Stroke Characteristics in the Elderly: A Hospital-Based Study in Cameroon.

INTRODUCTION: Advanced age is an important nonmodifiable risk factor for stroke. Little data are available on stroke in older people in sub-Saharan Africa. This study aimed to determine the clinical features of stroke and identify the predictive factors for poor outcomes in this age group. METHODS: A 4-month retrospective study was conducted using the Stroke Registry of Douala General Hospital. The main outcomes were mortality, poor functional recovery at 3 months (modified Rankin Scale score ≥3), and recurrence at 1 year. Factors associated with poor outcomes were determined using binary logistic regression. Survival was estimated using the Kaplan-Meier method. The significance threshold was set at p < 0.05. RESULTS: Elderly patients represented 38.6% of all stroke cases (n = 1,260). Male represented 48.6% of the old patients. The incidence of hypertension, diabetes, previous stroke, and cardiopathies was significantly higher in older patients (p < 0.05). Ischemic stroke accounted for 73.1% of stroke types. Cardiopathies, GCS 8-12, GCS <8, hemorrhagic stroke, NIHSS >14, and Barthel index at 1 month were independently associated with mortality. Being divorced, a modified Rankin scale score ≥3 at 1 month, and a Barthel index ≤60 at 1 month were independently associated with poor functional recovery at 3 months. Old patients represented 50% of recurrent stroke cases. Age >90 years (p < 0.001) and NIHSS <5 were independently associated to recurrence at 1 year. CONCLUSION: Approximately two out of five stroke cases were old. Cardiopathies, hemorrhagic stroke, and data related to stroke severity contribute to poor outcomes. A management approach that considers the particularities of this age group could contribute to improving the outcomes of these patients.

The effects of education intervention on the knowledge of some reproductive health issues amongst secondary school students in Douala IV Municipality, Cameroon.

This study aimed to determine the effects of education intervention on the knowledge of some reproductive health issues amongst secondary school students. It was longitudinal and interventional study carried out in two phases. Participants were adolescents and young adults randomly selected from secondary establishments using a Probability Proportional to Size sampling method. In phase 1, data were obtained by the use of questionnaire and analyzed using Epi-Info 6.04 and SPSS version 17.0. Education intervention was utilized in 3 randomly selected schools (experiment), but not in 3 others (control). Phase 2 carried out 6 months after the end of the first intervention consisted of collecting baseline data. There was a significant association between knowledge on unintended pregnancy and STIs mainly with type of establishment, class, age group, sex, religion (p<0.001 respectively) and being sexually active (p=0.016). There was a significant increase of awareness in the experimental schools (34.1% vs 76.5%, p<0.0001), but not in the control schools (34.5% vs 35.5%, p>0.10). Health education had a significant impact on the knowledge of participants. We recommend reproductive health education through the framework of school to be used as a national policy in African developing countries.

Cette étude visait à déterminer les effets de l'intervention éducative sur les connaissances en santé reproductive chez les élèves du secondaire. Il s'agissait d'une étude longitudinale et interventionnelle réalisée en deux phases. Les participants étaient des adolescents et jeunes adultes choisis au hasard dans des établissements secondaires de Douala, à l'aide d'une méthode d'échantillonnage probabiliste proportionnelle à la taille. Dans la phase 1, les données ont été obtenues à l'aide de questionnaires et analysées à l'aide des logiciels Epi-Info 6.04 et SPSS version 17.0. L'intervention éducative a été utilisée dans 3 écoles choisies au hasard (expérimentales), mais pas dans 3 autres (contrôle). La phase 2 réalisée 6 mois plus tard a consisté à collecter des données de base. Il y avait une association significative entre les connaissances et le type d'établissement, la classe, l'âge, le sexe, la religion (p < 0,001 respectivement) et être sexuellement actif (p = 0,016). Il y a eu une augmentation significative des connaissances dans les écoles expérimentales (34,1% contre 76,5%, p<0,0001), mais pas dans celles témoins (34,5% contre 35,5%, p>0,10). L'éducation à la santé a eu un impact significatif sur les connaissances des participants. Nous la recommandons comme une politique nationale dans les pays Africains en développement.

Measurement of fine particle concentrations and estimation of air quality index (AQI) over northeast Douala, Cameroon.

Due to absence of data on air quality monitoring and pollutant emissions in Douala, a measurement campaign along the principal street passage to the college grounds was started. Using the OC 300 Laser Dust Particle, fine particle concentrations are monitored during 1 week from Monday to Sunday. The instrument used detects four different sizes of particles: PM10, PM5, PM2.5, and PM1. The daily average concentrations measured ranged from 9.47 ± 0.26 to 50.14 ± 2.42 µg·m-3 for PM1.0; 13.13 ± 0.38 to 86.65 ± 3.96 µg·m-3 for PM2.5; 13.60 ± 0.40 to 100.56 ± 4.20 µg·m-3 for PM5; and 14.52 ± 0.42 to 114.59 ± 4.60 µg·m-3 for PM10. Exceptions made from PM5 and PM1.0 which were not in relation to the WHO (World Health Organization) guideline values, the level of PM10 and PM2.5 is higher than the WHO standards. The air quality index (AQI) is between very poor and poor during this measurement campaign, indicating that residents of the study region are highly exposed. Through the use of correlation studies, it has been demonstrated that the predominant source of fine particles in the studied region is vehicular activity. As a result, traffic density is the most significant factor causing the different air pollution levels seen in the tested areas.

