A Critical Review on HIV/AIDS and Wound Care

Wound infections in AIDS patients increase discomfort, prolong hospital stay, render an additional burden upon an already debilitated patient and weaken the immune system further. Treatment must relate to the aetiology of the wound and take into account the patients underlying health problems. The treatment of wounds in HIV-AIDS patients is not different from the standard treatment. There are wound -related criteria for selecting the appropriate types of dressing. The best dressing for postoperative wound healing by secondary intention is unknown. Continuing wound evaluation and the appraisal of what dressing is useful for the type of wound and stage of healing is the basis of optimum wound care Optimum wound care, emotional support; health education will enhance both the emotional and physical wellbeing of the HIV-AIDS patient.Key words: Human immunodeficiency virus (HIV), Acquired immune deficiency syndrome (AIDS), wound infection, delayed wound healing, optimum wound care, dressing types, nutrition, and pain contro

Prevalence and components of metabolic syndrome in HIV-infected patients at the Tiko Central Clinic and Cottage Hospital in Cameroon

Background: HAART and HIV related metabolic syndrome (MS) is associated with increased cardiovascular risk in aging HIV patients. This study was aimed at comparing the prevalence of MS between HIV-infected patients on HAART and apparently healthy HIV-uninfected individuals and identifying key MS components in these groups of subjects.Methods: This was a hospital-based case-control study. The cases were HIV sero-positive individuals on HAART for at least 6 months and controls were HIV sero-negative individuals.Results: 74/135 (54.8%) participants were females amongst which 53/75 (70.7%) and 21/60 (35%) were in the test and control groups respectively. The prevalence of MS was insignificantly higher in HIV-infected patients on HAART than in control subjects according to the IDF (22.7% versus 20%, p=0.834) and NCEP ATP III criteria (18.7% versus 18.3%, p=1.000) respectively. The most prevalent components of MS in HIV-infected patients on HAART were low HDL-c (100%), abdominal obesity (IDF: 68%, ATP III: 32%), and hypertension (28%). Multivariate analysis of MS components in HIV-infected patients on HAART revealed that hypertension (OR: 15.996, 95% CI: 3.385-75.585; p≤0.001) and high blood glucose (OR: 10.760, 95% CI: 1.642-70.505; p=0.013) were associated with MS. Significantly more HIV-infected females were seen with abdominal obesity than HIV-infected males (86.8% versus 4.5%, p≤0.001).Conclusions: Abdominal obesity is a driving component of MS in HIV-infected patients particularly among females and hypertension is a prevalent and predictor component of MS among HIV patients

Epidemiological Studies on Proteeae Isolates from Clinical Specimens in the Laquintinie Hospital in Douala, Cameroon

The tribe Proteeae is a group of bacteria within the family Enterobacteriaceae and is responsible for most cases of nosocomial infections in hospital settings. The objective of this study was to determine the prevalence of members of Proteeae from clinical specimens in Laquintinie hospital in Douala. Specimens were collected from patients and screened for Proteeae using standard microbiological and biochemical methods (API 20 Enterobacteriaceae gallery). Of the 3414 clinical specimens made of 2712 urine, 264 blood, 243 CSF and 195 wounds and burns, 1136 (33.3%) yielded a positive bacterial growth, of which 230 (20.2%) were Gram positive and 906 (79.7%) were Gram negative. 164 (14.4%) isolates were identified as members of Proteeae of which 110 (67.1%) were from urine, 37( 22.6%) from wounds and burns, 10(6.1%) from blood and 7( 4.3%) from CSF. Speciation of the Proteeae isolates showed that 111 (67.7%) were Proteus mirabilis, 21(12.8%) Proteus vulgaris, 11 (6.7%) Providencia alcalifaciens, 6 (3.6%) Providencia stuartii, 4 (2.4%) Morganella morganii and 5 (3.0%) Proteus penneri and Providencia rettgeri. There was a significant difference between the type of clinical specimens and the age of patients (X2 = 52.623 p<0.05). Most Proteeae isolates where susceptible to imipemen, ceftazidine, chloramphenicol, gentamicin, nalidixic acid, ofloxacin and amikacin. These findings have significant clinical and epidemiological implications.Keywords: Proteeae isolates, Clinical specimens, Laquintinie Hospital, Cameroo

Prevalence of onchocerciasis in the Fundong Health District, Cameroon after 6 years of continuous community-directed treatment with ivermectin

