Assessment of the 10-year risk of cardiovascular events among a group of Sub-Saharan African post-menopausal women

Background: Post-menopausal women may be at particular risk of developing cardiovascu­lar disease due to metabolic changes occurring at menopause. The present study aimed to assess the 10-year cardiovascular risk (CVR) among a group of post-menopausal women and to deter­mine associated factors. Methods: This was a cross-sectional study conducted among post-menopausal women in Yaoundé, Cameroon. CVR was calculated using the Framingham risk score. Results: We enrolled 108 women, their ages ranging from 45 to 80 years, with a mean of 56.4 ± ± 6.9 years. CVR ranged between 1.2% and greater than 30% with a mean of 13.4 ± 8.7%. Forty-three (39.8%) participants had a low CVR (< 10%), 39 (36.1%) women had a moderate CVR (10-20%), and 21 (24.1%) women had a high CVR (> 20%). Low-density lipoproteins cholesterol (LDL-C; b = 3.27, p = 0.004), fasting plasma glucose (b = 5.40, p = 0.015), and diastolic blood pressure (DBP; b = 3.49, p < 0.0001) were independently associated with CVR. Women not married (i.e. single, divorced or widowed) (adjusted odds ratio [aOR] 4.66, p = 0.002), those with high titers of LDL-C (≥ 1.6 g/L; aOR 5.07, p = 0.001), and those with elevated DBP (≥ 90 mm Hg; aOR 8.10, p < 0.0001) presented an increased likelihood to be at an advanced level of CVR. Conclusions: A significant number of post-menopausal women are at considerable risk of cardiovascular events in our setting. Therefore, they should be educated to adopt healthy life­styles for substantial reduction in their CVR

Insulin resistance and associated factors among HIV-infected patients in sub-Saharan Africa: a cross sectional study from Cameroon

BACKGROUND: Little is known on the magnitude and correlates of insulin resistance in HIV-infected people in Africa. We determined the prevalence of insulin resistance and investigated associated factors in HIV-infected adult Cameroonians. METHODS: We conducted a cross-sectional study at the Yaoundé Central Hospital, Cameroon; during which we enrolled HIV-infected people aged 30 to 74 years with no previous history of cardiovascular disease. An homeostatic model assessment of insulin resistance (HOMA-IR) like index served to assess insulin sensitivity with insulin resistance defined by values of 2.1 or higher. RESULTS: We included 452 patients (20% men). Their mean age was 44.4 ± 9.8 years and 88.5% of them were on antiretroviral therapy (93.3% on first line regimen including Zidovudine, lamivudine and Efavirenz/Nevirapine). Of all participants, 28.5% were overweight, 19.5% had obesity and 2.0% had diabetes. The prevalence of insulin resistance was 47.3% without any difference between patients on ART and those ART-naïve (48.5% vs. 38.5%; p = 0.480). Obesity was the only factor independently associated with insulin resistance (adjusted odds ratio: 2.28; 95% confidence interval: 1.10-4.72). CONCLUSION: Insulin resistance is present in nearly half of HIV-infected patients in Cameroon despite a low prevalence rate of diabetes, and is associated with obesity

Comparative study of the efficacy and tolerability of dihydroartemisinin - piperaquine - trimethoprim versus artemether - lumefantrine in the treatment of uncomplicated Plasmodium falciparum malaria in Cameroon, Ivory Coast and Senegal

<p>Abstract</p> <p>Background</p> <p>The ACT recommended by WHO is very effective and well-tolerated. However, these combinations need to be administered for three days, which may limit adherence to treatment.</p> <p>The combination of dihydroartemisinin - piperaquine phosphate - trimethoprim (Artecom^®, Odypharm Ltd), which involves treatment over two days, appears to be a good alternative, particularly in malaria-endemic areas. This study intends to compare the efficacy and tolerability of the combination dihydroartemisinin - piperaquine phosphate - trimethoprim (DPT) versus artemether - lumefantrine (AL) in the treatment of uncomplicated <it>Plasmodium falciparum </it>malaria in Cameroon, Ivory Coast and Senegal.</p> <p>Methods</p> <p>This was a randomized, controlled, open-label clinical trial with a 28-day follow-up period comparing DPT to AL as the reference drug. The study involved patients of at least two years of age, suffering from acute, uncomplicated <it>Plasmodium falciparum </it>malaria with fever. The WHO 2003 protocol was used.</p> <p>Results</p> <p>A total of 418 patients were included in the study and divided into two treatment groups: 212 in the DPT group and 206 in the AL group. The data analysis involved the 403 subjects who correctly followed the protocol (<it>per protocol </it>analysis), i.e. 206 (51.1%) in the DPT group and 197 (48.9%) in the AL group. The recovery rate at D14 was 100% in both treatment groups. The recovery rate at D28 was 99% in the DPT and AL groups before and after PCR results with one-sided 97.5% Confidence Interval of the rates difference > -1.90%. More than 96% of patients who received DPT were apyrexial 48 hours after treatment compared to 83.5% in the AL group (p < 0.001). More than 95% of the people in the DPT group had a parasite clearance time of 48 hours or less compared to approximately 90% in the AL group (p = 0.023). Both drugs were well tolerated. No serious adverse events were reported during the follow-up period. All of the adverse events observed were minor and did not result in the treatment being stopped in either treatment group. The main minor adverse events reported were vomiting, abdominal pain and pruritus.</p> <p>Conclusion</p> <p>The overall efficacy and tolerability of DPT are similar to those of AL. The ease of taking DPT and its short treatment course (two days) may help to improve adherence to treatment. Taken together, these findings make this medicinal product a treatment of choice for the effective management of malaria in Africa.</p

