Atmospheric Pollution and Atopic Dermatitis

Atopic dermatitis is a frequent allergic dermatological disorder seen frequently in childhood. Affected patients often have a genetic predisposition and other atopic diseases like asthma, hay fever and allergic rhinitis. There are several triggering factors for atopic dermatitis among which the most recently established one is atmospheric or air pollution. The latter is due to the increased in industrialization in cities with the emission of waste products in the atmosphere as air pollutants. The role played by these pollutants in the pathogenesis of atopic dermatitis still remains largely unclear. This chapter elucidates the relationship between atmospheric pollution and atopic dermatitis

Epidemiology of depressive disorders in people living with hypertension in Africa: a systematic review and meta-analysis

Objectives Better knowledge of epidemiology of depressive disorders in people living with hypertension can help to implement pertinent strategies to address its burden. The objective was to estimate the prevalence of depressive disorders and symptoms in people living with hypertension in Africa.Design Systematic review and meta-analysis.Data sources PubMed, EMBASE, African Index Medicus, African Journals OnLine were searched up to 31 January 2020, regardless of the language of publication.Eligibility criteria We included studies conducted among adult patients with hypertension (≥18 years) living in Africa and reporting the prevalence of depressive disorders and symptoms.Data extraction and synthesis Two independent investigators selected studies, extracted data and assessed the methodological quality of included studies by using the tools developed by Joanna Briggs Institute. Multivariate random-effects meta-analysis served to pool data by considering the variability between diagnostic tools used to identify patients with depressive disorders or symptoms.Results We included 11 studies with 5299 adults with hypertension. Data were collected between 2002 and 2017, from South Africa, Nigeria, Ghana, Ethiopia and Burkina Faso. The mean age varied between 50.3 years and 59.6 years. The proportion of men ranged from 28% to 54%. The adjusted prevalence of depressive disorders taking into account the variance between diagnostic tools was 17.9% (95% CI 13.0% to 23.4%). The prevalence of depressive symptoms and major depressive symptoms was 33.3% (95% CI 9.9% to 61.6%) and 7.8% (95% CI 3.0% to 14.5%), respectively. There was heterogeneity attributable to the diagnostic tools for depressive disorders and symptoms. There was no publication bias.Conclusion Notwithstanding the representativeness lack of some (sub) regions of Africa, weakening the generalisability of findings to the entire region; depressive disorders and symptoms are prevalent in people living with hypertension in Africa, indicating that strategies from clinicians, researchers and public health makers are needed to reduce its burden in the region

COVID-19 and dentistry in sub-Saharan Africa: an urgent need to strengthen preventive measures in oral health care settings.

To the editors of the Pan African Medical Journal, In December 2019, a new virus causing pneumonia called Severe Acute Respiratory Syndrom Coronavirus 2 (SARS-COV 2) appeared in the city of Wuhan in China. Since then, the disease named COVID-19 has spread around the world and was declared a pandemic on March 11, 2020 by the World Health Organization. As of May 10, 2020, the number of cases is estimated to 3,917,366, with 274,361 associated deaths. Even if the number of cases increased gradually, Africa still remains the least affected continent with 42,626 cases to date and 1,369 deaths [...]

Corrigendum: Lifestyle and Epidemiology: Poverty and Cardiovascular Diseases a Double Burden in African Populations

Cardiovascular diseases (CVDs), ranked top non-communicable diseases (NCDs), are the second leading cause of mortality in Africa, especially in sub-Saharan Africa (SSA) where they account for 73·4% global deaths and 80% of all premature deaths yearly. The ill-health due to CVDs in SSA is equivalent to the combined burden due to communicable, maternal, neonatal and nutritional diseases. Un-addressed, it is extrapolated that the Sustainable Development Goal 3.4 which targets NCDs will not be achieved. The preponderance of CVDs in SSA is due to determinants such as the epidemiological transition of diseases, aging, stress, illiteracy, poor health systems and poverty. This is quite worrisome for SSA dubbed “one of the most poverty stricken region on the globe”. As such, poverty in Africa may adversely affect CVDs, but this has been less examined. This chapter explores the impact of poverty on CVDs and healthcare systems related to CVDs in Africa

Global prevalence and incidence of surgical site infections after appendectomy: a systematic review and meta-analysis protocol.

