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BACKGROUND: Kidney dysfunction is common in patients with heart failure (HF) and has been associated with poor outcomes. This study aimed to determine the prevalence, correlates, and prognosis of kidney dysfunction in patients with HF in Cameroon, an understudied population. METHODS: We conducted a cross-sectional study in consecutive patients hospitalized with HF between June 2016 and November 2017 in the Buea Regional Hospital, Cameroon. Kidney dysfunction was defined as an estimated glomerular filtration rate < 60 ml/min/1.73m2. Prognostic outcomes included death and prolonged hospital stay (> 7 days). We also performed a sensitivity analysis excluding racial considerations. RESULTS: Seventy four patients (86.1% of those eligible) were included. Their median age was 60 (interquartile range: 44-72) years and 46.0% (n = 34) were males. Half of patients (n = 37) had kidney dysfunction. Correlates of kidney dysfunction included previous diagnosis of HF (adjusted odds ratio [aOR]4.3, 95% CI: 1.1-17.5) and left ventricular hypertrophy (aOR3.4, 95% CI: 1.1-9.9). Thirty-six (48.9%) had prolonged hospital stay, and seven (9.5%) patients died in hospital. Kidney dysfunction was not associated with in-hospital death (aOR 0.4, 95% CI: 0.1-2) nor prolonged hospital stay (aOR 2.04, 0.8-5.3). In sensitivity analysis (excluding racial consideration), factors associated with Kidney dysfunction in HF were; anemia (aOR: 3.0, 95% CI: 1.1-8.5), chronic heart failure (aOR: 4.7, 95% CI: 0.9-24.6), heart rate on admission < 90 bpm (aOR: 3.4, 95% CI: 1.1-9.1), left atrial dilation (aOR: 3.2, 95% CI: 1.04-10), and hypertensive heart disease (aOR: 3.1, 95% CI: 1.2-8.4). Kidney dysfunction in HF was associated with hospital stay > 7 days (OR: 2.6, 95% CI: 1-6.8). CONCLUSION: Moderate-to-severe kidney dysfunction was seen in half of the patients hospitalized with HF in our setting, and this was associated with a previous diagnosis of HF and left ventricular hypertrophy. Kidney dysfunction might not be the main driver of poor HF outcomes in this population. In sensitivity analysis, this was associated with anemia, chronic heart failure, heart rate on admission less than 90 bpm, left atrial dilatation, and hypertensive heart disease. Kidney dysfunction was associated with hospital stay > 7 days.
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Insuficiencia Cardíaca/complicaciones , Insuficiencia Renal/complicaciones , Insuficiencia Renal/epidemiología , Adulto , Anciano , Anciano de 80 o más Años , Camerún/epidemiología , Estudios Transversales , Femenino , Tasa de Filtración Glomerular , Insuficiencia Cardíaca/epidemiología , Insuficiencia Cardíaca/fisiopatología , Mortalidad Hospitalaria , Humanos , Hipertrofia Ventricular Izquierda/complicaciones , Riñón/fisiopatología , Tiempo de Internación , Masculino , Persona de Mediana Edad , Prevalencia , Estudios Prospectivos , Insuficiencia Renal/fisiopatología , Adulto JovenRESUMEN
BACKGROUND: Rheumatic Heart Disease (RHD) remains a major cause of childhood acquired heart disease in developing countries. However reported echocardiographic features are limited to a few countries. This report is on the demographic and echocardiographic features of RHD in children using data from the largest referral hospital in Yaounde, the capital city of Cameroon. METHODS: The register of the cardiac ultrasound unit of the Yaounde General Hospital for the period 2003-2013 served as basis for data collection. RHD diagnosis was based on the World Heart Federation Criteria for the diagnosis of RHD. Demographic data, pattern of valve lesions and severity were analyzed. RESULTS: A total of 1130 first echocardiographic examinations were performed in children aged ≤ 18 years. Sixty-five (5.8 %) had a definite echocardiographic diagnosis of RHD with their mean age being 11.8 years (SD 3.6) and 31 (47.1 %) being boys. The commonest primary reasons for requesting an echocardiographic examination were a clinical diagnosis of RHD (24.6 %) without heart failure, a clinical diagnosis of heart failure (24.6 %), and heart murmurs (21.5 %). Isolated mitral regurgitation was the most common valve lesion (49.2 %) and was frequently associated with aortic regurgitation (35.4 %). Severe lesions were found in 63.3 % of participants. No right heart lesion was reported. CONCLUSIONS: A sizable proportion of children undergoing echocardiographic examination at this major referral hospital in Cameroon had RHD, with lesions found only on the left heart. These lesions predominated on the mitral valve, were commonly associated with aortic regurgitation, and more often severe.
