon
| | - Marie Solange Ndom
- Department of Medicine and Specialities, Faculty of Medicine and Pharmaceutical Sciences, University of Douala, Douala, Cameroon
| | - Joseph Sango
- Department of Surgery and Specialities, Faculty of Medicine and Pharmaceutical Sciences, University of Douala, Douala, Cameroon
| | - Carole Ngo Yon
- Department of Surgery and Specialities, Faculty of Medicine and Pharmaceutical Sciences, University of Douala, Douala, Cameroon
| | - Sidick Moulium
- Department of Cardiology General Hospital, Douala, Cameroon
- Department of Medicine and Specialities, Faculty of Medicine and Pharmaceutical Sciences, University of Douala, Douala, Cameroon
| | - Viche Lade
- Department of Cardiology General Hospital, Douala, Cameroon
| | - Liliane Mfeukeu Kuaté
- Department of Medicine and Specialities, Faculty of Medicine and Biomedical Sciences, University of Yaounde, Yaounde, Cameroon
| | - Alain Patrick Menanga
- Department of Medicine and Specialities, Faculty of Medicine and Biomedical Sciences, University of Yaounde, Yaounde, Cameroon
| | - Eugène Sobngwi
- Department of Medicine and Specialities, Faculty of Medicine and Biomedical Sciences, University of Yaounde, Yaounde, Cameroon
| | - Richard Njock
- Department of Surgery and Specialities, Faculty of Medicine and Pharmaceutical Sciences, University of Douala, Douala, Cameroon
| | | | - Marcelin Ngowe Ngowe
- Department of Surgery and Specialities, Faculty of Medicine and Pharmaceutical Sciences, University of Douala, Douala, Cameroon
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Kamdem F, Meyanga Ngoah J, Nganou Gnindjio CN, Mekoulou Ndongo J, Ba H, Mouliom S, Viché L, Ngoté H, Kenmegne C, Tsague Kengni H, Ndom Ebongue MS, Djibrilla S, Bika Léle EC. Pattern and determinants of health-related quality of life of adolescents with congenital heart disease in Cameroon: A single-center cross-sectional study. JRSM Cardiovasc Dis 2024; 13:20480040241247396. [PMID: 38638397 PMCID: PMC11025313 DOI: 10.1177/20480040241247396] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/24/2023] [Revised: 02/27/2024] [Accepted: 03/27/2024] [Indexed: 04/20/2024] Open
Abstract
Background Health-related quality of life (HRQoL) assessment is necessary for the management of patients with congenital heart diseases (CHD). No study has yet been reported on Cameroonian adolescents. The aim of this study was to evaluate the profile of and look for determinants of HRQoL in adolescents with CHD in Cameroon. Methods This was a cross-sectional study with prospective recruitment carried out on 71 adolescents diagnosed with CHD aged 12 to 18 years and recruited at the Douala General Hospital. Sociodemographic and clinical data were collected using a structured questionnaire. HRQoL was assessed using the pediatric quality of life inventory (PedsQL4.0) for child and parent reports. Multivariate linear regression was used to assess the determinants of HRQoL. Differences were considered significant for p < 0.05. Results Mean age of participants was 15 ± 2 years with 54.9% women. Mean physical and psychosocial functioning scores were 50.7 ± 13.9 and 60.5 ± 9.6 for parent report and 49.5 ± 13.4 and 59.1 ± 9.1 for child report respectively; with no significant difference according to gender. Distribution of functioning scores according to anatomical complexity showed no significant difference while it was lower in patients with a greater physiological severity and to those with no surgical intervention compared to the others. After multivariate adjustments, physiological stage 3 or 4 was negatively associated while cardiac intervention was positively associated with HRQoL. Conclusion CHD adolescents exhibit a low level of quality of life. Cardiac intervention positively affects HRQoL and should be targeted in the reduction of HRQoL burden from CHD in Cameroon.
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Affiliation(s)
- Félicité Kamdem
- Department of Internal Medicine, Douala General Hospital, Douala, Cameroon
- Faculty of Medicine and Pharmaceutical Sciences, University of Douala, Douala, Cameroon
| | | | | | - Jerson Mekoulou Ndongo
- Physiology and Medicine of Physical Activities and Sports Unit, University of Douala, Douala, Cameroon
| | - Hamadou Ba
- Faculty of Medicine and Biomedical Sciences, University of Yaoundé I, Yaoundé, Cameroon
| | - Sidick Mouliom
- Department of Internal Medicine, Douala General Hospital, Douala, Cameroon
- Faculty of Medicine and Pharmaceutical Sciences, University of Douala, Douala, Cameroon
| | - Lade Viché
- Department of Internal Medicine, Douala General Hospital, Douala, Cameroon
- Faculty of Medicine and Biomedical Sciences, University of N'Gaoundéré, N’Gaoundéré, Cameroon
| | - Henri Ngoté
- Department of Internal Medicine, Douala General Hospital, Douala, Cameroon
| | - Caroline Kenmegne
- Department of Internal Medicine, Douala General Hospital, Douala, Cameroon
| | - Hermann Tsague Kengni
- Faculty of Medicine and Pharmaceutical Sciences, University of Douala, Douala, Cameroon
| | | | | | - Elysée Claude Bika Léle
- Physiology and Medicine of Physical Activities and Sports Unit, University of Douala, Douala, Cameroon
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Nganou-Gnindjio CN, Kamdem F, Hamadou B, Bomda RM, Etoa Etoga MC, Ndobo V, Djibrilla S, Mfeukeu Kuate L, Amougou SN, Owona A, Mintom P, Ebene GM, Wafeu GS, Menanga AP. Performance of systolic pressure index for lower limb peripheral arterial disease in a group of elderly in sub-Saharan Africa. Ann Cardiol Angeiol (Paris) 2023; 72:101608. [PMID: 37269805 DOI: 10.1016/j.ancard.2023.101608] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/19/2023] [Revised: 05/04/2023] [Accepted: 05/10/2023] [Indexed: 06/05/2023]
Abstract
BACKGROUND The automatic measurement of the ankle-brachial index (ABI) constitutes a reliable, simple, safe, rapid, and inexpensive alternative diagnostic screening test compared with the Doppler method for peripheral arterial disease (PAD). We aimed to compare the diagnostic performance of automatic ABI measurement tests to Doppler ultrasound for PAD in a group of patients aged 65 years and above, in Sub-Saharan Africa. METHODS This was an experimental comparative study of the performance of Doppler ultrasound to the automated ABI test in the diagnosis of PAD in patients aged ≥ 65 years followed-up at the Yaoundé Central Hospital, Cameroon between January to June 2018. An ABI threshold < 0.90 is defined as a PAD. We compare the sensitivity, and specificity of the high ankle-brachial index (ABI-HIGH), low ankle-brachial index (ABI-LOW), and the mean ankle-brachial index (ABI-MEAN) for both tests. RESULTS We included 137 subjects with an average age of 71.7 ± 6.8 years. In the ABI-HIGH mode, the automatic device had a sensitivity of 55% and a specificity of 98.35% with a difference between the two techniques of d = 0.024 (p = 0.016). In the ABI-MEAN mode, it had a sensitivity of 40.63% and a specificity of 99.15%; d = 0.071 (p < 0.0001). In the ABI-LOW mode, it had a sensitivity of 30.95% and a specificity of 99.11%; d = 0.119 (p < 0.0001). CONCLUSION The Automatic measurement of systolic pressure index has a better diagnostic performance in the detection of Peripheral Arterial Disease compared to the reference method by continuous Doppler in sub-Saharan African subjects aged ≥ 65 years.
