75 research outputs found
Prevalence and factors associated with overweight and obesity in selected health areas in a rural health district in Cameroon: a cross-sectional analysis
No full textBackground: overweight and obesity are major public health problems worldwide, with projections suggesting a proportional increase in the number of affected individuals in developing countries by the year 2030. Evidence-based preventive strategies are needed to reduce the burden of overweight and obesity in developing countries. We assessed the prevalence of, and factors associated with overweight and obesity in selected health areas in West Cameroon.Methods: data were collected from a community-based cross-sectional study, involving the consecutive recruitment of participants aged 18 years or older. Overweight and obesity were defined according to the WHO classification. The statistical software R (version 3.5.1, The R Foundation for statistical computing, Vienna, Austria) was used for statistical analysis. Multivariable logistic regression analysis was used to assess independent factors associated with overweight and obesity, and obesity.Results: records of 485 participants were included for analysis. The age and sex-standardized prevalence of overweight, obesity, and overweight and obesity were 31.1% (95% CI, 27.0–35.2), 18.9% (95% CI, 14.9–22.9), and 50.1% (95% CI, 45.7–54.6), respectively. In multivariable analysis, being female (adjusted OR [aOR] = 2.79, 95% CI = 1.69–4.63), married (aOR = 3.90, 95% CI = 2.23–6.95), and having secondary or tertiary education (aOR = 3.27, 95% CI = 1.77–6.17) were associated with higher odds of overweight and obesity, while current smokers had lower odds of overweight and obesity (aOR = 0.37, 95% CI = 0.16–0.82) when compared to their respective counterpart. Compared to their respective reference categories, being female being (aOR = 3.74, 95% CI = 2.01–7.30), married (aOR = 2.58, 95% CI = 1.37–5.05) and having secondary or tertiary education (aOR = 2.03, 95% CI = 1.00–4.23) were associated with higher odds of obesity after adjustments for confounding.Conclusion: we observed a high prevalence of overweight and obesity in this study. The odds of overweight and obesity was higher in females, married participants, and those with higher levels of education. Community-based interventions to control overweight and obesity should consider targeting these groups
Difficulties in diagnosis and treatment of severe secondary Raynaud’s phenomenon in a Cameroonian woman: a case report
No full textBackground: Raynaud's phenomenon is a microvascular disorder that results in exaggerated vasoconstriction over vasodilatation secondary to an alteration in autonomic control. Though benign, it can result in severe ulceration and ultimately gangrene associated with disfiguration and permanent deformity. We present a case of severe secondary Raynaud's phenomenon in a black-African patient from a resource-limited setting, with focus on the difficulties encountered in the diagnosis and treatment. Case presentation: A 43-year-old female Cameroonian farmer with a 7-year history of episodic paresthesia in her fingers and toes (when exposed to cold) presented to our emergency department with severe pain, ulceration, and "darkening" of her fingertips over a period of 2 days. An examination revealed bilateral ulceration and dry gangrene of her fingers and toes, based on which a diagnosis of secondary Raynaud's phenomenon due to a connective tissue disease was proposed. Results of paraclinical investigations were normal. Lifestyle modification along with a calcium channel blocker and phosphodiesterase type 5 inhibitor provided significant relief. Conclusions: An early diagnosis and knowledge on appropriate treatment of Raynaud's phenomenon is of vital importance to prevent permanent tissue damage and disability. Relying on biphasic color change for the diagnosis of Raynaud's phenomenon in black Africans can be potentially misleading
A rare presentation of ectopic ovary in a female adolescent and the impact of obesity: a case report
No full textBackground: Inguinal hernias in women of reproductive age containing the ovary are very rare. When they occur in this age group, they are mostly associated with malformations of the urogenital system. Prompt surgical intervention is the key to ensure survival of the ovary. Here we present a case of an ectopic ovary presenting like an acute appendicitis. Case presentation: A 16-year-old Cameroonian girl presented at our emergency service with an acute exacerbation of a mild and intermittent right iliac fossa pain of 5 days' duration. A clinical examination revealed android obesity and signs suggestive of an acute appendicitis. An abdominopelvic ultrasound scan showed an edematous right ovary in the canal of Nuck. A prompt hernia repair was done and her postoperative period was uneventful. Conclusions: An ectopic inguinal ovary remains a rare occurrence. An urgent and careful exploration of the hernia sac is the standard of care. Careful physical examination of obese girls and women is vital particularly in emergency settings, as obesity in our patient contributed greatly to a missed diagnosis. Clinicians should potentially consider the possibility of an ectopic ovary when faced with girls and women presenting with right iliac fossa pain
Major risk factors for heart failure and pulmonary heart disease in 500,000 adults in the China Kadoorie Biobank
No full textBackground: Observational and Mendelian randomisation (MR) studies conducted primarily in Western countries suggest that higher levels of systolic blood pressure (SBP), body mass index (BMI) and waist-to-hip ratio (WHR) are associated with higher risks of heart failure (HF). However, uncertainties persist about the shape and strength of these associations, especially in non-Western populations. Moreover, studies on the associations of SBP and adiposity with pulmonary heart disease (PHD) are limited.
