Incidence, risk factors, clinical presentation and treatment of ectopic pregnancy in the Limbe and Buea Regional Hospitals in Cameroon

INTRODUCTION : ectopic pregnancy (EP) is the leading cause of maternal mortality in the first trimester of pregnancy in our environment. This study aimed at evaluating the incidence, risk factors, clinical presentation and treatment of ectopic pregnancy in the Limbe and Buea Regional Hospitals in Cameroon. METHODS : this was a retrospective nested case control study carried out from December 2006 to December 2016. A ratio for control vs cases of 3:1 was obtained. Any pregnancy implanted outside the normal uterine cavity was considered as an ectopic pregnancy. Student's t-test was used to compare continuous variables and Pearson's Chi-square test for categorical variables. The association between EP and the demographical and clinical variables was estimated using logistic regression. Statistical significance was set at p-values<0.05. RESULTS : a total of 247 cases of EP were registered out of 17221 deliveries giving an incidence of 1.43% in ten years. History of pelvic inflammatory disease (OR = 3.10, CI (1.76-5.44), p < 0.001), previous EP (OR = 10.22, CI (2.61-14.82), p < 0.001), History of induced abortion (OR = 2.68, CI (3.32-9.73), p< 0.001), history of adnexa surgery (OR = 4.37, CI (2.17-10.32), p < 0.001) and history of appendectomy (OR = 2.16, CI (0.99-6.64) p< 0.001), were also found to be associated with increased risk of EP. More than five percent (5.52%) of the patients were in shock at presentation. Diagnosis was confirmed mainly by use of ultrasound (78.53%) and treatment was principally by laparotomy (97.55%) with salpingectomy (95.60%). Most (90.18%) of ectopic pregnancies were ruptured at presentation. Only 2.45% of cases were manage medically with the use of methotrexate. CONCLUSION : the incidence of ectopic pregnancy (EP) in our environment is within the global range (hospital-based incidence of 1.43%) and is rising. Late presentation, lack of modern diagnostic and management tools have made laparotomy with salpingectomy the principal method of management of ectopic pregnancy in our environment.http://www.clinical-medicine.panafrican-med-journal.comam2021School of Health Systems and Public Health (SHSPH

Prevalence of bacterial vaginosis and associated risk factors in pregnant women receiving antenatal care at the Kumba Health District (KHD), Cameroon

Abstract Background Bacterial vaginosis (BV) is a common reproductive tract disorder in women of child bearing age, accounting for one third of vaginal infections. It is characterized by an increase in vaginal pH, decreased Lactobacilli, and overgrowth of facultative and anaerobic bacteria. Studies have consistently shown BV to be a risk factor for adverse obstetric and gynecological outcomes. BV is believed to play a critical role in the transmission of sexually transmitted infections. Its aetiology and risk factors are poorly understood. This study determined the prevalence and risk factors for BV among pregnant women in Kumba Health District (KHD) Cameroon to generate findings that could guide the design of interventions for prevention of infection and associated poor pregnancy outcomes. Methods A structured questionnaire was administered to 309 women seeking antenatal care (ANC) in three health facilities in KHD between May to July 2016, to capture data on demographic, gynecological and obstetric characteristics, and hygiene behavior. High vaginal swabs (HVS) collected from these women were gram stained, examined under a microscope and BV evaluated by Nugent scoring. Chi square (χ2) test was used to determine the relationship between BV and factors investigated. Statistical significance was set at p < 0.05. Results The prevalence of BV was 26.2%. Nine point 1 % of participants had a mixed infection with Candida. BV was higher (29.5%) in participants from the rural area (χ2 = 8.609. P = 0.014), those who did not use antibiotics (31.9%) prior to the study (χ2 = 12.893, P = 0.002) and women with no history of a genital tract infection (χ2 = 18.154, P = 0.001). There was a significant difference in prevalence with respect to gestation age (χ2 = 13.959, P = 0.007) with the highest occurring in women in the second trimester (31.7%). Women who practiced douching (χ2 = 23.935, P = 0.000) and those who did not wash pants with disinfectant (χ2 = 7.253, P = 0.027) had a high prevalence. Conclusion BV could be a health concern among pregnant women in study area. BV prevalence was affected by some hygiene behaviors, socio-demographic and clinical factors. Screening and treatment of positive cases during antenatal visits to prevent adverse outcomes, as well as education of women on vaginal hygiene is highly recommended

The assessment of treatment and outcome of distal humeral fractures: A 10-year retrospective study of cases in Douala

