Malnutrition in patients admitted to the medical wards of the Douala General Hospital: a cross-sectional study

Abstract Background Malnutrition is common in acutely ill patients occurring in 30–50% of hospitalized patients. Awareness and screening for malnutrition is lacking in most health institutions in sub-Saharan Africa. This study aimed at screening for malnutrition using anthropometric and laboratory indices in patients admitted to the internal medicine wards. Methods A cross-sectional study. We screened for malnutrition in 251 consecutive patients admitted from January to March 2013 in the internal medicine wards. Malnutrition defined as body mass index (BMI) less than 18.5 kg/m2 and/or mid upper arm circumference (MUAC) less than 22 cm in women and 23 cm in men. Weight loss greater than 10% in the last 6 months prior to admission, relevant laboratory data, diagnosis at discharge and length of hospital stay (LOS) were also recorded. Results Mean age was 47 (SD 16) years. 52.6% were male. Mean BMI was 24.44 (SD 5.79) kg/m2 and MUAC was 27.8 (SD 5.0) cm. Median LOS was 7 (IQR 5–12) days. 42.4% of patients reported weight loss greater than 10% in the 6 months before hospitalization. MUAC and BMI correlated significantly (r = 0.78; p < 0.0001) and malnutrition by the two methods showed moderate agreement (κ = 0.56; p < 0.0001). Using the two methods in combination, the prevalence of malnutrition was 19.34% (35/251). Blood albumin and hemoglobin were significantly lower in malnourished patients. Malnourished patients had a significantly longer LOS (p = 0.019) when compared to those with no malnutrition. Malnutrition was most common amongst patients with malignancy. Conclusion Malnutrition is common in patients admitted to the medical wards of the Douala General Hospital. Nutritional screening and assessment should be integrated in the care package of all admitted patients

Characteristics of anti-hepatitis C virus antibody-positive patients in a hospital setting in Douala, Cameroon

Introduction: Hepatitis C virus (HCV) infection is a major public health problem, especially in resource-limited settings where many patients are diagnosed at the stage of complications. In Cameroon, where HCV is endemic, little is known about the clinical, biological, and virological profile of HCV-infected patients. Methods: A clinical case note review of all patients positive for antibodies against HCV diagnosed at the gastroenterology outpatient clinic of the Douala General Hospital, Cameroon, from January 2008 to December 2014, was performed. Results: A total of 524 patients were included in the study, 53% of whom were female. The mean age was 56 ± 13 years. A history of blood transfusion and a history of scarification were the most common potential risk factors for HCV exposure, as found in 16% and 13% of the study population, respectively. Current alcohol use was found in 24% of patients. Co-infection with hepatitis B virus and HIV was 3.6% and 3.4%, respectively. Among the patients, 39% had no complaint at diagnosis; only 16% were diagnosed through a routine medical checkup. Clinically, the most common finding was hepatomegaly (26.1% of patients). Transaminases above the upper limit of normal were found in 55.2% of patients, particularly those aged >57 years (p = 0.001). Genotypes 1 (43.95%), 2 (25.11%), and 4 (28.25%) were the most common. Liver cirrhosis was present in 11% of patients and hepatocellular carcinoma in 4%, the latter being more common in males (p < 0.001) and in those aged >57 years (p = 0.03). Conclusions: In the gastroenterology clinic of Douala General Hospital, while almost 40% of patients who were anti-HCV antibody-positive were asymptomatic and diagnosed fortuitously, some already presented complications, including cirrhosis and hepatocellular carcinoma. There is an urgent need to put in place programs to increase awareness and diagnosis of HCV infection and to develop extensive and targeted anti-HCV treatment guidelines to improve the management of these patients in Cameroon

Apport de l’endoscopie digestive haute dans le dépistage des lésions oesogastroduodénales dans un pays à ressources limitées

Introduction: L’endoscopie oesogastroduodénale a permis d’améliorer le diagnostic et la prise en charge des lésions oeso-gastroduodénales dans le monde. Notre travail avait pour but de déterminer l’apport diagnostique dans les cancers de l’endoscopie digestive haute à l’hôpital général de Douala. Méthodologie: Nous avons mené une étude transversale analytique, d’une période de 75 mois allant du 1er Janvier 2009 au 31 mars 2015. Ce travail avait pour cadre l’unité d’endoscopie digestive de l’hôpital général de Douala au Cameroun. Les paramètres étudiés étaient sociodémographiques, cliniques et endoscopiques. Résultats: Nous avons colligés 3529 comptes rendus d’endoscopies. La moyenne d’âge était de 43,4 ± 18,2ans. Les biopsies réalisées mettaient en évidence Helicobacter pylori dans 60,4% des cas. Pour ce qui est de l’histologique, l’endoscopie avait une sensibilité (Se) de 81% et une Valeur Prédictive Positive (VPP) de 86% pour la détection les lésions tumorales. Conclusion: L’endoscopie digestive haute permet de révéler la présence de lésions oeso-gastroduodénales, avec un réel bénéfice pour les lésions tumorales. Mots clés: endoscopie digestive haute, Helicobacter pylori, lésion, tumeur, Douala - Cameroun English Title: Contribution of upper gastrointestinal endoscopy in the detection of oesogastroduodenal lesions in a resource-limited country English Abstract Background: Worldwide, oesogastroduodenal endoscopy has improved the diagnosis and management of oeso-gastroduodenal lesions. Our work was aimed at determining the diagnostic contribution in cancers of upper gastrointestinal endoscopy at the Douala General Hospital. Methodology: We conducted a cross-sectional and analytical study, over a period of 75 months from January 1, 2009 to March 31, 2015. This work was conducted at the digestive endoscopy unit of Douala General Hospital in Cameroon. The parameters studied were sociodemographic, clinical and endoscopic. Results: We collected 3529 endoscopy reports. The mean age was 43.4 ± 18.2 years. The biopsies carried out showed Helicobacter pylori in 60.4% of the cases. In terms of histology, endoscopy had a sensitivity (Se) of 81% and a Positive Predictive Value (PPV) of 86% for the detection of tumor lesions. Conclusion: Upper gastrointestinal endoscopy reveals the presence of oeso-gastroduodenal lesions, with a real benefit for tumor lesions. Keywords: upper digestive endoscopy, Helicobacter pylori, lesion, tumor, Douala - Cameroo