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Mapoko BSE, Frambo A, Saidu Y, Mbassi EDB, Atenguena E, Azemafac K, Kobayashi E, Tabola L, Nkeng G, Sango A, Maison AM, Noa SA, Ntama A, Mapenya RRM, Tayou R, Kouya F, Mbah G, Douanla P, Fonkwa C, Biwole ME, Sando Z, Sone AM, Ndom P. Assessment of barriers to optimal cancer control in adult cancer treatment centres in Cameroon. Ecancermedicalscience 2023; 17:1601. [PMID: 37799946 PMCID: PMC10550327 DOI: 10.3332/ecancer.2023.1601] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/26/2022] [Indexed: 10/07/2023] Open
Abstract
Approximately 20,745 new cases of cancer were registered annually with 13,199 (64%) deaths in 2020 in Cameroon. Despite the increasing cancer burden, there is a paucity of reliable data that can enhance decision-making for cancer control in Cameroon. This assessment was, therefore, designed to generate data that may enable stakeholders, policymakers and funders to make data-driven decisions on cancer control. We conducted a cross-sectional survey in July 2020, which enabled us to collect data on key cancer variables from six adult cancer treatment centres in Cameroon. The key components of the assessment included case detection, service availability, human resource capacity, cost of chemotherapy and radiotherapy, the safety of chemotherapy sessions, data systems, patient education, palliative care, funding for chemotherapy and chemotherapy stock. Data were compiled and analysed using Microsoft Excel 2016. Data from four of the 6 sites show that 1,636 new cases were recorded representing an annual case detection rate of 11.8%. All the six assessed facilities offered chemotherapy services, 5/6 (83.3%) offered surgery for cancers, while just 1 (16.7%) offered radiotherapy services. In addition, none offered nuclear medicine services for cancer care and treatment. Similarly, none of the facilities had the WHO-recommended number of human resources for optimal cancer care. Overall, there were only 6 medical oncologists, 2 surgical oncologists, 3 radiation oncologists and 14 oncology nurses providing services across the 6 cancer treatment centres. Treatment services are expensive for an average national, with a complete course of chemotherapy followed by radiotherapy costing ~XAF 1,240,000 (~$2,480). None of the survey facilities had a recommended safe biosafety cabinet and clean room for the preparation of chemotherapies, rendering the preparation of chemotherapies suboptimal and hazardous. Data collection tools were manual, relatively available and very different across all the surveyed sites and the interval for data collection and transmission was collectively undefined. Optimal cancer care in adult cancer treatment centres is limited by several health systems and socio-economic factors. The identification of these barriers has enabled the formulation of action-oriented interventions, leveraging on the recently adopted national strategy for the prevention and control of cancers in the country.
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Affiliation(s)
| | - Andreas Frambo
- Clinton Health Access Initiative, Yaoundé 99322, Cameroon
| | - Yauba Saidu
- Clinton Health Access Initiative, Yaoundé 99322, Cameroon
- Institute for Global Health, University of Siena, Siena 53100, Italy
| | - Esther Dina Bell Mbassi
- Faculty of Medicine and Pharmaceutical Sciences, University of Douala, Douala 99322, Cameroon
| | - Etienne Atenguena
- Faculty of Medicine and Biomedical Sciences, University of Yaoundé I, Yaoundé 99322, Cameroon
| | - Kareen Azemafac
- Faculty of Medicine and Biomedical Sciences, University of Yaoundé I, Yaoundé 99322, Cameroon
| | | | - Lionel Tabola
- Faculty of Medicine and Biomedical Sciences, University of Yaoundé I, Yaoundé 99322, Cameroon
| | - Glenda Nkeng
- Faculty of Medicine and Biomedical Sciences, University of Yaoundé I, Yaoundé 99322, Cameroon
| | - Anne Sango
- Faculty of Health Sciences, University of Buea, Buea 99322, Cameroon
| | - Anne Marthe Maison
- Faculty of Medicine and Pharmaceutical Sciences, University of Douala, Douala 99322, Cameroon
| | - Sidonie Ananga Noa
- Faculty of Medicine and Pharmaceutical Sciences, University of Douala, Douala 99322, Cameroon
| | - Ambroise Ntama
- Faculty of Medicine and Pharmaceutical Sciences, University of Douala, Douala 99322, Cameroon
| | | | - Rachel Tayou
- Faculty of Health Sciences, University of Dschang, Dschang 99322, Cameroon
| | | | - Glenn Mbah
- Mbingo Baptist Hospital, Bamenda 99322, Cameroon
- Faculty of Health Sciences, University of Bamenda, Bamenda 99322, Cameroon
| | - Pelagie Douanla
- Faculty of Medicine and Biomedical Sciences, University of Yaoundé I, Yaoundé 99322, Cameroon
| | | | - Martin Essomba Biwole
- Faculty of Medicine and Pharmaceutical Sciences, University of Douala, Douala 99322, Cameroon
| | - Zacharie Sando
- Faculty of Medicine and Biomedical Sciences, University of Yaoundé I, Yaoundé 99322, Cameroon
| | - Albert Mouelle Sone
- Faculty of Medicine and Pharmaceutical Sciences, University of Douala, Douala 99322, Cameroon
| | - Paul Ndom
- Faculty of Medicine and Biomedical Sciences, University of Yaoundé I, Yaoundé 99322, Cameroon
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Sando Z, Nnomo ACE, Tabola L, Likeng JN, Nganwa G, Atenguena E, Mapoko BSE, Sango A, Ndom P, Njombou SM, Ngueffo LS, Nkoum BA. [Perceived severity of cancer and therapeutic pluralism among medical oncologists at the Yaoundé General Hospital]. Pan Afr Med J 2023; 44:96. [PMID: 37229306 PMCID: PMC10204101 DOI: 10.11604/pamj.2023.44.96.27765] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/08/2021] [Accepted: 02/02/2023] [Indexed: 05/27/2023] Open
Abstract
Introduction cancer is a potentially serious disease. The announcement of a cancer diagnosis is bad news. This diagnosis is experienced differently from one person to the next. Patient's behaviour and compliance reflects specific behaviors of relatives. Alternative treatments are commonly used in oncology in some African countries. The purpose of this study was to establish cancer patients' experience, the extent of the use of alternative treatments and factors influencing their choices. Methods we conducted a descriptive study at the Yaoundé General Hospital from December 2019 to May 2020. The study included patients over 18 years of age treated for cancer, who had been undergoing chemotherapy for at least three months and who agreed to complete the questionnaire. Results the interview involved 122 patients. Sex ratio was 1/1. The average age of patients was 45 years; 38.5% of patients thought that cancer is a very serious disease, 24% were desperate for diagnosis, 61% thought that recovery would be very slow. Pluralists in our sample accounted for 59.8%. Conclusion cancer patients and their relatives generally perceive cancer as serious. Patients experience a feeling of sudden and intense anxiety when they are diagnosed with cancer. Therapeutic pluralism is a frequent practice.
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Affiliation(s)
- Zacharie Sando
- Faculté de Médecine et des Sciences Biomédicales, Université de Yaoundé I, Yaoundé, Cameroun
| | | | - Lionel Tabola
- Faculté de Médecine et des Sciences Biomédicales, Université de Yaoundé I, Yaoundé, Cameroun
| | - Julienne Ngo Likeng
- Ecole des Sciences de la Santé, Université Catholique d´Afrique Centrale, Yaoundé, Cameroun
| | - Grace Nganwa
- Faculté de Médecine et des Sciences Pharmaceutiques, Université de Douala, Douala, Cameroun
| | - Etienne Atenguena
- Faculté de Médecine et des Sciences Biomédicales, Université de Yaoundé I, Yaoundé, Cameroun
| | | | | | - Paul Ndom
- Faculté de Médecine et des Sciences Biomédicales, Université de Yaoundé I, Yaoundé, Cameroun
| | - Sylvanie Makou Njombou
- Ecole des Sciences de la Santé, Université Catholique d´Afrique Centrale, Yaoundé, Cameroun
- Women Impetus for a Development (WIFAD), Cameroun
| | - Linda Sando Ngueffo
- Faculté de Médecine et des Sciences Biomédicales, Université de Yaoundé I, Yaoundé, Cameroun
- Women Impetus for a Development (WIFAD), Cameroun
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Vassilakos P, Clarke H, Murtas M, Stegmüller T, Wisniak A, Akhoundova F, Sando Z, Orock GE, Sormani J, Thiran JP, Petignat P. Telecytologic diagnosis of cervical smears for triage of self-sampled human papillomavirus-positive women in a resource-limited setting: concept development before implementation. J Am Soc Cytopathol 2023; 12:170-180. [PMID: 36922319 DOI: 10.1016/j.jasc.2023.02.001] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/12/2022] [Revised: 01/12/2023] [Accepted: 02/08/2023] [Indexed: 02/17/2023]
Abstract
INTRODUCTION Cytology is an option for triaging human papillomavirus (HPV)-positive women. The interpretation of cytologic slides requires expertise and financial resources that are not always available in resource-limited settings. A solution could be offered by manual preparation and digitization of slides on site for real-time remote cytologic diagnosis by specialists. In the present study, we evaluated the operational feasibility and cost of manual preparation and digitization of thin-layer slides and the diagnostic accuracy of screening with virtual microscopy. MATERIALS AND METHODS Operational feasibility was evaluated on 30 cervical samples obtained during colposcopy. The simplicity of the process and cellularity and quality of digitized thin-layer slides were evaluated. The diagnostic accuracy of digital versus glass slides to detect cervical intraepithelial neoplasia grade 2 or worse was assessed using a cohort of 264 HPV-positive Cameroonian women aged 30 to 49 years. The histologic results served as the reference standard. RESULTS Manual preparation was found to be feasible and economically viable. The quality characteristics of the digital slides were satisfactory, and the mean cellularity was 6078 squamous cells per slide. When using the atypical squamous cells of undetermined significance or worse threshold for positivity, the diagnostic performance of screening digital slides was not significantly different statistically compared with the same set of slides screened using a light microscope (P = 0.26). CONCLUSIONS We have developed an innovative triage concept for HPV-positive women. A quality-ensured telecytologic diagnosis could be an effective solution in areas with a shortage of specialists, applying a same day "test-triage-treat" approach. Our results warrant further on-site clinical validation in a large prospective screening trial.
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Affiliation(s)
- Pierre Vassilakos
- Gynecology Division, Geneva University Hospital, Geneva, Switzerland; Geneva Foundation for Medical Education and Research, Geneva, Switzerland
| | - Holly Clarke
- Gynecology Division, Geneva University Hospital, Geneva, Switzerland.
| | - Micol Murtas
- Gynecology Division, Geneva University Hospital, Geneva, Switzerland
| | - Thomas Stegmüller
- Swiss Federal Institute of Technology Lausanne, Lausanne, Switzerland
| | - Ania Wisniak
- Gynecology Division, Geneva University Hospital, Geneva, Switzerland
| | - Farida Akhoundova
- Gynecology Division, Geneva University Hospital, Geneva, Switzerland
| | - Zacharie Sando
- Gyneco-Obstetrics and Paediatric Hospital, Yaoundé, Cameroon
| | | | - Jessica Sormani
- Gynecology Division, Geneva University Hospital, Geneva, Switzerland
| | | | - Patrick Petignat
- Gynecology Division, Geneva University Hospital, Geneva, Switzerland
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Ngokwe ZB, Bienvenue NND, Siafa BA, Stephane NK, Sando Z. Secondary maxillary ameloblastic carcinoma: A case report. Advances in Oral and Maxillofacial Surgery 2023. [DOI: 10.1016/j.adoms.2023.100413] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/15/2023] Open
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Tchouaket MCT, Fokam J, Sosso SM, Semengue ENJ, Yagai B, Simo RK, Sando Z, Nka AD, Tchinda GP, Takou D, Fainguem N, Chenwi C, Ka'e AC, Abba A, Zam MKN, Perno CF, Colizzi V, Ndjolo A. High genotypic diversity of human papillomavirus among women in Cameroon: implications for vaccine effectiveness. IJID Reg 2022; 5:130-136. [PMID: 36313603 PMCID: PMC9596729 DOI: 10.1016/j.ijregi.2022.09.014] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 08/04/2022] [Revised: 09/27/2022] [Accepted: 09/30/2022] [Indexed: 12/02/2022]
Abstract
BACKGROUND The burden of human papillomavirus (HPV) is high in Cameroon, but knowledge on high-risk oncogenic HPV (HR-HPV) is limited. Our study sought to ascertain the HR-HPV genotypes circulating in Cameroon. METHODS A cross-sectional study was conducted among non-vaccinated women in Cameroon. Detection of HR-HPV was performed by real-time PCR on cervico-vaginal swabs. Predictors of HR-HPV were determined following logistic regression analysis, with p < 0.05 considered statistically significant. RESULTS In total, 364 women were enrolled, with a median age of 41 (34-50) years. Of these, 3.0% were smokers and 26.09% reported having more than three sexual partners. The overall HR-HPV positivity rate was 21.43% (95% CI 17.21-25.64). Predictors of HR-HPV were young age, i.e < 41 years (aOR (95% CI) 0.408 (0.194-0.862); p = 0.018), smoking (aOR 5.199 (1.314-20.575); p = 0.018), and having more than three sex partners (aOR: 2.335 (1.133-4.811); p = 0.022). Overall, 12 HR-HPV genotypes were identified, with 26.98% women coinfected with at least two HR-HPVs, including one case of a triple coinfection. According to to the circulating genotypes, potential vaccine effectiveness was 47% for the 4-valent vaccine and 70% for the 9-valent vaccine. CONCLUSION Within the Cameroonian context, at least one out of five women is likely to be an HR-HPV carrier, especially among young people, smokers, and those with multiple sexual partners. Importantly, HR-HPV infection is highly diversified, with vaccine efficacy ranging from about 47% (4-valent) to 70% (9-valent).