Clinical characteristics of Plasmodium falciparum infection among symptomatic patients presenting to a major urban military hospital in Cameroon.

BACKGROUND: Urban malaria has received insufficient attention in the literature. The prevalence and clinical characteristics of Plasmodium falciparum infection amongst patients presenting with suspected malaria were investigated at a major urban hospital in Douala, Cameroon with a particular focus on anaemia. METHODS: A cross-sectional, 18-week demographic and clinical survey was conducted of patients presenting to the Emergency Department of Douala Military Hospital with suspected malaria, largely defined by the presence or recent history of fever. Venous samples were tested for P. falciparum using rapid diagnostic tests and PCR, and anaemia was defined by haemoglobin level according to WHO definitions. Likelihood ratios (LR), odds ratios (OR), and population attributable risk percent (PARP) were calculated. RESULTS: Participants were ages 8 months to 86 years, 51% were women (257/503), and all districts of Douala were represented. Overall, 38.0% (n = 189/497) were anaemic, including 5.2% (n = 26/497) with severe anaemia. Anaemia prevalence was significantly higher (OR: 2.20, 95% CI 1.41-3.45) among children < 15 years (53.1%, n = 52/98) compared to adults (34%, n = 133/392). Plasmodium falciparum was detected in 37.2% by nested PCR. Among all participants, several factors were associated with clinically significant LR for P. falciparum infection, including age 10-14 years (positive LR: 3.73), living in the island district of Douala VI (positive LR: 3.41), travel to any of three northern regions (positive LR: 5.11), and high fever > 40 °C at presentation (positive LR: 4.83). Among all participants, 8.7% of anaemia was associated with P. falciparum infection, while the PARP was 33.2% among those < 15 years of age and 81.0% among 10-14-year-olds. CONCLUSIONS: The prevalence of P. falciparum infection in the urban hospital was high. Mirroring trends in many rural African settings, older children had the highest positivity rate for P. falciparum infection. Anaemia was also common in all age groups, and for those 10-14 years of age, 80% of the risk for anaemia was associated with P. falciparum infection. Malaria rates in major urban population centres can be high, and more research into the multifactorial causes of anaemia across the age spectrum are needed.

Determinants and aetiologies of postpartum pyrexia; a retrospective analysis in a tertiary health facility in the Littoral Region of Cameroon.

BACKGROUND: Postpartum febrile morbidity is relatively common, occurring in approximately 5-7% of births. Differentiating between potentially serious and benign causes of postpartum pyrexia (PP) is fundamental in curbing the mortality rate from sinister causes such as sepsis. The paucity of data on PP in Cameroon makes it difficult to access its actual burden. This study was aimed at determining the prevalence, risk factors and aetiologies of PP at a tertiary hospital in Douala, Cameroon. METHODS: This was a 2 - year hospital - based retrospective cohort study carried out at the Douala General Hospital (DGH), during which medical records of all postpartum admissions between January 1st 2017 and December 31st 2018 were reviewed. The review consisted of collecting data on socio-demographic characteristics, clinical profile, investigations and final diagnoses. The collected data was analysed in SPSS 23.0. Chi-squared test was used to test the association between variables and a logistic regression analysis was fitted to identify risk factors associated to PP. RESULTS: A total of 1520 postpartum files were reviewed. The prevalence of PP was 8.82%. The most frequent causes of PP were: malaria (46.7%), urinary tract infections (18.7%), puerperal sepsis (17.9%) and pneumonia (8.7%). E. coli was the most (49.3%) cultured germ isolated in positive cultures. Onset of PP was more common (85%) within the first 3 days postpartum and malaria (60%) was the leading aetiology within this period. Five or more vaginal examinations prior to delivery (OR 59.151, 95% CI: 21.463-163.019; p < 0.001), perineal tears (OR 45.157, 95% CI: 2.266-899.722; p < 0.001), and duration of labour > 18 h (OR 26.760, 95% CI: 7.100-100.862; p < 0.001) were the most significant risk factors associated with PP. CONCLUSION: Approximately 1 in every 12 postpartum cases in the DGH presents with PP. Malaria was the leading cause of PP at DGH especially for cases registered within 3 days postpartum. The risk factors identified were mostly associated to perinatal events, such as frequent vaginal examinations, perineal tears and prolonged labour. Efforts towards preventing identified risk factors thus becomes paramount in order to curb this high rate of PP in the DGH.

