Factors associated with adolescent school girl’s pregnancy in Kumbo East Health District North West region Cameroon

Introduction: teenage pregnancy is a social problem in Cameroon in general and in Kumbo East in particular. This results in physical, psychological and socio-economic consequences on the teenage mother, family and the society as a whole. In spite of studies and interventions that have been and are being implemented, the prevalence of unplanned teenage pregnancy in Kumbo East Health District is still high, suggesting that more efforts are required to achieve effective preventive measures. The aim of this study was to determine factors associated with adolescent school girl's pregnancy in Kumbo East health district. Methods: a cross-sectional descriptive study design was used and a simple random sampling technique was used to select 293 respondents aged 15 to 19year. The district hospital antenatal clinics and the Health Centres were selected. Data was obtained from 292 participants under the age of 20 years who were willing using a questionnaire administered through face-to-face interviews. Results: the study show a high prevalence (60.75%) of teenage pregnancy in the sampled antenatal clinics of Kumbo East Health District attributable to inadequate considerations given to factors associated with school girl's pregnancy. This study has indicated that the age of teenager at first pregnancy, low contraceptive use, socio-economic status and physical violence are factors that are greatly associated with teenage pregnancy. Among the reasons contributing to the low use of contraceptives are: sexually activity, lack of knowledge, fear of side effects, including sterility, condoms disappearing in the womb and inequality of power with sexual partners. This study shows that teenagers obtain information mainly from school (53%) and relatives (20%). Conclusion: the use of contraceptive alone may not reduce teenage pregnancy, however double method is very effective but addressing the impact of poverty on teenagers, empowering them on their rights and information in order to make right choices is very important

Kaolin consumption and outcome of surgery in women: a comparative study of 263 operations at the Yaoundé Gyneco-Obstetric and Pediatric Hospital

Background: Kaolin consumption is common in our sub-Saharan Africa. The objective of this study was to assess the effects of kaolin consumption on the outcome of surgery in women.Methods: It was a cohort study comparing the occurrence of complications during labor among 263 consecutively recruited women who underwent gynecologic or obstetric surgery at the Yaoundé Gyneco-Obstetric and Pediatric Hospital, Cameroon. Sixty of them (22.8%) declared kaolin consumption before surgery and 203 (77.2%) who denied having consumed kaolin before surgery.Results: Kaolin consumption was found to predispose to postsurgical infections (RR=3.03; IC=1.82-5.05).Conclusions: Kaolin geophagia should be identified before surgery to prevent related postsurgical infections. A systematic ban of kaolin consumption is also recommended.

Physiopathology and Management of Uterine Fibroids

Uterine fibroid is the most encountered benign tumour in women of reproductive age. It causes spontaneous abortions, missed abortions, painful red degeneration or infarction of the fibroids, abnormal foetal presentation, obstructed labour, and an increased likelihood of premature deliveries, caesarean deliveries, postpartum haemorrhage in pregnancy, whereas, in the non-pregnant women it is associated an irregular menstrual cycle sometimes associated with heavy menstrual bleeding, infertility, constipation, urinary incontinence, and leiosarcoma transformation. Till date is pathophysiology and management both in the non-pregnant and pregnant woman have not been well described. In this chapter, we present contemporary evidence to help elucidate this enigma

Predictive factors for perinatal death in nuchal cord cases: a case control study

Background: Nuchal cord is a common occurrence at delivery and it is known to be associated with birth asphyxia and perinatal death. The objective of this study was to identify the predictive factors of perinatal death in the presence of nuchal cord.Methods: This was a case-control study carried out during the period from October 1st 2014 to April 30th 2015 in three hospitals of Yaoundé, Cameroon, involving 204 parturients whose babies presented with a nuchal cord at delivery.Results: After multivariate analysis, independent predictive factors for perinatal death in nuchal cord cases were: post-term (OR=209.70; CI= 3.09-14212.66), antepartum hemorrhage (OR=18.21; CI=1.47-224.78), fetal heart rate abnormalities during labor (OR=11.74; CI=1.33-103.37), augmentation of labor (OR=24.04; CI=1.85-311.52), second stage of labor lasting more than 30 minutes (OR=172.50; CI=20.60-1444.20) and tight nuchal cord at birth (OR=16.29; CI=2.07-127.87).Conclusions: We recommend the identification of predictive factors for perinatal death in cases of known or suspected nuchal cord in order to consider cesarean section to prevent adverse fetal outcomes

