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Background Burns are a serious public health problem worldwide accounting for an estimated 265,000 deaths annually from fires alone. The vast majority (96%) of deaths from fire-related burns occur in low- and middle-income countries and burns are one of the leading causes of disability-adjusted life-years (DALYs) in the developing world. Most burn centres are situated in large cities and are inadequate for the high incidence of injuries. An 8 year review of 440 patients in the Douala General Hospital, showed that the majority of patients burned were males (n = 281, 68.9%), the mean age was 25.2 ± 17.77 years with an admission rate of 69.5% (306 patients). The modal and median age were 31.0 years and 25.0 years respectively, interquartile range (0.4–82). Majority of burns (n = 237, 53.9%) had burn surface area ≥ 10%, most burns were 2nd degree (n = 215, 48.9) and the commonest burn agents were flames (n = 170, 37.3%), electricity (n = 119, 26.3%) and water (n = 114, 25.2%). The paucity of data on burn mortality in Cameroon motivated this study and is aimed at determining the mortality rate, causes and factors associated with death of burnt patients in the burn unit of the Douala General Hospital (DGH). Methods It was a retrospective observational study carried out from the 1st of January 2008 to the 31st of December 2015 in the Burn Unit of the Douala General Hospital. An adapted questionnaire was used to collect demographic data, burn agents, burn depth; diagnostic delay, burn surface area, complications, comorbidity, mortality and its causes. Data was transferred to Microsoft Excel 2015 and the Statistical Package for Social Sciences (SPSS) version 20.0 for data analysis. Results During this 8 year period, 440 patients were studied and the mortality rate was 23.4% (103 patients). The fatal burn agents were, flames (n = 69, 67.0%), electricity (n = 15, 14.6%), water (n = 12, 11.6%), contact (n = 4, 3.9%), Oil (n = 2, 1.9%) and chemicals (n = 1, 1.0%). The causes of death were shock (n = 36, 35.0%), sepsis (n = 25, 24.3%), acute respiratory distress (n = 25, 24.3%), acute renal failure (n = 6, 5.8%), severe anaemia (n = 4, 3.9%) and unrecorded causes (n = 7, 6.7%). Conclusion A quarter of all patients died mostly from flame burns and to a lesser extent, electricity and scalds. Increase in burn depth and burn surface area worsened the prognosis. Shock (the commonest cause of death), sepsis, acute respiratory distress, acute renal failure and wound infection were significantly associated with mortality.

Background Hepatitis B virus (HBV) infection despite being a vaccine preventable disease remains a global public health problem. In Cameroon, the hepatitis B vaccine was introduced in the expanded program on immunisation in 2005, but there has been limited evaluation of the HBV surface antibody response post vaccination. Objective We investigated the immune response to hepatitis B vaccine in infants who received the DPT-Hep B-Hib vaccine, and we assessed HBsAg carriage in non-responders. We also investigated factors associated with non-response or poor response. Methods Using a hospital based cross sectional design and a structured questionnaire over a four-month period (January to April 2019), we collected data to determine factors associated with hepatitis B surface antibody (anti-HBs) response from infants aged 6 to 9 months attending infant welfare clinics (IWC) at the Buea and Limbe regional hospitals. We collected venous blood and measured anti-HBs titres using a quantitative Foresight® ELISA. We entered and analysed data using EpiData version 3.1 and SPSS version 25 respectively. Results Of the 161 infants enrolled, 159 (98.8%) developed anti-HBs antibodies. Of these 159, 157 (97.5%) and 117 (72.7%) developed ≥ 10.0 mIU/ml (seroprotection) and ≥ 100.0 mIU/ml anti-HBs titres respectively. Being younger (6 months old) was associated with seroprotection (Cramer V = 0.322, p = 0.001). Spearman rho’s relational analysis showed that immunity against HBV reduced as the duration since the last dose increased (r = −0.172; P = 0.029). However, a Firth logistic regression showed no significant association of factors with inadequate immunity. All 12 (7.5%) infants exposed to HBV at birth, received the hepatitis B vaccine at birth, including four who received HBIG, and all were protected. Four infants (2.5%) had anti-HBs titres Conclusion The seroprotective rate following hepatitis B vaccination of infants is high even in exposed infants. Our study suggests that Cameroon’s HBV vaccine in the Expanded Program on Immunisation (EPI) is effective against HBV, although we could not account for the 2.5% non-response rate. Large scale studies are needed to further explore non-response to the vaccine.

