[Severe high blood pressure recently diagnosed in an urban milieu from Subsahelian Africa: Epidemiologic, clinical, therapeutic and evolutionary aspects]. / Hypertension artérielle sévère nouvellement diagnostiquée dans un pays en Afrique sub-saharienne : aspects épidemio-cliniques, thérapeutique et évolutifs.

OBJECTIVES: High Blood Pressure (HBP) is a worldwide public health problem. It can be particularly severe in the Black race. Recent studies in Cameroon, showed an alarming prevalence, leading us to want to study the epidemiological, clinical, therapeutic and evaluative aspects of severe, (BP op to 180/110mmHg), recently diagnosed HBP in Yaounde. Our objective was to determine its clinical presentation and evolution. METHODS: We conducted nine months prospective cohort study, from January to September 2016. We recruited from the active population participants who voluntarily accepted blood pressure screening offered in various localities in Yaounde, and were aged from 18 years and above. RESULTS: Of a total of 6519 people who participated in the screening, 1875 (28.8%.), presented a HBP and 363 (5.6%) had severe HBP. Our cohort comprised 153 (42.1%) of these individuals with sustained severe hypertension, not on medication, who accepted the invitation to participate in the study. The range of 45-54 years and 55-64 years were the most represented; the sex ratio was 0.9. The cardiovascular risk factors number range from 5 to 8 with a median of 6. Systolic BP ranged from 184 to 225mmHg with a median of 200mmHg; while the diastolic BP ranged between 111-132.5mmHg with a median of 119mmHg. Kidney injury (77.8%) was the main complications. We identified 3 clinical forms: hypertensive emergencies 121 (79.1%) cases and hypertensive crises 32 (20.9%) cases. In these two groups, 33 (21.6%) patients presented with "super HBP" (a blood pressure>250/150mmHg). The average rate of BP control over 6 month was 39%. The main cause of poor BP control was lack of therapeutic compliance. We registered one death at the 3rd month of follow up due to acute kidney injury. CONCLUSION: Severe HBP prevalence in Yaounde is high in the active fraction of the population insidiously affected. Particularly, unsuspected renal impairment appears to be the major complication. The bad blood pressure control is linked to poor therapeutic observance and persistence.

[Mycological profile of onychomycosis in Yaoundé, Cameroon]. / Profil mycologique des onychomycoses vues en consultation de dermatologie à Yaoundé, Cameroun.

BACKGROUND: The lack of data concerning the mycological spectrum of onychomycosis in Cameroon prompted us to conduct the present study, which aimed to determine the mycological profile of onychomycosis diagnosed during dermatologic consultations in Yaoundé, Cameroon. METHODS: This was a cross-sectional study held from October 2014 to March 2015 in six hospitals of Yaoundé. Patients suspected of onychomycosis were consecutively recruited during dermatologic consultations; anamnestic and clinical data were recorded and one or several nail fragments sampled for mycological examination (direct examination or culture). RESULTS: A total of 3457 patients were examined during the study period, 117 of whom were suspected of onychomycosis; 133 samplings were performed. The distolateral subungual form was the dominating one: 72/110; 65.5%. The diagnosis was confirmed with 110 of the 133 samples (82.7%), these collected among 96 patients, hence a prevalence of 2.8% (96/3457). We isolated 99 germs, among which two-co-infestations. Dermatophytes (52/99; 52.5%), especially Trichophyton rubrum (23/52; 44.2%) and Trichophyton verrucosum (11/52; 21.2%) were the main pathogens causing onychomycois of the toes whereas yeasts (43/99; 43.4%), Candida albicans (31/43; 72.1%) in majority, were the prevailing germs incriminated in onychomycosis of the fingers. There were few cases of molds infestation (4/99; 4%). CONCLUSION: Onychomycosis are common in dermatology consultations in Yaoundé. Candida albicans, Trichophyton rubrum and Trichophyton verrucosum are the main pathogens in cause.

[Acne in Cameroon: Quality of life and psychiatric comorbidities]. / Acné au Cameroun : qualité de vie et comorbidités psychiatriques.

BACKGROUND AND AIMS: The impact of acne upon quality of life (QOL) among affected patients had not previously been investigated in Cameroon. The present study therefore sought to assess the QOL of patients with acne and related psychiatric comorbidities in this country. PATIENTS AND METHODS: This was a cross-sectional study conducted in three hospitals in Yaoundé, Cameroon. We included patients diagnosed with acne after a consultation with a dermatologist, and who consented to participate in the study. The ECLA scale was used for the clinical evaluation of acne and the CADI score was used to assess QOL. PHQ-9 and GAD-7 questionnaires were used for the respective screening of depression and anxiety. RESULTS: We enrolled 181 patients aged between 13 and 56years. According to the ECLA table, the acne global severity score ranged from 3 to 26 points. Impairment was observed in all patients' QOL, which ranged from 1 to 15 points. We noted 11 cases of depression (6.1%) and 14 cases of anxiety (7.7%). There was a positive and significant correlation between the severity of acne and impairment of patients' QOL (r=0.46; P<0.001). Likewise, the severity of acne and of depression and anxiety scores were positively and significantly correlated with one other: r=0.347 (P<0.001) and r=0.291 (P<0.001), respectively. CONCLUSION: Acne negatively impacts the QOL of patients presenting acne in Cameroon and is associated with depression and anxiety, which must therefore be taken into account when treating these patients.

