Prurigo strophulus: Epidemiological, clinical aspects and environmental factors among children in Yaoundé, Cameroon (Sub-Saharan Africa).

Background: Prurigo Strophulus (PS) is a chronic and recurrent inflammatory disease caused by a hypersensitivity reaction to arthropod bites. The objective of this study was to determine the prevalence of PS and its clinical characteristic in our context. Methods: We performed a cross-sectional study during February to May 2017 in Dermatology's units of six hospitals in Yaoundé. Children with clinical signs of PS were included. A questionnaire was administered for data collection. Results: A total of 112 children (62 boys and 50 girls) were included in the study, with a median age of 2 years; with range varied from 5 months to 16 years. The prevalence of PS was 5.4%. The most represented age group was 0-5 years (78.6%). PS lesions were most often located in exposed areas of body such as lower limbs (101/112; 90.2%), upper limbs (85/112; 75.9%) and face (19.6%). Papule-vesicle (87.5%) was the predominant type of lesions. Conclusion: PS is a common disease in Yaoundé (Cameroon). Papule-vesicle lesions are the most frequent signs. It is usually found in exposure areas of body.

Prevalence of Helicobacter pylori prevalence and upper gastrointestinal endoscopy in HIV/AIDS patients with gastrointestinal symptoms in the University Teaching Hospitals in Cameroon.

OBJECTIVE: To determine the prevalence of Helicobacter pylori (H. pylori) infection and of various upper gastrointestinal (GI) lesions in HIV+ patients with GI symptoms and the relation of H. pylori infection to CD4 cell counts. MATERIAL AND METHODS: In all, 56 HIV+ patients and 56 age- and sex-matched HIV- controls, all with upper GI symptoms, were evaluated by an upper endoscopy examination and gastric biopsy. H. pylori status was assessed with a urease test and histology. HIV was diagnosed with the rapid test and enzyme-linked immunosorbent assay (ELISA). RESULTS: The prevalence of H. pylori was 50% (28/56 [95%CI 36.3-63.7]) in HIV+ subjects and 55% (31/56 [95%CI 41.5-68.7]) in HIV- controls (p = 0.57). H. pylori infection rates did not differ significantly in HIV+ patients between those with a CD4 count ≥200/mm3 (52%) and those with a CD4 count <200/mm3 (42%) (p = 0.62). The prevalence on endoscopy of specific lesions in HIV+ patients and controls were compared: esophageal candidiasis (61%, 34/56 vs. 7%; p<0.0001), esophageal ulcers (18%, 10/56 vs 2%; p = 0.01), corpus gastritis (41%; 23/56 vs 5%; p<0.0001), and duodenitis (20%, 11/56, vs 0%; p = 0.001). CONCLUSIONS: The prevalence rate of H. pylori did not differ significantly between HIV+ and HIV- subjects. Prevalence of H. pylori was also lower, although not significantly, among HIV+ patients with CD4 T-cell counts below 200/mm3. On endoscopy, esophageal candidiasis was the most common finding in HIV+ patients, discovered by dysphagia.

[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.

Analyse démographique et endoscopique des patients atteints d'ulcère gastroduodénal à Yaoundé au Cameroun : qu'est ce qui a changé depuis les années 1990 ?