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Affiliation(s)
| | - Félicité Kamdem
- Faculty of Medicine and Pharmaceuticals Sciences, University of Douala, Cameroon
| | - Bâ Hamadou
- Faculty of Medicine and Biomedical Sciences, University of Yaoundé I, Cameroon
| | | | | | - Valérie Ndobo
- Faculty of Medicine and Biomedical Sciences, University of Yaoundé I, Cameroon
| | | | | | | | - Amalia Owona
- Faculty of Medicine and Biomedical Sciences, University of Yaoundé I, Cameroon
| | - Pierre Mintom
- Faculty of Medicine and Biomedical Sciences, University of Yaoundé I, Cameroon
| | - Guy Manon Ebene
- Faculty of Medicine and Biomedical Sciences, University of Yaoundé I, Cameroon
| | - Guy Sadeu Wafeu
- Faculty of Medicine and Biomedical Sciences, University of Yaoundé I, Cameroon
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Kamdem F, Nganou-Gnindjio CN, Ymele HK, Eboutibe POM, Djomou A, Léle ECB, Hamadou B, Mouliom S, Viché L, Ngoté H, Kenmegne C, Ebongue MSN, Djibrilla S, Essome H. Epidemiological features and mortality risk factors of peripartum cardiomyopathy in a group of Sub-Saharan African population. Ann Cardiol Angeiol (Paris) 2023; 72:101615. [PMID: 37348442 DOI: 10.1016/j.ancard.2023.101615] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/12/2023] [Revised: 05/22/2023] [Accepted: 05/25/2023] [Indexed: 06/24/2023]
Abstract
BACKGROUND Peripartum cardiomyopathy (PPCM) is a rare cause of heart failure occurring during pregnancy. Its prevalence seems more frequent in Africa but its epidemiological, clinical and evolutionary particularities remain unknown. This study aimed to evaluate the epidemiological features and mortality risk factors of PPCM. MATERIAL AND METHOD We conducted a retrospective cross-sectional study over 38 months (January 2018 to March 2021) in 3 hospitals in the city of Douala(Cameroon). We included all patients with heart failure between the last month of pregnancy and 5 months after delivery without an identified cause. Were excluded, files not containing data on echocardiography, patients with heart failure without dilation or with LVEF≥ 45% and patients with a history of heart disease of known aetiology. Chi² tests and binary logistic regression were used for data analysis; the survival curve according to Kaplan Meier was drawn for the evolution. The threshold of significance was set at 0.05. RESULTS A total of 2102 medical records of women with heart failure were searched. In these records, a total of 59 patients showed signs of peripartum heart failure and only 29 fulfilled the inclusion criteria. From a socio-demographic point of view, the average age was 29 ± 7 years and 51.7% of patients were over 30 years old. Among these patients, 79.3% of patients lived in urban areas and 10.3% of patients had a low socio-economic level. The hospital frequency of PPCM was 1.3%. Clinically, primiparous and pauciparous women were the most affected; the diagnosis was made after more than a month of progression in 65.5% of patients. Dyspnea was present in all patients. In addition, 89.7% of patients had a left ventricular end-diastolic diameter ≥ 62 m, 48.3 % had a left ventricular ejection fraction (LVEF) between 30% and 45%, and 51.7% had an LVEF < 30%. The associated mortality rate was 27.7%. The only prognostic factor independently associated with mortality was age < 30 years. CONCLUSION The frequency of PPCM is relatively low in Cameroonian urban settings. Moreover, its diagnosis is generally delayed and it induces high mortality. Its occurrence in a woman under the age of 30 is a factor of poor prognosis.
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Affiliation(s)
- Félicité Kamdem
- Department of Internal Medicine, Douala General Hospital, Cameroon; Faculty of Medicine and Pharmaceutical Sciences, University of Douala, Cameroon
| | | | | | | | - Armel Djomou
- Department of Internal Medicine, Douala Laquintinie Hospital, Cameroon
| | | | - Ba Hamadou
- Faculty of Medicine and Biomedical Sciences, University of Yaoundé I, Cameroon
| | - Sidick Mouliom
- Department of Internal Medicine, Douala General Hospital, Cameroon; Faculty of Medicine and Pharmaceutical Sciences, University of Douala, Cameroon
| | - Lade Viché
- Department of Internal Medicine, Douala General Hospital, Cameroon; Faculty of Medicine and Biomedical Sciences, University of Garoua, Cameroon
| | - Henri Ngoté
- Department of Internal Medicine, Douala General Hospital, Cameroon
| | | | - Marie Solange Ndom Ebongue
- Faculty of Medicine and Pharmaceutical Sciences, University of Douala, Cameroon; Department of Internal Medicine, Douala Laquintinie Hospital, Cameroon
| | - Siddikatou Djibrilla
- Department of Internal Medicine, Douala Laquintinie Hospital, Cameroon; Faculty of Health Sciences, University of Buea, Cameroon
| | - Henri Essome
- Faculty of Medicine and Pharmaceutical Sciences, University of Douala, Cameroon; Department of Internal Medicine, Douala Laquintinie Hospital, Cameroon
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Limbole E, Mipinda JB, Cavagna P, Hermann Y, Tchuem Tchuente-Noutchogouin M, Souleymane C, Asselin A, Mbaye A, Kamdem F, Sidy Ali A, Thiam S, N'da N'kenon Watani J, Antignac M, N'Guetta R, Jouven X. Stroke care in 17 Sub-Saharan African countries: the FEBRUARY study (2016–2021) from African research network. Eur Heart J 2022. [DOI: 10.1093/eurheartj/ehac544.1989] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/14/2022] Open
Abstract
Abstract
Background
Stroke is one of the leading causes of morbidity and mortality worldwide. Approximately 70% of deaths from stroke and 87% of stroke-related disability would occur in low- and middle-income countries. Between 2002 and 2020, estimation stroke mortality in Sub-Saharan Africa (SSA) was tripled. There is scarce data on management of stroke in SSA.
Purpose
To describe stroke care in cardiology departments in 17 SSA countries
Methods
We conducted a transversal and longitudinal study in CV department of 37 hospitals from 23 cities in 17 SSA countries (10 low income: Niger, Guinea, Benin, Mali, Democratic Republic of the Congo (DCR), Tchad, Burkina Faso, Togo, Burundi, Ethiopia and 7 middle income: Cote d'Ivoire, Senegal, Cameroon, Congo, Soudan, Mauritania, Gabon). The FEBRUARY study was designed by a multidisciplinary collaborative team of epidemiologists, pharmacists and cardiologists from Africa and France. This ongoing observatory included all inpatients in February from each year since 2016. Data including socio-demographic and clinical characteristics, causes of admission, clinical, biological, complementary examinations, treatments, length of stay and discharge diagnosis were collected by the investigating physicians. All analyses were performed through scripts developed in the R software (4.0.3 (2020-10-10)).
Results
Overall, 4360 patients were admitted to hospital over the 6 years of the study. Stroke was the third cause of hospitalization with 477 (11%) patients admitted. Proportions of patients admitted for stroke varied across countries from 0% in Ethiopia to 52% in DRC (p<0.01) (figure) and over the years from 11% in 2016 to 16.5% in 2021. Men represented 60.1% of stroke patients. Mean of age was 62.5±13.4 years. Overall, 300 patients (62.9%) were from low-income countries and 177 patients (37.1%) from middle-income countries. A majority of patients were living in urban areas (N=387; 82.9%) compared to rural areas (N=80; 17.1%). Individual wealth index was low, middle and high in 105 (23.2%), 152 (33.6%) and 196 (43.3%) patients respectively. Among stroke patients, 413 (89.8%) had a computed tomography. Ischemic stroke represented 71.8% of patients with stroke. Among CV risk factors, high blood pressure was identified in 81.9% of patients. In-hospital antithrombotic therapy was prescribed for 2 patients (0.42%). Anticoagulant therapy and antiplatelet therapy were prescribed for 26.4% and 53.5% of patients respectively. Proportions of patients treated with antiplatelet therapy varied across countries (p<0.05). At discharge, 8% and 44.4% of patients received anticoagulant therapy or antiplatelet therapy respectively. Mean of length of stay was 12.4±18.4 days. Stroke represent the second cause of mortality (18.7%) and did not vary significantly across countries.
Conclusion
Stroke was the third cause of admission with more than 1/10 patients and the second cause of mortality with almost 1/5 patients in cardiology departments in SSA.
Funding Acknowledgement
Type of funding sources: None.
