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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.
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.
Dynamics of insecticide resistance in malaria vectors in Benin: first evidence of the presence of L1014S kdr mutation in Anopheles gambiae from West Africa
Innocent Djègbè, Olayidé Boussari, Aboubakar Sidick, Thibaud Martin, Hilary Ranson, Fabrice Chandre, Martin Akogbéto, Vincent Corbel
Malaria Journal , 2011, DOI: 10.1186/1475-2875-10-261
Abstract: Anopheles gambiae s.l populations were collected from October 2008 to June 2010 in four sites selected on the basis of different use of insecticides and environment. WHO susceptibility tests were carried out to detect resistance to DDT, fenitrothion, bendiocarb, permethrin and deltamethrin. The synergist piperonyl butoxide was used to assess the role of non-target site mechanisms in pyrethroid resistance. Anopheles gambiae mosquitoes were identified to species and to molecular M and S forms using PCR techniques. Molecular and biochemical assays were carried out to determine kdr and Ace.1R allelic frequencies and activity of the detoxification enzymes.Throughout the surveys very high levels of mortality to bendiocarb and fenitrothion were observed in An. gambiae s.l. populations. However, high frequencies of resistance to DDT and pyrethroids were seen in both M and S form of An. gambiae s.s. and Anopheles arabiensis. PBO increased the toxicity of permethrin and restored almost full susceptibility to deltamethrin. Anopheles gambiae s.l. mosquitoes from Cotonou and Malanville showed higher oxidase activity compared to the Kisumu susceptible strain in 2009, whereas the esterase activity was higher in the mosquitoes from Bohicon in both 2008 and 2009. A high frequency of 1014F kdr allele was initially showed in An. gambiae from Cotonou and Tori-Bossito whereas it increased in mosquitoes from Bohicon and Malanville during the second year. For the first time the L1014S kdr mutation was found in An. arabiensis in Benin. The ace.1R mutation was almost absent in An. gambiae s.l.Pyrethroid and DDT resistance is widespread in malaria vector in Benin and both metabolic and target site resistance are implicated. Resistance was not correlated with a change of malaria species and/or molecular forms. The 1014S kdr allele was first identified in wild population of An. arabiensis hence confirming the expansion of pyrethroid resistance alleles in Africa.Despite intense national and int
Efficacy of Olyset? Plus, a New Long-Lasting Insecticidal Net Incorporating Permethrin and Piperonil-Butoxide against Multi-Resistant Malaria Vectors
Cédric Pennetier, Aziz Bouraima, Fabrice Chandre, Michael Piameu, Josiane Etang, Marie Rossignol, Ibrahim Sidick, Barnabas Zogo, Marie-No?lle Lacroix, Rajpal Yadav, Olivier Pigeon, Vincent Corbel1
PLOS ONE , 2013, DOI: 10.1371/journal.pone.0075134
Abstract: Due to the rapid extension of pyrethroid resistance in malaria vectors worldwide, manufacturers are developing new vector control tools including insecticide mixtures containing at least two active ingredients with different mode of action as part of insecticide resistance management. Olyset? Plus is a new long-lasting insecticidal net (LLIN) incorporating permethrin and a synergist, piperonyl butoxide (PBO), into its fibres in order to counteract metabolic-based pyrethroid resistance of mosquitoes. In this study, we evaluated the efficacy of Olyset? Plus both in laboratory and field against susceptible and multi-resistant malaria vectors and compared with Olyset Net, which is a permethrin incorporated into polyethylene net. In laboratory, Olyset? Plus performed better than Olyset? Net against susceptible Anopheles gambiae strain with a 2-day regeneration time owing to an improved permethrin bleeding rate with the new incorporation technology. It also performed better than Olyset? Net against multiple resistant populations of An. gambiae in experimental hut trials in West Africa. Moreover, the present study showed evidence for a benefit of incorporating a synergist, PBO, with a pyrethroid insecticide into mosquito netting. These results need to be further validated in a large-scale field trial to assess the durability and acceptability of this new tool for malaria vector control.
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