GAD-7 and PHQ-9 measurement of perinatal anxiety and depression in women with hypertensive disorders of pregnancy in Yaounde, Cameroon

Background: The aim of the study was to determine the prevalence of perinatal anxiety and depression in women with hypertensive diseases during pregnancy in Yaounde.Methods: Authors carried out a cross-sectional descriptive study over nine months from October 2015 to May 2016, amongst pregnant women with hypertensive pregnancy disorders followed up in three tertiary care centers in Yaounde. Authors collected information from the medical files of selected patients by using a pre-tested and validated questionnaire in the perinatal period. We classified blood pressure values as per the JNC 7 recommendations. Anxiety and mental depression were evaluated for using the Generalized Anxiety Disorder 7-item and the Patient Health Questionnaires-9 respectively. Data analysis was done using CSPro version 6.2 and SPSS version 20.0 software.Results: Authors included 202 patients during the study period. The mean age stood at 25.9± 6.4years (extremes 13-43years). Amongst these, 47.5% were single while 97.5% (197/202) had received at least primary education. Students represented 45.5% (92/202) of women while 102 (50.5%) of them had some form of employment in the public, private or informal sectors. Severe preeclampsia was the most prevalent hypertensive disorder in these women, with 69 (34.2%) developing eclampsia. We found that 79% (161/202) of these patients suffered from anxiety, 67.3% (136/202) were depressive while 61.3% (124/202) had both anxiety and depression.Conclusions: The prevalence of perinatal anxiety and depression in women with hypertensive pregnancy disorders is high. Associated factors must be looked out in order to prevent these situations

Maternal hyperglycemia during labor and related immediate post-partum maternal and perinatal outcomes at the Yaoundé Central Hospital, Cameroon

Abstract Background Data on the prevalence and complications of gestational diabetes are very scarce in Cameroon. The aim of this study was to evaluate the uptake of screening for gestational diabetes and assess the immediate post-partum outcome of hyperglycemic parturient mothers and perinatal outcome of their babies. Methods A prospective cohort study was held at the Maternity of the Yaoundé Central Hospital from March to June 2013. One hundred volunteer women in labor without overt diabetes mellitus and having fasted for 8 to 12 h were recruited. No intervention was given. A clinical examination was done and capillary glucose recorded. Parturient women were categorized into two groups (hyperglycemic and non-hyperglycemic subjects) based on glycemia results interpreted according to the International Association of Diabetes and Pregnancy Study Groups. Mothers’ clinical examination was repeated and neonates examined immediately after delivery. Perinatal outcomes associated with maternal hyperglycemia during labor were assessed using relative risks. A p value <0.05 was considered statistically significant. Results One hundred women with a mean age of 27 (SD 6) years were recruited. Of them, 22 (22 %) had already been screened for gestational diabetes at baseline. Thirty-one (31 %) were diagnosed with hyperglycemia during labor, and this condition was highly associated with macrosomia in neonates (RR = 8.9, 95 % CI 2.70–29.32; p < 0.001). Other complications associated with maternal hyperglycemia during labor were perineal tears, cesarean section, and intrauterine fetal death, though the association was not statistically significant. Conclusions The main finding of this study is that maternal hyperglycemia during labor is highly associated with macrosomia in neonates. About a third of mothers were concerned with hyperglycemia during labor, and gestational diabetes was insufficiently screened in this series

Ocean acidification increases the accumulation of toxic phenolic compounds across trophic levels

Increasing atmospheric CO2 concentrations are causing ocean acidification (OA), altering carbonate chemistry with consequences for marine organisms. Here we show that OA increases by 46–212% the production of phenolic compounds in phytoplankton grown under the elevated CO2 concentrations projected for the end of this century, compared with the ambient CO2 level. At the same time, mitochondrial respiration rate is enhanced under elevated CO2 concentrations by 130–160% in a single species or mixed phytoplankton assemblage. When fed with phytoplankton cells grown under OA, zooplankton assemblages have significantly higher phenolic compound content, by about 28–48%. The functional consequences of the increased accumulation of toxic phenolic compounds in primary and secondary producers have the potential to have profound consequences for marine ecosystem and seafood quality, with the possibility that fishery industries could be influenced as a result of progressive ocean change

Utilisation de l’echographie doppler couleur dans la localisation de l’insertion du cordon ombilical et le devenir materno-foetal à la maternité de l’hôpital central de Yaoundé : une étude descriptive et analytique

