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Abstract Background A relationship exists between birth weight (BW) and glomerular filtration rate (GFR) in postnatal kidney. Willing to fill a gap of knowledge in sub-Saharan Africa, we assessed the effect of BW on blood pressure (BP), proteinuria and GFR among Cameroonians children. Methods This was a cross-sectional hospital-based study from January to April 2018 at the Yaounde Gynaeco-Obstetric and Paediatric Hospital (YGOPH). We recruited low BW (LBW) [ 4000 g] children, aged 5–10 years, born and followed-up at YGOPH. We collected socio-demographic, clinical (weight, height, BP), laboratory (proteinuria, creatinine), maternal and birth data. The estimated GFR was calculated using the Schwartz equation. Results We included 80 children (61.2% boys) with 21 (26.2%) LBW, 45 (56.2%) NBW and 14 (15.5%) HBW; the median (interquartile range) age was 7.3 (6.3–8.1) years and 17 (21.2%) were overweight/obese. Two (2.5%) children, all with a NBW (4.4%), had an elevated BP whereas 2 (2.5%) other children, all with a LBW (9.5%), had hypertension (p = 0.233). Seven (8.7%) children had proteinuria with 19, 2.2 and 14.3% having LBW, NBW and HBW, respectively (p = 0.051). Equivalent figures were 18 (22.5%), 14.3, 24.2 and 28.6% for decreased GFR, respectively (p = 0.818). There was a trend towards an inverse relationship between BW and BP, proteinuria and GFR (p > 0.05). Conclusion Proteinuria is more pronounced in childhood with a history of LBW and HBW while LBW children are more prone to develop hypertension. Regular follow-up is needed to implement early nephroprotective measures among children with abnormal BW.

Background: This study aimed to gain an understanding of the challenges faced by people with hearing impairment (HI) in Cameroon, their understanding of the causes of HI, and how challenges could be remedied to improve the quality of life of persons with HI.Methods: Semi-structured one-on-one in-depth interviews and observation of participant behaviour when answering questions were used to collect data from 10 HI professionals (healthcare workers and educationists), and 10 persons affected by HI (including caregivers).Results: The results show that the different groups associate the causes of HI to genetics, environmental factors, and a spiritual curse. There were reported cases of stigma and discrimination of persons with HI, with people sometimes referring to HI as an “intellectual disorder.” Interviewees also highlighted the difficulty persons with HI have in accessing education and healthcare services and suggested the need for the government and health researchers to develop strategies for the prevention and early diagnosis of HI. These strategies include (1) the awareness of the general population regarding HI, (2) the development of facilities for the proper management and new-born screening of HI, and (3) the implementation of a premarital screening to reduce the burden of HI of genetic origin.Conclusions: This study confirms the difficult social interaction and access to proper management faced by persons with HI in Cameroon and further highlights the need to educate populations on the causes of HI for a better acceptance of individuals with HI in the Cameroonian society.

Introduction: epilepsy is responsible for a significant proportion of disease burden globally. Comorbidities of epilepsy alters the quality of life of patients. There is paucity of literature in Cameroon on comorbidities in children with epilepsy. The aim of our study was to describe the comorbidities and etiologies of pediatric epilepsy at the Yaounde Gyneco-Obstetric and Pediatric Hospital. Methods: this was a cross-sectional study using consecutive sampling techniques carried out on 159 children aged 0-17 years old with epilepsy who were interviewed and examined at the Yaounde Gyneco-Obstetric and Pediatric Hospital, Cameroon. The data were collected from patient files and during routine outpatient visits examination. We calculated prevalence ratios of epilepsy, comorbidities, and their 95% confidence intervals and used log-binomial regression to calculate adjusted prevalence ratios.Results: the prevalence of epilepsy was 5.9 %. The mean age was 6.1 years (SD 4.4). Hypoxic-ischemic encephalopathy 45(28.3%) was the leading cause of epilepsy. Mental retardation 83(52.2%), cerebral palsy 50(31.4%), attention-deficit/hyperactivity disorder 48(30.2%), and malnutrition 38(23.9%) were the main comorbidities observed in children with epilepsy. The prevalence ratios of mental retardation (OR =22.27, 95% CI 3.9-473.0, p= 0.000) and cerebral palsy (OR 18.20, 95% CI 5.29-80.31, p= 0.000) were greater in patients with infantile spasms. The others epileptic encephalopathies were significantly associated with buccofacial apraxia (OR 13.70, p=0.000), cerebral palsy (OR 13.38, p=0.000), and malnutrition (OR 3.59, p=0.04).Conclusion: mental retardation, cerebral palsy, attention-deficit/hyperactivity, and malnutrition are the most common comorbidities among epileptic children in Cameroon.

