Recherche et Titrage des Hémolysines Anti-A et Anti-B Chez Les Femmes en periode du postpartum immédiat au Centre Hospitalier et Universitaire de Yaoundé

But de l’étudeLes hémolysines apparaissent suite à une immunisation ABO et peuvent causer, à titre élevé, une hémolyse chez le receveur de sang ou chez le nouveau-né. Cette étude avait pour but de déterminer la fréquence et le titre des hémolysines anti-A et anti-B chez les femmes en période du post-partum immédiat ainsi que les facteurs de risque associés au Centre Hospitalier et Universitaire de Yaoundé.Patients et MéthodesUne étude descriptive et transversale a été menée chez les mères et leurs nouveau-nés. Les groupes sanguins ABO ont été déterminés chez tous les participants. Chez les mères, la recherche et titrage des hémolysines a été faite par la technique d’hémolyse en présence ducomplément à 37°C pendant 30 minutes. Les Khi carrés de Pearson et de Mentel-Haenszel ont servis pour des tests statistiques. Une valeur p<0,05 représentait une différence statistiquement significative. RésultatsSur 251 cas, après groupage sanguin ABO, Cinq mères de groupe AB ont été exclues et 246 retenues pour la recherche d’hémolysines. La fréquence de l’incompatibilité foeto-maternelle ABO était de 22,76% et celle des hémolysines était de 26,8%. Les hémolysines anti-A, anti-B et anti-AB ont été retrouvées respectivement dans 15%, 18,7% et 6,9% des cas. Les titres les plus élevés étaient ceux d’hémolysines anti-A. Les facteurs de risque comprenaient le mariage (p=0,01), la multiparité (p=0,02), le groupe sanguin des mères (p=0,02) et l’incompatibilité foeto-maternelle ABO (p<0,001).ConclusionCes résultats suggèrent la nécessité d’introduire la recherche systématique des hémolysines parmi les tests de suivi immunohématologique des femmes enceintes camerounaises.Mots Clés: Hémolysines anti-A et anti-A, Incompatibilité foeto-maternelle ABO, Maladie hémolytique du nouveau-né, Période du post-partum immédiate

Musculoskeletal Presentation of Multiple Myeloma at General Hospital Douala, Cameroon

Background: very little is known about musculoskeletal features of multiple myeloma (MM) in Africa.Objectives: To describe the musculoskeletalfeatures of multiple myeloma at presentation in a tertiary health care centre in sub-Saharan Africa.Design: A Cross sectional observational study.Setting: The Douala General Hospital, Cameroon from 2007 to 2013.Subjects: A patient was said to have MM according the current international consensus criteria for diagnosis and staging of MM. Patients with monoclonal gammopathy of undetermined significance, solitary plamocytoma and other haematologic malignancies were excluded.Results: A total of 62 patients were diagnosed with multiple myeloma, 63% were female. Mean age was 57± 12,1 (19-81) years. Musculoskeletal presentation included spine bone pains (75.6%); vertebral fracture with spinal cord compression in 46.8 %. Other clinical features at presentation included anaemia (70.93%), and nephropathy (17.74%). The average percentage of bone marrow plasmacytosis at diagnosis was 33% and Immunoglobulin G was found in 86% of patients. Sixty three per cent of patients were diagnosed at stage III of the disease.Conclusion: Presence of bone pain and anaemia should alert the clinician to investigate along the lines of multiple myeloma. Majority of the patients have osteolytic lesions and pathologic fractures at the time of diagnosis

Anemia in patients on chronic hemodialysis in Cameroon: prevalence, characteristics and management in low resources setting

Background: Anemia is a common complication of chronic kidney disease. We investigated the prevalence, characteristics and management of anemia in patients on chronic hemodialysis and assessed the response to blood-transfusion based management in Cameroon.Methods: This was a cohort study of five months’ duration (August-December 2008) conducted at the Yaoundé General Hospital’s hemodialysis center, involving 95 patients (67 men, 70.5%) on chronic hemodialysis by a native arterio-venous fistula. A monthly evaluation included full blood counts, number of pints of red cell concentrates transfused, and vital status.Results: At baseline, 75 (79%) patients had anemia which was microcytic and hypochromic in 32 (43%). Anemia was corrected in 67 (70.5%) patients using blood transfusion only, while 28 (29.5%) patients were receiving erythropoietin (11 regularly, 39%). Only 77.2% of 342 pints (median 3.0, range 0-17 per patients) of red cell concentrates prescribed were effectively received during the follow-up at an unacceptably high cost to patients and families. Mean hemoglobin and mean corpuscular hemoglobin levels remained stable during follow-up, while mean corpuscular volume increased. Erythropoietin treatment was the main determinant of favorable trajectories of hematological markers.Conclusions: Patients on chronic hemodialysis have predominantly microcytic hypochromic anemia, with limited capacity for correction using blood transfusion.Key words: Anemia; Blood transfusion; End stage renal disease; Hemodialysis; Sub-Saharan Afric

