Imaging of developmental delay in black African children: A hospital-based study in Yaoundé-Cameroon.

Background: The purpose of this study was to describe the anomalies observed on imaging for developmental delay in black African children. Methods: It was a descriptive cross-sectional study, which included children aged between 1 month to 6 years with developmental delay and had done a brain MRI and/or CT scan. Results: We included 94 children, 60.6% of whom were males. The mean age was 32.5 ± 6.8 months. A history of perinatal asphyxia found in 55.3% of cases. According to the Denver developmental II scale, profound developmental delay observed in 35.1% of cases, and severe developmental delay in 25.5%. DD was isolated in 2.1% of cases and associated with cerebral palsy, pyramidal syndrome, and microcephaly in respectively 83%, 79.8%, and 46.8% of cases. Brain CT scan and MRI accounted for 85.1% and 14.9% respectively. The tests were abnormal in 78.7% of the cases, and cerebral atrophy was the preponderant anomaly (cortical atrophy = 80%, subcortical atrophy = 69.3%). Epileptic patients were 4 times more likely to have abnormal brain imaging (OR = 4.12 and p = 0.05),. We did not find a link between the severity of psychomotor delay and the presence of significant anomalies in imaging. Conclusion: In our context, there is a high prevalence of organic anomalies in the imaging of psychomotor delay, which were dominated by cerebral atrophy secondary to hypoxic ischemic events.

Prevalence, complications and factors associated with severely elevated blood pressure in patients with hypertension: a cross-sectional study in two hospitals in Yaoundé, Cameroon.

Introduction: severely elevated blood pressure significantly increases cardiovascular morbidity and mortality in hypertensive Black patients. The objective of this study was to determine the prevalence, complications and factors associated with severe high blood pressure in hypertensive patients in Yaoundé, Cameroon. Methods: we conducted a cross-sectional study in the outpatient and cardiology units of two teaching hospitals in Yaoundé. We included consenting hypertensive patients aged over 18 years. We first measured their blood pressure (BP), then we collected their sociodemographic data, cardiovascular risk factors, follow-up data, and ended with a complete physical examination. We performed a regression analysis to assess correlates of severe hypertension. Results: we included a total of 153 patients with 33 (21.6%) of them having severe hypertension. Among the 33 patients, 16 (48.5%) were male and 17 (51.5%) were female. Their mean age was 60.52 ± 12.83 years. Chronic kidney disease (78.8%), hypertensive retinopathy (69.7%) and left ventricular hypertrophy (48.5%) were the most common complications. On multiple logistic regression analysis, inadequate follow-up was independently associated with severe hypertension (adjusted OR=7.09; 95% CI [2.29-21.9]). Conclusion: severely elevated BP is common among hypertensive patients in our setting with important physical and economic consequences. Increased patients awareness and improving access to primary care physicians and cardiologists, through health insurance or other means, may be an effective strategy for reducing cardiovascular morbidity and mortality among hypertensive Black patients.

Clinical predictors of significant intracranial computed tomography scan findings in adults experiencing headache disorder.

INTRODUCTION: Radiological assessments for adult headache disorder show significant intracranial findings in 2.5% to 10% of performed computed tomography scans (CT-scans), leading to an overuse consideration for CT-scan requests by physicians in headache-experiencing patients. Therefore, we undertook this study in order to determine predictors of significant intracranial CT-scan findings in adults experiencing headache disorder; in order to help physicians better select patients who need imaging, which would subsequently decrease the costs of headache disorder management and the useless irradiation rates. METHODS: We carried out a cross-sectional study in the medical imaging departments of Yaounde Central Hospital and Douala Laquintinie Hospital, which are two teaching hospitals in Cameroon, over a period of five months. We consecutively and non-exhaustively included all consenting patients aged eighteen years and above, referred to the radiology department to perform a head CT-scan as aetiological workup of headache disorder, from either a traumatic or non-traumatic mechanism. Patients having a known brain lesion and those with a Glasgow coma scale less than thirteen were excluded. The clinical history of patients was taken and a complete physical examination was performed. Demographic data, clinical characteristics of the headache, results of neurological and physical examinations were collected and correlated to the results of head CT-scan. RESULTS: We enrolled 169 patients in the study, 56.2% were males, with a sex ratio of 1.3; sudden onset of headache increased by two the risk of discovering significant intracranial pathology (p = 0.032). Occipital and cervical location of headache, headache evolving by crisis, and recurrent paroxysmal headache were rather significantly correlated to no structural brain finding. An abnormal neurological examination with specifically abnormal stretch reflexes, aphasia, loss of consciousness, raised intracranial signs, weakness, and meningeal signs were predictive of structural intracranial pathology. Otorrhagia, epistaxis, and periorbital ecchymosis in addition were predictive in post-traumatic headaches. CONCLUSION: Abnormal results from neurological examination are the best clinical parameters to predict structural intracranial pathology on CT-scan in adult patients experiencing headache disorder. In case of post-traumatic headaches, in addition, otorrhagia, epistaxis, and periorbital ecchymosis are too highly predictive.