Background: Analysis of arterial stiffness (AS) is a good marker of early arterial disease and an important determinant of cardiovascular risk, independent of other traditional cardiovascular risk factors. Carotid-femoral pulse wave velocity (CfPWV) is the gold standard to evaluate arterial stiffness. There is evidence that patients with rheumatoid arthritis (RA) have a higher arterial stiffness than their age-matched healthy counterparts and thus have higher cardiovascular (CV) risk. However, data on arterial stiffness in African rheumatoid arthritis patients is scarce. Objectives: To determine the patterns of arterial stiffness in rheumatoid arthritis patients in a sub-Saharan African setting, using CfPWV and Augmentation index (AIx). Method: We conducted a case-control study, at the Douala general hospital over four months (February to May 2018) on 63 subjects among which 31 RA patients matched for age and sex with 32 healthy subjects. AIx and CfPWV were determined non-invasively by radial pulse wave analysis and carotid femoral wave analysis respectively, using a sphygmocor Atcor device (SphygmoCor, PWV Medical, Sydney, Australia). Results: The mean age of RA patients was 47 ± 14 years with most of them being females (n = 26, 83.9%). CfPWV was significantly higher in RA patients compared to the control group (mean: 8.85 ± 2.1 vs 7.45 ± 1.38; p ≤ 0.01) as well as was AIx (Median: 33 [26 - 43] vs 26 [20 - 31]; p = 0.01). RA (OR: 6.105; 95% CI: 1.52 - 24.54; p 1.34; 95% CI: 1.14 - 5.17; p = 0.05), elevated CRP levels (OR: 4.01; 95% CI: 1.16 - 13.68; p = 0.03) and Hypertension (OR: 5.75; 95% CI: 1.24 -11.60; p Conclusion: Arterial stiffness, a well-recognized marker of cardiovascular risk is increased among patients suffering from rheumatoid arthritis when compared to a healthy control group.

Introduction: Stroke is a major public health concern. It is a frequent pathology, 80% of which is of ischemic origin. Approximately 86% of all stroke deaths worldwide occur in low- and middle-income countries. The objective of this study was to investigate prognostic factors for in hospital lethality of stroke cases admitted in a public university hospital in Burkina Faso. Methods: This was a retrospective cohort study with a descriptive and analytical aim on adults admitted for a stroke confirmed by a brain scan at the Sourô Sanou University Teaching Hospital (CHUSS) of Bobo-Dioulasso over the period from January 1, 2009, to December 31, 2013. Results: The proportion of cases confirmed by the brain CT scan was 32% of all patients admitted for stroke in the CHUSS. The overall case fatality was 27.6%. This lethality was more pronounced in patients with hemorrhagic stroke (35.8%) compared to patients with ischemic stroke (22.4%). Median survival was higher in patients with ischemic stroke than those with hemorrhagic one (36 and 25 days, respectively) with a statistically significant difference (p value = 0.001). In multivariate analysis and hemorrhagic stroke (hazard ratio [HR]: 2.25; CI 95%: 1.41–3.61), an altered state of consciousness (HR: 1.90; CI 95%: 1.20–2.99) and the presence of central facial paralysis (HR: 1.67; CI 95%: 1.04–2.67) are factors that increased significantly the lethality. Conclusion: The study has identified three prognostic factors of lethality that are the hemorrhagic stroke type, the altered state of consciousness, and the central facial paralysis. Given the high case fatality, it is important to develop and implement effective prevention and management strategies adapted to the resources for the optimal control of stroke in Africa.

