GAD-7 and PHQ-9 measurement of perinatal anxiety and depression in women with hypertensive disorders of pregnancy in Yaounde, Cameroon

Background: The aim of the study was to determine the prevalence of perinatal anxiety and depression in women with hypertensive diseases during pregnancy in Yaounde.Methods: Authors carried out a cross-sectional descriptive study over nine months from October 2015 to May 2016, amongst pregnant women with hypertensive pregnancy disorders followed up in three tertiary care centers in Yaounde. Authors collected information from the medical files of selected patients by using a pre-tested and validated questionnaire in the perinatal period. We classified blood pressure values as per the JNC 7 recommendations. Anxiety and mental depression were evaluated for using the Generalized Anxiety Disorder 7-item and the Patient Health Questionnaires-9 respectively. Data analysis was done using CSPro version 6.2 and SPSS version 20.0 software.Results: Authors included 202 patients during the study period. The mean age stood at 25.9± 6.4years (extremes 13-43years). Amongst these, 47.5% were single while 97.5% (197/202) had received at least primary education. Students represented 45.5% (92/202) of women while 102 (50.5%) of them had some form of employment in the public, private or informal sectors. Severe preeclampsia was the most prevalent hypertensive disorder in these women, with 69 (34.2%) developing eclampsia. We found that 79% (161/202) of these patients suffered from anxiety, 67.3% (136/202) were depressive while 61.3% (124/202) had both anxiety and depression.Conclusions: The prevalence of perinatal anxiety and depression in women with hypertensive pregnancy disorders is high. Associated factors must be looked out in order to prevent these situations

Factors associated with breast cancer occurrence before the age of 40 in Yaoundé

Background: In Cameroon, one third of breast cancers concern women less than 40 of age and young age appeared to be an independent predictor of adverse outcome. This study aimed to determine factors associated with the development of breast cancer before the age of 40 in Yaoundé.Methods: A case-control study was conducted for 7 months, from November 1st, 2016 to May 31st, 2017 at the General Hospital and the gyneco-obstetric and Paediatric Hospital of Yaoundé. Study compared the socio-demographic, clinical and lifestyle data of 50 women less than 40 of age with breast cancer (cases) with those of 200 women below 40 of age without breast cancer (controls). Descriptive statistics, bivariate and multivariate logistic regressions were performed to assess the socio-demographic, clinical and lifestyle data. Data were computed using the SPSS version 23.0 software. The significance threshold value was set at 0.05.Results: After multivariate analysis, the factors independently associated with the occurrence of breast cancer before the age of 40 were: age ≥ 30 (aOR = 2.05); family history of breast cancer (aOR = 8.65); parity ≥ 1 (aOR = 2.46); breastfeeding (aOR = 3.39); waist circumference ≥ 88 centimeters (cm) (aOR = 4.38); breast density ≥ 90                      (aOR = 2.89); physical activity ≤ 3 hours/week (aOR = 4.78). Conclusions: Breast cancer in women under 40 is associated with family history, reproductive life and women's lifestyles.  Breastfeeding more than 12 months, having a balanced diet, supplementary screening tests in women with dense breasts and practicing physical activity; would be  effective ways to prevent it in young women

The impact of sexual activity during the third trimester of pregnancy on labor outcome in nulliparous women

Background: In the environment, there’s not enough studies on the effects of sexual activity during pregnancy on labor outcome, especially for nulliparous women. The aim was to assess the effects of sexual activity during the third term of pregnancy on the outcome of labor in nulliparous women.Methods: A prospective cohort study on labor was carried out for 11 months at the labor ward of the Yaoundé gynaeco-obstetric and pediatric Hospital. In this study compared women were exposed to at least one unprotected sexual intercourse with vaginal ejaculation per week during the third trimester of pregnancy (exposed group), to those who had less than one unprotected sexual intercourse per week (non-exposed group).Results: Of the 1123 primiparous women who gave birth within the study period, 426 consented to enroll in the study. Amongst these women, 186 women in the exposed group compared to 240 women in the non-exposed group. Intercourse during pregnancy predisposed on arrival into the labor ward to a Bishop’s score ≥7 (RR = 1.94; CI = 1.63-2.3) and within the course of labor to a spontaneous per vaginal delivery (RR = 1.18; CI = 1.06-1.31) and an active phase duration <6 hours (RR = 1.52; CI = 1.36-1.7). Furthermore, sexual intercourse during pregnancy protected against labor induction (RR = 0.21; CI = 0.12-0.36), dystocia (RR = 0.36; CI =  0.27-0.49), cesarean section (RR = 0.29; CI = 0.15-0.55), episiotomy (RR = 0.56; CI = 0.36-0.87) and an Apgar  score <7 at the first minute of birth (RR = 0.31; CI = 0.14-0.7).Conclusions: Sexual activity during pregnancy improves the prognosis of labor in primiparous women. In the absence of contraindications, consented unprotected heterosexual vaginal intercourse should be promoted in nulliparous women

