Background: Cervical cancer (CC) is one of the most frequent cancers and the leading cause of death from gynecological cancer in Low and middle income countries, Cameroon inclusive. Surgery is the primary treatment mo...Background: Cervical cancer (CC) is one of the most frequent cancers and the leading cause of death from gynecological cancer in Low and middle income countries, Cameroon inclusive. Surgery is the primary treatment modality when the disease is diagnosed at early stage. Radical hysterectomy in cervical cancer has not been evaluated in recent years in Cameroon. The purpose of this study is thus to evaluate the epidemiological and clinical features and short term outcomes of patients who underwent surgery. Patients and methods: This retrospective study was conducted at the Douala Gynaeco-obstetric and Pediatric Hospital and the Douala General Hospital. Cervical cancer patients who underwent Radical hysterectomy between January 2015 and December 2020 were included. A pre-established data collection tool was used to record socio-demographic, clinical and outcomes information from patients’ files;additional outcome information was obtained from phone calls. Descriptive analysis was done using the SPSS version 26. Bivariate analysis was used to determine associations between disease and patients characteristics and occurrence of adverse postoperative outcome. P value of 0.05 was considered. Results: Sixty one patients were enrolled. Their ages ranged from 33 to 74 years with a mean age of 51.95 ± 10.29 years. Over 85% of women were married, 65.57% were unemployed and 86.88% were multiparous. Only 28% had never done cervical cancer screening. Most patients had stage IB1 to IB2 stage disease (57.1%). Less than 9% underwent radical hysterectomy and 8 of those (13.11%) suffered intraoperative complications. Twenty-five patients (40.98%) presented immediate and short term complications. There was no significant association between the disease or patients’ characteristics and adverse outcomes. Conclusion: Cervical cancer patients are relatively young in our settings and only 9% of them reach the hospital at early stage. Postoperative adverse outcomes rate is higher than that reported in the literature. Sensitization on s展开更多
<strong>Introduction:</strong><span><span><span style="font-family:""><span style="font-family:Verdana;"> Breast cancer remains a public health problem due ...<strong>Introduction:</strong><span><span><span style="font-family:""><span style="font-family:Verdana;"> Breast cancer remains a public health problem due to its sever</span><span style="font-family:Verdana;">ity and because it is the leading cause of death from cancer</span></span></span></span><span style="font-family:Verdana;"><span style="font-family:Verdana;"><span style="font-family:Verdana;">s</span></span></span><span style="font-family:Verdana;"><span style="font-family:Verdana;"><span style="font-family:Verdana;"> in women </span></span></span><span><span><span style="font-family:""><span style="font-family:Verdana;">worldwide as well as in Cameroon. Our objective was to study the diagnostic and </span><span style="font-family:Verdana;">therapeutic options that patients followed for breast cancer choose in</span><span style="font-family:Verdana;"> Yaound</span></span></span></span><span style="font-family:Verdana;"><span style="font-family:Verdana;"><span style="font-family:Verdana;">e</span></span></span><span><span><span style="font-family:""><span style="font-family:Verdana;">. </span><b><span style="font-family:Verdana;">Method:</span></b><span style="font-family:Verdana;"> This was an analytical cross-sectional study with prospective data collection among patients followed for breast cancer at two referral hospitals in Yaound</span></span></span></span><span style="font-family:Verdana;"><span style="font-family:Verdana;"><span style="font-family:Verdana;">e</span></span></span><span style="font-family:Verdana;"><span style="font-family:Verdana;"><span style="font-family:Verdana;"> from February 1, 2019 to August 31, 2019. Data collected were recorded and analyzed using R application version 3.5.0.</span></span></span><span style="font-family:Verdana;"><span style="font-family:Verdana;"><span style="font-family:Verdana;">,</span></span></span><span style="font-family:Verdana;"><span style="font-family:Verdana;"><span style="font-family:Verdana;"> p values < 0.05 w</span></span></span><span style="f展开更多