Introduction: Distal humeral fractures (DHF) are most often complex. Treatment is either through conservative or surgery (Open reduction and internal fixation, open reduction with external or Total elbow arthroplasty). Operative interventions represent a serious challenge to orthopaedic surgeons worldwide, challenges in surgical management is due to; local anatomic constrain, frequent comminution, displacement and osteopenia. Complication rates such as posttraumatic arthritis, ulnar neuritis, heterotrophic ossification, joint stiffness, failure of open reduction and non-union are as much as 15% to 25% and represent a significant cause of morbidity in these patients. Our aim therefore was to assess the treatment and outcome of management of distal humerus fractures at Douala General Hospital (DGH) and Laquintinie Hospital Douala (LHD). Materials and methods: This was a 10-year descriptive retrospective study carried out in LHD and DGH, from 2nd March 2010 to 2nd of March 2020.We used data collection form to collect information needed. Data concerning, socio demography, classification of the DHF, treatment option used, and the outcome after discharge was assessed using Mayo elbow assessment index. Data was stored in EPiinfo version 7, it was later exported and analysed with Statistical Package for the Social Sciences (SPSS) version 24, chi-square was the statistical test used. Results: We recruited 62 cases with a mean age of 37±13.37. The age range mostly affected was 18-30years. Of these, 53.2%(n=33) were male and 46.8%(n=29) were female. Majority of the cases (54.8%) resulted from road traffic accidents (RTA). Treatment offered was mainly surgical in 72.6% of cases. Conservative management was associated with- poor outcome (MAYO&lt;60) in 70%(n=7) while excellent outcome was only seen in those who did surgical management 100%(n=19) of cases(p=0.001). Conclusion: The most common treatment modality used in our study is surgical management. It was associated with favourable outcome; thus, this should be recommended as the mainstay treatment option. &nbsp; English title: Evaluation de la prise en charge et résultat des fractures de la palette humérale de l’adulte : Une étude rétrospective de 10 ans à Douala Introduction: Les fractures distale de l’humérus sont le plus souvent complexes. Leur traitement es sois conservatoire ou chirurgical. Le traitement chirurgical est un grand challenge pour les chirurgiens orthopédistes du monde entier ; ces challenges sont dus aux contraintes anatomiques locales, à la comminution fréquente, au déplacement des fragments d’os et à l’ostéopénie. Notre objectif était d’évaluer le traitement et les résultats de la prise en charge des fractures distales de l’humérus à L’Hôpital Géneral de Douala (HGD) et à L’Hôpital de Laquintinie de Douala (HLD). Matériel et méthodes: Une étude rétrospective et descriptive sur dix ans a été faite à HLD et HGD du 2 Mars 2010 au 2 Mars 2020. La collecte des données s’est faite par une étude des dossiers des patients ayant été pris en charge pour une fracture distale de l’humérus. Les informations sur l’aspect sociodémographiques, antécédent médicaux, classification des fractures distale de l’humérus, les traitements pris et les résultats évaluer par le Mayo Elbow Assesment Index. Les données ont été conservé dans EPI info puis transférer et analyser par SPSS 25. Résultats: Soixante-deux cas ont été recrutés avec un âge médian de 37+13,37. 53,2%(33) étais des hommes et 46,8%(29) des femmes. La plupart des cas (54,8%) était due à des accidents de la voie publique. Le traitement chirurgical a été proposé dans la majorité des cas (72.6%) . La prise en charge conservative était associée à de moins bons résultats (MAYO&lt;60) dans 70% (n=7) des cas et un excellent résultat a été observé chez ceux qui ont été pris en charge chirurgicalement 100% (n=19) (p=0,001). Conclusion: Le traitement le plus utilisé dans notre étude était le traitement chirurgical. Ce dernier étant associé à des meilleurs résultats. Nous recommandons la Chirurgie comme traitement standard des fractures distales de l’humérus

Prevalence, severity and associated factors of postpartum depression among mothers in the Buea health district

