Mother and Child Center

Yaoundé, Cameroon

Mother and Child Center

Yaoundé, Cameroon
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Ndombo P.K.,Mother and Child Center | Ndombo P.K.,University of Yaounde I | Ekei Q.M.,University of Buea | Tochie J.N.,University of Yaounde I | And 5 more authors.
Italian Journal of Pediatrics | Year: 2017

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. © 2017 The Author(s).

Noubiap J.J.N.,University of Yaounde I | Noubiap J.J.N.,Edea Regional Hospital | Nansseu J.R.N.,University of Yaounde I | Nansseu J.R.N.,Mother and Child Center | And 4 more authors.
BMC Medical Education | Year: 2013

Background: Hepatitis B virus (HBV) is the most contagious blood borne pathogen. The risk of occupational exposure to HBV among health care workers is a major concern, especially medical trainees. In this study we describe the knowledge of risk factors for HBV infection, history of accidental exposure to blood, awareness of HBV vaccine and the vaccination status among medical students in Cameroon. Methods. In April 2012, a cross-sectional survey was carried out using a pretested self-administered questionnaire among 111 medical students. Results: Sixty-two students (55.9%) had had at least one accidental exposure to blood since the beginning of their medical training, with a median of 2 (IQR, 1-3) exposures. There was a good knowledge of the risk factors for HBV infection and awareness of HBV vaccine among participants. However, only 20 (18%) participants had completed the three doses of primary HBV vaccination. Furthermore, only 2 of the 20 (10%) adequately vaccinated participants had a post-vaccination test to confirm a good immune response and thus an effective protection against HBV infection. The main reason for not being vaccinated was lack of money to pay for the vaccine (45.6%). Forty seven (42.3%) participants had been sensitized by their training institutions about the importance of HBV vaccination. These were more likely to be vaccinated compared to those who had not been sensitized (p<0,001). Conclusion: There is a high rate of accidental exposure to blood and a very low HBV vaccination uptake in medical students in Cameroon, leading to a high occupational risk of HBV infection. HBV vaccination should be strongly recommended for medical students and the vaccine made available free of charge at the beginning of their training. © 2013 Noubiap et al.; licensee BioMed Central Ltd.

Ndoula S.T.,University of Yaounde I | Ndoula S.T.,Guidiguis District Hospital | Ndoula S.T.,University of Maroua | Noubiap J.J.N.,University of Yaounde I | And 5 more authors.
International Journal of Immunogenetics | Year: 2014

Summary: Data on blood group phenotypes are important for blood transfusion programs, for disease association and population genetics studies. This study aimed at reporting the phenotypic and allelic distribution of ABO and Rhesus (Rh) groups in various ethnolinguistic groups in the Cameroonians. We obtained ABO and Rhesus blood groups and self-identified ethnicity from 14 546 Cameroonian students. Ethnicity was classified in seven major ethnolinguistic groups: Afro-Asiatic, Nilo-Saharan, Niger-Kordofanian/West Atlantic, Niger-Kordofanian/Adamawa-Ubangui, Niger-Kordofanian/Benue-Congo/Bantu/Grassfield, Niger-Kordofanian/Benue-Congo/Bantu/Mbam and Niger-Kordofanian/Benue-Congo/Bantu/Equatorial. ABO allelic frequencies were determined using the Bernstein method. Differences in phenotypic distribution of blood groups were assessed using the chi-square test; a P value <0.05 being considered as statistically significant. The frequencies of the antigens of blood groups O, A, B and AB were 48.62%, 25.07%, 21.86% and 4.45%, respectively. Rhesus-positive was 96.32%. The allelic frequencies of O, A and B genes were 0.6978, 0.1605 and 0.1416, respectively. Phenotypic frequencies of the blood groups in the general study population and in the different ethnolinguistic groups were in agreement with Hardy-Weinberg equilibrium expectations (P > 0.05). The frequencies of O, A, and B blood phenotypes were significantly lower, respectively, in the Nilo-Saharan group (P = 0.009), the Niger-Kordofanian/Benue-Congo/Bantu groups (P = 0.021) and the Niger-Kordofanian/West-Atlantic group. AB blood group was most frequent in the Niger-Kordofanian/Adamawa-Ubangui group (P = 0.024). Our study provides the first data on ethnic distribution of ABO and Rhesus blood groups in the Cameroonian population and suggests that its general profile is similar to those of several sub-Saharan African populations. We found some significant differences in phenotypic distribution amongst major ethnolinguistic groups. These data may be important for blood donor recruitment policy and blood transfusion service in Cameroon. © 2014 John Wiley & Sons Ltd.