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Cardiopatía Reumática/diagnóstico por imagen , Adolescente , Camerún/epidemiología , Niño , Preescolar , Femenino , Humanos , Lactante , Recién Nacido , Masculino , Auditoría Médica , Estudios Retrospectivos , Cardiopatía Reumática/epidemiología , Índice de Severidad de la Enfermedad , Centros de Atención Terciaria , UltrasonografíaRESUMEN
Introduction: there is a paucity of data on the epidemiology of COVID-19 infection in Cameroon with a few studies limited to big urban cities. The objective of this study was to describe the clinical characteristics and outcomes of hospitalized patients with COVID-19 at the Buea Regional Hospital, in the South West region of Cameroon. Methods: this was a retrospective cross-sectional study. The medical records of hospitalized patients with COVID-19 were reviewed from 2020 to 2021. Hospitalized patients with laboratory-confirmed COVID-19 were included. Binary logistic regression was used to identify factors associated with mortality. Results: two hundred and ten (210) patients were included in this cohort. There were 114 (54.7%) men. The mean age was 60±17.1 years. The common co-morbidities were hypertension (46.7%), diabetes mellitus (31%), and HIV infection (5.7%). The most common symptoms were dyspnea (93.3%), fatigue (93.8%), cough (77.6%), and fever (71.4%). The median oxygen saturation was 85% and the median respiratory rate was 24 cycles per minute. More than 80% had crackles on lung examination. Death occurred in 57 (27.1%) patients. In binary logistic regression, the factors independently associated with mortality were heart failure (aOR: 6.7, p=0.034), SBP < 100 mmHg (aOR: 8.1, p<0.001), RR > 24 cpm (aOR: 3, p=0.016), SaO2<90% (aOR: 6.2, p=0.031), blood glucose > 150mg/dL (aOR: 3.3, p=0.02), and CRP > 50 mg/L (aOR: 3.3, p=0.036). For every 1 mg/dL rise in blood glucose, the odds of death increased by 1% (p=0.011). For every 1 mg/L rise in the C-reactive protein (CRP), the odds of death increased by 1% (p=0.054). Conclusion: over half of hospitalized patients with laboratory-confirmed COVID-19 infection in the South West Region of Cameroon were males. Hypertension and diabetes were common co-morbidities. More than a quarter of these patients died. Furthermore, having heart failure, low systolic blood pressure (SBP), low oxygen saturation, elevated respiratory rate, high CRP and blood glucose levels on admission were associated with poor prognosis.
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COVID-19 , Hospitalización , Humanos , Camerún/epidemiología , Masculino , Femenino , Persona de Mediana Edad , COVID-19/epidemiología , COVID-19/mortalidad , Estudios Transversales , Estudios Retrospectivos , Anciano , Hospitalización/estadística & datos numéricos , Adulto , Factores de Riesgo , Comorbilidad , Anciano de 80 o más AñosRESUMEN
Introduction: pulmonary hypertension (PH) is a common and severe complication in patients with heart failure (HF). It is associated with increased morbidity and mortality. There is limited data in Cameroon on the prevalence of PH in hospitalized HF patients and its impact on outcome. Methods: we analyzed data from consecutive adult patients hospitalized with. Pulmonary hypertension (PH) was defined as pulmonary artery systolic pressure (PASP) ≥ 35mmHg. Results: eighty-six (86) consecutive patients were hospitalized and 66(76.7%) had measurable PASP on echocardiography. Of those with echocardiographically measurable PASP (66), there were 39 (59.1%) females. The median (IQR) age was 60 (42-76) years. The prevalence of PH was 93.9%. PH was present in all (100%) patients with right heart failure (RHF) and in 62 (93.9%) patients with left heart failure (LHF). Severe PH (PASP ≥55 mmHg) was seen in 45 (68.2%, [95% CI: 55.6-75.1]) patients. The mean PASP was significantly higher in those with isolated RHF compared with those who had isolated left or bi-ventricular failure. Factors likely associated with moderate-to-severe PH (PASP ≥ 45 mmHg) were female sex, RHF, and right atrial dilatation. After adjusting for sex, right atrial dilation was independently associated with moderate-to-severe PH. In-hospital death occurred in 7 (10.6%, [95% CI: 4.4-20.6]) patients. The median (IQR) time to death was 6 (3-7) days and ranged from 2 to 8 days. All deaths (100%) occurred in those with moderate-to-severe PH. Conclusion: the prevalence of pulmonary hypertension in hospitalized heart failure patients was high with two third of the patients having severe PH, and most commonly occurred in females. All deaths occurred in patients with moderate-to-severe PH.