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Affiliation(s)
- E Limbole
- Ngaliema Hospital , Kinshasa , Congo (Democratic Republic of the)
| | - J B Mipinda
- University hospital, Cardiology , Libreville , Gabon
| | - P Cavagna
- Pitie Salpetriere APHP University Hospital, Pharmacy , Paris , France
| | - Y Hermann
- Abidjan Institute of Cardiology , Abidjan , Côte d'Ivoire
| | | | - C Souleymane
- Point G university hospital center , Bamako , Mali
| | - A Asselin
- Paris Cardiovascular Research Center (PARCC) , Paris , France
| | - A Mbaye
- Grand Yoff General Hospital , Mdakar , Senegal
| | - F Kamdem
- Douala General Hospital , Douala , Cameroon
| | - A Sidy Ali
- Centre National de Cardiologie, Cardiology , Nouakchott , Mauritania
| | - S Thiam
- El Hadji-Ibrahima Niass Hospital, Cardiology , Kaolac , Senegal
| | | | - M Antignac
- Pitie Salpetriere APHP University Hospital, Pharmacy , Paris , France
| | - R N'Guetta
- Abidjan Institute of Cardiology , Abidjan , Côte d'Ivoire
| | - X Jouven
- European Georges Pompidou Hospital, AP-HP Centre, University of Paris, Cardiology , Paris , France
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Lemogoum D, Kamdem F, Ba H, Ngatchou W, Hye Ndindjock G, Dzudie A, Monkam Y, Mouliom S, Hermans MP, Bika Lele EC, van de Borne P. Epidemiology of acutely decompensated systolic heart failure over the 2003-2013 decade in Douala General Hospital, Cameroon. ESC Heart Fail 2020; 8:481-488. [PMID: 33225620 PMCID: PMC7835589 DOI: 10.1002/ehf2.13098] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/06/2020] [Revised: 10/09/2020] [Accepted: 10/21/2020] [Indexed: 11/09/2022] Open
Abstract
AIMS Acutely decompensated heart failure (HF) (ADHF) is a common cause of hospitalization and mortality worldwide. This study explores the epidemiology and prognostic factors of ADHF in Cameroonian patients. METHODS AND RESULTS This was a retrospective study conducted between January 2003 and December 2013 from the medical files of patients followed at the intensive care and cardiovascular units of Douala General Hospital in Cameroon. Clinical, electrocardiographic, echocardiographic, and biological data were collected from 142 patients (58.5% men; mean age 58 ± 14 years) hospitalized for ADHF with reduced ejection fraction (HFrEF), whose left ventricular ejection fraction was <50%, or alternatively whose shortening fraction was <28%, both assessed by echocardiography. The commonest risk factors associated with HFrEF were hypertension (59.2%), diabetes mellitus (16.2%), tobacco use (14.1%), and dyslipidaemia (7.7%), respectively. The major causes of HF in hospitalized patients were hypertensive heart disease (40%, n = 57); hypertrophic cardiomyopathy (33.8%, n = 48); and ischemic heart disease (21.8%, n = 31). The most frequent comorbid conditions were atrial fibrillation (25.4%, n = 36) and chronic kidney disease (18.3%, n = 26). Major biological abnormalities included increased bilirubinemia >12 mg/L (87.5%, n = 124); hyperuricaemia >70 mg/L (84.9%, n = 121); elevated serum creatinine (65.6%, n = 93); anaemia (59.1%, n = 84); hyperglycaemia on admission >1.8 g/L (42.3%, n = 60); and hyponatraemia <135 mEq/L (26.8%, n = 38). At admission, 33.8% (n = 48) of patients had no pharmacological treatment for HF. The most frequently used therapies upon admission included furosemide (50%, n = 71), angiotensin-converting enzyme inhibitors (ACEIs; 40.1%, n = 57); spironolactone (35.2%, n = 50); digoxin (26%, n = 37); beta-blockers (17.7%, n = 25); angiotensin-receptor blockers (ARBs; 7%, n = 10); and nitrates (7.0%). The overall in-hospital mortality rate was 20.4%. Factors associated with poor prognosis were systolic blood pressure <90 mmHg [odds ratio (OR) 3.88; confidence interval (CI) 1.36-11.05, P = 0.011], left ventricular ejection fraction <20% (OR 7.48; CI 2.84-19.71, P < 0.001), decreased renal function (OR 1.03; CI 1.00-1.05, P = 0.026), dobutamine use for cardiogenic shock (OR 2.74;CI 1.00-7.47, P = 0.049), pleural fluid effusion (OR 3.46; CI 1.07-11.20, P = 0.038), and prothrombin time <50% (OR 3.60; CI 1.11-11.68, P = 0.033). The use of ACEIs/ARBs was associated with reduced in-hospital mortality rate (OR 0.17; CI 0.02-0.81, P = 0.006). CONCLUSIONS Hypertensive heart disease, hypertrophic cardiomyopathy, and ischemic heart disease are the commonest causes of HF in this Cameroonian population. ADHF is associated with high in-hospital mortality in Cameroon. Hypotension, severe left ventricular systolic dysfunction, renal function impairment, and dobutamine administration were associated with worst acute HF outcomes. ACEIs/ARBs use was associated with improved survival.
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Affiliation(s)
- Daniel Lemogoum
- Faculty of Medicine and Pharmaceutical Sciences, University of Douala, Douala, Cameroon.,Cameroon Heart Institute, Cameroon Heart Foundation, Douala, Cameroon.,Department of Cardiology, ULB-Erasme Hospital, Free Brussels University, Brussels, Belgium
| | - Félicité Kamdem
- Faculty of Medicine and Pharmaceutical Sciences, University of Douala, Douala, Cameroon
| | - Hamadou Ba
- Faculty of Medicine and Biomedical Sciences, University of Yaounde, Yaounde, Cameroon
| | - William Ngatchou
- Faculty of Medicine and Pharmaceutical Sciences, University of Douala, Douala, Cameroon.,Cameroon Heart Institute, Cameroon Heart Foundation, Douala, Cameroon
| | | | - Anasthase Dzudie
- Faculty of Medicine and Biomedical Sciences, University of Yaounde, Yaounde, Cameroon
| | | | - Sidick Mouliom
- Faculty of Medicine and Pharmaceutical Sciences, University of Douala, Douala, Cameroon
| | - Michel P Hermans
- Endocrinology and Nutrition Unit, Cliniques Universitaires St-Luc, Université Catholique de Louvain, Brussels, Belgium
| | - Elysée Claude Bika Lele
- Cameroon Heart Institute, Cameroon Heart Foundation, Douala, Cameroon.,Unité de Physiologie et de Médecine des APS, Faculté des Sciences, University of Douala, BP: 7064, Douala, Cameroon
| | - Philippe van de Borne
- Department of Cardiology, ULB-Erasme Hospital, Free Brussels University, Brussels, Belgium
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Doualla M, Nkeck JR, Halle MP, Kamdem F, Agouak AI, Essouma M, Lobe YB, Ashuntantang G. Assessment of the efficacy of hemodialysis on uric acid clearance in a sub-Saharan African population at the end stage kidney disease. BMC Nephrol 2020; 21:378. [PMID: 32867705 PMCID: PMC7457757 DOI: 10.1186/s12882-020-02037-8] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/03/2020] [Accepted: 08/23/2020] [Indexed: 11/20/2022] Open
Abstract
Background Uricemia dramatically rises with the stage of chronic kidney disease (CKD) and correlates with its mortality. Hemodialysis (HD) being the most used treatment at the end stage in sub-Saharan Africa, we sought to evaluate its efficacy on the clearance of uric acid (UAc) when used alone and twice per week. Methods A cross-sectional study of all consenting patients with CKD stage 5 recruited at random during HD sessions in a reference Centre in Cameroon from January to April 2017. We collected socio-demographic data, relevant clinical information, HD related variables, and measured serum uric acid (SUA) levels before and after the dialysis to assess the uric acid clearance. A clearance between 65 and 80% and above 80% was considered as low and good efficacy of HD respectively. Statistical analysis was performed using SPSS version 21.0. Factors associated with HD efficacy were assessed using Fisher’s exact test and are presented with their odds ratios (OR) and 95% confidence levels. Results One hundred four patients (53 females) were included. The mean age was 49.9 ± 13.3 years. Hypertension (25%) and chronic glomerulonephritis (16%) were the main suspected etiologies of CKD. The median time on renal replacement therapy by HD was 3 years [1; 6]. The prevalence of hyperuricemia was 81.9%. The means of SUA levels were 78.8 ± 13.8 mg/L and 26.4 ± 6.6 mg/L respectively before and after dialysis. Mean SUA clearance was 66% ± 10%. The efficacy of HD on UAc was moderate in 92 (63.9%) and good in 2 (1.4%) patients. Excess weight (OR 0.4 [0.2; 0.9]) and Kt/Vurea < 1.2 (OR 0.1 [0.04; 0.2]) significantly reduces the efficacy of HD. Conclusion HD used alone for 2 sessions per week has a moderate efficacy on uric acid clearance in CKD. Therefore, we should improve the Kt/V (> 1.2), and combine HD to uric acid lowering drugs and diet modifications to increase its efficacy.
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Affiliation(s)
- Marie Doualla
- Faculty of Medicine and Biomedical Sciences, University of Yaoundé I, Yaoundé, Cameroon.,Faculty of Medicine and Pharmaceutical Sciences, University of Douala, Douala, Cameroon.,Douala General Hospital, Douala, Cameroon
| | - Jan René Nkeck
- Faculty of Medicine and Biomedical Sciences, University of Yaoundé I, Yaoundé, Cameroon.
| | - Marie Patrice Halle
- Faculty of Medicine and Pharmaceutical Sciences, University of Douala, Douala, Cameroon.,Douala General Hospital, Douala, Cameroon
| | - Félicité Kamdem
- Faculty of Medicine and Pharmaceutical Sciences, University of Douala, Douala, Cameroon
| | - Aude Ingrid Agouak
- Faculty of Medicine and Pharmaceutical Sciences, University of Douala, Douala, Cameroon
| | - Mickael Essouma
- Faculty of Medicine and Biomedical Sciences, University of Yaoundé I, Yaoundé, Cameroon
| | | | - Gloria Ashuntantang
- Faculty of Medicine and Biomedical Sciences, University of Yaoundé I, Yaoundé, Cameroon.,Faculty of Health Sciences, University of Buea, Buea, Cameroon
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8
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Dzudie A, Ngongang Ouankou C, Nganhyim L, Mouliom S, Ba H, Kamdem F, Ndjebet J, Nzali A, Tantchou C, Nkoke C, Barche B, Abanda M, Metogo Mbengono UA, Hentchoya R, Petipe Nkappe C, Ouankou M, Kouam Kouam C, Mintom P, Boombhi J, Kuate Mfeukeu L, Ngatchou W, Kingue S, Ngowe Ngowe M. Long-term prognosis of patients with permanent cardiac pacemaker indication in three referral cardiac centers in Cameroon: Insights from the National pacemaker registry. Ann Cardiol Angeiol (Paris) 2020; 70:18-24. [PMID: 32778387 DOI: 10.1016/j.ancard.2020.07.005] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/03/2020] [Accepted: 07/21/2020] [Indexed: 10/23/2022]
Abstract
BACKGROUND There is evidence that cardiac pacemakers improve symptoms and quality of life in patients with severe bradycardia. Globally, the number of pacemaker implantations is on the rise. However, the associated high-cost limits pacemaker's accessibility in low resource settings. This study aimed to investigate access to pacemakers and the long-term outcome of patients requiring a pacemaker. METHOD We conducted a cohort study in 03 health care structures in Cameroon. Participants aged at least 18 years with indication for a permanent pacemaker between January 2010 and May 2016 were included. Clinical profile, electrocardiography, pacemaker implantation parameters were recorded. Long-term survival was studied by event-free analysis using the Kaplan-Meier method. RESULTS In total, 147 participants (mean age 67.7±13.7 years, female 58.5%) were included. Fatigue (78.7%), dyspnoea (77.2%), dizziness (47.1%) and palpitations (40.4%) were the main symptoms while syncope was present in 35.7% of patients. The main indication for cardiac pacemaker was atrioventricular block (85.3%). Forty (27.2%) could not be implanted with 34 (85%) of participants highlighting cost of intervention as main reason. VVIR was the main mode of stimulation (70.5%). Of 125 patients in which follow-up was ascertained, 17(13.5%) died after a median survival time of 2.8 years post diagnosis [IQR: 1.8-4.2]. The survival curve was better in participants with a pacemaker with a Hazard ratio of 2.7 [CI: 1.0-7.3, P=0.045]. CONCLUSION Our patients with severe heart blocks presented late and more than a quarter did not have access to pacemaker but its implantation multiplied the survival rate by 2.7 times at approximately 3 years post diagnosis. Improving early detection of heart blocks and access to cardiac pacing to reduce mortality shall be a key future priority.
