Université des Montagnes

ABSTRACTBackground and AimsHelicobacter pylori infection is associated with increased intestinal permeability. It promotes the passage of bacterial endotoxin through the portal vein and reaches the liver, constituting a factor in the aggravation of hepatitis. This study aims to investigate the impact of H. pylori coinfection with HBV/HCV on the progression of hepatic pathophysiology, specifically the inflammatory system and hematological parameters, with the goal of enhancing the care of patients with hepatitis.MethodsAn analytical cross‐sectional study was carried out for 6 months in 2023. This study was carried out in people infected with the hepatitis B and/or C virus who were being monitored at Laquintinie Hospital. After having informed the participants about the objective of the study and obtaining their consent, we collected sociodemographic data and clinicobiological history. Subsequently, the diagnosis of H. pylori infection was made by testing for immunoglobulins G and M using the ELISA method. Then, inflammation was explored through the determination of C‐reactive protein (CRP) and the cytokines Interleukin‐6 and Interleukin‐8 (IL‐6, and IL‐8). Finally, the hemogram was carried out by the flow cytometry method. The data obtained were analyzed using SPSS statistical software.ResultsThe study population consisted of 184 patients with hepatitis, including 113 (61.4%) cases of hepatitis B and 71 (38.6%) cases of hepatitis C. A total of 94 (51.1%) patients were male and 90 (48.9%) female for a mean age of 41.55 ± 16.90 years. The frequency of coinfection was 37.5%. The mean CRP was 3.79 ± 3.5 mg/dL and 2.4 ± 2.1 mg/dL in coinfected and non‐coinfected patients, respectively (p = 0.057). IL‐6 was significantly associated with coinfection (p = 0.001). Furthermore, elevated IL‐6 was a predictive sign of H. pylori infection in patients with viral hepatitis B/C (OR = 2.88 [0.82–10.11]; p = 0.01). Furthermore, 22 (12.0%) patients presented thrombocytopenia, including 21 (30.4%) in the coinfected group and 1 (0.9%) in the non‐coinfected group (p = 0.01). Moreover, the reduction in platelets is a predictive factor of H. pylori infection (OR = 2.34[0.11–7.6]; p = 0.09).ConclusionThese results suggest that hepatitis B/C and H. pylori coinfection is a factor in worsening inflammation and thrombocytopenia in patients. Hence, the a need to prevent H. pylori coinfection and control the progression of the disease in patients with hepatitis.

Introduction: Lassa fever is an acute viral hemorrhagic illness endemic to West Africa, with an estimated 100,000 to 300,000 infections annually and approximately 5,000 deaths. Despite its public health significance, widespread misinformation, limited health literacy, and poor access to reliable educational resources hinder effective prevention and control. In this context, artificial intelligence (AI)-powered chatbots offer a novel approach to disseminating accurate, accessible, and source-attributed health information. This study aimed to develop and evaluate a custom retrieval-augmented generation (RAG)-based AI chatbot designed to improve health literacy on Lassa fever. Methods: This was a two-phase evaluation study conducted in a virtual setting. A RAG-based chatbot was developed using curated and trusted Lassa fever guidelines from the World Health Organization (WHO), Nigeria Centre for Disease Control (NCDC), and peer-reviewed literature. The evaluation involved: Expert Assessment:Forty-four predefined questions were submitted to the chatbot. Infectious disease specialists rated responses for appropriateness (appropriate/partly appropriate/inappropriate) and source attribution (matched/partly matched/unmatched/general knowledge). Simulated Consultations: sixteen patient-like queries were tested to assess real-world applicability and response quality. Results: In the expert assessment, 73% (32/44) of responses cited reference documents, of which 94% (30/32) were rated fully appropriate. Among general knowledge responses (27%, 12/44), only one (8%) was deemed inappropriate. In the simulated consultations, 100% (16/16) of responses were rated fully appropriate and correctly sourced. Conclusion: The custom AI chatbot demonstrated high accuracy and contextual relevance in delivering Lassa fever information, with strong performance in both expert and simulated evaluations. These findings support its utility as a scalable tool for public health education. Broader implementation and expansion of reference sources are recommended to further reduce reliance on general knowledge and enhance disease-specific literacy.

