Sleep Apnea Syndrome: Prevalence and Comorbidity with Other Non-communicable Diseases and HIV Infection, among Hospitalized Patients in Yaoundé, Cameroon

Background: Sleep apnea syndrome (SAS), a growing public health threat, is an emerging condition in sub-Saharan Africa (SSA). Related SSA studies have so far used an incomplete definition. This study is aimed at assessing SAS using an American Academy of Sleep Medicine (AASM) complete definition and at exploring its relationship with comorbidities, among patients hospitalized in a Cameroonian tertiary hospital. Methods: This cross-sectional study was conducted in cardiology, endocrinology, and neurology departments of the Yaoundé Central Hospital. Patients aged 21 and above were consecutively invited, and some of them were randomly selected to undergo a full night record using a portable sleep monitoring device, to diagnose sleep-disordered breathing (SDB). SAS was defined as an apnea - hypopnea index (AHI) ≥ 5/h, associated with either excessive daytime sleepiness or at least 3 compatible symptoms. Moderate to severe SAS (MS-SAS) stood for an AHI ≥ 15/h. We used chi-square or Fisher tests to compare SAS and non-SAS groups. Findings: One hundred and eleven patients presented a valid sleep monitoring report. Their mean age ± standard deviation (range) was 58 ± 12.5 (28-87) years, and 53.2% were female. The prevalence (95% confident interval (CI)) of SAS was 55.0 (45.7, 64.2)% and the one of MS-SAS 34.2 (25.4, 43.1)%. The obstructive pattern (90.2% of SAS and 86.8% of MS-SAS) was predominant. The prevalence of SAS among specific comorbidities ranged from 52.2% to 75.0%. Compared to SAS free patients, more SAS patients presented with hypertension (75.4% vs. 48.0%, p = 0.005%), history of stroke (36.7% vs. 32.0%, p = 0.756), cardiac failure (23.0% vs. 12.0%, p = 0.213), and combined cardiovascular comorbidity (80.3% vs. 52.0%, p = 0.003). Similar results were observed for MS-SAS. Metabolic and neuropsychiatric comorbidities did not differ between SAS and SAS-free patients. Conclusion: The SAS diagnosed using modified AASM definition showed high prevalence among patients hospitalized for acute medical conditions, as it was found with SDB. Unlike HIV infection, metabolic and brain conditions, cardiovascular comorbidities (hypertension and cardiac failure) were significantly more prevalent in SAS patients.</p

Epilepsy in the Sanaga‐Mbam valley, an onchocerciasis‐endemic region in Cameroon: electroclinical and neuropsychological findings

International audienceThis is an open access article under the terms of the Creat ive Commo ns Attri butio n-NonCo mmerc ial-NoDerivs License, which permits use and distribution in any medium, provided the original work is properly cited, the use is non-commercial and no modifications or adaptations are made

Clinical presentations of onchocerciasis-associated epilepsy (OAE) in Cameroon

Background: A high prevalence of epilepsy has been observed in several onchocerciasis-endemic countries, including Cameroon. However, little is known on the clinical presentations of the affected persons with epilepsy (PWE). A community-based study was conducted with the aim of describing the spectrum of seizures in selected onchocerciasis-endemic villages in Cameroon and documenting relevant medical history in patients with onchocerciasis-associated epilepsy (OAE). Methods: We carried out door-to-door surveys in 5 onchocerciasis-endemic villages in Cameroon and recruited all consenting PWE. Epilepsy was diagnosed using a 2-step approach consisting of the administration of a standardized 5-item questionnaire followed by confirmation of the suspected cases by a neurologist. Onchocerciasis-associated epilepsy was defined as ≥ 2 seizures without an obvious cause, starting between the ages of 3–18 years in previously healthy persons having resided for at least 3 years in an onchocerciasis-endemic area. Ivermectin use by PWE was verified. Seizure history, relevant past medical, and family history, as well as neurological findings, were noted. Results: In all, 156 PWE were recruited in the 5 villages. The modal age group for epilepsy onset was 10–14 years. The diagnostic criteria for OAE were met by 93.2% of the PWE. Participants had one or more of the following seizure types: generalized tonic–clonic seizures (89.1%), absences (38.5%), nodding (21.8%), focal nonmotor (7.7%), and focal motor seizures (1.9%). One case (0.6%) with the “Nakalanga syndrome” was identified. More than half (56.4%) of PWE had at least one seizure per month. In one village, 56.2% of PWE had onchocercal skin lesions. Conclusion: People with epilepsy in onchocerciasis-endemic villages in Cameroon present with a wide clinical spectrum including nodding seizures and Nakalanga features. A great majority of participants met the diagnostic criteria for OAE, suggesting that better onchocerciasis control could prevent new cases. Epilepsy management algorithms in these areas must be adjusted to reflect the varied seizure types.SCOPUS: ar.jDecretOANoAutActifinfo:eu-repo/semantics/publishe

