Introduction: diabetes mellitus is a global public health emergency, with a worldwide prevalence of 11.1% and a 77.6% increase in mortality over the past decade. In Bunia, Ituri Province, persistent armed conflict and reliance on commercially imported foods may influence diabetes risk, warranting an assessment of its prevalence and associated factors. Methods: a community-based cross-sectional study was conducted in Bunia from March to July 2024 using multistage stratified random sampling. Adults aged ≥18 years who had lived in Bunia for at least six months were included. Data were collected through structured questionnaires and anthropometric, physical, and biochemical measurements following the WHO STEPwise approach. Descriptive, bivariate, and multivariate analyses were performed. Results: a total of 1,808 participants were enrolled, including 1,086 women (60.07%), with a mean age of 39.95 ± 17.01 years. Secondary education was reported by 54% of participants, 54.81% were married, and 25.66% were engaged in commercial activities. Monthly income below USD 100 was reported by 43.53%. The prevalence of diabetes was 6.31% (95% CI: 5.2-7.5), and prediabetes was 12.17% (95% CI: 10.7-13.8). Diabetes prevalence was higher among women (4.03%) than men (2.27%). Factors independently associated with diabetes included advanced age (aOR = 1.029; 95% CI: 1.011-1.047), abdominal obesity (aOR = 1.035; 95% CI: 1.015-1.056), prolonged sedentary behavior (aOR = 1.002; 95% CI: 1.001-1.003), low-intensity physical activity (aOR = 2.002; 95% CI: 1.053-3.813), semi-urban residence (aOR = 2.655; 95% CI: 1.381-5.106), and occupations such as farming or mason´s assistant (aOR = 2.718; 95% CI: 1.084-6.814). Protective factors included family history of diabetes (aOR = 0.337; 95% CI: 0.204-0.558), appropriate salt intake (aOR = 0.527; 95% CI: 0.295-0.943), and low stress levels. Conclusion: diabetes prevalence in Bunia is shaped by demographic, behavioral, occupational, and environmental factors, underscoring the need for targeted prevention, health promotion, and management strategies for high-risk populations.

Genetic risk scores (GRSs) for type 1 diabetes (T1D) may assist T1D classification and prediction but are often developed from European populations. To improve health outcomes, it is important to understand the performance and utility of GRSs in diverse ancestry populations; we therefore assessed the capacity of three previously published T1D GRSs at differentiating people with and without type 1 diabetes in African (with/without T1D=194/235), European (n=1109/125), and Hispanic (266/170) ancestry populations in the USA, and from Cameroon and Uganda (n=144/5001).

Body weight misperception (discordance between perceived and measured body weight among adolescents) among adolescents is linked to unhealthy weight-control practices and adverse mental health outcomes. However, evidence on body weight misperception among adolescents from Sub-Saharan Africa remains limited. This study assessed the prevalence and correlates of body weight misperception among school-going adolescents in rural and urban settings in Yaoundé, Cameroon. We conducted a cross-sectional survey among 3,153 adolescents aged 12–19 years from ten secondary schools in the urban and peri urban localities in Yaoundé, Cameroon (September–October 2018). Data on weight perception, weight-control behaviours, and mental health were collected using the WHO Global School-based Student Health Survey questionnaire. Body Mass Index (BMI) for age z-score was calculated from measured height and weight using WHO Anthro plus. Logistic regression models were used to identify factors associated with misperception. Overall, 33.7