Effect of Bridelia ferruginea (Euphorbiaceae) Leaf Extract on Sucrose-induced Glucose Intolerance in Rats

Purpose: To evaluate the hypoglycaemic effect of the methanol extract of Bridelia ferruginea leaves (MEBF) on sucrose-induced glucose intolerance in rats.Methods: Male Wistar rats, aged 6 - 7 weeks and weighing 140 - 160 g, were used. The animals were fed standard rat chow supplemented with 35%, 50% or 65% sucrose for 8 weeks while control animals were fed standard rat chow. The hypoglycaemic effect of MEBF and the reference drugs (tolbutamide, and metformin) in the animals were evaluated following a single dose of these drugs and 6-day treatment. Plasma lipid profiles were also determined.Results: Fasting glucose concentrations ranged from 45 to 70 mg/dl, and the increase was significant in the sucrose diet groups from week 1. After 2 weeks on these diets, oral glucose tolerance test showed that sucrose feeding significantly impaired glucose homeostasis 1 and 2 hours after a glucose challenge (76.7 „b 2.0 versus 86.4 „b 8.5 and 66.7 „b 1.4 versus 75.5 „b 3.0, respectively). Fasting blood sugar levels were significantly (p < 0.05) reduced in sucrose-induced, glucose-intolerant rats after a singledose of MEBF. The extract also significantly reduced blood glucose (from 167 ¡Ó 23 mg/dL to 126 ¡Ó 5 mg/dL), serum total cholesterol (from 161 ¡Ó 20 mg/dL to 93 ¡Ó 10 mg/dL) and triglyceride levels (281 ¡Ó 25mg/dL to 228 ¡Ó 5 mg/dL) in glucose intolerant rats after 6 days of treatment.Conclusion: The methanol leaf extract of Bridelia ferruginea exhibited hypoglycaemic effect in glucoseintolerant rats

Clinical and biological profiles of prospective blood donors at the Yaoundé Central Hospital and the Yaoundé University Teaching Hospital: Profils cliniques et biologiques des futurs donneurs de sang à l'hôpital central de Yaoundé et au CHU de Yaoundé

Assessing the profiles of prospective donors could help develop strategies to improve blood safety in our context. This study aimed to evaluate the clinical and biological profiles of prospective Cameroonian blood donors. To attain this objective, we carried out a cross-sectional and analytical study on all prospective blood donors that presented at the Yaoundé Central Hospital (HCY) and Yaoundé University Teaching Hospital (YUTH) blood banks from January 2017 to May 2017. After obtaining participants’ consent, we collected information from them, examined them, and collected five-milliliter blood samples from each of them. These blood samples were used to test for HIV, HBV, HCV, and Syphilis. A total of 247 prospective donors were retained for the study. We found that group “O” was noted in 50.9% of the participants and 97% were Rhesus-positive. Of the four main transfusion transmissible infections (TTIs) screened, 57 participants tested positive for at least one; nine were tested positive for HIV, twenty-six for HBV, ten for HCV, and sixteen for Syphilis. Co-infection was noted in four of the participants with two of them testing positive for both HIV and HBV, one for both HIV and HCV, and one for both HCV and Syphilis. On univariate analysis, a significant association was found between lymph nodes measuring more than 2 cm and the presence of a TTI. The presence of lymph nodes measuring more than 2 cm was associated with the presence of a TTI. L'évaluation des profils des donneurs potentiels pourrait aider à développer des stratégies pour améliorer la sécurité du sang dans notre contexte. Cette étude visait à évaluer les profils cliniques et biologiques des candidats donneurs de sang camerounais. Pour atteindre cet objectif, nous avons mené une étude transversale et analytique sur tous les candidats donneurs de sang qui se sont présentés aux banques de sang du Centre Hospitalier Central de Yaoundé (HCY) et du CHU de Yaoundé (YUTH) de janvier 2017 à mai 2017. Après obtention des participants ' consentement, nous avons recueilli des informations auprès d'eux, les avons examinés et prélevé des échantillons de sang de cinq millilitres sur chacun d'eux. Ces échantillons de sang ont été utilisés pour tester le VIH, le VHB, le VHC et la syphilis. Au total, 247 donneurs potentiels ont été retenus pour l'étude. Nous avons constaté que le groupe « O » était noté chez 50,9 % des participants et 97 % étaient rhésus positifs. Sur les quatre principales infections transmissibles par transfusion (ITT) dépistées, 57 participants ont été testés positifs pour au moins une ; neuf ont été testés positifs pour le VIH, vingt-six pour le VHB, dix pour le VHC et seize pour la syphilis. Une co-infection a été notée chez quatre des participants, dont deux étaient positifs à la fois pour le VIH et le VHB, un pour le VIH et le VHC et un pour le VHC et la syphilis. En analyse univariée, une association significative a été retrouvée entre les ganglions mesurant plus de 2 cm et la présence d'un ITT. La présence de ganglions mesurant plus de 2 cm était associée à la présence d'un ITT