BackgroundLow socioeconomic status (SES) has been linked to poorer outcomes among patients with advanced chronic kidney disease, including those undergoing maintenance hemodialysis. Limited data are available from Sub-Saharan Africa. In this region, traditional SES indicators like education and income can be challenging to measure. Household wealth may serve as a more reliable SES indicator. Our aim was to evaluate SES using household wealth, its association with non-adherence, quality of life, anxiety and depression among hemodialysis patients in Cameroon.MethodsA cross-sectional study was conducted over four months in one urban and one semi-urban hemodialysis facilities in Cameroon. Consenting adult patients on maintenance hemodialysis for at least three months were included. Patients with cognitive impairment or language barriers (English or French) were excluded. Household wealth was assessed using the World Bank’s household wealth index adapted for Cameroon. Non-adherence was defined as missing ≥ 2 hemodialysis sessions within a six-week period. Quality of life was evaluated using the Kidney Disease Quality of Life-36 (KDQOL-36) questionnaire. Anxiety and depression risk were assessed using the Hospital Anxiety and Depression Scale (HADS); p-values < 0.05 were considered statistically significant.ResultsA total of 199 participants were included, with 52.8% (n = 109) males and a median age of 46 [IQR 36–56] years. Poverty affected 47.7% (n = 95) of participants, urban dwellers being more susceptible (52.5% n = 73 vs. 36.7% n = 22, p = 0.039). Poor participants had a greater percentage of patients < 46 years (56.8% n = 58 vs. 49% n = 40, p = 0.001) and unmarried status (43.1% n = 41 vs. 28.9% n = 30, p = 0.014). Non-adherence frequency was higher among poorer participants (42% n = 40 vs. 25% n = 26, p = 0.01). Globally, the quality of life was low across all household wealth groups. However, poorer participants experienced less physical function impairment (39% n = 37 vs. 52.9% n = 55, p = 0.04), fewer emotional role limitations (9.5% n = 9 vs. 19.2% n = 20, p = 0.048), and less depression (13.7% n = 13 vs. 26% n = 27, p = 0.04). In multivariate analysis, poverty increased the risk of non-adherence by 4.3 (95%CI 2.063–8.969, p < 0.001) and decrease the risk of depression by 0.7 (95%CI 0.063-0,963, p = 0.045).ConclusionPoverty, as assessed by household wealth, is common among hemodialysis patients, particularly the younger patients and urban dwellers. It is associated with increased risk of non-adherence but a lesser risk of depression.

Background: In large numbers of low- and middle-income countries, hospital waste management policies are conducted below the minimum standards due to resource scarcity. In these areas, accumulated wastes often represent potent sources of microbial populations that may evolve as health threats to humans’, animals’ and environmental health, further exacerbating poverty. Data from accumulated waste and/or its surrounding environment can therefore help to redefine, reorient and optimize waste management policies for the healthcare setting users’ safety. Objective: The aim of this cross-sectional study was to investigate the type, the diversity, the load and the drug susceptibility trends of bacteria populations that grow in the vicinity of solid waste accumulation sites in four healthcare facilities of the Ndé division, West Cameroon. Methods: Soil and air specimens were collected for bacterial screening at varying distances from the solid waste accumulation sites. Culture, isolation, identification, enumeration and susceptibility tests on bacteria isolates were performed according to standard protocols. Results: Relevant findings revealed diversified populations made up of 53 bacterial groups including Staphylococcus spp. (50.94%), Gram-positive rods (26.42%), Acinetobacter spp. (11.32%), Klebsiella spp. (7.55%), Serratia spp. and Pseudomonas spp. (1.89% each). In terms of their loads, Gram-negative rods loads were higher than those observed with other morphological types. Further details indicated higher loads and diversities in soil specimens collected in the vicinity of solid waste accumulation sites. These trends in loads and diversity were particularly obvious in one of the four target healthcare institutions. The susceptibility tests revealed multidrug resistance, with the highest rates recorded against beta-lactam antibiotics. The most effective drugs consisted of Gentamicin, Clindamycin, Erythromycin, and Trimethoprim/Sulfamethoxazole. Conclusion: These findings are indications that exposed human populations are at risk of contracting resistant bacteria, with a higher likelihood in the vicinity of accumulated wastes in all settings. Accordingly, contextual implementation of hospital hygiene policies in line with biosafety and biosecurity was suggested as a priority to meet the expectations of the 1st, 3rd and 4th United Nations Sustainable Development Goals.