Objective The objective of the article is to determine the effect of residual insulin secretion on glycaemic control among young Cameroonian individuals diagnosed with type 1 diabetes (T1D). Methods We conducted a hospital-based cross-sectional study from April to August 2022. Forty-two children and adolescents diagnosed with T1D attending the paediatric diabetes clinic of the Yaoundé Central Hospital in Cameroon were enrolled in the study. Residual insulin secretion was assessed by measuring plasma C-peptide concentrations before and after a mixed meal tolerance test (MMTT) using an enzyme-linked immunosorbent assay (ELISA) method. Glycosylated haemoglobin (HbA1c) was measured by boronate affinity chromatography with the HemoCue® HbA1c 501 analyser. Residual insulin secretion was classified as absent (<0.033 nmol/L), low (0.033-0.2 nmol/L), or high (≥0.2 nmol/L) based on stimulated C-peptide levels. Clinical characteristics and HbA1c values were compared between participants with high residual insulin secretion and the rest of the cohort. Results The median age of participants was 18.5 (16-24) years, with a median diabetes duration of three (2-10) years and a median HbA1c of 8.4% (6.9-11.3). Stimulated C-peptide was detectable (≥0.033 nmol/L) in 25 (60%) participants and above 0.2 nmol/L in 12 (29%). Compared with those without or with low residual insulin secretion, participants with high secretion had a shorter median duration of diabetes (two (IQR: 1-4) vs six (IQR: 2-11) years; p=0.009), lower median daily insulin doses (0.7 (IQR: 0.4-0.8) vs 0.9 (IQR: 0.7-1.3) IU/kg; p=0.008), fewer median episodes of severe hypoglycaemia (zero (IQR: 0-2) vs four (IQR: 1-6); p=0.006), higher median BMI (26.1 (IQR: 25-29.3) vs 22.9 (IQR: 19.4-25.6) kg/m²; p=0.02), and lower median HbA1c levels (7.1 (IQR: 6.1-8.3) vs 9.1 (IQR: 8.1-12.2)%; p=0.01). Conclusion High residual insulin secretion was observed in nearly one-third of young Cameroonians with T1D and was strongly associated with better glycaemic control.

Atypical diabetes subtypes and presentations are disproportionately prevalent in populations of African and Asian ancestry. This review discusses the epidemiology, clinical presentation, aetiopathogenesis and management of four atypical diabetes subtypes commonly reported in Black African populations. These are ketosis-prone diabetes (KPD), fibrocalculous pancreatic diabetes (FCPD), type 2 diabetes in individuals without overweight or obesity, and malnutrition-related diabetes (MRD). The review summarises current insights into these atypical diabetes subtypes in Black African populations and provides practical recommendations to guide their precision diagnosis and management in the African region. These four atypical diabetes subtypes exhibit phenotypic features that diverge from those of classical type 1 and type 2 diabetes. KPD is characterised by unprovoked, transient, index episodes of diabetic ketoacidosis, often in the absence of markers of islet cell autoimmunity, with frequent subsequent insulin independence and diabetes remission. FCPD typically presents in young lean individuals, with a strong male preponderance and with radiological evidence of pancreatic calcifications, reduced beta cell reserve and severe hyperglycaemia without ketosis. Type 2 diabetes in individuals without overweight or obesity is characterised by normal BMI with a trend towards low levels of markers of visceral adiposity, insulin resistance and an exaggerated beta cell secretory dysfunction. MRD is associated with a previous and persistent history of undernutrition, with features of undernutrition such as stunting and BMI <18.5 kg/m2, resistance to diabetic ketoacidosis, no evidence of visceral or ectopic adiposity, and severe beta cell secretory dysfunction. The high prevalence and heterogeneous presentation of these atypical forms of diabetes in African populations highlight the urgent need for enhanced collaborative research to better define their epidemiology, improve diagnostic accuracy and develop context-appropriate management strategies tailored to diverse African populations.