Fragile X Syndrome (FXS) is the most common x-linked monogenic cause of Intellectual Disability (ID) and Autism Spectrum Disorder (ASD). Taking care of children with ID is challenging and overwhelming due to the multiple facets of caregiving. This scoping review aimed at summarizing the qualitative literature on the experiences of families living with FXS, identify key themes and determine the gaps in the extant literature. We conducted a literature search in May 2019 using four databases; PubMed, Web of Science, African-Wide-Information, and Scopus. The keywords used in our search strategy were associated with caregivers, lived experiences, FXS, and qualitative research. All English language articles with full-text reporting were included. Studies associated with other neurodevelopmental conditions and quantitative studies were excluded. We identified 12 out of 203 articles that described the lived experiences of families with FXS. Most articles originated from the United States of America and mothers were the main caregivers. We summarized our findings into four major themes which are; grief experiences, challenges of living with FXS, coping mechanisms and the need to plan for future outcomes. This scoping review highlights the scarcity of qualitative FXS literature in the African population and frustrations endured by families with FXS due to the low knowledge of FXS by healthcare workers. More research is needed to evaluate the impact of living with FXS in males and fathers.

INTRODUCTION: Approximately 2.5 million children below 15 years are infected with the HIV virus, with 90% in sub-Saharan Africa. The Yaounde Gynaeco-obstetric and Pediatric hospital has been a treatment center for HIV since 2006. The aim of this study was to analyze the baseline demographic, clinical and immunologic characteristics of the children with the HIV infection in this hospital. METHODS: It was a retrospective, cross- sectional and analytic study, carried out between January and April 2011 which included 61 HIV positive children aged 0-15 years. The socio-demographic, clinical and immunologic data were obtained from their medical records. RESULTS: Most (52.5%) of the children studied were above 60 months of age with a mean age of 71 months. Most (57.4%) were females. Mother-to-child transmission was the principal mode of contamination in 88.5% of cases. More than half of their mothers (55.7%) did not receive antiretroviral prophylaxis during pregnancy and labor. Common clinical findings included prolonged fever (44.6%), malnutrition (37.6%), lymphadenopathy (34.4%), respiratory tract infections (34.4%) and diarrhea (24.5%). Diagnosis was confirmed by HIV serology for most of the patients (93.4%). Polymerase chain reaction served as method of diagnosis in only 6.6% of the cases. HIV 1 was the predominant viral type. More than half of the children (52.5%) were seen at an advanced stage of the disease. CONCLUSION: HIV screening during pregnancy and prevention of mother-to-child transmission should be reinforced in this context, and fathers of HIV-infected children should be encouraged to go for HIV testing.

Background and objective: Malaria is the most widely spread parasitic disease in the world, especially in the tropics affecting mostly children and pregnant women. In children, mostly under-fives carry the heaviest burden in terms of morbidity and mortality. The aim of this study was to determine the epidemiological and clinical aspects, and outcome of children 3 months to 15 years old with severe malaria at the Yaounde Gynaeco-Obstetric and Pediatric Hospital (YGOPH), a referral hospital in Yaounde, Cameroon. Methods: It was a descriptive study at the general pediatric unit of the YGOPH. We enrolled all children aged 3 months to 15 years admitted for severe malaria, with one or more signs of severity and confirmed by a Rapid Diagnostic Test (RDT) and/or thick blood smear (TBS). Results: Over six months, 1782 children were admitted in the unit and 466 had severe malaria giving a frequency of 26.10%. The mean age was 51 ± 42 months, and the sex ratio was 1.2. The highest transmission rate was during the rainy season, within the months of April and May. The main symptoms on admission were prostration, fever with body temperature ≥40 °C and convulsions (61.90%, 58.00%, and 30.30% respectively). RDT was positive in 98.90% of cases and TBS was positive in 60.00%. The outcome was favourable in 93.30% of the patients and 16 died giving a mortality rate of 3.80%. Conclusion: Severe malaria is a public health problem affecting mostly children under five years. Proper management consists of prompt diagnosis and early appropriate treatment. Prevention is by information, education and communication on environmental cleanliness and the use of insecticide-treated mosquito nets.