Clinical characteristics and outcome of HIV infected patients with chronic kidney disease in Sub Saharan Africa: an example from in Cameroon.

BACKGROUND: Chronic kidney disease (CKD) is one of the major complications of Human immune deficiency Virus (HIV) and a risk factor for poor outcome of these patients. We aimed to describe the profile and outcome of HIV positive patients with CKD in Douala general hospital in Cameroon. METHODS: HIV positive patients with CKD referred to the nephrologist from January 2007 to March 2013 were included. Socio demographic, clinical (history and stage of HIV, comorbidities, baseline nephropathy, used of c-ART), para clinical data at referral (serum urea, creatinine, full blood count, CD4 count, serum calcium, phosphorus, albumin), dialysis initiation and outcome at 1 year were collected from medical records. GFR was estimated using Chronic Kidney Disease Epidemiology Collaboration (CKD-EPI) equations. CKD was defined and classified according to the Kidney Disease Improving Global Outcomes (KDIGO 2012). RESULTS: We included 156 patients (51.3% men) with a mean age of 45.4 ± 12.1 years. Hypertension (36.5%), diabetes (17.9%) and Hepatitis C (7.7%) were the main comorbidities. HIV associated nephropathy (27.6%), chronic glomerulonephritis (15.4%) diabetes (14.1%) and hypertension (13.5%) were the leading causes of kidney disease. Before referral HIV status was known by 109 (69.9%) patients, with 76 (69.7%) being on c-ART. Median CD4 count was 241 (117-438) cells/mm3. Prevalence of anemia (93.9%), hypocalcemia (68.6%) and Proteinuria (77.6%) was high, 94 (60.3%) patients were at CKD stage 5 at referral and 37 (23.7%) underwent emergency dialysis. After 1 year, 64 (41.0%) patients were lost to follow up. The mortality rate was 49% and 25 (28.7%) were maintenance hemodialysis, and being on c-ART was associated with a lower risk of death (HR: 0.45; 95% CI: 0.23-0.89; p = 0.021). CONCLUSION: HIV patients with CKD were referred late with high morbidity and need for urgent hemodialysis. HIVAN was the main etiology of CKD and mortality rate was high mainly due to the absence of c-ART at referral.

Factors associated with late presentation of patients with chronic kidney disease in nephrology consultation in Cameroon-a descriptive cross-sectional study.

BACKGROUND: Late presentation (LP) of chronic kidney disease (CKD) patients to nephrologist is a serious problem worldwide with persistent high prevalence despite known benefits of early nephrology care. OBJECTIVE: Determine the prevalence and factors associated with LP of CKD patients to nephrologists in Cameroon. METHODS: A cross-sectional study from October 2015 to May 2016 at the nephrology units of the Douala General and Laquintinie hospitals, including all consenting incident CKD patients. Data collected were: socio-demographic, search of CKD diagnostic criteria during prior follow up, therapeutic itinerary, clinical and biological parameters at presentation, knowledge on CKD and attitude towards dialysis. LP was defined as eGFR < 30 ml/min/1.73 m2. It was physician-related whenever no CKD screening was done in the presence of risk factor or no referral to nephrologists at early stages; patient-related whenever patients did not have recourse to hospital care while symptomatic or disrespected a referral decision. p value <.05. RESULTS: We included 130 patients, mean age 53.10 ± 14.66 years, 60.77% males, 58.70% were referred by internal medicine physicians and 10% had recourse to complementary and alternative medicine (CAM). At presentation, 70.80% were symptomatic, 53% had CKD stage five, 86.12% were poorly graded on knowledge and 49% had a negative attitude towards dialysis. The prevalence of LP was 73.90%, 50% was physician-related, 44.79% patient-related and 5.21% both. Being accompanied (p = .038), a low level of education (p = .025) and recourse to CAM (p = .008) were associated with LP. CONCLUSION: LP is high in Cameroon, attributed to physician's practical attitudes and patient's socio-cultural behaviors and economic conditions.

Incidence, characteristics and prognosis of acute kidney injury in Cameroon: a prospective study at the Douala General Hospital.