INTRODUCTION:Various anthropometric and dietary indicators influence insulin resistance (IR), and lipid biomarkers may play a pivotal mediating role in these relationships. To investigate the mediating effects of lipid biomarkers on the relationships between anthropometric, dietary indicators, and IR, and the moderating role of sex in these associations. METHODS:A hospital-based cross-sectional study was conducted with 169 participants. Parallel mediation models assessed the mediating effects of lipid biomarkers (triglycerides, HDL, LDL, and total cholesterol) on the relationships between anthropometric (BMI, waist circumference, waist-to-hip ratio, and waist-to-height ratio) and dietary indicators (at least one starchy staple, at least one fruit, consumed all five recommended food groups (ALL-5), global dietary recommendations (GDR) score, and noncommunicable disease risk/protect scores) and IR. Moderated mediation analyses evaluated the moderating effect of sex. Statistical analyses were bootstrapped. RESULTS:The cumulative effect of lipid biomarkers fully mediated the relationship between WHtR and IR (Indirect Coef. = 0.65; 95% CI [0.02, 1.70]). TG significantly mediated the associations between WHR and IR (indirect Coef. = 0.55; 95% CI [0.11, 2.63]), BMI and IR (indirect Coef. = 0.76; 95% CI [0.17, 2.27]), and WC and IR (indirect Coef. = 0.72; 95% CI [0.04, 2.63]). Furthermore, LDL-C (Indirect Coef. = 1.99; 95% CI [0.24, 9.61]) and HDL-C (Indirect Coef. = 0.55; 95% CI [0.03, 2.57]) mediated the relationships of starchy staple and fruit intake with IR, respectively. Sex moderated the direct effect of WC on IR (interaction Coef. = 5.11, p = 0.002) but did not moderate the indirect pathways involving lipid biomarkers. CONCLUSIONS:These findings elucidate the intricate interplay between body composition, diet, lipid biomarkers, sex, and IR, providing insights for developing targeted prevention and intervention strategies to combat IR.

Maternal nutritional exposures during pregnancy are critical determinants of maternal and neonatal outcomes, yet remain inadequately characterized in many African settings, including Cameroon. The CAMELIA (Cameroon Maternal and Early Life Assessment) cohort aims to evaluate maternal nutritional status early in pregnancy, implement a structured nutritional intervention, and assess its impact on maternal, neonatal, and long-term metabolic outcomes. CAMELIA is a prospective, longitudinal interventional cohort enrolling 1,200 pregnant women at less than 22 weeks’ gestation in an urban primary healthcare facility in Cameroon (Hôpital Monseigneur Jean Zoa, Yaoundé). Participants are recruited at the first antenatal visit and followed through delivery and up to 42 days postpartum. Data and biological samples are collected across four visits: at enrolment (< 22 weeks), between 24 and 32 weeks of gestation, at delivery, and at 42 days postpartum. A structured multi-modal nutritional intervention (SUN-APP program) is initiated at enrolment, delivered through individual counselling, group education, monthly interactive workshops, and digital health support via weekly WhatsApp and SMS messages. Gestational hyperglycaemia is screened using fasting capillary blood glucose at V1 and V2, applying a threshold of ≥ 92 mg/dL. Primary outcomes are feasibility and acceptability of the intervention. Secondary outcomes include prevalence of gestational hyperglycaemia, hypertensive disorders, anaemia, low birth weight, and preterm birth. The study holds ethical approval from the Cameroon National Ethics Committee (CNERSH; approval no. 2025/04/1790/CE/CNERSH/SP) and is registered in the ISRCTN registry (ISRCTN13961105). The CAMELIA study provides a scalable and replicable framework for embedding structured nutritional risk screening and targeted interventions into routine antenatal care in a low-resource African setting. Findings will inform strategies for the prevention of gestational metabolic disorders and adverse perinatal outcomes across generations. ISRCTN13961105. Registered 14 August 2025.

Unclassified diabetes describes diabetes that does not fit into other categories. This category is used temporarily when there is no clear diagnostic category, especially close to the time of diagnosis. This implies that paraclinical investigations or the natural evolution of the disease will allow a definitive classification. We present the case of diabetes initially classified as type 1 in an adolescent. For ten years, the patient had high insulin requirements with negative autoantibodies, significant residual insulin secretion, and for the last 3 months of life, remission of diabetes in the context of a wound of the thigh, before a sudden death from hepatocellular failure, pushing to reconsider the initial diagnosis. This clinical case highlights difficulties in obtaining precision in the etiological diagnosis of diabetes in some patients based either on clinical manifestation, biological assessment, or evolution. It also shows that unclassified diabetes subtypes may not be transient.

