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Search Results: 1 - 10 of 383607 matches for " Robert J. I. Leke "
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Effects of gestational weight gain on the outcome of labor at the Yaounde central hospital maternity, Cameroon  [PDF]
Robinson E. Mbu, Hortence J. Fouedjio, Mpey Tabot, Fluorbert Y. Fouelifack, Florence N. Tumasang, Rebecca N. Tonye, Robert J. I. Leke
Open Journal of Obstetrics and Gynecology (OJOG) , 2013, DOI: 10.4236/ojog.2013.39118

Obesity rates are increasing in Cameroon. Obstetric literature has recently focused on the rising incidence of complications with increases in weight gain in pregnancy. Some of these complications include gestational diabetes, hypertensive disorders, operative deliveries, genital tract lacerations and fetal birth trauma. Examining the effects of excess weight gain during the course of pregnancy could help identify weight gain limits. The Institute of Medicine (IOM) was recommended by the World Health Organization (WHO) to develop guidelines for weight gain during pregnancy and we designed this study in order to determine delivery outcomes when weight is gained above these guidelines. We also sought to know if these guidelines are applicable in our environment. In this cross-sectional analytic design, pre-pregnancy and intra-partum BMIs were calculated for all the parturients who consented. They were classified into normal weight gain and excessive weight gain based on IOM recommendations. Those in the normal weight gain group were women with BMIs that ranged between 18.5 kg/m2 and 30 kg/m2 and who gained 9 - 16 kgs. Those who gained weight above these range were considered as having gained excessive weight during pregnancy. They were all follow-up in labor using the partogram. We compared prepartum, intra-partum and post-partum outcomes in the two groups by calculating odds ratios (ORs), 95% confidence intervals and p values. One hundred and ten (110) overweight women were matched against the same number of women who had normal weight gain. There was no significant difference between social status, marital status as well as level of educational and weight gain in the two groups. Underweight (BMI < 18.5), was strongly associated with excessive weight gain (OR 2.5, 95% CI 1 - 6 and p = 0.048). Women who gained weight above the recommended range suffered from preeclampsia 18.2% vs. 6.4% (OR 3.2, 95% CI 1.3 - 8.0, p = 0.014), higher cesarean section rates 27.3% vs. 10% (OR 3.3, 95% CI 1.5 - 7.1,

Reproductive Health Needs of Women Living with HIV/AIDS in Yaounde, Cameroon  [PDF]
Robinson E. Mbu, William A. Takang, Hortence J. Fouedjio, Ekane Joan, Flobert Y. Fouelifack, Florence N. Tumasang, Rebecca N. Tonye, Robert J. I. Leke
World Journal of AIDS (WJA) , 2014, DOI: 10.4236/wja.2014.41002

The population plagued with the HIV/AIDS pandemic in Cameroon is young, a generation that may desire or control fertility. For those who may become pregnant, the desire to have children may not be there. We carried out this study to look at the picture of the reproductive health needs of women living with HIV/AIDS in our setting. In this cross-sectional non-analytic design that lasted for three years, we employed both qualitative and quantitative methods to collect data from them after receiving ethical clearance (N221/CM/2009) from the National Ethics Committee. Consenting HIV infected women who were attending the “HIV Day Care” clinics and those who delivered and were in the post partum wards in four of our major hospitals in Yaounde were enrolled. Interviews were individualized. We used both CSPro version 4.1 and Statistical Package for Social Sciences (SPSS) version 19.0 softwares for data analysis. Four hundred and fifteen (415) women were enrolled; the mean age was 29 ± 7.8 years; the most represented age group was 24 -29 years. They were single (36.14%), well educated (5 out of 10 had attained university level of education), 61.20% revealed that their partners knew their HIV status, 82.4% believed that screening for cancer of the cervix was necessary for their status and 47.70% would want to be screened for some or all STIs. About 36.86% had the desire to have children, 57.1% of those who delivered did not plan to have the pregnancies out of which 82% would have wanted a modern method of contraception but did not have (82% unmet needs). Modern contraceptive use was associated with age and individual characteristics such as level of education. It was 64.34% among women who had secondary level of education and below as against 35.66% among those who had high school level of education and above. Contraceptive use was also high among women who were unmarried as against those who were married (89.64% vs 10.36%). The desire to have children decreased as age increased (43.85% vs 18.79%) and was lower among married women compared to those who were single (13.01% versus 49.64%). These women were found to have high unmet needs for modern contraception and showed interest in STIs and cervical cancer screening.