OBJECTIVE: There are limited data on AKI in sub-Saharan Africa. We aim to determine the incidence, characteristics and prognosis of AKI in Cameroon. PATIENTS AND METHODS: A prospective study including all consenting acute admissions in the internal medicine and the ICU of a tertiary referral hospital in Cameroon from January 2015 to June 2016. Serum creatinine assay was done on admission, days 2 and 7 to diagnose AKI. For patients with AKI, serum creatinine was done on discharge, days 30, 60 and 90. AKI was defined according to the modified KDIGO 2012 criteria as an increase or decrease in serum creatinine of 3 mg/l or greater, or an increase of 50% or more from the reference value obtained at admission or the known baseline value. AKI severity was graded using KDIGO2012 criteria. Outcome measures were renal recovery, mortality and causes of death. Renal recovery was complete if serum creatinine between the first 90 days was less than baseline or reference, partial if less than diagnosis but not baseline or reference, no-recovery if creatinine did not decrease or if the patient remained on dialysis. RESULTS: Of the 2402 patients included, 536 developed AKI giving a global incidence of 22.3% and annual incidence of 15 per 100 patients-years. Of the 536 patients with AKI, 43.3% were at stage 3, 54.7% were males, median age was 56 years. Pre-renal AKI (61.4%) and acute tubular necrosis (28.9%) were the most frequent forms. Main etiologies were sepsis (50.4%) and volume depletion (31.6%). Renal outcome was unknown in 34% of patients. Of the 354 patients with known renal function at 3 months, 84.2% recovered completely, 14.7% partially and 1.1% progressed to CKD. Global mortality rate was 36.9% mainly due to sepsis. CONCLUSIONS: AKI is frequent in our setting, mainly due to sepsis and hypovolemia. It carries a poor prognosis.

Hydrochemical and isotopic studies providing a new functional model for the coastal aquifers in Douala Coastal Sedimentary Basin (DCSB)/Cameroon.

A new conceptual model of the hydrogeological systems in Cameroon's Douala Coastal Sedimentary Basin (DCSB) was constructed. The model is based upon the basin's known geology, plus data from recent field campaigns that allowed the collection of rainwater and groundwater samples for analyses of stable isotopes (δ2H, δ18O, δ13C), radiogenic isotopes (3H, 14C), and water chemistry. Aquifer characteristics that were thereby deciphered include recharge, isotopic distributions, residence times, and mixing processes. Rainfall samples (mean δ18O = -2.0 ‰; mean δ2H = -6.80 ‰; weighted mean = -2.4 ‰ δ18O, -9.85 ‰ δ2H) scatter along two distinct lines, thus indicating that local rainfall events undergo processes during convective events, variability in humidity, amount effects, and seasonal variations. Stable isotope values of river water samples are close to the weighted mean of local precipitation, with some downstream enrichment. The Quaternary/Mio-Pliocene superficial aquifer system (depth < 70 m) and the intermediate Oligocene/Upper Eocene aquifer system (depth: 70 to 200 m) exhibit evidence of similar fractionation processes through an enrichment gradient of δ-values. The enrichment is more pronounced at the top of the superficial aquifer, which is very exposed to direct rainfall water infiltration, evaporation, and amount effects. The depth profiles of δ-values coupled to water chemistry and tritium contents, evidence leakage between (i) the superficial system's Quaternary alluvium sands and Mio-Pliocene sands; and (ii) the superficial and intermediate systems. Thus, the aquifers that contain modern, post nuclear groundwater are characterized by flow exchanges and direct recharge from rainfall events. In contrast, the Upper Eocene system has depleted δ-values and lower bicarbonate contents, suggesting not only that this system was recharged by rapid infiltration (with limited effect of evaporation), but that this recharge occurred during a cooler time in the past. The residence times (computed from 14C dates) indicate uncorrected ages ranging from hundreds to thousands of years.

Estimation of the introduction risk of non-indigenous species through ship ballast water in the Port of Douala (Cameroon).

The transport of non-indigenous species in ship's ballast water represents a threat to marine biodiversity. This study is the first on marine bioinvasion in Sub-Saharan Africa. The Port of Douala (PoD), located in the Gulf of Guinea, is experiencing increasing maritime traffic, hence the importance of preventing biological invasions. PoD received ballast water from 41 ports and 20 ecoregions during the study period (2018-2021). We used a biological invasion model and showed that ships from the ports of Antwerp, Durban, Dar es Salaam, Pointe-Noire (Southern Gulf of Guinea) and Dakar (Sahelian Upwelling), with their associated ecoregions present a major invasion risk. Treating ballast water from these ships to IMO D-2 standards could reduce their probability of biological invasion by 97.18, 98.43, 98.80, 98.77 and 98.84 %, respectively. Climate change may also mitigate the risk of biological invasion, particularly for ships in the North Sea ecoregion from the port of Antwerp.

[Epidemiological and clinical profile of cannabis users at the Addiction Care and Prevention Centre of the Laquintinie Hospital in Douala, Cameroon]. / Profil épidémiologique et clinique des consommateurs de cannabis au centre de soins d'accompagnement et de prévention en addictologie de l'Hôpital Laquintinie de Douala, Cameroun.

