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Search Results: 1 - 10 of 427981 matches for " Peter M Ndumbe "
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An update of malaria infection and anaemia in adults in Buea, Cameroon
Ebako N Takem, Eric A Achidi, Peter M Ndumbe
BMC Research Notes , 2010, DOI: 10.1186/1756-0500-3-121
Abstract: A cross-sectional study was carried out from November 2007 to July 2008 in health units in Buea, Cameroon. Adult patients with fever or history of fever were included in the study. Information on socio-demographic variables and other variables was collected using a questionnaire. Malaria parasitaemia status was determined by microscopy using Giemsa stained thick blood smears. Haemoglobin levels were determined by the microhaematocrit technique.The study population consisted of 250 adult patients with a mean age of 29.31 years (SD = 10.63) and 59.44% were females. 25.60% of the patients had malaria parasitaemia while 14.80% had anaemia (haemoglobin < 11 g/dl). Logistic regression revealed that those with malaria parasitaemia had more anaemia compared to those without malaria parasitaemia(OR = 4.33, 95%CI = 1.21-15.43, p = 0.02) after adjusting for age, sex, rural residence, socioeconomic status, use of antimalarials, use of insecticide treated nets(ITN) and white blood cell count.In adult patients with fever in this setting, malaria parasitaemia contributes to anaemia and is of public health impact. Our results also provide a baseline prevalence for malaria parasitaemia in febrile adults in health units in this setting.Anaemia is frequent in developing countries and its aetiology is usually multifactorial. The most important factors that contribute to anaemia include parasitic infections, HIV infection, chronic inflammatory disorders, micronutrient deficiencies and genetic disorders [1-6]. The main parasitic infections include malaria and helminth infections [7-11].Malaria related anaemia is associated with many factors which involve increased destruction and reduced production of red blood cells(RBCs) [12]. The relationship between malaria parasitaemia and haemoglobin has been well documented in previous studies in pregnant women [11,13-20]. Fewer previous studies in developing countries have involved non-pregnant adults [21-25]. Updating the role of malaria parasit
Bacteriuria amongst Pregnant Women in the Buea Health District, Cameroon: Prevalence, Predictors, Antibiotic Susceptibility Patterns and Diagnosis
Morike Ngoe Mokube, Julius Atashili, Gregory Edie Halle-Ekane, George M. Ikomey, Peter M. Ndumbe
PLOS ONE , 2013, DOI: 10.1371/journal.pone.0071086
Abstract: Background Bacteriuria is associated with significant maternal and foetal risks. However, its prevalence is not known in our community. Objectives This study was carried out to determine the prevalence and predictors of bacteriuria in pregnant women of the Buea Health District (BHD) as well as the antibiotic sensitivity patterns of bacterial isolates. It also sought to determine the diagnostic performance of the nitrite and leucocyte esterase tests in detecting bacteriuria in these women. Methods An observational analytic cross-sectional study was carried out amongst pregnant women attending selected antenatal care centres in Buea. We recruited 102 consenting pregnant women for the study. Demographic and clinical data were collected using structured questionnaires. Clean catch midstream urine was collected from each participant in sterile leak proof containers. Samples were examined biochemically, microscopically and by culture. Significant bacteriuria was defined as the presence of ≥108 bacteria/L of cultured urine. Identification and susceptibility of isolates was performed using API 20E and ATB UR EU (08) (BioMerieux, Marcy l'Etoile, France). Results Significant bacteriuria was found in the urine of 24 of the 102 women tested giving a bacteriuria prevalence of 23.5% in pregnant women of the BHD. Asymptomatic bacteriuria was detected in 8(7.8%) of the women. There was no statistically significant predictor of bacteriuria. Escherichia coli were the most isolated (33%) uropathogens and were 100% sensitive to cefixime, cefoxitin and cephalothin. The nitrite and leucocyte esterase tests for determining bacteriuria had sensitivities of 8%, 20.8% and specificities of 98.7% and 80.8% respectively. Conclusion Bacteriuria is frequent in pregnant women in the BHD suggesting the need for routine screening by urine culture. Empiric treatment with cefixime should be instituted until results of urine culture and sensitivity are available. Nitrite and leucocyte esterase tests were not sensitive enough to replace urine culture as screening tests.