Circulating Soluble Endoglin Levels in Pregnant Women in Cameroon and Malawi—Associations with Placental Malaria and Fetal Growth Restriction
Karlee L. Silver, Andrea L. Conroy, Rose G. F. Leke, Robert J. I. Leke, Philomina Gwanmesia, Malcolm E. Molyneux, Diane Taylor Wallace, Stephen J. Rogerson, Kevin C. Kain
PLOS ONE , 2011, DOI: 10.1371/journal.pone.0024985
Abstract: Placental infections with Plasmodium falciparum are associated with fetal growth restriction resulting in low birth weight (LBW). The mechanisms that mediate these effects have yet to be completely described; however, they are likely to involve inflammatory processes and dysregulation of angiogenesis. Soluble endoglin (sEng), a soluble receptor of transforming growth factor (TGF)-β previously associated with preeclampsia in pregnant women and with severe malaria in children, regulates the immune system and influences angiogenesis. We hypothesized that sEng may play a role in development of LBW associated with placental malaria (PM). Plasma levels of sEng were measured in women (i) followed prospectively throughout pregnancy in Cameroon (n = 52), and (ii) in a case-control study at delivery in Malawi (n = 479). The relationships between sEng levels and gravidity, peripheral and placental parasitemia, gestational age, and adverse outcomes of PM including maternal anemia and LBW were determined. In the longitudinal cohort from Cameroon, 28 of 52 women (54%) experienced at least one malaria infection during pregnancy. In Malawi we enrolled two aparasitemic gravidity-matched controls for every case with PM. sEng levels varied over the course of gestation and were significantly higher in early and late gestation as compared to delivery (P<0.006 and P<0.0001, respectively). Circulating sEng levels were higher in primigravidae than multigravidae from both Cameroon and Malawi, irrespective of malarial infection status (p<0.046 and p<0.001, respectively). Peripheral parasitemia in Cameroonian women and PM in Malawian women were each associated with elevated sEng levels following correction for gestational age and gravidity (p = 0.006 and p = 0.033, respectively). Increased sEng was also associated with the delivery of LBW infants in primigravid Malawian women (p = 0.017); the association was with fetal growth restriction (p = 0.003) but not pre-term delivery (p = 0.286). Increased circulating maternal sEng levels are associated with P. falciparum infection in pregnancy and with fetal growth restriction in primigravidae with PM.