Cannabis is the most widely used illicit drug in the world. It is consumed by age groups, the main ones being adolescents and young adults. Its consumption leads to somatic, psychiatric and social complications. Data in our context are scarce. The purpose of our work was to describe the epidemiological and clinical profile of patients with cannabis addiction at the Centre for Care, Support and Prevention of the Laquintinie Hospital in Douala. We conducted a retrospective cross-sectional study of patients followed from March 2021 to July 2022 for cannabis addiction at the Addiction Care, Support and Prevention Center of the Laquintinie Hospital in Douala. The diagnosis of use disorder was based on a dependency syndrome related to cannabis use (single event usage). Data entry and analysis were performed using SPSS version 7.1 software. Of the 45 cases of cannabis addiction, 44 (98%) were male patients with an average age of 21,97 years. The most affected age group was between 20 and 24 years (28/44 or 63%); 49% of consumers were students, 62% of mothers accompanying patient to the consultation. The age of cannabis use initiation was 16 years (31%), the most commonly used form of cannabis was herbal (100%) and 100% of patients used inhalation (smoking). The most common complication was amotivational syndrome (31%). Cannabis use initiation occurs at an early age. The most commonly used form of cannabis is herbal administered through inhalation (smoking). The most common complications are amotivational syndrome, cognitive disorders, sleep disorders and withdrawal syndrome.

Geochemical characterisation of clastic sediments in Kompina (N'kapa Formation, NW Douala Basin, West Cameroon): Implication for provenance, paleoweathering and sediment maturity.

Chemical analyses were carried out on clastic sedimentary rocks in Kompina (N'kapa Formation of the NW, Douala Basin, West Africa) to disclosed the composition of their source rock, characterised their tectonic domains, decipher the intensity of the past weathering, sedimentary cycles and maturity using concentrations of major oxides, REES and trace elements. Provenance diagram constructed from ratios of La/Co, La/Sc, Th/Sc, Cr/Th and from binary diagrams of Zr vs TiO2 and AL2O3vs TiO2, disclosed a felsic rock composition as the source rock of the Kompina clastic rocks. The felsic source rock composition designated for the studied clastic materials is also supported by LREE enrichment over HREE and a negative europium anomaly on chondrite calculation and diagram. New discriminant functions diagrams to delineate between active and passive domains such as DF 1&2(Arc-Rift-Col)M1, DF1&2(Arc-Rift-Col)M2 combined with diagrams of DF(A-P)M, DF(A-P)MT label a passive tectonic setting characteristics for the source rock where there studied clastic materials were sorted. The weathering intensity and plagioclase lixiviation revealed by the CIA and PIA indexes advocate a weak to intense strength of chemical weathering and lixiviation of plagioclase felspars while the CIX and PIX with elimination of CaO in their formulars show extreme intensity of weathering and lixiviation of plagioclase felspars. Most of the samples show immature nature from their ICV values > 1 but with the introduction of ICVnew in this work, where oxides of iron and calcite are considered as cement and eliminated from the formular show that all the studied samples have values < 1 indicating they are mature. Plotted diagrams of Th/Sc, and (Gd/Yb)N ratios, with relationship of Zr and (La/Yb)N shows that the studied clastic materials are mature, second cycle sediments, which have experience zircon mineral addition.

[Epidemiological and clinical features of cervical cancer in Cameroon: experience in the Douala General Hospital]. / Aspects épidémiologiques et cliniques des cancers du col de l'utérus au Cameroun: expérience de l'Hôpital Général de Douala.

Introduction: cervical cancer is a public health problem in Cameroon, ranking as the 2nd most frequent cancer. The purpose of our study was to describe the epidemiological and clinical characteristics of patients with cervical cancer at the Douala General Hospital in Cameroon. Method: we conducted a retrospective study over the period 1 January 2016 to 31 December 2017. Results: the study enrolled 357 women. Patients´ age ranged from 25 to 88 years, with an average age of 52.82 ± 12.36 years. Patients from the Western Region were more heavily represented, with a percentage of 42.2% (n= 124/294). The majority of them were unemployed housekeepers (57.3%; n=200/341). The age of first sexual intercourse was recorded for only 37% (n=133/357) of the study population, with an average age of 16.73 ± 2.16 years; while the average age on giving birth to the first child was 18.92 ± 3.44 years. On the other hand, 6.5% (n=11/169) of patients were smokers, while 44% (n=73/166) were alcohol abusers. Squamous cell carcinoma was the most common histologic type (85.6%; n=255/298). The most frequent stage at diagnosis was stage IIB (22.3%, n=71/319) followed by stage IIIB (21.6%; n=69/319). Conclusion: in Cameroon, cervical cancer commonly occurs in unemployed adult women and it is associated with an advanced-stage diagnosis. Hence the need to improve awareness of prevention and early diagnosis.

Risk factors associated to multidrug-resistant tuberculosis in patients attending the deido district hospital of Douala - Cameroon.