In the acute phase of the COVID-19 outbreak, focus is usually made on the fact that children are less susceptible to severe forms. However, the COVID-19 pandemic has numerous other issues in children’s health that maybe minimized in the Cameroonian context. A survey of pediatricians practicing in Cameroon showed a significant drop in pediatric outpatient consultations, from 60.4% of pediatricians seeing more than 30 patients per week before the pandemic to 9.9% during the pandemic. This had many consequences among which the delay in urgent care with an increased mortality, postponed routine immunization with the risk of an upsurge in vaccine-preventable diseases. Another study showed that mortality doubled during the months of April and May 2020 with 9.9% and 11.2% of hospital deaths respectively, compared to 4.9% (p = 0.0008) and 5.1% (p = 0.0001) during the same period of the previous year. The closure of schools and universities, by imposing an unusual sedentary lifestyle, could result in highest exposure to risk related to insufficient physical activity. Another major issue is the psychological impact of the outbreak on child’s mental health. Regarding the therapeutic and acute aspects of the care of children during the COVID-19 pandemic should not obscure a more global approach with other issues. The organization of care should be inclusive and take into account the physical, somatic impact as well as the psychological and socio-cultural aspects.

Abstract Background Fragile X Syndrome (FXS) is a neurogenetic condition that significantly impacts the lives of affected individuals and their families due to its association with intellectual disability (ID) and stigma. Method In this paper, we present the findings of an ethnographic study in the community of a patient who received a genetic diagnosis for FXS in Cameroon. This study builds on data from 28 participants of a royal family and 58 from the community who participated in 20 in‐depth interviews and nine focus group discussions. Results We identified two types of stigma in this community: public stigma directed towards the royal family and associative stigma experienced by royal family members. We outline the stereotyping labels used for the family and its children with Fragile X Syndrome and describe the stigma‐power dynamic between the community members and the royal family. First, most villagers use less stigmatizing terms to addressing FXS children from the chieftaincy because of their position in society. Secondly, due to their social position, the royal family uses their status to negotiate marriages with community members. From these observations, we can suggest that the primary role of stigma in this community is to keep people away from FXS and keep them down through domination and exploitation. Conclusion We advocate that other researchers examine if the same pattern exists in other inheritable forms of ID and conduct more qualitative research on FXS in Africa.

Abstract Background Most of the previous studies on Duchenne Muscular Dystrophy (DMD) were conducted in Caucasian, Asian, and Arab populations. Therefore, little is known about the features of this disease in Africans. In this study, we aimed to determine the clinical characteristics of DMD, and the common mutations associated with this condition in a group of Cameroonian patients. Methods We recruited DMD patients and performed a general physical examination on each of them. Multiplex ligand‐dependant probe amplification was carried out to investigate exon deletions and duplications in the DMD gene (OMIM: 300377) of patients and their mothers. Results A total of 17 male patients from 14 families were recruited, aged 14 ± 5.1 (8–23) years. The mean age at onset of symptoms was 4.6 ± 1.5 years, and the mean age at diagnosis was 12.1 ± 5.2 years. Proximal muscle weakness was noted in all patients and calf hypertrophy in the large majority of them (88.2%; 15/17). Flexion contractures were particularly frequent on the ankle (85.7%; 12/14). Wasting of shoulder girdle and thigh muscles was present in 50% (6/12) and 46.2% (6/13) of patients, respectively. No patient presented with hearing impairment. Deletions in DMD gene (OMIM: 300377) occurred in 45.5% of patients (5/11), while duplications were observed in 27.3% (3/11). Both mutation types were clustered between exons 45 and 50, and the proportion of de novo mutation was estimated at 18.2% (2/11). Conclusion Despite the first symptoms of DMD occurring in infancy, the diagnosis is frequently made later in adolescence, indicating an underestimation of the number of cases of DMD in Cameroon. Future screening of deletions and duplications in patients from Cameroon should focus on the distal part of the gene.

Abstract Background Vaccination is a major, but simple and cost effective public health intervention in the prevention of infectious diseases, especially in children. Nowadays, many children still miss scheduled vaccines in the Extended Program of Immunization (EPI) or are being vaccinated after the recommended ages.This study was aimed at assessing vaccination completeness and timeliness in children aged 0 to 11 months attending the vaccination clinic of the Yaounde Gynaeco-Obstetric and Pediatric Hospital. Methods This was an observational cross-sectional study over a period of 3 months (1st February to 30th April 2016). 400 mothers were interviewed and their children’s vaccination booklets analyzed. Information on the children and the parents was collected using a pretested questionnaire. Data analysis was done using SPSS version 20 software. Bivariate and multivariate analysis with logistic regression was done to assess the determinants of completeness and timeliness. Results A total of 400 mother-infant pairs were sampled. The vaccination completeness rate was 96.3%. This rate varied between 99.50% for BCG and 94.36% for IPV. Most of the children were born at the Yaounde Gynaeco-Obstetric and Pediatric hospital where they were regularly receiving their vaccines. The proportion of correctly vaccinated infants was 73.3%. The most differed vaccines were BCG, PCV13 and IPV. Factors influencing immunization completeness were the father’s profession and the mother’s level of education. Conclusions Despite the high immunization coverage, some children did not complete their EPI vaccines and many of them took at least one vaccine after the recommended age.