Background: Postpartum depression (PPD) is a debilitating mood condition affecting about 13% to 19% women post-delivery globally. This study aimed at investigating the prevalence, severity and factors associated to postpartum depression among birthing mothers in the Buea Health District.Method: We conducted a hospital-based cross-sectional study during the period of four months. Four health facilities were selected for the study by simple random sampling technique and respondents were enrolled by consecutive convenient sampling method. The participants of this study were mothers whose infants were within the age range one to 12 months. A structure questionnaire and the Patient Health Questionnaire 9 (PHQ-9) was administered by an interviewer to collect data. Data collected were entered into EpiData version 3.1 and analysed using the Statistical Package for Social Sciences (SPSS) version 21.0. Participants with PHQ-9 score of 5 points and above were considered as having postpartum depression. Based on the PHQ-9 score, depression can be classified into minimal (5-9), mild (10-14), moderate (15-19) and severe (≥20).Results: A total of 92 mothers participated in the study. The prevalence of PPD was 53.3% and the severity of depression varied from minimal (35.9%), mild (15.2%) to moderate (2.2%). Unemployment was the only factor significantly (χ2=8.114, P=0.017) associated with PPD.Conclusion: The high prevalence of postpartum depression among birthing mothers and the identification of the social and economic factors that contributed to PPD have the potential to serve as a framework for policy-makers to design interventions for PPD depression and other mental disorders among postnatal women in the Buea Health District in particular and Cameroon as a whole. Keywords: Postpartum depression, prevalence, associated factors, Buea Health District, Cameroon French Abstract: Prévalence et gravité de la dépression du post-partum chez les mères du district de santé de BueaContexte: La dépression du post-partum (DPP) est une condition d'humeur débilitante affectant environ 13% à 19% des femmes après l'accouchement dans le monde. Cette étude visait à estimer la prévalence et la gravité de la dépression du post-partum chez les mères qui accouchent dans le district sanitaire de Buea.Méthode: Nous avons mené une étude transversale en milieu hospitalier sur une période de quatre mois. Quatre établissements de santé ont été sélectionnés par une technique d'échantillonnage aléatoire simple et les répondants ont été consécutivement recrutés à l’aide d’une méthode d'échantillonnage par convenance. Ces participants étaient des mères dont leurs nourrissons étaient âgés d’un à 12 mois. Un questionnaire structuré et le Questionnaire sur la Santé du Patient 9 (QSP-9) ont été administrés par un intervieweur pour collecter les données. Les données collectées ont été saisies dans EpiData version 3.1, puis analysées à l'aide du logiciel de statistique SPSS version 21.0. Les participants avec un score QSP-9 supérieur ou égale à 5 points ont été considérés comme souffrant de dépression du post-partum. Sur la base du score de QSP-9, la&nbsp; épression est classée en minime (5-9), légère (10-14), modérée (15-19) et sévère (≥ 20).Résultats: Au total, 92 mères ont participé à cette étude. La prévalence de la DPP était de 53,3% et la gravité de la dépression variait de minime (35,9%), légère (15,2%) à modérée (2,2%). Le chômage était le seul facteur significativement (χ2 = 8,114 ; p = 0,017) associé à la DPP.Conclusion: La forte prévalence de la dépression du post-partum chez les mères qui accouchent et l'identification des facteurs sociaux et économiques qui ont contribué à la DPP ont le potentiel de servir de cadre aux décideurs politiques pour planifier des interventions contre la DPP et d'autres troubles mentaux chez les femmes postnatales dans le district de santé de Buea en particulier et au Cameroun dans son ensemble. Mots clés: Dépression du post-partum, prévalence, facteurs associés, district de santé de Buea, Camerou

Cellulitis in a rural farmer: case report

A 50year old rural farmer lady was admitted in to our service with copiously draining sore on the right leg. She had first received medicines for a small lesion on the ankle and later turned to traditional treatment when the medicines did not help. The traditional doctor diagnosed poison and treated her with scarifications and local application of traditional remedies; these worsened her lesions. Severe cellulitis was diagnosed in the hospital, and although amputation was an option, the leg was saved by critical analysis and the use of basic equipment. From this experience we recommend to our health services caring for our rural farmers to educate them on the importance of protective wares like simple shoes. Key words: rural farmer, cellulitis, skin graft French Abstract: Cas de cellulite chez une agricultrice ruraleUne agricultrice rurale âgée de 50 ans a été admise à notre service avec une large plaie sur la jambe droite. Elle avait au préalable reçu des médicaments pour une petite lésion à la cheville et s'est ensuite tournée vers un traitement traditionnel suite au résultat insatisfaisant. Le médecin traditionnel diagnostiqua le poison et la traita avec des cicatrisants par application locale des remèdes traditionnels ; lesquels ont aggravé ses lésions. Une cellulite sévère a été diagnostiquée à l'hôpital, et bien que l'amputation était une option, la jambe a été sauvée par une analyse critique et l'utilisation de l'équipement de base. De cette expérience, nous recommandons aux services de santé qui s'occupent des agriculteurs ruraux de les éduquer sur l'importance du port des équipements protecteurs tel que de simples chaussures. Mots-clés: Agriculteur rural, cellulite, greffe de pea