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Affiliation(s)
- A Dzudie
- Cardiology and Cardiac Pacing Unit, Douala General Hospital, P.O Box 4856 Douala, Cameroon; Clinical Research Education Networking & Consultancy (CRENC), Douala, Cameroon; Faculty of Medicine and Biomedical Sciences, University of Yaounde I, Yaounde, Cameroon.
| | | | - L Nganhyim
- Clinical Research Education Networking & Consultancy (CRENC), Douala, Cameroon
| | - S Mouliom
- Cardiology and Cardiac Pacing Unit, Douala General Hospital, P.O Box 4856 Douala, Cameroon
| | - H Ba
- Faculty of Medicine and Phramaceutical Sciences, University of Douala, Douala, Cameroon
| | - F Kamdem
- Faculty of Medicine and Phramaceutical Sciences, University of Douala, Douala, Cameroon
| | - J Ndjebet
- Douala Cardiovascular Centre, Douala, Cameroon
| | - A Nzali
- Deido District Hospital, Douala, Cameroon
| | | | - C Nkoke
- Clinical Research Education Networking & Consultancy (CRENC), Douala, Cameroon; Buea Regional Hospital, Buea, Cameroon
| | - B Barche
- Clinical Research Education Networking & Consultancy (CRENC), Douala, Cameroon; Faculty of Medicine and Phramaceutical Sciences, University of Douala, Douala, Cameroon; Douala Cardiovascular Centre, Douala, Cameroon
| | - M Abanda
- Clinical Research Education Networking & Consultancy (CRENC), Douala, Cameroon
| | - U A Metogo Mbengono
- Faculty of Medicine and Phramaceutical Sciences, University of Douala, Douala, Cameroon; Intensive Care Unit, Douala General Hospital, Douala, Cameroon
| | - R Hentchoya
- Intensive Care Unit, Douala General Hospital, Douala, Cameroon
| | - C Petipe Nkappe
- Buea Regional Hospital, Buea, Cameroon; Guidelines Advisory Network, Paris, France
| | - M Ouankou
- Cardiology and Medical Centre, Yaounde, Cameroon
| | - C Kouam Kouam
- Service of internal medicine and cardiology, Bafoussam regional hospital, Bafoussam, Cameroon
| | - P Mintom
- Faculty of Medicine and Phramaceutical Sciences, University of Douala, Douala, Cameroon; Deido District Hospital, Douala, Cameroon
| | - J Boombhi
- Faculty of Medicine and Biomedical Sciences, University of Yaounde I, Yaounde, Cameroon
| | - L Kuate Mfeukeu
- Faculty of Medicine and Biomedical Sciences, University of Yaounde I, Yaounde, Cameroon
| | - W Ngatchou
- Faculty of Medicine and Phramaceutical Sciences, University of Douala, Douala, Cameroon
| | - S Kingue
- Faculty of Medicine and Biomedical Sciences, University of Yaounde I, Yaounde, Cameroon
| | - M Ngowe Ngowe
- Faculty of Medicine and Phramaceutical Sciences, University of Douala, Douala, Cameroon
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9
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Kamdem F, Lemogoum D, Jingi AM, Guetchuin SC, Kenmegne C, Solange Doualla M, Luma H. 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. Prim Care Diabetes 2019; 13:370-375. [PMID: 31031133 DOI: 10.1016/j.pcd.2019.02.006] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/28/2018] [Revised: 02/03/2019] [Accepted: 02/10/2019] [Indexed: 01/13/2023]
Abstract
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.
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Affiliation(s)
- Félicité Kamdem
- Department of Internal Medicine, Douala General Hospital, Douala, Cameroon; Faculty of Medicine and Pharmaceutical Sciences, University of Douala, Douala, Cameroon
| | - Daniel Lemogoum
- Faculty of Medicine and Pharmaceutical Sciences, University of Douala, Douala, Cameroon; ULB-Erasme Hospital, Université Libre de Bruxelles, Brussels, Belgium
| | - Ahmadou Musa Jingi
- Faculty of Medicine and Biomedical Sciences, University of Yaoundé I, Yaoundé, Cameroon.
| | | | - Caroline Kenmegne
- Department of Internal Medicine, Douala General Hospital, Douala, Cameroon
| | - Marie Solange Doualla
- Department of Internal Medicine, Douala General Hospital, Douala, Cameroon; Faculty of Medicine and Biomedical Sciences, University of Yaoundé I, Yaoundé, Cameroon
| | - Henry Luma
- Department of Internal Medicine, Douala General Hospital, Douala, Cameroon; Faculty of Medicine and Biomedical Sciences, University of Yaoundé I, Yaoundé, Cameroon
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10
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Ngatchou W, Kamdem F, Lemogoum D, Ewane DF, Doualla MS, Jansens JL, Sango J, Origer P, Hacquebard JJ, Berre J, de Cannière D, Alima MB, Dzudie A, Ngote H, Mouliom S, Hentchoua R, Kana A, Coulibaly A, Jingi AM, Mfeukeu-Kuaté L, Priso EB, Luma H, Ménanga AP, Kingue S. Late mortality after cardiac interventions over 10-year period in two Cameroonian government-owned hospitals. Cardiovasc Diagn Ther 2019; 9:43-49. [PMID: 30881876 DOI: 10.21037/cdt.2018.11.10] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/06/2022]
Abstract
Background Cardiac surgery is a growing activity in Sub-Saharan Africa, however, data related to long-term mortality are scarce. We aimed to analyze outcome data of cardiac interventions in two hospitals in Cameroon over 10 years' period. Methods we conducted a retrospective analytical and descriptive study at the Douala General Hospital and Yaoundé General Hospital. All patients operated between January 2007 and December 2017, or their families were contacted by phone between January and April 2018 for a free of charges medical examination. Results Of a total of 98 patients operated during the study period, 8 (8.2%) were lost to follow-up. Finally, 90 patients [49 (54.4%) women and 41 (45.6%)] men were included. The mean age was 49±22 years (range, 13-89 years). The surgical indications were valvular heart diseases in 37 (41.1%) cases, congenital heart diseases in 11 (12.2%) cases, chronic constrictive pericarditis in 4 (4.4%) cases, and intra cardiac tumor in 1 (1.1%) case. Valve replacement was the most common type of surgery carried out in 37 (41.1%) cases-mostly with mechanical prosthesis. Pacemaker-mostly dual-chambers were implanted in 36 (40.0%) patients. The median follow-up was 26 months. The overall late mortality was 5.7%, and the overall survival rates at 5 and 10 years were 95.5% and 94.4% respectively. The overall survival rates at 5 and 10 years for mechanical valve prosthesis were 93.3% and 90% respectively. The survival at 10 years was 100% for patients with bioprosthesis. The survival rates at 10 years were 94.1% and 100% respectively for dual and single chamber pacemaker. Conclusions Long-term outcome of cardiac surgery in hospitals in Cameroon are acceptable with low mortality rate. However, outcome metrics beyond mortality should be implemented for a prospective data collection.