Introduction: Onchocerciasis is one of the leading infectious causes of blindness affecting over 37 million people of which 99% are in Africa. The purpose of this study was to determine the prevalence of onchocerciasis in the Fundong Health District, a locality where community-directed treatment with ivermectin has been carried out for 6 consecutive years. Methods: Questionnaires covering participants’ identity, Rapid Epidemiological Assessment (REA) for onchocerciasis and parasitological parameters were distributed to participants. Skin snip (SS) was collected for laboratory investigation. Results: A total of 404 participants belonging to 200 households were randomly selected from the Fundong Health District, of which 134 (33.2%) were males and 270(66.8%) were females, 14 (3.5%) had microfilaredermia and 15(3.7%) had nodules. There was no significant difference in the prevalence of microfilaredermia with respect to age of participants (X2=2.749, P=0.601). There was however a statistically significant difference in the prevalence of nodule and impaired vision/eye itching (IVIE) with respect to age (X2=24.67, P<0.001). The greatest rate of infection was found among farmers (2.5%) followed by students (0.7%) and businessmen (0.25%). Conclusion: This study shows that the study area is now hypo-endemic for onchocerciasis, following 6 years of continuous treatment with ivermectin. Careful monitoring of onchocerciasis should however be continued to avoid that the area returns to its initial hyper endemicity

Toxoplasma antibodies amongst HIV/AIDS patients attending the University Teaching Hospital Yaounde in Cameroon

Toxoplasmosis is caused by an obligatory intracellular protozoon. It causes a wide range of diseases with toxoplasma encephalitis commonly encountered in HIV/AIDS patients. This work was carried out to determine the seroprevalence of toxoplasma antibodies (IgM and IgG) in HIV/AIDS patients attending the Yaoundé University Teaching Hospital (UTH) in Cameroon. Sera were collected from 133 HIV/AIDS patients at the out-patient department and the ELISA technique was employed serologically to determine toxoplasma antibodies. Of the 133 patients 83 (62.4%) were females and 59 (37.6%) were males; ninety three (69.9%) were positive for toxoplasma antibodies. Fourteen (10.8%) of the 93 of seropositive patients presented with both IgG and IgM-antibodies in their sera while fifty six (42.1%) and 8 (6.0%) were only sero-positive for toxoplasma IgG or IgM-antibody respectively This rate of infection was not dependent on the patient’s sex or age (X2=11.49, P>0.05). The data provides enough evidence to conclude that 64.7% of the positive cases were due to reactivated infection.Key words: Toxoplasmosis, HIV/AIDS, Pregnancy, Risk factors, Prevalence, Yaounde, Cameroon.doi: 10.4314/ajcem.v12i3.

Prevalence of septicaemia and antibiotic sensitivity pattern of bacterial isolates at the University Teaching Hospital, Yaoundé, Cameroon

Bloodstream infections are important causes of mortality and morbidity. Rapid empiric antibiotic therapy is often needed. Knowledge of epidemiological data of common pathogens and their antibiotic sensitivity pattern is needed for rapid therapy. This study was aimed at determining the common causes of septicaemia and their antibiotic sensitivity pattern from the University Teaching Hospital, Yaoundé. Blood samples were collected and cultured aerobically. Isolates were identified using bacteriological and biochemical methods and antibiotic sensitivity was done using the Kirby- Bauer disc diffusion method. Results showed that of the 396 patients examined 112 (28.3%) had septicaemia. Children below the age of 15 years constituted the greatest percentage of infected subjects (63.4%) followed by patients aged between 16-30 years (10.7%) (P < 0.05). The highest incidence of septicaemia were from medicine (8.95‰), followed by paediatrics (7.04‰), surgery (6.46 ‰), out-patients (5.79‰), neonatology (5.12‰), obstetrics and gynaecology (5.05‰) and emergency (2.05‰) wards. The overall incidence of septicaemia was 5.79 per 1000 admissions. Gram-positive bacteria were encountered more often than gram negative bacteria (56.2% versus 43.8%,

Epidemiological Significance of the Colonization of Streptococcus Agalactiae in the Anorectum and Endocervix of Non-Parturients in Jos, Nigeria

Knowledge of Group B Streptococcus (GBS) carriage and infections in Africa is very scanty but few cases have been reported in Nigeria in particular. Streptococcus agalactiae has been reported to cause infections and diseases in non-parturients and adults ranging from bacteremia, osteomylitis, arthritis, and endocarditis to breast abscess among others, hence the necessity for this study. Fifty six non-pregnant women of different age groups and social status were screened for GBS in Plateau State Specialist Hospital using the Christie, Atkins and Munch-Petersen (CAMP) and hippurate hydrolysis tests. Two (3.6 %) of the 56 women were positive for GBS. The 2 isolates were all from the anorectum. The endocervix yielded no culture. The antibiogram showed that ampicillin is the drug of choice with all isolates (100%) sensitive to the drug. No statistically significant relationship was observed between the clinical and epidemiological characteristics of the patients and GBS carriage (P&gt;0.05). This survey shows a much lower carriage proportion than that reported in Ibadan, Nigeria from non-parturients.Key words: Streptococcus agalactiae, epidemiology, anorectum, endocervix, non-parturient

Seroepidemiology of Toxoplasmosis in Pregnant Women Attending the University Teaching Hospital in Yaounde, Cameroon

