Brachial circumference as an alternative to body mass index for the detection of in-hospital undernutrition in a referal hospital, Cameroon.

The prevalence of undernutrition in hospitals in Africa is estimated at about 57 %. Simple anthropometric methods are available to detect it, including measurement of the brachial circumference (BC) and the body mass index (BMI). The aim of this study was to identify a threshold value that might make it possible to diagnose undernutrition in hospitals. It was a cross sectional study carried out at Douala General Hospital - Cameroon over a five months period. The measurements studied were: BMI, BC and percentage of weight loss. The Pearson test was used to compare the quantitative variables. The Receiving Operating Characteristic curve enabled us to determine a threshold value of the BC according to BMI. The study included 333 patients, with a mean age of 45 ± 16 years (range : 18-86). BMI and BC were strongly correlated; BC =11.69 + 0.68(BMI), with r2 = 0.65 (P < 0.01)). The threshold value of BC retained to detect undernutrition was 27 cm. The prevalence of undernutrition at the Douala General Hospital varies according to the anthropometric parameter used. At a BC threshold of 27 cm, the prevalence of undenutrition in our population was 24,3%.

Prevalence of Helicobacter pylori prevalence and upper gastrointestinal endoscopy in HIV/AIDS patients with gastrointestinal symptoms in the University Teaching Hospitals in Cameroon.

OBJECTIVE: To determine the prevalence of Helicobacter pylori (H. pylori) infection and of various upper gastrointestinal (GI) lesions in HIV+ patients with GI symptoms and the relation of H. pylori infection to CD4 cell counts. MATERIAL AND METHODS: In all, 56 HIV+ patients and 56 age- and sex-matched HIV- controls, all with upper GI symptoms, were evaluated by an upper endoscopy examination and gastric biopsy. H. pylori status was assessed with a urease test and histology. HIV was diagnosed with the rapid test and enzyme-linked immunosorbent assay (ELISA). RESULTS: The prevalence of H. pylori was 50% (28/56 [95%CI 36.3-63.7]) in HIV+ subjects and 55% (31/56 [95%CI 41.5-68.7]) in HIV- controls (p = 0.57). H. pylori infection rates did not differ significantly in HIV+ patients between those with a CD4 count ≥200/mm3 (52%) and those with a CD4 count <200/mm3 (42%) (p = 0.62). The prevalence on endoscopy of specific lesions in HIV+ patients and controls were compared: esophageal candidiasis (61%, 34/56 vs. 7%; p<0.0001), esophageal ulcers (18%, 10/56 vs 2%; p = 0.01), corpus gastritis (41%; 23/56 vs 5%; p<0.0001), and duodenitis (20%, 11/56, vs 0%; p = 0.001). CONCLUSIONS: The prevalence rate of H. pylori did not differ significantly between HIV+ and HIV- subjects. Prevalence of H. pylori was also lower, although not significantly, among HIV+ patients with CD4 T-cell counts below 200/mm3. On endoscopy, esophageal candidiasis was the most common finding in HIV+ patients, discovered by dysphagia.

[Risk factors associated with gastroduodenal lesions in a Douala referral hospital (Cameroon)]. / Facteurs de risques associés aux lésions gastroduodénales dans un hôpital de référence à Douala (Cameroun).

INTRODUCTION: The causes of gastroduodenal lesions are multifactorial, and few studies have assessed the impact of each of these factors in Africa. The aim of this study was to identify factors associated with the occurrence of gastroduodenal lesions in Cameroon. METHOD: This prospective, analytical study took place over a 5-month period in the endoscopy unit of the Douala General Hospital. Lifestyle, medical history, demographic, and clinical variables were collected. Infection with Helicobacter pylori was determined with a rapid urease (CLO) test. Multivariate regression was used to determine risk factors. RESULTS: The study included 234 of 265 patients seen in the department over the study period. Gastroscopy was normal for 54.2% of the subjects. The prevalence of peptic ulcers was 17.1% and of inflammatory lesions 26.4%. Risk factors associated with a gastroduodenal lesion were: age greater than 60 years [OR age = 2.953; 95% CI: 1.399 to 6.231; p = 0.004], H. pylori infection [OR = 2.953; 95% CI: 1.399 to 6.231; p = 0.003] and regular NSAID use [OR = 0.912; 95% CI: 0.112 to 2.733; p = 0.044] either a month before the examination or over the long term. CONCLUSION: Age greater than 60 years, NSAID consumption, and H. pylori infection are associated with the occurrence of gastroduodenal lesions.

