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Heart failure in sub-Saharan Africa: A literature review with emphasis on individuals with diabetes
Andre Pascal Kengne,Anastase Dzudie,Eugene Sobngwi
Vascular Health and Risk Management , 2008,
Abstract: Andre Pascal Kengne1, Anastase Dzudie2, Eugene Sobngwi31The George Institute for International Health, University of Sydney, Australia; 2Heart failure and transplantation Unit, Louis Pradel’s Cardiovascular Hospital, Lyon, France; 3National Obesity Centre, Yaounde Central Hospital, CameroonPurpose: Heart failure is the ultimate complication of cardiac involvements in diabetes. The purpose of this review was to summarize current literature on heart failure among people with diabetes mellitus in sub-Saharan Africa (SSA).Method: Bibliographic search of published data on heart failure and diabetes in sub-Saharan Africa over the past 26 years.Results: Heart failure remains largely unexplored in general population and among people with diabetes in Africa. Heart failure accounts for over 30% of hospital admission in specialized cardiovascular units and 3%–7% in general internal medicine. Over 11% of adults with heart failure have diabetes. Risk factors for heart failure among those with diabetes include classical cardiovascular risk factors, without evidence of diabetes distinctiveness for other predictors common in Africa. Prevention, management, and outcomes of heart failure are less well known; recent data suggest improvement in the management of risk factors in clinical settings.Conclusions: Diabetes mellitus is growing in SSA. Related cardiovascular diseases are emerging as potential health problem. Heart failure as cardiovascular complication remains largely unexplored. Efforts are needed through research to improve our knowledge of heart failure at large in Africa. Multilevel preventive measures, building on evidences from other parts of the world must go along side.Keywords: diabetes mellitus, cardiovascular diseases, heart failure, sub-Saharan Africa
Epidemiology, Clinical Presentations and In-Hospital Mortality of Venous Thromboembolism at the Douala General Hospital: A Cross-Sectional Study in Cameroon, Sub-Saharan Africa  [PDF]
Félicité Kamdem, Bertrand Hugo Mbatchou Ngahane, Ba Hamadou, Agborbessong Mongyui, Marie Solange Doualla, Ahmadou Musa Jingi, Anastase Dzudie, Yves Monkam, Henri Ngote, Sidick Mouliom, Caroline Kenmegne, Jaff Kweban Fenkeu, Romuald Hentchoya, Albert Kana, Aminata Coulibaly, Henry Luma
World Journal of Cardiovascular Diseases (WJCD) , 2018, DOI: 10.4236/wjcd.2018.82012
Abstract: Background: Venous thromboembolism (VTE) is a major cause of morbidity and mortality worldwide. It is also the most common complication in hospitalized patients. Aims:?To?study the in-hospital prevalence of VTE, describe the socio-demographic characteristics of patients, determine the frequency of risk factors, describe the clinical presentations, and determine the short term outcome of VTE in hospitalized patients in a low-income tertiary hospital setting.Methods: We carried out a cross-sectional descriptive retrospective study over a period of 6 years and 4 months (January 2008 to April 2014) in the Douala General HospitalCameroon. Patients were cases of confirmed venous thromboembolic disease (VTE).Results: A total of 78 case files were retained for this study, giving an in-hospital prevalence of 4.4 per 1000 admissions. There were 42 (53.8%) males and 36 (46.1%) females. Their ages ranged from 18 to 89 years (median: 53 years, [IQR: 40?-?61]).There were 37 (47.4%) cases of Deep Vein Thrombosis (DVT), 31 (39.7%) cases of Pulmonary Embolism (PE), and 10 (12.8%) cases of PE associated with DVT (12.8%). The main risk factors were obesity (44.9%), hypertension (37.2%), immobility (20.5%), and long-haul travel (17.9%). The most frequent clinical presentations in PE were dyspnea (80.5%) and chest pain (65.9%). There were 8 (10%) in-hospital deaths. Conclusion: About twelve cases of VTE are seen yearly at the DGH, with an in-hospital mortality of ten percent. Obesity and hypertension were the main risk factors, with dyspnea and chest pain being the main clinical manifestations in PE, and lower limb swelling the main symptom in DVT.
