Epidemiological profile of perinatal mental disorders at a tertiary hospital in Yaoundé- Cameroon.

In developing countries, 15.6% of pregnant women and 19.8% after childbirth experience a mental disorder. In the absence of data on the situation in Cameroon, we carried out a study to determine the prevalence of perinatal mental illness in this hospital and its risk factors among women in perinatal period and the relationship between both at the Yaoundé Gynaeco-Obstetric and Paediatric Hospital, a reference mother and child hospital. We conducted a hospital-based, cross sectional, observational study. Data was collected using structured and semi-structured interviews. There were six sub-themes covered: participants' socio-demographic profile, clinical profile, perinatal history, psychopathology aspects with the Mini International Psychiatric Interview, the Edinburgh Postnatal Depression Scale, the State Trait Anxiety Inventory and the perinatal mental illness risk factors. Data entry was done using Microsoft Excel 2010 and transferred to Statistical Package for the Social Sciences version 23.0 for analysis. Among 194 women who participated in the study, the general prevalence for perinatal mental disorders was 53.6% (104/194), 25.8% among pregnant women and 27.8% among postnatal women. Comorbidities were present in 17.5% of our study population. We observed that 45.8% suffered from depression, 17% had a risk of suicide, 10.3% suffered from perinatal anxiety, 3.1% presented with post-traumatic stress disorder, 3.6% acute stress disorder, 7.7% had adjustment disorder. Concerning risk factors, we found a significant link between depression and severe anxiety before delivery (p < 0.05) and the absence of social support (p = 0.005). We found that women with at least four risk factors were 1.6 times more likely to present with a perinatal mental disorder. The prevalence of perinatal mental disorders at this Hospital is very high. This highlights the need for institutional screening and management of perinatal mental disorders, which suggests that we explore the situation in others and other health facilities in Cameroon.

Orbital exenteration in immunodeficiency virus-infected patients.

BACKGROUND: Orbital exenteration (OE) is a disfiguring procedure most commonly performed for locally advanced and potentially life-threatening periorbital malignancies. METHODS: We retrospectively reviewed records of 11 consecutive HIV patients who underwent OE for invasive orbital malignancy at our institution from January 2005 to December 2015. Patient demographic and clinic data and histopathology of the tumor were analyzed. RESULTS: There were eight (72.72%) female and three (27.28%) male participants ranging in age from 31 to 52 years with an mean of 39.4 years. Nine patients had been known to be HIV-positive for at least 2 years, and HIV-positive status was revealed at presentation for two patients. The mean CD4 cell count was 154.4 cells/mm3. Histopathological examination showed invasive orbital squamous cell carcinomas in nine patients (81.81%), achromic orbital melanoma in one patient (9.09%), and adenoid cystic carcinoma in one patient (9.09%). None of the patients underwent primary orbital reconstruction. The mean follow-up time was 3.4 months. Only one patient who underwent adjuvant radiotherapy was seen after 12 months. CONCLUSION: Oculo-orbital malignancies are very aggressive in HIV-positive individuals, especially in untreated patients. Routine screening for suspected ocular surface lesions and early surgical removal of all these lesions could help to avoid the need to perform the radical and disfiguring OE procedure.

Lesions oculaires de l'onchocercose et observance au Traitement a L'ivermectine Sous Directives Communautaires (TIDC)

BUT: Determiner si les complications oculaires de l'onchocercose influencaient l'observance des patients au TIDC. MATeRIELS ET MeTHODES: Nous avons mene une etude transversale descriptive dans la region du Littoral au Cameroun. Etaient inclus dans cette etude tous les sujets ages d'au moins 10 ans. Les variables etudiees etaient l'acuite visuelle; le type de deficience visuelle; le sexe; les lesions oculaires d'onchocercose; le nombre de prises d'Ivermectine au cours des 5 dernieres annees. ReSULTATS : Nous avons collige 764 patients soit 1528 yeux. Le nombre d'yeux presentant des lesions d'onchocercose etait de 56 et ceux n'en presentant pas etaient au nombre de 1472. Nous avons releve une prevalence de 48 de bonne observance au TIDC au sein de la population generale. Mais nous avons retrouve une prevalence de 57 de bonne observance chez les cas contre une prevalence de 48 chez les controles (P = 0;28). Une similarite dans la regularite de la prise de l'Ivermectine entre les femmes et les hommes a ete retrouvee. CONCLUSION :Les patients presentant des lesions oculaires de l'onchocercose ont majoritairement une bonne observance au TIDC dans la region du Littoral contrairement a ceux ne presentant pas de lesions oculaires de l'onchocercose. Le genre n'est pas un facteur influencant l'observance au TIDC dans notre etude contrairement a certaines donnees de la litterature. Le nombre de prises d'Ivermectine n'est pas un facteur predisposant les hommes aux atteintes oculaires de l'onchocercose. En cas d'absence de deficience Visuelle les patients avec des lesions oculaires de l'onchocercose ont une meilleure observance au TIDC. La presence de lesions oculaires de l'onchocercose semble etre un facteur motivant les patients atteints a une meilleure observance au TIDC

Clinical and Microbiological Assessment of Trachoma in the Kolofata Health District, Far North Region, Cameroon

Background and aims: Trachoma is a sight-threatening process triggered by the infection of the conjunctiva with <i>Chlamydiae</i>. Blindness associated with trachoma was reported in Sahelian areas of Cameroon. However, data on the prevalence of this neglected infection in the Far North Region are not available. The aim of this study was a) to assess clinical trachoma and b) to detect <i>Chlamydia</i> in the conjunctiva of trachomatous populations living in the Far North Regions of Cameroon.Methods: A total of 2,423 randomly selected children (1–10 years) and 1,590 women over 14 from randomly selected villages from the Kolofata Health District (115,000 inhabitants) were included in a cross-sectional study in February 2009. Trained staff examined and obtained conjunctival swabs from trachomatous subjects. DNA was extracted and amplified to detect <i>Chlamydia</i> DNA by real-time PCR. The quality of sampling was assessed by quantifying the number of epithelial cells.Results: Children (2,397 or 98.9% of the predicted number) and women (1,543; 97.0%) were examined. The prevalence of follicular trachoma (TF) in children was 21% (95% CI 17.8–24.5) and of intense inflammatory trachoma (TI) 5.2% (95% CI 3.6–7.3). Among the women, trichiasis (TT) was observed in 3.4% (95% CI 2.4–4.7), corneal opacities (CO) in 1.4% (95% CI 0.8–2.3) and trachoma-related blindness in 0.9% (95% CI 0.4–1.8). Conditions related to income, illiteracy, latrines, water supply and animals wandering close to dwellings were similar in all the villages. PCR was positive in 35% of children with active trachoma and in 6% of adult females presenting TT and/or related corneal opacities.Conclusion: The prevalence of trachoma and the severe trachoma <i>sequelae</i> found during this survey underline the urgent need to implement efficient blindness prevention interventions to improve the visual future of the people in the Sahelian region.