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Fibrilación Atrial , Insuficiencia Cardíaca , Hipertensión Pulmonar , Adulto , Humanos , Femenino , Persona de Mediana Edad , Anciano , Masculino , Hipertensión Pulmonar/epidemiología , Camerún/epidemiología , Fibrilación Atrial/complicaciones , Mortalidad Hospitalaria , Insuficiencia Cardíaca/epidemiología , Insuficiencia Cardíaca/etiología , Arteria PulmonarRESUMEN
Introduction: bacterial profile of diabetic foot infections and the antibiotic susceptibility are essential in the prescription of empirical antibiotics before the results of cultures of deep wound samples are available. The aim of this study was to determine the microbiological profile and antibiotic susceptibility of bacteria isolated from infected diabetic foot ulcers in patients attending the Yaoundé Central Hospital, Cameroon. Methods: we retrospectively analyzed the records of patients hospitalized between 2008 and 2013 for diabetic foot infections. The main outcomes were the bacteriological profile and susceptibility patterns of isolates from positive culture of deep wound sample before antibiotherapy, carried out in the national reference laboratory. Eligible clinical records of patients were retrieved from the hospitalization registry. Results: a total of 101 patient records were analyzed. The mean age of patients was 57.1 ± 9.1 years. There were more males (64.4%), mostly with type 2 diabetes (99%), with a median duration of 9 years (IQR: 4 - 14 years). Their median blood sugar on admission was 246 mg/dL. Five percent of patients died and 23% had a major amputation. Two hundred and twenty-five (225) germs were isolated, with an average of 2.25 germs per patient. Gram-negative bacteria were more frequent (75.2%). These were mainly Morganella morganii (13.8%), Klebsiella pneumonia (12%), Escherichia coli (11.6%), Proteus spp. (10.7%), and Pseudomonas aeruginosa (8.9%). Gram-positive bacteria (24.8%) were mainly Staphylococcus aureus (9.3%), Streptococcus spp. (7.6%), and Enterococcus spp. (7.1%). Gram-negative bacteria showed a high resistance to amoxicillin-clavulanic acid (78%), fluoroquinolones (55%), and gentamycin (50%). They were susceptible to imipenem (95%), amikacin (88%), and show moderate susceptibility to third generation cephalosporins (62%). Gram-positive bacteria were susceptible to vancomycine (94%), and moderately susceptible to pristinamycine (82%) and fusidic acid (67%). Conclusion: Gram-negative bacteria were more frequently associated with diabetic foot infections, and were frequently resistant to the usually prescribed antibiotics, but remain susceptible to imipenem and amikacin. Our findings should be considered when prescribing empirical anti-biotherapy for diabetic foot infections in our setting.
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Infecciones Bacterianas , Enfermedades Transmisibles , Diabetes Mellitus Tipo 2 , Pie Diabético , Anciano , Amicacina/uso terapéutico , Antibacterianos/farmacología , Antibacterianos/uso terapéutico , Bacterias , Infecciones Bacterianas/microbiología , Camerún/epidemiología , Enfermedades Transmisibles/tratamiento farmacológico , Diabetes Mellitus Tipo 2/complicaciones , Pie Diabético/epidemiología , Bacterias Gramnegativas , Bacterias Grampositivas , Humanos , Imipenem/uso terapéutico , Masculino , Pruebas de Sensibilidad Microbiana , Persona de Mediana Edad , Estudios RetrospectivosRESUMEN
Background: Several recent studies have shown differences in the risk profile and outcome of cardiovascular diseases between men and women, with a dearth of data from African populations. This study aimed to examine gender differences in a group of patients from Cameroon hospitalized with a hypertensive crisis. Methods: We conducted a cross-sectional study from June 2018 until June 2019. The criteria to define a hypertensive crisis (HC) were systolic and/or diastolic blood pressure should be ≥180/110 mmHg. We compared the clinical presentation and outcome of males versus females. Results: Out of the 1536 patients admitted, 95 (6.2%) had an HC. There were 49 (51.6%) men. There was no significant age difference between men and women (52.7 years vs. 49.3 years, p = 0.28). Alcohol consumption (p < 0.0001), previous stroke (p = 0.04), and smoking (p = 0.03) were significantly higher in men compared to women. Men had a higher proportion of psychomotor agitation (p = 0.05). There was an equal proportion of men and women with hypertensive emergencies. Although acute left ventricular failure was most frequent in women (46.4% vs 42.9%), cerebral infarction (14.3% vs 17.9%), and acute coronary syndrome (0% vs 7.1%) were higher in men, the differences were not statistically significant (all p > 0.05). Case fatality was also higher in men compared to women but the difference was not statistically significant. Conclusions: Men admitted for an HC had a significantly higher cardiovascular risk burden and higher psychomotor agitation. However, there were no significant differences in the types of hypertensive emergencies and outcomes between men and women.