ContextAnemia is a medical condition resulting from a reduction in the number of red blood cells below the reference range. It is a major public health problem, particularly among adolescents, as it can have negative effects on cognitive performance, growth and reproduction. This study aims to assess the determinants of anemia among adolescents in schools in the city of Douala.MethodsA cross-sectional study was carried out among 511 adolescents aged 10–15 years, selected by random sampling from four secondary schools in Douala. Data were collected using a structured questionnaire, including anthropometric measurements and hemoglobin tests to assess anemia. Anemia was defined according to specific thresholds (e.g. hemoglobin < 12 g/dL for girls and < 13 g/dL for boys). Severity was classified as mild, moderate and severe. Multiple logistic regression analysis was performed to identify determinants of anemia, controlling for confounding variables, and associations were established by calculating Odds ratios, Odds ratio adjusts, confidence intervals and P-value. Statistical significance was declared at P < 0.05.ResultsThe mean age of participants was 11.9 ± 1.30 years, with a slight predominance of girls (50.7%) over boys (49.3%). The prevalence of anemia was 40.3% (95% CI: 35.0–45.6%), including 15.7% mild anemia (95% CI: 12.0–19.4%), 23.9% moderate anemia (95% CI: 19.7–28.1%) and 0.7% severe anemia (95% CI: 0.1–2.7%). Independent determinants of anemia included rural residence [AOR = 8.39 (95% CI: 5.26–13.65); p < 0.001], status of parents divorced [OR = 2.60 (95% CI: 1.57- 4.34); p = 0.0001] or deceased [AOR = 7.73 (95% CI: 1.65- 41.90); p = 0.011], onset of first menstrual period [AOR = 6.59 (95% CI: 2.28–72.19); p = 0.001], the absence of iron supplementation [AOR = 1.68 (95% CI: 1.04–2.74; p = 0.034] and the occurrence of an illness in the previous three months (malaria, sickle cell disease, viral hepatitis, amoebiasis, typhoid fever, etc.) [AOR = 3.24 (95% CI: 1.14–22.37); p = 0.012].ConclusionsThis study highlights a worrying prevalence of anemia among adolescents in Douala, with clearly identified determinants. The results underline the importance of factors such as rural residence, parental status and menarche, which can inform public health policies. It is essential to integrate these elements into targeted intervention programs, particularly in nutrition and iron supplementation, especially in rural areas. Finally, longitudinal studies and intervention-based research are needed to better understand the causal mechanisms of adolescent anemia in this context.

Background and AimsThe more severe forms of sickle cell disease (SCD) are highly inflammatory genetic disorders that cause significant oxidative stress. To fight against the free radicals produced, the body has an antioxidant system. In addition, haptoglobin has been reported in several studies as possessing oxidant and inflammatory properties depending on the nature of the genotype. This study hypothesizes that the HP2 allele of haptoglobin may exacerbate oxidative stress in sickle cell patients with inflammation.MethodsAn analytical cross‐sectional study was conducted for 6 months. The patients recruited were those with severe forms of sickle cell anemia, regularly followed at the hematology department of the Yaoundé Central Hospital and the Bafoussam Regional Hospital. The Public Health Research Biotechnology Laboratory (LAPHER‐Biotech) in Yaoundé provided a framework for genotyping haptoglobin by allele‐specific PCR. Next, iron, oxidative stress, and inflammatory parameters were assessed by standard methods, and the statistical software R Version 4.1.1. allowed for the data analysis.ResultsSamples from 149 participants were analyzed. Patients with Hp phenotypes 2‐2 had a considerable elevation of reduced glutathione (14.3 μmol/L) compared to those of phenotype Hp 2‐1 (11.2 μmol/L) and genotype Hp 1‐1 (11.8 μmol/L) (p = 0.075). Malondialdehyde was significantly higher in patients with Hp phenotypes 2‐2 compared to those with Hp phenotype 2‐1 and Hp phenotype 1‐1 (p = 0.008). The oxidative stress index (OSI) was higher in patients with the Hp 2‐2 phenotype than those with the Hp 2‐1 and Hp 1‐1 phenotypes (p = 0.008) suggesting that they are more affected by oxidative stress.ConclusionThis study supports the hypothesis that the Hp 2‐2 phenotype of haptoglobin is associated with an imbalance in the oxidative balance in favor of oxidants, suggesting that the latter is a major contributor to the worsening pathophysiology of SCD.