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

First delivery of a COVID-19 positive patient in Cameroon

Since its appearance in China in December 2019, COVID-19 which is caused by the SARS-CoV-2 virus has become a real global health problem. Pregnant women are not immune to this novel infection, which makes it difficult for proper management of pregnancy and childbirth. Authors present here the first case of childbirth in Cameroon of a 19-year-old adolescent tested positive for COVID-19

GAD-7 and PHQ-9 measurement of perinatal anxiety and depression in women with hypertensive disorders of pregnancy in Yaounde, Cameroon

Background: The aim of the study was to determine the prevalence of perinatal anxiety and depression in women with hypertensive diseases during pregnancy in Yaounde.Methods: Authors carried out a cross-sectional descriptive study over nine months from October 2015 to May 2016, amongst pregnant women with hypertensive pregnancy disorders followed up in three tertiary care centers in Yaounde. Authors collected information from the medical files of selected patients by using a pre-tested and validated questionnaire in the perinatal period. We classified blood pressure values as per the JNC 7 recommendations. Anxiety and mental depression were evaluated for using the Generalized Anxiety Disorder 7-item and the Patient Health Questionnaires-9 respectively. Data analysis was done using CSPro version 6.2 and SPSS version 20.0 software.Results: Authors included 202 patients during the study period. The mean age stood at 25.9± 6.4years (extremes 13-43years). Amongst these, 47.5% were single while 97.5% (197/202) had received at least primary education. Students represented 45.5% (92/202) of women while 102 (50.5%) of them had some form of employment in the public, private or informal sectors. Severe preeclampsia was the most prevalent hypertensive disorder in these women, with 69 (34.2%) developing eclampsia. We found that 79% (161/202) of these patients suffered from anxiety, 67.3% (136/202) were depressive while 61.3% (124/202) had both anxiety and depression.Conclusions: The prevalence of perinatal anxiety and depression in women with hypertensive pregnancy disorders is high. Associated factors must be looked out in order to prevent these situations

Comparative effect of calcium supplementation on the incidence of pre-eclampsia and eclampsia among primigravid women

Background: Pre-eclampsia is a frequent and serious pregnancy complication contributing for the increasing maternal morbi-mortality rates. This study was designed to evaluate the effect of calcium supplementation during pregnancy, on the incidence of pre-eclampsia and eclampsia among primigravid women. Method: In a hospital-based, opened, randomized and controlled clinical trial carried out in the city of Yaounde, 70 women were randomized to either 1.5 g daily calcium supplements (n = 35) or vitamins at the same time (n = 35) from 20 weeks gestation till delivery. Were included all singleton healthy, primigravid women who offered their signed inform consent and were excluded, all women with any chronic condition. Primary outcomes were pre-eclampsia and eclampsia. Results: No significant difference was observed between the two study groups with respect to the baseline characteristics obtained at enrollment. We recorded a sevenfold decrease in the incidence of preeclampsia in the calcium group (RR = 0.26, CI 0.06 &ndash; 0.44, p = 0.024). The onset of pre-eclampsia was delayed 3 weeks in the calcium group. Meanwhile the mean diastolic blood pressure at delivery was of no significant difference (p = 0.126), the mean systolic blood pressure at delivery however, presented a significant difference between both groups (p = 0.009). Conclusion: A 1.5 g daily calcium supplementation of healthy normotensive primigravid women during pregnancy seems to be effective in reducing the incidence of pre-eclampsia.&nbsp

Sexual Risk Behaviour in a Student Population of the University of Yaoundé I, Cameroon

