Training Cameroonian researchers on pragmatic knowledge translation trials: a workshop report

Limited health research capacity in one of the factors that prevents developing countries from attaining  optimal health outcomes and achieving the Millennium Development Goals. We report here, the details of a  workshop on pragmatic knowledge translation trials for Cameroonian researchers, the material covered and additional resources to support capacity development. At the end of this workshop, knowledge gains were noted and participants were able to initiate proposals for funding. These proposals were aimed at improving the clinical management of diabetes, hypertension and malaria.Key words: Pragmatic trials, knowledge translation, capacity building, Cameroon, worksho

Diabetic retinopathy at the Yaoundé Central Hospital in Cameroon: epidemiology and angiographic findings

We carried out a cross-sectional analytical survey using data from patients who had done Fluorescein Angiography at the Yaounde Central Hospital Diabetic Retinopathy Prevention and Management Project between October 2007 and January 2010 to identify the risk factors, incidence and severity of different types of diabetic retinopathy. Data from 239 males (57.0%) and 180 females (43.0%) with diabetic retinopathy were included. Their mean age was 58.2 years. A majority of them were living with type II diabetes (96.2%). The mean duration of diabetes was 8.2 years. About sixty percent had both diabetes and hypertension. The average level of glycated haemoglobin was 9.72% (range 6-17.7%). Amongst the 419 patients with diabetic retinopathy, 292(69.7%) had non-proliferative diabetic retinopathy. One hundred and twelve (26.7%) of those with proliferative diabetic retinopathy had a formal indication for laser photocoagulation. Fifteen patients (3.6%) presented with complicated forms of proliferative diabetic retinopathy. Diabetic maculopathy was present in 30 patients (7.2%). Diabetic retinopathy is a frequent complication of diabetes in our setting which stems from inadequate emphasis on preventive measures. The technical requirements for managing some of the existing complications are still unavailable. Fluorescein Angiography is an important diagnostic tool which should be popularized.Pan African Medical Journal 2012; 13:5

Considerations in using text messages to improve adherence to highly active antiretroviral therapy: a qualitative study among clients in Yaoundé, Cameroon

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Evaluating the test re-test reliability and inter-subject variability of health care provider manual fluid resuscitation performance

BACKGROUND: Health Care Providers (HCPs) report that manual techniques of intravascular fluid resuscitation are commonly used during pediatric shock management. The optimal pediatric fluid resuscitation technique is currently unknown. We sought to determine HCP test-retest reliability (repeatability) and inter-subject variability of fluid resuscitation performance outcomes to inform the design of future studies. METHODS: Fifteen consenting HCPs from McMaster Children’s Hospital, in Hamilton, Canada participated in this single-arm interventional trial. Participants were oriented to a non-clinical model representing a 15 kg toddler, which incorporated a 22-gauge IV catheter. Following a standardization procedure, participants administered 600 mL (40 mL/kg) of saline to the simulated child under emergency conditions using prefilled 60-mL syringes. Each participant completed 5 testing trials. All testing was video recorded, with fluid administration time outcome data (in seconds) extracted from trial videos by two blinded outcome assessors. Data describing catheter dislodgement events, volume of saline effectively delivered, and participant demographics were also collected. The primary outcome of fluid administration time test-retest reliability was analyzed by one-way analysis of variance (ANOVA) and intra-class correlation (ICC), with good reliability defined as ICC > 0.70. RESULTS: Differences in HCP fluid administration times are attributable to inter-subject variability rather than intra-subject variability based on one-way ANOVA analysis, F (14,60) = 43.125; p < 0.001. Test-retest reliability of subjects was excellent with ICC = 0.97 (95% CI: 0.95-0.99); p < 0.001. CONCLUSIONS: Findings demonstrate excellent test-retest reliability of HCP fluid resuscitation performance in a setting involving a non-clinical model. Investigators can justify a single evaluation of HCP performance in future studies. ELECTRONIC SUPPLEMENTARY MATERIAL: The online version of this article (doi:10.1186/1756-0500-7-724) contains supplementary material, which is available to authorized users

The frequency and magnitude of growth failure in a group of HIV-infected children in Cameroon

Background: Growth impairment is a major manifestation of HIV infection in children and has been implicated as a major contributor to both morbidity and mortality. This study the first to be done in this setting, was aimed at comparing the growth of HIV infected children to that of noninfected children in two referral health facilities in Yaound&eacute;, Cameroon. Methods: A prospective case control study was carried out on 39 HIV infected children in two referral hospitals and followed up for a period of 12 months. Anthropometric measurements were taken and the sociodemographic variables of mothers and infants noted. Thirty nine infected children (mean age 45.3 months &plusmn; 41.6 SD) were age and sex matched with 39 non-infected children (mean age 44.4 &plusmn; 40.7 months). Results: Out of the 39 infected children, 26 (66.7%) had at least one of the three anthropometric indices (weight for height, weight for age, height for age) Z scores less than -2. Throughout follow-up, 20.5% of the infected children were wasted (weight to height Z score &lt; -2) versus none in the control group, 56.4% underweight (weight for age Z score &lt; -2) in the infected versus 2.6% in the control group, and 51.3% stunted (height for age Z score &lt; -2) in contrast to 5.1% in the control group. Conclusion: This study demonstrated that wasting; underweight and stunting are common findings in HIV- infected children, thus stressing the importance of anthropometry in the routine care of these children

An introduction to systematic reviews and meta-analysis: A workshop report on promoting evidence based medical practice through capacity building in research synthesis

The increasing urgency for evidence based practice, especially in resource limited settings has inspired many initiatives to this effect. In Africa there is limited skill in research synthesis and the production of systematic reviews. The Centre for the Development of Best Practices in Health, together with the South African Cochrane Centre organised a workshop to train Cameroonian researchers on how to initiate and complete systematic reviews. Five facilitators and fifteen participants met over a period of four days. At the end of the workshop the participants expressed high levels of satisfaction and motivation to conduct systematic reviews, but expressed the need for additional support. Facilitators of future systematic review courses should address challenges related to internet access, adult education and realistic expectations from the participants.Key words: Systematic reviews, meta-analysis, workshop, capacity building, Cameroo

Translating Cochrane Reviews to Ensure that Healthcare Decision-Making is Informed by High-Quality Research Evidence

Erik von Elm and colleagues discuss plans to increase access and global reach of Cochrane Reviews through translations into other languages. Please see later in the article for the Editors' Summar

Communication tools for end-of-life decision-making in the intensive care unit: a systematic review and meta-analysis

Appendix: Electronic search strategies. (DOC 72 kb

Educational interventions to train healthcare professionals in end-of-life communication: a systematic review and meta-analysis

GRADE Summary of Findings for Primary Outcomes – Overall quality of evidence by GRADE criteria. (PDF 47 kb