Abstract Introduction. Insulin resistance is the main feature of both type 2 diabetes mellitus (T2DM) and hepatitis C virus (HCV) infection and may worsen the prognosis of HCV infection. This study sought to assess insulin sensitivity in HCV-infected patients living with T2DM in Yaoundé, Cameroon. Methodology. We conducted a cross-sectional study of 20 consenting patients with T2DM, divided equally into two groups (10 HCV positive and 10 HCV negative) and matched for age and sex. Each patient underwent a clinical evaluation, HbA1c measurement, HCV antibody screen, viral RNA measurement, and a hyperinsulinemic-euglycemic clamp at 80 mU/m2/min to measure insulin sensitivity. The Spearman’s correlation coefficient was used to test the correlation between insulin sensitivity and HCV viral load. Results. All patients were on oral hypoglycemic agents (OHA) and 7/20 on insulin. The median weight, BMI, waist circumference, blood pressure, glycated hemoglobin, fat and fat free mass were comparable in both groups. The median HCV viral load was 6.4[5.9-6.7] log IU/ml. The adjusted M-value, reflecting insulin sensitivity, was 8.6 [1.35–9.04] mg/kg/min in HCV-positive subjects and 11.1 [2.1–11.5] mg/kg/min in HCV-negative subjects, with no statistically significant difference between the groups (p = 0.22). There was negative non-statistically significant correlation (r= -0.22, p= 0.35) between insulin sensitivity and detectable HCV viral load. Conclusion. Insulin sensitivity is not significantly different in HCV infected patients with T2DM compared to their HCV uninfected peers. Furthermore, there was a non-significant negative correlation between insulin sensitivity and a detectable viral load for HCV in type 2 diabetes patients. Résumé Introduction. La résistance à l'insuline est la principale caractéristique du diabète de type 2 (DT2) et de l'infection par le virus de l'hépatite C (VHC) et peut aggraver le pronostic de l'infection par le VHC. Cette étude visait à évaluer la sensibilité à l'insuline chez les patients infectés par le VHC et atteints de DT2 à Yaoundé, au Cameroun. Méthodologie. Nous avons mené une étude transversale sur 20 patients consentants atteints de DT2, divisés en deux groupes (10 VHC positifs et 10 VHC négatifs) et appariés pour l'âge et le sexe. Chaque patient a subi une évaluation clinique, une mesure de l'HbA1c, un dépistage des anticorps anti-VHC, une mesure de l'ARN viral et un clamp hyperinsulinémique-euglycémique à 80 mU/m2/min pour mesurer la sensibilité à l'insuline. Le coefficient de corrélation de Spearman a été utilisé pour tester la corrélation entre la sensibilité à l'insuline et la charge virale du VHC. Résultats. Tous les patients étaient sous antidiabétiques oraux et 7/20 sous insuline. Le poids médian, l'IMC, le tour de taille, la tension artérielle, l'hémoglobine glyquée, la masse grasse et la masse maigre étaient comparables dans les deux groupes. La charge virale médiane du VHC était de 6,4 [5,9-6,7] log IU/ml. La valeur M ajustée, reflétant la sensibilité à l'insuline, était de 8,6 [1,35–9,04] mg/kg/min chez les sujets positifs au VHC et de 11,1 [2,1–11,5] mg/kg/min chez les sujets négatifs au VHC, sans différence statistiquement significative entre les deux groupes (p = 0,22). Il y avait une corrélation négative non statistiquement significative (r= -0.22, p= 0.35) entre la sensibilité à l'insuline et la charge virale du VHC. Conclusion. La sensibilité à l'insuline n'est pas significativement différente chez les patients infectés par le VHC et atteints de DT2 par rapport aux patients non infectés par le VHC.