<strong>Background:</strong><span><span><span style="font-family:""><span style="font-family:Verdana;"> Children and adolescent mortality remains a public h...<strong>Background:</strong><span><span><span style="font-family:""><span style="font-family:Verdana;"> Children and adolescent mortality remains a public health concern in developing countries. This study aimed to describe risk factors and aetiologies of mortality among children and young adolescents at a tertiary hospital in the town of Douala, Cameroon. </span><b><span style="font-family:Verdana;">Methods:</span></b><span style="font-family:Verdana;"> We carried out a retrospective cohort study from January 1</span><sup><span style="font-family:Verdana;">st</span></sup><span style="font-family:Verdana;"> to May 31</span><sup><span style="font-family:Verdana;">st</span></sup><span style="font-family:Verdana;">, 2019 among deceased patients aged 1 month to 15 years admitted to the paediatric ward of the Gynaeco-Obstetric and Paediatric Hospital. Data of interest were collected and analysed. </span><b><span style="font-family:Verdana;">Results:</span></b><span style="font-family:Verdana;"> Out of 3088 children admitted, 123 death cases were recorded. The overall hospital mortality rate was 3.98%. Females accounted for 51% of the deceased patients. Fever was the main reason for consultation. Severe malaria was the most common diagnosis. In univariate logistic regression analysis, factors associated with mortality included hyperthermia (OR = 0.24;95% CI 0.80</span></span></span></span><span><span><span style="font-family:""> </span></span></span><span style="font-family:Verdana;"><span style="font-family:Verdana;"><span style="font-family:Verdana;">-</span></span></span><span><span><span style="font-family:""> </span></span></span><span><span><span style="font-family:""><span style="font-family:Verdana;">1.33;</span><i><span style="font-family:Verdana;">p</span></i><span style="font-family:Verdana;"> = 0.012), coma/impaired consciousness (OR = 0.30;95% CI 0.10</span></span></span></span><span><span><span style="font-family:""> </span></span></span><span style="font-family:Verdana;"><span style="font-family:Verdana;展开更多
<strong>Introduction:</strong><span style="font-family:""><span style="font-family:Verdana;"> The first case of the novel coronavirus (COVID-19) pandemic in Cameroon wa...<strong>Introduction:</strong><span style="font-family:""><span style="font-family:Verdana;"> The first case of the novel coronavirus (COVID-19) pandemic in Cameroon was confirmed on March 6, 2020. Though widely considered that pregnant women are more susceptible to respiratory tract infections, the available body of literature on the effect of COVID-19 on pregnancy outcomes is shy from being conclusive. In Cameroon, the Douala Gyneco-Obstetric and Pediatric Hospital (DGOPH) was one of the main frontline tertiary health facilities for the management of severe forms of the disease. After four months of managing COVID-19 cases in the general population and especially in pregnant women at the DGOPH, we decided to take a stop, analyze our findings from the patients managed in order to drive future policies and clinical practices via informed decisions. </span><b><span style="font-family:Verdana;">Overall objective: </span></b><span style="font-family:Verdana;">To describe and understand the clinical burden of patients managed for COVID</span></span><span style="font-family:Verdana;">-</span><span style="font-family:""><span style="font-family:Verdana;">19 in pregnancy or post-partum at the DGOPH.</span><b><span style="font-family:Verdana;"> Methodology:</span></b><span style="font-family:Verdana;"> Cross</span></span><span style="font-family:Verdana;">-</span><span style="font-family:""><span style="font-family:Verdana;">sectional and descriptive study covering four months—March 24</span><sup><span style="font-family:Verdana;">th</span></sup><span style="font-family:Verdana;"> to July 24</span><sup><span style="font-family:Verdana;">th</span></sup><span style="font-family:Verdana;"> 2020 at DGOPH. Using a pretested questionnaire, we systematically enrolled all patients who fulfilled the inclusion criteria, with analysis done using proportions from an excel spreadsheet.</span><b><span style="font-family:Verdana;"> Results: </span></b><span style="font-family:Verdana;">A total of 18 on the 301 pregnant women consulte展开更多
