Impact of Plasmodial Parasitaemia on the Quality of Erythrocyte Concentrates Distributed at the Blood Transfusion Center of the Regional Hospital of Bafoussam-Cameroon

Background: Blood transfusion is a potential route for transmission of Plasmodium, which lives mainly in erythrocytes and can survive low temperatures. Therefore, this study was undertaken in order to determine the plasmodial  parasitaemia in labile blood products for the evaluation of the quality of erythrocyte concentrates (EC) distributed at the Blood Transfusion Center of the Bafoussam Regional Hospital. Material and methods: This was an analytical cross-sectional study carried out between March 15 and May 31, 2021 on 101 EC. The data collection was done on one hand by using a questionnaire and the technical sheet for the evaluation of the quality of the EC compared to the Cameroonian reference and on the other hand, by the analysis of the blood taken from the donors. This analysis was made through the examinations of RDT malaria, Thick blood smear, Thin blood smear, measurement of the hemoglobin level thanks to the HemoCue and hemogram using the Urit 3000 automaton. Data analysis was done using Epi info and SPSS software. Results: The prevalence of malaria among donors of the Bafoussam Regional Hospital Blood Bank was 4.41%. By considering the three parameters simultaneously, a compliance rate of 34.65% was obtained. A positive, although non-significant, correlation was established between plasmodial parasitaemia and EC quality. Conclusion: The importance of quality control of ECs is essential, sofar as the parasitaemia of plasmodial is not negligible with one bag of erythrocyte concentrate out of three non-compliant

Survie globale des patients âgés de moins de 65 ans, porteurs du myélome multiple sous chimiothérapie à l’Hôpital Général de Douala

English Title: The overall survival of patients aged less than 65 years old with multiple myeloma under chemotherapy at the General Hospital of DoualaEnglish AbstractAbstract: the multiple myeloma or Khaler’s disease is a malignant hemopathy who falls under both old and young person. It is the second malignant hemopathy after the lymphomas. It is responsible for about 1% of death’s cancer and about 19% of death’s malignant hemopathy. The purpose of this study was to determine the overall survival of patients aged less than 65 years with multiple myeloma undergoing chemotherapy over a 10 years period at the General Hospital of Douala.Method: it was a retrospective, descriptive and analytical study conducted in the department of internal medicine (Hematology unit) going on 05 December 2016 to June 30 2017. The sample method was non-random, with consecutive and exhaustive type of recruitment of patient records obedient of the inclusion criteria. The analyzed variables were demographic, paraclinical, therapeutic and evolutionary. The survival curves were plotted using the Kapplan Meier method. The survival comparisons were made by the Log Rank test and the p-values interpreted at a threshold of 5%.Results: 51 patient’s records from 19 to 65 years old were eligible. The average age of patients was from 54,22 years to 8,608years. There was a slight female predominance with a sex ratio of 0, 21. The monoclonal gamma peak was in 81,81% of cases objective. The immunoglobulin G was predominant and the Kappa light evolution was found in 81, 1% of cases. Our patients were predominately on stage 3 of Durie and Salmon (70, 58%) and 50% at stage 3 of the ISS score. Our patients have been treated using VMCP, MP and MPT protocols. The VMCP was the most used protocol on the first and second line (58, 82% and 54, 16%) with a very good practical response rate of 60% in the first line. The second-line protocol choice and compliance were statistically significant on treatment response (p=0,02; p=0,026 respectively). For an average follow-up of 24,06 months (range: 1-120), the median SG was 38 months. The percentage of SG in 5 years was 26,90%. The median progression-free survival was 69 months. The survival with progression was 84, 36 months. The factors associated with the overall survival in our level were the protocol choice and the percentage of hemoglobin. (p= 0,04; p=0,08 respectively).Conclusion: the patients are diagnosed at an advanced stage. The health care, the good compliance and the use of news molecules could improve the survival of our patients. This group of patients benefit from the therapeutic intensification by an auto implantation not yet available in our context.Keywords: Mylemo of the young subject, survival, General Hospital in Doual

Late presentation to HIV/AIDS care at the Douala general hospital, Cameroon: its associated factors, and consequences

Abstract Background The introduction of anti-retroviral treatment (ART) has significantly reduced mortality and morbidity associated with HIV/AIDS. While treatment at early stages of the disease is related to a better prognosis, late presentation (LP) to care is harmful to the infected person, the society and is more costly. We aimed to describe late presentation to HIV care, its associated factors and consequences in patients followed up in a tertiary hospital in Cameroon. Methods We retrospectively assessed patients’ files between 1996 and 2014 at the Douala general hospital (DGH) HIV treatment centre. Late presentation (LP) to HIV care was defined as a CD4+ T cell count< 350 cells/mm3 or advanced clinical stages of the disease (WHO stages 3/4) at first presentation for care. We used logistic regression to study factors associated with late presentation and assessed occurrence of opportunistic infections and mortality at 3, 6 and 12 months after presentation to care. Results Of 1866 files studied, mean age was 40 (SD: 10) years, median CD4+ T cell count was 147 (IQR: 63–270) cells/mm3, 58.2% were at HIV clinical stages 3 and 4. The prevalence of late presentation to HIV care was 89.7% (95% CI: 88.2–91.0%) and remained above 80% from 1996 to 2014. Circumstances of diagnosis: prevention of mother to child transmission program/blood donation (OR = 0.16, 95% CI 0.10–0.29), having a positive partner (OR = 0.16, 95%CI = 0.10–0.26), and routine screening (OR = 0.13, 95%CI = 0.10–0.19) reduced the odds of presenting late compared to clinical suspicion. Students had lower odds of presenting late compared to people who had an employment (OR = 0.50, 95%CI = 0.26–0.98). Calendar time OR = 1.64, 95% CI = 1.08–2.48 for ≥2010 vs. < 2005) increased the odds of late presentation. Mortality and opportunistic infections prevalence remained significantly higher in late presenters at 3, 6 and 12 months than in early presenters. Conclusion Late presentation to HIV care is very high at the DGH and is related to poor outcome. More screening and sensitization campaigns should be carried out in the population to diagnose the disease at an earlier stage

