Institute Superieur Of Technology Medicale

Yaoundé, Cameroon

Institute Superieur Of Technology Medicale

Yaoundé, Cameroon
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Pefura-Yone E.W.,University of Yaounde I | Pefura-Yone E.W.,Yaounde Jamot Hospital | Balkissou A.D.,University of Yaounde I | Balkissou A.D.,Yaounde Jamot Hospital | And 4 more authors.
BMC Infectious Diseases | Year: 2017

Background: Death under care is a major challenge for tuberculosis (TB) treatment programs. We derived and validated a simple score to predict mortality during tuberculosis treatment in high endemicity areas. Methods: We used data for patients aged ≥15 years, diagnosed and treated for tuberculosis at the Yaounde Jamot Hospital between January 2012 and December 2013. Baseline characteristics associated with mortality were investigated using logistic regressions. A simple prognosis score (CABI) was constructed with regression coefficients for predictors in the final model. Internal validation used bootstrap resampling procedures. Models discrimination was assessed using c-statistics and calibration assessed via calibration plots and the Hosmer and Lemeshwow (H-L) statistics. The optimal score was based on the Youden's index. Results: A total of 2250 patients (men 57.2%) with a mean age of 35.8 years were included; among whom 213 deaths (cumulative incidence 9.5%) were recorded. Clinical form of tuberculosis (C), age (A, years), adjusted body mass index (B, BMI, kg/m2) and status for HIV (Human immunodefiency virus) infection (I) were significant predictors in the final model (ρ < 0.0001) which was of the form Death risk=1/(1+e -(-1.3120+0.0474 *age -0.1866*BMI+1.1637 (if smear negative TB)+0.5418(if extra-pulmonary TB)+1.3820(if HIV+))). The c-statistic was 0.812 in the derivation sample and 0.808 after correction for optimism. The calibration was good [H-Lχ2=6.44 (ρ=0.60)]. The optimal absolute risk threshold was 4.8%, corresponding to a sensitivity of 81% and specificity of 67%. Conclusions: The preliminary promising findings from this study require confirmation through independent external validation studies. If confirmed, the model derived could facilitate the stratification of TB patients for mortality risk and implementation of additional monitoring and management measures in vulnerable patients. © 2017 The Author(s).


Nguefack F.,University of Yaounde I | Awa D.M.,University of Yaounde I | Awa D.M.,Center Mere Et Enfant Of La Fondation Chantal Biya | Dongmo R.,Hopital de District de Efoulan | And 4 more authors.
Medecine et Sante Tropicales | Year: 2016

Physical abuse of children can be of varying nature. Children can be shaken, beaten, burnt, or cut by their parents or guardians. The incidence of trauma inflicted on children is underestimated in many countries, probably because clinical signs are misjudged, as this case report shows. This three-year-old boy was seen in several health facilities of Yaounde, Cameroon. He was treated erroneously for severe malaria and then for meningitis because he presented with neurologic signs, before the diagnosis of child abuse was made. This was confirmed after an imaging workup revealed fractures of the skull and the leg. The diagnosis was therefore delayed by at least six weeks from the date of the first consultation. This case report demonstrates that child abuse is not well known in our environment, and it is therefore crucial to train those who provide health care to children to recognize it. © 2016 John Libbey Eurotext.


PubMed | University of Yaounde I, University of Douala and Institute Superieur Of Technology Medicale
Type: Journal Article | Journal: Medecine et sante tropicales | Year: 2016

Physical abuse of children can be of varying nature. Children can be shaken, beaten, burnt, or cut by their parents or guardians. The incidence of trauma inflicted on children is underestimated in many countries, probably because clinical signs are misjudged, as this case report shows. This three-year-old boy was seen in several health facilities of Yaounde, Cameroon. He was treated erroneously for severe malaria and then for meningitis because he presented with neurologic signs, before the diagnosis of child abuse was made. This was confirmed after an imaging work-up revealed fractures of the skull and the leg. The diagnosis was therefore delayed by at least six weeks from the date of the first consultation. This case report demonstrates that child abuse is not well known in our environment, and it is therefore crucial to train those who provide health care to children to recognize it.