Bissek A.-C.Z.-K.,University of Yaounde I | Bissek A.-C.Z.-K.,Mother and Child Center | Tabah E.N.,Central Hospital Yaounde | Tabah E.N.,Ministry of Public Health | And 13 more authors.
BMC Dermatology | Year: 2012

Background: Skin disorders are generally considered to be more prevalent in the rural areas of Cameroon. This study was carried out to verify this assumption by describing the spectrum of skin disorders in a rural setting of Cameroon.Methods: We carried out a community-based clinical skin examination of 400 consenting subjects from 4 villages of Cameroon: Nyamanga (27%), Yebekolo (24%), Mbangassina (23%) and Bilomo (26%).Results: The overall prevalence of skin diseases in our sample was 62% {95% CI: 57.2%, 66.8%} (248/400). The commonest skin disorders were: fungal infections (25.4%), parasitic infestations (21.4%), atrophic skin disorders (11.7%), hypertrophic skin disorders (9.7%), disorders of skin appendages {acne} (8.9%), benign neoplasm (6.5%), bacterial skin infections (5.2%), pigmentation disorders (4.8%), and dermatitis/eczema (4.0%). Skin infections and infestations constituted 52.82% of all skin disorders. The overall prevalence of infectious and parasitic infestation was 32.75% {95%CI: 28.17%, 37.59%} (131/400) as against 29.25% {95%CI: 24.83%, 33.98%} (117/400) for non-infectious disorders.Among people with skin infections/parasitic infestations, those with fungal infections and onchocercal skin lesions were the most prevalent, accounting for 48.1% (63/131) and 35.1% (46/131); and an overall prevalence of 15.75% {95%CI: 12.3%, 19.7%} (63/400) and 11.5% {95%CI: 8.5%, 15.0%} (46/400) respectively.There was secondary bacterial infection in 12.1% {95%CI: 8.31%, 16.82%} (30/248) of subjects with skin diseases. Hypertrophic and atrophic disorders of the skin were mainly keloids (9.68%), scarification marks (6.05%) and burn scars (5.65%). Skin diseases like dermatitis and eczema (4.03%), malignant tumours and pigmentation disorders were rare in our sample.The proportion of subjects diagnosed with skin disorders after examination (62.8%) was significantly higher than the proportion of 40.8% that declared having skin diseases (p < 0.0001).Conclusion: The prevalence of skin diseases in the rural Mbam valley is alarming, dominated by easily treatable or preventable skin infections and their magnitude is highly neglected by the community, contrasting with findings in the urban setting. Similar studies are needed in other ecological/demographic settings of the country in order to construct a better understanding of the epidemiology of skin disorders. This would lead to the development of national policies to improve skin care. © 2012 Bissek et al.; licensee BioMed Central Ltd.

Noubiap J.J.N.,University of Yaounde I | Noubiap J.J.N.,Edea Regional Hospital | Nansseu J.R.N.,University of Yaounde I | Nansseu J.R.N.,Mother and Child Center | And 4 more authors.
International Archives of Medicine | Year: 2014

Background: Hepatitis B virus (HBV) infection is one of the most serious occupational hazards faced by healthcare workers. Surgical personnel are particularly at risk. HBV infection is preventable by vaccination, but no previous study has assessed HBV vaccination coverage among healthcare workers in Cameroon. We assessed knowledge of risk factors of HBV infection, awareness of HBV vaccine, and vaccination status of surgical residents in Cameroon. Methods. A structured pretested questionnaire was administered to 49 of the 70 surgical residents in Cameroon during the 2011-2012 academic year. Results: Since the beginning of their residency program, 28 (57.1%) had had at least one accidental exposure to blood, with a median of 2 (range 1 to 25) exposures. Most of them had a good knowledge of risk factors for HBV infection. Although 98.0% (n = 48) were aware of the HBV vaccine, and 89.8% (n = 44) knew that they were at high risk of infection, only 24.5% (n = 12) had received a full course of at least three doses of the vaccine. In addition, only 33.3% (4/12) underwent post-vaccination testing to confirm a good immunological response (and thus effective protection against HBV infection). Among the 53.1% (n = 28) who had never had any dose of HBV vaccine, the main reasons for not being vaccinated were lack of time (38.5%), lack of money to pay for vaccine (23.1%), and lack of sufficient information on the vaccine (19.2%). Only 20.4% (n = 10) had been sensitized by their training institutions about the importance of HBV vaccination. Conclusion: There is a low HBV vaccine uptake among surgical residents in Cameroon. As part of occupational safety measures, complete HBV vaccination should be strongly recommended and offered to surgical trainees before the beginning of their training program. © 2014 Noubiap et al.; licensee BioMed Central Ltd.

