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Few data on neuropsychiatric disorders in systemic lupus erythematosus (NPSLE) are available in sub-Saharan Africa. The purpose of this study was to determine their frequency and describe their features in Cameroon. We conducted a retrospective study collecting all the medical records of patients with systemic lupus erythematosus (SLE) hospitalized in the department of rheumatology of 3 hospitals in Cameroon from 2009 to 2019. Lupus activity was assessed using the SLE activity index (SLEDAI). A total of 108 records of patients with a mean age of 40.2 ± 13.7 years were included in the study. The frequency of NPSLE was 55.5% (n=60). Neuropsychiatric disorders were diagnosed concomitantly with SLE (37.0%; n = 40) while in 20 patients with SLE (18.5%) they occurred during the first year. When NPSLE were inaugural, central nervous system involvement was dominant, with demyelinating syndrome 27.8% (n=30) and headaches 21.3% (n=23). Mononeuropathy was the most frequent peripheral nervous system involvement (15.7%; n=17). Factors associated with NPSLE occurrence were malar rash (p=0.024), alopecia (p=0.024), very high lupus activity (p=0.011), arthralgia (p<0.001), anti-nuclear factor (p=0.002). NPSLE did not appear to influence either lupus activity (log rank p=0.227) or the probability of new onset lupus (log rank p=0.233). More than half of patients had NPSLE during the first year. The presence of cutaneous and articular signs, high lupus activity, and anti-nuclear factor were associated with the occurrence of NPSLE. [ABSTRACT FROM AUTHOR]

A retrospective study was carried out at Douala General Hospital, Cameroon, between July 2007 and July 2011, to determine the prevalence of HIV infection among the pulmonary tuberculosis (pTB) patients and to compare epidemiological profiles with respect to TB/HIV co-infection. The cases of all patients aged 15 years and above and diagnosed with pTB during the study period were reviewed. Sociodemographic data, sputum examination for acid-fast bacilli, previous TB-treatment status, and HIV status were recorded. The chi-square or Fisher's exact tests were used to compare the proportions. The independent sample t-test was used to compare means for the quantitative data. Of the 383 pTB patients included, 56.1% were males. The mean age was 38.9 ± 13.9 years (range 15–95). The age group 25–44 years was most represented, with 55.6% of the patients, while the least represented age group was that of patients over 65 years. The mean age of the females (36.2 ± 13.6 years) was statistically lower than that of the males (41.1 ± 13.8 years). Smear-positive pTB was diagnosed in 208 cases (54.6%). All the patients were tested for HIV infection. The overall prevalence of HIV among the pTB patients was 50.4%. There were no significant differences between the HIV-positive and HIV-negative groups with respect to age, sex, sputum examination for acid-fast bacilli, and previous TB-treatment status. The results suggest that the TB/HIV co-infection rate in Cameroon is high. Intensification of the screening of HIV infection in the general population and early management of HIV disease, especially in young women, could reduce the incidence of TB. [ABSTRACT FROM PUBLISHER]

Rituximab (RTX), a chimeric monoclonal anti-CD20 antibody has become part of the standard therapy for patients with CD20-expressing B-cell lymphoma and rheumatoid arthritis. After encouraging results with open studies in systemic lupus erythematosus (SLE), RTX has not shown its effectiveness in randomized controlled trials. However, its efficacy has been validated in renal, hematological, and neuropsychiatric disorders. Understanding the history of RTX in SLE would be instructive in the hydroxychloroquine (HCQ) saga in COVID-19. Three steps would be necessary and sufficient before definitively closing the debate: 1) determine the effective and safe dose of HCQ, as well as the minimum duration of treatment in COVID-19; 2) define the profile of patients in whom HCQ would be more likely to be effective (especially in asymptomatic patients and/or at the onset of the first signs of the disease) and 3) conduct one or more multicentre RCT to evaluate the efficacy and safety of HCQ in COVID-19 in SSA. [ABSTRACT FROM AUTHOR]

Atrial fibrillation is associated with increased risk of morbidity and mortality. There's limited data on the outcomes of atrial fibrillation patients in Africa. We aimed at evaluating the clinical outcomes and their associated factors in patients with atrial fibrillation on antithrombotic therapy in Douala. The Douala atrial fibrillation registry is a prospective, observational cohort study of patients with atrial fibrillation followed by cardiovascular specialists in 3 specialized care centres. From January to April 2018, all patients with electrocardiographic diagnosis of atrial fibrillation, aged 21 years or older, were included in the registry provided their consent. The composite endpoint of heart failure, stroke, major bleeding, hospitalisation and mortality as well as their individual occurrence were assessed at 12 months. Of 113 participants that were included, 6(5.3%) were lost to follow-up. The mean age was 70 ± 12 years, with a female predominance (68%). After a mean follow-up time of 12.2 ± 0.7 months, 51 patients (47.7%) had at least one outcome. Hospitalisation, all-cause mortality, heart failure, stroke and major bleeding rates were 33.3%, 16.8%, 15.2%, 4.8% and 2.9% respectively. There was no significant difference in the composite outcome and mortality according to the antithrombotic treatment. Previous heart failure [aHR = 3.07, 95% CI (1.48–6.36) p = 0.003], new onset atrial fibrillation [aHR= 4.00, 95% CI (0.96–8.19) p < 0.001] and paroxystic atrial fibrillation [aHR= 3.74, 95% CI (1.33–10.53) p = 0.013] were significant predictors of outcome. Half of patients with atrial fibrillation in this registry developed an outcome after one year of follow-up, with heart failure, new onset and paroxystic atrial fibrillation being the main predicting factors. Diagnosing and managing atrial fibrillation in patients with heart disease should therefore be considered as a key priority. [ABSTRACT FROM AUTHOR]

