Knowledge, perceptions and practices of COVID19 among the came-roonian population.

COVID19 is an emerging infectious disease that has spread all over the world and became a pandemic. Cameroon is the 7th most affected country in Africa, with most of the cases in metropoles. The main objective was to assess the knowledge, perceptions and practices of the Cameroonian populations about COVID19 infection. A cross-sectional study was conducted from May 15th to July 15th, 2020; targeting all Cameroonians over 15 years old living in Cameroon. A standard Google Forms® questionnaire was submitted via social media (WhatsApp and Facebook particularly). The sampling was consecutive and not exhaustive. The data were processed on Excel 2016 and analyzed through EPI info 3.5. The questionnaire included knowledge, perceptions and practices about the disease's existence, its functional signs, prevention and control. Knowledge, perceptions and practices were considered good for a response score ≥75% and poor for a score ≤25%. Intermediate scores were considered average and insufficient. Univariate and multivariate analyzes were performed to identify the factors associated with a significance level (P#x003C;0.05). Of the 996 (507 males) participants, the median age was 26±8 years. Health workers represented 20.8% of participants. A large proportion of the population (78.6%) had good knowledge, while more than half (56.5%) had good perceptions, but only (23.1%) had good practices. Having reached higher education (P=0.007), and being a health worker (P=0.0008) were associated with a good level of knowledge. High school education (P=0.040) and being a health worker (P=0.049) were associated with positive perceptions. Being employed (P=0.003) and having secondary education level (P=0.033) were associated with good practices. Knowledge and perceptions were good among the study population, but the practice level is still insufficient to effectively fight the COVID19 pandemic. Educational level, being employed or being healthcare workers were associated with good knowledge, perceptions and practices.

Gender difference in the association between gout at diagnosis and metabolic syndrome in African population: a retrospective cohort study.

Introduction: few studies have specifically investigated the link between metabolic syndrome (MetS) and gout in sub-Saharan Africa. This report aimed to evaluate in patients with gout the association between gout at diagnosis and MetS and to assess the gender difference. Methods: we performed a single-centre retrospective cohort study on all outpatients seen in the Rheumatology Unit of the General Hospital, Douala, Cameroon. We included records of patients with a recent diagnosis of gout according to the American College of Radiology (ACR) criteria. MetS was defined according to the harmonized criteria. Results: we included 511 patients (415 men), with a mean age at diagnosis of 55.9 ±10.8 years. Women were older than men. The mean serum uric acid was 8.24±2.23 mg/L, with hyperuricemia found in 394 patients (77.1%). MetS was present in 101 patients (19.7% [95% CI: 16.8%-22.1%]), significantly more common in men compared to women (23.6% vs. 10.8%; p<0.001). The main components of the MetS were: increased waist circumference (217 patients, 61.3%), obesity (256 patients, 52.2%), hypertension (208 patients, 40.7%), and diabetes mellitus (52 patients, 10.2%). Furthermore, hypertension, diabetes mellitus, obesity, and increased waist circumference were more frequent in women (p<0.001). There was no difference in dyslipidemia according to gender. The combination of components of the MetS was more frequent in men than women (p<0.001). Conclusion: MetS are common in newly diagnosed Cameroonian patients with gout, with increased waist circumference, obesity, hypertension and diabetes mellitus being the main components. These components are more common in women, but their combination was more frequent in men.

Hydroxychloroquine and COVID-19: can we learn from the use of rituximab in systemic lupus erythematosus?

Rituximab (RTX), a chimeric monoclonal anti-CD20 antibody has become part of the standard therapy for patients with CD20-expressing B-cell lymphoma and rheumatoid arthritis. After encouraging results with open studies in systemic lupus erythematosus (SLE), RTX has not shown its effectiveness in randomized controlled trials. However, its efficacy has been validated in renal, hematological, and neuropsychiatric disorders. Understanding the history of RTX in SLE would be instructive in the hydroxychloroquine (HCQ) saga in COVID-19. Three steps would be necessary and sufficient before definitively closing the debate: 1) determine the effective and safe dose of HCQ, as well as the minimum duration of treatment in COVID-19; 2) define the profile of patients in whom HCQ would be more likely to be effective (especially in asymptomatic patients and/or at the onset of the first signs of the disease) and 3) conduct one or more multicentre RCT to evaluate the efficacy and safety of HCQ in COVID-19 in SSA.

Normalisation of the psychometric encephalopathy score within the Cameroonian population.

BACKGROUND: Minimal hepatic encephalopathy (MHE) is the presence of neuropsychological abnormalities detectable by psychometric tests. Psychometric Hepatic Encephalopathy Score (PHES) is a gold standard test for the early diagnosis of MHE in cirrhotic patients. The aim of this study was to standardize the PHES in a healthy Cameroonian population and to evaluate the prevalence of MHE among cirrhotic patients. METHODS: This was a prospective, multicentric study from 1 December 2018 to 31 July 2019 in two groups: healthy volunteers and cirrhotic patients without clinical signs of hepatic encephalopathy. The results of the number connection test-A, number connection test-B, serial dotting test, line tracing test were expressed in seconds and those of the digit symbol test in points. RESULTS: A total of 102 healthy volunteers (54 men, 48 women) and 50 cirrhotic patients (29 men, 31 women) were included. The mean age was 38.1 ± 12.55 years in healthy volunteers and 49.3 ± 15.6 years in cirrhotic patients. The mean years of education level was 11.63 ± 4.20 years in healthy volunteers and 9.62 ± 3.9 years in cirrhotic patients. The PHES of the healthy volunteer group was - 0.08 ± 1.28 and the cut-off between normal and pathological values was set at - 3 points. PHES of the cirrhotic patients was - 7.66 ± 5.62 points and significantly lower than that of volunteers (p < 0.001). Prevalence of MHE was 74% among cirrhotic patients. Age and education level were associated with MHE. CONCLUSION: PHES cut-off value in Cameroonians is - 3, with MHE prevalence of 74% among cirrhotic patients.

The challenge of COVID-19 case identification and ascertainment in sub-Saharan Africa: the case of Cameroon.

Confirmation of COVID-19 infection is still challenging in Cameroon due to lack of sufficient RT-PCR tests and screening capacity. International organizations as well as philanthropic donators initially provided these tests. Due to limited kits availability, mass screening is currently a luxury that the country cannot afford. This impacts on estimates of disease prevalence, on the understanding of its burden and delays the implementation of targeted preventive measures. Besides RT-PCR, chest CT-scan could be a useful tool for screening purposes. However, its sensitivity and cost make its integration in management algorithms difficult. We discuss below the challenges and potential solutions that could ease the diagnosis of COVID-19 infection in Cameroon.