Prevalence and pattern of lower extremity injuries due to road traffic crashes in Fako Division, Cameroon

Introduction:&nbsp;low and middle income countries are disproportionately affected with road traffic injuries and the lower extremity is one of the most affected anatomical body parts. There exist very limited data on the pattern of lower extremity injuries in the Cameroon especially in the South West Region. We therefore, hypothesized that lower limb injuries are common in road traffic crashes and motorized two wheelers are the commonest cause. Methods:&nbsp;this was a hospital based prospective, cross sectional study. It involved four hospitals (Limbe and Buea Regional Hospitals, Baptist hospital Mutengene and Tiko District Hospital) in the Fako Division. It was carried out for three months. Victims of road traffic crashes received at emergency department of these hospitals during this period were assessed. Crash characteristics and injury characteristics were assessed and recorded. Results:&nbsp;we analyzed 411 crash victims, 197(47.93%) had lower extremity injuries. The male to female ratio was 1.4:1. Majority of crash victims were in their 3rd&nbsp;and 4th&nbsp;decades of life. The mean age of patients who had lower limb injuries was 33.30(±16.04). The most vulnerable road users were pedestrians (26.52%) and passengers on motor bikes (38.44%) and the commonest mechanism by which crash victims sustained injuries were: bike-car collisions (22.84%), and bike-pedestrian collisions (19.29%). Commercial motor bikes (62.77%) and taxis (22.38%) were the road users most involved in road traffic collisions. The leg 98(49.75%), thigh 23(11.68%), and knee 20(10.15%) were the most injured anatomical parts of the lower extremity. Fractures 68 (34.52%), lacerations 53(26.90%), and bruises 49(24.87%) were the most recurrent pattern of lower extremity injuries. Conclusion:&nbsp;in view of our findings we conclude therefore as follows: The prevalence of lower extremity injuries from Road Traffic Crashes in our study area was 47.93%. Associated risk factors to the road traffic crashes as identified by the victims were bad roads (10.15%) and bad weather (5.05%). The safety gargets were not adequately utilized by our victims, with 87.72% confirming that they did not wear the helmet and 87.50% affirming that they did not wear the seat belt at the time of the crash. The occupations mostly affected in our series were pupils and students (20.3%) and business people (19.2%), then the bike riders (15.23%). We thus recommend that the laws on the use of road safety gargets, especially helmets and seatbelts, be enforced, with riding and driving speeds reduced to below 60km/hour. Road usage should be avoided in bad weather and pedestrians lanes and zebra crossings be provided to minimize pedestrian-car or -bike collision

Musculoskeletal disorders among workers in the cameroon railways corporation-camrail, douala, cameroon

English Title: Musculoskeletal disorders among workers in the cameroon railways corporationcamrail, douala, cameroon Background: Occupational health is considered one of the drivers of economic development. This is why occupational diseases likemusculoskeletal disorders need to be prevented. Musculoskeletal ill health is reported among workers in the rail sector whose activities involve a lot of manual operations. Very little has been documented on musculoskeletal disorders in the rail sector in Cameroon. Objective: the objectives of this study were to determine the prevalence of musculoskeletal disorders and to identify possible&nbsp; associated factors among workers of the Cameroon Railways Corporation (CAMRAIL), Douala. Methods: we conducted a cross sectional, analytic, observational study among workers of the Cameroon Railways Corporation&nbsp; (CAMRAIL). Using a structured questionnaire derived from the health and safety Nordic musculoskeletal questionnaire (HSENMQ) and the Dutch musculoskeletal questionnaire (DMQ), we interviewed 300 workers chosen by convenient sampling at the central health centre of CAMRAIL in Douala. We collected information on the socio-demographic and professional characteristics of the workers, the physical and psychosocial work place factors, and lastly the occurrence of musculoskeletal symptoms in the previous year in nine bodyregions. Results: the mean age of workers was 44+/- 11years with an age range of 25 to 60 years. Male workers constituted 97% of the sample population. Technical workers formed 76% of the sample. The mean number of working years was 17+/-13.8 years. The prevalence of musculoskeletal symptoms was high at 74%. The lower back region was the commonest symptom site, with 50% of workers reporting symptoms in this area. It was also the region that caused the most work incapacity. The following factors showed significant association with musculoskeletal symptoms: age [OR=1.71,95%CI:0.81- 3.58, P=0.00119], duration of employment [OR=2.55,95%CI:1.14-5.63, P=0.0003],repetitive loading[OR=2.55,95%.CI:14-5.63,P=0.025], task control [0.47, 95%&nbsp; CI:0,24-0.91, P=0.026], social support[OR=0.43,95% CI:0.23-87, P=0.017]. Conclusion: Most of the workers were technicians and predominantly maels.74% of thenm had musculoskeletal disorders, and age and duration of work at the corporation were found to be associated with symptoms. Key words: Prevalence, Musculoskeletal Disorders, Workplace, Ergonomic