Epidemiologic Aspects of Atrial Fibrillation in a Tertiary Hospital in a Sub-Saharan Africa Setting  [PDF]
Félicité Kamdem, Ba Hamadou, Marius Kamdem, Christ Nadège Nganou, Anastase Dzudie, Yves Monkam, Samuel Kingue
Open Access Library Journal (OALib Journal) , 2017, DOI: 10.4236/oalib.1103384
Background: Atrial fibrillation (AF) is the most frequent sustained arrhythmia. The prevalence is increasing with that of other cardiovascular risk factors in our low-income setting. It is potentially serious due to the associated complications. Few data exist on the epidemiology of AF in Sub-Saharan Africa (SSA). Methodology: We carried out a cross-sectional study between 2005 and 2009 in the Cardiology Unit of the Douala General Hospital. Patients were adults ≥ 18 years of both sex, who had an ECG diagnosis of Atrial Fibrillation and a comprehensive investigation of the cause of AF. Results: A total of 2581 patients were seen in this unit, of whom 182 (7.1%, [95%: 6.1-8.1]) had AF. Their mean age was 59.2 ± 15.4 years, and there were 100 (58.2%, [95% CI: 51-65.6], p = 0.002) females. Hypertension was the most frequent risk factor (77.3%, [95% CI: 70.3-82.8]), and 163 (95.3%, [95% CI: 90.7-97.8]) of the patients were symptomatic. Hypertensive heart disease (45.6%, [95% CI: 38.3-53.1]), idiopathic dilated cardiomyopathy (19.3%, [95% CI: 14.1-25.9]), and valvular heart disease (16.4%, [95% CI: 11.6-22.6]) were the main etiologic factors of AF. The most frequent complications were heart failure seen in 77 (45%, [37.8-52.5]) and ischemic stroke in 27 (15.5%, [95% CI: 11.1 - 22]) of patients. Digoxine was prescribed in 121 (70.8%, [95% CI: 63.6-77.1]) patients to control heart rate, while amiodarone was prescribed in 67 (29.2%, [95% CI: 32.2-46.7]) patients to revert to sinus rhythm. No electrical cardioversion was carried out. Aspirine was prescribed in 119 (69.6%, [95% CI: 62.3-76]) patients, and anti-vitamin K in 53 (30.4%, [95% CI: 24.5-38.3]) patients. Conclusion: Atrial fibrillation was seen in seven percent of patients in the Cardiology Unit of this low-income setting. Patients were relatively young compared with high income settings. Hypertension, idiopathic dilated cardiomyopathy, and valvular heart disease were the main causes. Rate control was the main treatment strategy. Oral anti-coagulants were less frequently used.

Relationship between Children’s Body Mass Index and Parents’ Obesity and Socioeconomic Status: A Multilevel Analysis Applied with Luxembourg Data  [PDF]
Anastase Tchicaya, Nathalie Lorentz
Health (Health) , 2014, DOI: 10.4236/health.2014.617267
Abstract: Obesity in children is a health crisis because the problem is increasing in most developed countries. This study measures the relationship between body mass index (BMI) of children aged 7 - 12 years residing in Luxembourg and the weight and socioeconomic status of their parents. The data used are from the 2007 Socio-Economic Panel Liewen zu L?tzebuerg/European Union-Statistics on Income and Living Conditions survey, which covers a population of approximately 10,000 people. The study sample includes 775 children whose weight and height were recorded to calculate their BMI. The descriptive analysis with the socioeconomic distribution of the children’s BMI and the multilevel logistic regression of the probability to be in overweight or obese were performed. The mean BMI of children was 17.4 kg/m2 for boys and girls. The prevalence of overweight was 21.2% (including 3% who were obese). Weight status, educational level, physical activity, and eating habits of parents were associated with BMI in children. Furthermore, children of foreign nationality had 2.9 times more risk to be overweight or obese than other children of Luxembourg nationality (OR = 2.90, 95%CI: 1.38 - 6.10). Children living in household with at least one parent who was obese were 6.51 times more likely to be in overweight or obese compared to those in household with both parents normal (OR = 6.51, 95%CI: 2.48 - 17.08). Overall, nationality and weight status of parents were the main determinants of children’s weight status. Promoting healthy diets and regular physical activity and educating parents on the consequences of overweight and obesity on children’s health in adulthood are effective strategies to control overweight and obesity.