Pefura-Yone E.W.,University of Yaounde I | Pefura-Yone E.W.,Yaounde Jamot Hospital | Kengne A.P.,University of Cape Town | Balkissou A.D.,Yaounde Jamot Hospital | And 16 more authors.
BMC Research Notes | Year: 2016

Background: Obstructive lung disease (OLD), a major global public health problem, has been less investigated in African countries. We assessed the prevalence and determinants of OLD in Yaounde (the capital city of Cameroon), using internationally agreed definitions. Methods: Participants were adults (age ≥19 years) screened during a community-based survey between December 2013 and April 2014. Air flow limitation (AFL) was based on a pre-bronchodilator forced expiratory volume in 1 s (FEV1) and forced vital capacity (FVC) below the lower limit of normal (LLN, AFL-LLN). Chronic obstructive pulmonary disease (COPD) was based on post-bronchodilator FEV1/FVC ratio < LLN (COPD-LLN). Results: Of the 1287 subjects included, 51.9 % were female, 9.3 % were current smokers and their mean age was 34.4 ± 12.8 years. Forty-nine (3.8 %, 95 % CI 2.8-4.9 %) participants had AFL-LLN. Thirty-one subjects had COPD-LLN; giving a prevalence of COPD-LLN of (2.4 %, 95 % CI 1.6-3.3 %). In multivariable analysis, male gender (AOR 2.42; 95 % CI 1.12-5.20) and lifetime wheezing (AOR 2.88; 95 % CI 1.06-7.81) were the determinants of COPD-LLN. Otherwise, male sex (AOR 1.93, 95 % CI 1.00-3.73), age 40-59 years (AOR 1.99, 95 % CI 1.04-3.81) and lifetime wheezing (AOR 2.65, 95 % CI 1.13-6.20) remained as independent determinants of AFL-LLN. Conclusions: Obstructive lung disease based on more accurate definitions was relatively infrequent in this population. It is important to sensitize the medical staff and the general public about this condition which should be actively investigated in individuals aged 40 years and above. © 2016 Pefura-Yone et al.


Pefura-Yone E.W.,University of Yaounde I | Pefura-Yone E.W.,Yaounde Jamot Hospital | Kengne A.P.,South African Medical Research Council | Kengne A.P.,University of Cape Town | And 19 more authors.
PLoS ONE | Year: 2015

Background Population-based estimates of asthma and allergic rhinitis in sub-Saharan African adults are lacking. We assessed the prevalence and determinants of asthma and allergic rhinitis in urban adult Cameroonians. Methods A community-based survey was conducted from December 2013 to April 2014 among adults aged 19 years and above (N = 2,304, 57.3% women), selected through multilevel stratified random sampling across all districts of Yaounde (Capital city). Internationally validated questionnaires were used to investigate the presence of allergic diseases. Logistic regressions were employed to investigate the determinants of allergic conditions. Results Prevalence rates were 2.7% (95% CI: 2.1-3.4) for asthma-ever, 6.9% (5.9-7.9) for lifetime wheezing, 2.9% (92.2-3.6) for current wheezing and 11.4%(10.1-12.7) for self-reported lifetime allergic rhinitis; while 240 (10.4%) participants reported current symptoms of allergic rhinitis, and 125 (5.4%) had allergic rhino-conjunctivitis. The prevalence of current asthma medication use and self-reported asthma attack was 0.8 (0.4-1.2) and 1 (0.6-1.4) respectively. Multivariable adjusted determinants of current wheezing were signs of atopic eczema [2.91 (1.09-7.74)] and signs of allergic rhinitis [3.24 (1.83-5.71)]. Age group 31-40 years [0.27(0.09-0.78), p = 0.016] was an independent protective factor for wheezing. Determinants of current rhinitis symptoms were active smoking [2.20 (1.37-3.54), p<0.001], signs of atopic eczema [2.84 (1.48-5.46)] and current wheezing [3.02 (1.70-5.39)]. Conclusion Prevalence rates for asthma and allergic rhinitis among adults in this population were at the lower tails of those reported in other regions of the world. Beside the classical interrelation between allergic diseases found in this study, active smoking was an independent determinant of allergic rhinitis symptoms. Nationwide surveys are needed to investigate regional variations. © 2015 Pefura-Yone et al.


Pefura-Yone E.W.,University of Yaounde I | Pefura-Yone E.W.,Yaounde Jamot Hospital | Mbele-Onana C.L.,Institute Superieur Of Technology Medicale | Balkissou A.D.,Biyemassi District Hospital | And 7 more authors.
Journal of Asthma | Year: 2015