Introduction: L'échographie doppler couleur permet d'étudier l'insertion du cordon ombilical sur le placenta. Les études américaines et asiatiques montrent que les insertions anormales telles les  insertions vélamenteuses et marginales sont associées à une élévation de la morbidité et de la mortalité périnatales. En Afrique et plus particulièrement au Cameroun, aucune étude n'a été publiée sur le sujet. D'où notre motivation à mener ce travail.Méthodes: Il s'agissait d'une étude descriptive et analytique qui s'est déroulée sur une période deux ans (2011-2012) à la maternité principale de l'Hôpital Central de Yaoundé. Cette étude a inclus 66 patientes qui ont subi chacune une échographie doppler couleur entre la 18ième et 30ième semaine de gestation, précisant le type d'insertion du cordon ombilical sur le placenta. A l'accouchement, un examen  macroscopique du placenta a été réalisé afin de comparer le type d'insertion et réaliser les tests statistiques. Résultats: Des 66 grossesses étudiées, nous avons eu un pourcentage de visualisation du type d'insertion de 100%. Toutes les insertions étaient normales à l'échographie soit 20 centrales et 46 latérales. A l'examen macroscopique du placenta, nous avons obtenu 19 (28,8%) insertions centrales, 47(71,2%) insertions latérales ; aucune insertion anormale n'ayant été objectivée. Les tests statistiques nous permettent d'avoir une sensibilité de 95%, une spécificité de  97,8%, une exactitude de 98%, une valeur prédictive positive de 95% et une valeur prédictive négative de 97,8%. Pour ces insertions, nous n'avons pas retrouvé d'association entre le mode d'accouchement, le poids de naissance, et le Score d'apgar avec le type d'insertion du cordon ombilical. Conclusion: Nous avons conclu que l'échographie doppler couleur a une haute sensibilité et spécificité dans la détermination de l'insertion du cordon ombilical sur le placenta. Il n'y a pas d'association entre le type d'insertion et le devenir maternofoetal. Key words: Echographie doppler couleur, sensibilité, spécificité, insertion du cordon ombilica

Facteurs prédictifs de l’échec du Traitement Préventif Intermittent du paludisme à la sulfadoxine – pyriméthamine (TPIp-SP) dans une population de femmes enceintes à Yaoundé

Introduction: Le traitement préventif intermittent à la sulfadoxine-pyriméthamine (TPIp-SP) est recommandé pour prévenir le paludisme pendant la grossesse. Nous avons recherché les facteurs associés à l'échec de cette stratégie. Méthodes: Nous avons mené une étude cas - témoins dans deux formations sanitaires de Yaoundé, du 1er Mai 2014 au 30 Avril 2015. Les femmes enceintes sous TPIp-SP hospitalisées pour paludisme ayant un Test de Diagnostic Rapide (TDR) positif (cas) étaient comparées aux femmes enceintes sous TPIp-SP ayant un TDR négatif (témoins). Les logiciels Epi info 7 et SPSS 18.0 ont été utilisés avec P&lt;0,05 comme seuil de significativité. Résultats: Nous avons recruté 234 sujets, 109 cas (46,6%) et 125 témoins (53,4%). Les facteurs associés retrouvés étaient : la primiparité (P=0,03 ; OR=1,15; IC= 0,32 - 4,10), la non utilisation de la MILDA (P=0,006 ; OR= 2,31 ; IC= 1,26 - 4,25), un antécédent d'hospitalisation pour paludisme (P=0,007 ; OR= 2,19 ; IC= 1,23 - 3,89), le début de la TPIp-SP après la 28ème semaine de grossesse (P=0,001, OR= 3,55; IC= 1,7 - 7,61). Après régression logistique, la primiparité (P=0,024 ; OR=2,01 ; IC=1,1-3,7) et un antécédent d'hospitalisation pour paludisme (P=0,001 ; OR=2,83 ; IC=1,50-5,4) restaient associés à l'échec du TPIp-SP. Conclusion: Un antécédent d'hospitalisation pour accès palustre et la primiparité sont des facteurs prédictifs indépendants de l'échec de la TPIp-SP.Pan African Medical Journal 2016; 2

Descriptive analysis of 192 cases of breast cancer occurring before age 40 in Yaounde, Cameroon