Methods: This thesis used data from the China Kadoorie Biobank study, which is a prospective cohort study of 0.5 million middle-aged Chinese adults recruited from 10 geographically diverse areas (5 rural, 5 urban) during 2004–2008 and followed up through record linkage to morbidity and mortality registers. Cox regression yielded adjusted hazard ratios (HRs) for HF and PHD with usual SBP, BMI and WHR. The likelihood ratio test was used to quantify the effect of adjustments for confounding and assess for effect modification and mediation. Mendelian randomisation (MR) provided causal evidence of the most promising associations in the observational analyses. Two-tailed p-values less than 0.05 were considered statistically significant. Data was analysed in R version 4.2.2.
Results: The overall mean (SD) SBP, BMI and WHR at baseline were 131 (21) mmHg, 23.6 (3.4) kg/m2 and 0.88 (0.07), respectively. In observational analyses, SBP had a positive and log-linear association with HF (HR per 10 mmHg: 1.13, 95% CI 1.11–1.15; n=8,223) but was not associated with PHD. The MR analysis also showed a positive association of genetically-predicted SBP with HF (HR per 10 mmHg: 1.18, 1.01–1.39; n=1,160). In observational analyses, BMI and WHR had a J-shaped association with HF (HR per 1 SD for BMI >22 kg/m2: 1.21, 1.18–1.25; for WHR >0.85: 1.17, 1.13–1.21; n=1,160). The associations of BMI and WHR with HF persisted after mutually adjusting for each other. By contrast, BMI and WHR had a reverse J-shaped association with PHD (HR per 1 SD for BMI <26 kg/m2: 0.61, 0.59–0.63; n=1,104) that attenuated to the null after excluding PHD cases recorded within the first two years of follow-up and prior medical conditions at baseline. In MR, genetically-predicted BMI was positively associated with HF (HR per 1 SD: 1.39, 1.11–1.75) but showed no association with PHD. By contrast, genetically-predicted WHR was not associated with HF or PHD in MR.