Objective: To determine the prevalence of hypertension and associated risk factors among rural and urban pygmy and Bantu dwellers of southern Cameroon Design and Methods: In this cross-sectional cluster sampling survey, we examined 100 traditional pygmies (TP) living in equatorial forest in Kavabousse village under hunter-gatherer subsistence mode, 100 traditional Bantus (TB) living in Bidjouka village closed to Kavabousse (rural area); and 100 contemporary pygmies (CP) and 100 contemporary Bantus (CB) both living in the same urban environment in Kribi city. Trained observers recorded in each participant lifestyle and socio-demographic data, and clinical parameters. Brachial systolic blood pressure (SBP) and diastolic blood pressure (DBP) were measured in triplicate using an automatic sphygmomanometer (Omron 705 CP). Hypertension was defined as SBP/DBP > or = 140/90 mmHg. Results: As compared to Bantus, Pygmies were younger (38 ± 16 vs 45 ± 17 years, p = 0.0001), with lower body mass index (22.7 ± 3.3 vs 24.9 ± 4.6, p < 0.0001). Age-adjusted SBP and DBP were lower in Pygmies than in Bantus (p < 0.0001), however within group SBP and DBP were similar among rural and urban individuals. Age-adjusted prevalence of hypertension was lower in pygmies than Bantus globally (7.5% vs 21.5% p = 0.0001), and in rural and urban areas: 4% vs 19% and 11% vs 24 %, respectively, both p < 0.01). In pygmies taken separately, the age-adjusted prevalence of hypertension was lower in TP than in CP (4% vs 11%). In the whole study population, multivariate logistic regression analysis revealed that hypertension was independently associated with urban area (OR = 2.15, 95%CI: 1.14–4.05), Bantu status (OR = 2.17, 95%CI: 1.09–4.34), age > or = 50 years (OR = 2.15, 95%CI: 1.14–4.05), and abdominal obesity (OR = 0.20 95%CI: 0.09–0.46) (all p < 0.05). In pygmies taken separately, multivariate logistic regression analysis shown that age > or = 50 years (OR = 3.83, CI95%: 1.33–11.36) and urban area (OR = 3.33, CI95%: 1.04–11.11) (both p < 0.05) were independent determinants of hypertension. Conclusion: This study reveals that hunter-gatherer lifestyle is associated with lower prevalence of hypertension as illustrated in TP. Hypertension is more common in Bantus and CP, and is largely attributable to their westernized lifestyle and the growing urbanization of rural area.

BackgroundDespite being a global pandemic, little is known about the factors influencing in-hospital mortality of COVID-19 patients in sub-Saharan Africa. This study aimed to provide data on in-hospital mortality among COVID-19 patients hospitalized in a single large center in Cameroon.MethodsA hospital-based prospective follow-up was conducted from March 18 to June 30, 2020, including patients >18 years with positive PCR for SARS-COV-2 on nasopharyngeal swab admitted to the Laquintinie Douala hospital COVID unit. Predictors of in-hospital mortality were assessed using Kaplan Meir survival curves and Weibull regression for the accelerated time failure model. Statistical significance was considered as p < 0.05.ResultsOverall 712 patients (65,7% men) were included, mean age 52,80 ± 14,09 years. There were 580 (67,8% men) in-hospital patients. The median duration of hospital stay was eight days. The in-hospital mortality was 22.2%. Deceased patients compared to survivors were significantly older, had a higher temperature, respiratory rate, and heart rate, and lowest peripheral oxygen saturation at admission. After adjusting for age, sex, and other clinical patient characteristics, increased heart rate, increased temperature, decreased peripheral oxygen saturation. The critical clinical status was significantly associated with increased in-hospital mortality. In contrast, hospitalization duration greater than eight days and the use of hydroxychloroquine (HCQ) + azithromycin (AZM) therapy was associated with decreased risk of in-hospital mortality.ConclusionOne in five hospitalized COVID-19 patients die in a low-middle income setting. Critical clinical status, dyspnea, and increased heart rate were predictors of in-hospital mortality. This study will serve as a prerequisite for more robust subsequent follow-up studies. Also, these results will aid in revising national guidelines for the management of COVID-19 in Cameroon.

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.

Introduction : Little is known about the long-term outcomes of Severe Acute Malnutrition (SAM) during childhood. As such, this study aims to explore the association between childhood SAM and blood pressure (BP) variability in adulthood in a context without nutrition transition. Methodology : We identified 524 adults (Median age: 22 years) who were treated for SAM during childhood in Eastern DRC between 1988 and 2007. They were compared with 407 community unexposed age-and-sex matched with no history of SAM. The variables examined for this study were the systolic (SBP), diastolic (DBP), mean (MBP) and pulse (PP) blood pressures, as well as high blood pressure (HBP) in adulthood. For comparison, linear and logistic regression models were used for analysing continuous and dichotomous variables, respectively. Results : Of the 524 exposed located, 145 exposed were selected according to age. A total of 97 unexposed were recruited. Compared to unexposed, exposed had slightly higher SBP and PP after adjusting [SBP = 1.4 mm Hg (-2.2, 4.8) and PP = 2.6 mm Hg (-0.3, 6.0)]. However, their mean DBP was lower that of among the unexposed [ -1.6 mm Hg (-4.6, 1.5)]. MBP and creatinine levels were comparable between the two groups. The prevalence of HBP adjusted for age was higher among exposed than unexposed (9.7% vs 5.3%). In addition, the odds of having HBP was higher among exposed than unexposed, however the difference was not statistically significant [ORa 1.9 (0.7, 5.6)]. Finally, using multiple regression, although the effect was not significant, SAM was a major contributor to HBP [OR 3.1 (0.9,10.9), p = 0.064], while being male and higher BMI were the only independent predictors among the young population of this study. Conclusions : There was no significant impact from an episode of SAM during childhood on BP variability in young adults in a context without nutrition transition. However, people who experienced a period of SAM had a higher prevalence of HBP and a much higher risk of developing HBP than unexposed. Additional multicentre studies involving a larger cohort would provide greater understanding of the impact of SAM on the overall risk of BP disorders during adulthood.

