Economic Stress, Precariousness and Risk of High Blood Pressure: A Descriptive Survey of Life Models within Households of the Central Region of Cameroon

Context/Objective: High blood pressure (HBP) currently represents the most widespread chronic non-communicable disease in Cameroon. The increase in its prevalence in the country is the result of multiple factors including economic stress imposed by precariousness, poor living conditions, sources of anxiety, anguish, depression and other behavioral disorders. Economic stress is a globalizing concept that integrates into a purely hermeneutic approach, a particular functioning of the nervous system of an individual who faces employment problems and precarious remuneration conditions. The non-satisfaction by an individual of his basic needs due to insufficient financial means can cause him to become irritable, aggressive, and socially and symbolically isolated, thereby increasing the desire to resort to morbid life models such as excessive consumption of narcotics and other psychoactive substances often associated with high blood pressure. The fight against the emergence of BPH is a complex, multifaceted and multifactorial reality that requires taking into account economic stress. The main objective of this survey is to describe the situation of economic stress within the Cameroonian population, which imposes precariousness and life models at risk of high blood pressure. Specifically, we determined the level of household income and the sources of income. Methods: A cross-sectional survey with a descriptive aim among five hundred households in the Central Region of Cameroon was conducted. A probabilistic technique called simple randomness was used. The number of households to be surveyed was determined indirectly using the Cochrane formula. Data collection in face-to-face mode using a physical questionnaire took place from July 1 to August 31, 2023, after obtaining ethical clearance from the Regional Health Research Ethics Committee, Human from the Center and an administrative authorization for data collection. Regarding their processing, the data was grouped during processing in Excel sheets. Normality and reliability tests of the collected data were carried out. For this, the Chi-square test was used for data with a qualitative value and that of Kolmogorov-Sminorf for data with a quantitative value. Descriptive analysis was possible using R software version 3.2, SPSS version 25.0, XLSTAT 2016, PAST and EXCEL programs from Microsoft Office 2013. Results: The main results highlight economic stress, with 45.60% of households surveyed earning less than US$154 per month;55% of household heads were women in single-parent families;14% of household heads were unemployed, 22% worked in the private sector and 19% were self-employed. This general economic situation leads to precarious living conditions, thereby increasing the risk of high blood pressure among the Cameroonian population.

Diagnostic and Therapeutic Options of Breast Cancer Patients in Yaounde, Cameroon

Introduction: Breast cancer remains a public health problem due to its severity and because it is the leading cause of death from cancers in women worldwide as well as in Cameroon. Our objective was to study the diagnostic and therapeutic options that patients followed for breast cancer choose in Yaounde. Method: This was an analytical cross-sectional study with prospective data collection among patients followed for breast cancer at two referral hospitals in Yaounde from February 1, 2019 to August 31, 2019. Data collected were recorded and analyzed using R application version 3.5.0., p values < 0.05 were considered to be statistically significant. Results: A total of 105 patients were recruited, including 104 women and 1 man. The median age was 46 years with extremes of 25 and 77 years. Most patients (71%) had a monthly income of less than 175 USD. Patients in this study had opted for: contemporary medicine (49.5%), therapeutic abstention (38.1%), naturopathy (1.9%), self-medication (9.5%) and traditional medicine (1%). The factors significantly associated with the choice of contemporary medicine as a first diagnostic option were monthly income above 175 USD (OR = 0.37, 95% CI: 0.15 - 0.89, p = 0.028), good level of education (OR = 0.37, 95% CI: 0.16 - 0.82, p = 0.034) and good knowledge about breast cancer (OR = 0.28, 95% CI: 0.08 - 0.89, p = 0.005). The majority of patients (65.7%) sought contemporary medicine as the first therapeutic option after a diagnosis of breast cancer was confirmed, while about a third of them had chosen alternative treatment options including naturopathy (15.2%), traditional medicine (9.5%), religious practices (4.8%), therapeutic abstention (2.9%) and self-medication (1.9%). Conclusion: The first diagnostic and therapeutic choices of breast cancer patients in our setting are numerous and intricate, including contemporary medicine, therapeutic abstention, self-medication, traditional medicine, naturopathy and religious practices. There is a need to promote breast cancer awareness in our population.

Quality of Caesarean Sections in Rural Sub-Saharan Africa: A Prospective Study in Cameroon

Introduction: Caesarean section (CS) is a major reproductive health intervention to improve maternal and foetal outcomes if appropriately performed. This study aimed to assess the quality of Caesarean sections (CS) in a rural setting in Cameroon. Materials and Methods: A prospective study conducted in 3 hospitals from February 1st 2020 to April 30th 2020. One hundred and twenty women who had a CS were included. Data were grouped into 5 categories: 1) Sociodemographic and obstetrical characteristics, 2) Geographic and financial access, 3) Diagnostic procedures, 4) Operative parameters and 5) Post-operative parameters. The Dujardin’s model and context-relevant criteria served to construct the quality score. The scale was 0 - 20 and scores ≤ 15 were considered as unacceptable quality while those >15 were considered as acceptable quality CS. Logistic regressions permitted to measure associations. Results: There were 538 deliveries and 120 (22.3%) CS. The mean (SD) gestational age was 38.7 (2.6) weeks with extremes of 31 and 43 weeks. Group 5 of the Robson’s classification was predominant (35.0%). Motorbikes were the mode of transport to the maternity for 72.5% (87/120) of women. No referral was made by ambulance. Only 44 (36.7%) women had paid the full cost of the CS prior to surgery. In addition, 26 (21.6%) women had a complete clinical examination on admission. The surgical team was not complete (<6 staffs) in 56 (43.3%) cases. Anaesthesia was done by nurses in all cases. CS was done by a general practitioner and by nurses in 86 (71.7%) and 14 (11.7%) cases respectively. Overall, mean (SD) quality score (QS) was 16.33 (1.60). Sixty six of the 120 (55.3%) caesarean sections had unacceptable quality CS. Mean (SD) QS was significantly higher in faith-based hospitals than in public hospitals (18.00 (0.91) versus 15.59 (1.24);P < 0.001). Immediate postoperative clinical monitoring was effective only in 66 (55%) of cases. Apgar score was below 7 over 10 in 17 (14.2%) cases of which 6 freshes still births. No maternal death was recorded and maternal complications were recorded in 14 (11.7%) cases. Conclusion: The quality of CS is generally poor in rural settings in West-Cameroon. The quantity and quality of staffs required for Caesarean sections in the hospitals are sometimes insufficient. The poor quality of CS in this region could be addressed using the faith-based hospitals: St Vincent de Paul’s Hospital as a model.