[Diagnosis of hepatocellular carcinoma by needle puncture--aspiration and cytological test. The experience in Cameroon]. / Diagnostic du carcinome hépato-cellulaire par ponction-aspiration à l'aiguille et examen cytologique. L'expérience du Cameroun.

The authors report their experience of the diagnosis of hepatocellular carcinoma using needle aspiration cytology over a four year period (1989-1992). In 116 of the 119 patients presenting with histologically proven hepatocellular carcinoma, the diagnosis was previously established by cytology. This method has a 97% sensitivity. Also, in forty patients without hepatocellular carcinoma, previous cytology did not detect any carcinomatous cells and therefore recorded a 100% specificity. Thus, cytologic diagnosis of hepatocellular carcinoma is possible. In countries with limited resources in which this carcinoma is widespread, needle aspiration cytology needs to be well known and used.

[Anatomopathological aspects of colorectal polyps in Cameroon]. / Aspects anatomopathologiques des polypes colorectaux au Cameroun.

In order to present the main types of colo-rectal polyps in Cameroon, we reviewed all those cases received and examined in our Pathology laboratories during a six and a half year period (1st January 1984-30th June 1990). The polyps were sent by gastro-enterologists after resection during total colonoscopy, with information about age and sex of patients, signs and symptoms and sites and number of polyps. One hundred and two colorectal polyps were taken from 88 patients with a maximum of two polyps per patient. Out of these 102 polyps, we noted: 55 juvenile polyps (54%), 23 hyperplastic polyps (22.5%), 13 adenomatous polyps (12.5%), 10 inflammatory polyps (10%) and one polyp of the Peutz-Jeghers type. One case of hyperplastic polyposis and one of familial polyposis with adenomas on histological examination were registered. On the whole, juvenile polyps predominated and adenomas which can become carcinomas were less frequent than what is seen in Western developed countries. This may be due to the fact that the polyps we examined were only taken only from patients seen in outpatient department for gastrointestinal complaints.

[Gastroduodenal ulcers in children in Cameroon. Apropos of 28 cases diagnosed by endoscopy]. / Ulcères gastroduodénaux de l'enfant camerounais. A propos de vingt-huit cas de diagnostic endoscopique.

This study was undertaken to describe the epidemiology and clinical features of peptic ulcer in children on the basis of twenty-eight endoscopically documented cases. Mean age was 11,5 years (range 4-16 years). Twenty-five percent of patients had a positive family history for peptic ulcer and 32% had risk factors. Two-thirds of patients had abdominal pain, occasionally accompanied with bleeding. Duodenal ulcers were slightly more common (15 versus 13). The ulcer was chronic or primary in seventeen cases, whereas endoscopic findings showed that eleven cases were acute or secondary.

[Upper digestive system hemorrhages in Cameroon (apropos of 172 cases examined via endoscopy)]. / Les hémorragies digestives hautes au Cameroun (à propos de 172 cas explorés par endoscopie).

172 cases of upper gastrointestinal bleeding were explored endoscopically from 01 March 1987 to 15 May 1989 in 3 centers in Cameroon. The patients comprised 124 men and 48 women with an average age of 39.64 years. Haematemesis with resultant melena constituted the most frequent presentation (42.36%) while haematemesis and melena was the unique presentation in 37.22% and 17.91% of cases respectively. The aetiologic factors encountered were: duodenal ulcers (33.64%), acute gastric bleeding (22.08%) gastric ulcer (13.44%), ruptured gastroesophageal varices (13.92%). Predisposing factors included the ingestion of gastric irritant medication, spices and alcohol. The authors review the literature and in its light, discuss the epidemiology and aetiology of gastrointestinal bleeding in Cameroon.