Type 1 diabetes-associated mortality in Africa remains high despite several coordinated international initiatives. Therefore, understanding the causes of death will guide context-specific public health interventions. This descriptive case series examined the number and causes of death among children and young people (CYP) with type 1 diabetes (T1D) in the young-onset diabetes in sub-Saharan Africa (YODA) study in Cameroon. Among 313 CYP recruited between 2019 and 2022, 23 deaths were recorded (56.5% male). At recruitment, the median (IQR) age at diagnosis was 16 (13-18) years, BMI 21.5 (18.9-24.7) kg/m2, and plasma C-peptide concentration 116 (37-210) pmol/L, respectively. Causes of death included hypoglycaemia (7 cases), diabetic ketoacidosis (5 cases), infections (4 cases), undefined causes (4 cases), chronic liver disease (2 cases), and chronic kidney disease (1 case). Most deaths (17/23, 73.9%) occurred in individuals with significantly low plasma C-peptide levels (<200 pmol/L), signifying severe insulin deficiency. Hypoglycaemia deaths (85.7%, 6/7) were also common at significantly low C-peptide levels (<200 pmol/L). Nearly half (11/23, 47.8%) of the deaths occurred outside the hospital setting. These findings describe a possible relationship between low C-peptide and mortality for CYP living with T1D in Cameroon which should be investigated thoroughly prospectively.

BACKGROUND:Studies of type 1 diabetes in sub-Saharan Africa have suggested that the clinical phenotype might differ from phenotypes reported elsewhere. We aimed to establish whether type 1 diabetes diagnosed in children and young adults in three countries across sub-Saharan Africa is of autoimmune origin. METHODS:In this observational, cross-sectional study, we identified participants without obesity from outpatient clinics in government and private hospitals in Cameroon, Uganda, and South Africa who were of self-reported Black African ethnicity with young-onset (age <30 years), insulin-treated, clinically diagnosed type 1 diabetes. We measured islet autoantibodies to GADA, IA-2A, and ZnT8A, and calculated a genetic risk score (GRS) for type 1 diabetes, which we compared with control populations without diabetes derived from the Uganda Genome Resource databank and other studies. Endogenous insulin secretion was assessed using plasma C-peptide. We compared findings with those for participants with self-reported Black (n=429) and White (n=2602) ancestry with type 1 diabetes from the SEARCH for Diabetes in Youth (SEARCH) study in the USA. FINDINGS:Of 1072 participants identified between Aug 28, 2019, and March 31, 2022 (Cameroon and Uganda), and Oct 3, 2007, to Sept 14, 2015 (South Africa), 894 were included in our analysis (454 [50·8%] were male and 440 [49·2%] were female): 248 participants were from Cameroon, 370 from Uganda, and 276 from South Africa. Participants from sub-Saharan Africa were diagnosed with diabetes at a median age of 15 years (IQR 11-19), with a median diabetes duration of 5 years (2-10), and a BMI of 21·7 kg/m2 (19·5-24·1). Only 312 (34·9%) of 894 participants were positive for islet autoantibodies; these participants had classic features of type 1 diabetes, including 225 (82·7%) of 272 with plasma C-peptide <200 pmol/L, and high type 1 diabetes GRS. Those without islet autoantibodies (582 [65·1%] of 894) had significantly lower median type 1 diabetes GRS than those with autoantibodies (9·66 [IQR 7·77-11·33] vs 11·76 [10·49-12·91]; p<0·0001), suggesting a subgroup with a non-autoimmune diabetes subtype, with clinical features and C-peptide concentrations not consistent with type 2 diabetes. Among participants diagnosed younger than 20 years, autoantibody-negative diabetes was also observed in 65 (15·1%) of 429 participants with Black ancestry in SEARCH (although less frequently than in sub-Saharan Africa [59 (55·1%) of 107]), and these participants also had a low type 1 diabetes GRS (median 10·41 [IQR 8·65-12·22] in autoantibody-negative subgroup). No such pattern was observed in White participants in SEARCH: 241 (9·3%) of 2602 were autoantibody negative and median GRS for type 1 diabetes was similar in autoantibody-negative and autoantibody-positive participants (median 13·42 [IQR 11·80-14·61] vs 13·49 [12·29-14·58]). INTERPRETATION:In sub-Saharan Africa, clinically diagnosed type 1 diabetes is heterogeneous, comprising classic autoimmune type 1 diabetes and a novel, non-autoimmune, insulin-deficient diabetes subtype. There is evidence of this subtype in Black but not White individuals in the USA. Therefore, alternative causes must be considered in this group of individuals, and understanding the drivers of this subtype might offer new insights into prevention and treatment. FUNDING:UK National Institute of Health and Care Research. TRANSLATION:For the French translation of the abstract see Supplementary Materials section.