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Affiliation(s)
- William Ngatchou
- Faculty of Medicine and Pharmaceutical Sciences of Douala, Douala, Cameroon
| | - Félicité Kamdem
- Faculty of Medicine and Pharmaceutical Sciences of Douala, Douala, Cameroon.,Internal Medicine Department, Douala General Hospital, Douala, Cameroon
| | - Daniel Lemogoum
- Faculty of Medicine and Pharmaceutical Sciences of Douala, Douala, Cameroon
| | | | - Marie Solange Doualla
- Faculty of Medicine and Pharmaceutical Sciences of Douala, Douala, Cameroon.,Internal Medicine Department, Douala General Hospital, Douala, Cameroon
| | - Jean Luc Jansens
- Department of Cardiac Surgery, Erasme Hospital of Brussels, ULB, Belgium
| | - Joseph Sango
- Faculty of Medicine and Pharmaceutical Sciences of Douala, Douala, Cameroon
| | - Pierre Origer
- Department of Anesthesiology, St Pierre Hospital of Brussels, ULB, Belgium
| | | | - Jacques Berre
- Department of Cardiac Surgery, Erasme Hospital of Brussels, ULB, Belgium
| | | | | | - Anastase Dzudie
- Internal Medicine Department, Douala General Hospital, Douala, Cameroon
| | - Henry Ngote
- Internal Medicine Department, Douala General Hospital, Douala, Cameroon
| | - Sidiki Mouliom
- Internal Medicine Department, Douala General Hospital, Douala, Cameroon
| | - Romuald Hentchoua
- Anesthesiology and Intensive Care Units, Douala General Hospital, Douala, Cameroon
| | - Albert Kana
- Anesthesiology and Intensive Care Units, Douala General Hospital, Douala, Cameroon
| | - Aminata Coulibaly
- Anesthesiology and Intensive Care Units, Douala General Hospital, Douala, Cameroon
| | - Ahmadou M Jingi
- Faculty of Medicine and Biomedical Sciences of Yaoundé, Yaoundé, Cameroon
| | | | | | - Henry Luma
- Faculty of Medicine and Biomedical Sciences of Yaoundé, Yaoundé, Cameroon
| | | | - Samuel Kingue
- Department of Cardiology, Yaoundé General Hospital, Yaoundé, Cameroon
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11
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Kamdem F, Mapoure Y, Hamadou B, Souksouna F, Doualla MS, Jingi AM, Kenmegne C, Lekpa FK, Fenkeu JK, Imandy G, Mefo'o JPN, Luma H. Prevalence and risk factors of peripheral artery disease in black Africans with HIV infection: a cross-sectional hospital-based study. Vasc Health Risk Manag 2018; 14:401-408. [PMID: 30584314 PMCID: PMC6287665 DOI: 10.2147/vhrm.s165960] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/11/2023] Open
Abstract
Background The prevalence of peripheral artery disease (PAD) is not well known among HIV-infected patients in Africa. The aim of this study was to determine the prevalence and associated risk factors of PAD among HIV-infected patients at the Douala General Hospital (DGH). Methods This was a cross-sectional descriptive and analytic study between November 2015 and April 2016. We recruited patients aged ≥21 years, diagnosed with HIV infection, and who were receiving care at the DGH. We collected sociodemographic data and past medical history of patients. We measured their ankle-brachial index (ABI). We defined PAD as an ABI <0.9. We also measured their fasting blood glucose and lipid profile. Results We recruited 144 patients for this study. The mean age was 46±9 years, and 72.2% were females. Of which, 89% were on antiretroviral treatment (ARV). Their mean CD4+ T lymphocytes count was 451±306 cells/mm3. Their mean ABI was 1.12±0.17 and 1.07±0.11, respectively, on the left and right legs (P>0.05). The prevalence of PAD was 6.9% (95% CI: 3.4–12.4), and 60% of patients with PAD were symptomatic. After adjusting for age, sex and ARV, ARV treatment was protective (aOR: 0.18, [95% CI: 0.04–0.82], P=0.034), while WHO stages III or IV was associated with PAD (aOR: 11.1, [95% CI: 2.19–55.92], P=0.004). Conclusion The prevalence of PAD was not as high as expected in this group of patients with high cardiovascular risk infected with HIV. Advanced HIV disease was associated with PAD, while ARV was protective.
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Affiliation(s)
- Félicité Kamdem
- Internal Medicine Service, Douala General Hospital, Douala, Cameroon.,Faculty of Medicine and Pharmaceutical Sciences, University of Douala, Douala, Cameroon
| | - Yacouba Mapoure
- Internal Medicine Service, Douala General Hospital, Douala, Cameroon.,Faculty of Medicine and Pharmaceutical Sciences, University of Douala, Douala, Cameroon
| | - Ba Hamadou
- Department of Internal Medicine and Specialties, Faculty of Medicine and Biomedical Sciences, University of Yaounde 1, Yaounde, Cameroon,
| | - Fanny Souksouna
- Faculty of Medicine and Pharmaceutical Sciences, University of Douala, Douala, Cameroon
| | - Marie Solange Doualla
- Internal Medicine Service, Douala General Hospital, Douala, Cameroon.,Department of Internal Medicine and Specialties, Faculty of Medicine and Biomedical Sciences, University of Yaounde 1, Yaounde, Cameroon,
| | - Ahmadou Musa Jingi
- Department of Internal Medicine and Specialties, Faculty of Medicine and Biomedical Sciences, University of Yaounde 1, Yaounde, Cameroon,
| | - Caroline Kenmegne
- Internal Medicine Service, Douala General Hospital, Douala, Cameroon
| | - Fernando Kemta Lekpa
- Internal Medicine Service, Douala General Hospital, Douala, Cameroon.,Faculty of Health Sciences, University of Buea, Buea, Cameroon
| | | | - Gisèle Imandy
- Chemical Pathology Laboratory, Douala General Hospital, Douala, Cameroon
| | - Jean Pierre Nda Mefo'o
- Faculty of Medicine and Pharmaceutical Sciences, University of Douala, Douala, Cameroon.,Chemical Pathology Laboratory, Douala General Hospital, Douala, Cameroon
| | - Henry Luma
- Internal Medicine Service, Douala General Hospital, Douala, Cameroon.,Department of Internal Medicine and Specialties, Faculty of Medicine and Biomedical Sciences, University of Yaounde 1, Yaounde, Cameroon,
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12
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Doualla-Bija M, Lobe Batchama Y, Moutchia-Suh J, Ama Moor VJ, Kamdem F, Lekpa FK, Luma Namme H. Prevalence and characteristics of metabolic syndrome in gout patients in a hospital setting in sub-Saharan Africa. Diabetes Metab Syndr 2018; 12:1007-1011. [PMID: 29980454 DOI: 10.1016/j.dsx.2018.06.015] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/05/2018] [Accepted: 06/20/2018] [Indexed: 11/24/2022]
Abstract
BACKGROUND Evidence from epidemiological studies suggests an important association between gout and the metabolic syndrome (MetS). However, to the best of our knowledge, prevalence of metabolic syndrome in gout has not been reported in sub-Saharan African (SSA) settings. OBJECTIVES The aim of this study was to determine the prevalence and characteristics of MetS in gout in a SSA population. METHOD After prior ethical clearance, we carried out a cross-sectional study involving gout patients in a referral hospital in Douala-Cameroon. Metabolic syndrome was defined using International Diabetes Foundation criteria. Associations between variables were assessed using logistic regression.p < 0.05 was considered significant. RESULTS On 174 gout patients (48.3% females) who consented to participate in the study, the median (IQR) age was 55.00 (14.25) years, and the median (IQR) duration of gout was 7.5 (10.0) years. Prevalence of metabolic syndrome was 54.6% (95% CI: 47.9%-62.8%). One hundred and forty-seven (84.5%) participants had central obesity, 62 (35.6%) raised triglycerides, 79 (45.4%) reduced HDL-C, 129 (74.1%) raised blood pressure, and 85 (48.9%) had raised fasting plasma glucose. On logistic regression analyses, gout patients with metabolic syndrome significantly had a higher body mass index (OR: 1.09, 95% CI: 1.02-1.17), and higher levels of serum uric acid (OR: 1.02, 95% CI: 1.01-1.04). CONCLUSIONS About 1 out of every 2 gout patients in this population have metabolic syndrome. These gout patients with metabolic syndrome significantly have a higher body mass index, and higher levels of serum uric acid. Cohort studies are required to clearly establish the direction of the relationship between gout and metabolic syndrome.
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Affiliation(s)
- Marie Doualla-Bija
- Faculty of Medicine and Biomedical Sciences UY I, Yaoundé, Cameroon; General Hospital, Douala, Cameroon.
| | | | | | | | | | | | - Henry Luma Namme
- Faculty of Medicine and Biomedical Sciences UY I, Yaoundé, Cameroon.
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13
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Kamdem F, Kenmegne C, Hamadou B, Mapoure Y, Lekpa FK, Mouliom S, Jingi AM, Luma H, Doualla MS. Multiple cerebral infarction revealing Takayasu's disease: a case report in a 32-year-old man from Cameroon, sub-Saharan Africa. Clin Case Rep 2018; 6:569-573. [PMID: 29636915 PMCID: PMC5889272 DOI: 10.1002/ccr3.1380] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/22/2017] [Revised: 11/19/2017] [Accepted: 12/13/2017] [Indexed: 11/09/2022] Open
Abstract
This case suggests that young patients with few vascular risk factors, and who present with acute stroke syndrome involving more than one vascular territory should be screened for an inflammatory or infectious cause.