Effects of pre-operative anxiety on the post-operative recovery of surgical patients in the Buea Regional Hospital, Cameroon

Background: Preoperative anxiety is common in patients awaiting surgery. It may lead to delayed recovery. Medical practitioners are in good position to relieve preoperative anxiety. Therefore an assessment of preoperative anxiety and associated factors is a fundamental step for better management of anxious patients.Objective: The main objective of this study was to assess the effects of preoperative anxiety on patients’ recovery from the surgery.Materials and methods: This study was an observational cohort study, which recruited patients aged 18 years and above admitted for surgery at the Buea regional hospital. Data collection was done in two phases; the first phase was collected one day before the surgery using the Preoperative Intrusive Thought Inventory to assess the presence or absence of anxiety. The second phase assessed recovery one day, one week and one month after surgery, using the 0 to 10 pain scale, vital signs and physical activity. Data was coded and exported to statistical package for social science [SPSS] version 21 for analysis.Results: We studied 240 patients. 82[34%] of the participants were aged 31-40, and most of them were males 138[57.5%]. 129[53.8%] were married. 162[68%] of the respondents reported to have preoperative anxiety. There was a significant relationship [p value=.000] between anxiety and age, anxiety and gender, anxiety and medical diagnosis. The results showed no significant relationship between anxiety and vital signs [p value=.150]. However, there was a significant relationship between preoperative anxiety, postoperative pain and postoperative physical activity.Conclusion: Most of the patients who awaited surgery in the Buea regional hospital had anxiety. Preoperative anxiety was associated with factors such as age, gender, and diagnosis. Postoperative variables such as pain and physical activity were greatly influenced by preoperative anxiety. Keywords: Preoperative anxiety, surgery, recovery French Abstract: Effets de l'anxiété préopératoire sur la récupération postopératoire des patients admis en chirurgie à l'hôpital régional de Buea, CamerounContexte: L'anxiété préopératoire est courante chez les patients en attente d'une intervention chirurgicale. Cela peut entraîner un retard de récupération. Les médecins sont bien placés pour soulager l'anxiété préopératoire. Par conséquent, une évaluation de l'anxiété préopératoire et des facteurs associés est une étape fondamentale pour une meilleure prise en charge des patients anxieux.Objectif : L’objectif principal de cette étude était d'évaluer les effets de l'anxiété préopératoire sur le rétablissement du patient après la chirurgie.Méthodologie: Il s'agissait d'une étude cohorte observationnelle, menée chez des patients âgés de 18 ans et plus admis pour une intervention chirurgicale à l'hôpital régional de Buea. La collecte des données s'est déroulée en deux phases: la première phase s’est déroulée un jour avant la chirurgie en utilisant l'inventaire de la pensée intrusive préopératoire pour évaluer la présence ou l'absence d'anxiété. La Seconde phase consistait en l’évaluation de la récupération un jour, une semaine et un mois après la chirurgie, en utilisant l'échelle de douleur de 0 à 10, les signes vitaux et l'activité physique. Les données ont été codées et analysées à l’aide du progiciel statistique SPSS version 21.Résultats: Les données ont été collectées chez 240 patients, parmi lesquels 82 (34%) étaient âgés de 31 à 40 ans, 138 (57,5%) étaient des hommes, 129 (53,8%) étaient mariés et 162 (68%) des ont déclaré souffrir d'anxiété préopératoire. Il y avait une relation significative (p = 0,000) entre l'anxiété et l'âge, l'anxiété et le sexe, l'anxiété et le diagnostic médical. Les résultats n'ont montré aucune relation significative entre l'anxiété et les signes vitaux des participants (p = 0,150). Cependant, il y avait une relation significative entre l'anxiété préopératoire, la douleur postopératoire et l'activité physique postopératoire.Conclusion: La plupart des patients qui attendaient une intervention chirurgicale à l'hôpital régional de Buea étaient anxieux. L'anxiété préopératoire était associée à des facteurs tels que l'âge, le sexe et le diagnostic. Les variables postopératoires telles que la douleur et l'activité physique ont été fortement influencées par l'anxiété préopératoire. Mots clés: Anxiété préopératoire, chirurgie, récupératio