Introduction: Breast cancer is the most common cancer and the first cause of cancer-related deaths among women in Cameroon. The aim of the study was to investigate its risk factors for breast cancer at two University ...Introduction: Breast cancer is the most common cancer and the first cause of cancer-related deaths among women in Cameroon. The aim of the study was to investigate its risk factors for breast cancer at two University Teaching Hospitals in Yaoundé. Methodology: A case-control study was conducted for 5 months, from February 25th to July 25th 2015, at the Gynecology unit of the Yaoundé Gyneco-Obstetric and Pediatric Hospital (YGOPH) and the Medical Oncology unit of the Yaoundé General Hospital (YGH). One hundred and five patients with breast cancer (cases) were compared to 210 women who did not have breast cancer (controls). SPSS Version 18.0.0 software was used to analyze the data with a statistical significance considered at P-value 50 years (P three times per week (P = 0.002;OR = 2.14;CI = [1.33 - 3.45]), palm oil consumption > two times per week (P = 0.001;OR = 2.38;CI = [1.4 - 4.1]). After multivariate analysis, age > 50 years (aOR = 41.48;CI = [2.46 - 69.9]) and consumption of red meat > three times per week [aOR = 7.33;(1.49 - 36)] were the risk factors considered significant for breast cancer. Conclusion: Age > 50 years and red meat consumption are independent risk factors for breast cancer at the Yaoundé General Hospital and at the Yaoundé Gyneco-Obstetric and Pediatric Hospital.展开更多
Introduction: The SARS-COV-2 virus has been responsible for a health crisis in pregnancy, causing severe acute respiratory distress syndrome. Materno-foetal complications can be observed. Taking into account the mater...Introduction: The SARS-COV-2 virus has been responsible for a health crisis in pregnancy, causing severe acute respiratory distress syndrome. Materno-foetal complications can be observed. Taking into account the materno-foetal risks associated with COVID-19 infection in pregnant women and the low sample size of the first publication in Cameroon, we considered it necessary to conduct an in-depth study on the maternal and foetal prognosis of this condition in pregnant women in three hospitals in Douala. Materials and Methods: We conducted a cross-sectional survey with retrospective data collection in the three state tertiary and reference hospitals in Douala (DGOPH, DGH and DLH) from November 1, 2021 to April 30 2022 after obtaining ethical and administrative clearances. All records of COVID-19 pregnant women confirmed by reverse transcription polymerase chain reaction (RT PCR) or COVID-19 rapid diagnostic test (COVID RDT) were included. The survey form contained socio-demographic data, clinical and para-clinical characteristics, management and materno-foetal outcome. SPSS.26 and Microsoft Excel 2016 software were used to analyze the data, and a logistic regression model was used to look for associations between the variables. Results: We found in total 96 files that met our inclusion criteria. The most represented sector of activity was the unemployed (44.46%). Patients with a secondary level of education constituted the majority with 47% (45). The main comorbidity found was diabetes (27.2%). The most frequent symptom was fever, found in 87 patients (90.1%). In our series, a chest CT scan was performed in 50 patients. Caesarean section was the most common mode of delivery (58.3%). We recorded 15.6% of maternal deaths, mainly in patients admitted to intensive care. Factors associated with maternal death were: Maternal diabetes, high LDH and D-dimer levels, and 75% lung involvement on chest CT scan. Oxygen saturation > 94% on admission was a protective factor. Regarding fetal and neonatal outcomes, we registered 30.展开更多
Introduction: The COVID-19 pandemic has led to a massive influx of patients with suspected or confirmed flu to hospitals, paradoxically leading to a decrease in the attendance for some services. This study aspired to ...Introduction: The COVID-19 pandemic has led to a massive influx of patients with suspected or confirmed flu to hospitals, paradoxically leading to a decrease in the attendance for some services. This study aspired to assess the impact of the COVID-19 pandemic on the attendance of patients at the Radiology and Medical Imaging Department of a tertiary hospital in Douala, Cameroon. Materials and Methods: This was an observational, retrospective and descriptive hospital-based study. Data on