Background: Little is known about the long-term outcome of children treated for severe acute malnutrition (SAM) after nutritional rehabilitation. Objectives: To explore the association between SAM in childhood. noncommunicable diseases (NCDs). and low human capital in adulthood. Methods: We identified 524 adults (median age: 22 y) who were treated for SAM during childhood in Eastern Democratic Republic of Congo between 1988 and 2007. They were compared with 407 community unexposed age- and sex-matched subjects with no history of SAM. The variables of interest were cardiometabolic risk markers for NCDs and human capital. For the comparison, we used linear and logistic regressions to estimate the association between SAM in childhood and the risk of NCDs and ordinal logistic regression for the human capital. Results: Compared with unexposed subjects, the exposed participants had a higher waist circumference [1.2 (0.02. 2.3) cm; P = 0.015], and a larger waist-to-height ratio [0.01 (0.01. 0.02) cm; P < 0.001]. On the other hand, they had a smaller hip circumference [-1.5 (-2.6, -0.5) cm; P = 0.021]. Regarding cardiometabolic markers for NCDs, apart from a higher glycated hemoglobin (HbA1c) [0.4 (0.2, 0.6); P < 0.001], no difference was observed in other cardiometabolic markers for NCD between the 2 groups. Compared with unexposed participants, exposed participants had a higher risk of metabolic syndrome (crude OR: 2.35; 95% CI: 1.22, 4.54; P = 0.010) and visceral obesity [adjusted OR: 1.44 (1.09, 1.89); P = 0.001]. The prevalence of hypertension, diabetes, overweight, and dyslipidaemia was similar in both groups. Last. the proportion of malnutrition survivors with higher socioeconomic status level was lower. Conclusion: SAM during childhood was associated with a high risk of NCDs and lower human capital in adulthood. Thus, policymakers and funders seeking to fight the global spread of NCDs in adults in low-resource settings should consider the long-term benefit of reducing childhood SAM as a preventive measure to reduce the socioeconomic burden attributable to NCDs.

Background: Sleep disorders are known to be linked with numerous cardiovascular comorbidities including type 2 diabetes mellitus. The prevalence and impact of sleep quality and duration on diabetes in the Cameroonian population is not well established. This study evaluates the isolated and combined contribution of two aspects of sleep (duration and quality) on glucose homeostasis in an urban and rural Cameroonian population. Methods: This was a cross-sectional prospective survey conducted among 249 rural and 250 urban community dwellers in Cameroon aged ≥18 years. Self-reported sleep duration (SD) and quality were evaluated using the Pittsburgh Sleep Quality Index (PSQI). Poor sleep quality was considered for PSQI score>5 and short SD was considered≤ 6h. Diabetes was considered for fasting blood glucose>126mg/d Land/or use of glucose-lowering medications. Results: Mean age was 36±12 years, and men accounted for 39.1%. Frequency of poor sleep quality was 50.3% and was similar in urban and rural groups (48.2% vs 52.4% respectively, p=0.395). Short SD was present in 30.5% of subjects and was more frequent among urban dwellers (36.1% vs 24.8% in rural, p=0.006, respectively). Short SD was significantly associated with diabetes (OR 2.62, 95%CI 1.38-5.00). Although the frequency of diabetes was higher in participants with poor sleep quality compared to those with PSQI ≤5 (10% vs 6.5%, respectively), the observed difference was not significant (p>0.05). The combination of poor sleep quality and short SD was strongly associated with diabetes (OR 2.67, 95%CI 1.23-5.79). Conclusion: This survey demonstrates a significant association between short sleep duration as well as the combination of short sleep duration and poor sleep quality with type 2 diabetes prevalence. It is appropriate to consider sleep quality and duration as potentially modifiable variables associated with the presence or management of diabetes in these Cameroonian populations.