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Introduction: diabetes mellitus is a major health problem worldwide. It is associated with high cardiovascular morbi-mortality especially coronary artery disease. Myocardial ischemia is often asymptomatic (silent myocardial ischemia) in people with type 2 diabetes mellitus thus making early diagnosis difficult. Silent myocardial ischemia is defined as the objective evidence of myocardial ischemia in the absence of chest discomfort or other angina equivalents. This study aimed to determine the prevalence and determinants of silent myocardial ischemia in a population of people with type 2 diabetes using exercise stress electrocardiography. Methods: we carried out a cross-sectional study between January and April 2019 at the National Obesity Centre of the Yaounde Central Hospital. Patients with type 2 diabetes underwent a complete clinical evaluation, blood test, resting electrocardiogram (ECG), and exercise stress ECG according to the Bruce protocol. A positive stress test was defined as horizontal or down-sloping ST depression ≥ 1mm or upsloping ST depression of 2 mm or more 0.06 to 0.08 seconds after the J point. Results: a total of 112 patients with diabetes (63 males and 49 females) were screened. The median age was 58 (IQR: 51 - 64) years. The median time from diabetes diagnosis was 8 (IQR: 5 - 12) years. Fifty-seven (50.4%) had hypertension, 78 (69.0%) had dyslipidemia, 66 (58.4%) were obese, 70 (61.9%) had poor glycemic control, and 23 (20.2%) were smokers. Sixty-five (58%) patients had a positive exercise stress ECG test. Factors independently associated with a positive stress test were abdominal obesity (aOR: 4.2, [95% CI: 1.4 - 12.8]) and Female sex (aOR: 2.5, [95% CI: 1.1 - 5.7]). Conclusion: the prevalence of silent myocardial ischemia was high in a population of asymptomatic patients. This was independently associated with abdominal obesity and female sex.
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Enfermedad de la Arteria Coronaria , Diabetes Mellitus Tipo 2 , Isquemia Miocárdica , Camerún/epidemiología , Enfermedad de la Arteria Coronaria/complicaciones , Estudios Transversales , Diabetes Mellitus Tipo 2/complicaciones , Diabetes Mellitus Tipo 2/epidemiología , Electrocardiografía , Prueba de Esfuerzo , Femenino , Humanos , Masculino , Persona de Mediana Edad , Isquemia Miocárdica/diagnóstico , Isquemia Miocárdica/epidemiología , Obesidad Abdominal/complicaciones , PrevalenciaRESUMEN
Introduction: carotid and femoral intima-media thickness (IMT) and atherosclerotic plaques are considered as markers of generalized atherosclerosis and as independent predictors of cardiovascular events and mortality. This study aimed to determine the prevalence and correlates between carotid and femoral intima-media thickness and plaques in patients with major cardiovascular risk factors (CVRFs). Methods: we carried out a cross-sectional study at the Yaoundé Central Hospital between December 2017 and May 2018. B-mode ultrasound was used to assess for the presence of plaques and also measure the IMT at the carotid and femoral arteries in patients with CVRFs. Logistic regression analysis was performed to examine the association between ultrasound findings (presence of plaques or IMT > 0.9mm) and cardiovascular risk factors. A p-value <0.05 was considered significant. Results: amongst the 71 patients, 43.7% were male and 56.3% were female. The mean age was 61.6 ± 8.4 years and ranged from 40 to 75 years. Thirty-nine (54.9%) participants had carotid atherosclerotic plaques and 33 (46.5%) participants had femoral artery plaques. The plaque burden was higher in the carotid arteries. Plaques at one or more artery sites were seen in 67.6% of participants. An IMT ≥ 0.9 mm was seen in only 1.4 to 2.8% of participants. In the multivariable analysis using binary logistic regression, age > 50 years (males) or 60 years (females) (aOR: 11.3 [95% CI: 2.2 - 56.8], p=0.002) and presence of dyslipidemia (aOR: 3.6 [95% CI: 1.2 - 11], p=0.043) were associated with carotid artery plaques, while presence of dyslipidemia (aOR: 4.8 [95% CI1.8 - 13.3], p=0.004) and high cardiovascular risk profile (10-year risk> 20%) (aOR: 4.2 [95% CI: 1.2 - 13.2], p=0.0495) were associated with femoral artery plaques. Conclusion: plaques were more frequent than an IMT > 0.9 mm, with a higher plaque burden in the carotid arteries. Plaques were associated with advanced age, dyslipidemia, and a high cardiovascular risk profile.
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Enfermedades Cardiovasculares , Enfermedades de las Arterias Carótidas , Placa Aterosclerótica , Adulto , Anciano , Camerún/epidemiología , Enfermedades Cardiovasculares/epidemiología , Enfermedades Cardiovasculares/etiología , Arterias Carótidas/diagnóstico por imagen , Enfermedades de las Arterias Carótidas/diagnóstico por imagen , Enfermedades de las Arterias Carótidas/epidemiología , Grosor Intima-Media Carotídeo , Estudios Transversales , Femenino , Factores de Riesgo de Enfermedad Cardiaca , Humanos , Masculino , Persona de Mediana Edad , Placa Aterosclerótica/diagnóstico por imagen , Placa Aterosclerótica/epidemiología , Prevalencia , Factores de RiesgoRESUMEN
Pericardial effusion complicated by cardiac tamponade is a medical emergency. Large pericardial effusion and tamponade are rare in childhood. Tuberculosis remains a major cause of pericardial effusion in endemic areas. A 16-year-old adolescent with no significant past history was admitted to the medical unit of the Buea Regional hospital in the South West region of Cameroon for heart failure after presenting with abdominal distension, shortness of breath and fever of two weeks duration. Echocardiographic study during admission revealed a large pericardial effusion (27mm in thickness) with echocardiographic signs of tamponade. Echocardiographic guided pericardiocentesis was performed through a sub-xiphoid route and about 500 cc of heavily stained blood fluid that was not coagulating was drained. Pericardial fluid analysis for acid fast bacilli was negative. There was no evidence of malignancy. A strong suspicion of tuberculosis was made and he was started on anti-tuberculosis medications for presumptive hemorrhagic tuberculous pericarditis. Patient was asymptomatic during follow up and repeat echocardiographic examinations showed no re-accumulation of pericardial fluid. Tuberculosis should be considered as the etiology of pericardial effusion in endemic areas although the identification of mycobacterium is challenging in these settings.
