Accuracy of the novel Peguero Lo-Presti criterion for electrocardiographic detection of left ventricular hypertrophy in a black African population.

The diagnostic accuracy of the electrocardiogram for left ventricular hypertrophy (LVH) is limited. Recently, Peguero and collaborators proposed a novel voltage criterion for its detection with reportedly higher accuracy than the commonly used Cornell and Sokolow-Lyon criteria. While studies done in various populations have confirmed it, there are no available data from black African populations. We conducted a cross-sectional study in a population from Cameroon to compare the Peguero-Lo Presti criterion to the older Cornell, Sokolow-Lyon, and Cornell product criteria, pertaining to their sensitivity, specificity, and area under the receiver operating characteristic curve (AUC), with echocardiography as the reference standard. The study population consisted of 238 participants (54.2% female) with a mean age of 58 (SD 13) years. On echocardiography, the prevalence of LVH was 45.3% (n = 108). The sensitivity was 48.14%, 63.89%, 63.89%, and 67.29% for the Sokolow-Lyon, Peguero-Lo Presti, Cornell, and Cornell product criteria, respectively. The specificity was 73.84%, 75.97%, 79.23%, and 82.31% for the Peguero-Lo Presti, Cornell product, Cornell, and Sokolow-Lyon criteria, respectively. The overall accuracy of the Peguero-Lo Presti (AUC = 0.689) was not significantly different from that of the Cornell (AUC = 0.714), the Cornell product (AUC = 0.717), and the Sokolow-Lyon (AUC = 0.652) (all p Ëƒ .05). Hypertension and gender influenced the agreement between ECG criteria and echocardiography in the detection of LVH. In conclusion, in this black African population, Peguero-Lo Presti was not significantly more or less accurate than Cornell or Sokolow-Lyon.

Bacteriuria amongst pregnant women in the Buea Health District, Cameroon: prevalence, predictors, antibiotic susceptibility patterns and diagnosis.

BACKGROUND: Bacteriuria is associated with significant maternal and foetal risks. However, its prevalence is not known in our community. OBJECTIVES: This study was carried out to determine the prevalence and predictors of bacteriuria in pregnant women of the Buea Health District (BHD) as well as the antibiotic sensitivity patterns of bacterial isolates. It also sought to determine the diagnostic performance of the nitrite and leucocyte esterase tests in detecting bacteriuria in these women. METHODS: An observational analytic cross-sectional study was carried out amongst pregnant women attending selected antenatal care centres in Buea. We recruited 102 consenting pregnant women for the study. Demographic and clinical data were collected using structured questionnaires. Clean catch midstream urine was collected from each participant in sterile leak proof containers. Samples were examined biochemically, microscopically and by culture. Significant bacteriuria was defined as the presence of ≥108 bacteria/L of cultured urine. Identification and susceptibility of isolates was performed using API 20E and ATB UR EU (08) (BioMerieux, Marcy l'Etoile, France). RESULTS: Significant bacteriuria was found in the urine of 24 of the 102 women tested giving a bacteriuria prevalence of 23.5% in pregnant women of the BHD. Asymptomatic bacteriuria was detected in 8(7.8%) of the women. There was no statistically significant predictor of bacteriuria. Escherichia coli were the most isolated (33%) uropathogens and were 100% sensitive to cefixime, cefoxitin and cephalothin. The nitrite and leucocyte esterase tests for determining bacteriuria had sensitivities of 8%, 20.8% and specificities of 98.7% and 80.8% respectively. CONCLUSION: Bacteriuria is frequent in pregnant women in the BHD suggesting the need for routine screening by urine culture. Empiric treatment with cefixime should be instituted until results of urine culture and sensitivity are available. Nitrite and leucocyte esterase tests were not sensitive enough to replace urine culture as screening tests.