Assessment of barriers to optimal cancer control in adult cancer treatment centres in Cameroon.

Approximately 20,745 new cases of cancer were registered annually with 13,199 (64%) deaths in 2020 in Cameroon. Despite the increasing cancer burden, there is a paucity of reliable data that can enhance decision-making for cancer control in Cameroon. This assessment was, therefore, designed to generate data that may enable stakeholders, policymakers and funders to make data-driven decisions on cancer control. We conducted a cross-sectional survey in July 2020, which enabled us to collect data on key cancer variables from six adult cancer treatment centres in Cameroon. The key components of the assessment included case detection, service availability, human resource capacity, cost of chemotherapy and radiotherapy, the safety of chemotherapy sessions, data systems, patient education, palliative care, funding for chemotherapy and chemotherapy stock. Data were compiled and analysed using Microsoft Excel 2016. Data from four of the 6 sites show that 1,636 new cases were recorded representing an annual case detection rate of 11.8%. All the six assessed facilities offered chemotherapy services, 5/6 (83.3%) offered surgery for cancers, while just 1 (16.7%) offered radiotherapy services. In addition, none offered nuclear medicine services for cancer care and treatment. Similarly, none of the facilities had the WHO-recommended number of human resources for optimal cancer care. Overall, there were only 6 medical oncologists, 2 surgical oncologists, 3 radiation oncologists and 14 oncology nurses providing services across the 6 cancer treatment centres. Treatment services are expensive for an average national, with a complete course of chemotherapy followed by radiotherapy costing ~XAF 1,240,000 (~$2,480). None of the survey facilities had a recommended safe biosafety cabinet and clean room for the preparation of chemotherapies, rendering the preparation of chemotherapies suboptimal and hazardous. Data collection tools were manual, relatively available and very different across all the surveyed sites and the interval for data collection and transmission was collectively undefined. Optimal cancer care in adult cancer treatment centres is limited by several health systems and socio-economic factors. The identification of these barriers has enabled the formulation of action-oriented interventions, leveraging on the recently adopted national strategy for the prevention and control of cancers in the country.

[Perceived severity of cancer and therapeutic pluralism among medical oncologists at the Yaoundé General Hospital]. / Perception de la gravité de la maladie cancéreuse et pluralisme thérapeutique en oncologie médicale à l'Hôpital Général de Yaoundé.

Introduction: cancer is a potentially serious disease. The announcement of a cancer diagnosis is bad news. This diagnosis is experienced differently from one person to the next. Patient's behaviour and compliance reflects specific behaviors of relatives. Alternative treatments are commonly used in oncology in some African countries. The purpose of this study was to establish cancer patients' experience, the extent of the use of alternative treatments and factors influencing their choices. Methods: we conducted a descriptive study at the Yaoundé General Hospital from December 2019 to May 2020. The study included patients over 18 years of age treated for cancer, who had been undergoing chemotherapy for at least three months and who agreed to complete the questionnaire. Results: the interview involved 122 patients. Sex ratio was 1/1. The average age of patients was 45 years; 38.5% of patients thought that cancer is a very serious disease, 24% were desperate for diagnosis, 61% thought that recovery would be very slow. Pluralists in our sample accounted for 59.8%. Conclusion: cancer patients and their relatives generally perceive cancer as serious. Patients experience a feeling of sudden and intense anxiety when they are diagnosed with cancer. Therapeutic pluralism is a frequent practice.

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

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

[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.

Epidemiological, clinical and therapeutic characteristics of metastatic spinal cord compression in prostate cancer patients in two tertiary hospitals in Cameroon.

Introduction: prostate cancer represents the 3rd primary neoplasia responsible for metastatic spinal cord compression (MSCC). MSCC is an extreme oncological emergency, because it involves both functional and vital prognosis. The present study aimed to establish a pattern of MSCC in prostate cancer patients in Douala and Yaoundé general hospitals (Cameroon). Methods: this was a descriptive and retrospective study in the Radiotherapy and Medical Oncology services at both Douala and Yaoundé General Hospitals. The explored variables were general characteristics of the study population, clinical and paraclinical features, management and outcomes. Furthermore 5-year survival was analyzed by the Kaplan-Meier method. Logistic regression by determining the odd ratios and their 95% confidence was done using "Statistical Package for Social Sciences" (SPSS 23) software. The difference was considered significant at p < 0.05. Results: our series consisted of 151 patients out of which the mean age was 66.88 (SD: 8.71) years (95% CI: 44-88). Pain was the most common clinical symptom (53.33%; n= 80) and fracture-settlement accounted for majority (60%; n= 90.61) of the pain. Thoracic spine damage was encountered by 47.02% (n= 71). Patients received a total doses of irradiation between 20 and 30 gray (Gy). The main toxicity due to radiotherapy were asthenia (45.70%; n= 69.11). The overall survival at 5 years was 90.11%. Factors associated with fracture-settlement were smoking (aOR 10.04, 95% CI: 2.09-48.12; p = 0.004) and the localization of MSCC occurred (aOR 0.21, 95% CI: 0.05-0.77; p = 0.02). Conclusion: in summary the average age for developing the condition is 66.88 years and factors associated with fracture-settlement were smoking and the localization of MSCC. Back pain was the most common clinical sign and fracture-settlement was the first type of injury on medical magnetic resonance imaging. Therefore, we recommend that emphasis should be placed on increasing awareness of the population on the importance of early diagnosis.