Individual and Contextual Factors Associated with Low Childhood Immunisation Coverage in Sub-Saharan Africa: A Multilevel Analysis
Charles S. Wiysonge, Olalekan A. Uthman, Peter M. Ndumbe, Gregory D. Hussey
PLOS ONE , 2012, DOI: 10.1371/journal.pone.0037905
Abstract: Background In 2010, more than six million children in sub-Saharan Africa did not receive the full series of three doses of the diphtheria-tetanus-pertussis vaccine by one year of age. An evidence-based approach to addressing this burden of un-immunised children requires accurate knowledge of the underlying factors. We therefore developed and tested a model of childhood immunisation that includes individual, community and country-level characteristics. Method and Findings We conducted multilevel logistic regression analysis of Demographic and Health Survey data for 27,094 children aged 12–23 months, nested within 8,546 communities from 24 countries in sub-Saharan Africa. According to the intra-country and intra-community correlation coefficient implied by the estimated intercept component variance, 21% and 32% of the variance in unimmunised children were attributable to country- and community-level factors respectively. Children born to mothers (OR 1.35, 95%CI 1.18 to 1.53) and fathers (OR 1.13, 95%CI 1.12 to 1.40) with no formal education were more likely to be unimmunised than those born to parents with secondary or higher education. Children from the poorest households were 36% more likely to be unimmunised than counterparts from the richest households. Maternal access to media significantly reduced the odds of children being unimmunised (OR 0.94, 95%CI 0.94 to 0.99). Mothers with health seeking behaviours were less likely to have unimmunised children (OR 0.56, 95%CI 0.54 to 0.58). However, children from urban areas (OR 1.12, 95% CI 1.01 to 1.23), communities with high illiteracy rates (OR 1.13, 95% CI 1.05 to 1.23), and countries with high fertility rates (OR 4.43, 95% CI 1.04 to 18.92) were more likely to be unimmunised. Conclusion We found that individual and contextual factors were associated with childhood immunisation, suggesting that public health programmes designed to improve coverage of childhood immunisation should address people, and the communities and societies in which they live.
Prevalence and Predictors of Major Depression in HIV-Infected Patients on Antiretroviral Therapy in Bamenda, a Semi-Urban Center in Cameroon
Bradley N. Gaynes,Brian W. Pence,Julius Atashili,Julie O’Donnell,Dmitry Kats,Peter M. Ndumbe
PLOS ONE , 2012, DOI: 10.1371/journal.pone.0041699
Abstract: Recent blue-ribbon panel reports have concluded that HIV treatment programs in less wealthy countries must integrate mental health identification and treatment into normal HIV clinical care and that research on mental health and HIV in these settings should be a high priority. We assessed the epidemiology of depression in HIV patients on antiretroviral therapy in a small urban setting in Cameroon by administering a structured interview for depression to 400 patients consecutively attending the Bamenda Regional Hospital AIDS Treatment Center. One in five participants met lifetime criteria for MDD, and 7% had MDD within the prior year. Only 33% had ever spoken with a health professional about depression, and 12% reported ever having received depression treatment that was helpful or effective. Over 2/3 with past-year MDD had severe or very severe episodes. The number of prior depressive episodes and the number of HIV symptoms were the strongest predictors of past-year MDD. The prevalence of MDD in Cameroon is as high as that of other HIV-associated conditions, such as tuberculosis and Hepatitis B virus, whose care is incorporated into World Health Organization guidelines. The management of depression needs to be incorporated in HIV-care guidelines in Cameroon and other similar settings.
Yellow fever control in Cameroon: Where are we now and where are we going?