INTRODUCTION: Les maladies rares ont pour certaines des manifestations orales. Celles-ci sont souvent sous-étudiées; ce qui contribue à limiter l'offre de soins bucco-dentaires pour cette catégorie de patients. Le but est de déterminer les aspects épidémiologiques et cliniques des manifestations bucco-dentaires dans les maladies rares dans notre milieu. METHODES: nous avons effectué une étude transversale et descriptive sur une durée de 04 mois, dans deux hôpitaux de référence de Yaoundé: les informations ont été recueillies des dossiers médicaux, de l'interrogatoire des parents ou tuteurs et de l'examen bucco-dentaire des patients. Le seuil de significativité considéré pour p = 0,05. RESULTATS: les manifestations orales sur maladies rares sont variables et fonction du groupe d'affections, de la denture, et ont souvent un retentissement fonctionnel. Elles étaient présentes dans 97,2% de nos patients. En denture temporaire (59,4%), c'était plus des anomalies de forme et de position dentaire (conicité dentaire 7 cas/22, soit 32%), et en denture permanente des lésions carieuses (7 cas/10 soit 70%) et des anomalies de structure dentaire (4 cas/10 d'usure dentaire). Un lien significatif existait entre le type de denture, l'anomalie de structure (p=0,001) et de nombre (p=0,018). Les difficultés à la mastication (p=0,023) et à la succion (p=0,033) étaient liées aux groupes de maladies rares. CONCLUSION: les lésions orales dans les maladies rares bien que présentes dans notre milieu, sont souvent négligées. Les soins bucco-dentaires devraient être intégrés dans le paquet minimum des activités des formations sanitaires et rendus gratuits ou financièrement accessibles à ces patients handicapés ou présentant des besoins spécifiques.

INTRODUCTION: l'infirmité motrice cérébrale (IMC) désigne un ensemble de troubles permanents de la posture et du mouvement lié à une atteinte cérébrale non progressive survenue sur le cerveau en développement du f'tus ou du nourrisson. Les troubles de la croissance sont fréquents chez les enfants souffrant d'infirmité motrice cérébrale et sont liés à des problèmes nutritionnels et non nutritionnels. METHODES: nous avons mené une étude transversale analytique dans l'unité de neuropédiatrie de l'Hôpital Gynéco-Obstétrique et Pédiatrique de Yaoundé (HGOPY) du 02 janvier 2014 au 30 juin 2014. Ce travail comportait deux volets, d'une part comparer les différents indices anthropométriques des enfants en fonction du type d'IMC et d'autre part, comparer la croissance staturo-pondérale du groupe d'enfants atteints d'IMC à celle d'un groupe d'enfants témoins appariés selon le sexe et l'âge. Les mesures anthropométriques étaient réalisées suivant les recommandations de l'OMS. Les moyennes de z-score des différents indices anthropométriques étaient calculées et comparées dans les deux groupes. RESULTATS: au total 134 cas et 134 témoins répondant à aux critères d'inclusion ont été recrutés. Le sexe ratio était de 1,62. L'âge moyen des enfants était de 2,65 (SD 2,5) ans. La tétraparésie spastique était la forme clinique la plus représentée, 55,2% des cas présentaient des troubles de l'alimentation. Quatorze (12,3%) cas souffraient d'émaciation contre 2,7% des témoins, 29 (22,2%) des cas souffraient d'insuffisance pondérale contre 4 (3%) témoins, 42 (31,3%) des cas souffraient de retard statural contre 1 (0,7%) dans le groupe témoin. L'insuffisance pondérale et le retard de croissance statural étaient plus marqués chez les enfants présentant la forme mixte d'IMC, tandis que l'émaciation prédominait chez les enfants atteints de la forme choréoathétosique. Les différents indices anthropométriques étaient d'autant plus abaissés que le niveau d'invalidité était élevé. CONCLUSION: la malnutrition est donc très fréquente dans la population d'enfants souffrant d'IMC. Cette croissance sous optimale est plus marquée chez les patients présentant la forme mixte de paralysie cérébrale et la tétraparésie spastique ainsi que chez ceux présentant un déficit moteur sévère et des troubles nutritionnels. La prise en charge de l'enfant infirme moteur cérébral devrait intégrer une prise en charge nutritionnelle.