Background: Multidrug-resistant tuberculosis (MDR-TB) is defined as resistance to at least isoniazid and rifampicin. In Cameroon, the prevalence is estimated at 150 cases/100,000 inhabitants or 6000 cases out of an estimated population of 3 million. Objective: The aim of the present study was to determine the risk factors associated with MDR-TB at Deido District Hospital located in the littoral region of Cameroon. Methods: This was a cross-sectional and analytical retrospective study. Our sample included all TB patients undergoing treatment at the Diagnostic and Treatment Center of the hospital from January 2019 to August 2020. Identified risk factors of MDR-TB were analyzed using the SPSS software version 20.0. Results: A total of 304 participants were enrolled with a predominance of 185 (60.8%) men. The average age was 35 years (29-43 years). About 122/304 (40%) of the patients suffered from MDR-TB. The significant factors associated with MDR-TB were occupation (adjusted odd ratio [aOR] = 61.46), monthly income (aOR = 0.11), history of TB (aOR = 5.3), alcohol consumption (aOR = 12.7); self-medication (aOR = 5.4) and consultation of traditional healers for any cure (aOR = 155.84). Conclusion: The emergence of MDR-TB associated with several risk factors in the study area is worrisome and can be prevented by improving the living conditions of patients and putting in place appropriate treatment strategies.

Spectrum of central nervous system infections in a tertiary health care centre in Cameroon.

BACKGROUND: Central nervous system (CNS) infections are serious and debilitating diseases with significant mortality, and high prevalence in the context of human immunodeficiency virus (HIV) pandemic in Africa. However, their diagnosis remains challenging due to outdated technical platform. We aimed to determine the frequency of CNS infection and to describe the epidemiological, clinical and outcome of this at the Douala General Hospital (DGH), Cameroon. To carry out this study, we collected the medical records of patients hospitalized for CNS infections in the internal medicine department of DGH from January 2015 to December 2019. RESULTS: Among 8430 files reviewed, 336 cases of CNS infection were identified giving a frequency of CNS infection of 3.99% among which 204 files were included in the study (54.4% were male). HIV infection was found in 147 patients (72.1%) with 38.1% (n = 56) of them on regular follow-up. The most common clinical signs were fever (84.8%), headache (68.6%), meningeal syndrome (38.7%), and seizures (36.3%). Cerebral toxoplasmosis (24.5%), cryptococcal meningitis (21.1%), and acute bacterial meningitis (8.3%) were leading aetiologies. Of the 143 CSF samples, 70.6% (n = 101) were sterile. The in-hospital mortality rate was 23.5% with CNS infection of unknown cause (22.1%) be independently associated to this [OR = 2.24; 95% CI 1.04-4.80, p = 0.039]. CONCLUSION: Clinical presentations of CNS infections are same with classical data. HIV-related opportunistic infections are the main aetiologies. About one over four patients with CNS died. Two thirds of CSF are sterile using basic laboratory assessment giving a need to identify simple tests to increase sensibility and specificity of diagnostic tools in our setting.

Describing the growth and nutritional status of sickle cell disease children and adolescents with reference to WHO growth standards in Cameroon.

BACKGROUND: Sickle cell disease (SCD) is a chronic disease with many complications among which is growth retardation. Here, we described the growth and nutritional status patterns of children with SCD and adolescents living in Douala, Cameroon. METHODS: This cross-sectional study took place at the sickle cell treatment center of Douala Laquintinie Hospital from November 2015 to April 2016. The sociodemographic and anthropometric information of each SCD patient was determined, and then used for computing z-score indexes (weight for age, weight for height, body mass index for height, and height for age). The different indexes were used to determine the prevalence of malnutrition forms (stunting, wasting, underweight, and overweight/obesity) and compared to WHO standards by gender and age. RESULTS: A total of 208 children and adolescents participated in the study. The mean age was 8 years (±5) and the median age was 7 years. Males accounted for 53.4% of cases, giving a sex ratio of 1:1.1. The proportions of wasting, stunting, underweight, and overweight/obesity in the overall population were 7.1% (n = 15), 9.1% (n = 19), 3.6% (n = 5) and 3.3% (n = 7) respectively. In children under 5, wasting, stunting, underweight, and overweight/obesity were noted in 1.4% (n = 1), 9.5% (n = 7), 1.4% (n = 1), and 5.4% (n = 4) respectively. In patients aged 5 years and above, a proportion of 10.5% (n = 14) was wasted, 9.0% (n = 12) were stunted, 5.9% (n = 4) were underweight and 2.2% (n = 7) were overweight/obese. The growth curve of children under five in our study was superimposable to the WHO standard growth curve. In children older than 5 years, the left shift for stunting was more pronounced for boys compared to girls. CONCLUSION: Nine percent of children and adolescents with SCD are stunted. The growth deficit appeared to be higher in patients aged 5 years and above, more particularly in boys than girls. Overweight/obesity was uncommon in our series. More robust research designs and statistical analyses are needed to confirm or refute these findings.

Age and paleo-environmental evolution of the Douala Basin (Cameroon) during the Cenozoic: insights from palynology and sequence analysis.