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Taponamiento Cardíaco , Derrame Pericárdico , Tuberculosis , Adolescente , Camerún/epidemiología , Taponamiento Cardíaco/diagnóstico , Taponamiento Cardíaco/epidemiología , Taponamiento Cardíaco/etiología , Humanos , Masculino , Derrame Pericárdico/epidemiología , Derrame Pericárdico/etiología , Pericardiocentesis , Tuberculosis/complicaciones , Tuberculosis/diagnóstico , Tuberculosis/tratamiento farmacológicoRESUMEN
INTRODUCTION: hyperglycemic emergencies (diabetic ketoacidosis and hyperglycemic hyperosmolar state) are the most common serious acute metabolic complications of diabetes which result in significant morbidity and mortality. There is paucity of data on hyperglycemic emergencies in Cameroon. The objective of this study was to investigate the precipitants and outcomes of patients admitted for hyperglycemic emergencies in the Buea Regional Hospital in the South West Region of Cameroon. METHODS: in this retrospective study the medical records of patients admitted for hyperglycemic emergencies between 2013 and 2016 in the medical unit of the Buea Regional Hospital were reviewed. We extracted data on demographic characteristics, admission clinical characteristics, precipitants, and treatment outcomes. Logistic regression was used to determine predictors of mortality. RESULTS: data were available for 60 patients (51.7% females) admitted for hyperglycemic emergencies. The mean age was 55.2±16.3 (range 18-86). Overall there were 51 (85%) cases of hyperosmolar hyperglycemic state. Twenty six (43.3%) of the patients had hypertension. The most common precipitants of hyperglycemic emergencies were infections (41.7%), newly diagnosed diabetes (33.3%) and non-adherence to medications (33.3%). Mean admission blood glucose was 574mg/dl±70.0mg/dl. The median length of hospital stay was 6 days. Overall case fatality rate was 21.7%. Six (46.2%) deaths were related to infections. Predictors of mortality were a Glasgow coma score <13(p<0.001), a diastolic blood pressure <60 mmHg (p=0.034) and a heart rate >90(0.057) on admission. CONCLUSION: admission for hyperglycemic emergencies in this semi-urban hospital is associated with abnormally high case fatality. Infections, newly diagnosed diabetes and non-adherence to medications are the commonest precipitants of hyperglycemic emergencies. Public health measures to reduce morbidity and mortality from hyperglycemic crisis are urgently needed.
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Cetoacidosis Diabética/diagnóstico , Hiperglucemia/diagnóstico , Coma Hiperglucémico Hiperosmolar no Cetósico/diagnóstico , Adolescente , Adulto , Anciano , Anciano de 80 o más Años , Glucemia/metabolismo , Camerún , Diabetes Mellitus/diagnóstico , Diabetes Mellitus/epidemiología , Cetoacidosis Diabética/epidemiología , Cetoacidosis Diabética/terapia , Urgencias Médicas , Femenino , Hospitalización/estadística & datos numéricos , Humanos , Hiperglucemia/mortalidad , Hiperglucemia/terapia , Coma Hiperglucémico Hiperosmolar no Cetósico/epidemiología , Coma Hiperglucémico Hiperosmolar no Cetósico/terapia , Tiempo de Internación/estadística & datos numéricos , Masculino , Cumplimiento de la Medicación/estadística & datos numéricos , Persona de Mediana Edad , Estudios Retrospectivos , Resultado del Tratamiento , Adulto JovenRESUMEN
INTRODUCTION: HIV infection is a well-known risk factor for stroke, especially in young adults. In Cameroon, there is a death of data on the outcome of stroke among persons living with HIV (PLWH). This study aimed to assess the cardiovascular risk profile and mortality in PLWH who had a stroke. METHODS: this was a retrospective cohort study of all PLWH aged ≥18 years admitted for stroke between January 2010 and December 2019 to the Cardiology Unit of the Yaoundé Central Hospital, Cameroon. Cardiovascular risk was estimated using the modified Framingham score, with subsequent dichotomization into low and intermediate/high risk. Mortality was assessed on day 7 during hospitalization (medical records), at one month, and one year by telephone call to a relative. RESULTS: a total of 43 PLWH who had a stroke were enrolled. Their mean age was 52.1 (standard deviation 12.9) years, most of them were female (69.8%, n = 30). There were 25 (58.1%) patients on concomitant antiretroviral therapy. The Framingham cardiovascular risk score at admission was low in 29 patients (67.4%) and intermediate to high in 14 patients (32.6%). Ischemic stroke was the most common type of stroke in 36 persons (83.7%). The length of hospital stay was 11.4 (interquartile range 9.2-13.7) days. Mortality at 1 year was 46.5% (n = 20). CONCLUSION: stroke mortality was high in this population of PLWH. Most patients had a low Framingham score, suggesting that this risk estimation tool underestimates cardiovascular risk in PLWH.