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Affiliation(s)
- Michel Carlos Tommo Tchouaket
- Chantal Biya International Reference Center for Research on HIV/AIDS Prevention and Management (CIRCB), Yaoundé, Cameroon,Faculty of Health Sciences, University of Buea, Cameroon,Corresponding authors: Michel Tommo and Joseph Fokam, Chantal Biya International Reference Centre for Research on HIV/AIDS Prevention and Management (CIRCB), Yaoundé, Cameroon.
| | - Joseph Fokam
- Chantal Biya International Reference Center for Research on HIV/AIDS Prevention and Management (CIRCB), Yaoundé, Cameroon,Faculty of Health Sciences, University of Buea, Cameroon,University of Yaoundé I, Cameroon,School of Health Sciences, Catholic University of Central Africa, Yaoundé, Cameroon,Corresponding authors: Michel Tommo and Joseph Fokam, Chantal Biya International Reference Centre for Research on HIV/AIDS Prevention and Management (CIRCB), Yaoundé, Cameroon.
| | - Samuel Martin Sosso
- Chantal Biya International Reference Center for Research on HIV/AIDS Prevention and Management (CIRCB), Yaoundé, Cameroon
| | - Ezechiel Ngoufack Jagni Semengue
- Chantal Biya International Reference Center for Research on HIV/AIDS Prevention and Management (CIRCB), Yaoundé, Cameroon,Yaoundé Gyneco-obstetrics and Pediatric Hospital,University of Rome ‘Tor Vergata’, Rome, Italy
| | - Bouba Yagai
- Chantal Biya International Reference Center for Research on HIV/AIDS Prevention and Management (CIRCB), Yaoundé, Cameroon,University of Rome ‘Tor Vergata’, Rome, Italy
| | - Rachel Kamgaing Simo
- Chantal Biya International Reference Center for Research on HIV/AIDS Prevention and Management (CIRCB), Yaoundé, Cameroon
| | - Zacharie Sando
- University of Yaoundé I, Cameroon,University of Rome ‘Tor Vergata’, Rome, Italy
| | - Alex Durand Nka
- Chantal Biya International Reference Center for Research on HIV/AIDS Prevention and Management (CIRCB), Yaoundé, Cameroon,University of Rome ‘Tor Vergata’, Rome, Italy,Evangelical University of Bandjoun, Cameroon
| | | | - Désiré Takou
- Chantal Biya International Reference Center for Research on HIV/AIDS Prevention and Management (CIRCB), Yaoundé, Cameroon,University of Rome ‘Tor Vergata’, Rome, Italy
| | - Nadine Fainguem
- Chantal Biya International Reference Center for Research on HIV/AIDS Prevention and Management (CIRCB), Yaoundé, Cameroon,University of Rome ‘Tor Vergata’, Rome, Italy,Evangelical University of Bandjoun, Cameroon
| | - Collins Chenwi
- Chantal Biya International Reference Center for Research on HIV/AIDS Prevention and Management (CIRCB), Yaoundé, Cameroon,University of Yaoundé I, Cameroon
| | - Aude Christelle Ka'e
- Chantal Biya International Reference Center for Research on HIV/AIDS Prevention and Management (CIRCB), Yaoundé, Cameroon
| | - Aissatou Abba
- Chantal Biya International Reference Center for Research on HIV/AIDS Prevention and Management (CIRCB), Yaoundé, Cameroon
| | - Marie Krystel Nnomo Zam
- Chantal Biya International Reference Center for Research on HIV/AIDS Prevention and Management (CIRCB), Yaoundé, Cameroon,University of Yaoundé I, Cameroon
| | | | - Vittorio Colizzi
- Chantal Biya International Reference Center for Research on HIV/AIDS Prevention and Management (CIRCB), Yaoundé, Cameroon,University of Rome ‘Tor Vergata’, Rome, Italy,Evangelical University of Bandjoun, Cameroon
| | - Alexis Ndjolo
- Chantal Biya International Reference Center for Research on HIV/AIDS Prevention and Management (CIRCB), Yaoundé, Cameroon,University of Yaoundé I, Cameroon
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Mapoko BSE, Mayeh AMM, Mapenya RRM, Mbassi EDB, Okobalemba EA, Sango AJF, Noa SA, Ntama A, Sando Z, Ndom P, Biwole ME, Sone AM. [Epidemiological and clinical features of cervical cancer in Cameroon: experience in the Douala General Hospital]. Pan Afr Med J 2022; 42:109. [PMID: 36034043 PMCID: PMC9392009 DOI: 10.11604/pamj.2022.42.109.30704] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/11/2021] [Accepted: 05/02/2022] [Indexed: 11/22/2022] Open
Abstract
Introduction cervical cancer is a public health problem in Cameroon, ranking as the 2nd most frequent cancer. The purpose of our study was to describe the epidemiological and clinical characteristics of patients with cervical cancer at the Douala General Hospital in Cameroon. Method we conducted a retrospective study over the period 1 January 2016 to 31 December 2017. Results the study enrolled 357 women. Patients´ age ranged from 25 to 88 years, with an average age of 52.82 ± 12.36 years. Patients from the Western Region were more heavily represented, with a percentage of 42.2% (n= 124/294). The majority of them were unemployed housekeepers (57.3%; n=200/341). The age of first sexual intercourse was recorded for only 37% (n=133/357) of the study population, with an average age of 16.73 ± 2.16 years; while the average age on giving birth to the first child was 18.92 ± 3.44 years. On the other hand, 6.5% (n=11/169) of patients were smokers, while 44% (n=73/166) were alcohol abusers. Squamous cell carcinoma was the most common histologic type (85.6%; n=255/298). The most frequent stage at diagnosis was stage IIB (22.3%, n=71/319) followed by stage IIIB (21.6%; n=69/319). Conclusion in Cameroon, cervical cancer commonly occurs in unemployed adult women and it is associated with an advanced-stage diagnosis. Hence the need to improve awareness of prevention and early diagnosis.
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Affiliation(s)
- Berthe Sabine Esson Mapoko
- Faculté de Médecine et des Sciences Biomédicales, Université de Yaoundé I, Yaoundé, Cameroun,,Corresponding author: Berthe Sabine Esson Mapoko, Faculté de Médecine et des Sciences Biomédicales, Université de Yaoundé I, Yaoundé, Cameroun.
| | | | | | | | | | | | - Sidonie Ananga Noa
- Faculté de Médecine et des Sciences Pharmaceutiques, Université de Douala, Douala, Cameroun
| | - Ambroise Ntama
- Faculté de Médecine et des Sciences Pharmaceutiques, Université de Douala, Douala, Cameroun
| | - Zacharie Sando
- Faculté de Médecine et des Sciences Biomédicales, Université de Yaoundé I, Yaoundé, Cameroun
| | - Paul Ndom
- Faculté de Médecine et des Sciences Biomédicales, Université de Yaoundé I, Yaoundé, Cameroun
| | - Martin Essomba Biwole
- Faculté de Médecine et des Sciences Pharmaceutiques, Université de Douala, Douala, Cameroun
| | - Albert Mouelle Sone
- Faculté de Médecine et des Sciences Pharmaceutiques, Université de Douala, Douala, Cameroun
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Manga SM, Ye Y, Szychowski JM, Nulah KL, Ngalla C, Kincaid K, Boitano TK, Tita AT, Scarinci I, Huh WK, Sando Z, Liang MI. Pathology findings among women with alterations in uterine bleeding patterns in cameroon. Gynecol Oncol Rep 2021; 37:100821. [PMID: 34258361 PMCID: PMC8253902 DOI: 10.1016/j.gore.2021.100821] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/20/2021] [Revised: 06/14/2021] [Accepted: 06/20/2021] [Indexed: 11/08/2022] Open
Abstract
PURPOSE Endometrial cancer is on the rise in high-income countries but it has not been adequately studied in low-and-middle income countries especially in sub-Saharan Africa (SSA), likely due to scarce pathology facilities. The purpose of this study was to characterize and quantify the prevalence of endometrial hyperplasia or cancer in a cohort of women with abnormal uterine bleeding (AUB) who underwent endometrial biopsy in Cameroon. METHODS We designed a cross-sectional study using medical records to characterize women who underwent endometrial biopsy in the Cameroon Baptist Convention Health Services (CBCHS) from 2008 to 2019. Pathologic diagnoses were classified as either endometrial hyperplasia, endometrial cancer, or no endometrial hyperplasia/cancer. We reported the overall prevalence of endometrial hyperplasia or cancer. Bivariate analyses compared patient characteristics between women with endometrial cancer, endometrial hyperplasia, and neither. RESULTS The average age was 46.2 years and women had an average of 5.1 parity. We found that, 61 [(36.7% of 166 women; 95% CI (27.6-47.0%)] had endometrial hyperplasia or cancer. There were no cases of hyperplasia with atypia and 13 women had endometrial cancer. The remainder were comprised of benign or infectious pathologic findings. In bivariate analysis, mean ages were statistically different among the three groups (hyperplasia, cancer, and no hyperplasia/cancer), p < 0.001, and women with cancer had the highest age. Parity was statistically significantly different among the three groups (p = 0.002) and women with endometrial cancer had higher parity. CONCLUSION We found that just over 1 in 3 women with AUB who underwent endometrial biopsy at a health system in SSA were found to have pathologic findings of endometrial hyperplasia or cancer, with no cases of hyperplasia with atypia. Women with endometrial cancer had higher mean age and parity.
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Affiliation(s)
- Simon M. Manga
- Women’s Health Program, Cameroon Baptist Convention Health Services, Bamenda, P.O. Box 1, Nkwen, Bamenda, Cameroon
- Center for Women’s Reproductive Health, Department of Obstetrics & Gynecology, University of Alabama at Birmingham, 1700 6th Avenue South, Suite 10270, Birmingham, AL 35233, USA
| | - Yuanfan Ye
- Center for Women’s Reproductive Health, Department of Obstetrics & Gynecology, University of Alabama at Birmingham, 1700 6th Avenue South, Suite 10270, Birmingham, AL 35233, USA
| | - Jeff M. Szychowski
- Center for Women’s Reproductive Health, Department of Obstetrics & Gynecology, University of Alabama at Birmingham, 1700 6th Avenue South, Suite 10270, Birmingham, AL 35233, USA
| | - Kathleen L. Nulah
- Women’s Health Program, Cameroon Baptist Convention Health Services, Bamenda, P.O. Box 1, Nkwen, Bamenda, Cameroon
| | - Calvin Ngalla
- Women’s Health Program, Cameroon Baptist Convention Health Services, Bamenda, P.O. Box 1, Nkwen, Bamenda, Cameroon
| | - Kaitlyn Kincaid
- Department of Obstetrics & Gynecology, University of Alabama at Birmingham, 1700 6 Avenue South, Suite 10360, Birmingham, AL 35233, USA
| | - Teresa K.L. Boitano
- Department of Obstetrics & Gynecology, University of Alabama at Birmingham, 1700 6 Avenue South, Suite 10360, Birmingham, AL 35233, USA
| | - Alan T. Tita
- Center for Women’s Reproductive Health, Department of Obstetrics & Gynecology, University of Alabama at Birmingham, 1700 6th Avenue South, Suite 10270, Birmingham, AL 35233, USA
- Department of Obstetrics & Gynecology, University of Alabama at Birmingham, 1700 6 Avenue South, Suite 10360, Birmingham, AL 35233, USA
| | - Isabel Scarinci
- Division of Preventive Medicine, University of Alabama at Birmingham, 1717 11th Avenue South, MT Birmingham, AL 35233, USA
| | - Warner K. Huh
- Center for Women’s Reproductive Health, Department of Obstetrics & Gynecology, University of Alabama at Birmingham, 1700 6th Avenue South, Suite 10270, Birmingham, AL 35233, USA
- Division of Gynecologic Oncology, Department of Obstetrics & Gynecology, University of Alabama at Birmingham, 1700 6th Avenue South, Suite10250, Birmingham, AL 35233, USA
| | - Zacharie Sando
- Department of Pathology, Faculty of Medicine and Biomedical Sciences, University of Yaoundé 1, P.O. Box 1364, Yaoundé, Cameroon
| | - Margaret I. Liang
- Center for Women’s Reproductive Health, Department of Obstetrics & Gynecology, University of Alabama at Birmingham, 1700 6th Avenue South, Suite 10270, Birmingham, AL 35233, USA
- Division of Gynecologic Oncology, Department of Obstetrics & Gynecology, University of Alabama at Birmingham, 1700 6th Avenue South, Suite10250, Birmingham, AL 35233, USA
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Nkwabong E, Kengne B, Nkene Mawamba Y, Sando Z. Influence of the human immunodeficiency virus on cervical precancerous lesions. Int J Gynaecol Obstet 2021; 154:540-543. [PMID: 33544881 DOI: 10.1002/ijgo.13639] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/22/2020] [Revised: 01/26/2021] [Accepted: 02/03/2021] [Indexed: 12/24/2022]
Abstract
OBJECTIVE To study the influence of HIV status on the occurrence of cervical precancerous lesions (CPL). METHODS This analytical cross-sectional study was carried out between December 1, 2019 and May 31, 2020. All women with documented HIV status screened for CPL with biopsies performed were recruited. The main variables recorded included maternal age, educational level, number of sexual partners, age at first sexual intercourse, smoking, alcohol consumption, HIV status, CD4 count, and cervical biopsy result. Fisher exact test and Student's t test were used for comparison. A p value <0.05 was considered statistically significant. RESULTS Concerning women attending our screening units, CPL was more frequent among those living with HIV/AIDS (20/92; 21.7%) than among those not living with HIV/AIDS (29/290; 10.0%) (p = 0.004). As regards women living with HIV/AIDS, those with a CD4 count below 350/mL were more at risk of having a CPL (odds ratio [OR] 21.39, 95% confidence interval [CI] 5.60-81.56, p ˂ 0.001). High-grade lesions (cervical intraepithelial neoplasia Stage 2 or 3) were more often found in women living with HIV/AIDS (OR 3.83, 95% CI 1.09-13.45, p = 0.033). CONCLUSION More attention should be paid to women living with HIV/AIDS, especially those with CD4 count less than 350/mL, who should be screened more often with biopsy frequently conducted if indicated.
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Affiliation(s)
- Elie Nkwabong
- Faculty of Medicine and Biomedical Sciences, University of Yaoundé I, Yaoundé, Cameroon.,Department of Obstetrics and Gynecology, University Teaching Hospital, Yaoundé, Cameroon
| | - Berenis Kengne
- Faculty of Medicine and Biomedical Sciences, University of Yaoundé I, Yaoundé, Cameroon
| | - Yvette Nkene Mawamba
- Department of Obstetrics and Gynecology, University Teaching Hospital, Yaoundé, Cameroon
| | - Zacharie Sando
- Department of Pathology, Faculty of Medicine and Biomedical Sciences, University of Yaoundé I, Yaoundé, Cameroon
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Notue YA, Mbessoh UI, Nganwa G, Pambe JN, Mefire AC, Moifo B, Sando Z. Sarcomatoid malignant peritoneal mesothelioma presenting as a localized mesenteric tumor with no previous asbestos exposure. J Surg Case Rep 2020; 2020:rjaa419. [PMID: 33149886 PMCID: PMC7593109 DOI: 10.1093/jscr/rjaa419] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/09/2020] [Revised: 08/29/2020] [Accepted: 09/12/2020] [Indexed: 11/14/2022] Open
Abstract
Sarcomatoid malignant peritoneal mesothelioma is the rarest and most lethal form of peritoneal mesothelioma. We present the case of a sarcomatoid malignant peritoneal mesothelioma presenting as a localized mesenteric tumor in a 54-year-old female with no previous asbestos exposure. This clinical presentation is extremely rare and is the first documented in Cameroon.
