Factors Associated with Haemolytic Anaemia in the Internal Medicine Department of the Douala General Hospital in Cameroon

Introduction: Haemolytic anaemia (HA) is defined as a decrease in haemoglobin (Hb) levels below baseline due to excessive and premature destruction of red blood cells (RBCs) in the periphery resulting in a shortened life span of less than 120 days. Haemolysis can be corpuscular or extra-corpuscular. The aim of our study was to investigate the factors associated with it for optimal management of patients hospitalised in internal medicine at the Douala General Hospital (DGH). Methodology: We conducted an analytical cross-sectional study, including all patients admitted to the internal medicine department of the DGH from 11 February to 20 May 2022, and excluding patients with non-compliant samples. The search for haemolytic anaemia was carried out by means of blood count, reticulocyte count, blood smear, unconjugated bilirubin, lactate dehydrogenase and direct Coombs test. Sociodemographic, clinical and biological parameters were collected and analysed. Correlation was defined for a p value 0.05. Results: This study included 147 patients, 50.34% of whom were men, for a sex ratio of 1.01. The mean age was 52 ± 17.9 years. The most represented age group was 56 - 70 years (n = 49;33%) with extremes from 15 to 90 years. We counted 29.3% cases of haemolytic anaemia (HA) and 13.9% cases of autoimmune haemolytic anaemia (AIHA). Haemolytic anaemia (HA) was present in 54.14% of men for a sex ratio of 1.38;the most represented age group was 40 - 55 years, 37.2%. HA was associated with jaundice (OR: 3.74, CI: [1.70 - 8.22], p = 0.001), HIV - AIDS (OR: 2.72, CI: [0.98 - 7.53], p = 0.05), thrombocytopaenia (OR: 3.53, CI: [1.58 - 7.89], p = 0.02). LDH was elevated (OR: 2.86, CI: [1.30 - 6.26], p = 0.00) as well as elevated reticulocyte count (OR: 3.84, CI: [1.75 - 8.44], p = 0.01). Unconjugated bilirubin was elevated in all these patients. In multivariate analysis, factors associated with HA were a history of HIV/AIDS, jaundice, thrombocytopaenia and elevated reticulocyte count. Conclusion: Hemolytic anaemia is common in internal medicine and is significantly associated with thrombocytopenia, HIV/AIDS infection and jaundice.

A Public Health Model and Framework to Mitigate the Impact of Orphans and Vulnerable Children Due to HIV/AIDS in Cameroon

UNICEF, UNAIDS and USAID developed a global strategic framework to guide responses to care and protect orphans and other vulnerable children in the context of HIV/AIDS. In the developing world, about 132 million people have lost one or both parents due to the AIDS pandemic and 25 million children have been orphaned by HIV/AIDS in 2010. The HIV prevalence in Cameroon is estimated at 5.1%. As of 2010, there were 304,000 deaths due to AIDS in Cameroon. Out of 1,200,000 orphans and vulnerable children in Cameroon in 2010, 300,000 were AIDS orphans. The HIV/AIDS burden impacts child survival, growth and development in the traditional African setting. With so many orphans in the population, along with many vulnerable children, strategies must be developed to respond more effectively to their critical needs. This study provides a model for OVC care and support in Cameroon. The model was developed out of extensive work using a participatory approach involving traditional, administrative and health stakeholders on OVC in Yaounde I and Yaounde VI Councils, Nanga Eboko Health District, Isangelle, Ekondo Titi, and Bafaka-Balue communities in Cameroon. Consultancy services with PLAN Cameroon, the Pan African Institute for Development-West Africa coupled with facilitation of many training workshops on OVC with Save the orphans Foundation, the Ministry of Social Affairs, and the Ministry of Public Health and working with the National AIDS Control Committee. The essential components of a holistic framework for the care of OVC have been identified. A public health model for the care of OVC and a mechanism for their identification and a referral system for testing OVC for HIV are proposed. Through this model, a mechanism for the effective holistic care of OVC and collaboration is enhanced.

Coinfection with malaria and intestinal parasites, and its association with anaemia in children in Cameroon

Background:The purpose of this study was to determine the prevalence of coinfection with malaria and intestinal parasites,as well as to determine its association with anaemia in children aged 10 years and below in Muyuka,Cameroon.Materials and methods:This was a cross-sectional study.Participants were febrile children who were admitted to the Muyuka district hospital between April and October 2012.Blood and stool samples were collected from those participants who gave consent to take part in the study.Haemoglobin concentration(Hb)and complete blood count(CBC)were performed using an automated haematology analyser(Mindray®,BC-2800).Giemsa-stained blood film was examined to detect malaria parasites,while the formol-ether concentration technique was used to detect intestinal parasitic infections(IPIs).The Pearson’s chi-square,Student’s T-test and correlation analysis were all performed as part of the statistical analyses.Results:Four hundred and eleven(411)children successfully took part in this study.The prevalence of malaria,IPIs,malaria and IPI coinfection,and anaemia observed were 98.5%,11.9%,11.9%and 44.8%,respectively.Anaemia and IPIs were significantly associated with age;anaemia was more prevalent in children under five years of age(p=0.000),whereas IPIs were more prevalent in children aged between five and 10 years(p=0.006).The parasite species isolated included Ascaris lumbricoides(36[73.5%]),Entamoeba histolytica/dispar(9[18.4%])and hookworm(4[8.2%]).The mean Hb observed was 10.64 g/dl(±1.82).A significant negative correlation was observed between malaria parasite density and Hb.There was no significant difference in the prevalence of anaemia among children infected with malaria,IPIs,or malaria and IPI coinfection,or among non-infected children.Similarly,the mean Hb did not differ among infected and non-infected children.Conclusion:This study showed that malaria and IPIs still constitute a major public health problem in the study area despite a lack of any significant association between these infections and anaemia.The findings suggest that there is a need for the implementation of control measures to curb the rate of malaria and IPIs in the study area.