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Aim: Cancer is a real public health problem in the world, especially the so-called gastrointestinal cancers (GIC). In Cameroon, epidemiological data on these types of cancers are still poorly known. The present study aimed at determining epidemiological profile GIC in the town of Douala, Cameroon. Methodology: This was a retrospective study conducted at oncology and gastroenterology departments of two reference hospitals. Sociodemographic, clinical and toxicological information of the patients was recorded and analysed using SPSS version 26.0. The significance level was set at p-value < 0.05 for statistical tests. Results: During the study period, 479 cases of GIC cases were registered with male-to-female ratio of 1.20. The frequency of GIC cases gradually increased over study period (2016 – 2020). GIC cases were mostly found in patients aged 50-60 years (27.8%) and 60-70 years (27.3%). The main GIC types included colorectal (36.54%), liver (25.26%), stomach (15.24%) and pancreas (12.53%). A gender-specific distribution of all GIC types were found (p = 0.0016). Among men, the distribution of GIC varied with age; the majority of male patients with stomach cancer (54.3%) were aged 50 – 60 years while those diagnosed with colon cancer were mostly aged 50 – 60 years (35.4%) and 60 – 70 years (31.3%) (p = 0.0004). Finally, a statically significant association was found between GIC distribution and alcohol/tobacco consumption. Conclusion: GIC are realities in Cameroon and mainly affect the population over 30 years old. The knowledge of risk factors in the population would be useful for controlling their evolution in the country.

In this work, a method to reduce increase in optical density (OD) caused by multiple scanning in radiochromic film dosimetry in combination with a flatbed scanner is presented. Gafchromic EBT3 films are scanned with Epson Pro 1680 Expression scanner and time intervals of 15 minutes and 30 minutes are observed between consecutive scans to reduce the increase in temperature of the scanner. The maximum variations in OD after consecutive scans are calculated and compared to the values obtained for scans without interruption. For film irradiated to 3 Gy, a time interval of 15 minutes between two successive scans leads to a reduction of the OD increase of 56.2% compared to when films are scanned without interruption. Reductions of OD increase of 86.72% and 78.72% respectively for film irradiated to 1 Gy and 2 Gy are obtained when a time interval of 30 minutes is left between two successive scans. These results show that when time intervals are observed between consecutive scans, the increase in OD has significantly reduced. However, the method has the drawback of increasing the time needed to perform radiochromic film dosimetry.

PURPOSE Cervical cancer constitutes a public health problem in Cameroon where it represents 13.8% of cancers in women. We wanted to evaluate compliance with cervical cancer care with a focus on patients who are lost to follow-up from the time that symptoms suggestive of cervical cancer are clinically recognized to treatment. PATIENTS AND METHODS Sociodemographic data, attitude toward diagnosis and treatment, and reason for discontinuing care were recorded and analyzed for a period of 5 years from January 2010 to December 2015. RESULTS One hundred twenty-six patients had symptoms suggestive of cervical cancer, but only 110 (87.30%) could pay for biopsy, 29 (26.36%) of those did not collect their results, 17 (18.7%) denied their results, and 20 (19%) did not benefit from treatment. Only 44 of 110 patients were able to finish their cancer care treatment program. Reasons for discontinuing the cancer care included lack of financial means to pay for it, distance from the care center, and belief in alternative treatments. CONCLUSION This study highlights the magnitude of the difficulties of accessing and receiving cancer care in semiurban areas in Cameroon. Poverty, belief in alternative treatment options, and unequal distribution of care services determined which patients would be lost to follow-up. Redistribution of resources and cancer care providers is mandatory to improve this situation.