Objectif : La prévalence de l'ulcère gastro-duodénal semble être en diminution marquée ces dernières années dans les pays africains. Au Cameroun en 1990, elle était de 32%. L'objectif de notre étude était d'évaluer l'évolution de la prévalence de l'ulcère gastroduodénal et d'identifier ses caractéristiques démographiques et endoscopiques à Yaoundé, 25 ans après.Patients et méthodes : Etude rétrospective de la période allant du 1er janvier 2011 au 31 décembre 2014 dans trois hôpitaux universitaires de Yaoundé. Les comptes rendus d'endoscopie de 4685 patients consécutifs référés pour une endoscopie digestive haute ont été réexaminés. Nous avons inclus 489 patients (312 hommes et 177 femmes) avec un ulcère gastro-duodénal prouvé en endoscopie. Les données démographiques et endoscopiques ont été recueillies. Résultats : L'ulcère duodénal et l'ulcère gastrique étaient identifiés respectivement chez 295 (60,3%) et 157 (32,1%) patients, la double localisation gastrique et duodénale chez 37(7,6%), faisant une prévalence globale de 10,4%. L'âge moyen des patients était de 48,9 ans (extrêmes : 4 à 90 ans). Les patients ulcéreux gastriques étaient relativement plus âgés que les patients ulcéreux duodénaux (54,4 ans vs. 45,4 ans, p < 10-5). Le ratio homme/femme était de 2,2/1 pour l'ulcère duodénal et 1,2/1 pour l'ulcère gastrique. La prévalence globale de l'infection à H. pylori à l'histologie et/ou au test rapide à l'uréase était de 63,0% (308/489). L'infection était plus fréquente dans l'ulcère duodénal que gastrique (67,8% vs. 51,0%, p = 0,0005). L'ulcère gastro-duodénal était révélé par les épigastralgies (71,8%) et l'hémorragie (31,5%). L'hémorragie était liée à l'ulcère duodénal (p = 0,07) et au sexe masculin (p = 0,01). Il n'y avait pas de différence significative selon l'âge (p = 0,16). H. pylori protégeait contre l'hémorragie, risque relatif 0,7 (IC à 95% : 0,6-0,8 ; p = 0,00006).Conclusion : La prévalence de l'ulcère gastroduodénal a significativement diminué au Cameroun par rapport à 1990. Les patients ulcéreux sont devenus plus âgés avec une tendance à l'occidentalisation de la maladie ulcéreuse

Hepatite B chronique à antigene Hbe negative à Yaoundé, Cameroun

OBJECTIFS. L'hepatite B chronique a antigene HBe (AgHBe) negatif est associee a un mauvais pronostic et a un taux de reponse soutenue au traitement antiviral faible. Notre etude avait pour but de determiner les aspects epidemiologiques de l'hepatite B chronique a AgHBe negatif a Yaounde; centre de reference du traitement des hepatites chroniques au Cameroun. PATIENTS ET MeTHODES. De 2004 a 2012; 315 patients consecutifs porteurs chroniques de l'AgHBs ont ete enregistres. Les analyses serologiques ont ete effectuees en utilisant des kits commerciaux ELISA pour detecter l'AgHBs; les anti-HBc totaux; l'AgHBe; les anti-HBe; l'anti-delta et les anti-VHC. Les taux d'ADN VHB ont ete mesures par la technique COBAS Ampliprep (Roche). Les tests biochimiques pour le calcul du fibrotest/actitest ont ete realises avec l'automate COBAS (Roche). La prevalence de l'hepatite B chronique a AgHBe negatif; les donnees demographiques; l'association entre le taux d'ADN VHB et les dommages hepatiques ont ete explorees. ReSULTATS. La prevalence de l'hepatite B chronique a AgHBe negatif etait de 92;1%(290/315) [IC a 95% 88;4-94;7]. Le sexe ratio H/F etait de 2;8. Les transaminases ALAT etaient normales chez 67;2% (195/290) de patients. La cirrhose existait chez 6;1% (8/132). La viremie mediane etait de 1140 UI/ml; 70;3% (166/236) avaient un ADN VHB = 2000UI/ml et 20;3%(48/236) un ADN VHB indetectable. Aucune association statistiquement significative n'a ete notee entre le taux d'ADN VHB et l'age; le taux de transaminases ALAT ou la cirrhose. CONCLUSION. L'hepatite B chronique a AgHBe negatif est la forme predominante au Cameroun. Cette particularite souleve le probleme de la prise en charge therapeutique vu son mauvais pronostic

[Stevens-Johnson's syndrome following ingestion of gunpowder]. / Syndrome de Stevens-Johnson après ingestion de poudre à canon.