Background There is uncertainty regarding the status of emergency obstetric and neonatal care (EmONC) in the Cameroonian context where maternal and neonatal mortality are persistently high. This study sought to evaluate the coverage, functionality and quality of EmONC services in Kumba health district (KHD), the largest health district in Southwest Cameroon.. Methods A retrospective study of routine EmONC data for the periods 1 January 2011 to 31 December 2012 (when EmONC was being introduced) and 1 January 2013 to 31 December 2014 (when EmONC was fully instituted) was conducted. Coverage, functionality and quality of EmONC services were graded as per United Nations (UN) standards. Data was analysed using Epi-Info version 7 statistical software. Results Among the 31 health facilities in KHD, 12 (39%) had been delivering EmONC services. Three (25%) of these were geographically inaccessible Among the 9 facilities that were assessed, 4 facilities (44%) performed designated signal functions, with 2 being comprehensive (CEmONC) and 2 basic (BEmONC). These exceeded the required minimum of 2.8 EmONC facilities/500000, 0.6 CEmONC facilities/500000 and 2.2 BEmONC facilities/500000, with reference to an estimated KHD population of 265,071. The signal functions that were least likely to be performed were neonatal resuscitation, manual evacuation of retained products and use of anticonvulsants. In 2011–2012, the facilities performed 35% of expected deliveries. This dropped to 28% in 2013–2014. Caesarean sections as a proportion of expected deliveries remained very low: 1.5% in 2010–2011 and 3.6% in 2013–2014. In 2011–2012, met needs were 6.8% and increased to 7.3% in 2013–2014. Direct obstetric fatality rates increased from 8 to 11% (p = 0.64). Intrapartum and very early neonatal deaths increased from 4.% to 7 (p = 0.89). Conclusion Major gaps were observed in the performance of signal functions as well as the quality and utilization of EmONC. While the results of this study seem to indicate the need to sustainably scale up the utilization of quality EmONC, the interpretations of our findings require consideration of improvements in reporting of mortality data associated with the introduction of EmONC as well as dynamics in country-specific maternal health policies and the potential influence of these policies on EmONC indicators.

Background Depression is an important contributor to the global burden disease that affects people of communities all over the world. With high level of demands in academics and psychosocial pressure, medical students during their course of training tend to become depressed, leading to problems later in professional life and compromising patient care. In Cameroon, there is lack of data on the prevalence of depression and its impact on medical students. To determine the prevalence and predisposing factors associated with depression among medical students in Cameroon (preclinical and clinical). We also evaluated the impact of depression on self-reported academic performance. Methods A cross sectional study was carried out in all 4 state medical schools in 4 different regions from December 2015 to January 2016. Diagnosis of depression, major depression and its associated factors were assessed using the 9-Item-Patient Health Questionnaire (PHQ-9) and a structured questionnaire respectively. We included 618 medical students (response rate: 90.4%). Results About a third of them (30.6%, 95% CI: 22.8–36.7) were found to have major depressive disorder (PHQ Score ≥ 10). With regards to the severity of depression, 214 (34.6%), 163 (26.4%), 21 (3.4%), and 5 (0.80%) students were classified as having mild, moderate, moderately severe and severe depression respectively. The presence of a chronic disease (OR: 3.70, 95% CI: 1.72–7.94, p = 0.001), major life events (OR: 2.17, 95%CI: 1.32–3.58, P = 0.002), female gender (OR: 1.59, 95% CI: 1.06–2.37, p = 0.024) and being a student at the clinical level (OR: 4.26, 95% CI: 2.71–6.71, p

Vulva haematomas are uncommon outside the obstetric population, with an incidence of 3.7% and represent only 0.8% of all gynaecological emergencies. The first case is a 24-year-old G2P1011 referred after the failure of conservative management of a progressively increasing right labia majora swelling. Vulva incision, exploration and relieve of hematoma were done under local anaesthesia. The second case is a 17-year-old G1P1001, a student who presented with spontaneous pain and swelling of the left labia majora. The swelling was rapidly increasing, tense and tender. It spontaneously ruptured, clots were drained and the wound was packed. Vulva hematomas are not very common hence necessitating careful assessment, right diagnosis and management. Management could be conservative (analgesics, local compression) as well as surgical in cases of hemodynamic instability, rapidly increasing size of hematoma and pain intensity. Prompt surgical management reduces the risk of infection and longer hospital stays, which is important in low resource settings like ours.