The diagnosis and management of cerebral gliomas are challenging. The goal of this study was to evaluate the pattern of cerebral gliomas at the General Hospital Douala, Cameroon. A retrospective study was carried out over a period of 10 years. Non-glial lesions were not included. Data were analyzed with Epi info version 7.2.2.6 (Microsoft, Seattle, USA). 220 cases of brain tumors, comprising 56 gliomas (25.46% of all brain tumors) were managed during the study period. The mean age of the patients was 42.93 ± 16.90 years. 35 cases (62.5%) were males. Patients over 15 years of age represented 91.07% (n = 51) of the cases. The most frequent presenting complaints were headache and vomiting with 52 cases (92.86%) and 47 cases (83.93%) respectively. Brain computed tomography was done for all patients. The most frequent histological type was astrocytoma with 22 cases (39.29%) followed by glioblastoma with 20 cases (35.71%). The most performed surgical technique was partial removal with 33 cases (58.93%), followed by open biopsy with 14 cases (25.00%). Radiotherapy was administered to 54 patients (96.43%). The outcome ranged from full recovery in 8 cases (14.29%), recovery with persisting symptoms, in 15 cases (26.79%) and death in 26 cases (46.43%). Seven patients (12.50%) were lost to view. In this series, cerebral gliomas affected most often adult males. Most of them presented with signs of raised intracranial pressure. The outcome was poor with 46.43% of patients dying before 2 years after diagnosis.

Le premier colloque international sur l’albinisme oculocutane en Afrique subsaharienne s’est tenu a l’hotel Sawa de Douala, au Cameroun, les 24 et 25 juillet 2015. Il a ete organise conjointement par les universites de Douala, au Cameroun (Pr A. Mouelle Sone), de Lancaster, au Royaume-Uni (Pr C. Baker) et d’Aix-Marseille, en France (Pr R. Aquaron). Il a ete finance par le ministere [...]

Introduction Le cancer de l'œsophage est une affection rare. Le pronostic péjoratif est lié au diagnostic tardif. La survie à 5 ans est de moins de 20%. Le but de ce travail était de rechercher les facteurs associés à la survie des patients atteints d'un cancer de l'œsophage au Cameroun. Méthodes Il s'agissait d'une étude pronostique, sur une période de 11 ans allant du 1er janvier 2005 au 31 décembre 2015 dans les Hôpitaux Généraux de Yaoundé et de Douala. Les paramètres étudiés étaient ceux associés à la survie. La survie était établie en fonction de la date du diagnostic et de la date du décès ou de la dernière consultation. Le logiciel SPSS (Statistical Package for Social Sciences) version 23 a permis l'analyse des données. La survie était présentée sous forme de courbe de Kaplan Meier. Le Test de Log Rank a permis la comparaison entre les différents groupes. La régression de Cox a permis de ressortir les différents facteurs associés. Le seuil de significativité était de 0,05. Résultats Nous avons colligé 49 dossiers. L'âge moyen était de 57,83 ans. Le sexe masculin était présent dans 71,4% (n = 35) des cas pour un sex ratio à 2,49. Le suivi moyen était de 3,2 mois. La médiane de survie était de 6,67 mois (IC95% [1,33-10,4]) et la moyenne de survie était de 7,99 mois (IC95% [4,42-11,17]). En analyse multivariée après ajustement il ressortait que le stade IV était un facteur prédictif de mortalité (HR = 2,79; IC95% [1,13-6,89], p = 0,025]). Conclusion Le cancer de l'œsophage reste une affection rare au pronostic péjoratif. Le facteur pronostique est le stade tumoral.

The prevalence of undernutrition in hospitals in Africa is estimated at about 57 %. Simple anthropometric methods are available to detect it, including measurement of the brachial circumference (BC) and the body mass index (BMI). The aim of this study was to identify a threshold value that might make it possible to diagnose undernutrition in hospitals. It was a cross sectional study carried out at Douala General Hospital - Cameroon over a five months period. The measurements studied were: BMI, BC and percentage of weight loss. The Pearson test was used to compare the quantitative variables. The Receiving Operating Characteristic curve enabled us to determine a threshold value of the BC according to BMI. The study included 333 patients, with a mean age of 45 ± 16 years (range : 18-86). BMI and BC were strongly correlated; BC =11.69 + 0.68(BMI), with r2 = 0.65 (P