The effects of ProAlgaZyme novel algae infusion on metabolic syndrome and markers of cardiovascular health

<p>Abstract</p> <p>Background</p> <p>Metabolic Syndrome, or Syndrome X, is characterized by a set of metabolic and lipid imbalances that greatly increases the risk of developing diabetes and cardiovascular disease. The syndrome is highly prevalent in the United States and worldwide, and treatments are in high demand. ProAlgaZyme, a novel and proprietary freshwater algae infusion in purified water, has been the subject of several animal studies and has demonstrated low toxicity even with chronic administration at elevated doses. The infusion has been used historically for the treatment of several inflammatory and immune disorders in humans and is considered well-tolerated. Here, the infusion is evaluated for its effects on the cardiovascular risk factors present in metabolic syndrome in a randomized double-blind placebo-controlled study involving 60 overweight and obese persons, ages 25–60. All participants received four daily oral doses (1 fl oz) of ProAlgaZyme (N = 22) or water placebo (N = 30) for a total of 10 weeks, and were encouraged to maintain their normal levels of physical activity. Blood sampling and anthropometric measurements were taken at the beginning of the study period and after 4, 8 and 10 weeks of treatment. Eight participants did not complete the study.</p> <p>Results</p> <p>ProAlgaZyme brought about statistically significant (p < 0.001) reductions in the following: weight, body fat, total cholesterol, LDL-cholesterol, triglycerides, C-reactive protein and fasting blood glucose levels, accompanied by a significant (p < 0.001) increase in HDL-cholesterol levels over the 10-week study period. The infusion was well-tolerated and no side effects were noted.</p> <p>Conclusion</p> <p>ProAlgaZyme (4 fl oz daily) consumption resulted in significant reductions in weight and blood glucose levels, while significantly improving serum lipid profiles and reducing markers of inflammation, thus improving cardiovascular risk factors in overweight and obese subjects over a course of 10 weeks with an absence of adverse side effects.</p> <p>Trial Registration</p> <p>US ClinicalTrials.gov NCT00489333</p

Prevalence of diabetes mellitus and impaired glucose tolerance in a rural community of Angola

<p>Abstract</p> <p>Background</p> <p>To determine the prevalence of diabetes mellitus (DM) and impaired glucose tolerance (IGT) in a rural community (Bengo) of Angola.</p> <p>Methods</p> <p>A random sample of 421 subjects aged 30 to 69 years (30% men and 70% women) was selected from three villages of Bengo province. This cross-sectional home survey was conducted using a sampling design of stage conglomerates. First, clinical and anthropometric data were obtained and fasting capillary glucose level was determined. Subjects who screened positive (fasting capillary glucose ≥ 100 mg/dl and < 200 mg/dl) and each sixth consecutive subject who screened negative (fasting capillary glucose < 100 mg/dl) were submitted to the second phase of survey, consisting of the 75-g oral glucose tolerance test. Data was analyzed by the use of SAS statistical software.</p> <p>Results</p> <p>The prevalence rates of diabetes mellitus and IGT were 2.8% and 8.1%, respectively. The age group with the highest prevalence of diabetes was 60 to 69 years (42%). Impaired glucose tolerance prevalence was 38% in the 40 to 49 year age group and it increased with age, considering that the 50 to 59 and 60 to 69 year age groups as a whole represent 50% of all subjects with impaired glucose tolerance. The prevalence of diabetes mellitus did not differ significantly between men (3.2%) and women (2.7%) (p = 0.47). On the other hand, the prevalence of impaired glucose tolerance among women showed almost twice that found in men (9.1% vs. 5.6%, respectively). Overweight was present in 66.7% of the individuals with diabetes mellitus and 26.5% of individuals with impaired glucose tolerance showed overweight or obesity.</p> <p>Conclusions</p> <p>Although the prevalence of diabetes mellitus was low, the prevalence of impaired glucose tolerance is considered to be within an intermediary range, suggesting a future increase in the frequency of diabetes in this population.</p