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Affiliation(s)
- Félicité Kamdem
- Internal Medicine Service Douala General Hospital Douala Cameroon.,Faculty of Medicine and Pharmaceutical Sciences University of Douala Douala Cameroon
| | | | - Ba Hamadou
- Faculty of Medicine and Biomedical Sciences University of Yaounde 1 Yaounde Cameroon
| | - Yacouba Mapoure
- Internal Medicine Service Douala General Hospital Douala Cameroon.,Faculty of Medicine and Pharmaceutical Sciences University of Douala Douala Cameroon
| | - Fernando K Lekpa
- Internal Medicine Service Douala General Hospital Douala Cameroon
| | - Sidicki Mouliom
- Internal Medicine Service Douala General Hospital Douala Cameroon
| | - Ahmadou Musa Jingi
- Faculty of Medicine and Biomedical Sciences University of Yaounde 1 Yaounde Cameroon
| | - Henry Luma
- Internal Medicine Service Douala General Hospital Douala Cameroon.,Faculty of Medicine and Biomedical Sciences University of Yaounde 1 Yaounde Cameroon
| | - Marie Solange Doualla
- Internal Medicine Service Douala General Hospital Douala Cameroon.,Faculty of Medicine and Biomedical Sciences University of Yaounde 1 Yaounde Cameroon
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14
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Hamadou B, Boombhi J, Kamdem F, Fitame A, Amougou SN, Mfeukeu LK, Nganou CN, Menanga A, Ashuntantang G. Prevalence and correlates of chronic kidney disease in a group of patients with hypertension in the Savanah zone of Cameroon: a cross-sectional study in Sub-Saharan Africa. Cardiovasc Diagn Ther 2017; 7:581-588. [PMID: 29302463 PMCID: PMC5752830 DOI: 10.21037/cdt.2017.08.09] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/06/2017] [Accepted: 08/07/2017] [Indexed: 11/06/2022]
Abstract
BACKGROUND The prevalence of chronic kidney disease (CKD) is increasing worldwide due to an increase in the risk factors such as hypertension. The greatest burden is in low-income settings, coupled with late diagnosis and limited management resources. This work aimed at studying the prevalence and risk factors of CKD in a group of patients with hypertension in the Savanah zone in Sub-Saharan Africa (SSA). METHODS We carried out a cross-sectional study between January and May 2016 in the regional Hospital of Garoua-Cameroon. Participants were adults ≥18 years of both sexes, who had a diagnosis of hypertension. Patients underwent a comprehensive clinical, biological, and electrocardiographic evaluation. RESULTS A total of 400 patients with hypertension were included, of whom 132 (33%; 95% CI: 28.6-37.8%) were males. Their mean age was 54.16±11.17 years. Hypertension was controlled in 122 (30.5%; 95% CI: 26.2-35.2%) participants. Twelve percent had a positive urine dipstick for proteins. The mean glomerular filtration rate (GFR) was 75.27±24.87 mL/min/1.73m2. The prevalence of CKD was seen in 129 (32.3%; 95% CI: 27.9-36.98) participants. Stage 3A was the most frequent (62.01%). The main comorbidities were anemia (44.5%), obesity (39.75%), diabetes (32%), consumption of traditional medicines (15.75%), and hyperuricemia (10.75%). After multivariate analysis, age >50 years (aOR: 1.75; 95% CI: 1.06-2.89; P=0.027), female sex (aOR: 2.21; 95% CI: 1.29-3.78; P=0.0035), obesity (aOR: 1.58, 95% CI: 1.01-2.44; P=0.026) and the hyperuricemia (aOR: 3.67; 95% CI: 1.78-7.58; P<0.001) were independently associated with CKD. CONCLUSIONS The prevalence of CKD in adults with hypertension was high. This was associated with age greater than 50 years, female sex, obesity and the hyperuricemia.
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Affiliation(s)
- Ba Hamadou
- Department of Medicine and Specialties, Faculty of Medicine and Biomedical Sciences, University of Yaoundé I, Yaoundé, Cameroon
- Cardiology Unit, Central Hospital of Yaoundé, Yaoundé, Cameroon
| | - Jérôme Boombhi
- Department of Medicine and Specialties, Faculty of Medicine and Biomedical Sciences, University of Yaoundé I, Yaoundé, Cameroon
- Cardiology Unit, Medicine B, General Hospital of Yaoundé, Yaoundé, Cameroon
| | - Félicité Kamdem
- Faculty of Medicine and Pharmaceutical Sciences, University of Douala, Douala, Cameroon
| | - Adeline Fitame
- Department of Medicine and Specialties, Faculty of Medicine and Biomedical Sciences, University of Yaoundé I, Yaoundé, Cameroon
| | - Sylvie Ndongo Amougou
- Department of Medicine and Specialties, Faculty of Medicine and Biomedical Sciences, University of Yaoundé I, Yaoundé, Cameroon
- Cardiology Unit, University Teaching Hospital of Yaoundé, Yaoundé, Cameroon
| | - Liliane Kuate Mfeukeu
- Department of Medicine and Specialties, Faculty of Medicine and Biomedical Sciences, University of Yaoundé I, Yaoundé, Cameroon
- Cardiology Unit, Central Hospital of Yaoundé, Yaoundé, Cameroon
| | - Chris Nadège Nganou
- Department of Medicine and Specialties, Faculty of Medicine and Biomedical Sciences, University of Yaoundé I, Yaoundé, Cameroon
- Cardiology Unit, Central Hospital of Yaoundé, Yaoundé, Cameroon
| | - Alain Menanga
- Department of Medicine and Specialties, Faculty of Medicine and Biomedical Sciences, University of Yaoundé I, Yaoundé, Cameroon
- Cardiology Unit, Medicine B, General Hospital of Yaoundé, Yaoundé, Cameroon
| | - Gloria Ashuntantang
- Department of Medicine and Specialties, Faculty of Medicine and Biomedical Sciences, University of Yaoundé I, Yaoundé, Cameroon
- Nephrology and Hemodialysis Unit, General Hospital of Yaoundé, Yaoundé, Cameroon
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Kamdem F, Kedy Koum D, Hamadou B, Yemdji M, Luma H, Doualla MS, Noukeu D, Barla E, Akazong C, Dzudie A, Ngote H, Monkam Y, Mouliom S, Kingue S. Clinical, echocardiographic, and therapeutic aspects of congenital heart diseases of children at Douala General Hospital: A cross-sectional study in sub-Saharan Africa. CONGENIT HEART DIS 2017; 13:113-117. [DOI: 10.1111/chd.12529] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/25/2017] [Revised: 08/10/2017] [Accepted: 08/15/2017] [Indexed: 11/29/2022]
Affiliation(s)
- Félicité Kamdem
- Internal Medicine Service; Douala General Hospital; Douala Cameroon
- Department of Internal Medicine and Specialties, Faculty of Medicine and Pharmaceutical Sciences; University of Douala; Douala Cameroon
| | - Danielle Kedy Koum
- Department of Internal Medicine and Specialties, Faculty of Medicine and Pharmaceutical Sciences; University of Douala; Douala Cameroon
- Gyneco-Obstetric and Pediatric Hospital; Pediatric Service; Douala Cameroon
| | - Ba Hamadou
- Internal Medicine Service; Douala General Hospital; Douala Cameroon
- Department of Internal Medicine and Specialties, Faculty of Medicine and Biomedical Sciences; University of Yaounde 1; Yaounde Cameroon
| | - Mélanie Yemdji
- Internal Medicine Service; Douala General Hospital; Douala Cameroon
| | - Henry Luma
- Internal Medicine Service; Douala General Hospital; Douala Cameroon
- Department of Internal Medicine and Specialties, Faculty of Medicine and Biomedical Sciences; University of Yaounde 1; Yaounde Cameroon
| | - Marie Solange Doualla
- Internal Medicine Service; Douala General Hospital; Douala Cameroon
- Department of Internal Medicine and Specialties, Faculty of Medicine and Biomedical Sciences; University of Yaounde 1; Yaounde Cameroon
| | - Diomède Noukeu
- Douala General Hospital; Pediatric Service; Douala Cameroon
| | - Esther Barla
- Douala General Hospital; Pediatric Service; Douala Cameroon
| | | | - Anastase Dzudie
- Internal Medicine Service; Douala General Hospital; Douala Cameroon
- Department of Internal Medicine and Specialties, Faculty of Medicine and Biomedical Sciences; University of Yaounde 1; Yaounde Cameroon
| | - Henry Ngote
- Internal Medicine Service; Douala General Hospital; Douala Cameroon
| | - Yves Monkam
- Internal Medicine Service; Douala General Hospital; Douala Cameroon
| | - Sidiki Mouliom
- Internal Medicine Service; Douala General Hospital; Douala Cameroon
| | - Samuel Kingue
- Department of Internal Medicine and Specialties, Faculty of Medicine and Biomedical Sciences; University of Yaounde 1; Yaounde Cameroon
- Yaounde General Hospital; Yaounde Cameroon
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16
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Kamdem F, Lemogoum D, Doualla MS, Kemta Lepka F, Temfack E, Ngo Nouga Y, Kenmegne C, Luma H, Hermans MP. Glucose homeostasis abnormalities among Cameroon patients with newly diagnosed hypertension. J Clin Hypertens (Greenwich) 2017; 19:519-523. [PMID: 28042916 DOI: 10.1111/jch.12959] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/26/2016] [Revised: 11/04/2016] [Accepted: 11/11/2016] [Indexed: 11/27/2022]
Abstract
The authors assessed the frequency of glucose homeostasis abnormalities among 839 Cameroonians with newly diagnosed hypertension (mean age: 50.8±11 years; 49.9% female) in a cross-sectional survey conducted at the Douala General Hospital, Douala, Cameroon. In all participants, blood pressure, fasting plasma glucose (FPG), and lipids were recorded. Impaired fasting glycemia was described as an FPG level between 100 and 125 mg/dL and provisional diabetes as an FPG level ≥126 mg/dL. The FPG was 101±30 mg/dL. The overall proportion of abnormal glucose homeostasis was 38.3%, while 7.7% of patients (n=65) had known diabetes. A total of 23.7% (n=199) had impaired fasting glycemia and 6.8% (n=57) had provisional diabetes. Multivariable logistic regression revealed that male sex (odds ratio [OR], 1.53; 95% confidence interval [CI], 1.15-2.06), age older than 55 years (OR, 1.55; 95% CI, 1.15-2.09), and low-density lipoprotein cholesterol >1 g/L (OR, 1.34; 95% CI, 1.00-1.82) were independently associated with abnormal glucose homeostasis (all P<.05). Glucose homeostasis abnormalities are highly prevalent among Cameroonian patients with newly diagnosed hypertension.