BACKGROUND: A cutaneous adverse drug reaction is a skin eruption secondary to the intake of a drug, be it prescribed by a medical practitioner or taken as auto-medication for a given ailment. In this document we present an original case of Stevens-Johnson's syndrome secondary to the ingestion of gunpowder. PATIENTS AND METHODS: A 22-year-old female student was hospitalised for diffuse and painful skin eruptions for the previous three days. She had complained six days earlier of an allergic reaction to pineapples, an allergy she had presented for quite a long time. In an attempt to remedy the situation, her mother made her drink a solution made of gunpowder bought at a market mixed with some water. On the third day of this "treatment", the patient noticed eruptions on her skin. These were initially maculopapular, later becoming erosive, and she had a mild fever. Later, a variety of eruptions appeared on the skin, from hyper-pigmented macular papules to blisters and erosive lesions with no Nicolsky sign. These lesions spared the palms of the hands and the soles of the feet. The mucosa of the conjunctivae, nose, buccal cavity, vulva, vagina and anus were severely affected. This clinical presentation was typical of Steven Johnson syndrome. The patient had stopped taking the "treatment" when she noticed the first lesions. On therapy, the outcome was favourable, except for severe complications such as synechiae with diffuse dyschromia. CONCLUSION: To the best of our knowledge this is the first time gunpowder has been incriminated in Stevens-Johnson's syndrome.

[Cardiac surgery in Cameroon. Results at one year of the pilot phase]. / Chirurgie cardiaque au Cameroun. Résultats à un an de la phase pilote.

In the framework of implementation of his national program for control and prevention of cardiovascular diseases, Cameroonian government has set up a cardiac surgery project. We report in this manuscript results of one year follow up of the patients operated during the pilot phase. From September 22 till 26, 2008, 11 patients have been operated in Cameroun. Surgical procedures were 5 mitral mechanic valve replacement, 2 aortic mechanic valve replacement, 1 atrial septal defect closure, 2 pace maker implantation. No intrahospital death was observed. One patient died at 11th month after the operation due to mitral valve thrombosis and attributed to lack of compliance. One patient presented low cardiac output, pneumonia and a pleural effusion. 2 patients presented 2 minor complications consisting of pericarditis and superficial wound infection. The results of the pilot phase of cardiac surgery in Cameroon are effective. However, the sustainability of the program require human, material capacity building, and funding mechanism as well.

[Amebic liver abscesses in Yaoundé]. / Abscès amibien du foie à Yaoundé.

Until 1985, morbidity and mortality from amebic infections were high in sub-Saharan Africa (2). The aim of this work was to describe the clinical, diagnostic and prognostic aspects of amebic liver lesions in a large town in tropical Africa, seven years after the last study of this disease in the area. We studied 96 amebic liver abscesses in 77 patients in a study with prospective and retrospective components. The patients were aged 20 to 65 years and the diagnoses were made on the basis of clinical radiological and biological criteria. Most of the patients were men (3:1). The most frequent clinical signs and symptoms were: pain on (100%), fever (92.2%), enlarged right hypochondrium (89.6%), heptomegaly (45.4%) and weight loss (39.6%). Ultrasound scans showed that the abscesses were most frequently found in the liver, on the right-hand side (65.6%) and that they were 20 to 125 mm in diameter. Between 80 and 2,500 ml of pus was drained from each abscess. We found pleuropulmonary lesions in 10.4% of cases. Serological tests for amebae were strongly positive in almost all cases and HIV tests (carried out prospectively) were positive in 11.6% of cases. The amebic liver lesions appeared to be primary in 66% of cases. The patients were treated with metronidazole, combined if necessary, with drainage under ultrasound surveillance. Two of the patients died. The others were completely cured after a mean of 13 days in hospital. Amebic infestations are cosmopolitan in nature. They occur most frequently in tropical areas. Amebic infections are rife in tropical Africa, with a prevalence of 1 to 2% (1). Liver amebiasis is the principal form of amebic infection outside of the intestine. Liver amebiasis is often detected at the stage of abscess formation.

