Assessment of the Nutritional Status of Children Living in Orphanages in the City of Douala, Cameroon

Introduction: Malnutrition is characterised by metabolic disturbances identified by measurement of anthropometric and biological parameters. The purpose of this study was to determine the nutritional profile of children living in orphanages and to investigate the factors associated with malnutrition in these institutions. Methods: A cross-sectional study was conducted on subjects aged 0 to 18, living in 13 orphanages in Douala. Socio-demographic data, anthropometric and biological parameters were collected. The diagnosis of malnutrition at the clinical level was based on Z score <-2 for the different index and >2 for Weight-for-Height and Body Mass Index for Age. A blood sample permits the photometric assay of albumin, pre-albumin, and C Reactive Protein. The results were interpreted according to reference values for age. Results: Among the 176 children included, the average age was 10±4 years with a male predominance. The majority of children (51.1%) were placed in orphanages for lack of financial resources, and one or both parents orphaned were 42.1%. The wasting, underweight and stunting rates were 5.6%, 4.7%, and 18.2%, respectively. Hypo-pre-albuminemia and hypo-albuminemia were observed in 42.6% and 34.7% of children respectively. CRP was increased in 5.1% of cases. Stunting and orphanages with one caregiver for more than 5 children were predictive factors for hypo-albuminemia and Hypo-pre-albuminemia. Conclusion: Rates of wasting, stunting and underweight were high. Several children had sub-clinical malnutrition despite normal anthropometric index. These results recall the importance of biology for screening, in order to prevent the occurrence of clinical malnutrition

Feasibility and utility of active case finding of HIV-infected children and adolescents by provider-initiated testing and counselling: evidence from the Laquintinie hospital in Douala, Cameroon

Abstract Background Universal HIV testing and treatment of infected children remain challenging in resource-limited settings (RLS), leading to undiagnosed children/adolescents and limited access to pediatric antiretroviral therapy (ART). Our objective was to evaluate the feasibility of active cases finding of HIV-infected children/adolescents by provider-initiated testing and counseling in a health facility. Methods A cross-sectional prospective study was conducted from January through April 2016 at 6 entry-points (inpatient, outpatient, neonatology, immunization/family planning, tuberculosis, day-care units) at the Laquintinie Hospital of Douala (LHD), Cameroon. At each entry-point, following counseling with consenting parents, children/adolescents (0–19 years old) with unknown HIV status were tested using the Rapid Diagnostic Test (RDT) (Determine®) and confirmed with a second RDT (Oraquick®) according to national guidelines. For children less than 18 months, PCR was performed to confirm every positive RDT. Community health workers linked infected participants by accompanying them from the entry-point to the treatment centre for an immediate ART initiation following the « test and treat » strategy. Statistical analysis was performed, with p < 0.05 considered significant. Results Out of 3439 children seen at entry-points, 2107 had an unknown HIV status (61.3%) and HIV testing acceptance rate was 99.9% (2104). Their mean age was 2.1 (Sd = 2.96) years, with a sex ratio boy/girl of 6/5. HIV prevalence was 2.1% (44), without a significant difference between boys and girls (p = 0.081). High rates of HIV-infection were found among siblings/descendants (22.2%), TB treatment unit attendees (11.4%) and hospitalized children/adolescents (5.6%); p < 0.001. Up to 95.4% (42/44) of those infected children/adolescents were initiated on ART. Overall, 487 (23.2%) deaths were registered (122 per month) and among them, 7 (15.9%) were HIV-positive; mainly due to tuberculosis and malnutrition. Conclusion The consistent rate of unknown HIV status among children/adolescents attending health facilities, the high acceptability rates of HIV testing and linkage to ART, underscore the feasibility and utility of an active case finding model, using multiple entry-points at the health facility, in achieving the 90–90-90 targets for paediatric HIV/AIDS in RLS

Diagnosis and treatment challenges of autism spectrum disorder at a reference hospital in Douala, Cameroon

Abstract Background Autism spectrum disorder (ASD) is a neurodevelopmental disability associated with deficiency in social interaction, unusual development of social communication, and restricted or repetitive behaviors, interests and activities. This study aimed to describe management of pediatric ASD in Cameroon, a resource-constrained Central Africa country. Methods A retrospective study was conducted between December 2021 and May 2022 at the Pediatrics department of a reference hospital in the town of Douala. Data of interest of children with ASD were collected through eligible medical records and telephone discussions with their parents/guardians. Results Medical records of 145 children with ASD aged 2–15 years were included in the study, giving a hospital ASD prevalence of 3.7%. Time delay between parental concerns and hospital management was specified in 69 (47.58%) children, and among them 38 (55.07%) had a mean delay ± SD was less than five months. Children were mainly males (76%) and aged 4–5 years (37.93%), with mean age ± SD of 44.4 ± 22.2 months old. The main consultation reason was delayed language development (100%). Mean time delay between parental concerns and the first medical consultation was 18 months (range 1–60 month). Attention deficit hyperactivity disorder were found in 68.18% of children aged ≥ 6 years old. Neuropsychology (66.2%) was the most frequently used intervention. Some children were treated using traditional medicine. Conclusions Management of pediatric ASD is strongly influenced by socioeconomic and cultural context. It is crucial to implement behavioral change campaigns in community, organize training sessions to medical staff on diagnosis and treatment of ASD, and provide specialized centers with skilled staff and equipped material