Charles Wiysonge, Emmanuel Nomo, Jeanne Mawo, James Ofal, Julienne Mimbouga, Johnson Ticha, Peter M Ndumbe
BMC Medicine , 2008, DOI: 10.1186/1741-7015-6-3
Abstract: In January 2003, case-based surveillance of suspected yellow fever cases was instituted in the whole country. A year later, yellow fever immunisation at nine months of age (the same age as routine measles immunisation) was introduced. Supplementary immunisation activities (SIAs), both preventive and in response to outbreaks, also formed an integral part of the yellow fever control plan. Each level of the national health system makes a synthesis of its activities and sends this to the next higher level at defined regular intervals; monthly for routine data and daily for SIAs.From 2004 to 2006 the national routine yellow fever vaccination coverage rose from 58.7% to 72.2%. In addition, the country achieved parity between yellow fever and measles vaccination coverage in 2005 and has since maintained this performance level. The number of suspected yellow fever cases in the country increased from 156 in 2003 to 859 in 2006, and the proportion of districts that reported at least one suspected yellow fever case per year increased from 31.4% to 68.2%, respectively. Blood specimens were collected from all suspected cases (within 14 days of onset of symptoms) and tested at a central laboratory for yellow fever IgM antibodies; leading to confirmation of yellow fever outbreaks in the health districts of Bafia, Méri and Ntui in 2003, Ngaoundéré Rural in 2004, Yoko in 2005 and Messamena in 2006. Owing to constraints in rapidly mobilising the necessary resources, reactive SIAs were only conducted in Bafia and Méri several months after confirmation of the outbreak. In both districts, a total of 60,083 people (representing 88.2% of the 68,103 targeted) were vaccinated. Owing to the same constraints, SIAs were not conducted promptly in response to the outbreaks in Ntui, Ngaoundéré Rural, Yoko and Messamena. However, these four and two other health districts at high risk of yellow fever outbreaks (i.e. Maroua Urban and Ngaoundéré Urban) conducted preventive SIAs in November 2006, vacc
Some social determinants of urinary schistosomiasis in Northern Cameroon : implications for schistosomiasis control
Innocent Takougang, Jean Meli, Siméon Fotso, Fru Angwafo, Raoul Kamajeu, Peter M Ndumbe
African Journal of Health Sciences , 2004,
Abstract: The present study was designed to assess the perceptions of hematuria, the most conspicuous sign of urinary schistosomiasis, in selected communities of the sudano-sahelian zone of Cameroon. Study questionnaires related to knowledge, beliefs and stigma associated with hematuria were administered to 964 pupils from 15 randomly selected schools. In order to ascertain children perceptions, we interviewed 143 adults living less than 2 kilometers from the target school. School children provided urine samples that were examined using the dip stick and sedimentation methods. Exposure to sun was the most reported cause of hematuria (53% adult and 62% children respondents), followed by drinking of dirty water (18% adults and 41% children). Only 15% of adult and 26% school children could relate hematuria to wading, a common means of exposure to urinary schistosomiasis. More than half of the school children stated that hematuria was a sign of disease (56%). Few pupils perceived hematuria to be a sign of strength (6%), while others related it to puberty (30%). Most pupils (80%) reported that hematuria was preventable while others (20%) ascribed it to witchcraft. Pupils reported that hematuria could be cured in the hospital (65%), by the traditional healer (21%), or by reading Holy Scriptures (14%). Some respondents (35% of adult, and 40% of school children) stated that it was shameful to have blood in urine. Almost half of the adult respondents and 26% of the school children reported that hematuria was contagious. Boys and girls had similar levels of oviuria (OR=0.79 p>0.05), but boys were 4 times more likely to report hematuria (OR=3.62, p<0.001). There was a poor understanding of the means of exposure, transmission and treatment of hematuria. Some aspects of the perceptions of hematuria reported herein corroborate with previous studies carried out in Cameroon, Niger, Ghana, Kenya and Tanzania. They should be considered, together with other socioeconomic and cultural determinants in the design of educational messages applicable to the study region. African Journal of Health Sciences Vol. 11(3-4) 2004: 111-120
