Predictors of Herbal Medicine Use amongst Adults with Type 2 Diabetes in an Urban Setting in Cameroon

Background: Type 2 diabetes mellitus (T2DM) is currently a major global public health burden associated with elevated blood glucose. The use of herbal medicine in the management of type 2 diabetes is currently on the rise both in developed and developing countries. This study sets out to determine the prevalence of herbal medicine use and to identify the factors associated with herbal medicine use amongst type 2 diabetes patients. Methods: A community based cross-sectional study involves 123 adults living with type 2 diabetes (90 males and 30 females), mean age 58.7 ± 9.5 years in the Bamenda III health district of the North West Region of Cameroon. Data on the different types of herbs used, frequency and mode of herbal medicine use as well as reasons for using herbal medicines in the management of T2DM were assessed using a structured questionnaire. Anthropometric and diabetes related measurements were carried out following standard procedures. Logistic regression analysis was used to identify the independent predictors of herbal medicine use. Results: The prevalence of herbal medicine use was 24.4% (n = 30) amongst which 37.4 % used both herbs and orthodox medicine. A higher proportion of diabetic males used herbal medicines compared to females and this difference was significant (X2 = 5.243, p X2 = 10.75, p = 0.005). The most commonly used herbs were Vernonia amygdalina leaves (19.10%), Aloe vera (13.48%), Mangifera indica leaves (11.24%) including its bark and Carica papaya leaves (8.99%). Bivariate analysis indicated that being male (OR 2.8, 95% CI, 1.14 -6.79) and having attained secondary/tertiary education (OR 13.2, 95% CI, 1.6 - 29.9) were significantly (p 0.05) associated with herbal medicine use. Multivariate analysis revealed that having attained secondary /tertiary education (OR 10.5, 95% CI, 1.30 - 35.23) was an independent predictor of herbal medicine use in the study population. Conclusion: This study has demonstrated that amongst T2DM patients in Cameroon having attained secondary/tertiary education positively influences the use of herbal medicine in the management of T2DM.

Cross-Sectional Height-Specific Changes in Serum Lipid Concentrations in Cameroon Children

Background: Information on the relationship between height and changes in serum lipids in children is scarce in Cameroon. The aim of this study is to determine prevalence of dyslipidemia with respect to age and gender and assess the association between height increase and serum lipid changes in Cameroon children. Methods: This hospital-based cross-sectional analysis included 472 boys and 534 girls between the ages of 5 and 16 years. Body height, weight, and waist circumference (WC) of children were measured and z-scores calculated. Total cholesterol-TC, triglycerides-TG, low density lipoprotein cholesterol-LDL-C and high-density lipoprotein cholesterol-HDL-C concentrations in fasting blood samples were determined by enzymatic method using an automated clinical chemistry analyzer (RX Monaco, UK). Children were divided into increasing quartiles of height z-score. Multiple linear regression analysis was used to compare mean lipid concentrations across quartiles of height z-score after controlling for age, gender, body weight, WC and fasting blood glucose. Results: The prevalence of elevated TC and LDL-C were respectively 18.5% and 19.2% higher in girls than boys. Also, the prevalence of elevated TC and TG was highest among younger (5- to 9-year-old) girls and boys respectively. There was a significant decrease in mean TC (168.8 to 127.2 mg/dl;p p = 0.019) and LDL-C (91.1 to 69.4 mg/dl;p = 0.018) in boys;and a significant decrease in mean TC (171.2 to 144.7 mg/dl;p = 0.004) and HDL-C (62.8 to 28.7 mg/dl;p p = 0.053) and the decrease in TG (p = 0.211) and LDL-C (p = 0.732) in girls with increasing height were not significant. Conclusion: Serum lipids decreased with increasing height after controlling for different variables. This study indicates that short children have higher serum lipid concentrations and this may increase the risk of lipid disorders, which may persist into adulthood.

