Risk factors of cervical intraepithelial lesion in Douala-Cameroon: Implications of Herpes Simplex Virus Type 2, Chlamydia Trachomatis and Treponema Pallidum

Infection with high risk oncogenic human papillomavirus (HPV) such as HPVs 16 and 18 is the main cause of cervical cancer. The objective of this study was to determine the impact of Chlamydia trachomatis, Herpes simplex virus 2 (HSV 2), Treponema pallidum and some sexual behaviour on malignant progression of cervical lesion in Douala, Cameroon. From July 2009 to January 2010, we performed routine cervical smears to 163 consenting women, who completed a questionnaire on risk factors of cervical cancer. Blood samples were obtained for each of these women and used for the detection of antibodies against Chlamydia trachomatis, HSV 2 and Treponema pallidum. Results obtained showed that 26/163 (17 LSIL and 9 HSIL) of women had abnormal cytology, 75.5% (123/163) had HSV 2 infection, 19% (31/163) infected by Chlamydia trachomatis and 4.3% (7/163) infected by Treponema pallidum. Among the LSIL-positive women 35.3% (6/17) and 94.1% (16/17) were infected with Chlamydia trachomatis and HSV 2 respectively. Among those with HSIL cytology, 22.2% (2/9), 66.7% (6/9) and 11.1% (1/9) respectively had Chlamydia trachomatis, HSV 2 and Treponema pallidum. High parity and pregnancy rate was observed among women with positive cytology. Our finding shown high rate of cervical abnormalities among women infected with HSV 2; and among those with a higher number of parities and pregnancies. These results suggest that further investigations should be made in Cameroon to access real burden of these risk factors in the progression and persistence of cervical lesion.Key words:risk factors, cervical cancer, HSV 2, Chlamydia trachomatis, sexually transmitted infections.doi: 10.4314/ajcem.v12i3.

Predictors of childhood severe malaria in a densely populated area: Douala, Cameroon

The physiopathology of malaria is complex. More understanding would be useful for a better management of the disease. This study was undertaken to describe clinical presentation and some biochemical parameters in childhood malaria in order to identify some factors of disease severity. Eighty six (86) children (0 to 15 years old) were recruited in Douala, clinical data recorded and blood sample collected. Thirty one (31) healthy children were also targeted to serve as control. Blood glucose, hemoglobin, transaminases and nitric oxide were determined by spectrophotometry. C reactive protein (CRP) was also investigated. The results confirmed that severe malaria significantly affects children under 5 years. Severe malaria was associated with hyperpyrexia and prostration. Coma, convulsions and unconsciousness were more indicative of cerebral malaria. Hemoglobin and blood glucose levels decreased significantly in severe malaria patients compared with uncomplicated malaria patients or controls (P < 0.001). On the contrary, blood transaminases and CRP levels increased significantly in malaria patients compared to controls (P < 0.001). From these results, it is clear that childhood severe malaria is associated with prostration, coma, unconsciousness, convulsions and hyperpyrexia. Low levels of haemoglobin and glycemia, as well as high levels of transaminases and CRP has been identified as predictor of malaria severity.Keywords: Childhood malaria, clinical presentation, physiopatholog