RESUMEL’abces parodontal represente l’une des urgences dentaires les plus courantes necessitant une prise en charge immediate. Il est responsable d’une destruction rapide du parodonte avec un impact sur le pronostic de la dent affectee et dans certaines circonstances de consequences graves au niveau systemique. Nous rapportons la prise en charge d’un abces parodontal chez un sujet diabetique et hypertendu recu au service de stomatologie de l’Hopital General de Douala. Une amelioration de la pression arterielle a ete notee 15 jours apres traitement parodontal non chirurgical.ABSTRACTPeriodontal abscess is a common dental emergency requiring immediate treatment. It leads to a rapid destruction of the periodontium with an impact on the prognosis of the affected tooth and in certain circumstances with serious consequences at the systemic level. We report the management of a periodontal abscess in a diabetic and hypertensive patient received at the stomatology department of the Douala General Hospital. An improvement in blood pressure was observed 15 days after non-surgical periodontal treatment.

Background Evidence suggests that low birth weight (LBW) is associated with increased cardiovascular and metabolic risk in adulthood, including increased arterial stiffness, a marker of early vascular aging (EVA) assessable by pulse wave velocity (PWV), obesity and glucose homeostasis abnormalities. The present study aimed to explore the late impact of LBW on PWV and cardiometabolic phenotypes among young adult Cameroonians. Methods The study evaluated 120 subjects (mean age: 26 ± 5 years; 54% male sex) at the Cameroon Heart Institute, Douala, Cameroon, between January and June 2018. Birth weight (BW) and gestational age, sociodemographic, anthropometrics and fasting capillary blood glucose were recorded in all participants. Blood pressure (BP) and PWV were measured using an automatic oscillometric device (Mobil-O-Graph®). Multiple-adjusted linear regression was used to determine predictive factors for PWV. For assessment of potential impact of BW on EVA, PWV was adjusted for age, sex, body mass index (BMI) and mean arterial pressure (MAP). Results 28 participants (23.3%) of the study sample had LBW (<3000g). There was no gender difference between LBW or normal birth weight patients (NBW; controls). Age- and MAP-adjusted PWV (aPWV) were higher in women with LBW compared to NBW (5.6 m/s and 5.3 m/s respectively, P = 0.038). In men, aPWV was similar in LBW and NBW. In this study population, aPWV was higher (on average +15 cm/s) in LBW than in controls, although the difference was not statistically significant (P=0.083). Multivariate regression analysis showed age, male sex, BMI and MAP were independent determinants of PWV, but not LBW. Compared to NBW controls, the prevalence of overweight/obesity, impaired glucose homeostasis and diabetes was higher in LBW: 42.9% vs 37%; 10.7% vs 3.3%, and 3.6 % vs 1.1%, respectively. Moreover, compared with controls, LBW individuals who were overweight/obese in adulthood had a much higher mean fasting capillary glucose (1.54 ±0.17 g/l vs 0.87 ±0.11 g/l in NBW, p=0.003). Conclusion This study suggests that although LBW is associated with increased aortic stiffness in young adulthood, mainly in women, the association was predominantly driven by aging, MAP, BMI and male sex. In adulthood, LBW subjects exhibited higher obesity indices and altered glucose homeostasis.