Objective Medical and nursing students in Cameroon are likely to have mental health problems given the stressful nature of their studies. Paucity of mental health institutions in the country implies they hardly get access to professional help when needed and are obliged to develop coping strategies such as recreational drug use. This study aims to determine the prevalence and predictors of recreational drug use among a group of Cameroonian medical and nursing students. Results Cross-sectional analysis of 852 medical and nursing students (mean age 21.78 ± 3.14, 31.49% males) recruited by convenience sampling from three state-owned medical schools; and from two state-owned and two private nursing schools in Cameroon over a four-month period (January–April 2018). Information was collected via a printed self-administered and structured questionnaire from consenting students. Multivariable logistic regression analysis was used to identify independent predictors of recreational drug use. The overall prevalence of recreational drug use was 1.64% with tramadol and marijuana noted as the drugs used by these students. Independent predictors of recreational drug use were: presence of a chronic illness (OR 5.26; 95% CI 1.32, 20.97; p = 0.019), alcohol consumption (OR 5.08; 95% CI 1.54, 16.73; p = 0.008) and Total Oldenburg Burnout Inventory score (OR 1.11; 95% CI 1.02, 1.21; p = 0.021). The use of recreational drugs by medical and nursing students in Cameroon remains worrisome despite its very low prevalence, as it may negatively impact their performance and health. Electronic supplementary material The online version of this article (10.1186/s13104-018-3631-z) contains supplementary material, which is available to authorized users.

Background. The endemic nature of the hepatitis B virus (HBV) in Sub-Saharan Africa is a significant public health problem that places health care providers (medical students inclusive) at increased risk of occupational exposure. However vaccination against HBV is not systematic among medical students in Cameroon. Thus, we sought to evaluate awareness and HBV vaccine coverage among medical students in Cameroon. Methods. Using semistructured questionnaire and a cross-sectional approach, medical students from 3 State Universities in Cameroon were evaluated for their knowledge, attitudes, and vaccination status against the HBV. Data were collected over a 3-month period. HBV vaccine status was defined as complete (3 doses), partial (1 and 2 doses), and unvaccinated. Data were entered and analyzed using Epi-info 7. Results. There were 714 respondents among whom 186 (26.05%) had been vaccinated at least once against HBV. Sixty-six (9.24%) were partially vaccinated and 120 (16.81%) completely vaccinated. No student had done postvaccination serologic testing to confirm full immunisation. Eighty-three percent (83.00%) of respondents had adequate knowledge on HBV infection and vaccine, while 90.00% had adequate knowledge on HBV transmission. Most medical students had a positive attitude towards the HBV vaccine. The most common negative attitudes were worries about the side effects and fears of being infected by the vaccine. Conclusion. Despite adequate knowledge on HBV infection and vaccination only about 1 in 6 medical students had completed the HBV vaccination series. This highlights the need for better health policies aimed at increasing access and coverage of the HBV in at-risk populations like medical students.

Background Spina bifida and congenital talipes equinovarus (CTEV) are common congenital malformations which may occur together and increase morbidity. Monozygous twins are particularly at risk of these malformations and discordance in one type of malformation is typical. The occurrence of both spina bifida and CTEV in one twin of a monozygotic pair is rare. Case presentation A 22 year-old Cameroonian primigravida at 36 weeks of a twin gestation was received in our district hospital at the expulsive phase of labour on a background of sub-optimal antenatal care. A caesarean section indicated for cephalo-pelvic disproportion was performed and life monoamniotic male twins were extracted. The first twin was normal. The second twin had spina bifida cystica and severe bilateral CTEV. Routine postnatal care was ensured and at day 2 of life, the affected twin was evacuated to a tertiary hospital for proper management. He was later on reported dead from complications of hydrocephalus. Conclusions Spina bifida cystica with severe bilateral CTEV in one twin of a monoamniotic pair illustrates the complexity in the interplay of causal factors of these malformations even among monozygotic twins who are assumed to share similar genetic and environmental features. The occurrence and poor outcome of the malformations was probably potentiated by poor antenatal care. With postnatal diagnoses, a better outcome was difficult to secure even with prompt referral. Early prenatal diagnoses and appropriate counseling of parents are cardinal.