Introduction Les céphalées constituent un problème de santé publique mondial. La céphalée en « coup de tonnerre » est une forme rare de céphalée. Celle-ci connaît différentes étiologies dont la plus fréquente est l’hémorragie sous-arachnoïdienne. Les céphalées en « coup de tonnerre » (CCT) sont peu étudiées en Afrique. L’objectif de notre travail était de décrire les caractéristiques épidémiologiques et cliniques, de déterminer les étiologies ainsi que les facteurs pronostiques des céphalées en « coup de tonnerre » à l’Hôpital Général de Douala.Patients et Methode Nous avons mené une étude longitudinale rétrospective à l’unité de neurologie du service de médecine interne de l’Hôpital Général de Douala pendant une période de 4 ans (1er janvier 2010-31décembre 2013). Nous avons recruté les cas de céphalées en « coup de tonnerre » pendant 3 mois (1er mars au 31 mai 2014) à partir des dossiers médicaux, des registres d’hospitalisation et des entretiens téléphoniques. Etaient inclus dans l’étude les patients âgés de plus de 15 ans et exclus les patients avec des dossiers médicaux incomplets et/ou des traumatismes crâniens. Les données sociodémographiques, les caractéristiques cliniques, les différentes étiologies des céphalées en « coup de tonnerre », et le profil évolutif des patients ont été collectés. Tous nos patients avaient bénéficié d’un scanner cérébral sans injection incluant un angio-scanner, 27 avaient bénéficié d’une ponction lombaire et l’IRM avait été réalisée par 11 patients. L’analyse statistique s’est faite à l’aide du logiciel SPSS version 20.0. La comparaison des variables qualitatives et quantitatives a été faite grâce aux tests de Khi 2 et de T Student respectivement. Le pronostic a été déterminé par la méthode de Kaplan Meier. Les analyses uni-variée et multi-variée ont permis de déterminer les facteurs prédictifs de décès. Une valeur de p inférieure à 0,05 était considérée comme significative.Resultats Soixante cinq patients étaient inclus et 64,6% étaient de sexe féminin. L’âge moyen de survenue était de 46,1 ans. Les principaux antécédents médicaux étaient l’HTA (47,7%), l’alcoolisme (16,9%), et la migraine (15,4%). Le mode de survenue des céphalées en « coup de tonnerre » était spontané (67,7%), coïtal (9,2%), secondaire à la toux (7,7%). En comparant les signes et symptômes des hémorragies sous arachnoïdiennes avec ceux des autres étiologies de céphalées en « coup de tonnerre », la nausée, la raideur de la nuque, l’altération de la conscience étaient plus suggestives de l’hémorragie sousarachnoïdienne (p = 0,015, p = 0,000 et p = 0,017 respectivement). Les étiologies secondaires étaient les plus fréquentes (70,8%). Les principales étiologies de céphalées en « coup de tonnerre » étaient l’hémorragie sous-arachnoïdienne (36,9%), suivie de la crise de migraine sans aura (15,4%), et des hémorragies intracérébrales (12,3%). La durée moyenne d’hospitalisation était de 8,9 ± 6,1 jours et les patients avaient été suivis pendant une durée moyenne de 21,3 ± 13,4 mois. Les récidives au cours de cette période étaient de 3,8%. La mortalité globale était de 18,6%, 81,8% de décès sont survenus au premier mois, la première cause de décès était l’hémorragie sous-arachnoïdienne (11,9%). Les délais de consultation compris entre 24 et 168 heures, les antécédents de céphalées en « coup de tonnerre », la convulsion et la raideur de la nuque à l’admission étaient associés aux décès. Seule la convulsion était apparue comme facteur prédictif de décès (p = 0,007).Conclusion Les céphalées en « coup de tonnerre » touchent préférentiellement la femme. L’hémorragie sousarachnoïdienne est la première étiologie. L’altération de la conscience, la nausée, la raideur de la nuque sont suggestives de l’hémorragie sous-arachnoïdienne. La mortalité est élevée et due à l’hémorragie sousarachnoïdienne.