Assessment of labor and delivery in pregnant women on sulfadoxine-pyrimethamine regimen in Yaoundé gynaeco-obstetric and paediatric hospital: a comparative study of 313 cases

Background: Malaria is still a major public health problem in sub-Saharan Africa. The aim was to determine the prevalence of malaria infection at the onset of labor and the resulting complications.Methods: We carried out a five-month cross-sectional study at the Yaoundé Gyneco-Obstetric and Pediatric Hospital.  We used results from the rapid diagnostic test (RDT) to compare two groups of pregnant women admitted into the labor room. Women who tested positive were assigned to the exposed group versus negative to the non-exposed group. Independent factors associated with malaria infection were investigated by the logistic regression method.Results: Up to 79.6% (249/313) of women had received the sulfadoxin-pyrimethamine regimen with 32.9% (82/249) receiving at least 3 doses.  Malaria infection was detected in 32.2% (101/313) of women. Only 14.9% (15/101) of the exposed group had received 3 doses of SP versus 31.6% (67/212) of the non-exposed group. After univariate analysis, malaria infection at the onset of labor was associated to premature rupture of membranes (OR=1.39; CI=1.01-1.94), fever during labor (OR=73.37; CI=64.80-681.95), non-reassuring fetal status (OR=2.08; CI=1.36-3.20), low birth weight (OR=1.65; CI=1.23-4.13), prematurity (OR=2.79; CI=2.12-367), a poor Apgar score at the 1st minute and postpartum fever (OR=3.19; CI=2.56-4.00). Linear logistic regression indicated that the occurrence of fever during labor (aOR=63.09), and low Apgar score at the first minute (aOR=6.27) remained significant and malaria infection was significantly associated to the single marital status (aOR=2.56) and a history of malaria during the current pregnancy (aOR=2.56).Conclusions: Systematic RDTs is thus recommended at the last antenatal consultation to avoid identified complications

Descriptive analysis of 192 cases of breast cancer occurring before age 40 in Yaounde, Cameroon

Background: Breast cancer is today a global health problem. With 1,671,149 new cases diagnosed in 2012, it is the most common female cancer in the world and accounts for 11.9% of all cancers and it affects more people than prostate cancer. In 2008, The United States statistics showed that, for all cancer that affect women before 40 years, more than 40% of them concerned the breast. The aim of this study was to describe the clinical, histopathological and therapeutic aspects of breast cancer in women under 40 years of age in Yaoundé.Methods: This was a retrospective study with data collected from 192 medical case files of women treated over a period of 12 years, from January 2004 to December 2015 at the Yaounde General Hospital and the Yaounde Gyneco-Obstetric and Pediatric Hospital. Microsoft Epi Info version 3.4.5 and SPSS version 20.0 softwares were used for data analysis.Results: From 2004 to 2015, 1489 cases of breast cancer were treated in both hospitals. Of these, 462 women were less than 40 years old, representing a proportion of 31.0%. The mean age at diagnosis was 33.5±5.0 years and 17.7% of women had a family history of breast cancer. The average time before an initial consultation was 6.7±6.6 months.  Most cases were classified as T4 (46.1%). The most common histological type was ductal carcinoma (87.4%). Grades SBR II and SBR III were predominant (76.4%). Axillary dissection (64.4%) and neoadjuvant chemotherapy (43.9%) were the main therapeutic modalities. The overall survival rate at 5 years was 51.2%. Five-year survival rates with no local recurrence and no metastatic occurrence were 35.8% and 43.2% respectively.Conclusions: Breast cancer largely affects women under the age of 40 and is often discovered late, at an advanced stage. The prognosis appears poor. Only screening could facilitate diagnosis at an early stage of the disease for better outcomes

Risk factors for ectopic pregnancy in a population of Cameroonian women: A case-control study.