Prevalence of hepatitis C virus and other blood-borne viruses in Pygmies and neighbouring Bantus in southern Cameroon.

The prevalences of antibodies to hepatitis C virus (anti-HCV), human immunodeficiency virus (anti-HIV), human T lymphotrophic virus (anti-HTLV) and of hepatitis B surface antigen (HbsAg) were determined in 168 subjects aged 12 years and over (108 Pygmies, 60 Bantus) living in south Cameroon. In 167 subjects, we found an estimated minimal anti-HCV prevalence of 13%. The prevalence was significantly higher in Bantus (31.7%) than in Pygmies (11.1%) and increased with age in both groups, albeit more rapidly in Bantus. The overall prevalence of HBsAg was 7.2% and correlated with neither sex nor ethnic group. No association was found between anti-HCV and HbsAg prevalence rates. No subject was confirmed to be positive for HTLV or HIV. These findings confirm the high prevalence of HCV infection in south Cameroon and indicate that even secluded population groups are affected.

Maladie ulcereuse gastro-duodenale : acces aux moyens de diagnostic et de traitement en milieu tropical

Une etude prospective portant sur l'analyse des antecedents de 72 malades operes au CHU de Yaounde d'un ulcere gastro-duodenal complique avait pour but d'evaluer l'acces des malades aux moyens de diagnostic et de traitement pendant la maladie ulcereuse et pendant les complications. Les stenoses etaient la complication chirugicale la plus frequente (69;4 pour cent) devant les hemorragies (16;6 pour cent) et les perforations chez 43 malades (59;7 pour cent). Les examens diagnostiques avaient ete demandes chez 25 malades (34;7 pour cent); dont 9 TOGD et 6 fibroscopies; chez les 15 malades ayant eu une complication sur un ulcere connu; 5 malades (33;3 pour cent) avaient pu suivre dans le passe un traitement medical correct. Avec la survenue des complications; tous les malades ont eu acces aux moyens de diagnostic; dont 50 TOGD et 6 fibroscopies pour le diagnostic des hemorragies et et 8 radiographies de l'abdomen sans preparation pour le diagnostic des perforations. Apres le traitement chirurgical 6 malades (8;5 pour cent) ont poursuivi un traitement medical correct pendant 45 jours. En conclusion; cette etude montre que peu de malades souffrant de maladie ulcereuse gastro-duodenale ont acces aux moyens modernes de diagnostic et de traitement en milieu tropical. Une meilleure politique sanitaire s'impose en vue de controler cette maladie avant la survenue des complications

Value of whole-cell antigen extracts for serologic detection of Helicobacter pylori.

Whole-cell protein extracts of Helicobacter pylori strains were evaluated by enzyme-linked immunosorbent assay to detect immunoglobulin G antibody against H. pylori in 113 patients with upper gastrointestinal complaints. These antigen preparations were of value for detecting infection by H. pylori in patients with high antibody titers (> or = 12,800), whereas for patients with lower titers, the results were inconclusive.

[Purulent meningitis due to flavobacterium meningosepticum in Cameroonian children]. / Méningites purulentes à flavobacterium meningosepticum chez l'enfant camerounais.

Following a number of reports of purulent CSF specimens positive for Flavobacterium meningosepticum in pediatric patients in Yaoundé, a prospective study was carried out in the Department of Pediatrics of the Central Yaoundé Hospital from December 1988 through December 1989. The goals of this study were to determine the incidence of Flavobacterium meningosepticum among infants and children with purulent meningitis, to discover the origin of this pathogen, and to examine its susceptibility to antimicrobial agents. Flavobacterium meningosepticum (18.4% of cases) was second by order of incidence, after pneumococci (50%). Incidences were low for the other pathogens usually described in purulent meningitis (H. influenzae, meningococcus...). All the pneumococcus strains recovered were susceptible to ampicillin. In contrast, 21.43% of strains of Flavobacterium meningosepticum were resistant to both ampicillin and chloramphenicol (the combination currently used as first line therapy in the Department), and 14.25% of strains were resistant to cefotaxime. The origin of the Flavobacterium meningosepticum strains found remains to be discovered. The low incidence of H. influenzae deserves to be reevaluated over the next few years.