Acute appendicitis is a surgical emergency and the most frequent aetiology of acute surgical abdominal pain in developed countries. Universally, its widely approved treatment is appendectomy. Like all surgical procedures, appendectomy can be associated with many complications among which are surgical site infections (SSIs).Despite the increasing number of appendectomies done around the world and the associated morbidities related to SSI after appendectomy, there is still scarcity of data concerning the global epidemiology of SSI after appendectomy. The current review aims at providing a summary of the published data on epidemiology of SSI after appendectomy. We will include randomised controlled trials, cohort studies, case-control and cross-sectional studies. Electronic databases including Embase, MEDLINE and ISI Web of Science (Science Citation Index) will be searched for relevant abstracts of studies published between 1 January 2000 and 30 December 2017, without language restriction. The review will be reported according to the Preferred Reporting Items for Systematic Reviews and Meta-Analyses guidelines. After screening of abstracts, study selection, data extraction and assessment of risk of bias, we shall assess the studies individually for clinical and statistical heterogeneity. Appropriate meta-analytic techniques will then be used to pool studies judged to be clinically homogenous. Visual inspection of funnel plots and Egger's test will be used to detect publication bias. Results will be presented by country and continent. Since primary data are not collected in this study, ethical approval is not required. This review is expected to provide relevant data to help in quantifying the global burden of SSI after appendectomy. The final report will be published in a peer-reviewed journal. CRD42017075257

How to manage surgical patients during and early after COVID-19 pandemic: a practical approach for low-and middle-income countries (LMICs).

To the editors of the Pan African Medical Journal, Coronavirus disease 19 (COVID-19) pandemic caused by severe acute respiratory syndrome (SARS-CoV-2) is a global public health problem with major economic and social consequence of tremendous importance. Since the identification of its first case in Wuhan, Hubei, China in end December 2019, the exponential and rapid spread of the disease over all continents led the World Health Organization (WHO) to declare a pandemic in March, 11, 2020

Relative faible taux de mortalité de la COVID-19 au Cameroun : et si l’âge était le principal facteur ?

Depuis le début de la pandémie à COVID-19, un scénario catastrophique en termes de mortalité avait été prédit en Afrique subsaharienne. Dans cette correspondance, à partir des données de mortalité belge selon l’âge, nous réalisons une extrapolation à la population du Cameroun. Cette extrapolation montre que même avec le scénario belge, on devrait s’attendre à environ 2.319 décès par COVID-19 au Cameroun, soit une mortalité par habitant 10,3 fois moindre. En conclusion, la jeunesse de la population camerounaise pourrait être un des principaux facteurs de faible mortalité liée à la COVID-19 dans ce pays. Cependant des études sont nécessaires pour éliminer d’autres facteurs, notamment génétiques et environnementaux.[Relatively low mortality rate of COVID-19 in Cameroon: what if age was the main factor?] Since the beginning of the COVID-19 pandemic, a catastrophic scenario in terms of mortality was predicted in Sub-Saharan Africa. In this correspondence, we have compared adjusted case fatality rate of Belgian to that of Cameroon. Our estimates showed that, even with the Belgian scenario, about 2319 COVID-19 deaths should be expected in Cameroon, i.e. 10.3 times lower per inhabitant mortality. In conclusion, the youthfulness of the Cameroonian population could be the main factor of low mortality rate related to COVID-19 in this country. However, studies are needed to eliminate other factors, notably genetic and environmental

A cohort analysis of neonatal hospital mortality rate and predictors of neonatal mortality in a sub-urban hospital of Cameroon

Abstract Background In Cameroon, sustainable effort needs to be done to reduce the current neonatal mortality rate from 21 deaths per 1000 live births to the global target of fewer than ten deaths per 1000 live births by 2035. We aimed to determine the neonatal hospital mortality rate and predictors of neonatal hospital mortality (NHM) in a major referral sub-urban hospital of Cameroon in a bit to formulate interventions to curb this burden. Methods This was a prospective cohort study consecutively enrolling all neonates admitted into the neonatology unit of the Bamenda Regional Hospital (BRH) from November 2015 to February 2016. Through interviewed questionnaires to parents and physical examination of neonates, we studied socio-demographic characteristics, antenatal history, intrapartum history and clinical findings of neonates. Neonates further underwent relevant laboratory investigations for diagnosis. All neonates were followed up till 28 days after the post-menstrual term for the neonatal outcomes. Multiple logistic regression was used to determine predictors of NHM. Results We enrolled 332 out of 337 neonates admitted to the neonatology unit of BRH during the study period. Fifty-three percent (53%) were males. Their mean gestational age and birth weight were 36.9 ± 3.9 weeks and 2677.2 ± 923 g, respectively. The main causes of neonatal admissions were complications of preterm birth (32.2%), neonatal infections (31.3%), and birth asphyxia (14.5%). The neonatal hospital mortality rate was 15.7%. NHM was related to complications of preterm birth (69%), birth asphyxia (23%) and neonatal infections (6%). A five-minute Apgar score less than seven was the only predictor of NHM (aOR: 16.41; CI 95%: 6.35–42.47; p < 0.01). Conclusion Neonatal mortality still remains a significant health problem in sub-urban Cameroon, mainly as a result of three pathologies; complications of preterm birth, birth asphyxia, and infections. There is an urgent need to revamp the current health policies through the improvement of antenatal care, skilled birth attendants, neonatal resuscitation, timely detection and treatment of complications of preterm births, birth asphyxia, and infections