Epidemiology of onchocerciasis-associated epilepsy in the Mbam and Sanaga river valleys of Cameroon: Impact of more than 13 years of ivermectin

Background: A high epilepsy prevalence has been reported in several onchocerciasis-endemic villages along the Mbam and Sanaga river valleys in Cameroon, including Bilomo and Kelleng. We sought to determine the prevalence of epilepsy in these two villages following more than 13 years of community-directed treatment with ivermectin (CDTI). Methods: Door-to-door surveys were performed on the entire resident population in the villages in August 2017 and January 2018. Epilepsy was diagnosed using a 2-step approach: administration of a standardized 5-item questionnaire followed by confirmation by a neurologist. Previously published diagnostic criteria for onchocerciasis-associated epilepsy (OAE) were used. Ov16 serology was done for children aged 7-10 years to assess onchocerciasis transmission. Findings were compared with previous data from these two villages. Results: A total of 1525 individuals (1321 in Bilomo and 204 in Kelleng) in 233 households were surveyed in both villages. The crude prevalence of epilepsy was 4.6% in Bilomo (2017) and 7.8% in Kelleng (2018), including 12 (15.6% of cases) persons with epilepsy (PWE) with nodding seizures. The age and sex-standardized prevalence in Kelleng decreased from 13.5% in 2004 to 9.3% in 2018 (P < 0.001). The median age of PWE shifted from 17 (IQR: 12-22) years to 24 (IQR: 20-30) years in Bilomo (P < 0.001); and slightly from 24 (IQR: 14-34) years to 28 (IQR: 21.25-36.75) years in Kelleng (P = 0.112). Furthermore, 47.6% of all tested children between 7 and 10 years had Ov16 antibodies. Conclusions: There is a decrease in epilepsy prevalence after 13 years and more of CDTI in both villages. The age-shift observed in PWE suggests that ivermectin may prevent OAE in younger residents. Ov16 seropositivity in children indicates ongoing onchocerciasis transmission possibly due to suboptimal control measures. Our findings support the existence of OAE in Cameroon and highlight the need to strengthen onchocerciasis elimination programs.SCOPUS: ar.jinfo:eu-repo/semantics/publishe

Fear and depression during the COVID-19 outbreak in Cameroon : a nation-wide observational study

Abstract Background The COVID-19 pandemic has been associated with significant psychological and social distress worldwide. We investigated fear and depression among adults in Cameroon during different phases of the COVID-19 outbreak. Methods An online survey was conducted in Cameroon from June–December 2020 using a structured questionnaire. Socio-demographic data and information regarding COVID-19 history were obtained. Fear and depressive symptoms were assessed using the Fear of COVID-19 score (FCV-19S) and the Patient Health Questionnaire (PHQ-9), respectively. Responses were clustered in weeks to better appreciate their evolution over time. Results Overall, 7381 responses from all ten regions of Cameroon were analysed (median age: 30 years, 73.3% male). The prevalence of depression (PHQ-9 score ≥ 10) was 8.4%, and that of high fear of COVID-19 (FCV-19S scores ≥19) was 57.4%. These rates were similar across genders, age-groups, and region of residence. While mean weekly PHQ-9 scores remained fairly stable throughout the study period (range: 2.53–3.21; p = 0.101), mean FCV-19S scores were highest during the early weeks but decreased significantly thereafter (from 20.31 to 18.34; p <  0.001). Multivariate analyses revealed that having a postgraduate degree, a history of quarantine, flu-like symptoms during the past 14 days, and higher FCV-19S scores were associated with more severe depressive symptoms, while obtaining COVID-19 information from various sources reduced the odds for depression. Conclusion Depression amidst the COVID-19 crisis is less prevalent in Cameroon than in other countries. Prompt and widespread dissemination of adequate COVID-19 information may reduce the risks for depression by dispelling fear and anxiety among Cameroonians