Boula A.,Mother and Child Center | Waku-Kouomou D.,Centers for Disease Control and Prevention | Njiki Kinkela M.,Mother and Child Center | Esona M.D.,Centers for Disease Control and Prevention | And 13 more authors.
Infection, Genetics and Evolution | Year: 2014

Rotavirus is the most common cause of severe diarrheal disease in children under 5. years of age worldwide. The World Health Organization (WHO) estimated that 453,000 rotavirus-attributable deaths occur annually. Through the WHO, the Rotavirus Sentinel Surveillance Program was established in Cameroon in September 2007 with the Mother and Child Center (MCC) in Yaoundé playing the role of sentinel site and national laboratory for this program. The objectives of this surveillance were to assess the rotavirus disease burden and collect baseline information on rotavirus strains circulating in Cameroon. Diarrheal stool samples were collected in a pediatric hospital from children under 5, using the WHO case definition for rotavirus diarrhea. Antigen detection of rotavirus was performed by using an enzyme immunoassay (EIA). The genotypic characterization was performed using multiplexed semi-nested reverse transcription-polymerase chain reaction (RT-PCR) assays. Between September 2007 and December 2012, 2444 stool samples were received at the MCC laboratory for rotavirus antigen detection, of which 999 (41%) were EIA positive. Among EIA positive samples 898 were genotyped. Genotype prevalence varied each year. Genotype G9P[8] was the dominant type during 2007 (32%) and 2008 (24%), genotype G3P[6] predominated in 2010 (36%) and 2011 (25%), and G1P[8] was predominant in 2012 (44%). The findings showed that the rotavirus disease burden is high and there is a broad range of rotavirus strains circulating in Yaoundé. These data will help measure the impact of vaccination in the future. © 2014.

Tochie J.N.,University of Buea | Choukem S.-P.,University of Buea | Choukem S.-P.,Douala General Hospital | Langmia R.N.,Muna Memorial Clinic | And 3 more authors.
Pan African Medical Journal | Year: 2016

Introduction: Neonatal respiratory distress (NRD) is a main cause of neonatal morbidity and mortality in developing countries. Early detection of its risk factors and early treatment of its etiologies are major challenges. However, few studies in developing countries have provided data needed to tackle it. We aimed to determine the prevalence, predictors, etiologies and outcome of NRD in a tertiary health care centre of Cameroon. Methods: We analyzed the hospital files of all newborns admitted to the Neonatal unit of Douala General Hospital from 1st January 2011 to 28th February 2013. NRD was diagnosed based on the presence of one or more of the following signs: an abnormal respiratory rate, expiratory grunting, nasal flaring, chest wall recessions and thoraco-abdominal asynchrony with or without cyanosis, in their files. Socio-demographic and clinical variables of newborns and their mothers were analyzed using logistic regression analysis. Results: The prevalence of NRD was 47.5% out of the 703 newborns studied. Acute fetal distress, elective caesarean delivery, APGAR score < 7 at the 1st minute, prematurity, male gender and macrosomia were independent predictors of NRD. The main etiologies were neonatal infections (31%) and transient tachypnea of the newborn (25%). Its neonatal mortality rate was 24.5%, mainly associated with neonatal sepsis and hyaline membrane disease. Conclusion: NRD is a frequent emergency and causes high morbidity and mortality. Most of its risk factors and etiologies are preventable. Adequate follow-up of pregnancy and labor for timely intervention may improve the neonatal outcomes. © Tinuade Adetutu Ogunlesi et al.

PubMed | University of Yaounde I, Mother and Child Center, Health and Human Development Research Group, Bafoussam Regional Hospital and Yaounde Central Hospital
Type: | Journal: BMC endocrine disorders | Year: 2016