Hyperlactatemia in a group of HIV patients living in Yaounde-Cameroon

BACKGROUND AND AIM: Prolonged exposure to highly active antiretroviral therapy (HAART) is associated with adverse effects such as hyperlactatemia. We determined the prevalence and risk factors for developing hyperlactatemia among human immunodeficiency virus (HIV)-infected cameroonians on antiretroviral therapy (ART). METHODS: We conducted a cross-sectional study from January to April 2012 involving 91 HIV-infected patients receiving ART for at least 12 months and 30 HIV-infected patients who have never received ART (ART-naïve patients). Plasma lactate levels were determined after at least 12 hours of overnight fasting and hyperlactatemia defined as lactate concentrations ≥ 3 mmol/L. The prevalence of hyperlactatemia was determined and the risk factors were analyzed by a multivariate logistic regression model. RESULTS: The mean lactataemia was significantly higher in the group of HIV patients currently taking ART than in the ART-naïve one (2.3 ± 1.3 and 1.7 ± 0.7 mmol/L respectively, p = 0.002). Patients on first line ART regimens had significantly higher lactatemia than those on second line regimens (2.5 ± 1.5 and 1.9 ± 0.7 mmol/L respectively, p = 0.014). The prevalence of hyperlactatemia in HIV patients receiving ART and in ART-naïve HIV patients was respectively 18.7 and 6.7% (p = 0.095). ART-exposure (adjusted odds ratio (aOR) 5.44, 95% confidence interval (CI) 1.06 – 27.84; p = 0.042) and being on a first line regimen (aOR 16.22, 95% CI 1.57 – 167.91; p = 0.019) were independent strong predictors of hyperlactatemia. CONCLUSION: Hyperlactatemia was not rare in our study population. Being on a first line regimen constitutes an important risk factor for developing hyperlactatemia. Measurement of plasma lactate may be useful in optimizing the management of HIV-positive persons on ART

Syzyguim guineense Extracts Show Antioxidant Activities and Beneficial Activities on Oxidative Stress Induced by Ferric Chloride in the Liver Homogenate

The aim of this study was to determine the in vitro antioxidant activity, free radical scavenging property and the beneficial effects of extracts of various parts of Syzygium guineense in reducing oxidative stress damage in the liver. The effects of extracts on free radicals were determined on radicals DPPH, ABTS, NO and OH followed by the antioxidant properties using Ferric Reducing Antioxidant Power assay (FRAP) and hosphomolybdenum (PPMB). The phytochemical screening of these extracts was performed by determination of the phenolic content. The oxidative damage inhibition in the liver was determined by measuring malondialdehyde (MDA) as well as the activity of the antioxidant enzymes superoxide dismutase (SOD), catalase (CAT) and peroxidase. Overall, the bark extract of the ethanol/water or methanol showed the highest radical scavenging activities against DPPH, ABTS and OH radicals compared to the other extracts. This extract also contained the highest phenolic content implying the potential contribution of phenolic compounds towards the antioxidant activities. However, the methanol extract of the root demonstrated the highest protective effects of SOD and CAT against ferric chloride while the hydro-ethanol extract of the leaves exhibited the highest inhibitory effects on lipid peroxidation. These findings suggest that antioxidant properties of S. guineense extracts could be attributed to phenolic compounds revealed by phytochemical studies. Thus, the present results indicate clearly that the extracts of S. guineense possess antioxidant properties and could serve as free radical inhibitors or scavengers, acting possibly as primary antioxidants. The antioxidant properties of the bark extract may thus sustain its various biological activities

Dyslipidemia in Patients with a Cardiovascular Risk and Disease at the University Teaching Hospital of Yaoundé, Cameroon

