Skin Diseases Among Sub-Saharan African Prisoners: The Cameroonian Profile

Background: Overcrowding and promiscuity observed in our prisons are a spreading source of several diseases including infections transmitted by interhuman contact. It has been argued that skin diseases are the most frequent reasons for consultations in prisons. In Cameroon, no study has been done to assess the magnitude of this issue. Our study aimed at determining the profile of dermatological pathologies among Cameroonian prison inmates. Methods: This was a cross-sectional study at the Mfou Principal Prison from February to April 2014. Were included all prisoners who consulted the research team at the prison infirmary during the period of recruitment and who accepted to take part in the study. Prisoners were consulted and a structured questionnaire was used for data collection. Diagnosis was based on the anamnestic and clinical findings. Participants with uncertain diagnosis were excluded from the study. Data were entered into Microsoft excel 2010 spreadsheets and analyzed using SPSS version 17.0. Results: A total of 217 prisoners were retained for our study out of the 369 present in the prison during the study period. Among these 217 prisoners, 201 (92.6%) were males, 189 (87.1%) were Christians, 123 (56.7%) did not attend the secondary school, and 137 (63.1%) were single. Age ranged from 14 to 60 years with a mean of 32 ± 4.7 years and, age groups 21-30 and 31-40 being the most represented ones. More than half (57.1%) of our population exhibited skin diseases with scabies being present in 41% of cases. The dominating presentations of skin diseases were: scabies (71.8%), eczema (9.7%), dermatophytosis (specifically tinea corporis: 5.6%), pityriasis versicolor (4.8%), and acne (3.2%). Six point five percent of participants presented with more than one skin disease, and eczema was the most frequent disease associated with scabies in 8 cases (6.4%). Pityriasis versicolor was the most common skin disease among females (25% of women infected). Conclusion: There is a high prevalence of skin diseases among prisoners at the Mfou Principal Prison. of which scabies (71.6%), eczema (9.7%), dermatophytosis (5.6%) and pityriasis versicolor (4.8%) were the prevailing skin diseases encountered .There is thereby an urgent need to implement strong and efficient interventions in order to solve the problems of over population, poor hygiene, precarious quality of life and lack of health care in our prisons

Chimiotherapie des angiosarcomes de Kaposi au service d'oncologie medicale de L'hopital General de Yaounde, Cameroun

Compte tenu de la séroprévalence de l'infection à VIH/SIDA au Cameroun (5,5%), le service d'oncologie médicale de l'Hôpital Général de Yaoundé, prend en charge par chimiothérapie les patients porteurs d'angiosarcome de Kaposi. Nous avons voulu évaluer la chimiothérapie de l'angiosarcome de Kaposi dans notre service. Une étude descriptive rétrospective a été menée sur une année. Les patients recrutés ont été ceux avec un diagnostic d'angiosarcome de Kaposi. Les données collectées étaient les suivantes : le sexe, l'âge, la localisation, les pathologies associées, la chimiothérapie administrée, les réponses et la tolérance. Les deux dernières données ont été évaluées selon les critères de l'OMS. Au cours de cette année, 57 patients ont été reçus pour un angiosarcome de Kaposi dont 31 (54,4%) hommes et 26 (47,6%) femmes. Les âges extrêmes ont été 14 et 76 ans avec une moyenne de 39,05 ans. La localisation principale était tégumentaire (65,6% des localisations), diffuse pour la plupart des cas. Des 43 patients testés, 38 (88,4%) avaient une sérologie VIH positive et 5 (11,6%) négatifs. Dans notre échantillon, 84,6% ont reçu une polychimiothérapie associant la doxorubucine, la bléomycine et la vincristine. Seuls 20 patients des 38 séropositifs soit 52,6% ont reçu des antiretroviraux. La réponse partielle a été objectivée chez 16 sur 19 (84,2%) de nos patients. La toxicité observée a été hématologique et 13 patients (22,8%) ont été transfusés pour anémie. Nous concluons que la chimiothérapie est bénéfique dans le traitement du sarcome de Kaposi. Des études comparatives ultérieures précisent si le traitement de ces patients améliore la qualité de vie et la survie. Clinics in Mother and Child Health Vol. 3(1) 2006: 469-47

