Radical Hysterectomy in Cervical Cancer: Patients’ Epidemiological and Clinical Profiles and Perioperative Outcome in Two Referral Hospitals in Cameroon

Background: Cervical cancer (CC) is one of the most frequent cancers and the leading cause of death from gynecological cancer in Low and middle income countries, Cameroon inclusive. Surgery is the primary treatment modality when the disease is diagnosed at early stage. Radical hysterectomy in cervical cancer has not been evaluated in recent years in Cameroon. The purpose of this study is thus to evaluate the epidemiological and clinical features and short term outcomes of patients who underwent surgery. Patients and methods: This retrospective study was conducted at the Douala Gynaeco-obstetric and Pediatric Hospital and the Douala General Hospital. Cervical cancer patients who underwent Radical hysterectomy between January 2015 and December 2020 were included. A pre-established data collection tool was used to record socio-demographic, clinical and outcomes information from patients’ files;additional outcome information was obtained from phone calls. Descriptive analysis was done using the SPSS version 26. Bivariate analysis was used to determine associations between disease and patients characteristics and occurrence of adverse postoperative outcome. P value of 0.05 was considered. Results: Sixty one patients were enrolled. Their ages ranged from 33 to 74 years with a mean age of 51.95 ± 10.29 years. Over 85% of women were married, 65.57% were unemployed and 86.88% were multiparous. Only 28% had never done cervical cancer screening. Most patients had stage IB1 to IB2 stage disease (57.1%). Less than 9% underwent radical hysterectomy and 8 of those (13.11%) suffered intraoperative complications. Twenty-five patients (40.98%) presented immediate and short term complications. There was no significant association between the disease or patients’ characteristics and adverse outcomes. Conclusion: Cervical cancer patients are relatively young in our settings and only 9% of them reach the hospital at early stage. Postoperative adverse outcomes rate is higher than that reported in the literature. Sensitization on screening and awareness of early symptoms can reverse the situation.

Epidemiological Profile of Women with Mental Disorders in Hospital in Dakar

Introduction: Women are currently more likely than men to suffer from mental health problems. The prevalence of mental health problems among women is also increasing. However, few studies conducted in Africa provide epidemiological data on women. The aim of this study was to describe the epidemiological profile of women with mental health problems in Dakar. Methodology: This was a cross-sectional, retrospective, descriptive study over a five-year period, from 1 January 2017 to 31 December 2021. It concerned all women hospitalised for psychiatric reasons at the Psychiatry Department of Fann Hospital, Dakar, Senegal. The data collection form provided information on the sociodemographic profile, i.e., age, current address, marital status, ethnicity, religion, level of education, professional activity, and use of psychoactive substances. Results: The prevalence of mental disorders was 34.9% and concerned the following ICD-10 pathology groups [F00 - 09], [F10 - F19], [F20 - F29], [F30 - F39], [F40 - 48], [F50 - F59] and [F60 - F69]. The mean age of the patients was 37 years, with a standard deviation of 13 and extremes from 16 to 74 years. Most patients were unmarried (56%). Among the married patients, the monogamous regime was in the majority in our study: 56% compared with 44% for the polygamous regime. Women had to attend French school in 74% of cases. In our study, 32% of patients had reached university level. The majority were unemployed (67%). The notion of mourning was found in 214 patients (30.2%). The birth of one or more children marked the lives of 184 patients (26%). Divorce was noted in 103 patients (14.5%). Marital conflicts were experienced by 94 patients (13.3%). Twenty percent of the patients had used psychoactive substances. Conclusion: The epidemiological profile of a woman with a mental disorder in Dakar is that of a single woman in her forties who had attended university and was a housewife. She does not use psychoactive substances and has experienced at least one mourning in her life.

Epidemiological Profile of Obesity among Adults Aged 21 to 65 Years Living in Yopougon, Cocody and Abobo (District of Abidjan, Côte d’Ivoire)

Objective: The study aims to establish the epidemiological profile of obesity in Abidjan. Methods: It was a cross-sectional study carried out in Côte d’Ivoire with 349 volunteers aged 21 to 65 years old and living in 330 households located in Yopougon, Cocody and Abobo, three Municipalities in the city of Abidjan. Results: Out of 349 participants, 90 or 25.8% were declared obese according to BMI. Based on IMG, 62.8% of people had abnormally high body fat. Abdominal obesity was more common in Yopougon and Cocody than in Abobo. Relative to BMI, 36.1% of women were obese compared to 12.9% of men. The same observation was made with regard to the umbilical perimeter. Indeed, abdominal obesity was more observed in women with a rate of 52.6% compared to 11.6% in men. 35.6% of obese people have no level of education. According to the respondents, a very high proportion of weight gain occurred after the age of 10. It was between 10 and 21 years old in Yopougon and Cocody and between 18 and 21 years old in Abobo. More than 70% of obese people living in Yopougon, Cocody and Abobo would not consider obesity as a disease while 40.7% have said they were very little informed about obesity. Conclusion: Two major points have emerged from the examination of the data collected: 1) The prevalence of overweight and obesity remains very high in the three Communes of Abidjan. 2) The occurrence of obesity would be influenced by the sociodemographic characteristics of the populations. Also, updating these sociodemographic characteristics is essential to better adapt national strategies for obesity and overweight combating.