The gold standard for malaria diagnosis is the microscopic examination of Giemsa stained thick blood smears though microscopy mostly may not detect the presence of Plasmodium species infections in asymptomatic samples. In the reported study, we used two diagnostic methods viz. the conventional microscopic examination and polymerase chain reaction (PCR) assay to analyse the asymptomatic malaria samples. PCR assay amplifying 18S small-subunit ribosomal RNA (SSU rRNA) gene of Plasmodium in 122 samples confirmed 68% of isolates as asymptomatic P. falciparum infections; with 87.9% mono-infections. We observed that the P. malariae positive samples were not diagnosed in microscopic examination of the blood smears but the PCR based diagnostic method revealed the presence of 12% P. malariae infections in asymptomatic samples from Yaounde region of Cameroon where no official cases of P. malariae have been reported for over a decade. The sequence analysis further confirmed the presence of 12% P. malariae in malaria positive samples with three base pair deletions and five substitutions in the SSU rRNA gene.

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.Keywords: co-infection, epidemiology, health management, quantitative research, screening, sub-Saharan AfricaAfrican Journal of AIDS Research 2012, 11(4): 349–352

There is a huge need for health research to support contextually relevant health service and policy solutions to better the health of populations in sub-Saharan Africa. This need contrasts with the very timid engagement of healthcare practitioners in research in the region.It is against this background that the Douala General Hospital (a tertiary-care hospital in Cameroon), under the stewardship of its chief executive officer, organised the first annual scientific and research day in October 2014. This maiden event saw the participation of local research leaders and the eminent director of the South African Hatter Institute for Cardiovascular Research in Africa, who co-chaired the event. The aim was to educate students, clinicians and junior researchers on the importance of clinical research and evidence-based medicine around the leading theme of the event: action for clinical research and good medical practice.Several abstracts were presented, covering various aspects of medicine, including cardiology, rheumatology, paediatrics, pulmonology, HIV medicine, and obstetrics and gynaecology, together with key lectures on cardiac disease and pregnancy, and plenary sessions on research methodology, scientific writing and publishing. It is hoped that this event will enhance clinical research and the dissemination of research findings to improve evidence-based clinical practice in the country.

Ionizing radiations damage cells, tissues and organs among which the liver through a cascade of molecular events that are triggered by reactive oxygen species (ROS), lipid peroxidation and nitrogen species (NS). Aged Garlic Extract (AGE) has been demonstrated to possess free radical scavenging capacity and antioxidant activity. Therefore, the present study has been focused in analyzing the properties of AGE against the lipid peroxidation and oxidative damages of rat liver tissues induced by acute radiation. Eight groups, five healthy male rats each were used (20 irradiated and 20 Sham Irradiated), among which some were receiving via gavages distilled water, the others AGE at different doses (25 mg/kg and 50 mg/kg) and the rest vitamin E + Alpha Lipoic Acid. Then, biochemical analyses, lipid peroxidation, total Protein and antioxidants assessment were made from blood samples and liver tissue homogenates. Exposure of rats to gamma radiation caused a significant increase in the level of Malondialdehyde, Nitrite, transaminase enzymes, alkaline phosphatase, and Bilirubin (Total Serum Bilirubin, Direct Bilirubin and Unconjugated Bilirubin) level while a significant decrease was recorded in serum total proteins, glutathione content, superoxide dismutase, catalase activities and total protein level. AGE treated rats revealed a significant improvement in all previous parameters. From these results, it can be concluded that AGE may have significant anti-radiation properties in rat’s liver after radiation exposure.