The Douala basin in Cameroon is one of the West African basins created during the opening of the South Atlantic Ocean after the break-up of the Gondwana superstructure. Until now, no detailed studies of age and paleo-environmental evolution of this basin during the Cenozoic have been carried out, especially on outcrops sections. Palynological and sequence analyses have been performed on the outcrops in the Missole I and Dibamba localities in the central part of this basin. This integrated approach allow us propose a new age and paleo-environmental evolution of the Douala Basin. Three palynomorph assemblages have been identified: (i) the Paleocene-Eocene palynomorph assemblage (A) from the Missole I deposits; (ii) the Oligocene palynomorph assemblage (B) from the lower part of the Dibamba deposits; and (iii) the Lower to Middle Miocene palynomorph assemblages (C) from the upper part of the Dibamba deposits. Sequence analysis indicates four depositional sequences with a vertical succession, characterized by major transgressive depositional sequences (depositional sequence "a", "b", and "c"), and a minor regressive depositional sequence ("d"). The trangressive sequences were deposited in lagoon or marginal marine environments during Paleocene-Eocene, while the regressive sequence was deposited in prograding continental shelf during the Oligocene-Middle Miocene. The recognized depositional sequence and associated depositional environments were controlled by spasmodic subsidence, margin uplift and climatic variations. Climate evolved from a wet-dry subtropical to tropical during the Paleocene-Eocene and a warm humid subtropical during the Oligocene up to Lower Middle Miocene with overall shift of the Douala basin from the Southern to the Northern hemisphere. This study reveals the existence of Oligocene deposits (Souellaba Formation) in the outcrops and could be useful for future correlation with the offshore part of the Douala Basin.

Comparative analysis of two molecular tests for the detection of COVID-19 in Cameroon.

INTRODUCTION: COVID-19 equation in Cameroon is yet to be resolved. There is an urgent need for a rapid response strategy to the increasing demand of polymerase chain reaction (PCR) test results for both patients, travelers and competitors to various games. We assessed the diagnostic performance of the AmpliQuick® SARS-CoV-2 against the classic Reverse transcription polymerase chain reaction (RT-PCR). METHODS: a cross-sectional and comparative study was conducted from April 27th to May 29th, 2021 in the city of Douala, Cameroon. The samples consisted of any nasopharyngeal sample received at the Douala Gynaeco-Obstetrics and Pediatric Hospital molecular biology laboratory, regardless of its origin. Sociodemographic parameters (age, profession (footballers, travelers, other), matrimonial status, nationality), comorbidity and known status of COVID-19, were recorded at collection sites. The main collection sites were the Deido Health District and the Douala Gynaeco-Obstetric and Pediatric Hospital. We performed testing using AmpliQuick® SARS-CoV-2 and the classic RT-PCR (Da An Gene Co.Ltd) on each sample during the one month period. Analytical performance parameters were determined. To determine the sensitivity of both methods, the Bayesian latent class model was performed on the median with 95% confidence interval, with p≤0.05 as significant level, as well as Kappa (κ) agreement between tests. An ethical clearance was sought and obtained from the University of Douala Institutional Ethics Committee. RESULTS: a total of 1813 participants were enrolled, with the predominance of male (68.68%) and the age group 31 to 40 years old (31.33%). Most participants were married (53.46%) with only few with known COVID-19 status (5.47%). One thousand eight hundred and ten (1810) tests were performed by AMPLIQUICK® SARS-CoV-2 while only 1107 could be achieved with the classic RT-PCR. Over the study period, it was noted a drastic reduction in the time necessary to render results with the AMPLIQUICK® SARS-CoV-2 from 24 hours to 3 hours. The AMPLIQUICK® SARS-CoV-2 reduced technician hands-on time and its practicability was noticed based on the prefilled and ready-to-use microplates. A prevalence of 1.93% and 1.45% were obtained for AMPLIQUICK® SARS-CoV-2 and the classic RT-PCR respectively. This difference in the prevalence showed that AMPLIQUICK® SARS-CoV-2 (Sensitivity 83.5% [CI=64.6-95.2]) was more accurate than the classic RT-PCR (67.8% [CI=46.6-84.9]). CONCLUSION: it is time for a change of attitude to scale up the COVID-19 testing ability in Cameroon and the AMPLIQUICK® SARS-CoV-2 is an alternative diagnosis strategy which should help resolve the situation of timely and reliable results.

[Evaluation of two COVID-19 antigenic diagnostic tests: BIOSYNEX® COVID-19 Ag BSS and BIOSYNEX® COVID-19 Ag + BSS compared to AmpliQuick® SARS-CoV-2 PCR]. / Evaluation de deux tests de diagnostic antigénique du COVID-19: BIOSYNEX® COVID-19 Ag BSS et BIOSYNEX® COVID-19 Ag+ BSS comparés à la PCR AmpliQuick® SARS-CoV-2.