Hematuria and dysuria in the self-diagnosis of urinary chistosomiasis among school-children in Northern Cameroon
Innocent Takougang, Jean Meli, Siméon Fotso, Fru Angwafo, Raoul Kamajeu, Peter M Ndumbe
African Journal of Health Sciences , 2004,
Abstract: The present study was designed to assess the value of self reported hematuria and dysuria in the diagnosis of urinary schistosomiasis at the individual level. A sample of 964 school children of grade 5 and 6 from 15 schools of the French speaking educational system in the Sudano-sahelian zone of northern Cameroon were submitted to a questionnaire related to hematuria and dysuria, and provided a urine sample each. The urine samples were processed using the dip stick and sedimentation methods, and the degree of microhematuria andoviuria determined. In all 964 questionnaires were collected, 843 urine samples examined for microhematuria and 871 for oviuria. The percentage of children reporting hematuria increased with the degree of microhematuria and the intensity of infection. Among the various indicators of urinary schistosome infection, microhematuria had the highest sensitivity (76%), followed by self reported hematuria or dysuria (65%), and dysuria (52%). The specificity was highest for self reported hematuria, and lowest for self reported hematuria or dysuria. The efficiency of self reported hematuria or dysuria increased with the intensity of infection and was highest (100%) for heavy infections (>400 eggs/ml g urine). We advocate the use of self reported hematuria or dysuria for the assessment of S. haematobium at the individual level. African Journal of Health Sciences Vol. 11(3-4) 2004: 121-127
Impact of Malaria on Hematological Parameters in People Living with HIV/AIDS Attending the Laquintinie Hospital in Douala, Cameroon
Gervais Gouana Tchinda, Julius Atashili, Eric A. Achidi, Henri L. Kamga, Anna L. Njunda, Peter M. Ndumbe
PLOS ONE , 2012, DOI: 10.1371/journal.pone.0040553
Abstract: Background People living with HIV/AIDS (PLWHA) frequently have abnormal blood counts including anemia, leucopenia and thrombocytopenia. The role of infection with plasmodia on these hematological parameters in PLWHA is not well known. In this study we compared selected hematological parameters between malaria positive and negative PLWHA. Methods We conducted a cross-sectional study of PLWHA attending the Douala Laquintinie hospital. After obtaining consent, demographic and clinical data were obtained via a standardized questionnaire. Blood samples collected for hematological assays were run using an automated full blood counter. Malaria parasitaemia was determined by blood smear microscopy. Results A total of 238 adult PLWHA were enrolled, 48.3% of who were on antiretroviral therapy and 24.8% of whom had malaria parasitaemia. The respective mean (±SD) of hemoglobin level, RBC count, WBC count, platelet count, lymphocyte count and CD4+ T cell counts in malaria co-infected patients versus non-infected patients were: 10.8(±1.9) g/dl versus 11.4(±2.0)g/dl; 3,745,254(±793,353) cells/μl versus 3,888,966(±648,195) cells/μl; 4,403(±1,534) cells/μl versus 4,920(±1,922) cells/μl; 216,051(±93,884) cells/μl versus 226,792(±98,664) cells/μl; 1,846(±711) cells/μl versus 2,052(±845) cells/μl and 245(±195) cells/μl versus 301(±211) cells/μl. All these means were not statistically significantly different from each other. Conclusion There was no significant difference in studied hematological parameters between malaria positive and negative PLWHA. These data suggest little or no impact of malaria infection. Hematological anomalies in PLWHA in this area need not be necessarily attributed to malaria. These need to be further investigated to identify and treat other potential causes.
