Cryptoccocal Neuromeningitis in Immunocompetent Infant in Bonassama District Hospital, Douala: A Case Report

Cryptococcosis is rare in children. We report a case of cryptococcal meningitis in an infant whose mother works as a poultry farmer (chicken farm). The infant was received in the context of fever with convulsions. We performed a lumbar puncture and started antibiotic treatment. Cerebrospinal fluid (CSF) analysis was performed including Indian ink staining. CSF results showed the presence of yeast and we replaced antibiotics with fluconazol-based treatment. After the loss of sight and the appearance of a motor deficit, a brain scan was performed showing cerebral edema. Several lumbar punctures were performed for 02 weeks until partial recovery of visual acuity and motor deficit. This case highlights the importance of taking into account the patient’s history when making the diagnosis. In our case, the working conditions and the employment of the mother guided the realization of the Indian ink coloring of the CSF. Treatment with fluconazol continued for 22 weeks with a completely regained visual acuity and gradual improvement in motor deficit despite limited resources.

Paediatric Mortality: Aetiologies and Predictors among Children Aged 1 Month to 15 Years in a Tertiary Hospital in Douala, Cameroon

Background: Children and adolescent mortality remains a public health concern in developing countries. This study aimed to describe risk factors and aetiologies of mortality among children and young adolescents at a tertiary hospital in the town of Douala, Cameroon. Methods: We carried out a retrospective cohort study from January 1st to May 31st, 2019 among deceased patients aged 1 month to 15 years admitted to the paediatric ward of the Gynaeco-Obstetric and Paediatric Hospital. Data of interest were collected and analysed. Results: Out of 3088 children admitted, 123 death cases were recorded. The overall hospital mortality rate was 3.98%. Females accounted for 51% of the deceased patients. Fever was the main reason for consultation. Severe malaria was the most common diagnosis. In univariate logistic regression analysis, factors associated with mortality included hyperthermia (OR = 0.24;95% CI 0.80 - 1.33;p = 0.012), coma/impaired consciousness (OR = 0.30;95% CI 0.10 - 0.88;p = 0.029), pneumonia (OR = 3.95;95% CI 1.42 - 10.97;p = 0.008), antipyretic therapy (OR = 0.28;95% CI 0.11 - 0.73;p = 0.009), and no medication (OR = 4.50;95% CI 1.05 - 9.29;p = 0.043). In multivariate regression analysis, coma/impaired consciousness was found to be the only factor associated with mortality (OR = 6.24;95% CI 1.15 - 33.73;p = 0.034). Conclusion: The present study reveals that most of death cases were due to preventable causes, especially infectious diseases. Efficient reduction in children and adolescent mortality could be achieved by adequately addressing these causes.

Risk Factors for COVID-19 Related Death during the First Three Waves of the Pandemic in an Epidemic Treatment Center at Dakar, Senegal

Introduction-Objective: COVID-19 is a highly transmissible but often mild viral infection. However, some patients can present severe COVID-19 and subsequently die. The aim of the present study was to assess the risk factors for COVID-19 related death during the first three waves of the disease at the Epidemic Treatment Center (ETC) of Dakar Principal Hospital (DPH). Method: We conducted a descriptive and analytical perspective survival study from April 4, 2020 to September 25, 2021, including adult patients with COVID-19, hospitalized at the ETC of DPH. Log Rank test and multivariate Cox model were performed to identify risk factors for death. Results: We included 556 COVID-19 patients with mean age of 57 ± 17 years and a male-to-female ratio of 1.26. The number of deaths during one month of follow-up was 41, representing a cumulative risk of 7.4%. The log Rank test showed that being from the third wave (p = 0.0056), advanced age (p = 0.00098), presence of at least one comorbidity (p = 0.034), High blood pressure (p = 0.024), d-dimer level ≥ 1000 IU/L (p Conclusion: Our study showed that elderly and third-wave of COVID-19 patients were more at risk to die. Knowledge of risk factors for COVID-19 related death could improve the prognosis of these patients.

Indications, Yield and Outcome of Colonoscopy: A 7-Year Retrospective Study in a Resource-Limited Setting

Background and Aims: Diagnostic colonoscopy allows exploration of the colonic mucosa. Indications are multiple. The purpose of this work was to describe the indications and to report the lesions observed during colonoscopy at the General Hospital of Douala. Methods: This was a cross-sectional study with retrospective data collection over a period of 7 years (January 1, 2010 to January 31, 2017). The data collected from the reports were socio-demographic characteristics, indications and lesions observed at colonoscopy. Binary logistic regression allowed us to identify the independent risk factors associated with the presence of tumors and polyps. Results: We included 719 exams. The main indications were rectorrhagia (29.5%), abdominal pain (25.9%) and constipation (17.8%). A colonic lesion was found in 60.1% of cases. A colorectal tumor accounted for 10.3% of cases. Factors independently associated with colonic tumor were complete colonoscopy (aOR: 0.167 95% CI [0.096 - 0.289], p Conclusion: The presence of weight loss, abdominal or rectal mass should motivate the realization of a complete colonoscopy in search of a colorectal tumor. The most observed lesions remain hemorrhoids, polyps and diverticulosis of the colon.

Unexpected Association of HIV, Hepatitis C Virus Infection, Lymph Node Tuberculosis, and Sickle Cell Disease: A Case Report in a 35-Year-Old Woman from Cameroon

Introduction: HIV infection is a public health issue. Developing countries are facing the challenge of patient populations that remain undiagnosed and under-served in combined antiretroviral treatment (cART) leading to opportunistic infections. Lymph node tuberculosis is one of the most common. His firm diagnosis is not always easy in resources limited country. Case Presentation: We report a case of a 35-year-old woman known HIV for the past 10 years but not on treatment. She presented with a four-month history of fatigue, weight loss and pain in the right flank. The diagnosis of lymph node tuberculosis, hepatitis c virus infection and sickle cell disease was done. After 6 months of treatment, there was a favourable clinical evolution. Conclusion: This case report highlights the necessity to screen for opportunistic and non-opportunistic co-infection in HIV infected patient.

Neonatal Transfer Situation Following Implementation of a Perinatal Network: An Analysis in Douala, Cameroon

Background: Postnatal transfer (PT) is interhospital transport of care-needing newborns. In 2016, a perinatal network was implemented to facilitate PT in the town of Douala, Cameroon. The network was supposed to improve PT-related care standards. This study aimed at determining characteristics of PT five years following the implementation of this network. Methods: A cross-sectional study was carried out from February to May 2021 at neonatology wards of six hospitals in Douala. Medical records of newborns transferred to the hospitals were scrutinized to document their characteristics. Parents were contacted to obtain information on PT route and itinerary. Data were analyzed using Epi Info software and summarized as percentages, mean and odds ratio. Results: In total, 234 of the 1159 newborns admitted were transferred, giving a PT prevalence of 20.2% (95% CI 17.9% - 22.6%). Male-to-female ratio of the transferred newborns was 1.3. Neonatal infection (26.5%), prematurity (23.5%) and respiratory distress (15.4%) were the main reasons for transfer. Only 3% of the PT was medicalized while only 2% of the newborns were transferred through perinatal network. On admission, hypothermia and respiratory distress were found in 31% and 35% of the newborns, respectively. The mortality rate among babies was 20% and these had a two-fold risk of dying (95% CI 1.58 - 3.44, p Conclusion: PT and the perinatal network are lowly organized and implemented in Douala. Sensitization of medical staff on in utero transfer, creating center for coordination of the network, and implementation of neonatal transport system could improve the quality of PT.