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Enfermedades Cardiovasculares/epidemiología , Infecciones por VIH/epidemiología , Hospitalización/estadística & datos numéricos , Accidente Cerebrovascular/epidemiología , Adulto , Anciano , Fármacos Anti-VIH/administración & dosificación , Camerún , Estudios de Cohortes , Femenino , Infecciones por VIH/tratamiento farmacológico , Factores de Riesgo de Enfermedad Cardiaca , Humanos , Accidente Cerebrovascular Isquémico/epidemiología , Accidente Cerebrovascular Isquémico/mortalidad , Tiempo de Internación , Estudios Longitudinales , Masculino , Persona de Mediana Edad , Estudios Retrospectivos , Factores de Riesgo , Accidente Cerebrovascular/mortalidadRESUMEN
Ventricular noncompaction or hypertrabeculation is rare and unclassified cardiomyopathy that mostly affects the left ventricle. We report the case of biventricular hypertrabeculation in a 54-year-old woman who presented with congestive heart failure de novo associated with arrhythmia in a low-income setting. We also discussed the therapeutic challenges.
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OBJECTIVES: The aim of this study was to investigate the prevalence and associated factors of masked hypertension in obese patients in Yaounde. METHODS: We carried out a cross-sectional study from January to September 2017 at the National Obesity Center of the Yaounde Central Hospital. Masked hypertension was defined when the mean 24 h SBP was greater than or equal to 130 mmHg and/or the mean 24 h DBP was greater than or equal to 80 mmHg with normal office blood pressure (SBP/DBP) <140/90 mmHg. Logistic regression was used to examine the relationship of masked hypertension with associated factors. RESULTS: Among the 90 participants included, 67.8% were females. The mean age (±SD) was 46 (±8) years. The mean clinical measurements were 120 ± 9.4 mmHg and 75.5 ± 7.9 mmHg, respectively, for the SBP and the DBP. On 24 h ambulatory measurement, the mean was 123.9 ± 14.4/74.7 ± 8.9 mmHg, respectively, for the SBP/DBP. The prevalence of masked hypertension was 33.3%. Masked hypertension was significantly associated with high-normal office blood pressure [odds ratio (OR) = 2.90, P = 0.02] and to dyslipidemia (OR = 3.60, P = 0.01), but not to the male sex, diabetes, physical activity, and tobacco/alcohol. CONCLUSION: Our findings suggest that the prevalence of masked hypertension is high and that physicians should consider ambulatory blood pressure monitoring for obese individuals with high-normal office blood pressure or dyslipidemia.
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Hipertensión , Hipertensión Enmascarada , Adulto , Presión Sanguínea , Monitoreo Ambulatorio de la Presión Arterial , Camerún/epidemiología , Estudios Transversales , Femenino , Humanos , Hipertensión/complicaciones , Hipertensión/epidemiología , Masculino , Hipertensión Enmascarada/epidemiología , Persona de Mediana Edad , Obesidad/complicaciones , Obesidad/epidemiología , PrevalenciaRESUMEN
BACKGROUND: Diabetes is a public health problem worldwide, associated with increased morbidity and mortality. According to the International Diabetes Federation (IDF) 2017 data, around 425 million people worldwide suffer from diabetes. This number is expected to increase to 629 million in 2045. Various occidental studies reported the increased prevalence and lower control of diabetes among prisoners. However, there is no data on the characteristics of inmates with diabetes in sub-Saharan Africa. METHODS: A cross-sectional study among incarcerated detainees from the Yaoundé Central Prison was conducted from January to July 2017. Diabetes was defined according to the American Diabetes Association (ADA) criteria. Analyzed variables included phenotypic characteristics, lifestyle, the reason for detention, the sentence severity, and the length of detention. RESULTS: We recruited 437 inmates (344 men) with an average age of 37.0 (95% CI: 35.9-38.3) years. The most frequent age group was 20 to 39 years with 281 (64.7%) inmates, and the mean prison stay was 29.1 (95% CI: 25.7-32.8) months. The prevalence of diabetes in the Yaoundé Central Prison was 9.4%. The main cardiovascular risk factors were a sedentary lifestyle (91.1%), hypertension (39.6%), smoking (31.6%), and alcohol consumption (28.1%). Hypertension (p = 0.005), obesity (p = 0.005), obesity (p = 0.005), obesity (p = 0.005), obesity (p = 0.005), obesity (p = 0.005), obesity (. CONCLUSION: Diabetes prevalence in the Yaoundé Central Prison was high, at 9.4%, compared to that in the general population. It was associated with other classical cardiovascular risk factors and factors linked to the sentence (minor and major crimes). This trial is registered with CE00617/CRERSHC/2016.