Background: Breast cancer is today a global health problem. With 1,671,149 new cases diagnosed in 2012, it is the most common female cancer in the world and accounts for 11.9% of all cancers and it affects more people than prostate cancer. In 2008, The United States statistics showed that, for all cancer that affect women before 40 years, more than 40% of them concerned the breast. The aim of this study was to describe the clinical, histopathological and therapeutic aspects of breast cancer in women under 40 years of age in Yaoundé.Methods: This was a retrospective study with data collected from 192 medical case files of women treated over a period of 12 years, from January 2004 to December 2015 at the Yaounde General Hospital and the Yaounde Gyneco-Obstetric and Pediatric Hospital. Microsoft Epi Info version 3.4.5 and SPSS version 20.0 softwares were used for data analysis.Results: From 2004 to 2015, 1489 cases of breast cancer were treated in both hospitals. Of these, 462 women were less than 40 years old, representing a proportion of 31.0%. The mean age at diagnosis was 33.5±5.0 years and 17.7% of women had a family history of breast cancer. The average time before an initial consultation was 6.7±6.6 months.  Most cases were classified as T4 (46.1%). The most common histological type was ductal carcinoma (87.4%). Grades SBR II and SBR III were predominant (76.4%). Axillary dissection (64.4%) and neoadjuvant chemotherapy (43.9%) were the main therapeutic modalities. The overall survival rate at 5 years was 51.2%. Five-year survival rates with no local recurrence and no metastatic occurrence were 35.8% and 43.2% respectively.Conclusions: Breast cancer largely affects women under the age of 40 and is often discovered late, at an advanced stage. The prognosis appears poor. Only screening could facilitate diagnosis at an early stage of the disease for better outcomes

Maternal hyperglycemia during labor and related immediate post-partum maternal and perinatal outcomes at the Yaound\ue9 Central Hospital, Cameroon

Background: Data on the prevalence and complications of gestational diabetes are very scarce in Cameroon. The aim of this study was to evaluate the uptake of screening for gestational diabetes and assess the immediate post-partum outcome of hyperglycemic parturient mothers and perinatal outcome of their babies. Methods: A prospective cohort study was held at the Maternity of the Yaound\ue9 Central Hospital from March to June 2013. One hundred volunteer women in labor without overt diabetes mellitus and having fasted for 8 to 12 h were recruited. No intervention was given. A clinical examination was done and capillary glucose recorded. Parturient women were categorized into two groups (hyperglycemic and non-hyperglycemic subjects) based on glycemia results interpreted according to the International Association of Diabetes and Pregnancy Study Groups. Mothers\u2019 clinical examination was repeated and neonates examined immediately after delivery. Perinatal outcomes associated with maternal hyperglycemia during labor were assessed using relative risks. A p value &lt;0.05 was considered statistically significant. Results: One hundred women with a mean age of 27 (SD 6) years were recruited. Of them, 22 (22 %) had already been screened for gestational diabetes at baseline. Thirty-one (31 %) were diagnosed with hyperglycemia during labor, and this condition was highly associated with macrosomia in neonates (RR = 8.9, 95 % CI 2.70\u201329.32; p &lt; 0.001). Other complications associated with maternal hyperglycemia during labor were perineal tears, cesarean section, and intrauterine fetal death, though the association was not statistically significant. Conclusions: The main finding of this study is that maternal hyperglycemia during labor is highly associated with macrosomia in neonates. About a third of mothers were concerned with hyperglycemia during labor, and gestational diabetes was insufficiently screened in this series

Predictors of eclampsia among preeclamptic patients: a case control study in Yaounde, Cameroon

Background: Preeclampsia is a major cause of maternal mortality. Eclampsia is a dramatic complication of preeclampsia. This study aimed at identifying clinical predictors of eclampsia among preeclamptic patients.Methods: We carried out a case-control study from November 1, 2014 to April 30, 2015 in six health facilities in Yaounde. Cases were women who have had eclamptic seizures antepartum, perpartum or within 48 hours of delivery. Controls were preeclamptic women who did not convulse till 48 hours after delivery. Unadjusted and adjusted Odds Ratios were calculated.Results: After univariable analysis the following parameters were associated with eclampsia: headache (uOR: 2.9; 95% CI: 1.4-6.2) and absence of stable income (uOR: 17.6; 95% CI: 6.2-49.8). After multivariate analysis predictors of eclampsia among pre-eclamptic patients were: age &lt;20 years (aOR: 2.5; 95% CI: 1.0-5.9), family history of high blood pressure in the mother (aOR: 4.8; 95% CI: 1.2-19.3), antenatal care by a nurse auxiliary (aOR: 9.3; 95% CI: 2.4-35.9), right upper abdominal quadrant pain (aOR: 9.9; 95% CI:1.2-77.9) visual disturbances (aOR:7.9; 95% CI: 2.3-26.9).Conclusions: These predictors of eclampsia can be used for early initiation of aggressive preventive therapy in pre-eclamptic patients