Plasma concentrations of soluble Fas receptors (Fas) and Fas ligands (FasL) in relation to CD4+ cell counts in HIV-1 positive and negative patients in Yaounde, Cameroon
George M Ikomey, Marie-Claire Okomo-Assoumou, Julius Atashili, Martha T Mesembe, Bertha Mukwele, Emilia Lyonga, Agnes Eyoh, Peter M Ndumbe
BMC Research Notes , 2012, DOI: 10.1186/1756-0500-5-322
Abstract: In a cross-sectional study, 39 antiretroviral na?ve HIV-1 positive and negative participants were recruited in Yaounde, Cameroon. CD4+ lymphocyte cell counts were quantified from whole blood using an automated FACScount machine (Becton-Dickinson, Belgium). Plasma samples obtained were analyzed for soluble Fas receptors and Fas ligands in both HIV-1 positive and negative samples using two different quantitative sandwich ELISA kits (Quantikine?, R&D Systems , UK).Plasma levels of Fas receptors were higher in HIV-1 positive patients (median?=?1486pg/ml IQR?=?1193, 1830pg/ml) compared to HIV-negative controls (median?=?1244pg/ml, IQR?=?1109, 1325pg/ml), p-value <0.001. Plasma levels of Fas ligands were also higher in HIV-1 positive patients (median?=?154pg/ml, IQR?=?111, 203pg/ml) compared to HIV-negative controls (median?=?51pg/ml, IQR?=?32, 88pg/ml), p-value?=?0.005. Plasma concentrations of soluble fas receptors and ligands tended to be negatively correlated with the CD4+ cell counts of HIV-positive patients; the correlation coefficients were -0.34 (value?=?0.78) and-0.3 (p-value?=?0.51) respectively.In this population of patients in Cameroon, plasma concentrations of Fas receptors and Fas ligands tend to be higher in HIV-positive patients. The Fas pathway of apoptosis may have a role in the depletion of CD4+ cell countsInfection with human immunodeficiency virus type 1 (HIV-1) is characterised by a gradual and progressive CD4+ T-helper cell depletion [1]. The Fas mediated mechanism of apoptosis during activation induced cell death (AICD) system is a key regulator of apoptosis in normal and malignant T cells [2,3]. Many studies have shown that the mechanism of T-cell receptor(TCR)-triggered activated induce cell death (AICD) in peripheral T-cell mediated via CD95 receptor/ligand interaction are up regulated and involved in this loss of CD4+ cells in HIV-1 infected patients[2,4]. All T-lymphocytes cells express the CD95 cell-surface receptor, a member of the TNF-R/NGT
Age trends in the prevalence of cervical squamous intraepithelial lesions among HIV-positive women in Cameroon: a cross-sectional study
Julius Atashili, William C Miller, Jennifer S Smith, Peter M Ndumbe, George M Ikomey, Joseph Eron, Allen C Rinas, Evan Myers, Adaora A Adimora
BMC Research Notes , 2012, DOI: 10.1186/1756-0500-5-590
Abstract: We enrolled, interviewed and conducted conventional cervical cytology in 282 women, aged 19–68 years, initiating antiretroviral therapy in three clinics in Cameroon. In bivariable analyses, the crude relationship between age and the presence of lesions was assessed using locally weighted regression (LOWESS) methods. In multivariate analyses, generalized linear models with prevalence as the outcome, an identity link and a binomial distribution, were used to estimate prevalence differences. Bias analyses were conducted to assess the potential effect of inaccuracies in cytology.SIL were detected in 43.5% of the 276 women with satisfactory samples, 17.8% of whom had ASC-H/HSIL. On average, women aged 26 to 59 tended to have a slightly higher prevalence of any SIL than other women (Prevalence difference PD: 6.5%; 95%CI: -11.4, 24.4%). This PD was a function of CD4 count (heterogeneity test p-value =0.09): amongst patients with CD4 counts less than 200cells/uL, the prevalence was higher in patients aged 26–59, while there was essentially no difference amongst women with CD4 counts greater than 200 cells/uL. ASC-H/HSIL were present in women as young as 19 and as old as 62. Overall the prevalence of ASC-H/HSIL increased by 0.7% (95%CI: -3.8%, 5.1%) per decade increase in age.Both severe and less severe lesions were prevalent at all ages suggesting little utility of age-targeted screening among HIV-positive women. Nevertheless, the long-term evolution of these lesions needs to be assessed in prospective studies.Cervical cancer is the second most common cancer in women worldwide [1]. Although cervical cancer incidence and mortality is higher in HIV-positive women, resource limitations restrict the implementation of systematic screening programs in these women in developing countries. With the recent increase in access to antiretroviral therapy HIV-positive women are expected to live longer, potentially allowing sufficient time for cervical cancer to develop. Targeted screenin
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