Facteurs influençant l’initiation au traitement antirétroviral des personnes vivant avec le VIH dans les Centres de Traitement Agréés de Bamenda et de Bertoua au Cameroun

Introduction: : L'objectif de ce travail était de déterminer les facteurs influençant l'initiation au  traitement antirétroviral des personnes vivant avec le VIH (PVVIH) dans les centres de traitements  agrées (CTA) de Bamenda et de Bertoua au Cameroun. Méthodes: Il s'agissait d'une étude transversale, analytique réalisée de Janvier à Avril 2011, dans les CTA de Bamenda et de Bertoua. Pour cette étude, nous avons obtenu une clairance éthique.Résultats: Nous avons étudiés 460 dossiers de patients séropositifs en phase d'initiation au traitement antirétroviral dans lesCTA de Bamenda et de Bertoua, 53,9% et 46,1% respectivement. L 'âge médian   était de 36 ans. La plupart des séropositifs à Bertoua (41) avaient fait un dépistage volontaire du VIH par rapport à ceux de Bamenda (22) (p= 0.008). Il y 'avait plus de VIH de type 1 et 2 dans le CTA de Bamenda (15) par rapport à Bertoua (3) (p= 0.011). La majorité des patients était classé au stade clinique II à Bamenda (54,0%) tandis qu 'à Bertoua le stade clinique III était prédominant (52,4%) (p=0,000). Le  taux médian de CD4 était de 133 cellules/mm3 dans le CTA de Bamenda et de 175 cellules/mm3 à Bertoua (p=0,008). La Zidovudine était plus prescrit à Bamenda et le Ténofovir à Bertoua (p=0,000). L 'Efavirenz était plus prescrit à Bertoua tandis que la Névirapine l 'était plus à Bamenda (p=0,000). Le Lopinavir/r était plus prescrit à  Bamenda qu 'à Bertoua (p=0,017).Conclusion: Il apparait urgent de standardiser la prise en charge des PVVIH dans les CTA du Cameroun.Key words: VIH, Personnes vivant avec le VIH, Traitement antirétroviral, Bamenda, Bertoua; Centre de traitement agrée, Cameroun

Arterial compliance in a group of normotensive and untreated hypertensive Cameroonian subjects in Yaounde

Introduction: Arterial compliance is an independent predictor of cardiovascular events. It decreases with age and this decrease is accelerated by hypertension. The objectives were to determine the arterial compliance in a group of normotensive and untreated hypertensive stage 1, 2 and 3 Cameroonian subjects. Methods: A cross-sectional study was conducted from August 2012 to February 2013 in Yaoundé. Our sample size was 88 participants. The PulsePen® device was used to determine cfPWV (carotid-femoral Pulse Wave Velocity) and central Augmentation Index % (AIx). Other measurements obtained were: blood pressure (BP), body mass index (BMI), fasting glycaemia, lipid profile and serum creatinine. Results: Our sample's mean age was 35.48 years and ranged from 20 to 60 years. The means of: cfPWV, SBP, DBP, Pulse Pressure (PP) and Heart Rate (HR) showed a statistically significant increase (p-value < 0.05) across the groups from normotensive to severely hypertensive patients. cfPWV was significantly correlated (p-value< 0.05) to: Age, Central SBP, Central DBP, Central PP, HR, BMI and central Augmentation index (AIx). Furthermore, cfPWV was significantly dependent on LVH (p-value <0.05). Conclusion: This study suggests that arterial compliance decreases with increase severity of hypertension, indicating a higher risk of developing cardiovascular events in severely hypertensive patients.Pan African Medical Journal 2016; 2

219: Prevalence, awareness, treatment and control of hypertension in a self-selected sub-Saharan African urban population: A cross-sectional study

ObjectivesHypertension has been established as a major public health problem in Africa, but its specific contributions to disease burden are still incompletely understood. We quantified the burden and determinants of hypertension, detection, treatment and control rates among adults in major cities in Cameroon.Patients and methodsThis was a cross-sectional and community-based multicenter study in major cities in Cameroon. Participants were self-selected urban dwellers from the Center, Littoral, North-West and West Regions, who attended on May 17th 2011 a screening campaign advertised through mass media. Primary outcome measure was hypertension defined as systolic (and/or diastolic) blood pressure ≥140 (90)mmHg, or ongoing blood pressure (BP) lowering medications.ResultsIn all, 2120 participants (1003 women) were included. Among them, 1007 (prevalence rate 47.5%) had hypertension, including 319 (awareness rate 31.7%) who were aware of their status. The prevalence of hypertension increased with age overall and by sex and region. Among aware hypertensive subjects, 191 (treatment rate 59.9%) were on regular BP lowering medication, and among those treated, 47 (controlled rate 24.6%) were at target BP levels (i.e. systolic (and diastolic) BP <140 (90)mmHg). In multivariable logistic regressions analysis, male gender, advanced age, parental history of hypertension, diabetes mellitus, elevated waist, and elevated body mass index (BMI) were the significant predictors of hypertension. Likewise, male gender, high BMI and physical inactivity were associated with poor control.ConclusionsHigh prevalence of hypertension with low awareness, treatment and control were found in this urban population; these findings are significant and alarming with consideration to the various improvements in the access to healthcare and the continuing efforts to educate communities over the past decades