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Affiliation(s)
- Yves Alain Notue
- Department of Surgery, Mbouo Protestant Hospital, Bandjoun, Cameroon
| | | | - Grace Nganwa
- Department of Biological Sciences, Faculty of Medicine and Pharmaceutical Sciences, University of Douala, Douala, Cameroon
| | - Judith Ngo Pambe
- Faculty of Medicine and Biomedical Sciences University of Yaounde I, Yaoundé, Cameroon
| | | | - Boniface Moifo
- Faculty of Medicine and Biomedical Sciences University of Yaounde I, Yaoundé, Cameroon
| | - Zacharie Sando
- Faculty of Medicine and Biomedical Sciences University of Yaounde I, Yaoundé, Cameroon
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10
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Fouogue JT, Noubom M, Kenfack B, Dongmo NT, Tabeu M, Megozeu L, Alima JM, Fogang YF, Nyam LCRA, Fouelifack FY, Fouedjio JH, Manebou PLFN, Bibou Ze CD, Kouam BF, Fomete LN, Tebeu PM, Kemfang JDN, Foumane P, Sando Z, Orock GEE. Poor knowledge of COVID-19 and unfavourable perception of the response to the pandemic by healthcare workers at the Bafoussam Regional Hospital (West Region-Cameroon). Pan Afr Med J 2020; 37:19. [PMID: 33343798 DOI: 10.11604/pamj.supp.2020.37.19.25688] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/21/2020] [Accepted: 09/14/2020] [Indexed: 12/18/2022] Open
Abstract
Introduction WHO warned against a dramatic impact of COVID-19 in Africa unless adequate response strategies are implemented. Whatever the strategy, the role of health staff is pivotal. Objective: Assess knowledge and perception of the response to COVID-19 among health staff. Methods we used a convenience non probabilistic sample to conduct a survey with a self-administered questionnaire from April 14 - 29, 2020 at the Bafoussam Regional Hospital (BRH). All the staff was invited to participate. Analyses were done with Microsoft Excel 2010 and Epi-Info version 7.1.5.2. Results response rate was 76.1% (464/610). Mean age (SD) was 35.0 (8.9) years. Sex ratio (M/F) was 101/356. Nursing/midwifery staff (56.8%) and in-patients units (49.94%) were predominant. Origin and transmission of SARS-CoV-2 were poorly known while knowledge of clinical signs and the role of laboratory tests were good. For 53.2% of respondents all therapeutic regimens are supportive and only 31.6% trusted state-recommended drugs. For 169 of respondents (36.9%), herbal remedies prevent/cure COVID-19. Seventy percent (70%) felt they were not knowledgeable enough to handle COVID-19 cases. Eighty-five point six percent (85.6%) thought the BRH had insufficient resources to fight COVID-19 and 55.6% were dissatisfied with its response (weaknesses: medicines/technologies (74.5%), service delivery (28.1%), staff (10.9%)). Sixty-eight percent (68%) reported insufficient protection on duty. Seventy-six point five percent (76.5%) reported a drop in non-COVID-19 services. Eighty-five point five (85.5%) percent said they complied with community preventive measures. For 44% of respondents, regulations on COVID-19 corpses should be made more culture-sensitive. Fifty one point two percent (51.2%) of respondents were against vaccine trial in their community. Conclusion knowledge was poor and perception of the response to COVID-19 was unfavourable.
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Affiliation(s)
- Jovanny Tsuala Fouogue
- Faculty of Medicine and Pharmaceutical Sciences, University of Dschang, Dschang, West Region, Cameroon.,Bafoussam Regional Hospital, Bafoussam, West Region, Cameroon
| | - Michel Noubom
- Faculty of Medicine and Pharmaceutical Sciences, University of Dschang, Dschang, West Region, Cameroon.,Bafoussam Regional Hospital, Bafoussam, West Region, Cameroon
| | - Bruno Kenfack
- Faculty of Medicine and Pharmaceutical Sciences, University of Dschang, Dschang, West Region, Cameroon
| | | | - Maxime Tabeu
- Bafoussam Regional Hospital, Bafoussam, West Region, Cameroon
| | - Linda Megozeu
- Bafoussam Regional Hospital, Bafoussam, West Region, Cameroon
| | | | - Yannick Fogoum Fogang
- Faculty of Medicine and Pharmaceutical Sciences, University of Dschang, Dschang, West Region, Cameroon.,Bafoussam Regional Hospital, Bafoussam, West Region, Cameroon
| | | | | | | | | | | | | | - Lauriane Nomene Fomete
- Agence Nationale de Recherche sur le Sida et les Hépatite Virales - Site Cameroun, Yaoundé, Centre Region, Cameroon
| | - Pierre Marie Tebeu
- Faculty of Medicine and Biomedical Sciences, University of Yaoundé 1, Yaoundé, Cameroon
| | | | - Pascal Foumane
- Faculty of Medicine and Biomedical Sciences, University of Yaoundé 1, Yaoundé, Cameroon
| | - Zacharie Sando
- Faculty of Medicine and Biomedical Sciences, University of Yaoundé 1, Yaoundé, Cameroon
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11
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Mbouché LO, Epoupa Ngallé FG, Sando Z, Choukem SP, Angwafo FF. The case series of functional adrenal tumors: Experience of two tertiary hospitals in Yaoundé, Cameroon. Int J Surg Case Rep 2020; 72:577-583. [PMID: 32698292 PMCID: PMC7327872 DOI: 10.1016/j.ijscr.2020.05.097] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/19/2020] [Revised: 05/28/2020] [Accepted: 05/28/2020] [Indexed: 11/24/2022] Open
Abstract
This is a case series of functional adrenal tumors and treatment outcomes. A diversity of cases is presented with clinical, medical imaging, macroscopic and microscopic features included. Successful management of two cases of adrenal insufficiency following classic adrenalectomy in a low resource community is reported.
Introduction Adrenal tumors are often found incidentally during abdominal imaging. Functioning adrenal tumors are less frequent than these incidentalomas discovered unexpectedly. We report treatment outcomes (major complications) of 7 cases of symptomatic adrenal masses from 2009 to 2019. Presentation of the cases Seven cases of functioning adrenal tumors: four adenomas presenting with Cushing’s syndrome, two adrenal carcinomas, and one pheochromocytoma are described. The preoperative diagnoses were made through clinical manifestations, an increase in urinary free cortisol with normal ACTH, elevated metanephrine and enlarged masses on CT. The diagnoses were established on histopathology of adrenalectomy specimens. Adrenal insufficiency in two patients following surgery was corrected with corticoid replacement therapy. One patient died of hypovolemia the day of surgery and another from anaphylactic shock (allergy) late in the post-operative period. Discussion Pre, intra and post-operative complications from vascular instability often complicate surgery in functioning adrenal tumors. Adrenal adenomas manifest as Cushing’s syndrome in 10–15 % of patients. They are the most common adrenal tumor although the diagnosis is most often coincidental to abdominal imaging. The incidence of adrenal adenoma increases with age, up to 7 % in the seventh decade. Laparoscopic adrenalectomy, which was not available in our hospitals then, is standard treatment for most tumors. It is alleged to have better outcomes in trained and tested hands. Conclusion Surgery of functioning adrenal tumors demands close collaboration of multiple clinical disciplines to manage vascular instability and adrenal insufficiency, especially in resource strapped communities.
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Affiliation(s)
- L O Mbouché
- Department of Surgery, Yaoundé Gynaeco-Obstetric and Pediatric Hospital, University of Yaoundé I, Cameroon.
| | - F G Epoupa Ngallé
- Department of Surgery, Yaoundé Gynaeco-Obstetric and Pediatric Hospital, University of Yaoundé I, Cameroon
| | - Z Sando
- Department of Pathology, Yaoundé Gynaeco-Obstetric and Pediatric Hospital, University of Yaoundé I, Cameroon
| | - S P Choukem
- Department of Internal Medicine, Douala General Hospital, University of Dschang, Cameroon
| | - F F Angwafo
- Department of Surgery, Yaoundé Gynaeco-Obstetric and Pediatric Hospital, University of Yaoundé I, Cameroon
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12
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Fouogue JT, Noubom M, Kenfack B, Dongmo NT, Tabeu M, Megozeu L, Alima JM, Fogang YF, Nyam LCRA, Fouelifack FY, Fouedjio JH, Manebou PLFN, Bibou Ze CD, Kouam BF, Fomete LN, Tebeu PM, Kemfang JDN, Foumane P, Sando Z, Orock GEE. Poor knowledge of COVID-19 and unfavourable perception of the response to the pandemic by healthcare workers at the Bafoussam Regional Hospital (West Region-Cameroon). Pan Afr Med J 2020. [PMID: 33343798 PMCID: PMC7733347 DOI: 10.11604/pamj.supp.2020.37.1.25688] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/18/2022] Open
Abstract
Introduction WHO warned against a dramatic impact of COVID-19 in Africa unless adequate response strategies are implemented. Whatever the strategy, the role of health staff is pivotal. Objective: Assess knowledge and perception of the response to COVID-19 among health staff. Methods we used a convenience non probabilistic sample to conduct a survey with a self-administered questionnaire from April 14 - 29, 2020 at the Bafoussam Regional Hospital (BRH). All the staff was invited to participate. Analyses were done with Microsoft Excel 2010 and Epi-Info version 7.1.5.2. Results response rate was 76.1% (464/610). Mean age (SD) was 35.0 (8.9) years. Sex ratio (M/F) was 101/356. Nursing/midwifery staff (56.8%) and in-patients units (49.94%) were predominant. Origin and transmission of SARS-CoV-2 were poorly known while knowledge of clinical signs and the role of laboratory tests were good. For 53.2% of respondents all therapeutic regimens are supportive and only 31.6% trusted state-recommended drugs. For 169 of respondents (36.9%), herbal remedies prevent/cure COVID-19. Seventy percent (70%) felt they were not knowledgeable enough to handle COVID-19 cases. Eighty-five point six percent (85.6%) thought the BRH had insufficient resources to fight COVID-19 and 55.6% were dissatisfied with its response (weaknesses: medicines/technologies (74.5%), service delivery (28.1%), staff (10.9%)). Sixty-eight percent (68%) reported insufficient protection on duty. Seventy-six point five percent (76.5%) reported a drop in non-COVID-19 services. Eighty-five point five (85.5%) percent said they complied with community preventive measures. For 44% of respondents, regulations on COVID-19 corpses should be made more culture-sensitive. Fifty one point two percent (51.2%) of respondents were against vaccine trial in their community. Conclusion knowledge was poor and perception of the response to COVID-19 was unfavourable.
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Affiliation(s)
- Jovanny Tsuala Fouogue
- Faculty of Medicine and Pharmaceutical Sciences, University of Dschang, Dschang, West Region, Cameroon
- Bafoussam Regional Hospital, Bafoussam, West Region, Cameroon
- Corresponding author: Jovanny Tsuala Fouogue, Faculty of Medicine and Pharmaceutical Sciences, University of Dschang, Dschang, West Region, Cameroon.
| | - Michel Noubom
- Faculty of Medicine and Pharmaceutical Sciences, University of Dschang, Dschang, West Region, Cameroon
- Bafoussam Regional Hospital, Bafoussam, West Region, Cameroon
| | - Bruno Kenfack
- Faculty of Medicine and Pharmaceutical Sciences, University of Dschang, Dschang, West Region, Cameroon
| | | | - Maxime Tabeu
- Bafoussam Regional Hospital, Bafoussam, West Region, Cameroon
| | - Linda Megozeu
- Bafoussam Regional Hospital, Bafoussam, West Region, Cameroon
| | | | - Yannick Fogoum Fogang
- Faculty of Medicine and Pharmaceutical Sciences, University of Dschang, Dschang, West Region, Cameroon
- Bafoussam Regional Hospital, Bafoussam, West Region, Cameroon
| | | | | | | | | | | | | | - Lauriane Nomene Fomete
- Agence Nationale de Recherche sur le Sida et les Hépatite Virales - Site Cameroun, Yaoundé, Centre Region, Cameroon
| | - Pierre Marie Tebeu
- Faculty of Medicine and Biomedical Sciences, University of Yaoundé 1, Yaoundé, Cameroon
| | | | - Pascal Foumane
- Faculty of Medicine and Biomedical Sciences, University of Yaoundé 1, Yaoundé, Cameroon
| | - Zacharie Sando
- Faculty of Medicine and Biomedical Sciences, University of Yaoundé 1, Yaoundé, Cameroon
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13
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Tseuguem PP, Ngangoum DAM, Pouadjeu JM, Piégang BN, Sando Z, Kolber BJ, Tidgewell KJ, Nguelefack TB. Aqueous and methanol extracts of Paullinia pinnata L. (Sapindaceae) improve inflammation, pain and histological features in CFA-induced mono-arthritis: Evidence from in vivo and in vitro studies. J Ethnopharmacol 2019; 236:183-195. [PMID: 30849505 PMCID: PMC6484438 DOI: 10.1016/j.jep.2019.02.048] [Citation(s) in RCA: 12] [Impact Index Per Article: 2.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 12/07/2018] [Revised: 01/31/2019] [Accepted: 02/28/2019] [Indexed: 06/09/2023]
Abstract
ETHNOPHARMACOLOGICAL RELEVANCE Paullinia pinnata L. (Sapindaceae) is an African woody vine, traditionally used for the treatment of itch and pain-related conditions such as rheumatoid arthritis. AIM This work evaluates, in vitro and in vivo, the anti-inflammatory and analgesic effects of aqueous (AEPP) and methanol (MEPP) extracts from Paullinia pinnata leaves. METHODS AEPP and MEPP (100, 200 and 300 mg/kg/day) were administered orally in monoarthritic rats induced by a unilateral injection of 50 μl of Complete Freund's Adjuvant (CFA) in the ankle joint. During the 14 days of treatment, pain and inflammation were evaluated alternatively in both ankle and paw of the CFA-injected leg. Malondialdehyde (MDA) and glutathione (GSH) levels were assessed in serum and spinal cord. Histology of soft tissue of the ankle was also analyzed. For in vitro studies, AEPP and MEPP (10, 30 and 100 μg/ml) were evaluated against nitric oxide (NO) production by macrophages that were either non-stimulated or stimulated with LPS, 8-Br-AMPc and the mixture of both substances after 8 h exposure. These extracts were also evaluated on TNF-α and IL-1β production in cells stimulated with LPS for 8 h. Finally, the ability of the extracts to bind to neuroactive receptors was evaluated in vitro using competitive binding assays with >45 molecular targets. RESULTS AEPP and MEPP significantly reduced by 20-98% (p < 0.001) the inflammation and pain sensation in both the ankle and paw. AEPP significantly increased glutathione levels (p < 0.05) in serum. Both extracts reduced MDA production in serum and spinal cord (p < 0.001), and significantly improved tissue reorganization in treated arthritic rats. P. pinnata extracts did not affect NO production in non-stimulated macrophages but significantly reduced it by 47-88% in stimulated macrophages. AEPP and MEPP also significantly inhibited TNF-α (35-68%) and IL-1β (31-36%) production in LPS stimulated macrophages. No cytotoxic effect of plant extracts was observed. MEPP showed concentration-dependent affinity for Sigma 2 receptors with an IC50 of 50 μg/ml. CONCLUSION These results demonstrate the analgesic and anti-inflammatory effects of P. pinnata extracts on monoarthritis and further support its traditional use for pain and inflammation. These activities are at least partly due to the ability of these extracts to inhibit the production of NO, TNF-α, IL-1β and to likely modulate Sigma 2 receptors.
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MESH Headings
- Analgesics/isolation & purification
- Analgesics/pharmacology
- Analgesics/therapeutic use
- Animals
- Ankle Joint/drug effects
- Ankle Joint/immunology
- Ankle Joint/pathology
- Anti-Inflammatory Agents/isolation & purification
- Anti-Inflammatory Agents/pharmacology
- Anti-Inflammatory Agents/therapeutic use
- Arthralgia/drug therapy
- Arthralgia/etiology
- Arthralgia/pathology
- Arthritis, Experimental/complications
- Arthritis, Experimental/drug therapy
- Arthritis, Experimental/immunology
- Arthritis, Experimental/pathology
- Arthritis, Rheumatoid/complications
- Arthritis, Rheumatoid/drug therapy
- Arthritis, Rheumatoid/immunology
- Arthritis, Rheumatoid/pathology
- Drug Evaluation, Preclinical
- Female
- Freund's Adjuvant/administration & dosage
- Freund's Adjuvant/immunology
- Humans
- Male
- Medicine, African Traditional/methods
- Methanol/chemistry
- Nitric Oxide/metabolism
- Paullinia/chemistry
- Plant Extracts/isolation & purification
- Plant Extracts/pharmacology
- Plant Extracts/therapeutic use
- Plant Leaves/chemistry
- Rats
- Rats, Wistar
- Treatment Outcome
- Water/chemistry
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Affiliation(s)
- Pius Pum Tseuguem
- Laboratory of Animal Physiology and Phytopharmacology, Faculty of Sciences, University of Dschang, P.O.Box 67, Dschang, Cameroon.
| | - Douglas Alphonse Mouga Ngangoum
- Laboratory of Animal Physiology and Phytopharmacology, Faculty of Sciences, University of Dschang, P.O.Box 67, Dschang, Cameroon.
| | - Judith Manialeu Pouadjeu
- Laboratory of Animal Physiology and Phytopharmacology, Faculty of Sciences, University of Dschang, P.O.Box 67, Dschang, Cameroon.
| | - Basile Nganmegne Piégang
- Laboratory of Animal Physiology and Phytopharmacology, Faculty of Sciences, University of Dschang, P.O.Box 67, Dschang, Cameroon.
| | - Zacharie Sando
- Faculty of Medicine and Biomedical Sciences, University of Yaoundé I, Cameroon.
| | - Benedict James Kolber
- Department of Biological Sciences, Duquesne University, 600 Forbes Avenue, Pittsburgh, PA, 15282, USA.
| | - Kevin John Tidgewell
- Division of Medicinal Chemistry, Duquesne University, 600 Forbes Avenue, Pittsburgh, PA, 15282, USA.
| | - Télesphore Benoît Nguelefack
- Laboratory of Animal Physiology and Phytopharmacology, Faculty of Sciences, University of Dschang, P.O.Box 67, Dschang, Cameroon.