Epidemiological Profile of Breast Neoplasia in the Municipality of Valença (RJ Brazil): Study from 2009 to 2017

Breast neoplasms are the main oncological pathology in Gynecology and Obstetrics, with increasing rates of incidence and mortality in the female population. According to the World Health Organization (WHO), more than 1 million new cases of breast cancer are diagnosed worldwide every year. This study aims to understand and analyze the epidemiological profile of patients diagnosed with breast cancer in the last nine years in the city of Valença—RJ, Brazil. A descriptive, documentary-retrospective analysis was carried out from January 2009 to December 2017, on 96 records of women who underwent breast biopsy at the Escola Escola de Valença (HEV), referred by the HEV Gynecology outpatient clinic. The results compared the variables age, race, parity, alcoholism, smoking, comorbidities, histological type, family history and screening performed with the scenario of breast cancer in the world, concluding that it is essential to identify patients at risk development of breast cancer to guide prevention, screening and early detection of pathology. The cases in the municipality are similar to other studies in relation to smoking, alcohol consumption, associated comorbidities, histological type and family history. However, the prevalence in younger people stands out, as well as the high percentage of women who have not had previous screening, which highlights the importance of the development and spread of women’s health in this city in the south of the state.

Metabolic Syndrome: Epidemiological, Clinical and Biological Profiles in the Cardiology and Internal Medicine Departments of the Mother-Child CHU “Luxembourg”

Introduction: The metabolic syndrome is a clinical entity defined by the association in the same subject of four of the following five factors: abdominal obesity (or android), type 2 diabetes, hypertension, hypo HDL cholesterolemia, hypertriglyceridemia. The aim of the work was to study the epidemiological, clinical-biological profiles and complications of patients in the cardiology and internal medicine department of the Mother-Child CHU “Luxembourg”. Materials and Methods: We carried out a cross-sectional study, from September 2019 to June 2020 in the cardiology and internal department of the mother-child CHU “Luxembourg”. All patients with metabolic syndrome admitted to the two departments who agreed to participate during the study period were included in the study. These patients meet the 2009 harmonization attempt criteria (IDF 2009). The variables studied were: socio-demographic characteristics (sex, age, profession), pathological history, clinical signs (functional signs, BMI, waist size), paraclinical signs (ECG, cardiac ultrasound, laboratory assessment) and complications. Results: A total of 104 patients were included. The female sex represented 58.65% of cases. The 60 to 69 age group was the majority with 40.78%, housewives occupied 41.34% of cases. Diabetes, arterial hypertension and dyslipidemia were the most represented cardiovascular risk factors with respectively: 80.77%, 79.81% and 53.85%. Visual blurring was the most common functional sign with 23.08% of cases. Moderate obesity was observed in 34% of patients. Waist circumference was high in 39.53% of male patients and 37.70% of female patients. Cardiac ultrasound found a severely collapsed ejection fraction in 25% of patients. HDL-c levels were low in 64.52% of male patients and 75% of female patients. The most observed complications were: dyslipidemia (53.85%), stroke and renal failure with 23% respectively. Conclusion: The metabolic syndrome remains a real public health problem, constantly increasing in our populations and constitutes a danger by its constituent elements.

Epidemiological Aspects of Cervicofacial Cellulitis Due to Dental Origin in the City of Ouagadougou (Burkina Faso)

Background: Head and neck cellulitis of dental origin are polymicrobial bacterial infections involving the cellulo-adipose spaces of the face and neck. The objective of this work was to describe the epidemiological and clinical profile of patients with head and neck cellulitis. Methods: This was a cross-sectional study conducted from 1 January to 30 June 2020. All patients consulting for cervico-facial cellulitis of dental origin in 2 university hospitals in Ouagadougou were included in the study. The usual parameters of descriptive statistics were estimated for each variable. Results: Two hundred and ninety-two cases (184 men and 108 women), aged 3 to 85 years were collected. The 25 - 35 years old were the most affected (33%). Decay was the leading dental cause (95.6%). The delay in consultation was included within 7 days in 74.66% of cases. Ninety-one-point forty-four percent of patients had poor oral hygiene. Diffuse cellulitis was the most common (64.04%) and peri-mandibular regions were the most invaded (42.81%). Conclusion: The frequencies observed in our study allow us to conclude that cervicofacial cellulitis of dental origin is still frequent and affects a young and disadvantaged population.