patient attendance was extracted from the medical records at the Radiology Unit of Douala Gyneco-Obstetric and Pediatric Hospital (DGOPH) between the 1<sup>st</sup> of March 2019 and the 30<sup>th</sup> of August 2021. Results: There was a drop in the number of sonographies and conventional radiographies by 25.73% and 18.26% respectively during the peaks pandemic period of 2020 compared to the preceding pre-pandemic era (2019). There was a recovery in 2021 as the numbers increased. Computed tomography studies increased by 40.65% during the peak pandemic period of 2020. Conclusion: This study enables us to understand the health-seeking behavior during the COVID-19 pandemic. The increase in CT utilization during the peak period of the pandemic nevertheless required caution in order to ensure safety and to promote rational cost-effective utilization.展开更多
<strong>Introduction: </strong>Pregnancy is a physiologic state associated with decreased immunity, and the use of medical imaging modalities with ionizing radiation must be justified as potential benefits...<strong>Introduction: </strong>Pregnancy is a physiologic state associated with decreased immunity, and the use of medical imaging modalities with ionizing radiation must be justified as potential benefits must outweigh the risk of any harm. However, in the wake of SARS-CoV-2 virus pandemic, chest computed tomography (CT) is necessary to assess the severity of the disease. The objective of this study was to compare the chest CT findings of pregnant and non-pregnant women with SARS-CoV-2 viral pneumonia at a tertiary hospital setting. <strong>Materials and Methods: </strong>This was a cross-sectional, retrospective, descriptive study of admission records of pregnant and non-pregnant patients aged 15 - 49 years during a three (3) months period (April-July 2020) in DGOPH. Logistic regression was used to search for predictors of lung involvement during COVID-19. <strong>Results:</strong> A total of 31 patient files were studied of which 9 (29%) were those of pregnant women. The pregnant women mostly had a combination of lung ground-glass opacities and consolidation on CT compared to the non-pregnant women (7 out of 9 cases, 77.8%, vs. 6 out of 22 cases, 22.7%;p = 0.01). The group of pregnant women had more than 3 affected lobes (50.0% vs. 22.7%, p = 0.04) with a middle lobe predilection (77.8% vs. 31.8%, p = 0.02). CT predictors of COVID-19 pneumonia in the group of pregnant women after the multivariable logistic regression analysis were the presence of nodules (aOR = 13.9;95% CI: 1.25 - 134.2;p = 0.032) and linear bands of interlobular septal thickening (aOR = 17.8;95% CI: 1.46 - 217.6;p = 0.024). <strong>Conclusion: </strong>In this study, the chest CT of pregnant women with COVID-19 pneumonia revealed mostly a combination of findings compared to non-pregnant women, with more affected lobes. These findings suggest the likelihood of a greater CT severity of COVID-19 pneumonia among pregnant women and therefore the need for timely and appropriate management.展开更多
Saharan Africa (SSA) contributes 29% of the global unsafe abortions with 62% of abortion-related deaths. This is due to restrictive abortion laws, low quality post abortion care (PAC) and inadequate access to effectiv...Saharan Africa (SSA) contributes 29% of the global unsafe abortions with 62% of abortion-related deaths. This is due to restrictive abortion laws, low quality post abortion care (PAC) and inadequate access to effective modern contraception. The overall objective was to review current literature on PAC in SSA and make recommendations for improvement especially in Cameroon. A literature review was conducted on PAC in SSA published </span><span style="font-family:Verdana;">during</span><span style="font-family:Verdana;"> 2000-2018. The following databases were searched</span><span style="font-family:Verdana;">:</span><span style="font-family:Verdana;"> MEDLINE, POPLINE, COCHRANE Library, African Index Medicus and GOOGLE Scholar. Thirty articles were reviewed from 16 countries ranging from observational studies to systematic reviews with meta-analysis. Major outcomes: 1) Manual vacuum aspiration (MVA) and misoprostol are equally safe and effective. 2) There is comparable</span><span style="font-family:""> </span><span style="font-family:Verdana;">effectiveness between physicians and trained mid-level cadres in PAC management. 3) PAC contraception uptake was increased when offered immediately before patient leaves the facility. 4) Gaps to PAC service use include inadequate access, low quality care and less adolescent-friendly environment. Task shifting of PAC to trained mid-level staff, decentralization of medical PAC using misoprostol, offering post abortion counselling and contraception to clients before leaving the health facility, encouraging linkage and provider-community partnership in PAC and reinforcement of advocacy for less restrictive abortion laws in Cameroon are recommended.展开更多