Purpose: The study was carried out to investigate the epidemiology and associated toxoplasmosis predisposing risk factors in Cameroon. Methods: The survey took place at the Yaounde University Teaching Hospital from May to June 2008. Serum samples were collected from 110 pregnant women attending the ante natal clinic using aseptic techniques after obtaining informed consent. The samples were analysed using toxo-lgG immunocomb and toxo-IgM &ldquo;capture&rdquo; ELISA. A structured questionnaire was used to collect information on predisposing risk factors for toxoplamosis from each patient. Data was analysed on Epi-Info using confidence intervals and chi-square statistic test. Results: The average age of the women was 27.9+5.8years and the mean gestational age was 4.1+0.2months. The overall IgG seroprevalence was 65.5% {95% CI: 53.7-71.7%} and that of IgG and IgM co-infection was 2.7%. The seroprevalence was 75% in the first trimester, 60.6% in the second trimester and 50% in the third trimester. No statistically significant relationships were established between anti-toxoplasma IgG and IgM antibodies and abortion history, meat consumption, potable water sources, cat ownership and age. Conclusion: The prevalence of IgG antibodies to Toxoplasma gondii is high and the first trimester in pregnancy carries the highest risk. All pregnant women should be screened for toxoplasmosis and educated on predisposing risk factors during antenatal visits.Keywords: Toxoplasma gondii, Pregnancy, IgG, IgM, Prevalenc

The impact of health education on the prevalence of faecal-orally transmitted parasitic infections among school children in a rural community in Cameroon

Background: Faecal-orally transmitted parasites are those parasites which are spread through faecal contamination of food and drinks. Infections with these parasites are among the most common in the world being responsible for considerable morbidity and mortality, especially in children. This study was carried out to determine the impact of health education on the prevalence of faecal-orally transmitted parasitic infections among primary school children in a typical African rural community. Methods: An intervention study was conducted in two villages in the South-West Region of Cameroon. A total of 370 volunteer pupils aged between 5-15 years were enrolled in the study out of which 208 were from Kake II experimental arm) and 162 from Barombi-Kang (control arm). The research was conducted in two phases. In phase 1, stool samples were collected from all participants and analyzed using the formol-ether concentration technique and health education was given to the pupils in the experimental village but not in the control village. Phase 2 was conducted six months later during which only stool samples were collected and analyzed from both villages. Results: Before health education intervention (phase1) faecal-orally transmitted parasites were present in 106 (50.9%) stool specimens collected in Kake II and in 84 (51.5%) of those collected in Barombi-kang. The difference in prevalence between these two villages was not significant (P&gt;0.05). After health education intervention (phase2), 56 (26.9%) stool specimens were positive for faecal-oral parasite in Kake II and 92 (54.7%) in Barombi-kang, and the difference in prevalence between these two villages was statistically significant (P0.05). The change in the prevalence of infection was significant in Kake II (50.9% vs. 26.9%, P0.05). Hence, health education applied in the experimental village was responsible for the drop in the prevalence observed, especially among pupils infected with Ascaris lumbricoides (24.9% vs. 3.4%, P=0.004) Conclusion: Health education through the framework of schools can be used as a strategy for the control of faecal-orally transmitted parasitic infections among children in African rural communities.Key words: Intestinal parasites, parasitic infections, health education, Cameroo

Electrolyte imbalance in type 2 diabetes: a case study from the West region of Cameroon

Background: Diabetes mellitus remains a global public health challenge despite advances in medicine, with Cameroon harboring about half a million patients. Electrolyte imbalance has been reported to contribute to the complications observed in diabetes. The aim of this study was to investigate electrolyte disturbances in type 2 diabetic (T2D) patients under follow up in two health facilities (Dschang District Hospital and Bafoussam Regional Hospital) of the West Region of Cameroon.Methods: The study involved 200 T2D patients and 50 non-diabetic control subjects. A questionnaire was used to acquire demographic, anthropometric, clinical and psychosocial data. Fasting blood samples were collected for the determination of fasting plasma glucose (FPG), glycated haemoglobin, calcium, potassium and sodium levels. The diabetic population was divided into two and three groups according to their glycated hemoglobin and FPG levels respectively. The Student’s t-test was used to compare mean values between patients and controls, while the chi square test was used to assess for differences between categorical variables. The significance level was set at 5%.Results: Almost all diabetic patients were diagnosed of hypernatremia (98%) versus 70% for the control group (p<0.001). There was no record of hyponatremia. Hypercalcemia was observed in 30% of the diabetic patients and hypocalcemia in 48%. The prevalence of hyperkalemia was comparable between patients and controls, while control subjects tended to be more hypokalemic (p=0.038). For all three electrolytes investigated, more than 70% of the imbalances were observed in patients with hyperglycemia when compared to patients having normal FPG or hypoglycemia.Conclusions: Electrolyte imbalance is common in type 2 diabetic patients from the West Region of Cameroon, especially those presenting with hyperglycemia