English Title: Periodontal status and treatment needs in the Cameroonian militaryenvironment Introduction : La profession de militaire implique l’aptitude mentale et physique lors des missions de combat. L'objectif de ce travail etait d'evaluer l’etat parodontal et les besoins en soins parodontaux des militaires camerounais ainsi que d’identifier les facteurs associes a la maladie parodontale chez ces derniers. Materiels et Methode : Une etude transversale d'une duree de 03 mois a ete menee dans quatre formations sanitaires militaires de la ville de Yaounde au Cameroun. Ont ete inclus, les militaires âges de 19 ans au moins ayant accepte de participer a l'etude. L’evaluation de l’etat parodontal et des besoins en soins parodontaux a ete faite a l’aide de l’indice CPITN (Community periodontal index of treatments needs). L’analyse statistique a ete faite a l’aide du logiciel IBM SPSS 20.0. Des regressions logistiques simples et multiple ont ete realisees pour determiner les facteurs associes a la maladie parodontale Resultats : 857 personnels militaires ont ete examines. 82,3% d’entre eux avaient un mauvais etat parodontal, 81,2% avaient besoin d’enseignement a l’hygiene bucco-dentaire et 78,2% d’un detartrage. Les facteurs associes a la maladie parodontale etaient l’âge (OR = 2,1[1,5-3]), le statut matrimonial (OR = 1,8[1,2-2,8]), l’anciennete dans l’armee (OR=1,9[1,3-2,9]) et la mauvaise hygiene bucco-dentaire (OR = 9,1[4,9-37,5]). Conclusion : Au terme de ce travail, il ressort que le militaire camerounais presente un mauvais etat parodontal ainsi qu’un besoin important en detartrage mais aussi d’education a l’hygiene bucco-dentaire. Mots cles : Sante parodontale, besoins en soins parodontaux, indice communautaire parodontal, militaire, Cameroun.

English Title: Periodontal health and Arterial hypertension: pilot study at the Douala General Hospital Introduction : L’hypertension arterielle (HTA) constitue le facteur de risque cardiovasculaire majeur dans le monde. Les etudes scientifiques recentes rapportent un lien de causalite entre la parodontite et l’HTA. L’objectif de ce travail etait d’evaluer la sante parodontale des patients hypertendus suivis a l’Hopital General de Douala. Materiels et Methode : Une etude transversale a ete menee sur une duree de 2 mois du 15 Janvier au 20 Mars dans les services de Cardiologie et de Stomatologie de l’Hopital General de Douala au Cameroun. Pour etre inclus dans l’etude le patient devait etre âge de 30 ans au moins, hypertendu et accepter de participer a l’etude. Chaque patient a beneficie de 2 mesures de pression arterielle brachiale a l’aide d’un tensiometre automatique. L’HTA etait consideree controlee chez les participants avec une PA<140/90 mmHg sous traitement antihypertenseurs. Un sondage parodontal a permis de recueillir les mesures de Profondeur de Poche (PP) et de Perte d’Attache Clinique (PAC). La parodontite a ete definie selon les criteres du Centers for Disease Control and Prevention et l'American Academy of Periodontology 2007. Resultats : 80 patients ont accepte de participer a l’etude. L’âge moyen de la population etait de 57 ± 10 ans. Le sexe ratio H/F etait de 0,7. La duree moyenne de l’HTA etait de 9 ± 8 ans. L’HTA etait controlee chez 17% d’entre eux. La frequence de la parodontite etait de 46%, soit 22,5% pour la forme moderee, 15% pour la forme legere et 8,8% pour la forme severe. La parodontite legere etait plus frequente chez les hypertendus controles que chez ceux non controles (35,5% versus 9,5% p=0,02). La parodontite severe a ete decrite uniquement chez les non controles. Conclusion : Les patients hypertendus de l’Hopital General de Douala presentent une frequence elevee de parodontite. Mots cles : Sante Parodontale, Parodontite, Hypertension Arterielle, Controle, Hopital General, Douala.