Epidemiology, Clinical and Paraclinical Presentations of Pulmonary Embolism: A Cross-Sectional Study in a Sub-Saharan Africa Setting  [PDF]
Bertrand Hugo Mbatchou Ngahane, Félicité Kamdem, Silvain Raoul Simeni Njonnou, Nina Chebou, Anastase Dzudie, Serge Arnold Ebongue, Bruno Tengang, Fernando Kemta Lekpa, Yacouba Mapoure Njankouo, Sidick Mouliom, Henri Roger Ngote, Henry Luma Namme
Open Journal of Respiratory Diseases (OJRD) , 2019, DOI: 10.4236/ojrd.2019.93008
Abstract: Background: Venous thromboembolic (VTE) disease burden is increasing worldwide, representing a major cause of cardiovascular death and public health problem. Pulmonary embolism (PE) is the most serious clinical presentation of VTE. Epidemiological and clinical data on PE are still lacking in Africa, particularly in Cameroon. This study aimed at determining the clinical features as well as imaging presentation and outcome of pulmonary embolism. Methods: A cross-sectional study was carried out in three hospitals in Douala. We retrospectively reviewed patient records admitted for PE from January 2009 to May 2017. We collected data on epidemiology, clinical presentation, venous Doppler/pulmonary computed tomographic angiography (CTA), and outcome. Results: We included 103 patients (56 males) with PE. Their median age was 52 years. The main risk factors were obesity (49.5%), hypertension (35.0%), long trip (24.3%) and cancer (18.4%). The most frequent clinical presentations were dyspnoea (83.4%), chest pain (78.6%), and cough (40.8%). Additionally, pleural effusion (32.8%), atelectasis (25.7%) and pulmonary hyperlucency (20.0%) were the most frequent findings on chest X-ray. The main abnormalities found in electrocardiogram were sinus tachycardia (63.4%), S1Q3T3 aspect (37.6%) and right axial deviation (28.7%). Moreover, right cavities dilatation (26.0%), pulmonary artery hypertension (35.0%) and pulmonary artery dilatation (21.0%) were the main echocardiographic findings. Low-molecular-weight heparin (LMWH) was the initial anticoagulant in all cases. There were 19 (18.4%) in-hospital deaths, and the mean hospital stay was 8.5 ± 5 days. Conclusion: PE is not rare in our setting. Obesity, long trip and cancer are the main risk factors, while dyspnoea, chest pain and respiratory distress are the main clinical presentation for PE. LMWH remains the therapeutic agent of choice. Lastly, in-hospital mortality is very high.
Recent results in hyperring and hyperfield theory
Anastase Nakassis
International Journal of Mathematics and Mathematical Sciences , 1988, DOI: 10.1155/s0161171288000250
Abstract: This survey article presents some recent results in the theory of hyperfields and hyperrings, algebraic structures for which the “sum ” of two elements is a subset of the structure. The results in this paper show that these structures cannot always be embedded in the decomposition of an ordinary structure (ring or field) in equivalence classes and that the structural results for hyperfields and hyperrings cannot be derived from the corresponding results in field and ring theory.
A topological property of 2(N)
Anastase Nakassis
International Journal of Mathematics and Mathematical Sciences , 1980, DOI: 10.1155/s0161171280000518
Abstract: In this paper we prove that the Stone-Cech-compactification of the natural numbers does not admit a countable infinite decomposition into subsets homeomorphic to each other and to the said compactification.