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14
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Vassilakos P, Tebeu PM, Halle-Ekane GE, Sando Z, Kenfack B, Baumann F, Petignat P. [Not Available]. Rev Med Suisse 2019; 15:601-605. [PMID: 30865394] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Subscribe] [Scholar Register] [Indexed: 06/09/2023]
Affiliation(s)
- Pierre Vassilakos
- Fondation genevoise pour la formation et la recherche médicales, Centre collaborateur de l'OMS pour l'éducation et la recherche en reproduction humaine, 150 Route de Ferney, 1211 Genève 2 Service de gynécologie, HUG, 1211 Genève 14
| | - Pierre-Marie Tebeu
- Centre Inter-Etats d'enseignement supérieur en santé publique d'Afrique centrale, N2, Brazzaville, République du Congo, Brazzaville
| | | | - Zacharie Sando
- Service d'anatomie et cytologie pathologiques, Hôpital gynéco-obstétrique et pédiatrique, BP 4342, Yaoundé, Cameroun
| | - Bruno Kenfack
- Département des sciences biomédicales, Université de Dschang, BP 67, Dschang, Cameroun
| | - Fritz Baumann
- Faculté de médecine, Université de Genève, 1211 Genève 4
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Abstract
This cross-sectional descriptive study, aimed at accessing the accuracy of Pap smear in diagnosing cervical precancerous lesions, was carried out between 3 January and 30 April 2017. All women screened for cervical dysplasia by means of Pap smear with biopsy done for confirmation were subsequently recruited. Data were analysed using SPSS 20.0. A total of 231 women were screened for cervical dysplasia using Pap smear with 75 biopsies performed. Cervical dysplasia was noticed in 54 cases. The sensitivity, specificity, positive predictive and negative predictive values of Pap smear were 55.5%, 75%, 88.2% and 33.3%, respectively. The sensitivity of Pap smear remains low. Therefore, biopsy should be done in cases of macroscopic cervical architectural changes irrespective of the result of the Pap smear. Moreover, to reduce the number of women with cervical precancerous lesions, the government should make available financial resources to set up HPV vaccination programmes rather than screening programmes.
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Affiliation(s)
- Elie Nkwabong
- 1 Associate Professor, Department of Obstetrics & Gynecology, University Teaching Hospital / Faculty of Medicine and Biomedical Sciences, Yaoundé, Cameroon
| | | | - Zacharie Sando
- 3 Associate Professor, Department of Pathology, Faculty of Medicine and Biomedical Sciences, Yaoundé, Cameroon
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16
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Fouogue JT, Tchounzou R, Fouelifack FY, Fouedjio JH, Dohbit JS, Sando Z, Mboudou ET. Evaluation of patients' satisfaction after laparoscopic surgery in a tertiary hospital in Cameroon (Africa). Pan Afr Med J 2018; 28:216. [PMID: 29629002 PMCID: PMC5881559 DOI: 10.11604/pamj.2017.28.216.11441] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/18/2016] [Accepted: 10/28/2017] [Indexed: 11/11/2022] Open
Abstract
Introduction Access to laparoscopy is low in Cameroon where customers' satisfaction has not been reported so far. We assessed patients' satisfaction with the process of care during laparoscopic surgery in a new tertiary hospital. Methods A questionnaire was addressed to consenting patients (guardians for patients under 18) with complete medical records who underwent laparoscopy at the Douala Gynaeco-Obstetric and Paediatric Hospital (Cameroon) from November 1, 2015 to July 31, 2016. The following modified Likert's scale was used to assess satisfaction: very weak: 0-2.5; weak 2.6-5; good: 5.1-7.5; very good: 7.6-10. Only descriptive statistics were used. Results Response rate was 90% (45/50). Of the 45 respondents, 39 (86.7%) were female, 14(31.1%) were referred and 39 (86.7%) paid by direct cash deposit. Mean age was 36.8±11.9 years. Laparoscopies were carried out in emergency for 3 (6.7%) patients. Digestive abnormalities indicated 13 (28.9%) laparoscopies while gynaecologic diseases accounted for 32 (71.1%) cases. Perception of the overall care process was good with a mean satisfaction score of 6.8 ± 1.4. Scores in categories were: 0% (Very weak); 13.3% (weak); 57.8% (good) and 28.9% (very good). Specifically mean satisfaction scores were: 7.8 ± 1.0 with doctors' care; 7.1 ± 1.3 with hospital administration; 7.0 ± 1.2 with nursing and 4.7 ± 1.4 with the costs. Main complaints were: long waiting time (73.3%), constraining geographical access (66.7%) and expensiveness (48.9%). Conclusion Patients were globally satisfied with the process of care but financial and geographical barriers should be addressed.
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Affiliation(s)
| | - Robert Tchounzou
- Douala Gynaeco-Obstetric and Pediatric Hospital, Douala, Cameroon
| | | | | | - Julius Sama Dohbit
- Faculty of Medicine and Biomedical Sciences of the University of Yaoundé I, Yaoundé, Cameroon
| | - Zacharie Sando
- Faculty of Medicine and Biomedical Sciences of the University of Yaoundé I, Yaoundé, Cameroon
| | - Emile Telesphore Mboudou
- Douala Gynaeco-Obstetric and Pediatric Hospital, Douala, Cameroon.,Faculty of Medicine and Biomedical Sciences of the University of Yaoundé I, Yaoundé, Cameroon
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17
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Cholli P, Bradford L, Manga S, Nulah K, Kiyang E, Manjuh F, DeGregorio G, Ogembo RK, Orock E, Liu Y, Wamai RG, Sheldon LK, Gona PN, Sando Z, Welty T, Welty E, Ogembo JG. Screening for cervical cancer among HIV-positive and HIV-negative women in Cameroon using simultaneous co-testing with careHPV DNA testing and visual inspection enhanced by digital cervicography: Findings of initial screening and one-year follow-up. Gynecol Oncol 2017; 148:118-125. [PMID: 29153541 DOI: 10.1016/j.ygyno.2017.11.002] [Citation(s) in RCA: 13] [Impact Index Per Article: 1.9] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/13/2017] [Revised: 10/31/2017] [Accepted: 11/02/2017] [Indexed: 12/27/2022]
Abstract
OBJECTIVE The World Health Organization (WHO)'s cervical cancer screening guidelines for limited-resource settings recommend sequential screening followed by same-day treatment under a "screen-and-treat" approach. We aimed to (1) assess feasibility and clinical outcomes of screening HIV-positive and HIV-negative Cameroonian women by pairing visual inspection with acetic acid and Lugol's iodine enhanced by digital cervicography (VIA/VILI-DC) with careHPV, a high-risk human papillomavirus (HR-HPV) nucleic acid test designed for low-resource settings; and (2) determine persistence of HR-HPV infection after one-year follow-up to inform optimal screening, treatment, and follow-up algorithms. METHODS We co-tested 913 previously unscreened women aged ≥30years and applied WHO-recommended treatment for all VIA/VILI-DC-positive women. Baseline prevalence of HR-HPV and HIV were 24% and 42%, respectively. RESULTS On initial screen, 44 (5%) women were VIA/VILI-DC-positive, of whom 22 had HR-HPV infection, indicating 50% of women screened false-positive and would have been triaged for unnecessary same-day treatment. VIA/VILI-DC-positive women with HIV infection were three times more likely to be HR-HPV-positive than HIV-negative women (65% vs. 20%). All women positive for either VIA/VILI-DC or HR-HPV (n=245) were invited for repeat co-testing after one year, of which 136 (56%) returned for follow-up. Of 122 women who were HR-HPV-positive on initial screen, 60 (49%) re-tested negative, of whom 6 had received treatment after initial screen, indicating that 44% of initially HR-HPV-positive women spontaneously cleared infection after one year without treatment. Women with HIV were more likely to remain HR-HPV-positive on follow-up than HIV-negative women (61% vs. 22%, p<0.001). Treatment was offered to all VIA/VILI-DC positive women on initial screen, and to all women screening VIA/VILI-DC or HR-HPV positive on follow-up. CONCLUSIONS We found careHPV co-testing with VIA/VILI-DC to be feasible and valuable in identifying false-positives, but careHPV screening-to-result time was too long to inform same-day treatment.
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Affiliation(s)
- Preetam Cholli
- University of Massachusetts Medical School, 55 N Lake Avenue, Worcester, MA 01655, United States
| | - Leslie Bradford
- University of Massachusetts Medical School, 55 N Lake Avenue, Worcester, MA 01655, United States
| | - Simon Manga
- Cameroon Baptist Convention Health Services, PO Box 1, Bamenda, North West Region, Cameroon
| | - Kathleen Nulah
- Cameroon Baptist Convention Health Services, PO Box 1, Bamenda, North West Region, Cameroon
| | - Edith Kiyang
- Cameroon Baptist Convention Health Services, PO Box 1, Bamenda, North West Region, Cameroon
| | - Florence Manjuh
- Cameroon Baptist Convention Health Services, PO Box 1, Bamenda, North West Region, Cameroon
| | - Geneva DeGregorio
- University of Massachusetts Medical School, 55 N Lake Avenue, Worcester, MA 01655, United States
| | - Rebecca K Ogembo
- University of Massachusetts Medical School, 55 N Lake Avenue, Worcester, MA 01655, United States
| | - Enow Orock
- Regional Hospital, PO Box 32, Buea, Cameroon
| | - Yuxin Liu
- University of Massachusetts Medical School, 55 N Lake Avenue, Worcester, MA 01655, United States; Mount Sinai Health System, Icahn School of Medicine at Mount Sinai, 1 Gustave L. Levy Pl, New York, NY 10029, United States
| | - Richard G Wamai
- Northeastern University, 360 Huntington Ave, Boston, MA 02115, United States
| | - Lisa Kennedy Sheldon
- Oncology Nursing Society, 125 Enterprise Drive, Pittsburgh, PA 15275, United States
| | - Philimon N Gona
- Northeastern University, 360 Huntington Ave, Boston, MA 02115, United States
| | - Zacharie Sando
- Yaoundé Gyneco-Obstetric and Pediatric Hospital, Yaoundé, PO Box 4362, Central Region, Cameroon
| | - Thomas Welty
- Cameroon Baptist Convention Health Services, PO Box 1, Bamenda, North West Region, Cameroon
| | - Edith Welty
- Cameroon Baptist Convention Health Services, PO Box 1, Bamenda, North West Region, Cameroon
| | - Javier Gordon Ogembo
- University of Massachusetts Medical School, 55 N Lake Avenue, Worcester, MA 01655, United States; Beckman Research Institute of City of Hope, 1500 E Duarte Road, Duarte, CA 91010, United States.
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Nansseu JR, Mbogning DM, Monamele GC, Tamoh SF, Gonsu HK, Kouanfack C, Yanwou YN, Sando Z. Sero-epidemiology of human immunodeficiency virus, hepatitis B virus and hepatitis C virus: a cross-sectional survey in a rural setting of the West region of Cameroon. Pan Afr Med J 2017; 28:201. [PMID: 29610639 PMCID: PMC5878856 DOI: 10.11604/pamj.2017.28.201.12717] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/09/2017] [Accepted: 09/04/2017] [Indexed: 11/21/2022] Open
Abstract
INTRODUCTION Human immunodeficiency Virus (HIV), hepatitis B virus (HBV), and hepatitis C virus (HCV) are the three most common chronic viral infections worldwide, specifically in sub-Saharan Africa (SSA). This study aimed to determine the sero-epidemiology of HIV, HBV and HCV infections in a rural setting of the West region of Cameroon, a SSA country. METHODS We conducted a cross-sectional study from August 2 to 5, 2014 in the three health districts of the Menoua Division, West region of Cameroon. Sixteen villages were randomly selected. Participants were currently living in the Division at the time of the survey, and enrolled after they had provided a signed consent form. HIV screening used the "determine test" followed by Hexagon HIV for positive cases to the first assay. HBV and HCV were detected using DIASpot HBsAg and DIASpot HCV-Ab, respectively. RESULTS On the whole, 612 subjects consented to take part in this study, of whom 71.1% were females. Mean age of the study population was 45.3 ± 17.9 years. The seroprevalences of HIV, HBV and HCV infections were 1.0% (6/582), 4.5% (20/443) and 6.3% (23/365), respectively. The 41-50 years age group was the most represented among HIV-positive subjects. HBV prevalence was higher in the 21-30 years age group (13.4%), followed by the 51-60 years age group (7.8%), with a significant difference of prevalences among age groups (p = 0.002). All HCV-positive cases were above 40 years of age with a higher prevalence in the > 70 years age group (33.3%) followed by the 61-70 years age group (14.5%); there was a significant difference between the age groups (p = 0.001). CONCLUSION The seroprevalences of HIV, HBV and HCV infections in the Menoua Division of the West region of Cameroon were 1.0%, 4.5% and 6.3%, respectively. Preventive measures against these health threats need to be reinforced in this setting.
