Cardiovascular complications are a major cause of morbidity and mortality in people with type 2 diabetes. The aim of this cross-sectional study was to assess the baseline cardiovascular risk of newly ...diagnosed type 2 diabetic patients, using the modified Framingham point-score scale.
Data on cardiovascular risk factors were collected from 97 consecutive newly diagnosed type 2 diabetic patients at the Yaounde Central Hospital, Cameroon. Projected 10-year cardiovascular risk was estimated for each patient using the modified point score of Framingham.
Men and women were equally represented and the age of the participants ranged from 33 to 86 years. Mean values for total, low-density lipoprotein (LDL) and non-high-density lipoprotein (HDL) cholesterol were relatively elevated in the study population while HDL cholesterol levels were low. Total cardiovascular risk scores and the individual scores for each of the parameters in our model were significantly higher in females than in males. The 10-year risk for coronary artery disease was above 20% in 7.2% (6.7-7.7) of subjects, and between 10 and 20% in 21.7% (20.8-22.6). Overall, men were more at risk than women (p < 0.001).
Patients with type 2 diabetes already had increased cardiovascular risk at clinical diagnosis in Cameroon. There is therefore considerable need for cardiovascular risk-factor intervention, particularly for hypertension and obesity, as well as dyslipidaemia, along with tight metabolic control.
Background and objective: Cardiovascular complications are a major cause of morbidity and mortality in people with type 2 diabetes. The aim of this cross-sectional study was to assess the baseline ...cardiovascular risk of newly diagnosed type 2 diabetic patients, using the modified Framingham point-score scale. Methods: Data on cardiovascular risk factors were collected from 97 consecutive newly diagnosed type 2 diabetic patients at the Yaounde Central Hospital, Cameroon. Projected 10-year cardiovascular risk was estimated for each patient using the modified point score of Framingham. Results: Men and women were equally represented and the age of the participants ranged from 33 to 86 years. Mean values for total, low-density lipoprotein (LDL) and non-high-density lipoprotein (HDL) cholesterol were relatively elevated in the study population while HDL cholesterol levels were low. Total cardiovascular risk scores and the individual scores for each of the parameters in our model were significantly higher in females than in males. The 10-year risk for coronary artery disease was above 20% in 7.2% (6.7-7.7) of subjects, and between 10 and 20% in 21.7% (20.8-22.6). overall, men were more at risk than women (p < 0.001). Conclusions: Patients with type 2 diabetes already had increased cardiovascular risk at clinical diagnosis in Cameroon. There is therefore considerable need for cardiovascular risk-factor intervention, particularly for hypertension and obesity, as well as dyslipidaemia, along with tight metabolic control.
This thesis presents and analyses the findings of research into the management of diabetes in one urban and one rural district of Cameroon. The phenomenon of noncommunicable diseases like diabetes ...mellitus is becoming a recurrent problem in middle and low-income countries, notably in Sub-Sahara Africa. This ethnographic study, in the tradition of medical anthropology, involved over two years of fieldwork, and has been undertaken to shed more light on the paradoxes that underpin the interpretation and management of diabetes in Cameroon. Initially, I set out to study how diabetes was managed in clinical settings; but as the research developed my enquiries led out from the clinic to encompass first the perspectives of patients and their families, and in the end the perspectives of traditional healers also. It thus draws together four distinct sets of actors engaged in the process of treating diabetes mellitus: clinical staff, patients, their families, and traditional healers. In this research, I explored the ways in which Cameroonians negotiate a meaningful and manageable path between alternative therapeutic regimes. But as my analysis shows, behind different therapeutic approaches lie alternative presumptions about aetiology and efficacy, about behaviour and the body. In integrating the perspectives of the different actors identified above, the research highlights three major themes. The first concerns the concept of 'compliance', and the language of frustration voiced by clinic staff about patient reluctance to adhere to medication and advice. The second concerns 'aetiology' and the ultimately incompatible styles of reasoning and understanding advanced to explain the causes and consequences of diabetes, including its complications and its significance as chronic and incurable in a 11 cultural context where the notion of an incurable disease is still seen as unconvincing. The third concerns ideas of 'power', and the differing ways in which power is attributed or assumed, ranging from the apparent power of biomedical knowledge and clinic injunctions, to the assumed power of traditional explanatory frameworks, or the powers of divination of traditional healers, or the powers of witchcraft or ancestors in inducing diabetes. My thesis is unusual (a) in subject matter, (b) in its comparative scope, and (c) in being done by a Cameroonian ethnographer. While rural Bafut has been the site of several previous ethnographic studies, almost nothing has been done ethnographically in Yaounde. This thesis shows that, contrary to my initial working hypothesis, the similarities in outlook and behaviour between rural and urban settings are more striking than the differences. The universe of the clinic and biomedicine is not more effective and accepted in the city, as might have been anticipated, for in both settings traditional healing beliefs continue to hold a strong influence, creating the problems around 'compliance' mentioned above.