Background Stevens–Johnson syndrome is one of the manifestations of mucocutaneous adverse drug reactions. Although antimicrobials are responsible for greater than 50% of these adverse drug reactions, there is no documented case implicating ivermectin as the culprit. Case summary A 38 year old adult Cameroonian male presented to our health facility with facial rash, painful oral sores, black eschars on lips and red tearing eyes 3 days following ingestion of ivermectin received during a nationwide anti-filarial campaign. He had no known chronic illness, no known allergies and was not on any medications prior to the campaign. Physical examination revealed discharging erythematous eyes, crusted and blister-like lesions with cracks on his lips and oral mucosa. His laboratory tests were unremarkable but for a positive Human Immunodeficiency Virus (HIV) test. A diagnosis of Ivermectin induced Stevens–Johnson syndrome in a newly diagnosed HIV patient was made. The patient was managed with supportive therapy and the evolution thereafter was favourable. Conclusion Stevens–Johnson syndrome is a potential side effect of ivermectin and susceptibility to this adverse effect may be increased in HIV infection.

Background Concurrent thyroid cancer (TC) and hyperthyroidism (HT) is rare though increasingly being reported. HT due to TC is much rarer and more challenging especially in Africa where TC and HT have significant case fatality rates. Case presentation We present a 37-year-old Cameroonian female who had been on irregular regimens of propranolol and digoxin as treatment for worsening palpitations for 12 months. She came to our district hospital for her propranolol medication refill. We fortuitously identified features of HT and found a left uninodular goiter with no cervical lymphadenopathy. She was referred for thyroid assessment which suggested primary HT and an enlarged heterogeneous left lobe with a well-defined homogenous solid mass. We restarted her on propranolol and referred her for a course of methimazole. At the referral hospital, she also underwent a left thyroid lobectomy. The resected lobe was sent for histopathology which revealed a neoplastic nodule with features suggestive of a papillary thyroid cancer (PTC) causing HT. The patient’s clinical progress postoperatively was good and there was regression of hyperthyroid symptoms. Conclusions The historical, clinical, and laboratory findings were suggestive of HT due to PTC. A high index of suspicion, prompt referral and counter-referral lead to a positive outcome of such a rare case in a resource poor setting. We advocate for systematic and careful evaluation of all thyroid nodules.

Background Chronic leg ulcers (CLUs) pose serious public health concerns worldwide. They mainly affect the elderly population. Pinch grafting (PG) could be used to treat a variety of CLUs. However, in Cameroon, there is scarce data on the outcome of PG of CLUs in elderly patients in rural hospitals where most of these patients seek for medical attention and where clinicians rely on unconventional wound dressing methods to treat CLUs. Our objective was to describe the outcome of PG of CLUs in elderly patients in rural Cameroon. Methods This was a prospective study conducted in a rural hospital of North West Cameroon. From February 2015 to January 2016, comprehensive historical and clinical data were collected per elderly patient who presented with a chronic leg ulcer necessitating PG. PG was done using a simple procedure and each patient followed up for 8 months. Outcome was described in terms of ulcer healing and pain and donor site complications. Results Our series included 13 patients: 8 males (61.54%; 95% CI: 31.58–86.14) and 5 females (38.46%; 95% CI: 13.86–68.42) aged from 69 to 88 years (mean: 77.54 ± 5.70 years). Three patients (23.08%; 95% CI: 5.04–53.81) had associated co-morbidities. All the ulcers were unilateral with durations ranging from 7 to 41 months (mean: 19.46 ± 11.03 months). The ulcers ranged in size from 9.0 to 38.1 cm2 (mean: 17.66 ± 8.35 cm 2). We registered one (7.69%; 95% CI: 0.19–36.03) graft rejection. Concerning the other ulcers, ten (83.33%; 95% CI: 51.59–97.91) had healed after 12 postoperative weeks while 2 (16.67%; 95% CI: 2.09%–48.41) had healed after 14 postoperative weeks and the mean healing time was 12.33 ± 0.78 weeks. Patients with healed ulcers had reduced ulcer site pain from the immediate postoperative period but there was no significant difference in the mean pain scores before and after graft (6.77 against 4.23, p = 0.13). These ulcers remained healed after 8 postoperative months. Each donor site had healed 2 weeks after PG. Donor site problems were minimal and included hypopigmentation. Conclusion The outcome of PG of CLUs in our series of older patients was satisfactory. This finding does not discount the role of conservative therapy, but we encourage clinicians in rural Cameroon to consider PG over long-term unconventional conservative therapy in the elderly.