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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.

cervical cancer is a public health problem in Cameroon, ranking as the 2we conducted a retrospective study over the period 1 January 2016 to 31 December 2017.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).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.

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.

English Title: The overall survival of patients aged less than 65 years old with multiple myeloma under chemotherapy at the General Hospital of DoualaEnglish AbstractAbstract: the multiple myeloma or Khaler’s disease is a malignant hemopathy who falls under both old and young person. It is the second malignant hemopathy after the lymphomas. It is responsible for about 1% of death’s cancer and about 19% of death’s malignant hemopathy. The purpose of this study was to determine the overall survival of patients aged less than 65 years with multiple myeloma undergoing chemotherapy over a 10 years period at the General Hospital of Douala.Method: it was a retrospective, descriptive and analytical study conducted in the department of internal medicine (Hematology unit) going on 05 December 2016 to June 30 2017. The sample method was non-random, with consecutive and exhaustive type of recruitment of patient records obedient of the inclusion criteria. The analyzed variables were demographic, paraclinical, therapeutic and evolutionary. The survival curves were plotted using the Kapplan Meier method. The survival comparisons were made by the Log Rank test and the p-values interpreted at a threshold of 5%.Results: 51 patient’s records from 19 to 65 years old were eligible. The average age of patients was from 54,22 years to 8,608years. There was a slight female predominance with a sex ratio of 0, 21. The monoclonal gamma peak was in 81,81% of cases objective. The immunoglobulin G was predominant and the Kappa light evolution was found in 81, 1% of cases. Our patients were predominately on stage 3 of Durie and Salmon (70, 58%) and 50% at stage 3 of the ISS score. Our patients have been treated using VMCP, MP and MPT protocols. The VMCP was the most used protocol on the first and second line (58, 82% and 54, 16%) with a very good practical response rate of 60% in the first line. The second-line protocol choice and compliance were statistically significant on treatment response (p=0,02; p=0,026 respectively). For an average follow-up of 24,06 months (range: 1-120), the median SG was 38 months. The percentage of SG in 5 years was 26,90%. The median progression-free survival was 69 months. The survival with progression was 84, 36 months. The factors associated with the overall survival in our level were the protocol choice and the percentage of hemoglobin. (p= 0,04; p=0,08 respectively).Conclusion: the patients are diagnosed at an advanced stage. The health care, the good compliance and the use of news molecules could improve the survival of our patients. This group of patients benefit from the therapeutic intensification by an auto implantation not yet available in our context.Keywords: Mylemo of the young subject, survival, General Hospital in Douala

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 [...]

In this cross-sectional study, we investigated host genetic factors and ethnic variation in circulating Plasmodium falciparum merozoite surface protein 2 (msp-2) clones among children with asymptomatic malaria. Isolates from seventy two asymptomatic malaria children were used for genotyping block 3 of msp-2 gene by nested polymerase chain reaction (PCR). Sickle cell trait and glucose-6-phosphate dehydrogenase (G6PD) deficiency were analysed by restriction fragment length polymorphism of DNA products from PCR targeting codons 6 and 68 of the beta-globin (HBB) and G6PD genes respectively. ABO blood group was typed by agglutination method. A total of forty two msp-2 genotypes (20 for 3D7 and 22 for FC27) were detected for an average (standard error of mean) multiplicity of infection (MOI) of 2.45 (0.16). The MOI was statistically the same among the five identified ethnic groups (P = 0.83). The overall prevalence of sickle cell trait and G6PD deficiency were 12.50 % and 22.22 % respectively. MOI was similar between children with Hb AA and Hb AS genotypes (P = 0.42). MOI was significantly high among children with a mutant G6PD genotype (P = 0.017). MOI was significantly higher in blood group O than group A (P = 0.03). Our findings show that although ethnicity and sickle cell trait have no association with MOI, the association was observed with G6PD genotype and ABO group. The results suggest the need for extension and expansion of the current study in order to investigate the mechanisms involved.

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.