Evaluation de la pertinence des demandes d’angioscanner thoracique pour suspicion d’embolie pulmonaire à Yaoundé

Introduction : L’objectif de la présente étude était d’évaluer la pertinence des demandes d’angioscanner pour suspicion d’embolie pulmonaire (EP) à Yaoundé. Matériel et méthodes : Il s’agissait d’une étude transversale descriptive avec collecte rétrospective et prospective des données. Elle s’est déroulée sur une durée de 7 mois, dans les services de Cardiologie et d’Imagerie médicale de 4 hôpitaux de la ville de Yaoundé. Étaient inclus tous les patients ayant réalisés ou réalisant un angioscanner thoracique pour suspicion d’embolie pulmonaire (EP) durant la période de novembre 2018 à mai 2019. Les variables étudiées étaient les données sociodémographiques, la probabilité clinique de l’EP par le score de Wells, les facteurs prédisposants, ainsi que le recours aux examens paracliniques (D-dimères, échocardiographie, échodoppler des membres). La pertinence de la demande d’angioscanner thoracique a été évaluée selon les recommandations de la Société Européenne de Cardiologie. Le test de Khi carré et le test exact de Fisher ont été utilisés pour rechercher les facteurs associés au diagnostic d’embolie pulmonaire. Une valeur p&lt;0,05 a été considéré comme statistiquement significative. Résultats : Nous avons retenu au total 71 patients dont la moyenne d’âge était de 54 ±15 ans avec des extrêmes de 18 et 89 ans. A l’évaluation du score de Wells, 25 patients (35,2%) avaient une probabilité clinique faible, 40 (56,3%) avaient une probabilité clinique intermédiaire et 6 (8,5%) avaient une probabilité clinique forte. La demande d’angioscanner thoracique était pertinente dans 76% des cas. La proportion d’embolie pulmonaire au scanner était de 39,4% (N=28). Cette fréquence était proportionnelle au degré de suspicion clinique soit 12% en cas de probabilité faible, 47,5% en cas de probabilité intermédiaire, et 100% en cas de probabilité forte. Le facteur le plus associé au diagnostic d’EP était la présence de signes de thrombose veineuse profonde (p=0,012). Conclusion: Les demandes d’angioscanner sont pertinentes dans trois quarts des cas dans notre série. L’utilisation du score de probabilité de Wells est fortement corrélée au diagnostic d’embolie pulmonaire en particulier en présence de signes cliniques de thrombose veineuse profonde. Ces résultats suggèrent de renforcer la sensibilisation des prescripteurs sur l’utilisation courante de ce score afin de limiter le risque d’irradiation et les dépenses financières des patients. English title: Relevance in the request of computed tomography pulmonary angiography for suspected pulmonary embolism in Yaoundé&nbsp; Introduction: The present study aimed to evaluate the relevance in the prescription of computed tomography pulmonary angiography for pulmonary embolism suspicion in Yaoundé. Materials and methods. We conducted a cross sectional study during a period of 7 months (November 2018 to May 2019) at the cardiology and imaging units of 4 hospitals in Yaoundé. All consenting patients who underwent CTPA were included in the study. The variables studied were socio-demographic data, clinical probability (using Wells score) and paraclinical workups (D-dimers testing, echocardiography, venous ultrasonography). The relevance of prescription was evaluate using the European Society of Cardiology‘s guidelines. Chi square and Fisher tests were used to find association between clinical parameters and diagnostic of pulmonary embolism. A p value&lt;0.05 was considered statistically significant. Results. A total number of 71 patients were recruited; the mean age was 54 ±15.4 years ranging between 18 to 89 years. In assessment of the Wells score, 25 patients (35.2%) had low clinical probability, 40 (56.3%) had intermediate clinical probability and 6 (8.5%) had high clinical probability. We have found that 76% of the request were appropriated according to the current guidelines of the European Society of Cardiology (ESC). The proportion of the pulmonary embolism in our population study was 39.4%. There was a linear relationship between level of clinical suspicion and proportion of pulmonary embolism with 12% in low probability, 47.5% in intermediate probability, and 100% in high Probability. The most associated factor of pulmonary embolism in CTPA was the presence of sign of deep venous thrombosis (p=0,012). Conclusion. The clinical request of computed tomography pulmonary angiography was relevant in three quarter of cases in our population. In case of high clinical suspicion, the diagnostic of pulmonary embolism was always positive. There is an urgent need to reinforce sensibilization of physician about adequate clinical request to reduce the risk of irradiation and high expenditure of the patients