Liver and Kidney Biochemical Profile of Typhoid Fever Patients at the Dschang District Hospital, West Cameroon: A Cross-Sectional Study

Background: Typhoid fever remains prevalent in developing countries and most often affects liver and kidney. This study aimed to assess biochemical disturbances of the liver and kidney in patients with typhoid fever at the Dschang District Hospital, appreciate the implication of the disease duration as well as the type and the duration of treatment.Methods and materials:  This cross-sectional study was conducted at the Dschang District Hospital, Cameroon. A total of 263 participants and a structure questionnaire was used to collect sociodemographic data. Stool culture was used for the diagnosis of typhoid fever. Liver and kidney biomarkers were access using spectrophotometric technic. Results: By these technics, 112 healthy individuals (Control Group, CG), and 151 patients diagnosed with typhoid fever (Study Group, SG) were obtained. A significant lower level of albumin (p<0.05) was noted in SG compare to CG while other biochemical parameters of the liver and kidney function (ALT, AST, T-BILI, C-BILI, ALP, γ-GT, urea and creatinine) presented a significant higher levels at varying degrees, especially for ALT (p <0.001), AST, ALP, urea and creatinine (p <0.01), T-BILI, C-BILI and γ-GT (p <0.05). Relatively to the variation of biochemical parameters with respect to the duration of illness in the patients before their arrival to the hospital, except albumin which had a significant (p<0.05) decreased level from the first to the third week of the disease, ALT and AST had a significant (p<0.05) increased level from the first to the third week of the disease and, T-BILI, C-BILI, UC-BILI, ALP and γ-GT from the second to the third week of the disease. Relatively to the type of drug intake, the serum level of ALT, γ-GT, albumin and creatinine were significantly increased (p<0.05) with fluoroquinolones and indigenous (medicinal plants) intake while the serum level of AST, T-BILI, C-BILI, UC-BILI, ALP, urea and creatinine clearance were significantly (p<0.05) increased only with indigenous intake. Relatively to the duration of treatment, except creatinine clearance that significantly (p<0.05) decreased at the third week of treatment, the serum level of ALAT, ASAT, C-BILLI, ALP, γ-GT and albumin were significantly (p<0.05) increased from the first to the third week of the treatment, the serum level of T-BILI, UC-BILI and urea from the second to the third week of the treatment, and the serum level of creatinine at the third week of the treatment. There was a significant correlation between disease duration, drug intake duration and the serum level of ALT, AST, total bilirubin, conjugated bilirubin, unconjugated bilirubin, ALP, γ-GT, urea, creatinine, albumin and creatinine clearance. Conclusion: The results of this study suggest that typhoid fever negatively affects the proper functioning of the liver and kidneys, which varies depending on the duration of the illness, self-medication with conventional drugs such as fluoroquinolones and medicinal plants, and the duration of treatment

Title: Primary Dysmenorrhea: Associated Symptoms, Impact and Management among Females in the Menoua Division of the West Region of Cameroon. Cross-sectional Study Running Title: Primary Dysmenorrhea in the Menoua Division

Primary dysmenorrhea, or painful menstruation in the absence of pelvic pathology is a common and often debilitating gynecological condition that affects between 45% and 95% of women at reproductive age. The current study aimed to assess the prevalence of dysmenorrhea and associated menstrual symptoms and their self-management techniques among females. This cross-sectional study was conducted in the Menoua Division, which has six subdivisions namely: Fokoue, Dschang, NKongni, Penka Michel, Santchou and Fongo tongo .For this purpose, 668 women aged from 12 to 38 years were considered. A self-administered questionnaire was used to collect data. The main results revealed that dysmenorrhea was reported on almost two-thirds of the women (66.17%). In the 442 girls who reported dysmenorrhea Severe pain was reported by 20.71 % of respondents. More than one-third of the respondents (39.75%) reported using pain relief medications with 23.38 % of herbal medicine and 76.54 % of synthetic medicines. The gastrointestinal problems (diarrhoea and vomiting were the most common symptoms experienced. Less than 19.41% of respondents reported having consulted a doctor for their dysmenorrhea, while most of them consulted friends and family.Dysmenorrhea is a very common problem among university students. A number of symptoms were related to dysmenorrhea. Even though it is common, and may not have a pathological cause, few women seek medical advice. Increasing the awareness might help in relieving the burden of this common health problem

Evaluation of metabolic syndrome in undergraduate students at the University of Dschang

Metabolic syndrome (MetS) is a cluster of risk factors for cardiovascular diseases (CVD), such as obesity, dyslipidemia, high blood pressure, and high blood glucose; it increases morbidity and mortality of CVD. MetS affects both adults and youths, leading to an impaired quality of life and a lowering of life expectancy. This study aimed to assess various aspects of metabolic syndrome, in undergraduate students at the University of Dschang. A questionnaire was distributed to 307 students of both sex; 203 meeting inclusion criteria were selected for anthropometric and blood pressure measurements followed by blood sample collection, for the dosage of biochemical markers (blood glucose, total cholesterol, LDL cholesterol, HDL cholesterol, triglyceridemia, and C-reactive protein). Results indicate that the prevalence of metabolic syndrome within the study population was 11.33 %. It has a significant predominance among obese and overweight patients (P˂0.05), compared to normal ones. Elevated blood pressure (OR= 23.4) and low HDL cholesterol levels (OR= 20.4) appeared to be the most determinant components of metabolic syndrome in the study population. We found an increase of metabolic syndrome prevalence with frequent consumption (3 to 4 times per week) of ‘‘Koki’’ (P=0.023), ‘‘Achu’’ (P=0.01), ‘’Corn couscous’’ (P=0.012), Salads (P=0.031), ‘‘Ndolè’’ (P=0.039) and pork (P=0.04). On the contrary, the prevalence of metabolic syndrome decreases significantly, with frequent consumption of green vegetables (P=0.016). Metabolic syndrome is present in undergraduate students of the University of Dschang, as a consequence of excess fat storage. Its main features are elevated blood pressure and low HDL-cholesterol level.Keywords: Obesity; Metabolic syndrome; cardiovascular risk factor; students; University of Dschan