Introduction Les accidents vasculaires cerebraux (AVC) constituent la premiere cause d’hospitalisation en neurologie en Afrique Subsaharienne. Objectifs Etudier la survie, les facteurs predictifs de deces per hospitalisation et le pronostic fonctionnel a court, moyen et long terme des AVC a l’hopital General de Douala. Methodes Nous avons mene une etude de cohorte prospective de janvier 2010 a decembre 2014 a l’hopital General de Douala. Etaient inclus dans l’etude, les patients âges de plus de 15 ans hospitalises pour AVC confirmes par l’imagerie cerebrale. Les hemorragies meningees et les thromboses veineuses cerebrales avaient ete exclues de l’etude. La survie a ete determinee par la methode de Kaplan Meier et les facteurs predictifs de deces intra-hospitalier determines par analyse univariee et multivariee selon le modele de Cox. Resultats Cinq cent un patients etaient inclus avec 59,88 % d’hommes et l’âge moyen des patients etait de 58,93 ± 13,19 ans. La mortalite hospitaliere etait de 24,8 %. Le score de Glasgow Discussion La mortalite hospitaliere des AVC etait similaire a celle de litterature. Les scores de Glasgow et de NIHSS ont ete rapportes par d’autres auteurs comme facteurs predictifs de deces postAVC. Conclusion Cette etude suggere que les accidents vasculaires cerebraux sont responsables d’une forte mortalite associee a des sequelles et par consequent d’un cout non negligeable pour la societe.

Purpose: To find the fastest and most effective/efficient method to economically deliver fractionated half-body irradiation (HBI) for widespread (WS), symptomatic, metastatic bone cancer. Methods and Materials: A Phase III trial with 3 HBI arms: (Arm A) Control (15 Gy/5 fractions/5 days); (Arm B) Hyperfractionation (HF) (8 Gy/2 fractions/1 day); (Arm C) Accelerated HF (12 Gy/4 fractions/2 days). Six countries randomized 156 patients (all with WS bone metastases): 51, 56, and 49 patients to Arms A, B, and C, respectively. There were 72 (46%) breast, 50 (32%) prostate, 9 (6%) lung, and 25 (16%) miscellaneous primary tumors. Initial performance status (PS) was 1–2 in 101 (65%) and PS 3–4 in 55 (35%). The lower, upper, and middle halves of the body were treated 79, 68, and 9 times. Results: Pain relief was seen in 91% of patients (45% complete [CR] and 46% partial [PR]) within 3–8 days. Overall (OS), median (MST), and pain-free (PFS) survival was 174, 150, and 122 days. Breast tumors had a higher OS (279 days) than that of other primary tumors, but when analyzed by treatment, was not significantly different than prostate tumors in Arm A. No survival differences were found in patients with PS 1–2 vs. 3–4, CR vs. PR, bone with/without visceral metastases, or by the number of metastases ( 15 bone lesions). Quality of life (QOL) assessed by the percent of the remaining life free of pain was 71%; furthermore significant improvements in PS, pain, and narcotic scores were seen after HBI. Toxicity was very acceptable (41% none, 50% mild/moderate, 12% severe but transitory); more was seen with upper HBI. Conclusion: In terms of response, time to response, OS, MST, PFS, QOL, and toxicity, schedules for Arms A and C were similar for all but prostate primaries. Schedule for Arm B, which delivered the lowest biologic dose in the shortest time, had significantly worse results in pain relief, OS, MST, PFS, and QOL. Results indicate that, for most primary tumor types (except prostate), delivering two HBI daily doses of 3 Gy in 2 consecutive days is as effective as delivering a daily dose of 3 Gy for 5 consecutive days. Thus, this is a faster and much more convenient HBI schedule for the palliation of pain in widespread cancer.

With 47% of the population under 15 years of age and the control of infectious and other communicable diseases, cancer will likely constitute a major health problem in West Africa in future. Radiotherapy facilities and trained manpower to run them are very limited within the subregion. This paper quantifies the severity of the situation and discusses a practical approach aimed at coping with the situation through the organisation of a training programme for radiotherapists, medical physicists and radiation technologists as part of the strategies for cancer control in West Africa. A curriculum is proposed for the training of radiotherapists.