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Affiliation(s)
- Jobert Richie Nansseu
- Faculty of Medicine and Biomedical Sciences, University of Yaoundé I, Yaoundé, Cameroon
- Department of Disease, Epidemics and Pandemics Control, Ministry of Public Health, Yaoundé, Cameroon
| | | | | | | | - Hortense Kamga Gonsu
- Faculty of Medicine and Biomedical Sciences, University of Yaoundé I, Yaoundé, Cameroon
- Laboratory of Bacteriology, Yaoundé University Teaching Hospital, Yaoundé, Cameroon
| | | | - Yves Nathan Yanwou
- Faculty of Medicine and Biomedical Sciences, University of Yaoundé I, Yaoundé, Cameroon
| | - Zacharie Sando
- Faculty of Medicine and Biomedical Sciences, University of Yaoundé I, Yaoundé, Cameroon
- Department of Pathology, Yaoundé Gynaeco-Obstetrics and Pediatric Hospital, Yaoundé, Cameroon
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Fouogue JT, Fouelifack FY, Fouedjio JH, Tchounzou R, Sando Z, Mboudou ET. First steps of laparoscopic surgery in a sub-Saharan African setting: a nine-month review at the Douala Gynaeco-Obstetric and Pediatric Hospital (Cameroon). Facts Views Vis Obgyn 2017; 9:105-110. [PMID: 29209487 PMCID: PMC5708350] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/24/2022] Open
Abstract
OBJECTIVES To describe the first laparoscopic surgeries in a tertiary hospital in Cameroon. METHODS We carried out a descriptive study at the Douala Gynaeco-Obstetric and Pediatric Hospital (DGOPH). We examined the files of the 45 patients who underwent laparoscopic surgery from November 1, 2015 to July 31, 2016. Descriptive statistics were computed for patients' characteristics and surgical parameters. RESULTS Mean (SD) age was 36.8(11.9) years. Women made up 86.7% of the sample. Twelve patients (26.7%) had a previous laparotomy. Cash deposit (86.7%) was the main mode of payment. Thirty-two (71.1%) laparoscopies were gynaeco-obstetrical (GO) and 13 (28.9%) were digestive. Main indications were infertility (59.4%) and chronic cholecystitis (30.8%) for GO and digestive laparoscopies respectively. Mean (SD) durations were 89.1(57.5) and 55.5(41.0) minutes for digestive and GO laparoscopies respectively. Mean (SD) costs were 1065.4 (406.1) and 934.2 (657.0) USD for digestive and GO laparoscopies respectively. Mean (SD) lengths of hospital stays were 5.5 (2.5) and 5.5 (2.5) days for digestive and GO laparoscopies respectively. Local staff carried out all GO laparoscopies while foreign (Belgian) experts did digestive cases. Only one (2.2%) complication (colic perforation) was registered. CONCLUSION The beginnings of laparoscopy at the DGOPH were successful thanks to strong local leadership and Belgian technical assistance.
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Affiliation(s)
- JT Fouogue
- Gynaeco-Obstetric unit of the Douala Gynaeco-Obstetric and Pediatric Hospital; Douala – Cameroon. PO Box 812
| | - FY Fouelifack
- HigherInstitute of Medical Technologies; Yaoundé – Cameroon. PO Box: 31186
| | - JH Fouedjio
- Faculty of Medicine and Biomedical Sciences of the University of Yaoundé 1; Yaoundé – Cameroon. PO Box: 1364
| | - R Tchounzou
- Gynaeco-Obstetric unit of the Douala Gynaeco-Obstetric and Pediatric Hospital; Douala – Cameroon. PO Box 812.,Faculty of Health Sciences of the University of Buea; Buea – Cameroon. PO Box 63
| | - Z Sando
- Faculty of Medicine and Biomedical Sciences of the University of Yaoundé 1; Yaoundé – Cameroon. PO Box: 1364
| | - ET Mboudou
- Gynaeco-Obstetric unit of the Douala Gynaeco-Obstetric and Pediatric Hospital; Douala – Cameroon. PO Box 812.,Faculty of Medicine and Biomedical Sciences of the University of Yaoundé 1; Yaoundé – Cameroon. PO Box: 1364
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DeGregorio G, Manga S, Kiyang E, Manjuh F, Bradford L, Cholli P, Wamai R, Ogembo R, Sando Z, Liu Y, Sheldon LK, Nulah K, Welty T, Welty E, Ogembo JG. Implementing a Fee-for-Service Cervical Cancer Screening and Treatment Program in Cameroon: Challenges and Opportunities. Oncologist 2017; 22:850-859. [PMID: 28536303 DOI: 10.1634/theoncologist.2016-0383] [Citation(s) in RCA: 25] [Impact Index Per Article: 3.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/03/2016] [Accepted: 02/07/2017] [Indexed: 01/13/2023] Open
Abstract
BACKGROUND Cervical cancer screening is one of the most effective cancer prevention strategies, but most women in Africa have never been screened. In 2007, the Cameroon Baptist Convention Health Services, a large faith-based health care system in Cameroon, initiated the Women's Health Program (WHP) to address this disparity. The WHP provides fee-for-service cervical cancer screening using visual inspection with acetic acid enhanced by digital cervicography (VIA-DC), prioritizing care for women living with HIV/AIDS. They also provide clinical breast examination, family planning (FP) services, and treatment for reproductive tract infection (RTI). Here, we document the strengths and challenges of the WHP screening program and the unique aspects of the WHP model, including a fee-for-service payment system and the provision of other women's health services. METHODS We retrospectively reviewed WHP medical records from women who presented for cervical cancer screening from 2007-2014. RESULTS In 8 years, WHP nurses screened 44,979 women for cervical cancer. The number of women screened increased nearly every year. The WHP is sustained primarily on fees-for-service, with external funding totaling about $20,000 annually. In 2014, of 12,191 women screened for cervical cancer, 99% received clinical breast exams, 19% received FP services, and 4.7% received treatment for RTIs. We document successes, challenges, solutions implemented, and recommendations for optimizing this screening model. CONCLUSION The WHP's experience using a fee-for-service model for cervical cancer screening demonstrates that in Cameroon VIA-DC is acceptable, feasible, and scalable and can be nearly self-sustaining. Integrating other women's health services enabled women to address additional health care needs. IMPLICATION FOR PRACTICE The Cameroon Baptist Convention Health Services Women's Health Program successfully implemented a nurse-led, fee-for-service cervical cancer screening program using visual inspection with acetic acid-enhanced by digital cervicography in the setting of a large faith-based health care system in Cameroon. It is potentially replicable in many African countries, where faith-based organizations provide a large portion of health care. The cost-recovery model and concept of offering multiple services in a single clinic rather than stand-alone "silo" cervical cancer screening could provide a model for other low-and-middle-income countries planning to roll out a new, or make an existing, cervical cancer screening services accessible, comprehensive, and sustainable.
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Affiliation(s)
- Geneva DeGregorio
- University of Massachusetts Medical School, Worcester, Massachusetts, USA
| | - Simon Manga
- Cameroon Baptist Convention Health Services, Bamenda, Cameroon
| | - Edith Kiyang
- Cameroon Baptist Convention Health Services, Bamenda, Cameroon
| | - Florence Manjuh
- Cameroon Baptist Convention Health Services, Bamenda, Cameroon
| | - Leslie Bradford
- University of Massachusetts Medical School, Worcester, Massachusetts, USA
| | - Preetam Cholli
- University of Massachusetts Medical School, Worcester, Massachusetts, USA
| | | | - Rebecca Ogembo
- University of Massachusetts Medical School, Worcester, Massachusetts, USA
| | - Zacharie Sando
- The Yaoundé Gyneco-Obstetrics and Pediatric Hospital, Yaoundé, Cameroon
| | - Yuxin Liu
- University of Massachusetts Medical School, Worcester, Massachusetts, USA
| | | | - Kathleen Nulah
- Cameroon Baptist Convention Health Services, Bamenda, Cameroon
| | - Thomas Welty
- Cameroon Baptist Convention Health Services, Bamenda, Cameroon
| | - Edith Welty
- Cameroon Baptist Convention Health Services, Bamenda, Cameroon
| | - Javier Gordon Ogembo
- University of Massachusetts Medical School, Worcester, Massachusetts, USA
- Beckman Research Institute of City of Hope, Duarte, California, USA
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Ama Moor VJ, Nya Biapa PC, Nono Njinkio BL, Moukette Moukette B, Sando Z, Kenfack C, Ateba B, Ngo Matip ME, Pieme CA, Ngogang J. Hypolipidemic effect and activation of Lecithin Cholesterol Acyl Transferase (LCAT) by aqueous extract of Spirulina platensis during toxicological investigation. BMC Nutr 2017; 3:25. [PMID: 32153807 PMCID: PMC7050855 DOI: 10.1186/s40795-017-0146-2] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/17/2016] [Accepted: 03/08/2017] [Indexed: 11/10/2022] Open
Abstract
BACKGROUND Spirulina platensis produced in Nomayos (Cameroon) is used as a dietary supplement. S. platensis is known as a neutraceutical with many beneficial effects on humans like lipid-lowering action. This study aims to investigate the mechanism of hypolipidemic action of aqueous extract of Spirulina platensis (S. platensis) through the toxicological studies. METHODS In this study, we included two month old Wistar rats, weighing between 180 and 200 g. Aqueous S. platensis was extracted and prepared using standard methods. The rats received a supplementation of S. platensis at 5000 mg/Kg of body weight as single dose in acute toxicity whereas different doses (250, 500, 1000 mg / kg body weight) were administered in subacute toxicity compared to control. Acute and subacute toxicities were determined according to the guidelines 420 (14 days) and 407 (28 days) of the Organization for Economic Cooperation and Development (OECD) respectively. Biochemical parameters such as urea, creatinine, total and direct bilirubin, lipid profile and transaminases; and histopathological analysis of the liver and kidneys were used to evaluate the toxicity of S. platensis on these Wistar rats. Plasmatic hydroxymethyl glutaryl coenzyme A reductase (HMG CoA reductase) and lecithine cholesterol acyl transferase (LCAT) were performed to explain the lipid-lowering action of S. platensis. Histopathological analysis of the liver and kidneys was performed. RESULTS Our results show a decrease in total cholesterol for male rats (from 84 to 74 mg/dl) when the dose of S. platensis increased; this reduction of the total cholesterol level in male rats was significant at 500 mg/kg. There was also a significant inhibition of HMG CoA reductase in a dose dependent manner between 25 and 84.5 fold compared to the control in both male and female groups. At the dose of 250 mg/kg bw, the level of LCAT was higher compared with other groups and control, but the difference was not statistically significant. A slight inflammation in the liver and the mesangial hyperplasia of the renal glomeruli was revealed by the histopathological investigation in subacute toxicity. CONCLUSION Spirulina platensis from Cameroon appears to have little toxic effects and may demonstrate hypolipidemic activity through the activation of LCAT.
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Affiliation(s)
- Vicky Jocelyne Ama Moor
- Department Physiological Sciences and Biochemistry, Faculty of Medicine and Biomedical Sciences - University of Yaounde 1, Yaounde, Cameroon
| | | | - Borgia Legrand Nono Njinkio
- Department of Pharmarcy and Traditional Medicine, Faculty of Medicine and Biomedical Sciences, University of Yaoundé I, Yaounde, Cameroon
| | - Bruno Moukette Moukette
- Department Physiological Sciences and Biochemistry, Faculty of Medicine and Biomedical Sciences - University of Yaounde 1, Yaounde, Cameroon
| | - Zacharie Sando
- Department Physiological Sciences and Biochemistry, Faculty of Medicine and Biomedical Sciences - University of Yaounde 1, Yaounde, Cameroon
| | - Cyril Kenfack
- Department of Physics, Cepamoq, University of Douala, Douala, Cameroon
| | - Baruch Ateba
- Department of Physics, Cepamoq, University of Douala, Douala, Cameroon
| | - Marthe Elise Ngo Matip
- Department of Biochemistry, Faculty of Sciences, University of Ngaoundere, Ngaoundere, Cameroon
| | - Constant Anatole Pieme
- Department Physiological Sciences and Biochemistry, Faculty of Medicine and Biomedical Sciences - University of Yaounde 1, Yaounde, Cameroon
| | - Jeanne Ngogang
- Department Physiological Sciences and Biochemistry, Faculty of Medicine and Biomedical Sciences - University of Yaounde 1, Yaounde, Cameroon
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DeGregorio GA, Bradford LS, Manga S, Tih PM, Wamai R, Ogembo R, Sando Z, Liu Y, Schwaiger C, Rao SR, Kalmakis K, Kennedy Sheldon L, Nulah K, Welty E, Welty T, Ogembo JG. Prevalence, Predictors, and Same Day Treatment of Positive VIA Enhanced by Digital Cervicography and Histopathology Results in a Cervical Cancer Prevention Program in Cameroon. PLoS One 2016; 11:e0157319. [PMID: 27280882 PMCID: PMC4900564 DOI: 10.1371/journal.pone.0157319] [Citation(s) in RCA: 23] [Impact Index Per Article: 2.9] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/31/2016] [Accepted: 05/29/2016] [Indexed: 11/25/2022] Open
Abstract
Background In 2007, the Cameroon Baptist Convention Health Services (CBCHS) implemented a screen-and-treat cervical cancer prevention program using visual inspection with acetic acid enhanced by digital cervicography (VIA-DC). Methods We retrospectively analyzed 46,048 medical records of women who received care through the CBCHS Women’s Health Program from 2007 through 2014 to determine the prevalence and predictors of positive VIA-DC, rates of same day treatment, and cohort prevalence of invasive cervical cancer (ICC). Results Of the 44,979 women who were screened for cervical cancer, 9.0% were VIA-DC-positive, 66.8% were VIA-DC-negative, 22.0% were VIA-DC-inadequate (normal ectocervix, but portions of the transformation zone were obscured), and 2.2% were VIA-DC-uncertain (cervical abnormalities confounding VIA-DC interpretation). Risk factors significantly associated with VIA-DC-positive screen were HIV-positivity, young age at sexual debut, higher lifetime number of sexual partners, low education status and higher gravidity. In 2014, 31.1% of women eligible for cryotherapy underwent same day treatment. Among the 32,788 women screened from 2007 through 2013, 201 cases of ICC were identified corresponding to a cohort prevalence of 613 per 100,000. Conclusions High rate of VIA-DC-positive screens suggests a significant burden of potential cervical cancer cases and highlights the need for expansion of cervical cancer screening and prevention throughout the 10 regions of Cameroon. VIA-DC-inadequate rates were also high, especially in older women, and additional screening methods are needed to confirm whether these results are truly negative. In comparison to similar screening programs in sub-Saharan Africa there was low utilization of same day cryotherapy treatment. Further studies are required to characterize possible program specific barriers to treatment, for example cultural demands, health system challenges and cost of procedure. The prevalence of ICC among women who presented for screening was high and requires further investigation.
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Affiliation(s)
- Geneva A. DeGregorio
- Department of Obstetrics and Gynecology, University of Massachusetts Medical School, Worcester, MA, United States of America
| | - Leslie S. Bradford
- Department of Obstetrics and Gynecology, University of Massachusetts Medical School, Worcester, MA, United States of America
| | - Simon Manga
- Cameroon Baptist Convention Health Services, Bamenda, North West Region, Cameroon
| | - Pius M. Tih
- Cameroon Baptist Convention Health Services, Bamenda, North West Region, Cameroon
| | - Richard Wamai
- Department of African American Studies, Northeastern University, Boston, MA, United States of America
| | - Rebecca Ogembo
- Graduate School of Nursing, University of Massachusetts Medical School, Worcester, MA, United States of America
| | - Zacharie Sando
- Yaoundé Gyneco-Obstetrics and Pediatric Hospital, Yaoundé, Centre Region, Cameroon
| | - Yuxin Liu
- Department of Pathology, University of Massachusetts Medical School, Worcester, MA, United States of America
| | - Constance Schwaiger
- School of Nursing, University of Massachusetts Amherst, Amherst, MA, United States of America
| | - Sowmya R. Rao
- Department of Surgery, Boston University School of Medicine, Boston, MA, United States of America
| | - Karen Kalmakis
- School of Nursing, University of Massachusetts Amherst, Amherst, MA, United States of America
| | - Lisa Kennedy Sheldon
- Department of Nursing, University of Massachusetts Boston, Boston, MA, United States of America
| | - Kathleen Nulah
- Cameroon Baptist Convention Health Services, Bamenda, North West Region, Cameroon
| | - Edith Welty
- Cameroon Baptist Convention Health Services, Bamenda, North West Region, Cameroon
| | - Thomas Welty
- Cameroon Baptist Convention Health Services, Bamenda, North West Region, Cameroon
| | - Javier Gordon Ogembo
- Department of Medicine, University of Massachusetts Medical School, Worcester, MA, United States of America
- * E-mail:
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Sando Z, Fokouo JV, Mebada AO, Djomou F, NDjolo A, Oyono JLE. Epidemiological and histopathological patterns of salivary gland tumors in Cameroon. Pan Afr Med J 2016; 23:66. [PMID: 27217890 PMCID: PMC4862794 DOI: 10.11604/pamj.2016.23.66.5105] [Citation(s) in RCA: 16] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/20/2014] [Accepted: 02/13/2015] [Indexed: 11/28/2022] Open
Abstract
INTRODUCTION Tumors of salivary glands are rare. According to Johns and Goldsmith in 1989, their annual incidence is less than 1/100000 without noteworthy geographical gap. But other authors suggest that their distribution may vary according to the race and geographical location. In Cameroon, existing studies give incomplete data. Hence, we underwent this study in order to draw the general profile of salivary gland tumors in Cameroon. METHODS A retrospective study was carried out on the period spanning from January 2000 to December 2010 (11 years). It was done in nine Pathology services of different hospitals in Yaoundé, Douala and Bamenda. We consulted the archive registers of those services, retaining any patient with salivary gland tumor, whatever the histological type or location. Information gathered was the year of diagnosis, the service, the age and sex, the site of the tumor (gland) the histological type and the benign/ malignant character. RESULTS We recruited a total of 275 files. Women were 56% (154/275) and men 44% (121/275) of the sample. Fifty eight tumors were malignant (21.9%) while 217 were benign (78.1%). The overall mean age was 37.44 years, with extremes between 1 and 84 years. Pleomorphic adenoma (60.36%) was the most common benign tumor. Adenoid cystic carcinoma (31%), mucoepidermoid carcinoma (22.4%) and adenocarcinoma (19%) were the most common malignant tumors. Palate (66.7%), cheek (30%) and lips (3.3%) were the sites were the minor salivary glands were mostly involved. CONCLUSION The differences with western world authors suggest a geographical variability of salivary gland tumors.