文摘Background: Cervical cancer (CC) is one of the most frequent cancers and the leading cause of death from gynecological cancer in Low and middle income countries, Cameroon inclusive. Surgery is the primary treatment modality when the disease is diagnosed at early stage. Radical hysterectomy in cervical cancer has not been evaluated in recent years in Cameroon. The purpose of this study is thus to evaluate the epidemiological and clinical features and short term outcomes of patients who underwent surgery. Patients and methods: This retrospective study was conducted at the Douala Gynaeco-obstetric and Pediatric Hospital and the Douala General Hospital. Cervical cancer patients who underwent Radical hysterectomy between January 2015 and December 2020 were included. A pre-established data collection tool was used to record socio-demographic, clinical and outcomes information from patients’ files;additional outcome information was obtained from phone calls. Descriptive analysis was done using the SPSS version 26. Bivariate analysis was used to determine associations between disease and patients characteristics and occurrence of adverse postoperative outcome. P value of 0.05 was considered. Results: Sixty one patients were enrolled. Their ages ranged from 33 to 74 years with a mean age of 51.95 ± 10.29 years. Over 85% of women were married, 65.57% were unemployed and 86.88% were multiparous. Only 28% had never done cervical cancer screening. Most patients had stage IB1 to IB2 stage disease (57.1%). Less than 9% underwent radical hysterectomy and 8 of those (13.11%) suffered intraoperative complications. Twenty-five patients (40.98%) presented immediate and short term complications. There was no significant association between the disease or patients’ characteristics and adverse outcomes. Conclusion: Cervical cancer patients are relatively young in our settings and only 9% of them reach the hospital at early stage. Postoperative adverse outcomes rate is higher than that reported in the literature. Sensitization on s
文摘<strong>Introduction:</strong><span><span><span style="font-family:""><span style="font-family:Verdana;"> Breast cancer remains a public health problem due to its sever</span><span style="font-family:Verdana;">ity and because it is the leading cause of death from cancer</span></span></span></span><span style="font-family:Verdana;"><span style="font-family:Verdana;"><span style="font-family:Verdana;">s</span></span></span><span style="font-family:Verdana;"><span style="font-family:Verdana;"><span style="font-family:Verdana;"> in women </span></span></span><span><span><span style="font-family:""><span style="font-family:Verdana;">worldwide as well as in Cameroon. Our objective was to study the diagnostic and </span><span style="font-family:Verdana;">therapeutic options that patients followed for breast cancer choose in</span><span style="font-family:Verdana;"> Yaound</span></span></span></span><span style="font-family:Verdana;"><span style="font-family:Verdana;"><span style="font-family:Verdana;">e</span></span></span><span><span><span style="font-family:""><span style="font-family:Verdana;">. </span><b><span style="font-family:Verdana;">Method:</span></b><span style="font-family:Verdana;"> This was an analytical cross-sectional study with prospective data collection among patients followed for breast cancer at two referral hospitals in Yaound</span></span></span></span><span style="font-family:Verdana;"><span style="font-family:Verdana;"><span style="font-family:Verdana;">e</span></span></span><span style="font-family:Verdana;"><span style="font-family:Verdana;"><span style="font-family:Verdana;"> from February 1, 2019 to August 31, 2019. Data collected were recorded and analyzed using R application version 3.5.0.</span></span></span><span style="font-family:Verdana;"><span style="font-family:Verdana;"><span style="font-family:Verdana;">,</span></span></span><span style="font-family:Verdana;"><span style="font-family:Verdana;"><span style="font-family:Verdana;"> p values < 0.05 w</span></span></span><span style="f
