Prevalence, Indications and Morbidity of Caesarean Sections in a Referral Hospital of the Health Voucher Program: The Case of Garoua Regional Hospital in the Northern Region of Cameroon

Caesarean section (CS) is a surgical procedure performed to remove a fetus from the mother’s uterus through an incision on the abdominal wall, then on the uterine wall. The indications of CS vary not only between countries, but also from one hospital to another and from one team to another within the same hospital. Despite advances in asepsis and anesthesia/resuscitation technics, there are still complications of varying severity inherent to the gravid-puerperal state on one hand and the technics used on the other, irrespective of the operative indication. Thus, the present study was carried out with the objectives of determining the prevalence, identifying the indications, and evaluating the morbidity linked to caesarean sections in our environment. Cameroon has also set up a health voucher program in its northern region, aimed at reducing maternal and fetus morbidity and mortality. The program aims to improve financial access in antenatal care and deliveries, including caesarean sections, in this low-income region of the country. We conducted a descriptive cross-sectional study with retrospective data collection, from February 1, 2022, to May 31, 2022. We included all women who gave birth by caesarean section. In our study series, out of 905 parturient admissions into the Department of Obstetrics and Gynecology, 226 were caesarian cases. The overall frequency of CS during our study period was 25%. Fetal indications were dominated by cephalopelvic disproportion and non-reassuring fetal heart in 17.3% and 13.7% of cases respectively. Intraoperative complications were dominated by hemorrhage (15.5%). In our study, we noted an 11.1% of prevalence perinatal mortality. Cameroon is a low-income country with limited financial resources, especially in the Northern region. The health voucher program has improved financial access to caesarean sections for parturient in northern Cameroon, and consequently to emergency obstetric and neonatal care.

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.