Objective. To determine the frequency of lipid abnormalities in patients with a cardiovascular risk and disease at the University Teaching Hospital (UTH) of Yaoundé. Materials and Methods. We conducted a cross-sectional study from 1 March to 31 May 2015 at the UTH of Yaoundé. We included all patients seen in the outpatient department with a diagnosis of a cardiovascular disease or a risk factor for cardiovascular disease. Patients who accepted to participate in the study were asked to answer a questionnaire; after that a blood sample was taken for lipid profile. An informed consent was signed by all the participants and the study has received approval from the national ethic committee. Results. We recruited 264 patients of which 119 were men and 145 were women with a sex ratio of 0.82. Mean age was 61.36 years. The frequency of lipid profiles abnormalities was as follows: low HDL cholesterol (44.3%), hypertriglyceridemia (18.9%), high LDL cholesterol (3.8%), and high total cholesterol 3.4%). Hypertriglyceridemia was strongly associated with type 2 diabetes mellitus. Conclusion. Low levels of HDL cholesterol and hypertriglyceridemia are more prevalent in our study population. More studies are needed to confirm this finding in our environment

Relationship between Higher Atherogenic Index of Plasma and Oxidative Stress of a Group of Patients Living with Sickle Cell Anemia in Cameroon

Dyslipidemia is highly prevalent in sickle cell anemia (SCA) patients and is one of the major risk factors for cardiovascular diseases induced by oxidative stress in Africa. The aim of this research was to investigate the correlation between higher atherogenic index of plasma (API) and oxidative stress in a group of patients living with SCA in Cameroon. Methods. A group of 85 homozygote SS patients (male and female) were enrolled at the Central hospital of Yaounde in Cameroon between May and October 2017. After informed consent through the signature of a consent form was obtained, the plasma was collected to determine the lipid profile while the lysate solution of RBC was used to explore some markers of oxidative stress using spectrophotometric methods. Results. Among the 85 patients included in our study, the mean age was 30 ± 5 years and the female to male ratio was 0.97. The majority of the patients (52–81%) had dyslipidaemia, and 22.4% of the patients demonstrated a higher level of atherogenic index of plasma. The patients with a higher level of total cholesterol (TC) (>240 mg/dl) and low-density lipoprotein (LDL-C) (>159 mg/dl) had at least 1,334 fold of malondialdeheyde (MDA) concentration than those with normal level. Also in the same patients, the higher atherogenic plasmatic index (API) significantly (p<0.05) increased with the concentration of MDA. Except HDL-C, the other parameters of lipid profile had significant (p<0.05) correlation with reduced glutathione (GsH) and total antioxidant capacity (TAC). The significant (p<0.05) and linear regression was found between the increased MDA and higher API. Conclusion. Dyslipidemia increases oxidative stress and higher API which leads to coronary vascular disease in patients with SCA

Atherogenic index of plasma and 10-year risk of cardiovascular disease in adult Africans living with HIV infection: A cross-sectional study from Yaoundé, Cameroon

Background The paucity of data regarding the association between atherogenic index of plasma and risk of cardiovascular disease in HIV-infected populations living in sub-Saharan Africa prompted us to conduct this study which aimed to assess the relationship between atherogenic index of plasma and risk of cardiovascular disease among a Cameroonian HIV-infected population. Methods This was a cross-sectional study conducted among 452 HIV-infected adults in Yaoundé, Cameroon. Risk of cardiovascular disease was calculated using the Framingham risk score; atherogenic index of plasma was derived as log (triglycerides/high-density lipoproteins cholesterol). Results Participants’ mean age (80% females) was 44.4 ± 9.8 years. Atherogenic index of plasma values ranged from –0.63 to 1.36 with a median of 0.11 (25th–75th percentiles: –0.08-0.31). Most participants (88.5%) were on antiretroviral treatment. There was a significant correlation between atherogenic index of plasma and fasting plasma glucose (r = 0.116; p  = 0.014), atherogenic index of plasma and total cholesterol (r = –0.164; p  < 0.001). Atherogenic index of plasma was significantly associated with the risk of cardiovascular disease either in univariable (β = 5.05, 95% CI: 3.31–6.79; p  < 0.001, R 2  = 0.067) or in multivariable linear regression model after adjusting for socio-demographic, clinical and biological confounders (adjusted β = 3.79, 95% CI: 1.65 – 4.88; p  < 0.001, R 2  = 0.187). Conclusion Atherogenic index of plasma may be an independent factor impacting the risk of cardiovascular disease among Cameroonian HIV-infected people. More studies are needed to better elucidate the association between atherogenic index of plasma and risk of cardiovascular disease in our setting