文摘<strong>Background:</strong><span><span><span style="font-family:""><span style="font-family:Verdana;"> Children and adolescent mortality remains a public health concern in developing countries. This study aimed to describe risk factors and aetiologies of mortality among children and young adolescents at a tertiary hospital in the town of Douala, Cameroon. </span><b><span style="font-family:Verdana;">Methods:</span></b><span style="font-family:Verdana;"> We carried out a retrospective cohort study from January 1</span><sup><span style="font-family:Verdana;">st</span></sup><span style="font-family:Verdana;"> to May 31</span><sup><span style="font-family:Verdana;">st</span></sup><span style="font-family:Verdana;">, 2019 among deceased patients aged 1 month to 15 years admitted to the paediatric ward of the Gynaeco-Obstetric and Paediatric Hospital. Data of interest were collected and analysed. </span><b><span style="font-family:Verdana;">Results:</span></b><span style="font-family:Verdana;"> Out of 3088 children admitted, 123 death cases were recorded. The overall hospital mortality rate was 3.98%. Females accounted for 51% of the deceased patients. Fever was the main reason for consultation. Severe malaria was the most common diagnosis. In univariate logistic regression analysis, factors associated with mortality included hyperthermia (OR = 0.24;95% CI 0.80</span></span></span></span><span><span><span style="font-family:""> </span></span></span><span style="font-family:Verdana;"><span style="font-family:Verdana;"><span style="font-family:Verdana;">-</span></span></span><span><span><span style="font-family:""> </span></span></span><span><span><span style="font-family:""><span style="font-family:Verdana;">1.33;</span><i><span style="font-family:Verdana;">p</span></i><span style="font-family:Verdana;"> = 0.012), coma/impaired consciousness (OR = 0.30;95% CI 0.10</span></span></span></span><span><span><span style="font-family:""> </span></span></span><span style="font-family:Verdana;"><span style="font-family:Verdana;
文摘<strong>Introduction:</strong><span style="font-family:""><span style="font-family:Verdana;"> The first case of the novel coronavirus (COVID-19) pandemic in Cameroon was confirmed on March 6, 2020. Though widely considered that pregnant women are more susceptible to respiratory tract infections, the available body of literature on the effect of COVID-19 on pregnancy outcomes is shy from being conclusive. In Cameroon, the Douala Gyneco-Obstetric and Pediatric Hospital (DGOPH) was one of the main frontline tertiary health facilities for the management of severe forms of the disease. After four months of managing COVID-19 cases in the general population and especially in pregnant women at the DGOPH, we decided to take a stop, analyze our findings from the patients managed in order to drive future policies and clinical practices via informed decisions. </span><b><span style="font-family:Verdana;">Overall objective: </span></b><span style="font-family:Verdana;">To describe and understand the clinical burden of patients managed for COVID</span></span><span style="font-family:Verdana;">-</span><span style="font-family:""><span style="font-family:Verdana;">19 in pregnancy or post-partum at the DGOPH.</span><b><span style="font-family:Verdana;"> Methodology:</span></b><span style="font-family:Verdana;"> Cross</span></span><span style="font-family:Verdana;">-</span><span style="font-family:""><span style="font-family:Verdana;">sectional and descriptive study covering four months—March 24</span><sup><span style="font-family:Verdana;">th</span></sup><span style="font-family:Verdana;"> to July 24</span><sup><span style="font-family:Verdana;">th</span></sup><span style="font-family:Verdana;"> 2020 at DGOPH. Using a pretested questionnaire, we systematically enrolled all patients who fulfilled the inclusion criteria, with analysis done using proportions from an excel spreadsheet.</span><b><span style="font-family:Verdana;"> Results: </span></b><span style="font-family:Verdana;">A total of 18 on the 301 pregnant women consulte