Abstract Aims Acutely decompensated heart failure (HF) (ADHF) is a common cause of hospitalization and mortality worldwide. This study explores the epidemiology and prognostic factors of ADHF in Cameroonian patients. Methods and results This was a retrospective study conducted between January 2003 and December 2013 from the medical files of patients followed at the intensive care and cardiovascular units of Douala General Hospital in Cameroon. Clinical, electrocardiographic, echocardiographic, and biological data were collected from 142 patients (58.5% men; mean age 58 ± 14 years) hospitalized for ADHF with reduced ejection fraction (HFrEF), whose left ventricular ejection fraction was <50%, or alternatively whose shortening fraction was <28%, both assessed by echocardiography. The commonest risk factors associated with HFrEF were hypertension (59.2%), diabetes mellitus (16.2%), tobacco use (14.1%), and dyslipidaemia (7.7%), respectively. The major causes of HF in hospitalized patients were hypertensive heart disease (40%, n = 57); hypertrophic cardiomyopathy (33.8%, n = 48); and ischemic heart disease (21.8%, n = 31). The most frequent comorbid conditions were atrial fibrillation (25.4%, n = 36) and chronic kidney disease (18.3%, n = 26). Major biological abnormalities included increased bilirubinemia >12 mg/L (87.5%, n = 124); hyperuricaemia >70 mg/L (84.9%, n = 121); elevated serum creatinine (65.6%, n = 93); anaemia (59.1%, n = 84); hyperglycaemia on admission >1.8 g/L (42.3%, n = 60); and hyponatraemia <135 mEq/L (26.8%, n = 38). At admission, 33.8% (n = 48) of patients had no pharmacological treatment for HF. The most frequently used therapies upon admission included furosemide (50%, n = 71), angiotensin‐converting enzyme inhibitors (ACEIs; 40.1%, n = 57); spironolactone (35.2%, n = 50); digoxin (26%, n = 37); beta‐blockers (17.7%, n = 25); angiotensin‐receptor blockers (ARBs; 7%, n = 10); and nitrates (7.0%). The overall in‐hospital mortality rate was 20.4%. Factors associated with poor prognosis were systolic blood pressure <90 mmHg [odds ratio (OR) 3.88; confidence interval (CI) 1.36–11.05, P = 0.011], left ventricular ejection fraction <20% (OR 7.48; CI 2.84–19.71, P < 0.001), decreased renal function (OR 1.03; CI 1.00–1.05, P = 0.026), dobutamine use for cardiogenic shock (OR 2.74;CI 1.00–7.47, P = 0.049), pleural fluid effusion (OR 3.46; CI 1.07–11.20, P = 0.038), and prothrombin time <50% (OR 3.60; CI 1.11–11.68, P = 0.033). The use of ACEIs/ARBs was associated with reduced in‐hospital mortality rate (OR 0.17; CI 0.02–0.81, P = 0.006). Conclusions Hypertensive heart disease, hypertrophic cardiomyopathy, and ischemic heart disease are the commonest causes of HF in this Cameroonian population. ADHF is associated with high in‐hospital mortality in Cameroon. Hypotension, severe left ventricular systolic dysfunction, renal function impairment, and dobutamine administration were associated with worst acute HF outcomes. ACEIs/ARBs use was associated with improved survival.

Background It is well documented that treatment for severe acute malnutrition (SAM) is effective. However, little is known about the long-term outcomes for children treated for SAM. We sought to trace former SAM patients 11 to 30 years after their discharge from hospital, and to describe their longer-term survival and their growth to adulthood. Methods A total of 1,981 records of subjects admitted for SAM between 1988 and 2007 were taken from the archives of Lwiro hospital, in South Kivu, DRC. The median age on admission was 41 months. Between December 2017 and June 2018, we set about identifying these subjects (cases) in the health zones of Miti-Murhesa and Katana. For deceased subjects, the cause and year of death were collected. A Cox proportional hazards multivariate regression analysis was used to identify the death-related factors. For the cases seen, age- and gender-matched community controls were selected for a comparison of anthropometric indicators. Results A total of 600 subjects were traced, and 201 subjects were deceased. Of the deceased subjects, 65·6% were under 10 years old at the time of their death. Of the deaths, 59·2% occurred within 5 years of discharge from hospital. The main causes of death were malaria (14·9%), kwashiorkor (13·9%), respiratory infections (10·4%), and diarrhoeal diseases (8·9%). The risk of death was higher in subjects with SAM, MAM combined with CM, and in male subjects, with HRs* of 1·83 (p = 0·043), 2.35 (p = 0·030) and 1.44 (p = 0·013) respectively. Compared with their controls, the cases had a low weight (-1·7 kg, p = 0·001), short height [sitting (-1·3 cm, p = 0·006) and standing (-1·7 cm, p = 0·003)], short legs (-1·6 cm, p = 0·002), and a small mid-upper arm circumference (-3·2mm, p = 0·051). There was no difference in terms of BMI, thoracic length, or head and thoracic circumference between the two groups. Conclusion SAM during childhood has lasting negative effects on growth to adulthood. In addition, these adults have characteristics that may place them at risk of chronic non-communicable diseases later in life.