The Antibody Response of Pregnant Cameroonian Women to VAR2CSA ID1-ID2a, a Small Recombinant Protein Containing the CSA-Binding Site
Anna Babakhanyan, Rose G. F. Leke, Ali Salanti, Naveen Bobbili, Philomina Gwanmesia, Robert J. I. Leke, Isabella A. Quakyi, John J. Chen, Diane Wallace Taylor
PLOS ONE , 2014, DOI: 10.1371/journal.pone.0088173
Abstract: In pregnant women, Plasmodium falciparum-infected erythrocytes expressing the VAR2CSA antigen bind to chondroitin sulfate A in the placenta causing placental malaria. The binding site of VAR2CSA is present in the ID1-ID2a region. This study sought to determine if pregnant Cameroonian women naturally acquire antibodies to ID1-ID2a and if antibodies to ID1-ID2a correlate with absence of placental malaria at delivery. Antibody levels to full-length VAR2CSA and ID1-ID2a were measured in plasma samples from 745 pregnant Cameroonian women, 144 Cameroonian men, and 66 US subjects. IgM levels and IgG avidity to ID1-ID2a were also determined. As expected, antibodies to ID1-ID2a were absent in US controls. Although pregnant Cameroonian women developed increasing levels of antibodies to full-length VAR2CSA during pregnancy, no increase in either IgM or IgG to ID1-ID2a was observed. Surprisingly, no differences in antibody levels to ID1-ID2a were detected between Cameroonian men and pregnant women. For example, in rural settings only 8–9% of males had antibodies to full-length VAR2CSA, but 90–96% had antibodies to ID1-ID2a. In addition, no significant difference in the avidity of IgG to ID1-ID2a was found between pregnant women and Cameroonian men, and no correlation between antibody levels at delivery and absence of placental malaria was found. Thus, the response to ID1-ID2a was not pregnancy specific, but predominantly against cross-reactivity epitopes, which may have been induced by other PfEMP1 antigens, malarial antigens, or microbes. Currently, ID1-ID2a is a leading vaccine candidate, since it binds to the CSA with the same affinity as the full-length molecule and elicits binding-inhibitory antibodies in animals. Further studies are needed to determine if the presence of naturally acquired cross-reactive antibodies in women living in malaria endemic countries will alter the response to ID1-ID2a following vaccination with ID1-ID2a.
Twin gestation: Is induction of labor possible in highly selected cases?  [PDF]
R. E. Mbu, J. Fouedjio, Y. Fouelifack, J. T. Ngo Batta, F. N. Tumasang, S. N. Ako, R. N. Tonye, M. B. Mbu, R. J. I. Leke
Open Journal of Obstetrics and Gynecology (OJOG) , 2012, DOI: 10.4236/ojog.2012.23043
Abstract: Induction of labor has been in practice for several decades but the decision to induce labor in multifetal gestations has not been accepted by many practitioners in contemporary obstetrics. The aim of this study was to compare maternal and fetal outcomes among women with uncomplicated twin gestations who were induced at term and those who were not. It was a cross-sectional analytic study that lasted ten years, (1st January 2000 to 31st December 2009 inclusive) at the maternity of the central hospital, Yaounde, Cameroon. 158 women were enrolled, 79 were induced and 79 went into labor spontaneously. Maternal and fetal outcomes, duration of labor, the prevalence of caesarean section were compared in the two groups. The average age of the women in the groups was 26, 75 ± 3.65 years (range 15 - 41 years). For those who were induced, indication was premature rupture of membranes in 44 (56%) of cases. The characteristics of induced and none induced women were similar, except for the number of antenatal consultations (P ≤ 0.001). There was a significant difference in the duration of labor in the two groups (6 hrs versus 9, 75 hrs; P ≤ 0.001). The overall rate of vaginal delivery in the two groups was 87, 97% (n = 139), 88.87% in the group that was induced versus 86.07% in the group that labor was spontaneous (OR 1, 22; 95% IC 0, 51-2, 92; p ≤ 0.90). With respect to primary outcomes, there were no statistically significant differences between the group that labor was induced and that which labor was spontaneous. The prevalence of caesarean delivery was similar in the two groups (10%, 12% vs 13%, 92%; OR 0%, 7%; 95% IC 0, 27-1, 85; P ≤ 0.50). The main indications for caesarean section were acute fetal distress and failed induction. The first and fifth minute APGAR scores less than 7 in the first twins delivered in the two groups were similar. The 312 children delivered in both arms did not show any complications at birth. However, there were 3 neonatal deaths (1 vs 2). There were no cases of uterine rupture or maternal deaths among the 156 women. Induction of labor may be proposed to women with uncomplicated term twin gestations with specific indications. Induction in these highly selected cases does not impute any additional risks but close monitoring of labor is very necessary.