文摘Introduction: Breast cancer is the most common cancer and the first cause of cancer-related deaths among women in Cameroon. The aim of the study was to investigate its risk factors for breast cancer at two University Teaching Hospitals in Yaoundé. Methodology: A case-control study was conducted for 5 months, from February 25th to July 25th 2015, at the Gynecology unit of the Yaoundé Gyneco-Obstetric and Pediatric Hospital (YGOPH) and the Medical Oncology unit of the Yaoundé General Hospital (YGH). One hundred and five patients with breast cancer (cases) were compared to 210 women who did not have breast cancer (controls). SPSS Version 18.0.0 software was used to analyze the data with a statistical significance considered at P-value 50 years (P three times per week (P = 0.002;OR = 2.14;CI = [1.33 - 3.45]), palm oil consumption > two times per week (P = 0.001;OR = 2.38;CI = [1.4 - 4.1]). After multivariate analysis, age > 50 years (aOR = 41.48;CI = [2.46 - 69.9]) and consumption of red meat > three times per week [aOR = 7.33;(1.49 - 36)] were the risk factors considered significant for breast cancer. Conclusion: Age > 50 years and red meat consumption are independent risk factors for breast cancer at the Yaoundé General Hospital and at the Yaoundé Gyneco-Obstetric and Pediatric Hospital.
文摘Introduction: The SARS-COV-2 virus has been responsible for a health crisis in pregnancy, causing severe acute respiratory distress syndrome. Materno-foetal complications can be observed. Taking into account the materno-foetal risks associated with COVID-19 infection in pregnant women and the low sample size of the first publication in Cameroon, we considered it necessary to conduct an in-depth study on the maternal and foetal prognosis of this condition in pregnant women in three hospitals in Douala. Materials and Methods: We conducted a cross-sectional survey with retrospective data collection in the three state tertiary and reference hospitals in Douala (DGOPH, DGH and DLH) from November 1, 2021 to April 30 2022 after obtaining ethical and administrative clearances. All records of COVID-19 pregnant women confirmed by reverse transcription polymerase chain reaction (RT PCR) or COVID-19 rapid diagnostic test (COVID RDT) were included. The survey form contained socio-demographic data, clinical and para-clinical characteristics, management and materno-foetal outcome. SPSS.26 and Microsoft Excel 2016 software were used to analyze the data, and a logistic regression model was used to look for associations between the variables. Results: We found in total 96 files that met our inclusion criteria. The most represented sector of activity was the unemployed (44.46%). Patients with a secondary level of education constituted the majority with 47% (45). The main comorbidity found was diabetes (27.2%). The most frequent symptom was fever, found in 87 patients (90.1%). In our series, a chest CT scan was performed in 50 patients. Caesarean section was the most common mode of delivery (58.3%). We recorded 15.6% of maternal deaths, mainly in patients admitted to intensive care. Factors associated with maternal death were: Maternal diabetes, high LDH and D-dimer levels, and 75% lung involvement on chest CT scan. Oxygen saturation > 94% on admission was a protective factor. Regarding fetal and neonatal outcomes, we registered 30.
文摘Introduction: The COVID-19 pandemic has led to a massive influx of patients with suspected or confirmed flu to hospitals, paradoxically leading to a decrease in the attendance for some services. This study aspired to assess the impact of the COVID-19 pandemic on the attendance of patients at the Radiology and Medical Imaging Department of a tertiary hospital in Douala, Cameroon. Materials and Methods: This was an observational, retrospective and descriptive hospital-based study. Data on patient attendance was extracted from the medical records at the Radiology Unit of Douala Gyneco-Obstetric and Pediatric Hospital (DGOPH) between the 1<sup>st</sup> of March 2019 and the 30<sup>th</sup> of August 2021. Results: There was a drop in the number of sonographies and conventional radiographies by 25.73% and 18.26% respectively during the peaks pandemic period of 2020 compared to the preceding pre-pandemic era (2019). There was a recovery in 2021 as the numbers increased. Computed tomography studies increased by 40.65% during the peak pandemic period of 2020. Conclusion: This study enables us to understand the health-seeking behavior during the COVID-19 pandemic. The increase in CT utilization during the peak period of the pandemic nevertheless required caution in order to ensure safety and to promote rational cost-effective utilization.