INTRODUCTION:The impact of urbanization and living conditions on the prevalence of hypertension in the Cameroonian population is poorly known.AIM:To evaluate the prevalence and determinants of blood pressure (BP) in adult Pygmies and Bantus living in urban and rural areas of Southern Cameroon.PARTICIPANTS AND METHODS:This was a cross-sectional comparative study of 406 adults (96 urban Bantus, 100 urban Pygmies, 111 rural Bantus and 99 tropical rainforest Pygmies with a traditional Pygmies way of life), recruited in Southern Cameroon (mean age 42 ± 17 years; 56.7% women). Sociodemographic, anthropometric and BP parameters were collected. Hypertension was defined as BP at least 140/90 mmHg and/or use of BP-lowering drug(s).RESULTS:The age-standardized prevalence of hypertension in urban Bantus, rural Bantus, urban Pygmies and traditional Pygmies was 18.0, 13.5, 9.3 and 4.1%, respectively. Mean SBP and DBP differed significantly according to Bantu vs. Pygmy ethnicity, and urban vs. rural residency. After multiple adjustments, mean arterial pressure was significantly associated with age, BMI, Bantu ancestry and urban residency.CONCLUSION:Bantu ethnicity and urban residency are significantly associated with high-BP among people from Southern Cameroon.

Coronavirus disease 19 (COVID-19) is a global public health threat placing enormous pressure and significant strain on health system worldwide. In that purpose, surgical activities are particularly and highly impacted by its rapid spread with as consequence, a markedly and substantial decreasing numbers of elective surgeries. The economic and health consequence of the drastic reduction of surgical activities had severe and terrific impact on already fragile and weak health system in low-and middle-income countries (LMICs). Hence, there is an urgent need to define a cost-effective, resource-sensitive and context specific guidelines for surgical care delivery in LMICs settings during and early after this pandemic.

The aim of our study was to evaluate the relationship between Peripheral Arterial Occlusive Disease (PAOD) and Periodontitis in Diabetics subjects followed in Douala General Hospital, Cameroon. Materials and Method: We conducted a cross-sectional study from January 1 to March 20, 2020. To be included in the study, subjects had to be either type 1 or type 2 diabetics, at least 18 years of age and benefiting from either inpatient or outpatient followed up in the internal medicine department. Ankle Brachial Index (ABI) were measured for each participant with manual sphygmomanometer and pocket Doppler. Periodontitis was classified based on pocket depth (PD) and clinical attachment (CAL) values according the Centers For Disease Control and Prevention and the American Academy of Periodontology 2007 (CDC/AAP) All statistical analyses were performed using Epi Info7 software. Logistic regression analysis was performed to determine factors associated to PAOD in our sample. Results: A total of 100 patients were recruited. Mean periodontal parameters such as PD, CAL, number of sites with PD>4mm, number of sites with CAL>3mm were significantly higher in PAOD diabetics subjects compared to those without PAOD. After multivariate logistic regression, the factors remaining associated to PAOD were periodontitis (OR=3,60 [1,12-11,53]) and hypercholesteremia (OR=5,99 [2,04-17,55]). Conclusion: Management of periodontitis may reduce the risk of having PAOD in diabetic subjects followed at the Douala General Hospital, Cameroon.

INTRODUCTION:The incidence of Diabetes in children and teenagers increased by 30.2% between 2001 and 2009, with the main cause being an increase in the prevalence of overweight and obesity. Despite its high morbidity and mortality, few studies in Cameroon have focused on the study of abnormal glucose metabolism in schools. METHODOLOGY:This cross-sectional study was carried out in three schools institutions of two health districts selected from a three-stage cluster sampling survey-which consisted of a simple draw without discount for department selection, a simple random survey for the choice of health districts, and finally a simple random survey for the choice of schools institutions. RESULTS:Among the 815 participants, the prevalence of impaired fasting glucose and diabetes was 34.1% and 1.8% respectively. Glucose metabolism abnormalities were significantly higher in rural area than in urban areas (40% vs. 31.6%, p=0.016), and were significantly associated with abdominal obesity (p=0.027). Overweight and obesity were significantly higher in rural areas (p=0.0002), as well as abdominal obesity (p=0.0004). CONCLUSION:Abnormalities of glucose metabolism are a major health problem in schools in Cameroon. Thus, it is urgent to develop a health policy involving teachers and parents in the fight against overweight and obesity in schools.