What Is the Role of Work-Related Factors in Self-Reported Health Inequalities among Employed Individuals? A Longitudinal Study in Luxembourg  [PDF]
Anastase Tchicaya, Nathalie Lorentz, Kristell Leduc
Health (Health) , 2018, DOI: 10.4236/health.2018.109087
Abstract: Objectives: We measured health inequalities among employed Luxembourg residents over time and the socio-economic and work-related determinants. Design and Setting: Longitudinal data were obtained from the Socio-economic Liewen zu Lëtzebuerg/European Union Survey on Income and Living Conditions, which has been conducted each year since 2003 in Luxembourg. Participants: Participants comprised 727 Luxembourg residents (58% men), aged between 21 and 55 years in 2003, who were employed between 2003 and 2012. Primary and Secondary Outcomes Measured: The variable of interest was self-reported health. We used transition indicators on work-related factors to consider changes that individuals may have experienced in their job over this period. Results: People who moved from a part-time to a full-time contract (odds ratio (OR): 5.52, confidence interval (CI): 1.55 - 19.73), and those who moved from the 3rd or 4th quartile of earnings to the 1st or 2nd quartile (OR: 2.48, CI: 1.02 - 6.05) between 2003 and 2012, had a higher risk of being in poor health in 2012. The risk of deterioration in self-reported health in 2012 among people who were healthy in 2003 was associated with the type of contract, economic activity, and occupation. Conclusion: Health inequalities occur among employed people in Luxembourg. Their importance varies according to work-related characteristics and economic activity. Our findings showed that declined health status was associated with contract type, profession, and economic activity. This suggests that measures should be taken to maintain good health for people working in these specific occupations or economic sectors (e.g. preventive action, reduction of risk exposure, change of occupation in the same company, and so on).
Effect of Salting Methods on Quality of Smoked Dry Laked Fish
Tenin Dzudie,Joel Scher
Journal of Food Technology , 2013,
Abstract: Tilapia species (Dreochromis aureus) were used in the present study. They were randomly allocated to three treatment groups of non-salted, brine-salted and dry-salted fishes. Loss in weight was greatest during smoking and least during drying. The pH of the fresh tilapia as well as that of the smoke-dried one increased with the level of salt in the products. Methods of salting the fishes significantly (P<0.05) affected the levels of lipid oxidation. Smoking of the fishes exhibited greater antioxidant activity. In respect of the overall acceptability, brine-salted and smoked tilapia was rated higher than the other two samples.
Socioeconomic inequality and obesity prevalence trends in luxembourg, 1995–2007
Anastase Tchicaya, Nathalie Lorentz
BMC Research Notes , 2012, DOI: 10.1186/1756-0500-5-467
Abstract: The data used in this study were taken from 2 surveys on household income and living conditions conducted in 1995 and 2007. The target population was household residents aged 16?years and older, and body mass index (BMI) data were self-reported. Average BMI, overweight, and obesity prevalence rates were calculated according to each demographic (gender, nationality, marital status), SES (educational level, profession, and place of residence), and behavioural (physical activity and diet) factors. A multivariate logistic regression analysis was conducted to measure the relationship between obesity and demographic, SES, and behavioural factors. All analyses were conducted according to gender, and data used were weighted.Between 1995 and 2007, the average BMI remained nearly constant among men and women in the entire study population. Obesity prevalence increased by 24.5% through the study period (14.3% in 1995 to 17.8% in 2007). Obesity prevalence increased by 18.5% for men (15.1% in 1995 to 17.9% in 2007) and by 30% for women (13.6% in 1995 to 17.7% in 2007). Between 1995 and 2007, obesity increased sharply by 48.2% (from 11% to 16.3%) in Portuguese men, 76.7% (from 13.3% to 23.5%) in Portuguese women, 79.7% (from 17.2% to 30.9%) in widowed men, and 84.3% (from 12.1% to 22.3%) in divorced women. Multivariate logistic regression analysis showed that the relationship between the educational level and obesity was not statistically significant for men, but was significant for women.The prevalence of overweight and obesity is high in Luxembourg and has changed slightly in recent years. SES inequalities in obesity exist and are most compelling among women. The fight against obesity should focus on education, with emphasis on the socially disadvantaged segment of the population.Overweight and obesity are gradually becoming highly critical health problems in most developed countries [1]. In 1997, the World Health Organization (WHO) reported that obesity is a chronic disease an
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