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Affiliation(s)
- Zacharie Sando
- Faculty of Medicine and Biomedical Sciences (FMBS) of the University of Yaoundé I, Yaoundé, Cameroon; Pathology Service of Gyneco-Obstetric and Pediatric Hospital, Yaoundé, Cameroon
| | - Jean Valentin Fokouo
- Faculty of Medicine and Biomedical Sciences (FMBS) of the University of Yaoundé I, Yaoundé, Cameroon
| | - Arlette Onomo Mebada
- Faculty of Medicine and Biomedical Sciences (FMBS) of the University of Yaoundé I, Yaoundé, Cameroon
| | - François Djomou
- Faculty of Medicine and Biomedical Sciences (FMBS) of the University of Yaoundé I, Yaoundé, Cameroon; Otolaryngology Service of University Hospital Center, Yaoundé, Cameroon
| | - Alexis NDjolo
- Faculty of Medicine and Biomedical Sciences (FMBS) of the University of Yaoundé I, Yaoundé, Cameroon
| | - Jean Louis Essame Oyono
- Faculty of Medicine and Biomedical Sciences (FMBS) of the University of Yaoundé I, Yaoundé, Cameroon; Centre Pasteur du Cameroun, Yaoundé, Cameroon
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Fouelifack FY, Fouedjio JH, Fouogue JT, Sando Z, Fouelifa LD, Mbu RE. Associations of body mass index and gestational weight gain with term pregnancy outcomes in urban Cameroon: a retrospective cohort study in a tertiary hospital. BMC Res Notes 2015; 8:806. [PMID: 26686851 PMCID: PMC4684922 DOI: 10.1186/s13104-015-1765-9] [Citation(s) in RCA: 12] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/24/2015] [Accepted: 11/30/2015] [Indexed: 11/10/2022] Open
Abstract
BACKGROUND Obesity is a rising public health issue worldwide. Guidelines regarding maternal body mass index (BMI) and gestational weight gain (GWG) are missing in Cameroon where maternal mortality rate remains very high. We hypothesized that obesity and inappropriate GWG are associated with poor pregnancy outcomes. We aimed at assessing associations of BMI and GWG with pregnancy outcomes. METHODS This was a retrospective cohort study at the Yaoundé Central Hospital. We included women with term singleton deliveries in the post-partum ward. The World Health Organisation classification of BMI and the United States Institute Of Medicine (IOM) categories of GWG were used to stratify participants. Poor maternal outcome was defined by the occurence of caesarean section, preeclampsia or obstetrical haemorrhage. Poor perinatal outcome was defined by the occurence of perinatal death, admission in intensive care unit, low birth weight, macrosomia or fifth minute Apgar score <7. Multiple logistic regressions were used to calculate unadjusted and adjusted Odds Ratios (uOR, aOR) for poor maternal outcome (PMO) and for poor perinatal outcome (PPO) in each category of BMI and GWG. Adjustment was done for age, scarred uterus, sickle cell disease, malaria, human immunodeficiency virus (HIV) infection, parity and smoking. RESULTS Of the 462 participants, 17 (4 %) were underweight (BMI < 18.5), 228 (49 %) had normal pre-pregnancy BMI, 152 (33 %) were overweight (25 ≤ BMI < 30) and 65 (14 %) were obese (BMI ≥ 30). Following the IOM recommendations, GWG was normal for 186 (40 %) participants, less than recommended for 131 (28 %) and above the recommended norms for 145 (32 %). GWG above the IOM recommendation was significantly associated with PMO (aOR: 1.7, 95 % CI 1.1-2.8). GWG less than the IOM recommended values, overweight and obesity were not significantly associated with poor pregnancy outcomes. CONCLUSION While waiting for local recommendations for GWG, the IOM recommendations can be used for Cameroonian women as far as maternal outcome is concerned. Unlike in studies in different ethnic and racial groups, abnormal BMI was not associated with poor pregnancy outcomes in our cohort of Cameroonian women.
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Affiliation(s)
- Florent Ymele Fouelifack
- Obstetrics and Gynecology Unit of Yaoundé Central Hospital, Department of Obstetrics and Gynecology, Higher Institute of Medical Technology of Nkolondom, Yaoundé, Cameroon. .,Research, Education and Health Development Group "GARES-Falaise" Dschang-Cameroon, P.O. Box: 31186, Yaoundé, Cameroon.
| | - Jeanne Hortence Fouedjio
- Department of Obstetrics and Gynecology of the Faculty of Medicine and Biomedical Sciences of University of Yaoundé 1, Obstetrics and Gynecology Unit of the Yaoundé Central Hospital, Yaoundé, Cameroon.
| | - Jovanny Tsuala Fouogue
- Obstetrics and Gynecology unit of the Douala Gynaeco-Obstetric and Pediatric Hospital, Douala, Cameroon.
| | - Zacharie Sando
- Department of Anatomy and Morphological Sciences of the Faculty of Medicine and Biomedical Sciences of the University of Yaoundé 1, P.O. Box 1364, Yaoundé, Cameroon.
| | - Loic Dongmo Fouelifa
- Faculty of Medicine, School of Armies Health Services of Lomé, University of Lomé, P.O. Box: 14148, Lomé, Togo.
| | - Robinson Enow Mbu
- Department of Obstetrics and Gynecology of the Faculty of Medicine and Biomedical Sciences of University of Yaoundé 1, Obstetrics and Gynecology Unit of the Yaoundé Central Hospital, Yaoundé, Cameroon.
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Bradford L, DeGregorio G, Tih P, Wamai R, Sando Z, Welty E, Welty T, Kennedy-Sheldon L, Ogembo J. Evaluation of WHO-endorsed "see and treat" cervical cancer screening in HIV-positive and HIV-negative women in Cameroon. Gynecol Oncol 2015. [DOI: 10.1016/j.ygyno.2015.01.065] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/26/2022]
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Pirek D, Petignat P, Vassilakos P, Gourmaud J, Pache JC, Rubbia-Brandt L, Sando Z, McKee TA, Ho L. Human papillomavirus genotype distribution among Cameroonian women with invasive cervical cancer: a retrospective study. Sex Transm Infect 2015; 91:440-4. [PMID: 25746041 DOI: 10.1136/sextrans-2014-051642] [Citation(s) in RCA: 12] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/30/2014] [Accepted: 02/14/2015] [Indexed: 01/20/2023] Open
Abstract
OBJECTIVES We determined the human papillomavirus (HPV) types present in invasive cervical cancer (ICC) of women in Cameroon in order to estimate the potential efficacies of HPV prophylactic vaccines. METHODS This is a retrospective study using 181 formalin-fixed paraffin-embedded cervical tissue samples of ICC collected from the Institute of Pathology, Gyneco-Obstetric and Pediatric Hospital, Yaoundé, Cameroon. HPV was detected by PCR using modified GP5+/GP6+ (MGP) primers. Genotyping was performed by reverse-blot hybridisation, which allowed the detection of 9 of the 14 high-risk HPV types. RESULTS Of the 181 samples, 91.7% were squamous cell carcinomas and 6.6% were adenocarcinomas. Counting all the single and multiple infections, the three most common high-risk types in descending order were HPV16 (88%), HPV45 (32%) and HPV18 (14.8%). 54.9% of cases were infected with a single HPV type and 45.1% had two or more HPV infections. CONCLUSIONS The frequencies of HPV16, HPV45 and multiple infections are all higher than previously reported. These observations have significant implications on the consideration of vaccination strategies because each vaccine has different duration and efficacies in cross-protection of different HPV types. The method used proved to be sensitive and cost-efficient for retrospective studies where fresh materials are not available.
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Affiliation(s)
- David Pirek
- Department of Obstetrics and Gynecology, University Hospitals of Geneva, Geneva, Switzerland
| | - Patrick Petignat
- Department of Obstetrics and Gynecology, University Hospitals of Geneva, Geneva, Switzerland
| | - Pierre Vassilakos
- Geneva Foundation for Medical Education and Research, Geneva, Switzerland
| | - Jolanta Gourmaud
- Department of Clinical Pathology, University Hospitals of Geneva, Geneva, Switzerland
| | - Jean-Claude Pache
- Department of Clinical Pathology, University Hospitals of Geneva, Geneva, Switzerland
| | - Laura Rubbia-Brandt
- Department of Clinical Pathology, University Hospitals of Geneva, Geneva, Switzerland
| | - Zacharie Sando
- Department of Clinical Pathology, Gyneco-Obstetric and Pediatric Hospital, Yaoundé, Cameroon
| | | | - Liza Ho
- Department of Clinical Pathology, University Hospitals of Geneva, Geneva, Switzerland
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Ngowa JDK, Kasia JM, Yomi J, Nana AN, Ngassam A, Domkam I, Sando Z, Ndom P. Breast Cancer Survival in Cameroon: Analysis of a Cohort of 404 Patients at the Yaoundé General Hospital. ACTA ACUST UNITED AC 2015. [DOI: 10.4236/abcr.2015.42005] [Citation(s) in RCA: 16] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/20/2022]
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Nkwabong E, Kamgnia Nounemi N, Sando Z, Mbu RE, Mbede J. Risk factors and placental histopathological findings of term born low birth weight neonates. Placenta 2014; 36:138-41. [PMID: 25552188 DOI: 10.1016/j.placenta.2014.12.005] [Citation(s) in RCA: 14] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/23/2014] [Revised: 12/08/2014] [Accepted: 12/11/2014] [Indexed: 10/24/2022]
Abstract
INTRODUCTION Low birth weight (LBW) is associated with increased neonatal morbidity and mortality. Hence, this condition should be well studied. The aims of this study were to identify the risk factors for term born LBW, as well as the placental histopathological lesions observed. METHODS This case control study was carried out in the University Teaching Hospital and the Central Maternity, both of Yaoundé, Cameroon, from November 1st, 2013 to April 30th, 2014. Maternal medical records and placentas of term born (≥37 completed weeks) LBW (<2500 g at birth) or normal weight (3000-3500 g) were compared. The main variables recorded included maternal age and parity, maternal height, complications that occurred during pregnancy, maternal pre-gestational body mass index, the number of antenatal visits, the sex and birth weight of the newborn, the umbilical cord length, the placental weight and placental histology. Data were analyzed using Epi info 3.5.4. Fisher exact test, t-test and logistic regression were used for comparison. P < 0.05 was considered statistically significant. RESULTS and DISCUSSION A total of 30 cases of LBW and the same number of controls were examined. Significant risk factors for LBW were primiparity (aOR 14.0, 95%CI 2.1-92.7), hypertensive diseases of pregnancy (aOR 18.1, 95%CI 1.02-322.5) and <4 antenatal visits (aOR 9.5, 95%CI 1.3-67.5). Significant placental lesions were placental infarction (aOR 19.5, 95%CI 2.9-130.1) and chronic villitis (aOR 35.9, 95%CI 1.2-1034.3). Our study showed that primiparous women, those with pregnancy-induced hypertensive diseases and those with <4 antenatal visits were more at risk for LBW. Significant placental lesions observed among LBW were placental infarcts and chronic villitis. Since LBW has the tendency to recur, and given that some causes such as placental infarcts are preventable, we recommend that a histological examination of the placenta should always be carried out in cases of LBW.
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Affiliation(s)
- E Nkwabong
- Department of Obstetrics & Gynecology, Central Maternity/Faculty of Medicine and Biomedical Sciences, Yaoundé, Cameroon.
| | | | - Z Sando
- Department of Pathology, Faculty of Medicine and Biomedical Sciences, Yaoundé, Cameroon
| | - R E Mbu
- Department of Obstetrics & Gynecology, Central Maternity/Faculty of Medicine and Biomedical Sciences, Yaoundé, Cameroon
| | - J Mbede
- Department of Paediatrics, University Teaching Hospital, Yaoundé, Cameroon
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Sando Z, Fouelifack FY, Fouogue JT, Fouedjio JH, Ndeby YSN, Djomou F, Fewou A, Oyono JLE. [Histopathological study of cervical lymphadenopathy in Yaounde, Cameroon]. Pan Afr Med J 2014; 19:185. [PMID: 25848448 PMCID: PMC4378886 DOI: 10.11604/pamj.2014.19.185.4302] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/04/2014] [Accepted: 09/07/2014] [Indexed: 11/28/2022] Open
Abstract
Introduction Les adénopathies cervicales ont été très peu étudiées au Cameroun. Méthodes Pour améliorer leur connaissance nous avons mené une étude rétrospective et descriptive dans les cinq principaux laboratoires de la capitale du pays en vue d'en déterminer les aspects histopathologiques. Résultats Nous avons colligé 292 cas. L’âge moyen était de 30,95 ±4,11ans et le ratio homme / femme était de 0,96/1. Les principaux diagnostics histologiques étaient les suivants: tuberculose ganglionnaire (39,38%), les lymphadénites (18,49%), les lymphomes malins non hodgkiniens (12,33%), la maladie de Kaposi ganglionnaire (5,82%), les métastases de carcinome (5,82%) et la maladie de Hodgkin (5,14%). Dans 95,65% des cas le diagnostic était posé au-delà du deuxième mois d’évolution des symptômes. Conclusion Nos résultats, quoique préliminaires, sont une contribution à l'amélioration de la stratégie diagnostique et thérapeutique dans nos hôpitaux aux ressources limitées.