Background:The burden of diabetes is rising dramatically in low- and middle-income countries. The menace of substandard and falsified drugs constitutes a major hazard that compromises healthcare. The DIABDAF study aimed to assess the quality of routinely used antidiabetic drugs including oral drugs and insulins in sub-Saharan Africa. Methods:Drugs were collected in 13 sub-Saharan African cities in licensed and unlicensed places of sales between February 2020 and March 2023. Chemical analyses were conducted blindly in a public laboratory following recommended good laboratory practices. Drug quality was classified based on the ratio of measured to expected active ingredient dosage: 95-105% as good (A), 85-94·99% or 105·01-115% as low (B), and below 85% or above 115% as very low (C). Impurity levels were assessed using thresholds from the United States and European Pharmacopoeias monographs. Findings:A convenient samples of 4951 antidiabetic drugs were collected from 13 sub-Saharan African countries (Seven middle-income and six low-income countries). Out of the 1673 (of 4951 collected) drug samples randomly tested, 28·0% (n: 468, 95% CI [22·3-33·0]) failed to meet standards related to the expected content of active ingredients (B: 27·2% 95% CI [21·5-32·0]; C: 0·8% 95% CI [0·2-3·5]), with more samples showing underdosage (19·31% 95% CI [14·8-24·3]) than overdosage (8·67% 95% CI [5·3-12·5]). Impurity levels were excessive in 9·68% (n: 162, 95% CI [6·0-14·8]) of samples. Overall, 32·8% (n: 548, 95% CI [26·5-38·1]) were deemed to be of poor quality according to active ingredient content or impurity level. In multivariate logistic regression, factors associated with worse quality were drugs, expired status, and country of purchase. Interpretation:In this multinational study assessing the quality of antidiabetic drugs in sub-Saharan Africa, we found a significant proportion of poor-quality drugs. National health authorities must take action to ensure access to safe, high-quality medications for diabetic patients. Funding:DIABDAF study was exclusively supported by French public grant (INSERM, AVIESAN, AP-HP, and University of Paris Cité).

Abstract Introduction There is a higher risk of occurrence of noncommunicable diseases such as hypertension and type 2 diabetes mellitus as age increases. Given that data on the burden of undernutrition among these patients are scarce in our context, we aimed to assess the nutritional status of elderly patients with type 2 diabetes mellitus followed at Bamenda Regional Hospital. Methods: We conducted a cross-sectional study at the diabetic unit and the consultation unit of the hemodialysis center of the Bamenda Regional Hospital. The study population consisted of 146 outpatients aged 60 years and above, with type 2 diabetes mellitus attending the consultation from February 1st to May 31st, 2023 who gave their informed consent during our study period. Nutritional status was assessed using MNA-SF and GLIM criteria. Data were collected using a pretested questionnaire. Data were analyzed using the computer software SPSS version 26. Results: The mean age was 68.7 years. Normal BMI was found in 35.6% (n=52) of participants whereas 1.4% (n=2) had a BMI below 18.5kg/m2. The prevalence of undernutrition in elderly patients with type 2 diabetes mellitus was 12.3% according to the MNA-SF and 15.1% according to the GLIM criteria. A poor fasting blood glucose status, a normal body mass index, waist circumference, and serum albumin levels summarized the clinical and biological presentation of the undernourished participants. There was a strong association between age above 70 years and undernutrition [OR 4.1(95% CI: 1.48-11.3)] but not with diabetes duration. An association between polypharmacy and undernutrition [OR 0.29 (95% CI: 0.12-0.74)] was also reported. Conclusion: The prevalence of undernutrition in elderly patients with type 2 diabetes mellitus was 12.3% and 15.1% with respect to the screening tool used. (MNA-SF and the GLIM criteria). There was a four-fold increase in the risk of undernutrition in patients above 70 years.