Gynaecological morbidity among HIV positive pregnant women in Cameroon
Enow R Mbu, Eugene J Kongnyuy, FX Mbopi-Keou, Rebecca N Tonye, Philip N Nana, Robert JI Leke
Reproductive Health , 2008, DOI: 10.1186/1742-4755-5-3
Abstract: Two thousand and eight (2008) pregnant women were screened for HIV, lower genital tract infections and lower genital tract neoplasia at booking antenatal visit.About 10% (198/2008) were HIV positive. All lower genital tract infections except candidiasis were more prevalent among HIV positive compared to HIV negative women: vaginal candidiasis (36.9% vs 35.4%; p = 0.678), Trichomoniasis (21.2% vs 10.6%; p < 0.001), gonorrhoea (10.1% vs 2.5%; p < 0.001), bacterial vaginosis (21.2% vs 15.2%; p = 0.026), syphilis (35.9% vs 10.6%; p < 0.001), and Chlamydia trachomatis (38.4% vs 7.1%; p < 0.001). Similarly, HIV positive women more likely to have preinvasive cervical lesions: low-grade squamous intraepithelial lesion (SIL) (18.2% vs 4.4%; p < 0.001) and high-grade squamous intraepithelial lesion (12.1% vs 1.5%; p < 0.001).We conclude that (i) sexually transmitted infections (STIs) are common in both HIV positive and HIV negative pregnant women in Cameroon, and (ii) STIs and preinvasive cervical lesions are more prevalent in HIV-infected pregnant women compared to their non-infected compatriots. We recommend routine screening and treatment of STIs during antenatal care in Cameroon and other countries with similar social profiles.There are three categories of reproductive morbidity – obstetric, gynaecological and contraceptive morbidity. Gynaecological morbidity has been defined as 'any condition, disease or dysfunction of the reproductive system that is not related to pregnancy, abortion or childbirth but may be related to sexual behaviour' [1].Gynaecological conditions are frequent in women infected with Human Immunodeficiency Virus (HIV). Both pregnancy and HIV/AIDS predispose women to certain gynaecological conditions because of modification of the immune system [2,3]. The Centers for Disease Control and Prevention (CDC) classification system for HIV infection includes several gynaecological conditions such as persistent, frequent or poorly responsive episodes of vaginal
Cord prolapse, associated factors and fetal outcome: a report of 47 cases from the Yaounde Central Hospital, Cameroon.
P.N Nana, P.M Tebeu, R.E Mbu, J.I Fomulu, R Leke
Clinics in Mother and Child Health , 2010,
Abstract: Cord prolapse is a condition in which the umbilical cord comes ahead of the presenting part. Fetal demise occurs as a consequence of the compression of the cord by the presenting part. We conducted this study to determine profile of pregnancy and its outcome at the Central Hospital Yaounde, Cameroon. This was an observational, descriptive and retrospective study of deliveries complicated by cord prolapse between January 2003 and December 2006 at the Central Maternity of the Central Hospital Yaounde. Data was retrieved from patient’s files, operation room registers and admission registers. During this period, there were a total of 6924 deliveries amongst which 47 were complicated by umbilical cord prolapse (2.8 per 1000 deliveries). Among the women with cord prolapse, 62.2% were delivered by emergency caesarean section. Fetal demise was reported in 32 % of the women upon admission. An abnormal pelvis was seen in 25.5% of the women. Artificial rupture of membranes was carried out in 40.4%. This study shows that cord prolapse is associated with severe fetal consequences in our unit. A good knowledge of the risk factors, prompt diagnosis and rapid intervention by medical staff are required. KEY WORDS: Cord prolapsed - Perinatal morbidity and mortality - Caesarean section - Vaginal delivery.