Seeking diagnostic and prognostic biomarkers for childhood bacterial pneumonia in sub-Saharan Africa: study protocol for an observational study

INTRODUCTION: Clinically diagnosed pneumonia in children is a leading cause of paediatric hospitalisation and mortality. The aetiology is usually bacterial or viral, but malaria can cause a syndrome indistinguishable from clinical pneumonia. There is no method with high sensitivity to detect a bacterial infection in these patients and, as result, antibiotics are frequently overprescribed. Conversely, unrecognised concomitant bacterial infection in patients with malarial infections occur with omission of antibiotic therapy from patients with bacterial infections. Previously, we identified two combinations of blood proteins with 96% sensitivity and 86% specificity for detecting bacterial disease. The current project aimed to validate and improve these combinations by evaluating additional biomarkers in paediatric patients with clinical pneumonia. Our goal was to describe combinations of a limited number of proteins with high sensitivity and specificity for bacterial infection to be incorporated in future point-of-care tests. Furthermore, we seek to explore signatures to prognosticate clinical pneumonia. METHODS AND ANALYSIS: Patients (n=900) aged 2-59 months presenting with clinical pneumonia at two Gambian hospitals will be enrolled and classified according to criteria for definitive bacterial aetiology (based on microbiological tests and chest radiographs). We will measure proteins at admission using Luminex-based immunoassays in 90 children with definitive and 160 with probable bacterial aetiology, and 160 children classified according to the prognosis of their disease. Previously identified diagnostic signatures will be assessed through accuracy measures. Moreover, we will seek new diagnostic and prognostic signatures through machine learning methods, including support vector machine, penalised regression and classification trees. ETHICS AND DISSEMINATION: Ethics approval has been obtained from the Gambia Government/Medical Research Council Unit The Gambia Joint Ethics Committee (protocol 1616) and the institutional review board of Boston University Medical Centre (STUDY00000958). Study results will be disseminated to the staff of the study hospitals, in scientific seminars and meetings, and in publications. TRIAL REGISTRATION NUMBER: H-38462

Tropical Data: Approach and Methodology as Applied to Trachoma Prevalence Surveys

PURPOSE: Population-based prevalence surveys are essential for decision-making on interventions to achieve trachoma elimination as a public health problem. This paper outlines the methodologies of Tropical Data, which supports work to undertake those surveys. METHODS: Tropical Data is a consortium of partners that supports health ministries worldwide to conduct globally standardised prevalence surveys that conform to World Health Organization recommendations. Founding principles are health ministry ownership, partnership and collaboration, and quality assurance and quality control at every step of the survey process. Support covers survey planning, survey design, training, electronic data collection and fieldwork, and data management, analysis and dissemination. Methods are adapted to meet local context and needs. Customisations, operational research and integration of other diseases into routine trachoma surveys have also been supported. RESULTS: Between 29th February 2016 and 24th April 2023, 3373 trachoma surveys across 50 countries have been supported, resulting in 10,818,502 people being examined for trachoma. CONCLUSION: This health ministry-led, standardised approach, with support from the start to the end of the survey process, has helped all trachoma elimination stakeholders to know where interventions are needed, where interventions can be stopped, and when elimination as a public health problem has been achieved. Flexibility to meet specific country contexts, adaptation to changes in global guidance and adjustments in response to user feedback have facilitated innovation in evidence-based methodologies, and supported health ministries to strive for global disease control targets

A retrospective study to assess the evaluation of living related kidney donors and their outcomes following nephrectomy at Kenyatta National Hospital