This thesis presents and analyses the findings of research into the management of diabetes in one urban and one rural district of Cameroon. The phenomenon of noncommunicable diseases like diabetes ...mellitus is becoming a recurrent problem in middle and low-income countries, notably in Sub-Sahara Africa. This ethnographic study, in the tradition of medical anthropology, involved over two years of fieldwork, and has been undertaken to shed more light on the paradoxes that underpin the interpretation and management of diabetes in Cameroon. Initially, I set out to study how diabetes was managed in clinical settings; but as the research developed my enquiries led out from the clinic to encompass first the perspectives of patients and their families, and in the end the perspectives of traditional healers also. It thus draws together four distinct sets of actors engaged in the process of treating diabetes mellitus: clinical staff, patients, their families, and traditional healers. In this research, I explored the ways in which Cameroonians negotiate a meaningful and manageable path between alternative therapeutic regimes. But as my analysis shows, behind different therapeutic approaches lie alternative presumptions about aetiology and efficacy, about behaviour and the body. In integrating the perspectives of the different actors identified above, the research highlights three major themes. The first concerns the concept of 'compliance', and the language of frustration voiced by clinic staff about patient reluctance to adhere to medication and advice. The second concerns 'aetiology' and the ultimately incompatible styles of reasoning and understanding advanced to explain the causes and consequences of diabetes, including its complications and its significance as chronic and incurable in a 11 cultural context where the notion of an incurable disease is still seen as unconvincing. The third concerns ideas of 'power', and the differing ways in which power is attributed or assumed, ranging from the apparent power of biomedical knowledge and clinic injunctions, to the assumed power of traditional explanatory frameworks, or the powers of divination of traditional healers, or the powers of witchcraft or ancestors in inducing diabetes. My thesis is unusual (a) in subject matter, (b) in its comparative scope, and (c) in being done by a Cameroonian ethnographer. While rural Bafut has been the site of several previous ethnographic studies, almost nothing has been done ethnographically in Yaounde. This thesis shows that, contrary to my initial working hypothesis, the similarities in outlook and behaviour between rural and urban settings are more striking than the differences. The universe of the clinic and biomedicine is not more effective and accepted in the city, as might have been anticipated, for in both settings traditional healing beliefs continue to hold a strong influence, creating the problems around 'compliance' mentioned above.
Background Yaws is an infectious, debilitating and disfiguring disease of poverty that mainly affects children in rural communities in tropical areas. In Cameroon, mass-treatment campaigns carried ...out in the 1950s reduced yaws to such low levels that it was presumed the disease was eradicated. In 2010, an epidemiological study in Bankim Health District detected 29 cases of yaws. Five different means of detecting yaws in clinical and community settings were initiated in Bankim over the following five years. Methodology This observational study reviews data on the number of cases of yaws identified by each of the five yaws detection approaches: 1) passive yaws detection at local clinics after staff attended Neglected Tropical Disease awareness workshops, 2) community-based case detection carried out in remote communities by hospital staff who relied on community health workers to identify cases, 3) yaws screening following mass Buruli Ulcer outreach programs being piloted in the district, 4) school-based screening programs conducted as stand-alone and follow-up activities to mass outreach events, and 5) house to house active surveillance activities conducted in thirty-eight communities. Implementation of each of the four community-based approaches was observed by a team of health social scientists tasked with assessing the strengths and limitations of each detection method. Findings Eight hundred and fifteen cases of yaws were detected between 2012 and 2015. Only 7% were detected at local clinics. Small outreach programs and household surveys detected yaws in a broad spectrum of communities. The most successful means of yaws detection, accounting for over 70% of cases identified, were mass outreach programs and school based screenings in communities where yaws was detected. Conclusion The five interventions for detecting yaws had a synergistic effect and proved to be valuable components of a yaws eradication program. Well planned, culturally sensitive mass out-reach educational programs accompanied by school-based programs proved to be particularly effective in Bankim. Including yaws detection in a Buruli Ulcer outreach program constituted a win-win situation, as the demonstration effect of yaws treatment (rapid cure) increased confidence in early Buruli ulcer treatment. Mass outreach programs functioned as magnets for both diseases as well as other kinds of chronic wounds that future outreach programs need to address.
Chronic diseases are becoming increasingly important in sub-Saharan Africa (SSA). The current density and distribution of health workforce suggest that SSA cannot respond to the growing demand for ...chronic disease care, together with the frequent infectious diseases. Innovative approaches are therefore needed to rapidly expand the health workforce. In this article, we discuss the evidences in support of nurse-led strategies for chronic disease management in SSA, with a focus on hypertension and diabetes mellitus.
Aim: This study describes the impact of HIV/AIDS on the inpatient service of the main teaching hospital in Cameroon in 2001.
Methods: The authors analyzed routinely collected hospital data and data ...validated by survey of clinical notes.
Results: Admission and bed utilization rates for HIV/AIDS over the period accounted for 20.1% and 17%, respectively, primarily due to the management of opportunistic infections in young people (mean age, 39.9 years). Housewives (21.9%) and students (10.3%) were the most identified groups. Tuberculosis (23.3%), the most frequent infection, was associated with a good prognosis. Hospital stay ranged from 1 to 99 days. HIV/AIDS accounted for 49.3% of deaths registered.
Conclusion: HIV/AIDS is the major cause of hospital admissions and death in this service. This situation is likely to remain constant for some time given the national prevalence of HIV. Consideration needs to be given to the options for prevention and provision of care.
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