Introduction: Au moment où la création des unités neuro-vasculaires est d'actualité, il est nécessaire de connaître les complications des AVC afin de mieux planifier les ressources. L'objectif était d'étudier les complications médicales à la phase aigüe des AVC et d'évaluer l'impact sur la mortalité.Méthodes: Il s'agit d'une étude transversale analytique sur 5 ans menée à l'Unité de Neurologie du service de Médecine Interne et du service de Réanimation de l'Hôpital Général de Douala. Nous avons inclus les patients âgés de plus de 15 ans admis pour AVC confirmé par un scanner cérébral dans les 15 premiers jours. Etaient exclus les patients avec la thrombose veineuse cérébrale ou l'hémorragie sousarachnoïdienne. Le test de Khi 2 a été utilisé pour rechercher les complications associées à la mortalité. Et les complications ayant un P < 0,200 seront intégrées dans l'analyse multivariée selon le modèle de régression de Cox. P < 0,05 était considéré comme statistiquement significatif.Résultats: Des 580 patients inclus, 57,2 % étaient des hommes et l'âge moyen était de 59,31±12,71 ans. Les complications cliniques étaient retrouvées chez 63,8 % des cas et dominées par le coma (22,8 %), l'infection urinaire (21%), l'infection broncho-pulmonaire (20,7 %), les céphalées (16,6 %) et les troubles de la déglutition (11,7 %) et le paludisme (10,2%). La mortalité globale était 23,62%. Le coma était associé à la mortalité (p = 0,0001). Les anomalies biologiques associées à la mortalité étaient les dysnatrémies (p = 0,0001), les dyskaliémies(p = 0,01) et la thrombopénie (p = 0,02). Le coma [p < 0,0001 ; OR = 50 ; IC95% : 21,95 - 113,88] et la thrombopénie [p < 0,04 ; OR = 2,67 ; IC95% : 1,04 - 6,83] sont apparus comme facteurs prédictifs de mortalité.Conclusion: Les complications sont nombreuses au cours des AVC et associées à une mortalité élevée. La mise en place des unités neurovasculaires devrait tenir compte de ces complications au moment d'identifier les ressources nécessaires mais aussi au moment de la formation du personnel dédié.Mots clés: Accident vasculaire cérébral - complications - mortalité -DoualaEnglish Title: Medical complications in the acute phase of cerebral vascular accidentsEnglish AbstractIntroduction: Stroke is a major public health problem worldwide. In developing countries, stroke mortality is high compare to those due to the three main killer infectious diseases including tuberculosis, HIV / AIDS and malaria. It represents the first cause of hospitalization in the neurology services in Sub-Saharan Africa. Mortality is often due to complications that can be neurologic or not neurological. For a better allocation of resources, it is necessary to know the complications that may occur in stroke patient.Objective: The aim of our study was to describe medical complications during the acute phase of stroke and their impact on mortality at the Douala General Hospital (DGH).Method: This was a longitudinal retrospective study that was carried out from 01st January 2010 to 31 December 2014. It was conducted in the Neurological Unit of the Service of Internal Medicine and Intensive Care Units of DGH. Were included in the study all the file of patient aged above 15 years admitted for stroke confirmed by brain imaging. Patient with subarachnoid hemorrhage and cerebral venous thrombosis were excluded. Qualitative variables were compared by the Chi-square test while the Student t test was used to compare quantitative variables. Independent predictors of death were found using multivariate analysis. P < 0.05 was considered statistically significant.Results: We include 580 patients with 57.24% been men. The mean age was 59.31 ± 12.71 years. The leading stroke risk factors were hypertension (71.2%), alcohol (30.5%), diabetes (22.8%), obesity (16.4%), stroke recurrency (16%) and tobacco (15,7%). The mean duration of hospitalization was 8.03 ± 6.26 days. Ischaemic stroke represented 60.5%. 63.8% of patients present at least one clinical complication. Coma (22.8%) and urinary tract infection (21%) were the most common neurological and not neurological complications respectively. The overall mortality was 23.62%. Only coma [p < 0,0001 ; OR = 50 ; IC95% : 21,95 - 113,88] and thrombopenia [p < 0,04 ; OR = 2,67 ; IC95% : 1,04 - 6,83] appeared to predict death in stroke patient.Conclusion: Stroke is associated with high mortality. Coma and thrombopenia are predictive factors of death. There is therefore a clear need to linger in order to better manage these medical complications and a better quality of life for our patients.Keywords: Stroke, medical complication, acute phase, Douala, Cameroon

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.