Influence of gut microbiota on neuropsychiatric disorders

The last decade has witnessed a growing appreciation of the fundamental role played by an early assembly of a diverse and balanced gut microbiota and its subsequent maintenance for future health of the host. Gut microbiota is currently viewed as a key regulator of a fluent bidirectional dialogue between the gut and the brain(gut-brain axis). A number of preclinical studies have suggested that the microbiota and its genome(microbiome) may play a key role in neurodevelopmental and neurodegenerative disorders. Furthermore, alterations in the gut microbiota composition in humans have also been linked to a variety of neuropsychiatric conditions, including depression, autism and Parkinson's disease. However, it is not yet clear whether these changes in the microbiome are causally related to such diseases or are secondary effects thereof. In this respect, recent studies in animals have indicated that gut microbiota transplantation can transfer a behavioral phenotype, suggesting that the gut microbiota may be a modifiable factor modulating the development or pathogenesis of neuropsychiatric conditions. Further studies are warranted to establish whether or not the findings of preclinical animal experiments can be generalized to humans. Moreover, although different communication routes between the microbiota and brain have been identified, further studies must elucidate all the underlying mechanisms involved. Such research is expected to contribute to the design of strategies to modulate the gut microbiota and its functions with a view to improving mental health, and thus provide opportunities to improve the management of psychiatric diseases. Here, we review the evidence supporting a role of the gut microbiota in neuropsychiatric disorders and the state of the art regarding the mechanisms underlying its contribution to mental illness and health. We also consider the stages of life where the gut microbiota is more susceptible to the effects of environmental stressors, and the possible microbiota-targeted intervention strategies that could improve health status and prevent psychiatric disorders in the near future.

The Contribution of Linear Growth Components to Hypertension in Secondary School Adolescents in an Urban Setting in Cameroon

Background: Components of height have been found to be positively associated with blood pressure (BP) both in developed and developing nations. However, amongst Cameroon secondary school adolescents, the relationship between heights, SH and SH/H with BP has rarely been studied. The purpose of this study was to determine the proportion of secondary school adolescents with elevated BP and high BP and to evaluate the relationship between the different components of linear growth with BP. Methods: An institution-based cross-sectional study involving 602 adolescents (399 girls and 203 boys, mean age 14.9 ± 2.3 years) attending some public and private secondary schools in the Bamenda municipality of the North West Region of Cameroon. Anthropometric and BP measurements were carried out following standard procedures. Pearson correlation and linear regression were used to determine the relationship between the various components of height (height, SH, SH/H) with BP amongst the children. Results: The overall prevalence of elevated BP and hypertension amongst the study participants was 21.9% and 15.6% respectively (with 8.3% and 7.3% of the hypertensive children in Stage I and Stage II respectively). However, there were no significant gender differences in the prevalence of elevated BP and high BP (p = 0.497). Girls had a significantly (p Conclusion: This study has demonstrated that height was positively associated with SBP amongst children and adolescents. Thus, height can be used in predicting adolescents with a high risk of developing high BP in our setting.

An Assessment of Predisposing Factors of Atherogenic Dyslipidemia in an Urban Pediatric Population in Cameroon

Background: Dyslipidemia in childhood contributes to an increased risk of cardiovascular diseases later in life. This study sets out to determine the prevalence of dyslipidemia and describe the associations between selected variables and dyslipidemia in Cameroon urban children. Methods: This cross-sectional hospital-based study included 415 children (188 boys and 227 girls) between the ages of 5 and 16 years. Dyslipidemia was defined as an abnormal value of one or more of the following lipids: Total cholesterol (TC), triglycerides (TG), low-density lipoprotein cholesterol (LDL-C) and high-density lipoprotein cholesterol (HDL-C). Percentage body fat (%BF) was estimated using bio-electric impedance analysis. A structured questionnaire was used by parents to report physical activity, screen time and eating habits of the children. Relationships between predictors and dyslipidemia were assessed using multiple binary logistic regression analyses. Results: The prevalence of dyslipidemia was 46.0%. Dyslipidemic children had significantly higher %BF, TG and LDL-C and lower HDL-C than the normal children (p p = 0.004), short stature (OR 2.8, 95% CI 1.1 - 6.8, p = 0.041), physical activity p Conclusion: This study confirms that obesity, short stature, physical activity < 60 minutes/day and never/occasional consumption of fruits/vegetables were associated with dyslipidemia. Also, a high proportion of children had one or more lipid disorders. This is concerning and indicates the importance of assessing dyslipidemia in pre-school children in future studies.