The Effect of Spirulina platensis versus Soybean on Insulin Resistance in HIV-Infected Patients: A Randomized Pilot Study

HIV-infected patients develop abnormalities of glucose metabolism due to the virus and antiretroviral drugs. Spirulina and soybean are nutritional supplements that are cheap, accessible in our community and affect glucose metabolism. We carried out a randomized study to assess the effect of Spirulina platensis versus soybean as a food supplement on HIV/HAART-associated insulin resistance (IR) in 33 insulin-resistant HIV-infected patients. The study lasted for two months at the National Obesity Centre of Cameroon. Insulin resistance was measured using the short insulin tolerance test. Physical activity and diet did not change over the study duration. On-treatment analysis was used to analyze data. The Mann-Whitney U test, the Students T test and the Chi square test were used as appropriate. Curve gradients were analyzed using ANCOVA. Seventeen subjects were randomized to spirulina and 16 to soybean. Each received 19 g of supplement daily. The follow up rate was 65% vs. 100% for spirulina and soybean groups, respectively, and both groups were comparable at baseline. After eight weeks, insulin sensitivity (IS) increased by 224.7% vs. 60% in the spirulina and soybean groups respectively (p < 0.001). One hundred per cent vs. 69% of subjects on spirulina versus soybean, respectively, improved their IS (p = 0.049) with a 1.45 (1.05–2.02) chance of improving insulin sensitivity on spirulina. This pilot study suggests that insulin sensitivity in HIV patients improves more when spirulina rather than soybean is used as a nutritional supplement. Trial registration: ClinicalTrials.gov identifier NCT01141777

Overweight and obesity in children aged 3-13 years in urban Cameroon:a cross-sectional study of prevalence and association with socio-economic status

BACKGROUND: Childhood overweight/obesity is increasing rapidly in developing countries. There is a need to provide more evidence on its burden in sub-Saharan Africa, and to identify associated factors in order to set preventive measures. We aimed to determine the prevalence of overweight/obesity and assess its association with the socioeconomic status in nursery and primary school children in urban Cameroon. METHODS: In this cross-sectional study, we included by multi-staged cluster random sampling 1343 children from high (HSES, n = 673) and low (LSES, n = 670) socioeconomic status schools in Douala. Parent/child demographic data were collected, and children’s anthropometric parameters were measured using validated methods. The World Health Organization body mass index-for-age reference curves were used. RESULTS: The prevalence of overweight/obesity was 12.5% (13.2% in girls, 11.8% in boys). The risk of overweight/obesity was 2.40 (95% CI 1.70, 3.40) higher in HSES children compared to LSES after adjusting for age and gender. However this association was attenuated to 1.18 (95% CI 0.59, 2.35) once adjustment had been made for a range of potential confounders. CONCLUSIONS: Overweight/obesity is relatively common in sub-Saharan African children and prevalence is associated with HSES. However, this association may be mediated by sweet drink consumption, passive means of travel to school and not doing sport at school. We suggest that these potentially modifiable behaviors may be effective targets for obesity prevention. Further studies should specifically focus on unhealthy behaviors that mediate overweight/obesity as well as other non communicable diseases in children. ELECTRONIC SUPPLEMENTARY MATERIAL: The online version of this article (doi:10.1186/s40608-017-0146-4) contains supplementary material, which is available to authorized users

Sexual behavior of HIV-positive women in Cameroon

This study aimed at describing the sexual behavior of HIV-positive women in Cameroon. In a cross-sectional study, 282 HIV-infected women were enrolled in 3 HIV-treatment clinics in Cameroon. Of the 282 participants, 257 had been diagnosed with HIV for more than 6 months. Approximately half (46.8%) of these 257 women reported no sex partners in the 6 months before the study; 42.9% had 1 partner; and 1.5% had more than 1 partner. There was a significant decrease in the number of partners, new partners, and an increase in condom use with these partners following HIV diagnosis (P value < .05). However, more than half (55.2%) of the sexually active participants reported inconsistent or no condom use during sexual intercourse. Although HIV-positive women tend to adopt less risky behavior after HIV diagnosis, a substantial proportion of sexually active ones still have risky behaviors. Reinforcing risk reduction programs for these women is imperative