Sex Hormones Affect Aging Process by Influencing Lipid Profiles, Cellular Immunological Function and Lipid Peroxides and Oxidation System

Objectives To investigate the correlation between sex hormones(SH) and aging. Methods Through epidemiological investigation in our country, the levels of SH were measured by radioimmunoassy; lipid profile, glucose and apolipoprotein by automatic biochemic analytical instrument; T cell subsets by flow cytometer; and MDA, SOD were evaluated by the thiobarbituric acid (TBA) test and the nitrite method modified by Oyanagui respectively using spectrophotometry. Results In men, the serum levels of follicle stimulating hormone ( FSH)、luteinizing hormone(LH) increased significantly with aging, but serum prolactin(PRL) and progesterone(P) levels remained unchanged in all life; Both testosterone (T) and free testosterone (FT) all decreased greatly with aging, but 17β - estradiol( 17β - E_2) was reverse ; E_2 was negatively correlated with T and E_2/T increased with aging. The level of serum total cholesterol (TC) increased with aging, but triglycerides (TG) remain unchanged; compared with young group, high - density lipoprotein cholesterol ( HDL - C) ; HDL - C/TC of other groups decreased significantly, but low - density lipoprotein cholesterol ( LDL - C ) changed inversely; HDL- C/LDL- C reduced slightly with aging and showed no difference between groups. Apolipoprotein A1 (apoA1) and apoB all enhanced greatly with aging; meanwhile the ratio of apoA1/apoB decreased. The concentration of serum glucose (GLU) was unchanged in all life. To compare with those in the young group, CD3 + , CD4 + in other groups reduced greatly, CD4 + remained unchanged. Meanwhile, CD8 + increased significantly with aging. Compared with the young group, serum malondialdehyde(MDA) value of the old ones increased obviously, but the activity of superoxide dismutase(SOD) was reverse. By partial correlation analysis (controlling BMI, FSH, LH and PRL), TC、 LDL-C、apoA1、apoB、CD8 + 、MDA of men all presented a positive correlation with E_2/T respectively, their correlation coefficients (γ) were 0. 262、0. 136、 0. 532、0. 379、0. 394、0. 234 (P < 0. 001 ) ; HDL - C、 HDL- C/TC、HDL- C/LDL- C、CD3 + 、CD4 +/CD8 + 、SOD showed a negatively correlation with E_2/T respectively, γequaled - 0.563、- 0.332、- 0.654、- 0.1530、-0.4140、-0.236(P<0.001). In women, the serum concentrations of FSH、LH increased significantly after menopause; PRL increased little with aging; compared with young group, E_2 and P in postmenopausal groups reduced obviously, E_2/P revealed significant reduce with aging. T enhanced significantly after menopause, but nor did FT. E_2, P and the ratio of E_2/P were negatively correlated with age respectively by bivariate correlation analysis, and a positive relation between T and age. After 70 years old, the level of TC increased obviously, and so did that of TG after menopause; HDL decreased with aging, but LDL increased after 70, with the result that the ratios of HDL- C/TC and HDL- C/LDL- C all reduced with aging; apoA1 decreased gently after 70, but apoB increased signifi- cantly after menopause; correspondingly, the ratio of apoA1/apoB declined obviously. The concentration of GLU increased with aging. CD3 + and CD4 + didn't change until 60, but reduced after 60. Compared with the young groups, CD8 + remained unchanged, CD4 +/CD8 + reduced greatly with aging, CD4 + and CD8 + presented a negatively correlation with age respectively. The value of MDA in serum of women increased notably after 70 years old, but SOD activity already decreased significantly from 60. By partial correlation analysis (controlling BMI, FSH, LH and PRL), HDL-C、CD4 +、CD4 +/CD8 + showed a certain correlation with E_2/P respectively; γ were 0. 245、 0.157、0. 154 ( P <0.05 ) ; TG、 LDL、 apoB、 apoA1/ apoB、SOD presented a negatively correlation with E_2/P respectively, γ were 0. 452、 0. 236、 0.321、 0. 135、 0.156、0.154、0.426 ( P < 0.05 ). Conclusions The Disequilibrium of SH had correlations with lipid profile, cellular immunological function and lipid peroxides and oxidation system; these suggested SH took an important role in the process of aging.