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Affiliation(s)
- Zacharie Sando
- Service d'Anatomie Pathologique de l'Hôpital Gynéco-Obstétrique et Pédiatrique de Yaoundé, Cameroun ; Faculté de Médecine et des Sciences Biomédicales de l'Université de Yaoundé 1, Cameroun
| | | | | | - Jeanne Hortence Fouedjio
- Faculté de Médecine et des Sciences Biomédicales de l'Université de Yaoundé 1, Cameroun ; Hôpital Central de Yaoundé, Cameroun
| | | | - Francois Djomou
- Faculté de Médecine et des Sciences Biomédicales de l'Université de Yaoundé 1, Cameroun ; Service d'Oto-Rhino-Laryngologie du Centre Hospitalier et Universitaire de Yaoundé
| | - Amadou Fewou
- Faculté de Médecine et des Sciences Biomédicales de l'Université de Yaoundé 1, Cameroun
| | - Jean-Louis Essame Oyono
- Faculté de Médecine et des Sciences Biomédicales de l'Université de Yaoundé 1, Cameroun ; Service d'Anatomie Pathologique du Centre Hospitalier et Universitaire de Yaoundé, Cameroun
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Abstract
We herein report a case of abdominal pregnancy managed in Yaounde (Cameroon). The 33 year old G5P2022 woman was referred to our setting for management of an abdominal pregnancy of 34 weeks diagnosed during the first routine obstetrical ultrasonography done two days earlier. This ultrasonography revealed a live foetus within intestinal loops with a severe oligoamnios. After two days of lung maturation, laparotomy was carried out and the live male baby weighed 2 600 grammes. The placenta was left on its implantation sites: omentun, uterine fundus and intestinal loops. The mother did well post-operatively and the resorption of the placenta took 11 months. The newborn presented compression deformities and died three days later of respiratory distress. This case illustrates that intra-abdominal fetuses can reach viability. Though rare, abdominal pregnancy remains a threat to mothers. Practitioners should therefore know the traps in its management.
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Affiliation(s)
| | - Jovanny Tsuala Fouogue
- Department of Obstetrics and Gynaecology, Faculty of Medicine and Biomedical Sciences, University of Yaounde 1, Yaoundé, Cameroon
| | - Jeanne Hortence Fouedjio
- Department of Obstetrics and Gynaecology, Yaounde Central Hospital, Yaoundé, Cameroon ; Department of Obstetrics and Gynaecology, Faculty of Medicine and Biomedical Sciences, University of Yaounde 1, Yaoundé, Cameroon
| | - Zacharie Sando
- Head of the Pathology Unit, Yaounde Gynaeco-Obstetric and Pediatric Hospital, Yaoundé, Cameroon
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Fouedjio JH, Fouogue JT, Fouelifack FY, Nangue C, Sando Z, Mbu RE. [Torsion of uterine appendages during pregnancy: report of a case at Yaoundé Central Hospital, Cameroon]. Pan Afr Med J 2014; 17:39. [PMID: 24932350 PMCID: PMC4048683 DOI: 10.11604/pamj.2014.17.39.3006] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/02/2013] [Accepted: 11/09/2013] [Indexed: 11/26/2022] Open
Abstract
Les kystes ovariens sont dans la majorité des cas asymptomatiques et peuvent être de découverte fortuite lors d'une échographie. Ils ne deviennent symptomatiques que lorsque survient une complication. Nous présentons un cas de torsion d'annexe gauche diagnostiqué à 8 semaines et 4 jours de grossesse. Nous avons réalisé une annexectomie Suivie de l'administration de progestérone retard à la dose 500 mg par jour. L'évolution a été marquée par la survenue d'un avortement au cinquième jour post opératoire. L'analyse anatomopathologique de la masse chirurgicale a conclu à une apoplexie ovarienne. L'ablation chirurgicale du corps jaune au premier trimestre de la grossesse pose le problème du maintien de celle - ci et devrait être présente à l'esprit des praticiens avant toute chirurgie pelvienne pendant cette période.
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Affiliation(s)
- Jeanne Hortence Fouedjio
- Unité de Gynécologie-Obstétrique de l'Hôpital Central de Yaoundé, Yaoundé, Cameroun ; Département de Gynécologie-Obstétrique de la Faculté de Médecine et des Sciences Biomédicales de l'Université de Yaoundé 1, Yaoundé, Cameroun
| | - Jovanny Tsuala Fouogue
- Département de Gynécologie-Obstétrique de la Faculté de Médecine et des Sciences Biomédicales de l'Université de Yaoundé 1, Yaoundé, Cameroun
| | | | - Charlette Nangue
- Laboratoire d'Anatomie Pathologique de l'Hôpital Central de Yaoundé, Yaoundé, Cameroun
| | - Zacharie Sando
- Département de Sciences Morphologiques et d'Anatomie Pathologique de la Faculté de Médecine et des Sciences Biomédicales de l'Université de Yaoundé 1, Yaoundé, Cameroun
| | - Robinson Enow Mbu
- Unité de Gynécologie-Obstétrique de l'Hôpital Central de Yaoundé, Yaoundé, Cameroun ; Département de Gynécologie-Obstétrique de la Faculté de Médecine et des Sciences Biomédicales de l'Université de Yaoundé 1, Yaoundé, Cameroun
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Fouelifack FY, Fouogue JT, Messi JO, Kamga DT, Fouedjio JH, Sando Z. Spontaneous second-trimester ruptured pregnancy of rudimentary horn: a case report in Yaounde, Cameroon. Pan Afr Med J 2014; 18:86. [PMID: 25400853 PMCID: PMC4231311 DOI: 10.11604/pamj.2014.18.86.4579] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/14/2014] [Accepted: 05/24/2014] [Indexed: 11/24/2022] Open
Abstract
Rudimentary uterine horn pregnancy is rare and, to our knowledge, has not been previously reported in Cameroon. We herein report the case of a 22 year old second gravida referred for acute abdominal pain at 17 weeks of gestation. Physical examination revealed hemoperitoneum with hypovolemic shock. After resuscitation, an emergency exploratory laparotomy was done and we found hemoperitoneum of 3,500 milliliters, a bicornuate uterus with a ruptured right rudimentary communicating horn containing a non viable foetus. There were no other abnormalities. We performed an excision of the rudimentary horn with ipsilateral salpingectomy. Post-operative course was uneventful and the woman was discharged seven days later. This case emphasizes the importance of good antenatal care to avoid complications.
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Affiliation(s)
| | - Jovanny Tsuala Fouogue
- Department of Obstetrics and Gynecology of the Faculty of Medicine and Biomedical Sciences of the University of Yaounde 1, Yaounde, Cameroon
| | - John Owoudou Messi
- Department of Obstetrics and Gynecology of the Faculty of Medicine and Biomedical Sciences of the University of Yaounde 1, Yaounde, Cameroon
| | - Danielle Tiako Kamga
- Department of Obstetrics and Gynecology of the Faculty of Medicine and Biomedical Sciences of the University of Yaounde 1, Yaounde, Cameroon
| | - Jeanne Hortence Fouedjio
- Obstetrics and Gynecology Unit of the Yaounde Central Hospital, Yaounde, Cameroon ; Department of Obstetrics and Gynecology of the Faculty of Medicine and Biomedical Sciences of the University of Yaounde 1, Yaounde, Cameroon
| | - Zacharie Sando
- Department of Anatomy and Morphological Sciences of Faculty of Medicine and Biomedical Sciences of the University of Yaounde 1, Yaounde, Cameroon
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Sando Z, Fouogue JT, Fouelifack FY, Fouedjio JH, Mboudou ET, Essame JLO. [Profile of breast and gynecological cancers in Yaoundé--Cameroon]. Pan Afr Med J 2014; 17:28. [PMID: 24932339 PMCID: PMC4048679 DOI: 10.11604/pamj.2014.17.28.3447] [Citation(s) in RCA: 22] [Impact Index Per Article: 2.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/06/2013] [Accepted: 11/09/2013] [Indexed: 01/31/2023] Open
Affiliation(s)
- Zacharie Sando
- Département des sciences morphologiques de la Faculté de Médecine et des Sciences Biomédicales de l'Université de Yaoundé 1, Cameroun ; Chef Service de l'unité d'anatomie pathologique de l'Hôpital Gynéco-Obstétrique et Pédiatrique de Yaoundé, Cameroun
| | - Jovanny Tsuala Fouogue
- Département de Gynécologie et obstétriques de la Faculté de Médecine et des Sciences Biomédicales de l'Université de Yaoundé I, Cameroun
| | | | - Jeanne Hortence Fouedjio
- Département de Gynécologie et obstétriques de la Faculté de Médecine et des Sciences Biomédicales de l'Université de Yaoundé I, Cameroun ; Unité de Gynécologie et d'Obstétrique de l'Hôpital Central de Yaoundé, Cameroun
| | - Emile Telesphore Mboudou
- Département de Gynécologie et obstétriques de la Faculté de Médecine et des Sciences Biomédicales de l'Université de Yaoundé I, Cameroun ; Chef de l'Unité de Gynécologie et Obstétriques de l'Hôpital Gynéco-Obstétrique et Pédiatrique de Yaoundé-Cameroun
| | - Jean Louis Oyono Essame
- Chef de département des sciences morphologiques de la Faculté de Médecine et des Sciences Biomédicales de l'Université de Yaoundé 1, Cameroun
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Fouelifack FY, Fouogue JT, Fouedjio JH, Sando Z, Mbu RE. [Massive postpartum vulvar hematoma: about one case at Yaounde Central Hospital (Cameroon)]. Pan Afr Med J 2014; 19:167. [PMID: 25810803 PMCID: PMC4364687 DOI: 10.11604/pamj.2014.19.167.5603] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/13/2014] [Accepted: 10/13/2014] [Indexed: 11/11/2022] Open
Affiliation(s)
| | - Jovanny Tsuala Fouogue
- Département de Gynécologie et Obstétriques de la Faculté de Médecine et des Sciences Biomédicales de l'Université de Yaoundé 1, Cameroun
| | - Jeanne Hortence Fouedjio
- Service de Gynécologie et Obstétriques de l'Hôpital Central de Yaoundé, Cameroun ; Département de Gynécologie et Obstétriques de la Faculté de Médecine et des Sciences Biomédicales de l'Université de Yaoundé 1, Cameroun
| | - Zacharie Sando
- Départerment des Sciences Morphologiques de la Faculté de Médecine et des Sciences biomédicales de l'Université de Yaoundé 1, Cameroun
| | - Robinson Enow Mbu
- Service de Gynécologie et Obstétriques de l'Hôpital Central de Yaoundé, Cameroun ; Département de Gynécologie et Obstétriques de la Faculté de Médecine et des Sciences Biomédicales de l'Université de Yaoundé 1, Cameroun
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Moifo B, Mouafo Tambo F, Nguefack S, Sando Z, Abogo S, Gonsu Fostin J. [Sacrococcygeal teratoma of delayed diagnosis: clinical and radiological features of two cases and therapeutic considerations]. Mali Med 2014; 29:61-65. [PMID: 30049144] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Subscribe] [Scholar Register] [Indexed: 06/08/2023]
Abstract
The sacrococcygeal teratoma is a rare congenital embryonal tumor with high potential for malignant transformation and therefore considered as a neonate surgical emergency. The authors report two cases of sacrococcygeal teratomas with late diagnosis and treatment. The first case was a degenerated sacrococcygeal teratoma revealed by paraplegia in a 17-month-old infant with multiple metastasis and fatal outcome. The second case was a 14-month-old infant with a benign infected form of sacrococcygeal teratoma, successfully treated surgically. The authors highlight the diagnostic difficulties still existing in the tropical environment, and recall the need for a prenatal diagnosis and early treatment.
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Affiliation(s)
- B Moifo
- Service de Radiologie et Imagerie Médicale
| | | | - S Nguefack
- Service de Pédiatrie et spécialités pédiatriques
| | - Z Sando
- Service d'Anatomie Pathologique; Hôpital Gynéco Obstétrique et Pédiatrique de Yaoundé - Cameroun
| | - S Abogo
- Service de Radiologie et Imagerie Médicale
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Fouelifack FY, Fouogue JT, Fouedjio JH, Sando Z. A case of abdominal textiloma following gynecologic surgery at the Yaounde Central Hospital, Cameroon. Pan Afr Med J 2013; 16:147. [PMID: 24876905 PMCID: PMC4031094 DOI: 10.11604/pamj.2013.16.147.3201] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/09/2013] [Accepted: 11/09/2013] [Indexed: 11/13/2022] Open
Abstract
Textiloma is the inadvertent retention of a textile foreign body on the surgical site. It is a rare complication of surgery but which carries severe consequences for both patients and surgeons in terms of morbi-mortality and medico-legal procedures respectively. We herein report the case of an abdominal textiloma in a 42 year old woman who underwent a total abdominal hysterectomy for symptomatic leiomyomas. We also depict the errors that led to this mishap in a tertiary hospital in Yaounde (Cameroon). The textiloma was recognized six weeks after the causative surgery and removed by laparotomy without further complications.
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Affiliation(s)
- Florent Ymele Fouelifack
- Department of Obstetrics and Gynecology of the Yaoundé Central Hospital - Cameroon ; Research, Education and Health Development Associate's Group (REHDAG), Dschang, Cameroon
| | | | - Jeanne Hortence Fouedjio
- Department of Obstetrics and Gynecology of the Yaoundé Central Hospital - Cameroon ; Faculty of Medicine and biomedical Sciences of the University of Yaoundé I - Cameroon
| | - Zacharie Sando
- Faculty of Medicine and biomedical Sciences of the University of Yaoundé I - Cameroon ; Head of the Unit of the Yaoundé Gyneco-obstetrics and Pediatric Hospital, Cameroon
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Abstract
Ovarian pregnancy is very rare and to our knowledge, no case has been reported in Cameroon. We herein report a case at the Yaounde Central Hospital. It is the case of a 29 years old woman who consulted in emergency for left pelvic pain at 9 weeks of pregnancy. The level of beta human chorionic gonadotropin was 96702 milli-international Units/ milliliter and ultrasound revealed an intra-ovarian gestational sac, an empty uterus and no peritoneal effusion. In the absence of facilities for laparoscopy, an emergency laparotomy was done. We found the non ruptured mass inside the left ovary. The left fallopian tube, the uterus and the right adnexae were normal. We did a successful ovarian dissection and resection of gestational sac. Trophoblastic tissue was found at pathology. Similar symptoms should draw attention of practitioners on the plausibility of ovarian pregnancy.
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Affiliation(s)
| | | | | | - Zacharie Sando
- Faculty of Medicine and Biomedical Sciences of the University of Yaounde 1, Cameroon ; Pathology Unit of the Yaounde Gyneco-Obstetric and Pediatric Hospital, Cameroon
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Foumane P, Sando Z, Dohbit JS, Bilo'o LL, Mboudou ET, Oyono JLE. The diagnosis of uterine cervical polyps in a low resource setting: the positive predictive value of clinical judgment--a series of 192 cases at the Yaounde Gynaeco-Obstetric and Paediatric Hospital, Cameroon. Trop Doct 2013; 43:54-6. [PMID: 23796672 DOI: 10.1177/0049475513486783] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
Abstract
As far as we know, the accuracy of clinical judgment in diagnosing uterine cervical polyps has not been assessed in sub-Saharan Africa. Our objective was to discover the positive predictive value (PPV) of clinical judgment in the diagnosis of cervical polyps. This is a retrospective descriptive study of 192 patients, carried out by the Departments of Pathology and Gynaecology of the Yaoundé Gynaeco-Obstetric and Paediatric Hospital, Cameroon. The diagnosis of cervical polyp was confirmed by histopathology examination in 169 patients, giving a PPV rate of 88.0%. The PPV of clinical judgment in the diagnosis of cervical polyps is acceptable in our setting but the frequency of premalignant and malignant lesions encountered is too high (10.4%), even in the presence of a confirmed cervical polyp (8.9%). Even in areas where there are limited resources, we recommend a systematic histopathology examination of any clinically suspected cervical polyp.