[Serum procalcitonin: a reliable tool for the diagnosis and follow-up of neonatal bacterial infections in Sub-Saharan Africa]. / Intérêt du dosage de la procalcitonine sérique dans le diagnostic et le suivi des infections néonatales d'origine bactérienne à Yaoundé, Cameroun.

BACKGROUND AND AIM: Neonatal infection (NNI) is a public health problem in developing countries where pediatricians and specifically neonatologists encounter many diagnostic difficulties. Having a precise and easily measurable biological marker, with a high sensitivity and a high negative predictive value, that can rapidly detect NNI, remains a great challenge. The aim of this study was to determine the place of serum procalcitonin (PCT) in the diagnosis and follow-up of bacterial NNI in resource-limited contexts. METHODS: We carried out a cross-sectional study from October 2009 to February 2010 at the Mother and Child Centre of the Chantal Biya Foundation, Cameroon. We included all neonates born at term, suspected of NNI, and hospitalized in the Neonatal Care Unit of the aforementioned centre during the study period. We measured PCT levels at entry and 48h later, and determined its sensitivity, specificity, and positive and negative predictive values. RESULTS: Twenty-five out of the 98 neonates enrolled presented with a confirmed diagnosis of NNI. PCT was positive in 92.4% of cases. Contrariwise, serum C-reactive protein was positive in 84.6% of patients with a cut-off point at 6mg/L, and remained positive in only 38.4% of cases when the cut-off point was raised to 20mg/L. The sensitivity, specificity, and positive and negative predictive values of PCT were 96.0%, 77.7%, 85.3%, and 93.3%, respectively. Six deaths were recorded, five of which exhibited very high PCT levels (≥10ng/mL). All neonates with negative PCT levels had a good clinical outcome as none of them died. If PCT were to be considered as a diagnostic tool of NNI, only 43 (43.9%) neonates would have benefited from a justified antibiotic therapy exceeding 48h, with a significant reduction in duration of hospitalization (9.1±3.3 vs 5.1±4.6 days; P<0.05). CONCLUSION: PCT may be an early and reliable indicator of bacterial NNI. Its course throughout hospitalization may reflect the therapeutic response, and elevated levels of PCT may be highly suggestive of a poor clinical prognosis. PCT could therefore serve as a useful tool for the screening, diagnosis, and follow-up of neonates suspected of bacterial NNI in resource-poor settings.

Phenotypic and allelic distribution of the ABO and Rhesus (D) blood groups in the Cameroonian population.

Data on blood group phenotypes are important for blood transfusion programs, for disease association and population genetics studies. This study aimed at reporting the phenotypic and allelic distribution of ABO and Rhesus (Rh) groups in various ethnolinguistic groups in the Cameroonians. We obtained ABO and Rhesus blood groups and self-identified ethnicity from 14,546 Cameroonian students. Ethnicity was classified in seven major ethnolinguistic groups: Afro-Asiatic, Nilo-Saharan, Niger-Kordofanian/West Atlantic, Niger-Kordofanian/Adamawa-Ubangui, Niger-Kordofanian/Benue-Congo/Bantu/Grassfield, Niger-Kordofanian/Benue-Congo/Bantu/Mbam and Niger-Kordofanian/Benue-Congo/Bantu/Equatorial. ABO allelic frequencies were determined using the Bernstein method. Differences in phenotypic distribution of blood groups were assessed using the chi-square test; a P value <0.05 being considered as statistically significant. The frequencies of the antigens of blood groups O, A, B and AB were 48.62%, 25.07%, 21.86% and 4.45%, respectively. Rhesus-positive was 96.32%. The allelic frequencies of O, A and B genes were 0.6978, 0.1605 and 0.1416, respectively. Phenotypic frequencies of the blood groups in the general study population and in the different ethnolinguistic groups were in agreement with Hardy-Weinberg equilibrium expectations (P > 0.05). The frequencies of O, A, and B blood phenotypes were significantly lower, respectively, in the Nilo-Saharan group (P = 0.009), the Niger-Kordofanian/Benue-Congo/Bantu groups (P = 0.021) and the Niger-Kordofanian/West-Atlantic group. AB blood group was most frequent in the Niger-Kordofanian/Adamawa-Ubangui group (P = 0.024). Our study provides the first data on ethnic distribution of ABO and Rhesus blood groups in the Cameroonian population and suggests that its general profile is similar to those of several sub-Saharan African populations. We found some significant differences in phenotypic distribution amongst major ethnolinguistic groups. These data may be important for blood donor recruitment policy and blood transfusion service in Cameroon.