INTRODUCTION: the COVID-19 pandemic causes biological diagnostic problems that remain relevant in low-income countries in general and in Cameroon in particular. Rapids tests that reliably detect SARS-CoV-2 virus antigen present themselves as an important alternative in several contexts. The objective of our study was to evaluate the diagnostic performance of two rapid diagnostic tests BIOSYNEX® COVID-19 Ag BSS and BIOSYNEX® COVID-19 Ag + BSS, compared to each other and to the AmpliQuick® SARS-CoV-2 PCR test. METHODS: a cross-sectional and comparative study was carried out from April 27 to May 29, 2021 in the city of Douala in Cameroon. The samples consisted of nasopharyngeal swabs received at the molecular biology laboratory of the Douala Gyneco-obstetric and pediatric hospital, whatever their origin. The socio-demographic parameters (age, profession, football players, travelers, others), marital status, nationality), comorbidity and known status of COVID-19, were recorded on the collection sites. The main collection sites were the Deïdo Health District and the Douala Gyneco-Obstetric and Pediatric Hospital. We performed the diagnosis of COVID-19 using the rapid diagnostic test (RDT) BIOSYNEX® COVID-19 Ag BSS and RDT BIOSYNEX® COVID-19 Ag + BSS compared to each other and to the AmpliQuick® SARS-CoV-2 polymerase chain reaction (PCR) test on each sample. Statistical analysis of the data was performed using Microsoft Excel and SPSS version 17 software. To determine the sensitivity of the two RDTs, the Bayesian latent class model was performed on the median with a 95% confidence interval with p<0.05 as the significant level. An ethical clearance was sought and obtained from the University of Douala Institutional Ethics Committee. RESULTS: a total of 1813 participants were included in our study, with a predominance of men (1226, 68.68 %) and the most represented age group was that of 31 to 40 years (568, 31.33 %). Most of the participants were married (888, 53.46%) and only a few had a known COVID-19 status (75, 5.47%). The two rapid tests on our study population show much closed COVID-19 prevalence values, respectively 2.03 for BIOSYNEX® COVID-19 Ag BSS and 2.17 for BIOSYNEX® COVID-19 Ag + BSS. RDT BIOSYNEX® COVID-19 Ag + BSS showed higher sensitivity 94.1% vs. 87.5% for RDT BIOSYNEX® COVID-19 Ag BSS with almost identical specificity 98.9% for RDT BIOSYNEX® COVID-19 Ag + BSS vs. 98.7% for RDT BIOSYNEX® COVID-19 Ag BSS compared to AmpliQuick® SARS-CoV-2. BIOSYNEX® COVID-19 Ag + BSS RDT showed a negative predictive value of 99.9% compared to BIOSYNEX® COVID-19 Ag BSS RDT. There is a 99.9% agreement between the RDT BIOSYNEX® COVID-19 Ag BSS and the RDT BIOSYNEX® COVID-19 Ag + BSS. Conclusion: the RDT BIOSYNEX®COVID-19 Ag + BSS and RDT BIOSYNEX® COVID-19 Ag BSS can be used for the diagnosis of SARS-CoV-2 and can have an important contribution in the context of mass screenings and screening in remote areas.

Assessment of Ordinary Kriging and Inverse Distance Weighting Methods for Modeling Chromium and Cadmium Soil Pollution in E-Waste Sites in Douala, Cameroon.

BACKGROUND: Several studies have demonstrated that chromium (Cr) and cadmium (Cd) have adverse impacts on the environment and human health. These elements are present in electronic waste (e-waste) recycling sites. Several interpolation methods have been used to evaluate geographical impacts on humans and the environment. OBJECTIVES: The aim of the present paper is to compare the accuracy of inverse distance weighting (IDW) and ordinary kriging (OK) in topsoil analysis of e-waste recycling sites in Douala, Cameroon. METHODS: Selecting the proper spatial interpolation method is crucial for carrying out surface analysis. Ordinary kriging and IDW are interpolation methods used for spatial analysis and surface mapping. Two sets of samples were used and compared. The performances of interpolation methods were evaluated and compared using cross-validation. RESULTS: The results showed that the OK method performed better than IDW prediction for the spatial distribution of Cr, but the two interpolation methods had the same result for Cd (in the first set of samples). Results from Kolmogorov-Smirnov and Shapiro-Wilk tests showed that the data were normally distributed in the study area. The p value (0.302 and 0.773) was greater than 0.05 for Cr and for Cd (0.267 and 0.712). In the second set of samples, the OK method results (for Cd and Cr) were greatly diminished and the concentrations dropped, looking more like an average on the maps. However, the IDW interpolation gave a better representation of the concentration of Cd and Cr on the maps of the study area. For the second set of samples, OK and IDW for Cd and Cr had more similar results, especially in terms of root mean square error (RMSE). CONCLUSIONS: Many parameters were better identified from the RMSE statistic obtained from cross-validation after exhaustive testing. Inverse distance weighting appeared more adequate in limited urban areas. COMPETING INTERESTS: The authors declare no competing financial interests.