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Affiliation(s)
- Pascal Foumane
- Faculty of Medicine and Biomedical Sciences (FMBS), University of Yaoundé 1, PO Box 4362, Yaoundé, Cameroon.
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Sando Z, Fouelifack FY, Fouogue JT, Fouedjio JH, Anoudem CE, Nangue C. Carcinosarcoma of the corpus uteri (Malignant Müllerian Mixed Tumor): a case report in Yaoundé (Cameroon). Pan Afr Med J 2013; 16:145. [PMID: 24876903 PMCID: PMC4031095 DOI: 10.11604/pamj.2013.16.145.3497] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/18/2013] [Accepted: 11/29/2013] [Indexed: 11/11/2022] Open
Abstract
Carcinosarcoma of the uterus is a rare tumor representing 2-4% of uterine malignancies. Its prognosis is poor with a 5 years survival rate of 10-30%. We report a first documented case of carcinosarcoma occurring in a 62 years old woman who presented with postmenopausal vaginal bleeding for one year. The preoperative biopsy of endometrium revealed a leiomyosarcoma. Total body Computerized Tomography (CT) Scan revealed a mass limited to the uterus without other abnormalities. We carried out a total abdominal hysterectomy with bilateral salpingo-oophorectomy. Post operative histology of the specimen found a carcinosarcoma. The patient underwent a course of radiotherapy and a total body CT Scan done eight months later revealed no signs of recurrence or metastasis. Clinicopathological aspects, treatment options and prognosis of this aggressive neoplasm are reviewed. We recommend practitioners to be aware of this lesion for an early diagnosis and appropriate treatment.
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Affiliation(s)
- Zacharie Sando
- Yaounde Gyneco-Obstetric and Pediatric Hospital, Cameroon ; Faculty of Medicine and Biomedical Sciences of the University of Yaounde 1, Cameroon
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Fouedjio JH, Fouelifack FY, Fouogue JT, Sando Z. Ruptured heterotopic pregnancy in a natural conception cycle: a case report at the Yaounde central Hospital (Cameroon). Pan Afr Med J 2013; 16:106. [PMID: 24876895 PMCID: PMC4033585 DOI: 10.11604/pamj.2013.16.106.3506] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/22/2013] [Accepted: 11/09/2013] [Indexed: 11/11/2022] Open
Abstract
Heterotopic pregnancy is very rare under natural circumstances. We report the case of a 28 year old Gravida2 Para1001 woman at 9 weeks of pregnancy who consulted in emergency for acute pelvic pain following metrorrhagia. Physical exam revealed hemoperitoneum without shock. An emergency ultrasonography revealed two gestational sacs, one intra-uterine and the other extra-uterine. Laparotomy was done and the findings were: a ruptured right tubal pregnancy with 1,300 milliliters of hemoperitoneum, type B left utero-adnexal adhesions and an increased uterus consistent with a 9 weeks pregnancy. Right total salpingectomy was done and the patient did well postoperatively. That intrauterine pregnancy evolved normally under progesterone supply and the woman delivered a termed live female baby weighing 3.1 kilogrammes. In our context where ultrasound is not always available, practitioners carrying out salpingectomy for ruptured ectopic pregnancies should bear in mind the plausibleness of heterotopic pregnancy in order to properly handle the uterus.
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Affiliation(s)
- Jeanne Hortence Fouedjio
- Obstetrics and Gynecology Unit of the Yaounde Central Hospital-Cameroon ; Faculty of Medicine and Biomedical Sciences of the University of Yaounde 1- Cameroon
| | | | | | - Zacharie Sando
- Faculty of Medicine and Biomedical Sciences of the University of Yaounde 1- Cameroon ; Head of the pathology unit of the Yaounde Gyneco-Obstetric and pediatric hospital - Cameroon
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Noubom M, Kenfack B, Donfack JH, Nembot FD, Sando Z. Clinical case of Botryomycome fulminant at the Center of Diagnostic and Treatment of Tuberculosis of Baleng (West - Cameroon). Pan Afr Med J 2013; 14:131. [PMID: 23734276 PMCID: PMC3670179 DOI: 10.11604/pamj.2013.14.131.2387] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/17/2013] [Accepted: 01/29/2013] [Indexed: 11/30/2022] Open
Abstract
Botryomycome also called pyogenic granuloma, is an inflammatory tumor of the skin and mucous membranes often caused by superinfection of minor traumatism. Its uniqueness lies in its granulomatous organization in which each granulation contains bacteria and the predominance of many newly formed blood vessels, with the lights on variables ratings and a turgid endothelium responsible for the ulcero-hemorragic appearance. This delicate condition poses a real problem of treatment which included: an appropriate antibiotherapy, surgical removal or electrocoagulation which, until today is more difficult in countries with limited income. An octagenarian came to our hospital with a large mass on the left foot. This mass had the appearance of a malignant tumor. However, the anatomopathologic diagnosis showed that it was a pyogenic granuloma. The importance of the mass, its location on the sole of the foot, imposed the functional impairment of this member. Electrocoagulation is not available in our hospital and the surgical excision proposed was refused by the patient. The patient was treated with the antibiotics Ceftriaxone and Gentalline at indicated doses for 15 days. After the failure of that antibiotherapy treatment, as a last resort, the patient was treated for a month with another combination of antibiotics (free of cost) made of dapsone and rifampicin. This new combination gave very good results. This example shows dapsone and rifampicin can be use as a new weapon for the management of pyogenic granuloma in countries with limited incomes.
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Affiliation(s)
- Michel Noubom
- Department of Biomedical Sciences, University of Dschang, Cameroon
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Mouafo Tambo FFL, Birraux J, Wonkam A, Sando Z, Joko YW, Mure PY, Coultre CL, Andze GO, Sosso MAL. Urethral duplication in a 12-year-old child. Afr J Paediatr Surg 2011; 8:313-6. [PMID: 22248898 DOI: 10.4103/0189-6725.91667] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/04/2022] Open
Abstract
Urethral duplication is a rare congenital malformation affecting mainly boys. The authors report a case in a Cameroonian child who was diagnosed and managed at the Gynaeco-Obstetric and Paediatric Hospital, Yaounde. The malformation was characterized by the presence of an incontinent epispadic urethra and a normal apical urethra. We describe the difficulties faced in the management of this disorder in a developing country.
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Affiliation(s)
- Faustin F Licien Mouafo Tambo
- Department of Surgery and Subspecialties, Paediatrics Surgical Unit, Yaounde Gynaeco-Obstetric and Paediatrics Hospital, Yaounde, Cameroon.
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Tebeu PM, Major AL, Rapiti E, Petignat P, Bouchardy C, Sando Z, de Bernis L, Ali L, Mhawech-Fauceglia P. The attitude and knowledge of cervical cancer by Cameroonian women; a clinical survey conducted in Maroua, the capital of Far North Province of Cameroon. Int J Gynecol Cancer 2008; 18:761-5. [PMID: 17868337 DOI: 10.1111/j.1525-1438.2007.01066.x] [Citation(s) in RCA: 50] [Impact Index Per Article: 3.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/30/2022] Open
Abstract
This study was conducted to assess the knowledge, attitudes, and assumption of cervical cancer by women living in Maroua, the capital of the Far North Province of Cameroon. In a 1-month period, 171 women were surveyed as to their socioeconomic status, sexual habits, prior knowledge of cervical cancer, its prevention, and their attitudes toward cervical cancer. Of 171 women, 48 (28%) had prior knowledge of cervical cancer; they were classified as the "aware group" compared with 123 of 171 (72%) women who were uninformed about cervical cancer and they were classified as the "unaware group" (UG). The UG of women tended to be single mothers, illiterate, housewives, and had their first child before the age of 20 (P < 0.005). Despite the awareness of cervical cancer by 28% of women, only a minority of them, 4 of 48 (8.3%), underwent a preventative screening test. Only 71 of 171 (41.5%) women stated that they would be having a screening test in the future. The awareness of cervical cancer by women in Cameroon is still inadequate. Thus, to avoid deaths from cervical cancer, a curable and preventable disease, the need of an aggressive campaign to make Cameroonian women aware of cervical cancer and its prevention is needed.
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Affiliation(s)
- P-M Tebeu
- Department of Obstetrics and Gynecology, Provincial Hospital of Maroua-Cameroon, Maroua, Cameroon.
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Bahebeck J, Atangana R, Eyenga V, Pisoh A, Sando Z, Hoffmeyer P. Bone tumours in Cameroon: incidence, demography and histopathology. Int Orthop 2003; 27:315-7. [PMID: 12942193 PMCID: PMC3461868 DOI: 10.1007/s00264-003-0480-7] [Citation(s) in RCA: 20] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Accepted: 04/30/2003] [Indexed: 11/26/2022]
Abstract
A multicentre analysis was carried out on bone tumours in Cameroon during a 10-year period. Registers and patient records of five pathology laboratories were consulted, and all patients with a histological report of a bone tumour were included in the study. A total of 268 bone tumours were studied and the average incidence was 27 tumours a year, or two per one million inhabitants. Of these tumours 48% were benign, 45% were primary bone cancers and only 6% were metastatic disease. Among the primary malignant bone tumours, osteosarcoma was the most frequent (39%), followed by non-Hodgkin's primary bone lymphoma, fibrosarcoma, chondrosarcoma, and Ewing's sarcoma. Primary site of the metastatic bone tumours was prostatic adenocarcinoma, breast cancer, hepatocarcinoma and thyroid cancer. In Cameroon many bone tumours are not diagnosed due to lack of medical facilities and little awareness among our medical staff. It is likely that the real incidence is at least ten times higher than that shown in our report.
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Affiliation(s)
- J Bahebeck
- Service d'Orthopédie et de Traumatologie, Hôpitaux Universitaires de Yaoundé, Yaounde, Camaroon.
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Robyr R, Nazeer S, Vassilakos P, Matute JC, Sando Z, Halle G, Mbakop A, Campana A. Feasibility of cytology-based cervical cancer screening in rural Cameroon. Acta Cytol 2002; 46:1110-6. [PMID: 12462091 DOI: 10.1159/000327116] [Citation(s) in RCA: 18] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/19/2022]
Abstract
OBJECTIVE To determine the prevalence of cervical cancer and its precursors in a rural population in Cameroon and to evaluate the feasibility of a cytology-based screening program in such areas. STUDY DESIGN A prospective study was conducted in the rural town of Bafang. Following an advocacy campaign, 750 women were recruited. After a clinical examination, all women had a Pap smear with the Cervex Brush. Each sample had two preparations, conventional and liquid based. The conventional smears were interpreted in Bafang. Cytologically abnormal cases, those with clinical inflammation and/or macroscopic cervical lesions, had a colposcopic examination and directed biopsy. HSIL and colposcopically abnormal cases were treated with large loop excision of the transformation zone (LLETZ). The liquid-based preparations and histopathology were performed in Geneva and the results sent to Cameroon for patient follow-up. RESULTS Mean age and parity of the women screened were 43.7 years and 7.8, respectively. The conventional smears showed 3.6% cervical abnormalities: 2% (15/740) ASCUS/LSIL and 1.6% (12/740) HSIL. The liquid-based preparations showed 12.6% (91/722) cervical abnormalities: 10.1% (73/722) ASCUS/LSIL and 2.5% (18/722) HSIL. Fifty percent of samples in both preparations showed evidence of inflammation. Histology was performed on 64 colposcopically directed punch biopsies and LLETZ specimens. The histologic diagnoses agreed with the cytologic findings in 60% (14/23) of conventional smears and 85% (12/14) of liquid-based preparations. CONCLUSION There is a high rate of cervical intraepithelial neoplasia in the unscreened rural population of Cameroon. The situation is complicated by a high rate of cervical infection. A population-based cytologic screening program for cervical cancer would not be feasible in rural Cameroon because of high cost, low quality and limited technical facilities. Rural Africa requires an algorithm using a simple, low-cost technique of mass screening and an improved cytology service only to triage selected patients.
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Affiliation(s)
- Romaine Robyr
- Department of Obstetrics and Gynecology, Geneva University Hospital, Geneva, Switzerland
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Sando Z, Borisch B, Bosman F. [Autopsies: from the past to the future]. Rev Med Suisse Romande 1999; 119:763-7. [PMID: 10582486] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 02/14/2023]
MESH Headings
- Autopsy/history
- Education, Medical/history
- History, 15th Century
- History, 16th Century
- History, 17th Century
- History, 18th Century
- History, 19th Century
- History, 20th Century
- History, Ancient
- History, Medieval
- Humans
- Pathology, Clinical/education
- Pathology, Clinical/history
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Affiliation(s)
- Z Sando
- Institut universitaire de pathologie, Lausanne
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Sando Z, Taban F, Mathez-Loic F, Anagnostopoulou ID, Remadi S. [Risks of diagnostic errors in pathology research of post-abortion herpetic endometritis: limitations of immunohistochemistry in situ hybridization]. Ann Pathol 1996; 16:279-81. [PMID: 9172618] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/04/2023]
Abstract
Endometrial Herpes-simplex infection is rare. Less than 10 cases have been reported. The impact of herpetic endometritis and abortion is not known, because of the scarcity of clinical and histological data. We present and discuss two cases of abortion with microscopic intranuclear inclusion of biotin, suggestive of herpetic endometritis. These inclusions were positively marked on immunohistochemistry, using anti-herpes antibodies. Similar results were obtained with in situ hybridization using biotin labeled probes (commonly used in some laboratories). But the normal accumulation of biotin in the endometrial cells of pregnant women diminishes the value of such results in gestational material. In fact the interaction between intranuclear endogenous biotin and the avidin-biotin-peroxidase complex may explain the positive controls, performed without anti-herpes antibodies. The biotin labeled probes may also explain the positive results of in situ hybridization. We strongly support the opinion that in pregnant women, the diagnosis of herpetic endometritis needs methodological precautions to avoid pitfall caused by endogenous biotin.
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Affiliation(s)
- Z Sando
- Institut de Pathologie Clinique, Centre Médical Universitaire, Genève, Suisse
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Abstract
Epidermoid cysts of the liver are extremely rare and have been described in both children and adults. Their etiology remains an enigma, and several theories have been suggested as to their origin. Due to their possible malignant potential, early detection and resection are mandatory whether the cysts are unilocular or multilocular.
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Affiliation(s)
- Z Sando
- Department of Pathology, Hôpital Cantonal Universitaire University of Geneva, Geneva, Switzerland
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Abstract
Mandibular osteosarcoma is a rare neoplasm, appearing in young adults as a mass often accompanied by pain, occasionally with paraesthesias, gingival haemorrhages and mobility of teeth, and rarely with ulceration of the skin or mucosa. Roentgenological lytic and/or sclerotic findings are non-specific. Some patients have a previous history of Paget's disease, antecedent radiation treatment, or fibrous dysplasia. Malignant osteoid production can be minimal, resulting in diagnostic difficulties. We report a case of a 33 year-old woman, who, in the absence of a clinical soil associated with the condition, was presented with advanced disease. Immunohistochemical study using alpha-actin smooth muscle antibody disclosed bizarre tumor cells with "dendritic" appearance, to our knowledge, never described thus far. This report draws attention to this uncommon neoplasm and reviews the pertinent literature related to this entity.
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Affiliation(s)
- S Remadi
- Institut de Pathologie Clinique, Hôpital Cantonal Universitaire de Genève, Switzerland
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