Le Syndrome de Miller Fisher est caractérisé par l'association d'une ophtalmoplégie, d'une ataxie et d'une aréflexie ostéo-tendineuse. Une infection virale est le plus souvent retrouvée dans les jours ou semaines qui précèdent la symptomatologie. Nous rapportons un cas de syndrome de Miller Fisher survenu chez une femme de 75 ans, et ce au décours d'une infection pulmonaire à Mycoplasma pneumoniae. Les sérologies virales habituelles étaient négatives. Les anticorps anti GQ1b étaient absents. Il n'y avait pas de lésion du tronc cérébral à l'imagerie par résonnance magnétique. L'évolution clinique était favorable après perfusion d'immunoglobulines humaines polyvalentes et des macrolides en comprimés. La sérologie Mycoplasma pneumoniae doit être systématiquement recherchée dans le bilan du syndrome de Miller Fisher.

INTRODUCTION: Cette étude dont le but était d'évaluer la contribution de l'électroencéphalogramme (EEG) en neurologie pédiatrique et de déterminer les indications pertinentes chez l'enfant de 0 à 15 ans. METHODES: Il s'agit d'une étude rétrospective et descriptive réalisée au laboratoire d'électroencéphalographie de l'Hôpital Gynéco-Obstétrique et Pédiatrique de Yaoundé du 1er novembre 2011 au 15 mars 2012. RESULTATS: L'âge moyen des patients était de 70.2 mois avec des extrêmes de 0 et 180 mois. Le sexe ratio était de 1.04. Cent quatre vingt treize des 500 tracés de veille étaient anormaux 41 des 114 tracés de sommeil étaient anormaux et 78 des 500 tracés réalisés présentaient un rythme de fond ralenti pour l'âge. Cent cinquante tracés présentaient des anomalies épileptiques dont 81 focales, 35 multifocales et 34 des anomalies généralisées. Sur les 137 patients dont l'EEG était compatible avec une épilepsie, le lobe temporal était le plus souvent le siège d'anomalies épileptiques avec des épilepsies temporales et des épilepsies à pointes centro-temporales, venaient ensuite le lobe frontal, les épilepsies généralisées, les épilepsies du lobe occipital et l'hypsarythmie. Chez 13 des 150 patients avec des anomalies épileptiques à l'EEG, les anomalies retrouvées ne rentraient pas dans le cadre d'un syndrome épileptique particulier. Lorsque l'épilepsie était connue, la probabilité d'avoir un tracé EEG anormal était 1,44 fois plus élevée (OR=1.44 (0.83-2.52) même si la corrélation n'était pas statistiquement significative (p=0.1). En revanche lorsque l'épilepsie était suspectée, il y avait 3.43 fois plus de risques d'avoir un tracé anormal (OR=3.43 (2.27-5.18) avec une corrélation statistiquement significative (p ;0.05). Les convulsions fébriles, les mouvements anormaux, le retard psychomoteur, les troubles déficitaires de l'attention avec hyperinésie, la perte de connaissance et les troubles du langage n'étaient pas significativement corrélés avec un risque accru d'avoir un EEG anormal. CONCLUSION: L'EEG a un rôle aussi bien dans la confirmation et la caractérisation de divers syndromes épileptiques et suspicions d'épilepsie que dans la discrimination des manifestations paroxystiques non épileptiques chez l'enfant. Les renseignements cliniques sont indispensables pour une lecture optimale du tracé.

INTRODUCTION: The burden of these neurological diseases is higher in developing countries. However, there is a paucity and scarcity of literature on neurological diseases in sub-Saharan Africa. This study was therefore undertaken to determine the pattern of neurological diseases in this setting and then, compare to those elsewhere in the African continent and also serve as a baseline for planning and care for neurological disorders in Cameroon. METHODS: The study was conducted at the Clinique Bastos, in Yaoundé, city capital of Cameroon, centre region. Over a period of six years, all medical records were reviewed by a neurologist and neurological diagnoses classified according to ICD-10. RESULTS: Out of 4526 admissions 912 patients (20.15%) were given a neurological diagnosis. The most frequent neurological disorders were headache (31.9%), epilepsy (9.86%), intervertebral disc disorder (7.67%), followed by lumbar and cervical arthrosis, polyneuropathy, stroke, Parkinson disease and dementia. According to ICD-10 classification, Episodic and paroxysmal disorders (headaches, epilepsy, cerebrovascular, sleep disorders) were observed on 424 (46.48%) patients; followed by nerve, nerve root and plexus disorders in 115 (12.6%) patients. CONCLUSION: The above data emphasizes that neurological disease contributes substantially to morbidity in an urban African hospital. Headaches, epilepsy and intervertebral disc disorders are major causes of morbidity.