Objectives: The distribution and impact of various aeroallergens on asthma occurrence vary across regions. We investigated the association between sensitisation to perennial aeroallergens and asthma risk in children and adolescents in Yaounde, Cameroon. Methods: This was a case-control study involving children and adolescents with asthma (cases) vs. non-allergic counterparts (controls). Children/adolescents with doctor-diagnosed asthma were included over a period of 30 months, and controls were selected from the community through random sampling. Logistic regression models were used to relate perennial aeroallergens sensitisation with asthma. Results: The asthma and control groups included, respectively, 151 and 372 participants, with no sex ratio difference. The mean age (standard deviation) was 11.9 (4.4) years in cases and 11.3 (3.7) years in controls. The prevalence of sensitisation to any aeroallergen (cases vs. controls) was 76.8% (116/151) and 32.3% (120/372), p < 0.001. Sensitisation to mites was found in 104 (68.9%) cases vs. 56 (15.1%) controls, p < 0.001. In multivariable analysis, sensitisation to Alternaria alternata, Blattella germanica and dander (cat and dog) was not associated with asthma. However, sensitisation to mites was significantly associated with asthma. Odds ratios (95% CI) for sensitisation to Dermatophagoides pteronyssinus, Dermatophagoides farinae and Blomia tropicalis in relation with asthma were 7.28 (3.75-14.15), 2.65 (1.27-5.45) and 3.23 (1.68-6.21), respectively. Conclusions: Sensitisation to mites was the main perennial allergenic factor associated with asthma in children and adolescents in this setting. This has application for the selection of patients with asthma who could benefit from the control of exposure to mites and specific immunotherapy. © 2014 Informa Healthcare USA, Inc.


PubMed | University of Yaounde I, Institute Superieur Of Technology Medicale, Yaounde Jamot Hospital and University of Cape Town
Type: | Journal: BMC research notes | Year: 2016

Obstructive lung disease (OLD), a major global public health problem, has been less investigated in African countries. We assessed the prevalence and determinants of OLD in Yaounde (the capital city of Cameroon), using internationally agreed definitions.Participants were adults (age >19 years) screened during a community-based survey between December 2013 and April 2014. Air flow limitation (AFL) was based on a pre-bronchodilator forced expiratory volume in 1 s (FEV1) and forced vital capacity (FVC) below the lower limit of normal (LLN, AFL-LLN). Chronic obstructive pulmonary disease (COPD) was based on post-bronchodilator FEV1/FVC ratio < LLN (COPD-LLN).Of the 1287 subjects included, 51.9% were female, 9.3% were current smokers and their mean age was 34.4 12.8 years. Forty-nine (3.8%, 95% CI 2.8-4.9%) participants had AFL-LLN. Thirty-one subjects had COPD-LLN; giving a prevalence of COPD-LLN of (2.4%, 95% CI 1.6-3.3%). In multivariable analysis, male gender (AOR 2.42; 95% CI 1.12-5.20) and lifetime wheezing (AOR 2.88; 95% CI 1.06-7.81) were the determinants of COPD-LLN. Otherwise, male sex (AOR 1.93, 95% CI 1.00-3.73), age 40-59 years (AOR 1.99, 95% CI 1.04-3.81) and lifetime wheezing (AOR 2.65, 95% CI 1.13-6.20) remained as independent determinants of AFL-LLN.Obstructive lung disease based on more accurate definitions was relatively infrequent in this population. It is important to sensitize the medical staff and the general public about this condition which should be actively investigated in individuals aged 40 years and above.


PubMed | University of Yaounde I, Institute Superieur Of Technology Medicale, Biyemassi District Hospital and University of Cape Town
Type: Journal Article | Journal: PloS one | Year: 2015

Population-based estimates of asthma and allergic rhinitis in sub-Saharan African adults are lacking. We assessed the prevalence and determinants of asthma and allergic rhinitis in urban adult Cameroonians.A community-based survey was conducted from December 2013 to April 2014 among adults aged 19 years and above (N = 2,304, 57.3% women), selected through multilevel stratified random sampling across all districts of Yaounde (Capital city). Internationally validated questionnaires were used to investigate the presence of allergic diseases. Logistic regressions were employed to investigate the determinants of allergic conditions.Prevalence rates were 2.7% (95% CI: 2.1-3.4) for asthma-ever, 6.9% (5.9-7.9) for lifetime wheezing, 2.9% (92.2-3.6) for current wheezing and 11.4% (10.1-12.7) for self-reported lifetime allergic rhinitis; while 240 (10.4%) participants reported current symptoms of allergic rhinitis, and 125 (5.4%) had allergic rhino-conjunctivitis. The prevalence of current asthma medication use and self-reported asthma attack was 0.8 (0.4-1.2) and 1 (0.6-1.4) respectively. Multivariable adjusted determinants of current wheezing were signs of atopic eczema [2.91 (1.09-7.74)] and signs of allergic rhinitis [3.24 (1.83-5.71)]. Age group 31-40 years [0.27(0.09-0.78), p = 0.016] was an independent protective factor for wheezing. Determinants of current rhinitis symptoms were active smoking [2.20 (1.37-3.54), p<0.001], signs of atopic eczema [2.84 (1.48-5.46)] and current wheezing [3.02 (1.70-5.39)].Prevalence rates for asthma and allergic rhinitis among adults in this population were at the lower tails of those reported in other regions of the world. Beside the classical interrelation between allergic diseases found in this study, active smoking was an independent determinant of allergic rhinitis symptoms. Nationwide surveys are needed to investigate regional variations.

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