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Affiliation(s)
- Félicité Kamdem
- Internal Medicine Unit, Douala General Hospital, Douala, Cameroon.,Faculty of Medicine and Pharmaceutical Sciences, University of Douala, Douala, Cameroon
| | - Daniel Lemogoum
- Faculty of Medicine and Pharmaceutical Sciences, University of Douala, Douala, Cameroon
| | - Marie-Solange Doualla
- Internal Medicine Unit, Douala General Hospital, Douala, Cameroon.,Faculty of Medicine and Biomedical Sciences, University of Yaoundé I, Yaoundé, Cameroon
| | - Fernando Kemta Lepka
- Internal Medicine Unit, Douala General Hospital, Douala, Cameroon.,Faculty of Health Sciences, University of Buea, Buea, Cameroon
| | - Elvis Temfack
- Internal Medicine Unit, Douala General Hospital, Douala, Cameroon
| | - Yvette Ngo Nouga
- Internal Medicine Unit, Douala General Hospital, Douala, Cameroon
| | | | - Henry Luma
- Internal Medicine Unit, Douala General Hospital, Douala, Cameroon.,Faculty of Medicine and Biomedical Sciences, University of Yaoundé I, Yaoundé, Cameroon
| | - Michel P Hermans
- Endocrinologyand Nutrition Unit, Cliniques Universitaires St-Luc, Université Catholique de Louvain, Brussels, Belgium
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Hongieh Abanda M, Dzudie A, Aminde L, Kamdem F, Dzekem B. Echocardiography in pulmonary hypertension due to left heart disease: a focus on the right heart changes in patients with hypertensive heart disease at the Douala General Hospital, Cameroon. Archives of Cardiovascular Diseases Supplements 2017. [DOI: 10.1016/s1878-6480(17)30165-9] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/19/2022]
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18
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Ngatchou W, Ngbwa Evina A, Halle MP, Massom A, Ekane S, Basile E, Origer P, Haquebard JP, Olinga Olinga A, Jansens JL, Watel A, Lecain A, Bol Alima M, Van Uytvanck A, Segers B, Haentjens L, Berre J, Bal O, Preumont N, Kana J, Kamdem F, Hentchoya R, Etori P, Ndofor B, Ngote H, Kasum A, Coulibaly A, Doualla MS, Luma H, Cogan E, Lebrun E, Gamela G, Germay O, Mouelle A, Belley Priso E, Dzudie A, Lemogoum D, Dehon P. Outcome of permanent vascular access for haemodialysis in patients with end-stage renal disease in Cameroon: results from the pilot experience of the Douala general hospital. Acta Chir Belg 2016; 116:36-40. [PMID: 27385139 DOI: 10.1080/00015458.2015.1136496] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/21/2022]
Abstract
Background Chronic Kidney disease is a major health problem in the world. Native arteriovenous Fistula (AVF) is well established as the best vascular access for haemodialysis. Little is known about the outcome of AVF in sub-Saharan Africa. We aim to analyze the outcome of patients undergoing AVF creation during the pilot program established at the Douala general hospital (DGH). Method This was hospital-based, longitudinal study with a retrospective phase (April 2010-January 2014) and a prospective phase (January 2014-April 2014). All consecutive patients operated for AVF creation were included in this study. Socio-demographics data, functionality, and complications were analyzed. Results Eighty-one patients including 52 men were enrolled in this study (49 prospectively and 32 retrospectively). The mean age was 52, 3 years (range 18-81 years). Hypertension (66, 7%), diabetes (17, 3%), and HIV (8, 6%) were the most observed co-morbidities. About 96.3% of AVF were native and 3.7% were prosthetic graft. Radiocephalic AVF was performed at a rate of 77.8%. The primary function rate was 97.7% and the mean follow-up period 43.4 weeks. The overall rate of complications was 44.4% of whom 30.5% were early, 30.5% secondary, and 39% lasted. The treatment of these complications was conservative in 48.7% of cases. Conclusions The results of the pilot program of AVF creation at the DGH are encouraging. However, the sustainability of this project requires human capacity building.
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Mbatchou Ngahane BH, Nganda MM, Dzudie A, Luma H, Kamdem F, Ngote HR, Monkam Y, Kuaban C. Prevalence and determinants of excessive daytime sleepiness in hypertensive patients: a cross-sectional study in Douala, Cameroon. BMJ Open 2015; 5:e008339. [PMID: 26224018 PMCID: PMC4521539 DOI: 10.1136/bmjopen-2015-008339] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/04/2022] Open
Abstract
OBJECTIVE To determine the prevalence and determinants of excessive daytime sleepiness (EDS) among a group of sub-Saharan Africans living with hypertension. DESIGN A cross-sectional study. SETTING Cardiology outpatient unit of the Douala General Hospital in Cameroon. PARTICIPANTS Patients aged 15 years and over, being followed for hypertension between 1st January and 31st July 2013. Patients with unstable heart failure, stroke and head trauma were excluded. MAIN OUTCOME MEASURE EDS was the outcome of interest. It was defined as an Epworth sleeping scale greater or equal to 10. Logistic regression was used to identify factors associated with EDS. RESULTS A total of 411 patients participated in this study, with a sex ratio (male/female) of 0.58 and a mean age of 55.56 years. No patient was underweight and the mean body mass index was 30 kg/m(2). Controlled blood pressure was found in 92 (22.4%) patients. The prevalence of EDS was 62.78% (95% CI 58.08 to 67.47). The factors independently associated with EDS were: type 2 diabetes (OR 2.51; 95% CI 1 to 6.29), obesity (OR 2.75; 95% CI 1.52 to 4.97), snoring (OR 7.92; 95% CI 4.43 to 14.15) and uncontrolled blood pressure (OR 4.34; 95% CI 2.24 to 8.40). CONCLUSIONS A significant proportion of hypertensive patients suffer from EDS and present a high risk of sleep apnoea. Preventive measures targeted on weight loss, type 2 diabetes and snoring should be considered among these patients.
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Affiliation(s)
- Bertrand Hugo Mbatchou Ngahane
- Department of Internal Medicine, Douala General Hospital, Douala, Cameroon
- Faculty of Medicine and Pharmaceutical Sciences, University of Douala, Douala, Cameroon
| | - Motto Malea Nganda
- Department of Internal Medicine, Douala General Hospital, Douala, Cameroon
| | - Anastase Dzudie
- Department of Internal Medicine, Douala General Hospital, Douala, Cameroon
- Faculty of Medicine, University of Cape Town, Cape Town, South Africa
| | - Henry Luma
- Department of Internal Medicine, Douala General Hospital, Douala, Cameroon
| | - Félicité Kamdem
- Department of Internal Medicine, Douala General Hospital, Douala, Cameroon
| | - Henri Roger Ngote
- Department of Internal Medicine, Douala General Hospital, Douala, Cameroon
| | - Yves Monkam
- Department of Internal Medicine, Douala General Hospital, Douala, Cameroon
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Takah N, Dzudie A, Ndjebet J, Wawo G, Kamdem F, Monkam Y, Luma H, Ngu KB, Kengne AP. Ambulatory blood pressure measurement in the main cities of Cameroon: prevalence of masked and white coat hypertension, and influence of body mass index. Pan Afr Med J 2014; 19:240. [PMID: 25848455 PMCID: PMC4377287 DOI: 10.11604/pamj.2014.19.240.4887] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/25/2014] [Accepted: 10/18/2014] [Indexed: 11/11/2022] Open
Abstract
Introduction Identifying White Coat Hypertension (WCH) may avoid inappropriate commitment of individuals to lifelong and costly blood pressure (BP) lowering medications’. We assessed the prevalence and determinants of WCH in urban clinical settings in Cameroon. Methods Participants were a consecutive sample of adults, who underwent ambulatory BP measurements (ABPM) for the diagnosis of hypertension and evaluation of treatmentin three referral cardiac clinics in the cities of Yaounde and Douala, between January 2006 and July 2011. WCH was defined as an office-based systolic (or diastolic) BP ≥ 140(90) mmHg together with an average day time ambulatory systolic (and diastolic) BP < 135(85) mmHg. Results Of the 500 participants included, 188 (37.6%) were women, 230 (46%) were nonsmokers and 53 (10.6%) had diabetes mellitus. The mean age was 51.6±10.2years. The ABPM readings were higher in men than in women (p<0.05).The prevalence of WCH was 26.4% overall, 39.3% in women and22.4% in men (p=0.01).In multivariable analysis, body mass index was the only significant determinant of WCH (Odds ratio= 1.15(95% confidence intervals: 1.00-1.43), p<0.05). Conclusion The prevalence of WCH was high in our study population and was correlated only with BMI. Accurate measurement of BP and appropriate diagnosis of hypertension using ABPM in this setting may help limiting the consequences of over estimating hypertension severity on individuals, families and health systems.