[Anatomopathological aspects of colorectal polyps in Cameroon]. / Aspects anatomopathologiques des polypes colorectaux au Cameroun.

In order to present the main types of colo-rectal polyps in Cameroon, we reviewed all those cases received and examined in our Pathology laboratories during a six and a half year period (1st January 1984-30th June 1990). The polyps were sent by gastro-enterologists after resection during total colonoscopy, with information about age and sex of patients, signs and symptoms and sites and number of polyps. One hundred and two colorectal polyps were taken from 88 patients with a maximum of two polyps per patient. Out of these 102 polyps, we noted: 55 juvenile polyps (54%), 23 hyperplastic polyps (22.5%), 13 adenomatous polyps (12.5%), 10 inflammatory polyps (10%) and one polyp of the Peutz-Jeghers type. One case of hyperplastic polyposis and one of familial polyposis with adenomas on histological examination were registered. On the whole, juvenile polyps predominated and adenomas which can become carcinomas were less frequent than what is seen in Western developed countries. This may be due to the fact that the polyps we examined were only taken only from patients seen in outpatient department for gastrointestinal complaints.

[Gastroduodenal ulcers in children in Cameroon. Apropos of 28 cases diagnosed by endoscopy]. / Ulcères gastroduodénaux de l'enfant camerounais. A propos de vingt-huit cas de diagnostic endoscopique.

This study was undertaken to describe the epidemiology and clinical features of peptic ulcer in children on the basis of twenty-eight endoscopically documented cases. Mean age was 11,5 years (range 4-16 years). Twenty-five percent of patients had a positive family history for peptic ulcer and 32% had risk factors. Two-thirds of patients had abdominal pain, occasionally accompanied with bleeding. Duodenal ulcers were slightly more common (15 versus 13). The ulcer was chronic or primary in seventeen cases, whereas endoscopic findings showed that eleven cases were acute or secondary.

[Biliary calculi in adults in Cameroon. Epidemio-clinical and morphological aspects (apropos of 52 cases seen in Yaounde)]. / La lithiase biliaire de l'adulte Camerounais. Aspects épidémio-cliniques et morphologiques (a propos de 52 cas observés à Yaoundé).

Fifty-two cases of cholelithiasis were retrospectively studied in the Central Hospital of Yaounde over a period of 30 months. Nineteen males and 33 females with an average age of 40 years (range from 15 to 70 years). Forty-six p.c. of these patients had asymptomatic cholelithiasis and most of it consisted in only one gallstone. Etiologic factors found were: sickle-cell anemia, obesity, pregnancy and cirrhosis.

[Upper digestive system hemorrhages in Cameroon (apropos of 172 cases examined via endoscopy)]. / Les hémorragies digestives hautes au Cameroun (à propos de 172 cas explorés par endoscopie).

172 cases of upper gastrointestinal bleeding were explored endoscopically from 01 March 1987 to 15 May 1989 in 3 centers in Cameroon. The patients comprised 124 men and 48 women with an average age of 39.64 years. Haematemesis with resultant melena constituted the most frequent presentation (42.36%) while haematemesis and melena was the unique presentation in 37.22% and 17.91% of cases respectively. The aetiologic factors encountered were: duodenal ulcers (33.64%), acute gastric bleeding (22.08%) gastric ulcer (13.44%), ruptured gastroesophageal varices (13.92%). Predisposing factors included the ingestion of gastric irritant medication, spices and alcohol. The authors review the literature and in its light, discuss the epidemiology and aetiology of gastrointestinal bleeding in Cameroon.