An Analytical Study of Laws and Policies Influencing the Use of Land in Metropolitan Lagos, Nigeria
I. Olugbenga,Akinmoladun,Leke Oduwaye
The Social Sciences , 2013,
Abstract: This study investigates laws and policies influencing land use in metropolitan Lagos. Analysis of these laws and policies were presented based on the responses on 755 questionnaires administered on residents in 43 zones into which metropolitan Lagos was divided. The division was based on peculiarities of the land use structure of the city. Among government policies and laws influencing land use in the study area are land acquisition policy, master plan and zoning, rent laws, sources of land ownership, building approval procedure, property and land use charge laws. The application of the principal component technique for the analysis shows that joining properties and sources of ownership are the two most prominent factors influencing land use in metropolitan Lagos. The study suggests that to achieve sustainable land use in metropolitan Lagos, there is need to re-appraise the position of land acquisition policy in the study area with a view to making proposals which will open up the acquired lands for rational uses by the public and the government. It is also recommended that all levels of government should embark on appropriate planning scheme as they are empowered to do by the Lagos State Urban and Regional Planning Law, of 1998. Such schemes should give strong consideration to rezoning. The city s building regulations and land tenure should be re-examined and reviewed with a view to making them more responsive to current and future needs of the city as most of the planning regulations are no more appropriate to cope with the emerging realities of the city land use planning.
Acceptability of intrapartum HIV counselling and testing in Cameroon
Eugene J Kongnyuy, Enow R Mbu, Francois X Mbopi-Keou, Nelson Fomulu, Philip N Nana, Pierre M Tebeu, Rebecca N Tonye, Robert JI Leke
BMC Pregnancy and Childbirth , 2009, DOI: 10.1186/1471-2393-9-9
Abstract: The study was conducted in four hospitals (two referral and two districts hospitals) in Cameroon. Labouring women with unknown HIV status were counselled and those who accepted were tested for HIV.A total of 2413 women were counselled and 2130 (88.3%) accepted to be tested for HIV. Of the 2130 women tested, 214 (10.1%) were HIV positive. Acceptability of HIV testing during labour was negatively associated with maternal age, parity and number of antenatal visits, but positively associated with level of education. HIV sero-status was positively associated with maternal age, parity, number of antenatal visits and level education.Acceptability of intrapartum HIV testing is high and the prevalence of HIV is also high among women with unknown HIV sero-status in Cameroon. We recommend an opt-out approach (where women are informed that HIV testing will be routine during labour if HIV status is unknown but each person may decline to be tested) for Cameroon and countries with similar social profiles.About 3.2 million infants and young children worldwide are infected with Human Immunodeficiency Virus (HIV) and more than 95% of them get the virus from their mother, usually during the intrapartum period [1,2]. The traditional method for preventing mother-to-child transmission (MTCT) of HIV is voluntary testing during antenatal care and provision of antiretroviral prophylaxis to the HIV-infected women and their newborns [3,4].The World Health Organisation estimates that in developing countries, 32% of pregnant women give birth with no previous antenatal care [5]. Although universal antenatal HIV testing is standard in the USA, an estimated 40% of HIV transmissions in 2000 occurred among mothers whose HIV infection was unrecognized [6]. In settings where many women give birth with unknown HIV status either because of low antenatal attendance or otherwise, HIV testing during labour provides the last window of opportunity before delivery for interventions to reduce MTCT of HIV [7,8]
Existence and Stability of Equilibrium Points in the Robe’s Restricted Three-Body Problem with Variable Masses  [PDF]
Jagadish Singh, Oni Leke
International Journal of Astronomy and Astrophysics (IJAA) , 2013, DOI: 10.4236/ijaa.2013.32013

The positions and linear stability of the equilibrium points of the Robe’s circular restricted three-body problem, are generalized to include the effect of mass variations of the primaries in accordance with the unified Meshcherskii law, when the motion of the primaries is determined by the Gylden-Meshcherskii problem. The autonomized dynamical system with constant coefficients here is possible, only when the shell is empty or when the densities of the medium and the infinitesimal body are equal. We found that the center of the shell is an equilibrium point. Further, when k1; k being the constant of a particular integral of the Gylden-Meshcherskii problem; a pair of equilibrium point, lying in the \"\"-plane with each forming triangles with the center of the shell and the second primary exist. Several of the points exist depending on k; hence every point inside the shell is an equilibrium point. The linear stability of the equilibrium points is examined and it is seen that the point at the center of the shell of the autonomized system is conditionally stable; while that of the non-autonomized system is unstable. The triangular equilibrium points on the \"\"-plane of both systems are unstable.

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