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Consumo de Bebidas Alcohólicas/efectos adversos , Diabetes Mellitus/epidemiología , Prisioneros , Conducta Sedentaria , Fumar/efectos adversos , Adulto , Camerún , Estudios Transversales , Diabetes Mellitus/etiología , Femenino , Humanos , Masculino , Persona de Mediana Edad , Prevalencia , Prisiones , Factores de Riesgo , Adulto JovenRESUMEN
BACKGROUND: Sub-Saharan Africa (SSA) is experiencing an epidemic of cardiovascular diseases (CVD) as a result of a rapid epidemiological transition. Little is known about the admission for CVD and outcome in rural and semi-urban settings in Cameroon in this era of epidemiological transition. The aim of this study was to determine the frequency and the pattern of CVD admissions in the South West region of Cameroon. METHODS: This retrospective descriptive study included all adult patients admitted for CVD in the medical unit of the Buea Regional Hospital between Jan 2016 and December 2017. RESULTS: Out of the 3140 patients admitted, 499(15.9%) had CVD. There were 304(60.9%) females. The mean age was 58.7±16.2 years. There was no age difference between men and women (59.7 years vs 58.1years, p = 0.29). The most commonly affected age group was those aged 50-59 years (22%). Heart failure (38.5%), stroke (33.3%) and uncontrolled hypertension (22.4%) were the most prevalent CVDs. The length of hospital stay ranged from 1 to 37 days with a median length of hospital stay of 7 days. In-hospital case fatality was 78(15.8%). Mortality was higher in women compared to men (9% vs 7%, p = 0.43). The case fatality for stroke was higher compared to case fatality for heart failure (21.7% vs 16.7%, p = 0.23). CONCLUSION: CVDs are a common cause of hospital admission in this semi-urban setting, dominated by heart failure. Women were disproportionately affected and it was associated with high mortality. Prevention, early detection and management of risk factors for cardiovascular disease are imperative given the growing burden of CVD in SSA to reduce CVD morbidity and mortality.
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Enfermedades Cardiovasculares/epidemiología , Admisión del Paciente/estadística & datos numéricos , Adulto , Anciano , Camerún , Femenino , Humanos , Tiempo de Internación/estadística & datos numéricos , Masculino , Persona de Mediana Edad , Derivación y Consulta/estadística & datos numéricosRESUMEN
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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Glucemia/metabolismo , Trastornos del Metabolismo de la Glucosa/sangre , Trastornos del Metabolismo de la Glucosa/epidemiología , Salud Rural , Instituciones Académicas , Salud Urbana , Adolescente , Factores de Edad , Biomarcadores/sangre , Camerún/epidemiología , Estudios Transversales , Femenino , Trastornos del Metabolismo de la Glucosa/diagnóstico , Humanos , Masculino , Obesidad Abdominal/sangre , Obesidad Abdominal/epidemiología , Obesidad Infantil/sangre , Obesidad Infantil/epidemiología , Prevalencia , Factores de Riesgo , Adulto JovenRESUMEN
INTRODUCTION: Hypogonadism refers to a syndrome that results from failure of gonads to function properly. The main concern is considerable rise in morbidity, as shown by increased cardiovascular risk, infertility, osteoporosis and above all, the psychological impact on the life of the patients with hypogonadism. Judicious steroid replacement and culturally-sensitive psychological support before and during steroid therapy remains the key tool in the management of this condition. The present study aimed at filling the knowledge gap on hypogonadism in Cameroon. METHODS: We conducted a cross-sectional study over a period of 12 months, in 3 reference hospitals of Cameroon. We included males and females diagnosed with hypogonadism, aged 16 to 50 years and 16 to 45 years respectively. After a complete clinical examination, patients were invited to fill the modified middlesex hospital questionnaire for psychoneurotic evaluation. RESULTS: We recruited 59 patients with a sex ratio of 1:1. The mean age of the females and males were 27.7 ± 9.1years and 30.8 ± 11.7 years respectively. Normosmic Idiopathic Hypogonadotropic Hypogonadism (NIHH) was the most common presentation. Compulsive obsessive traits, phobic anxiety and hysterical trait, were most pronounced in these patients. Testosterone titers significantly correlated positively with testicular size and negatively with body mass index (BMI). A significant positive correlation was found between the testicular volumes measured with ultrasound (US) and with the orchidometer. CONCLUSION: Normosmic idiopathic hypogonadotropic hypogonadism is the most common presentation of hypogonadism in the study population. There is a significant psychosocial impact requiring further investigation and attention.
