Intestinal helminths in some cases of acute appendicitis operated in Bamenda, Cameroon

Background: Acute appendicitis is the most frequent infectious surgical abdominal emergency and previous studies have noted the presence of parasites in the appendicular lumen.Objective: This study was done to determine the involvement of intestinal worms in the etiology of acute appendicitis.Materials and Methods: This was a prospective and descriptive study concerning cases of confirmed and operated acute appendicitis between 15th April, 2013 and 14th April, 2015 at the People’s Clinic, Ngomgham, Bamenda, Cameroon. The appendicular content was macroscopically examined for parasites and formol-ether concentration technique was carried out for ova detection.Results: A total of 112 patients were operated for acute abdominal pain within the study period. There were 74 (60.8%) cases confirmed with acute appendicitis of which 45 (60.1%) were males and 29 (39.2%) were. The most affected age group was the 21 to 40 years (50%). The removed appendices appeared congestive in 30 (40.5%) cases, suppurated in 27 (40.5%) cases and gangrenous in 17 (23.0%) cases.There was no relationship between the appearance of the removed appendix and the gender of participants (P>0.05).Three different helminth ova were identified in the 74 samples. In decreasing prevalence, the parasite trend was 8 (10.8%) Ascaris lumbricoides, 5 (6.8%) Enterobius vermicularis, 3 (6.0%), Ankylostoma duodenale, Adult Ascaris lumbricoides and Enterobius vermicularis were seen in 1 and 3 cases respectively.Conclusion: A small percentage of parasitic worm eggs were found in the appendicular content, though a good portion of patients took medications against parasites before surgery. Intestinal worms could not be incriminated in the causation of the appendicitis; nevertheless, one adult ascaris was found as an evident cause of appendicular lumen obstruction.Keywords: Intestinal Helminthes, Acute appendicitis, Bamend

Candiduria in HIV Infected Patients in Yaoundé, Cameroon

Objective: To detect Candida species in the urine of patients living with human immuno-deficiency virus (HIV), and correlate the presence of candiduria and CD4 counts. Patients and Methods: The study population consisted of 105 hospitalized patients from the Military and Central Hospitals of Yaoundé, who either were HIV positive or already suffering from AIDS. The patients consisted of 63 females (60%) and 42 males (40%) giving a male to female ratio of 1:1.5. Midstream urine samples were collected from all patients and mycological examination of the centrifuged sediments was done. Patients with CD4 counts > 499 lymphocytes/mm3 were a proxy control group. Results: 38 of 105 (36.2%) subjects had candiduria. 71% of the cases were asympto-matic. The percentage of patients positive versus negative for candiduria increased progressively from stage-A (5%) to B (32%) to C (63%) HIV infection. There was thus a correlation between candiduria and the CDC disease stage. Its presence heralded an advanced immuno-suppressed state of the AIDS patient. Conclusion: In resource-poor communities, where viral copy and CD4 count determination are expensive, candiduria may serve as one of the indicators for anti-retroviral therapy. We recommend routine detection of candiduria in this high-risk group of HIV/AIDS patients. Candidurie chez les patients infectés par HIV au Yaoundé, Cameroun Objectifs : Pour détecter des espèces de candida dans l\'urine des patients vivant avec HIV, et corréler la présence de candidurie au compte des CD4. Patients et méthodes : La population d\'étude s\'est composée de 105 patients hospitalisés dans les hôpitaux militaires et centraux de Yaoundé, tous les patients étaient HIV positif ou souffrant déjà du SIDA. Les patients se sont composés de 63 femmes (60%) et de 42 hommes (40%) avec un sexe ratio de 1/1,5. Des échantillons d\'urine du milieu du jet ont été prélevés chez tous les patients et l\'examen mycologique des sédiments centrifugés a été fait. Les patients présentant un compte de CD4 de plus de 499 lymphocytes/mm3 étaient un groupe de référence. Résultats : 38 des 105 patients (36.2%) ont présenté une candidurie. 71% des patients étaient asymptomatiques. Le pourcentage des patients positifs pour la candidurie a augmenté progressivement du stade A (5%) à B (32%) puis à C (63%) de l\'infection par le HIV. Il y avait ainsi une corrélation entre le candiduria et le stade de la maladie de CDC. Sa présence a annoncé un état d'immuno-dépression avancé. Conclusion : Dans les communautés de faibles ressources, où la détermination de la réplication virale et du compte de CD4 sont chers, la candidurie peut servir d\'un des indicateurs de la thérapie anti-rétrovirale. Nous recommandons la détection courante de candidurie dans ce groupe de patients à gros risque de HIV/SIDA. African Journal of Urology Vol.11(1) 2005: 61-6

Prevalence of cryptococcosis among HIV-infected patients in Yaounde, Cameroon

Background: Cryptococcus neoformans is encapsulated yeast which causes life-threatening infections in up to 40% of AIDS patients in Africa.Objective: To investigate the prevalence of cryptococcosis among HIV infected patients in Yaounde.Methods: In a hospital-based surveillance study of cryptococcosis, the colonization of Cerebrospinal Fluid (CSF), urine and blood sample by C. neoformans was evaluated by direct microscopic examination and culture techniques. Data obtained were then analyzed based on the medical records of the patients.Results: Among the 105 patients sampled for the study, the CD4 counts varied between 31 and 304 lymphocytes/mm3. Direct specimens examination (n= 294) in India ink preparations revealed polysaccharide capsule in 25 (8.5%) of the samples. Upon culture, 29 (9.86 %) samples were positive of C. neoformans (23 from the CSFs and 6 from the urine). All the positive samples were obtained from patients who were not on Antiretroviral Therapy (ART). Meningo-encephalitis symptoms were observed in 13 patients with C. neoformans in CSFs.Conclusion: This study reveals that cryptococcosis is rife in AIDS patients in Yaounde. Therefore, to minimize the death toll, we recommend that its routine check should be integrated in the management of HIV/AIDS patients.Key words: Cryptococcosis, HIV/AIDS patients, prevalence, Yaounde