Clinical Manifestations and Changes of Haematological Markers among Active People Living in Polluted City: The Case of Douala, Cameroon

International audienceUrban air pollution, despite its dangerous health impact, is poorly studied in sub-Saharan Africa (sSA). Epidemiological data on this silent killer are almost non-existent for cities of Cameroon, which seems to be one of the sSA countries where populations are highly exposed to air pollutants. Objective: The present study was conducted in Douala city, and aimed at determining the association of urban air quality degradation with respiratory and systemic health in active populations exposed to air pollutants on a daily basis. Methods: A cross-sectional study was conducted from 2017 to 2019 in 1182 active people consisting of motorbikes drivers (MD), outdoor urban workers (UW), and fuel station sellers (FSS). A standardized questionnaire was used to document participants' data. One hundred and twenty-six (126) motorbike drivers were selected to evaluate the relationship between haematological (white blood cells, platelets) and inflammatory (C-reactive protein-CRP) biomarkers, and air pollution; compared with those of a sixty-five (65) motorbike drivers' control group enrolled in Dschang, another town situated at about 216.3 km from Douala. Results: Among those recruited in urban Douala, some respiratory disorders such as running nostrils, colds, common fever, sore throats, dry cough, wheezing, chest pain, shortness of breath and systemic symptoms such as headaches, eye irritation, conjunctivitis, watery eyes and general tiredness were very common among MD, UW, and FSS. Regarding biological data, blood monocytes, lymphocytes and CRP were found to be significantly increased among selected MD in Douala, compared to control groups in Dschang. Conversely, a more significant decrease in blood neutrophil level was observed among MD in Douala than control groups in Dschang. These changes of haematological markers were significantly associated with place of residence, site of activity, and daily duration. Conclusion: Our results suggest the risk of suffering from respiratory impairments and systemic symptoms with exposure to urban air pollution among active people working near highways in Douala

Diagnostic Accuracy of CareStart™ Malaria HRP2 and SD Bioline Pf/PAN for Malaria in Febrile Outpatients in Varying Malaria Transmission Settings in Cameroon

Background: There was an increase in the number of malaria cases in Cameroon in 2018 that could reflect changes in provider practice, despite effective interventions. In this study, we assessed the diagnostic performance of two malaria rapid diagnostic tests (mRDTs) for diagnostic confirmation of suspected cases of malaria in public and private health facilities in two malaria transmission settings in Cameroon. Methods: We evaluated the diagnostic performance of CareStart pf and SD Bioline Pf/PAN mRDT and compared these parameters by RDT type and transmission setting. Nested PCR and blood film microscopy were used as references. The chi square test was used for independent sample comparisons, while the McNemar’s test was used to test for the dependence of categorical data in paired sample testing. A p < 0.05 was considered significant in all comparisons. The R (v.4.0.2) software was used for analyses. Results: A total of 1126 participants consented for the study in the four sites. The diagnostic accuracy of the CareStart Pf mRDT was 0.93.6% (0.911–0.961) in Yaoundé, 0.930% (0.90–0.960) in Ngounso, 0.84% (0.794–0.891) in St Vincent Catholic Hospital Dschang and 0.407 (0.345–0.468) in Dschang district hospital. For SD Bioline Pf/PAN the accuracy was 0.759 (0.738–0.846) for St Vincent Catholic Hospital Dschang and 0.426 (0.372–0.496) for the Dschang district hospital. The accuracy was slightly lower in each case but not statistically different when PCR was considered as the reference. The likelihood ratios of the positive and negative tests were high in the high transmission settings of Yaoundé (10.99 (6.24–19.35)) and Ngounso (14.40 (7.89–26.28)) compared to the low transmission settings of Dschang (0.71 (0.37–1.37)) and St Vincent Catholic hospital (7.37 (4.32−12.59)). There was a high degree of agreement between the tests in Yaoundé (Cohen’s Kappa: 0.85 ± 0.05 (0.7–0.95)) and Ngounso (Cohen’s Kappa: 0.86 ± 0.05 (0.74, 0.97)) and moderate agreement in St Vincent hospital Dschang (k: 0.58 ± 0.06 (0.44–0.71)) and poor agreement in the District Hospital Dschang (Cohen’s Kappa: −0.11 ± 0.05 (−0.21–0.01)). The diagnostic indicators of the SD Bioline Pf/PAN were slightly better than for CareStart Pf mRDT in St Vincent Catholic hospital Dschang, irrespective of the reference test. Conclusions: Publicly procured malaria rapid diagnostic tests in Cameroon have maintained high accuracy (91–94%) in the clinical diagnosis of malaria in high malaria transmission regions of Cameroon, although they failed to reach WHO standards. We observed an exception in the low transmission region of Dschang, West region, where the accuracy tended to be lower and variable between facilities located in this town. These results underscore the importance of the routine monitoring of the quality and performance of malaria RDTs in diverse settings in malaria endemic areas