Conclusions: In this Chinese population, SBP and BMI were positively associated with HF but not PHD. However, WHR was not associated with HF or PHD. These findings contribute to the limited knowledge of the associations of SBP and adiposity with HF in non-Western populations and provide preliminary evidence of the associations of SBP and adiposity with PHD
Adolescent deliveries in semi-urban Cameroon: prevalence and adverse neonatal outcomes
No full textAbstract Objectives Adolescent pregnancies are high risk due to the increased probability of adverse outcomes; as adolescents are usually considered to be ill-equipped to deal with the burden of pregnancy. We sought to determine the prevalence of adolescent deliveries in a secondary-level care hospital in semi-urban Cameroon-Bamenda, the adverse neonatal outcomes and to assess if previous obstetric history could preclude adolescents from having adverse outcomes in their present pregnancy. Results The prevalence of adolescent deliveries was 8.7% (95% CI 7.01–10.73%). The neonates of adolescent mothers were more likely to have severe asphyxia (OR 4.0; 95% CI 1.2–12.9; p = 0.03) and low birth weight (OR 2.4; 95% CI 1.3–4.4; p < 0.01). The neonates of primipara adolescents were just as likely to have complications as multipara adolescents. The prevalence of adolescent deliveries (8.7%) in the Regional Hospital Bamenda is high. Their babies are at a high risk of adverse neonatal outcomes irrespective of their previous obstetric history (previous delivery) emphasising that adolescents are generally ill-prepared to deal with pregnancy. Strategies to reduce the prevalence of adolescent deliveries should be investigated and implemented in view of attaining the sustainable development goals
Prevalence and factors associated with medication adherence among patients with hypertension in sub-Saharan Africa: protocol for a systematic review and meta-analysis
No full textHypertension is the leading cardiovascular risk factor globally, associated with a high morbidity and mortality. The high prevalence of hypertension in sub-Saharan Africa (SSA) is associated with contrastingly low awareness, treatment and control rates. Adherence to medication remains a major determinant of optimal blood pressure control. This systematic review aims to determine the prevalence, and factors associated with adherence to antihypertensive pharmacotherapy among patients with hypertension in SSA.We will include studies published in Africa up to 31 December 2017. The following databases will be searched: PubMed, Embase, SCOPUS and Web of Science to identify potential studies without language restriction. To minimise chances of missing studies, resources specific to African literature such as WHO AFROLIB, African Index Medicus and African Journals Online will also be searched. Two reviewers will independently screen studies, extract data and critically appraise included studies for risk of bias, and a third reviewer will resolve discrepancies. A random-effects meta-analysis is planned to pool study-specific estimates to obtain a summary measure presented in Forest plots. Heterogeneity of included studies will be assessed using the χtest on Cochrane's Q statistic and quantified using I. Publication bias will be assessed using the Egger's test and funnel plots. This protocol has been prepared according to the Preferred Reporting Items for Systematic Reviews and Meta-analyses for Protocols 2015 statement.An ethical approval is not required for the proposed study, as it will be based on already published data. The end report will be presented at conferences and published in a peer-reviewed journal.CRD42017079838
Pyosalpinx causing acute appendicitis in a 32-year-old Cameroonian female: a case report
No full textPyosalpinx as a cause of acute appendicitis is very rare. We report the first case of a right pyosalpinx causing an extrinsic compression of the appendiceal lumen and consequently an acute appendicitis following an obstruction.A 32\ua0year old female\ua0from the North west region of Cameroon, presented with an acute exacerbation of a mild chronic right iliac fossa pain over a 2\ua0day duration. She underwent exploratory laparotomy and intraoperative findings were a bilateral pyosalpinx, with the right fallopian tube adhering to the caecum and the terminal ileum, and obstructing the lumen of an inflammed appendix. A classical appendectomy and a right salpingectomy were done. The post-operative period was uneventful and she returned after 2\ua0weeks for a follow-up visit with no further complaints.We describe to the best of our knowledge, the first case of an acute appendicitis caused by an extrinsic obstruction of the appendiceal lumen by a pyosalpinx. The close proximity of the caecum to the right fallopian tube most likely accounted for this occurrence. Although a rare entity, physicians should always keep in mind very rare causes of an acute appendicitis to guide management. This case highlights the shortcomings of pelvic ultrasonography in the diagnosis this condition. A pelvic computed tomography scanning should therefore be sought in case of a doubtful pelvic ultrasonography result. Finally, there is an urgent need to improve the awareness on sexually transmitted infections in our setting
Purple urine bag syndrome in an 80-year-old female Cameroonian
No full textPurple urine bag syndrome is a rare clinical entity commonly seen in elderly females with a long-term urinary catheterization. It presents as purple discoloration of the patient's plastic urine bag and tubing. We report the first case of this rare entity from Central Africa. We present the case of an 80-year-old female with purple urine associated with signs of urinary tract infection. Her symptoms resolved after 3 days of intravenous antibiotic treatment and diet modification. Purple urine bag syndrome remains rare, especially in African literature. Awareness of this benign syndrome is necessary for clinicians so as to adequately manage up to and including the associated anxiety
MOESM2 of Adolescent deliveries in rural Cameroon: comparison of delivery outcomes between primipara and multipara adolescents
No full textAdditional file 2: Table S1. Multivariable logistic regression analysis showing the influence of parity on low birth weight after adjusting for confounders
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