ObjectiveTo identify the risk factors for ectopic pregnancy (EP) in a population of Cameroonian women.Sample and methodsWe performed a matched case-control study; 88 women with diagnosed EP (cases), and 176 women with first trimester intrauterine pregnancy (IUP) (controls), who underwent questionnaires. Odds Ratio (OR) and 95% confidence intervals (CIs) were calculated and adjusted for potential confounding factors via multivariate logistic regression analysis.ResultsOf the fifteen identified risk factors, 4 were independently associated with increased odds of EP: prior pelvic inflammatory disease (PID) (adjusted odds ratio [AOR] 13.18; 95% CI 6.19-27.42), followed by current use of levonorgestrel-only pills for emergency contraception (LNG-EC) (AOR 10.15; 95% CI 2.21-46.56), previous use of depot medroxyprogesterone acetate (DMPA) (AOR 3.01; 95% CI 1.04-8.69) and smoking at the time of conception (AOR 2.68; 95% CI 1.12-6.40).ConclusionThe present study confirms the wide variety of EP's risk factors. Moreover, some new findings including current use of LNG-EC, previous use of DMPA, smoking at the time of conception are noteworthy. Thus, in our limited resources country where prevention remains the cornerstone for reducing EP chances of occurrence, clinicians should do enough counselling, especially to women with known risk factors. The necessity to facilitate access to more equipment to enable early diagnosis of EP is very crucial and should be seriously considered, in order to reduce the burden of EP in Cameroonian women

Disparities in cervical cancer screening programs in Cameroon: a scoping review of facilitators and barriers to implementation and uptake of screening

Abstract Background Cervical cancer is the fourth most common cancer worldwide. Organized screening has achieved significant reductions in cervical cancer incidence and mortality in many high-income countries (HICs). But the gap between HICs and low-and-middle-income countries (LMICs) is still substantial as the highest burden of the disease is in LMICs. Cameroon is a LMIC, where cervical cancer is the leading cause of cancer-related deaths among women, only 3–5% of eligible women have been screened and there is no effective national cervical cancer prevention program. Objective(s) Identify facilitators and barriers to the implementation and uptake of existing cervical cancer screening programs in Cameroon to inform the implementation of a comprehensive national program. Methods We conducted a scoping review using the Preferred Reporting Items for Systematic Reviews and Meta-analysis, extension for Scoping Reviews (PRISMA-ScR). Google Scholar and five electronic databases (PubMed, CINAHL, Embase, Cochrane library and Web of Science) were searched systematically from 2012 to 2022. Articles on cervical cancer screening programs in Cameroon were eligible for inclusion. Two reviewers independently screened search results and extracted relevant data. Results A total of 182 articles were identified using our search strategy, and 20 were included. There was scarcity of publications from the North, Adamawa, East and South regions of Cameroon. Barriers and facilitators found were presented using the World Health Organisation framework for health systems. Cross-cutting barriers were: (1) the lack of a national training curriculum for screening providers with no elaborate, harmonized screening and treatment algorithm for cervical precancers; and (2) women’s lack of information about cervical cancer screening activities. Conversely, provision of screening services at a low or no cost to women in some programs and the feasibility of using novel point of care screening methods like the Human Papillomavirus DNA test were identified as facilitators. Conclusion This scoping review indicates that there are knowledge and research gaps concerning the state of cervical cancer screening services in some regions of Cameroon. Moreover, it underlines the need for comprehensive cancer control policies and practices integrating all six-health system building blocks to reduce disparities between regions, and rural versus urban areas in Cameroon