BackgroundCardiac surgery is a growing activity in Sub-Saharan Africa, however, data related to long-term mortality are scarce. We aimed to analyze outcome data of cardiac interventions in two hospitals in Cameroon over 10 years' period.Methodswe conducted a retrospective analytical and descriptive study at the Douala General Hospital and Yaoundé General Hospital. All patients operated between January 2007 and December 2017, or their families were contacted by phone between January and April 2018 for a free of charges medical examination.ResultsOf a total of 98 patients operated during the study period, 8 (8.2%) were lost to follow-up. Finally, 90 patients [49 (54.4%) women and 41 (45.6%)] men were included. The mean age was 49±22 years (range, 13-89 years). The surgical indications were valvular heart diseases in 37 (41.1%) cases, congenital heart diseases in 11 (12.2%) cases, chronic constrictive pericarditis in 4 (4.4%) cases, and intra cardiac tumor in 1 (1.1%) case. Valve replacement was the most common type of surgery carried out in 37 (41.1%) cases-mostly with mechanical prosthesis. Pacemaker-mostly dual-chambers were implanted in 36 (40.0%) patients. The median follow-up was 26 months. The overall late mortality was 5.7%, and the overall survival rates at 5 and 10 years were 95.5% and 94.4% respectively. The overall survival rates at 5 and 10 years for mechanical valve prosthesis were 93.3% and 90% respectively. The survival at 10 years was 100% for patients with bioprosthesis. The survival rates at 10 years were 94.1% and 100% respectively for dual and single chamber pacemaker.ConclusionsLong-term outcome of cardiac surgery in hospitals in Cameroon are acceptable with low mortality rate. However, outcome metrics beyond mortality should be implemented for a prospective data collection.

ABSTRACT Introduction. Les troubles du sommeil ont des effets cardiometaboliques nefastes; leur prevalence est en augmentation depuis des decennies a cause e des avancees technologiques, de l’industrialisation et des changements du mode de vie. L’objectif de notre travail etait de decrire la prevalence de la mauvaise qualite du sommeil et les facteurs de risque cardiovasculaires associes en milieu scolaire. Methodes. Nous avons realise une etude descriptive et transversale. Le choix des etablissements s’est fait par tirage au sort. Nous avons effectue un echantillonnage consecutif et aleatoire, trois etablissements ont ete choisis : un en milieu urbain (College FX Vogt) et deux en milieu rural (Lycee de Bayangam et College Elie Allegret de Mbouo). La population etait composee de tous les eleves volontaires du second cycle qui avaient eu le consentement d’au moins un parent. Resultats. L’etude a concerne 815 participants dont 420 du milieu rural et 395 du milieu urbain. L’âge moyen etait de 18±3 ans avec 54% de participants du sexe feminin. L’âge etait plus eleve en milieu rural (p 5) etait de 40,3% en milieu urbain et 41% en milieu rural (p=0,785). En milieu rural, la mauvaise qualite de sommeil etait trois fois plus elevee chez les consommateurs de tabac (p=0,028) et deux fois plus elevee chez les inactifs (p=0,018). En milieu urbain, seuls la PA ≥ 140/90 mm Hg et le tabagisme etaient associes a une mauvaise qualite de sommeil (p= 0,004 et 0,045). Conclusion.: La mauvaise qualite du sommeil a une prevalence elevee en milieu scolaire camerounais. Elle est associee a l’hypertension arterielle, au tabagisme, a l’inactivite physique et au surpoids /obesite. RESUME Introduction: Sleep disorders have adverse effects on the body, especially the cardio-metabolic effects. The prevalence is steadily increasing due to technological advances, industrialization, and unhealthy lifestyles. The aim of this study was to report on the prevalence of sleep disorders and the associated cardiovascular risk factors in the school setting. Methods. We carried out a cross-sectional study in three randomly selected urban (one) and rural (two) schools. The study population was composed of all second cycle pupils who consented to participate in the study. Results. A total of 815 pupils (420 rural and 395 urban) participated in this study. Their average age was 18±3 years, and 54% were females. The rural participants were older (p 5) was 40.3% in the urban, and 41% in the rural participants (p=0.785). Among rural pupils, poor sleep quality was three times more frequent in those who smoked tobacco (p=0.028), and two times more frequent in those who were inactive (p=0.018). In urban participants, High Blood pressure (p=0.004) and tobacco use (p= 0.045) were associated with poor sleep quality. Conclusion. The prevalence of poor sleep quality is high in the school setting in Cameroon. This is associated with high blood pressure, tobacco use, physical inactivity, and overweight/obesity.