Abstract Background Kidney transplantation is the renal replacement therapy of choice for end stage renal disease. To ensure safety regular audit of the donation process is necessary. The aim of this study was to assess the evaluation of potential living related kidney donors and document their outcomes following nephrectomy. Methods This was a retrospective descriptive study involving all living related kidney donors seen at Kenyatta National Hospital (KNH) renal unit from 2010 to 2014. Upon approval by KNH/ERC, the records of all kidney donors were retrieved. Demographic characteristics, number of potential and actual donors, their clinical, laboratory and radiological data as well as documented complications and deaths were recorded. SPSS version 17(Chicago, Ilinois) was used for data entry and analysis. Chi square test and Mann Whitney U test were used as tests of association for categorical and continuous data respectively, with P value set at <0.05. Results Median age of the donors was 34 years (IQR 31–39). First-degree relatives were majority(84.5%). Renal function assessment was done using mean glomerular filtration rate (GFR) from the radionuclide scan (DTPA) and serum creatinine levels. The donors had a mean GFR of 99.2 ± SD 6.6. All the haematological and biochemical tests were within normal. Majority(42.9%) were HLA compatible, but data on HLA typing was missing for 22% of the patients records. On CT angiogram, single renal artery and single renal vein were found in 94 and 88% respectively. Immediate complications included excessive bleeding(2%) and breach of other cavities (4%). Paralytic ileus (32%) and atelectasis (27%) were the most common early postoperative complications. There was no mortality. Conclusion Our study reports no fatality but significant post-operative complications. These are significant findings that may be used to review and improve care and to educate potential kidney donors on the safety of this procedure in our centre, in a bid to widen the pool of potential living kidney donors

Posterior urethral valves in children: A review of 28 cases in Yaounde, Cameroon

We reviewed the files of 28 children treated or followed up for posterior urethral valves (PUV) from 1st January 1985 to the 31st of December 1996 in the University Teaching Hospital, Central Hospital and the General Hospital in Yaounde. Our objectives were to review the epidemiological aspects of PUV in Yaounde, assess the clinical presentation, diagnostic procedures and outcome following surgery in terms of renal function and patient growth. The mean age at diagnosis was 2.9 years (range 9days-13 years), mean age at first consultation after onset of symptoms 1.6 years (range 1 day-8 years) and the mean interval between age of first consultation and age at diagnosis was 9.7 months. The most frequent urinary symptoms were dribbling (60.7%) and dysuria (54%), whereas frequent non-urinary symptoms were fever (25%) and failure to thrive (25%). Diagnosis was confirmed on ultrasound in 3 patients and in the remaining 25 both ultrasound and voiding cystourethrograms made the confirmation.There was an overall improvement at follow-up in the glomerular filtration rates (GFR) in 67% of the patients although absolute values remained low in all but 1 patient. Growth was also improved in 56% of the patients. Concerning treatment, 26 patients underwent surgery and 2 were lost to follow-up after diagnosis. 20 patients underwent endoscopic valve ablations, 4 Blocksom vesicostomies, 3 cystostomies and 2 catheter ablations. At final evaluation, we noted 6 deaths (21%), 10 lost to follow-up (36%). Causes of the deaths were septicemia: 3 cases (50%); post-obstructive diuresis: 2 cases (33%) and chronic renal failure: 1 case (17%). We thus conclude that, efforts should be made by clinicians especially (obstetricians, surgeons, radiologists, and pediatricians) to make early diagnosis and management of PUV so that renal impairment should be avoided and optimal growth ensured. Clinics in Mother and Child Health Vol. 1(2) 2004: 89-9

Light-driven liquid metal nanotransformers for biomedical theranostics

Room temperature liquid metals (LMs) represent a class of emerging multifunctional materials with attractive novel properties. Here, we show that photopolymerized LMs present a unique nanoscale capsule structure characterized by high water dispersibility and low toxicity. We also demonstrate that the LM nanocapsule generates heat and reactive oxygen species under biologically neutral near-infrared (NIR) laser irradiation. Concomitantly, NIR laser exposure induces a transformation in LM shape, destruction of the nanocapsules, contactless controlled release of the loaded drugs, optical manipulations of a microfluidic blood vessel model and spatiotemporal targeted marking for X-ray-enhanced imaging in biological organs and a living mouse. By exploiting the physicochemical properties of LMs, we achieve effective cancer cell elimination and control of intercellular calcium ion flux. In addition, LMs display a photoacoustic effect in living animals during NIR laser treatment, making this system a powerful tool for bioimaging.MOE (Min. of Education, S’pore)Published versio