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Hipogonadismo/fisiopatología , Testículo/diagnóstico por imagen , Testosterona/sangre , Adolescente , Adulto , Índice de Masa Corporal , Camerún , Estudios Transversales , Femenino , Humanos , Hipogonadismo/epidemiología , Hipogonadismo/psicología , Histeria/epidemiología , Masculino , Persona de Mediana Edad , Trastorno Obsesivo Compulsivo/epidemiología , Trastornos Fóbicos/epidemiología , Ultrasonografía , Adulto JovenRESUMEN
BACKGROUND: Early diagnosis and adequate treatment of Group A streptococcal throat infection is an important initial stage in the primary prevention of acute rheumatic fever and rheumatic heart disease. This preventable condition associated with high mortality rates mandates a thorough understanding by the general public and the health. OBJECTIVE: The aim of the study was to assess the level of awareness about different aspects of rheumatic heart disease in patients coming to the outpatient department of the Buea regional Hospital, South West region of Cameroon. METHODS: This was a cross-sectional descriptive study carried in the outpatient department of the Buea Regional Hospital, Cameroon. The study population was adults and children aged 9 years and above. Data collection was done by using a self-administered questionnaire addressed to assess awareness on rheumatic heart disease. RESULTS: A total of 256 participants were interviewed, of which 70 (27.3%) were males. Their mean age was 34.4 ± 11.9 years (males: 36.2 ± 12.7 years versus females: 33.7 ± 11.6 years, p = 0.129). Most of the participants were in the 20 to 29 year old group (37.9%). More than two thirds (71.1%) of the participants reported having had sore throat at least once. The disease was treated with antibiotics in only 45.4%, with the treatment prescribed by a health care professional in 35.8% of the cases. About 73% of the respondents did not know what causes sore throat, and most (71.1%) were unaware of any complications that could arise from poorly treated sore throat. More than 70% of the participants did not know that sore throat can be associated with heart disease. Rheumatic heart disease was unknown to 82% of the participants and 95% of them did not know what causes RHD. Only 5.1% percent of the participants had an adequate knowledge of RHD. Age ≤ 35 years, post-secondary level of education, and having heard of RHD were significantly associated with an adequate knowledge. After adjusting for age, post-secondary education (aOR: 9, [95% C: 1.2-67.5], p = 0.019), and having heard of RHD (aOR: 18.1, [95% CI: 4.7-70.3], p<0.001) were still associated with a fair knowledge. CONCLUSIONS: Levels of knowledge and awareness on rheumatic heart disease is low. This study provides important insight into the perception and practices related to sore throat that can be used in the design of awareness activities aimed reducing the risk of RHD in Cameroon. The appropriateness of antibiotics prescribed, and the health care provider awareness and knowledge levels regarding RHD in Cameroon has not been reported yet in the literature. This grey area deserves more research.
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Conocimientos, Actitudes y Práctica en Salud , Cardiopatía Reumática/epidemiología , Adolescente , Adulto , África del Sur del Sahara/epidemiología , Camerún/epidemiología , Niño , Estudios Transversales , Femenino , Alfabetización en Salud/métodos , Hospitales , Humanos , Masculino , Persona de Mediana Edad , Faringitis/epidemiología , Prevención Primaria , Fiebre Reumática/epidemiología , Autoinforme , Infecciones Estreptocócicas/epidemiología , Encuestas y CuestionariosRESUMEN
Acute pulmonary embolism with significant right ventricular strain could be associated with a low-pitch peripheral systolic murmur radiating to the axillae.
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OBJECTIVE: Rheumatic heart disease (RHD) prevails as a major public health problem in sub-Saharan Africa. In Cameroon, reports on RHD have been so far limited to a few cities. We sought to describe the demographic, clinical and echocardiographic features of rheumatic heart disease in the Buea Regional Hospital, South West region of Cameroon. Echocardiography reports between June 2016 and June 2017 were reviewed. The diagnosis of RHD was based on the World Heart Federation Criteria for the diagnosis of RHD. RESULTS: A total of 669 echocardiograms were performed over the 1 year study period. Twenty-one (3.1%) had a definite echocardiographic diagnosis of RHD. There were 14 (66.7%) females. The age range was 13-94 years with a mean age of 47.8 ± 20.3 years. The most common indications for echocardiography were heart failure (47.6%), and dyspnea (42.9%). The mitral valve was the most commonly affected valve in 80.9% of cases. The most common valve lesion was isolated mitral stenosis (42.9%), followed by isolated mitral regurgitation (28.6%). There were no lesions on the tricuspid and pulmonic valves. Severe lesions were found in 80.9% of the patients. The complications were pulmonary hypertension (66.7%) and atrial fibrillation (9.5%).