Occupational factors are not factors for chronicity in patients with low back pain in sub-Saharan Africans: a hospital-based study from Cameroon

Background: Factors associated to chronicity of nonspecific Low Back Pain (LBP) are scarce in sub-Saharan Africa (SSA). Objectives: To identify the factors associated to the persistence at two years of nonspecific LBP in rheumatology outpatients seen in a teaching hospital in Cameroon. Design: This was a cross-sectional study done in the General Hospital, Douala. Methods: Adult patients with chronic LBP were included and divided into two groups according to disease duration (<2 years and ≥2 years). Factors associated to the persistence at 2 years of LBP was statistically significant if p<0.05. Results: Two hundred and three patients (157 women) with nonspecific LBP with mean age 55.9±12.8 years were included. The patients  were grouped into workers involved in heavy labour or in jobs that require physical efforts (n = 122; 60.1%) and workers in blue-collar jobs with prolonged standing and/or sitting (n = 81; 31.9%). The following factors were significantly associated with the persistence at two years of LBP: advanced age, female gender, high number of children (for women), history of LBP, multiple recurrences with persistent pain and the high pain intensity. Even though there is a tendency towards the statistical significance of the lifting of heavy loads (p=0.06), we did not find any significant association between the occupational factors and the persistence at two years of LBP. Conclusion: There is a lack of association between the occupational factors and the persistence at two years of the LBP in a sub-Saharan population in Cameroon. Only some socio-demographic and clinical factors are statistically significant

Neurological disorders in the emergency centre of the Douala General Hospital, Cameroon: A cross-sectional study

The aim of this study was to determine the prevalence, aetiologies and outcome of neurological disorders at the emergency centre (EC) of the Douala General Hospital (DGH). Patients and methods: A cross-sectional study was carried out from 1st January to 30th April 2014, at the EC of the DGH, in Cameroon. We included all patients above 15 years of age who presented with isolated or associated neurological complaints. Data collected for each patient were: socio-demographic, clinical and laboratory characteristics, time lapse before management and the prognosis. Patients with no definitive diagnosis made in the EC, had their files reviewed on the wards by the investigators for the final diagnosis and/or aetiology. Results: Of 1844 patients who were consulted in the EC over the study period, 502 of them presented with neurological disorders (27.2%). The mean age was 44.4 ± 17.8 years with 53.6% males. The common symptoms were headache (47.8%), loss of consciousness (19.5%), lumbar pain (11%), hemiparesis (8.4%), and seizure (7%). Non-traumatic neurological disorders were common (86.1%). The common aetiologies were malaria (16.9%), stroke (13.5%), primary headaches (13.1%), head injury (12.9%) and metabolic encephalopathy (12.4%). Mean time lapse to be consulted by a general practitioner was 23.1 ± 20.7 min and 2.1 ± 1.3 h for neurologist’s consultation. The time lapse to receive initial medical care was 26.3 ± 30.6 min. The mean duration to have an imaging result was 1.3 ± 0.9 h and 3.1 ± 1.7 h for laboratory tests. The in-hospital mortality rate of neurological disorders was 15.1%. Conclusion: Neurological disorders are common in the emergency centre of the DGH. Aetiologies are diverse and in-hospital mortality is high. This highlights the need to organize neurologist calls at the EC and/or to improve the human resources capacity through regular training and evaluation