Introduction. Chronic kidney disease (CKD) is frequent amongst human immunodeficiency virus (HIV)-positive patients, and screening is not routinely performed in Sub-Saharan Africa due to resource constraints. We aimed to determine the prevalence of CKD and associated factors in HIV-infected patients in Cameroon. Materials and Methods. A cross-sectional study in Northern Cameroon included HIV-positive patients who attended the HIV clinic. Patients with an estimated glomerular filtration rate less than 60 mL/min/1.73 m² or urinary abnormalities underwent a second measurement 3 months later. Glomerular filtration rate was estimated using the 4-variable Modification of Diet in Renal Disease (MDRD) and the Chronic Kidney Disease Epidemiology Collaboration (CKD-EPI) equations. Logistic regression was used to identify factors associated with CKD. Results. We included 709 participants. The median CD4 count was 219 cells/mL. Proteinuria accounted for 34.4%; leukocyturia, 6.9%; and hematuria, 6.1%. Prevalence of CKD was 44.4% (CKD-EPI) and 47.2% (MDRD). Stages 3 to 5 of CKD were documented in 11.6% using the CKD-EPI and 7.5% using the MDRD. Factors associated with CKD were an age greater than 35 years (odds ratio [OR], 104; 95% confidence interval [CI], 1.02 to 1.06), longer duration of HIV (OR, 2.60; 95% CI, 1.53 to 3.95), history of hepatitis B (OR, 3.04; 95% CI, 1.08 to 8.54), and CD4 cells less than 200 cells/mL (OR, 3.64; 95% CI, 2.55 to 5.21). Conclusions. The prevalence of CKD is high among HIV patients in Cameroon. There is a need of implementing measures to encourage early detection of kidney disease in these patients. [ABSTRACT FROM AUTHOR]

Background: Sensitization to aeroallergens increases the risk of developing asthma or allergic rhinitis. Data on sensitization to airborne allergens in the general population in sub-Saharan Africa are lacking. The aim of this study was to determine the prevalence and determinants of sensitization to common aeroallergens in a population of young adults. Methods: A cross-sectional study was conducted among students of the Faculty of Medicine and Pharmaceutical Sciences of the University of Douala between 1st February and 30th April 2014. We consecutively recruited all the students present in class or in hospital during our visit. They filled an anonymous questionnaire and underwent skin prick tests with common aeroallergens. A logistic regression model of the SPSS.20 software was used to investigate factors associated with sensitization to common aeroallergens. Results: Of the 600 students included in the study, 305 (50.8%) were female. The mean age of participants was 22.6 ± 2.7 years. The prevalence of sensitization to aeroallergens was 42.8% (95% CI 38.8-46.8). Dermatophagoides pteronyssimus (24.2%), Dermatophagoides farinae (22.8%), Blomia tropicalis (23.3%) and Blatella germanica (15.2%) were the most common allergens found. Allergic rhinitis, asthma symptoms and family atopy were independently associated to sensitization to common aeroallergens. Conclusion: A significant proportion of young adults are sensitized to common aeroallergens. Dust mites and cockroach should be included in the panel of aeroallergens in Cameroon. [ABSTRACT FROM AUTHOR]

Introduction: La prévalence du tabagisme parmi le personnel de santé hospitalier au Cameroun n'est pas connue alors que le tabagisme est en expansion dans ce pays avec 13,2% de fumeurs selon l'OMS. Pour combler ce manque une enquête sur les consommations, les connaissances, opinions et attitudes vis-à-vis des fumeurs a été conduite à l'Hôpital Général de Douala, l'un des hôpitaux de référence du Cameroun. Méthodes: Du 1er au 30 Avril 2010, des questionnaires anonymes ont été distribués par des enquêteurs dans les services ou via les surveillants et recueillis et analysés de façon anonyme. Résultats: Sur 402 questionnaires distribués 277 ont été récupérés. La prévalence de fumeurs est de 3,6% parmi les soignants et de 9,4% parmi les autres personnels soit en moyenne sur l'ensemble de l'hôpital 5,4%. Les produits fumés étaient toujours des cigarettes. L'initiation du tabagisme à souvent été tardive (21,5 ans) et la dépendance est absente ou faible chez 33% des fumeurs. Les personnes pensent que c'est leur devoir de questionner sur le tabac et de prendre en charge les fumeurs, mais ils sont presque un sur deux à ignorer la loi Camerounaise. Conclusion: Le tabagisme chez le personnel hospitalier est une réalité au Cameroun ; le personnel soignant et les pouvoirs publics devraient s'impliquer davantage dans la lutte contre ce fléau qui est en expansion dans les pays du sud. [ABSTRACT FROM AUTHOR]