The metabolic impact of participating in a diabetes camp is little known among children and adolescents living with type 1 diabetes in sub-Saharan Africa. We aimed to assess the changes in glycemic control and insulin doses in a group of children and adolescents living with type 1 diabetes in Cameroon during and after camp attendance.During a 5-day camp, we collected data on insulin doses, HbA1c, weight and blood glucose at least six times per day in a group of children and adolescents living with type 1 diabetes. We compared the evolution of these parameters 3 and 12months after camp.Thirty-two campers completed the study. The mean age was 192years and the median duration of diabetes was 2 [IQR: 1.8-5] years. The mean HbA1c was 7.92.2% and the mean insulin dose was 4920 units/day upon arrival at camp. HbA1c dropped by 0.6% after 12months (p=0.029). Despite the significant (p=0.04) reduction in insulin dose from 4920 to 4418 units/day at the end of camp, hypoglycemic episodes occurred in 26 campers. However, the mean number of hypoglycemic episodes reduced from 1.32 (range: 0-4) on the first day, to 0.54 (range: 0-2) on the last day of camp (p=0.006). Weight increased by 6kg (p=0.028) between 3 and 12months after camp, but insulin doses remained unchanged.Attending camp for children and adolescents living with diabetes is associated with a significant decrease in HbA1c twelve months after camp without changes in insulin doses. Including camps as an integral part of type 1 diabetes management in children and adolescents in sub-Saharan Africa may yield some NCT02632032 . Registered 4 December 2015.

PubMed | Centers for Disease Control and Prevention, World Health Organization, Complexe Pediatrique de Bangui, Institute Pasteur Of Bangui and 2 more.
Type: Journal Article | Journal: Tropical medicine & international health : TM & IH | Year: 2016

The goal of the SURVAC pilot project was to strengthen disease surveillance and response in three countries; Cameroon (CAE), Democratic Republic of the Congo (DRC) and Central African Republic (CAR).Seven laboratories involved in rotavirus surveillance were provided with equipment, reagents and supplies. CDC and WHO staff provided on-site classroom and bench training in biosafety, quality assurance, quality control (QC), rotavirus diagnosis using Enzyme Immunoassay (EIA) and genotyping of rotavirus strains using the Reverse Transcription Polymerase-chain reaction (RT-PCR). All laboratory data were reported through WHO/AFRO.Twenty-three staff members were trained on RT-PCR for rotavirus genotyping which was introduced for the first time in all three countries. In CAE, the number of samples analysed by EIA and RT-PCR increased tenfold between 2007 and 2013. In DRC, this number increased fivefold, from 2009 to 2013 whereas in CAR, it increased fourfold between 2011 and 2013. All laboratories passed WHO proficiency testing in 2014.Laboratory capacity was strengthened through equipping laboratories and strengthening a subregional laboratory workforce for surveillance of rotavirus gastroenteritis. Each of the three countries generated rotavirus surveillance and genotyping data enabling the mapping of circulating genotypes. These results will help monitor the impact of rotavirus vaccination in these countries.

PubMed | J. Craig Venter Institute, University of Liverpool, University of Pretoria, Bill and Melinda Gates Foundation and 7 more.
Type: | Journal: Infection, genetics and evolution : journal of molecular epidemiology and evolutionary genetics in infectious diseases | Year: 2015

Group A rotaviruses (RVA) are among the main global causes of severe diarrhea in children under the age of 5years. Strain diversity, mixed infections and untypeable RVA strains are frequently reported in Africa. We analysed rotavirus-positive human stool samples (n=13) obtained from hospitalised children under the age of 5years who presented with acute gastroenteritis at sentinel hospital sites in six African countries, as well as bovine and porcine stool samples (n=1 each), to gain insights into rotavirus diversity and evolution. Polyacrylamide gel electrophoresis (PAGE) analysis and genotyping with G-(VP7) and P-specific (VP4) typing primers suggested that 13 of the 15 samples contained more than 11 segments and/or mixed G/P genotypes. Full-length amplicons for each segment were generated using RVA-specific primers and sequenced using the Ion Torrent and/or Illumina MiSeq next-generation sequencing platforms. Sequencing detected at least one segment in each sample for which duplicate sequences, often having distinct genotypes, existed. This supported and extended the PAGE and RT-PCR genotyping findings that suggested these samples were collected from individuals that had mixed rotavirus infections. The study reports the first porcine (MRC-DPRU1567) and bovine (MRC-DPRU3010) mixed infections. We also report a unique genome segment 9 (VP7), whose G9 genotype belongs to lineage VI and clusters with porcine reference strains. Previously, African G9 strains have all been in lineage III. Furthermore, additional RVA segments isolated from humans have a clear evolutionary relationship with porcine, bovine and ovine rotavirus sequences, indicating relatively recent interspecies transmission and reassortment. Thus, multiple RVA strains from sub-Saharan Africa are infecting mammalian hosts with unpredictable variations in their gene segment combinations. Whole-genome sequence analyses of mixed RVA strains underscore the considerable diversity of rotavirus sequences and genome segment combinations that result from a complex evolutionary history involving multiple host species.

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