Association between Placental Malaria and Severe Pre-Eclampsia in Two University Hospitals of Yaounde City

Context: Pre-eclampsia and placental malaria, are two diseases that share pathophysiological similarities, such as placental ischemia, endothelial dysfunction and production of pro-inflammatory cytokines. Objective: The objective of our study was to investigate the association between placental malaria lesions and severe pre-eclampsia. Methodology: We conducted a prospective analytical cross-sectional study in two University Hospitals in the city of Yaounde (Yaounde Central Hospital and the Gynaecological Obstetrics and Paediatrics Hospital), and in the laboratory of the Centre Pasteur in Yaounde over an eight-month period (1st January 2021 – 1st September 2021). All patients with pre-eclampsia diagnosed according to the criteria of the International Society for the Study of Hypertension (ISSHP) and free of chronic metabolic or infectious pathology were included in this study. The patients were divided into two groups: group 1 (mild pre-eclampsia) and group 2: severe pre-eclampsia. Socio-demographic, clinical and histopathological characteristics specific to pre-eclampsia and placental malaria were investigated. Statistical analysis was performed with SPSS 23.0 software, Chi 2 was used to compare categorical variables, Student t-test was used to compare means, and logistic regression was used to assess the association between placental malaria lesions and PES. Results: The mean age of our study population was 29.93 ± 7.36 years versus 28.28 ± 7.18 years in patients with mild and severe pre-eclampsia respectively. Pre-eclampsia placental lesions (accelerated villous maturation, infarction) were significantly greater in patients with severe pre-eclampsia (p Conclusion: Placental malaria lesions were significantly associated with severe pre-eclampsia and increased the risk of developing severe pre-eclampsia placental lesions by a factor of 10.

Immuno-Histochemical Profile of Breast Cancers at the General Hospital of Douala-Cameroon

Introduction: The aim of the study was to describe the immunohistochemical aspects of breast cancers at Douala General Hospital, Cameroon. Methodology: This was a descriptive study with retrospective data collection, conducted from January 1st 2010 and December 31st 2019. It was focused on histologically proven breast cancers followed up at Douala General Hospital. Results: We collected 285 cases of breast cancer, all female, representing an annual frequency of 28.5 cases. The mean age of the patients was 48 ± 13 years. The most frequent histological form was infiltrating ductal carcinoma (83.9%), with grade II predominating (38.6%). Immunohistochemical analyses were performed on 89 patients (31.23%). The triple-negative subtype was the most common class (35.95%), followed by Luminal A (32.60);Human Epidermal Receptor 2-class and Luminal B tumors were observed at a frequency of 13.48% each. Treatment consisted mainly of surgery (78.60%) combined with chemotherapy (65.97%) and/or radiotherapy (63.16%). Hormonal treatment was used in only 10.18% of patients. Targeted therapy was exceptional (4%). Conclusion: Triple-negative phenotype is the most common. However, potentially hormone-sensitive tumors account for almost half of all patients, who are relatively young. Individualized treatments are rare. It is important to systematize these analyses for all breast cancers, with a view to appropriate management in our environment.

Pregnancies Outcome after Assisted Reproductive Technology: A Multicenter Case Control Study in a Low Income Setting Douala, Cameroon

The objective was to assess the outcome of pregnancies after assisted reproductive technology (ART). It was a case-control study carried out in four health facilities in Douala-Cameroon, over a period of five years. The cases were pregnant women who conceived through ART and the controls were those who conceived naturally. Cases and controls were matched for maternal age and parity (one case for two controls). A logistic regression analysis was used to compute Odds ratios. Statistical significance was set at 0.05. A total of 174 women who conceived through ART and 348 who conceived naturally were enrolled. Some independent factors associated with ART were: age over 45 years [aOR: 7.55; 95% CI (1.55 - 36.76);p: 0.01], twin pregnancies [aOR: 16.55; 95% CI (7.91 - 34.60);p < 0.01], Cervical cerclage [aOR: 3.04; 95% CI (1.23 - 7.50);p: 0.01], miscarriages [aOR: 11.73; 95% CI (5.07 - 27.10);p: 0.01], elective cesarean section [aOR: 4.63; 95% CI (2.27 - 9.45);p: 0.01] and low birth weight [aOR: 3.32; 95% CI (1.90 - 5.82);p < 0.01]. Women who conceived by ART were older with higher rates of multiple pregnancy and complications. We recommend transfer of a single embryo.

Epidemiological and Histological Profile of Cervical Cancer in Cameroon: About 2078 Cases

Objective: To describe the epidemiological and histological aspects of cervical cancer in Cameroon. Materials and Methods: It was a descriptive retrospective study carried out over a period of 10 years (2005-2014), on malignant tumors of the cervix observed at the laboratory of Anatomic Pathology in four regions (Center, Littoral, West, South-west). The studied parameters were frequency, age, sex, localization, histological type and the immuno-histochemical aspects. Results: A total of 2078 cases with an annual frequency of 20.78 cases were registered;the peak was reached in 2010 with 304 cases (14.62%). Cervical cancer was the main genital cancer affecting women with a percentage of 82.26%. The average age of the patients was 52.33 ± 12. 80 years old, with extremes from 22 to 93 years old. The age group from 40 to 59 had more than half of the cases, with 1094 cases (52.65%). The major histological types recorded were squamous cell cancer with 1687 cases (81.51%) and adenocarcinoma with 269 cases (12.95%). Conclusion: Cervical cancer is the chief genital cancer affecting female genital organs. The predominant histological types are squamous cell cancers.

Prenatal Diagnosis of Congenital Malformations in Douala General Hospital

To determine the prevalence of congenital malformations and the proportion of cases diagnosed before birth;to specify this proportion according to the type of malformation and the sonographer qualification. Methods: It was a cross-sectional study carried out at the Douala General Hospital in the obstetric and neonatal units over a period of 42 months, from January 2008 to June 2012. The procedure consisted of;firstly an explanation of the study purpose with consent of parents obtained, thereafter, the parents were interviewed and data extracted from their files. The new born had a complete clinical exam. Morphological and biological assessment were done to ascertain diagnosis if needed. They were then followed up for 48 hours. Data were analysed using SPSS. Statistical analyses were mainly descriptive: mean, median, mode and frequency were calculated. Results: During this period, 6048 neonates were examined, 99 of whom had a malformation giving a prevalence of 1.64%. Musculoskeletal defects were the most common (36.4%), followed by digestive tract defects (22.2%). Ultrasounds were carried out mainly in the second term. Among the malformed babies, only 16.2% were diagnosed during the prenatal period. The obstetricians did better than radiologist in the prenatal diagnosis of congenital malformations. All the urinary tract malformations and 33.3% of the polymalformations were diagnosed by prenatal echography. Among the malformed babies, 33% died within the first 48 hours of life and poly-malformed babies were more concerned (66.7%). Conclusion: The prevalence of congenital birth defect was 1.64%. The rate of prenatal diagnosis remained low, meanwhile one third of the affected babies die after births. An early diagnosis would anticipate on medical care at birth and allow therapeutics abortions when indicated.