Adult Kidney Cancer in Mauritania: Clinical and Therapeutic Aspects

Introduction: since its creation, our urology department has taken care of tumor pathologies in particular kidney cancer in adults;our goal is to study the clinical and therapeutic epidemiological profiles of adult kidney cancer in Mauritania. Materials and Methods: We carried out a retrospective study over a period of six years, from January 1, 2012 to December 31, 2017, including all cases of adult kidney cancer registered in the urology-andrology departments of the Cheikh Zayed Hospital and Pathological Anatomy of the National Hospital of Nouakchott (Mauritania). Results: we collected 50 cases of kidney cancer. The average annual incidence was 8.3 cases. The average age of the patients was 52.98 years with extremes of 18 and 84 years. There was a female predominance (52%) or 29 women for 21 men. Lumbar pain was the most frequent clinical expression, more than half of the patients had symptoms over a period of at least 12 months before the first consultation. The left kidney was the most frequently affected. The right localization was demonstrated in 23 patients, the extension assessment was made with thoraco-abdomino-pelvic CT in 40 patients. Twelve patients had a tumor localized in the kidney. The extension assessment had made it possible to objectify the existence of metastases in 17 of our patients (37%). The preferred locations of these metastases were pulmonary and hepatic. Surgical intervention was performed in 44 patients (88%), of whom 36 underwent radical nephrectomy (72%), and two patients underwent partial nephrectomy (4.5%). Surgical abstention was decided from the outset in 6 patients (13.6%). None of our patients had received treatment with anti-angiogenics. The histological type most observed in our patients was renal cell carcinoma, observed in 34 patients, or 77.72%. At the time of the study, more than a third of the patients had died. The mortality rate in our series had reached 24%. A specific survival rate could not be assessed due to lack of information in the files and significant numbers of patients lost to follow-up at the time of the study. Conclusion: adult kidney cancer in Mauritania is characterized by its low incidence, its occurrence in a relatively young population, its female predominance, its often late diagnosis at locally advanced and metastatic stages, and the treatment is the most often surgical.

Viral Hepatitis C during a Screening Campaign in General Population of Benin: Seroprevalence and Associated Factors

Introduction: Hepatitis C is a global public health problem. The purpose of this study was to determine the prevalence and factors associated with hepatitis C virus (HCV) antibody carriage during mass screening in several localities throughout Benin. Methods: This was a descriptive and analytical cross-sectional study with prospective data collection. This collection took place from 20 to 28 July 2019 at a free voluntary hepatitis C screening organized in Benin by Rotary Clubs in 23 sites throughout the country. A rapid diagnostic orientation test was used for the detection of anti-HCV antibodies. Results: A total of 9035 voluntary participants were included, mostly of Beninese nationality (99.0%), with a median age of 27 years, of whom 51.1% (4619/9035) were single and mainly schoolchildren, pupils or students (37.9%;3426/9035). HCV seroprevalence was 1.0% (87/9035) [95% CI = 0.8% - 1.2%]. This infection was associated with age greater than 42 years (ORa = 2.71;95% CI: 1.06 - 6.95), p < 0.03, and history of diabetes (ORa = 3.9;95% CI: 1.9 - 7.6). Conclusion: HCV antibody seroprevalence is relatively low in the study population: 1%. Factors associated with HCV antibody carriage were age, occupation and diabetic history.

Spatio-temporal analysis of leprosy risks in a municipality in the state of Mato Grosso-Brazilian Amazon: results from the leprosy post-exposure prophylaxis program in Brazil

Background Leprosy post-exposure prophylaxis(LPEP)with single dose rifampicin(SDR)can be integrated into different leprosy control program set-ups once contact tracing has been established.We analyzed the spatio-temporal changes in the distribution of index cases(IC)and co-prevalent cases among contacts of leprosy patients(CP)over the course of the LPEP program in one of the four study areas in Brazil,namely the municipality of Alta Floresta,state of Mato Grosso,in the Brazilian Amazon basin.Methods Leprosy cases were mapped,and socioeconomic indicators were evaluated to explain the leprosy distribution of all leprosy cases diagnosed in the period 2016–2018.Data were obtained on new leprosy cases[Notifiable diseases information system(Sinan)],contacts traced by the LPEP program,and socioeconomic variables[Brazilian Institute of Geography and Statistics(IBGE)].Kernel,SCAN,factor analysis and spatial regression were applied to analyze changes.Results Overall,the new case detection rate(NCDR)was 20/10000 inhabitants or 304 new cases,of which 55 were CP cases among the 2076 examined contacts.Changes over time were observed in the geographic distribution of cases.The highest concentration of cases was observed in the northeast of the study area,including one significant cluster(Relative risk=2.24;population 27427,P-value<0.001)in an area characterized by different indicators associated with poverty as identified through spatial regression(Coefficient 3.34,P-value=0.01).Conclusions The disease distribution was partly explained by poverty indicators.LPEP influences the spatial dynamic of the disease and results highlighted the relevance of systematic contact surveillance for leprosy elimination.