Leucémie aigüe de l’adulte au Cameroun: aspects épidémiologique, clinique et biologique

Introduction: Les leucémies aigues constituent un groupe hétérogène de proliférations malignes du tissu hématopoïétique caractérisé par une expansion clonale de cellules immatures ou blastes. C’est une hémopathie maligne rare, qui présente une forte mortalité dans les pays en voie de développement avec une croissance au cours de ces dernières années.Objectif: le but de ce travail était de déterminer les profils épidémiologique, clinique, et biologique de la leucémie aigüe de l’adulte au Cameroun.Méthodes: Cette étude était multicentrique, rétrospective, descriptive et concernait trois structures hospitalières du Cameroun. Nous avons sélectionné dans les archives des trois hôpitaux (hôpital général de Douala ou HGD ; hôpital central de Yaoundé ou HCY ; centre hospitalier universitaire de Yaoundé ou CHUY), les dossiers des patients porteurs de leucémie aigüe sur une période de 10 ans. Etaient inclus les dossiers d’archives des patients âgés de plus de 18 ans, ayant une leucémie aigüe documentée. Les variables étudiées étaient : les données épidémiologiques, le motif de consultation, les signes cliniques, le type de leucémie et les données du bilan hématologique.Résultats: Au total, 70 dossiers de patients ont été retenus. L’incidence de la leucémie aigüe en 2016 était de 0,36/100000 habitants, l’âge moyen était de 43,77 ± 1,89 ans. La tranche d’âge de 39-49 ans était la plus représentée (25,7%). Il existait une prédominance masculine avec un sexe ratio H/F de 1,87. Les patients référés représentaient 68% des cas, l’anémie représentait le principal motif de consultation dans 29% des cas. Parmi les signes cliniques, la fièvre, le saignement spontané ont été retrouvé dans respectivement 89% et 50% des cas. Dans 37% des cas, il y’avait des adénopathies. La moyenne des globules blancs était de 27020 ± 46432,210 /mm³, celle de l’hémoglobine de 7,2 ± 0,447 g/dl (LAL) et les plaquettes 54500 ± 28493,371 /mm³. On observait en moyenne 76 ± 6,989 % de blastes. La LAM a été retrouvée dans 68% des cas et la LM2 dans 16 % des cas.Conclusion: La leucémie aigüe de l’adulte est une pathologie encore méconnue, les patients arrivent à un stade avancé de la maladie avec l’hyperthermie et l’anémie. Le plateau technique limité et la difficulté financière ne permettent pas d’avoir le bilan optimal dans notre contexte.Mots-clés: Leucémie aigüe, épidémiologie, clinique, biologie, CamerounEnglish Title: Acute adult leukemia in Cameroon: epidemiological, clinical and biological aspectsEnglish AbstractIntroduction: Acute leukemia is a heterogeneous group of malignant proliferations of hematopoietic tissue characterized by clonal expansion of immature or blast cells. It is a rare hematological malignancy, which presents a high mortality in the developing countries with a growth in recent years.Purpose: The purpose of this work was to determine the epidemiological, clinical, and biological profiles of acute adult leukemia in Cameroon.Methods: This study was a multicenter, retrospective and descriptive and involved three hospitals in Cameroon. We collected information from the archives of the 3 hospitals (general hospital of Douala or HGD, central hospital of Yaounde or HCY, University Hospital of Yaoundé or CHUY), the files of the patients carrying acute leukemia over a period of 10 years. Included were archival records of patients over 18 years of age with documented acute leukemia. The variables studied were: epidemiological data, reason for consultation, clinical signs, type of leukemia and hematological assessment data.Results: A total of 70 patient files were selected. The incidence of acute leukemia in 2016 was 0.36 / 100,000 inhabitants; the average age was 43.77 ± 1.89 years. The age group 39-49 was the most represented (25.7%). There was a male predominance with a sex ratio H / F of 1.87. Referred patients represented 68% of cases, anemia was the main reason for consultation in 29% of cases. Among clinical signs, fever and spontaneous bleeding accounted for 89% and 50% of cases, respectively. In 37% of cases, there was lymphadenopathy. Mean white blood cells were 27020 ± 46432.210 / mm³, hemoglobin 7.2 ± 0.447 g/ dl (LAL) and platelets 54500 ± 28493.371 / mm³. The blasts accounted for 76 ± 6.989%. AML was found in 68% of cases and LM2 in 16% of cases.Conclusion: Acute adult leukemia is a still unknown pathology; patients arrive at an advanced stage of the disease with hyperthermia and anemia. The limited technical platform and the financial difficulty do not allow an optimal balance in our context.Keywords: Acute leukemia, epidemiology, clinical, biology, Cameroo

Additional file 1: of Chronic complications and quality of life of patients living with sickle cell disease and receiving care in three hospitals in Cameroon: a cross-sectional study

Questionnaire. (DOCX 21 kb