文摘<strong>Introduction: </strong>Pregnancy is a physiologic state associated with decreased immunity, and the use of medical imaging modalities with ionizing radiation must be justified as potential benefits must outweigh the risk of any harm. However, in the wake of SARS-CoV-2 virus pandemic, chest computed tomography (CT) is necessary to assess the severity of the disease. The objective of this study was to compare the chest CT findings of pregnant and non-pregnant women with SARS-CoV-2 viral pneumonia at a tertiary hospital setting. <strong>Materials and Methods: </strong>This was a cross-sectional, retrospective, descriptive study of admission records of pregnant and non-pregnant patients aged 15 - 49 years during a three (3) months period (April-July 2020) in DGOPH. Logistic regression was used to search for predictors of lung involvement during COVID-19. <strong>Results:</strong> A total of 31 patient files were studied of which 9 (29%) were those of pregnant women. The pregnant women mostly had a combination of lung ground-glass opacities and consolidation on CT compared to the non-pregnant women (7 out of 9 cases, 77.8%, vs. 6 out of 22 cases, 22.7%;p = 0.01). The group of pregnant women had more than 3 affected lobes (50.0% vs. 22.7%, p = 0.04) with a middle lobe predilection (77.8% vs. 31.8%, p = 0.02). CT predictors of COVID-19 pneumonia in the group of pregnant women after the multivariable logistic regression analysis were the presence of nodules (aOR = 13.9;95% CI: 1.25 - 134.2;p = 0.032) and linear bands of interlobular septal thickening (aOR = 17.8;95% CI: 1.46 - 217.6;p = 0.024). <strong>Conclusion: </strong>In this study, the chest CT of pregnant women with COVID-19 pneumonia revealed mostly a combination of findings compared to non-pregnant women, with more affected lobes. These findings suggest the likelihood of a greater CT severity of COVID-19 pneumonia among pregnant women and therefore the need for timely and appropriate management.
文摘Saharan Africa (SSA) contributes 29% of the global unsafe abortions with 62% of abortion-related deaths. This is due to restrictive abortion laws, low quality post abortion care (PAC) and inadequate access to effective modern contraception. The overall objective was to review current literature on PAC in SSA and make recommendations for improvement especially in Cameroon. A literature review was conducted on PAC in SSA published </span><span style="font-family:Verdana;">during</span><span style="font-family:Verdana;"> 2000-2018. The following databases were searched</span><span style="font-family:Verdana;">:</span><span style="font-family:Verdana;"> MEDLINE, POPLINE, COCHRANE Library, African Index Medicus and GOOGLE Scholar. Thirty articles were reviewed from 16 countries ranging from observational studies to systematic reviews with meta-analysis. Major outcomes: 1) Manual vacuum aspiration (MVA) and misoprostol are equally safe and effective. 2) There is comparable</span><span style="font-family:""> </span><span style="font-family:Verdana;">effectiveness between physicians and trained mid-level cadres in PAC management. 3) PAC contraception uptake was increased when offered immediately before patient leaves the facility. 4) Gaps to PAC service use include inadequate access, low quality care and less adolescent-friendly environment. Task shifting of PAC to trained mid-level staff, decentralization of medical PAC using misoprostol, offering post abortion counselling and contraception to clients before leaving the health facility, encouraging linkage and provider-community partnership in PAC and reinforcement of advocacy for less restrictive abortion laws in Cameroon are recommended.