Background: In Cameroon, many young people engage in sexual risk behaviours (SRB) and experiences that can result in unintended health outcomes.Objective: To determine the frequency and type of SRB among adolescents and young adults in the University of Yaounde I (UYI).Patients and Method: We carried out a descriptive cross-sectional study over a 7 months period from December 10th to the 10th June 2019, in a population of students aged between 15-24 years old at the UYI. Socio-demographic and data on sexual behaviors were collected thanks to a pre-tested self-administered survey form through group interview. Statistical analysis was performed using STATA version 13.1.Results: We included 856 students in this study. The sex ratio male/female was 1.5/1. The 15-19 age group was the main represented (57.2%). Students were mainly single (87%) and lived with their families (74%). The prevalence of sexual risk behaviors was 38.0%. Sexual risk behaviors included: unprotected sex (41.2%; 134/325), multiple partners (25.2%; 82/325), early sexual intercourse (16.3%; 53/325), sex frequency ≥ 4/week (14.2%; 46/325), homosexual intercourse (5%; 16/325), anal sex (3%; 10/325) and oral sex (1.2%; 4/325).Conclusion: The prevalence of SRB is high in our setting. There is a need to increase students' awareness of healthy sexual habits in order to ensure safe sex and to prevent Human Immunodeficiency Virus and others sexual transmitted Infections. Key words: sexual risk behaviors, adolescents, students, University, Yaoundé English Title: Comportements sexuels à risque dans une population d’étudiants de l’Université de Yaoundé I Contexte : Au Cameroun, de nombreux jeunes adoptent des comportements sexuels pouvant être délétères pour leur santéObjectif : Nous avons pour objectif de déterminer la fréquence et les types de comportements sexuels des étudiants de l’Université de Yaoundé I.Méthode : Nous avons mené une étude transversale descriptive durant 7 mois, du 10 Décembre au 10 juin 2019 portant sur les étudiants de la Faculté des sciences de l’Université de Yaoundé I. Nous avons étudié les caractéristiques socio-démographiques et les habitudes sexuelles des étudiants des deux sexes âgés de 15 à 24 ans. Les données ont été analysées à l’aide des logiciels STATA version 13.1 et Epi-info version 7.2.2.6.Résultats : Nous avons inclus 856 étudiants. Le sexe ratio homme femme était de 2/3. La tranche d’âge de 15 – 19 ans était majoritaire (57,2%). Les étudiants étaient souvent célibataires (87%) et vivaient en famille (74%). La prévalence des comportements sexuels à risque était de 38,0%. Les comportements sexuels à risque étaient : les rapports sexuels (RS) non protégés (41,2% ; 134/325), le multipartenariat (25,2% ; 82/325), les RS précoces (16,3% ; 53/325), une fréquence de RS ≥4/semaine (14,2% ; 46/325), les RS homosexuels (5,0% ; 16/325), les RS anaux (3% ; 10/325) et la fellation (1,2% ; 4/325).Conclusion : La prévalence des comportements sexuels à risque était élevée. La sensibilisation des étudiants sur les habitudes sexuelles saines est nécessaire pour une sexualité à moindre risque de transmission des infections sexuellement transmissibles et du VIH. Mots clés : comportements sexuels à risque, adolescents, étudiants, université, Yaound

Exploring the effects of peri-partum ingestion of traditional medicine on maternal and foetal outcomes: a prospective cohort study

Abstract Objective In Africa, 80% of women ingest traditional medicine (TM) during pregnancy. Although widely used in Cameroon, no study in has either demonstrated its safety or effectiveness. Hence, we sought to determine the effects of TM ingestions during the peri-partum period on maternal and foetal outcomes. A cohort study was conducted from January to April 2016 in two referral maternity departments of Cameroon. We consecutively enrolled all consenting parturients with gestational age above 28 weeks. We divided them into two groups; exposed and unexposed. The exposure studied was ingestion of TM within 72 h prior to delivery. Variables studied were socio-demographic characteristics, type and frequency of TM ingested and details of labour. Results We enrolled a total of 603 parturients of whom 147 in the exposed group and 456 in the non-exposed group. The most frequently used TM were honey and Triumfetta pentandra A. Ingestion of TM in the peri-paritum period was associated with intra-partum vaginal bleeding, dystocic labour, tachysystole and uterine atony. No adverse neonatal outcome was observed. Overall, these findings could help guide the direction of future research into the safety and potential benefits of peri-partum TM use, as well as serving as a preliminary reference for counselling

Evaluation de la Prévention de la Transmission Mère –Enfant du virus de l’hépatite B dans un pays à haute endémicité : cas de la maternité principale de Yaoundé au Cameroun

English Title: Evaluation of prevention of the mother-to-child transmission of hepatitis B virus in a Country with high endemicity: Case of the principal maternity of Yaoundé Central Hospital in Cameroon Résumé: La transmission mère-enfant du virus de l’hépatite B reste une préoccupation dans les pays à haute endémicité. Dans ces pays près de 50% des patients porteurs du virus de l’hépatite B sont contaminés dans l’enfance. Ce travail avait pour but d’évaluer la Prévention de la Transmission Mère –Enfant (PTME) du VHB à la maternité principale de Yaoundé au Cameroun.Patientes et Méthode: Il s’agissait d’une étude transversale descriptive qui avait pour cadre la maternité principale de l’hôpital central de Yaoundé. La période d’étude était de dix mois. L’étude concernait toutes les femmes enceintes admises à la maternité principale quel que soit leur statut sérologique viral B du 1er octobre 2018 au 31 juillet 2019.Résultats: Nous avons inclus 281 patientes. La moyenne d’âge était de 27,9 ± 6,1 ans. La prévalence de l’Ag HBs chez les femmes enceintes était de 12/197 cas (6,1%). Les patientes avec un Ag HBs positif avaient toutes accouché par voie basse. Le vaccin contre le VHB avait été administré chez 11 enfants (73,6%) nés des mères porteuses de l’Ag HBs. Cette vaccination s’est faite dans un délai de moins de 12 heures chez 10 enfants (66,7%). L’administration d’une sérothérapie par l’Immunoglobuline anti HBs était observée dans 10 cas (66,7%).Conclusion: La PTME du VHB est essentielle dans les pays à haute endémicité. A la maternité principale de Yaoundé cette PTME n’est pas encore optimale car toutes les patientes ne sont pas dépistées avant l’accouchement. Mots clés : VHB – Dépistage - PTME – femme enceinte – Yaoundé –Cameroun &nbsp