Introduction Chronic venous disease is a global public health problem, with high morbidity and economic distress. There is scarcity of data on this disease in sub-Saharan Africa. Methods We conducted the first population-based study over a period of 20 months from 1st February 2020 to 30th September 2021 in the 10 regions of Cameroon. A stratify sampling method was chose to select study site. Socio-demographic data, personal and family history, anthropometric parameters, clinical signs, illustrative images, CEAP (Clinical-Etiological-Anatomical-Pathophysiological) classification revised in 2004, VCSS (venous Clinical Severity Score) and risk factor assessment score were used to construct the survey form. Chi-squared test and Fischer exact test were used to compare the prevalence of chronic venous disease across different potential risk factors (sex, age category, previous history of deep vein thrombosis, hypertension, diabetes, smoking status, obesity). Simple and multiple logistic regression models were used to obtain crude and adjusted odds ratio for risk factors associated with chronic venous insufficiency. Statistical analyses were done with R version 4.2 for Linux and the threshold for statistical significance was 0.05. Results A total of 6578 participants were included in the study, with a mean age of 41.09 ± 16.02 years with female predominance (54.3%). The prevalence of chronic venous disease was 21.8% (95% CI: 20.8–22.9) and the prevalence of chronic venous insufficiency (C3–C6) was 7.02% ( n = 462). Night cramps (43.2%), oedema (21.7%), lower limbs pain (20.4%) mostly worsens by walking and heavy legs (16.2%) were more common symptoms. The mean total venous clinical severity score was 0.69 ± 1.76 and this score had a significant positive correlation with C classification ( p < .001). In the multivariate analysis, the following factors were independently associated with CVD: Male gender (aOR: 1.27; 95%CI: 1.04–1.56; p = .021), retired people (aOR: 46.9; 95% CI: 12.6–174.5; p < .001), hypertension (aOR: 289.5; 95%CI: 169.69–493.1; p < .001), diabetes (aOR: 2.19; 95% CI: 1.21–3.96; p = .009), obesity (aOR: 10.22; 95%CI: 7.67–13.62; p < .001). Smoking appears as a protective factor (aOR: 0.18; 95%CI: 0.10–0.30; p < .001). Conclusion Chronic venous disease is frequent in Cameroon and main traditional cardiovascular risk factors are associated to this condition. Systematic screening of the CVD in these specific groups could reduce the burden of the disease and its economic impact.

BackgroundThe burden of gestational diabetes (GDM) and the optimal screening strategies in African populations are yet to be determined. We assessed the prevalence of GDM and the performance of various screening tests in a Cameroonian population.MethodsWe carried out a cross-sectional study involving the screening of 983 women at 24-28 weeks of pregnancy for GDM using serial tests, including fasting plasma (FPG), random blood glucose (RBG), a 1-hour 50g glucose challenge test (GCT), and standard 2-hour oral glucose tolerance test (OGTT). GDM was defined using the World Health Organization (WHO 1999), International Association of Diabetes and Pregnancy Special Group (IADPSG 2010), and National Institute for Health Care Excellence (NICE 2015) criteria. GDM correlates were assessed using logistic regressions, and c-statistics were used to assess the performance of screening strategies.FindingsGDM prevalence was 5·9%, 17·7%, and 11·0% using WHO, IADPSG, and NICE criteria, respectively. Previous stillbirth [odds ratio: 3·14, 95%CI: 1·27-7·76)] was the main correlate of GDM. The optimal cut-points to diagnose WHO-defined GDM were 5·9 mmol/L for RPG (c-statistic 0·62) and 7·1 mmol/L for 1-hour 50g GCT (c-statistic 0·76). The same cut-off value for RPG was applicable for IADPSG-diagnosed GDM while the threshold was 6·5 mmol/L (c-statistic 0·61) for NICE-diagnosed GDM. The optimal cut-off of 1-hour 50g GCT was similar for IADPSG and NICE-diagnosed GDM. WHO-defined GDM was always confirmed by another diagnosis strategy while IADPSG and GCT independently identified at least 66·9 and 41·0% of the cases.InterpretationGDM is common among Cameroonian women. Effective detection of GDM in under-resourced settings may require simpler algorithms including the initial use of FPG, which could substantially increase screening yield.