The aim of this study was to describe the clinical and immunological profile of patients infected with HIV after initiation of antiretroviral therapy. Sociodemographic characteristics, clinical and immunological patients were recorded. Chi square test and Mann-Whitney were used to compare variables. The multivariate regression model identified risk factors. So that, 936 (56.2%) patients were in stages III and IV of the WHO and 65.2% at an advanced stage of the disease. Factors associated with initiation at an advanced stage, were male sex (p = 0.007) and time to diagnosis (p = 0.005). In 2/3 cases, treatment is started at an advanced stage of disease. It is therefore important to intensify awareness campaigns for early detection and encourage patients to ensure regular medical follow-up screening., SCOPUS: ar.j, info:eu-repo/semantics/published

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

Objectif Décrire les caractéristiques des crises épileptiques au cours de la toxoplasmose cérébrale (TC) chez les patients immunodéprimés au VIH à l’Hôpital Général de Douala (HGD).Matériel méthodesIl s’agissait d’une étude descriptive rétrospective des cas de TC diagnostiquée entre janvier 2000 et décembre 2012. La prévalence, le type, la fréquence des crises épileptiques et les thérapeutiques antiépileptiques ont été étudiées. Les patients avec un antécédent de crises épileptiques étaient exclus. Le test de Khi-2 a été utilisé pour rechercher les facteurs associés à la survenue des crises épileptiques tandis que le test de Student a été utilisé pour comparer les moyennes. P < 0,05 était considéré comme statistiquement significatif.Résultats 146 patients étaient inclus avec 78 femmes pour un sex-ratio de 0,87 en faveur des femmes. L’âge moyen était de 39,38 ± 9,88 ans. Le taux de CD4 moyen était de 115,63 ± 142,70 éléments/ml. La prévalence des crises épileptiques était de 45,2% et 61% des épileptiques étaient répétées. Les crises épileptiques généralisées prédominaient avec 75,8%. Seuls la fièvre (p < 0,012), les céphalées (p < 0,004), le syndrome d’hypertension intracrânienne (p < 0,038), un taux de CD4 < 50/ mm3 (p < 0,02) et un taux d’hémoglobine

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.

The aim of this study was to describe the clinical and immunological profile of patients infected with HIV after initiation of antiretroviral therapy. Sociodemographic characteristics, clinical and immunological patients were recorded. Chi square test and Mann-Whitney were used to compare variables. The multivariate regression model identified risk factors. So that, 936 (56.2%) patients were in stages III and IV of the WHO and 65.2% at an advanced stage of the disease. Factors associated with initiation at an advanced stage, were male sex (p = 0.007) and time to diagnosis (p = 0.005). In 2/3 cases, treatment is started at an advanced stage of disease. It is therefore important to intensify awareness campaigns for early detection and encourage patients to ensure regular medical follow-up screening.

Les auteurs abordent la prise en charge thérapeutique du sarcome de Kaposi associé au VIH, qui pose des problèmes d’indications thérapeutiques, certains auteurs émettant l’idée que les traitements antirétroviraux seuls pourraient suffire pour son traitement. Sur la base d’une expérience de près de dix ans pendant lesquels 720 patients ont été pris en charge, les auteurs passent d’abord en revue les différentes présentations cliniques du sarcome de kaposi associé au VIH. Ils proposent ensuite les indications thérapeutiques, et donnent enfin un peu plus longuement les modalités de la radiothérapie qu’ils proposent pour ces malades.MOTS CLES: Sarcome de Kaposi épidémique – Présentations cliniques – Indications thérapeutiques- Radiothérapie

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.

The aim of this study was to present the sites of cancers diagnosed in men and women aged 50 years and above in Cameroon. From the registries of the pathology laboratory of the Yaoundé Central Hospital which at the national level receives the majority of samples sent for histopathology analysis, we recorded all cases of cancers diagnosed in people aged 50 years and above, during the period from 1st January 1987 to 31st August 1996 (9 years 8 months). 1,925 cancers were recorded: -1,005 of these (52.2%) were issued from men aged fifty years and above. These 1,005 cancers came from seventeen sites, the most common being: liver (226 cases = 22.49%), prostate (222 cases = 22.09%), skin (195 cases = 19.40%) and ENT (100 cases = 9.95%); that made 73.93% (above 3/4) of cancers observed in men aged fifty years and above from this study. -920 of these (47.8%) were diagnosed from women aged fifty years and above. These 920 cancers came from twenty-two sites, the most common being: uterine cervix (292 cases = 31.74%), breast (170 cases = 18.48%), skin (111 cases = 12.07%) and liver (90 cases = 9.78%); that made 72.07% (about 3/4) of cancers observed in women aged fifty years and above, from this study.

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.