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Affiliation(s)
- Noah Takah
- Global Health Systems Solution, Limbe, Cameroon
| | - Anastase Dzudie
- Department of Internal Medicine, Faculty of Health Sciences, University of Buea, Buea, Cameroon ; Department of Internal Medicine, Faculty of Health Sciences, University of Cape Town, South Africa ; Department of Internal Medicine, Douala General Hospital, Douala, Cameroon
| | - Jules Ndjebet
- Douala cardiovascular centre of Bonapriso, Douala, Cameroon
| | - Guela Wawo
- Faculty of Medicine and Biomedical Sciences, University of Yaounde 1, Yaounde, Cameroon
| | - Félicité Kamdem
- Department of Internal Medicine, Douala General Hospital, Douala, Cameroon
| | - Yves Monkam
- Department of Internal Medicine, Douala General Hospital, Douala, Cameroon
| | - Henry Luma
- Department of Internal Medicine, Douala General Hospital, Douala, Cameroon
| | - Kathleen Blackett Ngu
- Department of Internal Medicine, Yaoundé University Teaching Hospital Yaoundé, Cameroon
| | - André Pascal Kengne
- Department of Internal Medicine, Faculty of Health Sciences, University of Cape Town, South Africa ; South African Medical Research Council of South Africa, Cape Town South Africa Department of Medicine, University of Cape Town, Cape Town, South Africa ; Non-Communicable Diseases Research Unit, South African Medical Research Council, Cape Town, South Africa
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Doualla M, Ashuntantang G, Luma H, Kamdem F. AB0836 Serum Uric Acid Level and Severity of Arterial Hypertension in A Treatment-Naive Hypertensive Population in Sub-Saharan Africa. Ann Rheum Dis 2014. [DOI: 10.1136/annrheumdis-2014-eular.5596] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/03/2022]
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22
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Dzudie A, Choukem SPN, Adam AK, Kengne AP, Gouking P, Dehayem M, Kamdem F, Doualla MS, Joko HA, Lobe ME, Mbouende YM, Luma H, Mbanya JC, Kingue S. Prevalence and determinants of electrocardiographic abnormalities in sub-Saharan African individuals with type 2 diabetes. Cardiovasc J Afr 2012; 23:533-7. [PMID: 22992779 PMCID: PMC3721941 DOI: 10.5830/cvja-2012-054] [Citation(s) in RCA: 8] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/28/2011] [Accepted: 07/04/2012] [Indexed: 11/06/2022] Open
Abstract
Aim This study assessed the prevalence and determinants of electrocardiographic abnormalities in a group of type 2 diabetes patients recruited from two referral centres in Cameroon. Methods A total of 420 patients (49% men) receiving chronic diabetes care at the Douala General and Yaoundé Central hospitals were included. Electrocardiographic abnormalities were investigated, identified and related to potential determinants, with logistic regressions. Results The mean age and median duration of diagnosis were 56.7 years and four years, respectively. The main electrocardiographic aberrations (prevalence %) were: T-wave abnormalities (20.9%), Cornell product left ventricular hypertrophy (16.4%), arrhythmia (16.2%), ischaemic heart disease (13.6%), conduction defects (11.9%), QTc prolongation (10.2%) and ectopic beats (4.8%). Blood pressure variables were consistently associated with all electrocardiographic abnormalities. Diabetes-specific factors were associated with some abnormalities only. Conclusions Electrocardiographic aberrations in this population were dominated by repolarisation, conduction defects and left ventricular hypertrophy, and were more related to blood pressure than diabetes-specific factors.
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Affiliation(s)
- A Dzudie
- Department of Internal Medicine, Douala General Hospital, Cameroon
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Dzudie A, Kengne AP, Muna WFT, Ba H, Menanga A, Kouam Kouam C, Abah J, Monkam Y, Biholong C, Mintom P, Kamdem F, Djomou A, Ndjebet J, Wambo C, Luma H, Ngu KB, Kingue S. Prevalence, awareness, treatment and control of hypertension in a self-selected sub-Saharan African urban population: a cross-sectional study. BMJ Open 2012; 2:bmjopen-2012-001217. [PMID: 22923629 PMCID: PMC3433777 DOI: 10.1136/bmjopen-2012-001217] [Citation(s) in RCA: 128] [Impact Index Per Article: 10.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/04/2022] Open
Abstract
OBJECTIVES Hypertension has been established as a major public health problem in Africa, but its specific contributions to disease burden are still incompletely understood. We report the prevalence and determinants of hypertension, detection, treatment and control rates among adults in major cities in Cameroon. DESIGN Cross-sectional study. SETTINGS Community-based multicentre study in major cities in Cameroon. PARTICIPANTS Participants were self-selected urban dwellers from the Center, Littoral, North-West and West Regions, who attended on 17 May 2011 a screening campaign advertised through mass media. PRIMARY AND SECONDARY OUTCOMES MEASURES: Hypertension defined as systolic (and/or diastolic) blood pressure (BP)≥ 140 (90) mm Hg, or ongoing BP-lowering medications. RESULTS In all, 2120 participants (1003 women) were included. Among them, 1007 (prevalence rate 47.5%) had hypertension, including 319 (awareness rate 31.7%) who were aware of their status. The prevalence of hypertension increased with age overall and by sex and region. Among aware hypertensive participants, 191 (treatment rate 59.9%) were on regular BP-lowering medication, and among those treated, 47 (controlled rate 24.6%) were at target BP levels (ie, systolic (and diastolic) BP<140 (90) mm Hg). In multivariable logistic regression analysis, male gender, advanced age, parental history of hypertension, diabetes mellitus, elevated waist and elevated body mass index (BMI) were the significant predictors of hypertension. Likewise, male gender, high BMI and physical inactivity were associated with poor control. CONCLUSIONS High prevalence of hypertension with low awareness, treatment and control were found in this urban population; these findings are significant and alarming with consideration to the various improvements in the access to healthcare and the continuing efforts to educate communities over the last few decades.
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Affiliation(s)
- Anastase Dzudie
- Department of Internal Medicine, Douala General Hospital, Douala, Cameroon
- Department of Internal Medicine, Faculty of Health Sciences, University of Buea, Buea, Cameroon
| | - André Pascal Kengne
- NCRP or Cardiovascular and Metabolic Disease, South African Medical Research Council & University of Cape Town, Cape Town, South Africa
| | - Walinjom F T Muna
- Department of Internal Medicine, Faculty of Medicine and Biomedical Sciences, Yaounde, Cameroon
- Department of Internal Medicine, Yaounde General Hospital,Douala, Cameroon
| | - Hamadou Ba
- Department of Internal Medicine, Yaounde General Hospital,Douala, Cameroon
| | - Alain Menanga
- Department of Internal Medicine, Faculty of Medicine and Biomedical Sciences, Yaounde, Cameroon
- Department of Internal Medicine, Yaounde General Hospital,Douala, Cameroon
| | - Charles Kouam Kouam
- Department of Internal Medicine, Bafoussam Regional Hospital, Douala, Cameroon
| | - Joseph Abah
- Department of Internal Medicine, Bamenda Military Hospital, North West Region, Cameroon
| | - Yves Monkam
- Department of Internal Medicine, Douala General Hospital, Douala, Cameroon
| | - Christian Biholong
- Department of Internal Medicine, Douala General Hospital, Douala, Cameroon
| | - Pierre Mintom
- Department of Internal Medicine, Yaounde General Hospital,Douala, Cameroon
| | - Félicité Kamdem
- Department of Internal Medicine, Douala General Hospital, Douala, Cameroon
| | - Armel Djomou
- Department of Internal Medicine, Douala General Hospital, Douala, Cameroon
| | - Jules Ndjebet
- Department of Internal Medicine, Douala General Hospital, Douala, Cameroon
| | - Cyrille Wambo
- Department of Internal Medicine, Douala General Hospital, Douala, Cameroon
| | - Henry Luma
- Department of Internal Medicine, Douala General Hospital, Douala, Cameroon
| | - Kathleen Blackett Ngu
- Department of Internal Medicine, Yaounde University Teaching Hospital, Yaounde, Cameroon
| | - Samuel Kingue
- Department of Internal Medicine, Faculty of Medicine and Biomedical Sciences, Yaounde, Cameroon
- Department of Internal Medicine, Yaounde General Hospital,Douala, Cameroon
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