Background: Tuberculosis (TB) caused by Mycobacterium tuberculosis is an infectious disease affecting mainly the lungs and persists as the leading cause of death worldwide. With the emergence of coronavirus disease-19 (COVID-19) pandemic, the management and outcome of TB has been greatly affected because of the global shift in attention. This study aims to determine the effects of COVID-19 pandemic on the TB treatment uptake and outcomes in the Fako Division of Cameroon. Methods: A hospital-based retrospective and cross-sectional study was carried out in 3 Health Districts of the Fako Division of Cameroon. Extraction forms and structured questionnaire were used to collect both quantitative and qualitative data from records and health personnel, respectively. Data on treatment uptake and outcomes before and during the pandemic were compared, as well as challenges faced in TB diagnosis and treatment during the pandemic. Results: Of the 1557 reviewed files of TB patients, treatment uptake was lower (73.40%) during compared to before (82.30%) the pandemic (P &lt; 0.0001). A larger proportion (83.30%) had a successful outcome before compared to (74.3%) during the pandemic (P &lt; 0.0001). There was a significant drop in both good TB treatment uptake (8.9%) and successful outcomes (9%), respectively, during the pandemic. A number of significant challenges faced in TB diagnosis and treatment during the pandemic included shortage of drugs (63.6%) and diagnostic materials (54.5%), as well as decrease in the diagnosis rate of TB patients (90.9%) with the main reason being fear of being quarantined at the hospital (63.6%). Conclusions: A decrease in TB treatment uptake and successful outcomes was observed during the COVID-19 period compared to prior the pandemic. This is indicative of poor usage of the TB services during the pandemic as a result of COVID-19 barrier measures and laxity in the TB control programs. TB programs require some intensification geared towards strengthening the patient-centered approach and a community-based active TB case finding, especially in the current potential resurgence of the pandemic.

Abstract BACKGROUND Dental fluorosis is a developmental disturbance of enamel that results from ingestion of high amounts of fluoride during tooth mineralization. Consumption of untreated fluoridated ground water remains the main cause of dental fluorosis. AIM To establish the risk factors of dental fluorosis in three communities of the Far North Region of Cameroon. METHODOLOGY: A descriptive, cross-sectional study conducted on individuals who have lived for a minimum of 6 years in Far North Region of Cameroon using structured questionnaires and oral examination. The Thylstrup and Fejerskov index was used in evaluating the severity of dental fluorosis. Fluoride contents of drinking water were analysed using fluoride electrodes. RESULTS A total of 1971 persons mean of age 17.15(SD = ± 16.18), (85.64%) born in the study area participated in the study. The prevalence of dental fluorosis was 89.1%. Fluorosis was first observed between the ages of 1 to 10 years old, 1781(90.01%) perceived dental fluorosis to be normal, 1772(89.90%) did not know the cause of dental fluorosis in their community. A TFI score of 0 was recorded by 10.9% of the population with higher scores in females 3.04(SD = ± 2.3 SD), illiterates 3.31(± 2.45), farmers 3.49(± 2.3 SD) and those who lived in their own homes 3.06(± 2.31 SD). Sources of drinking water included borehole 61.6%, 47.4% well water,2.2% bottled water while 80% used toothpaste for brushing. One out of five commercial bottled water brands had higher than normal fluoride content (1.60mgF/L), pipe borne water 1.7mgF/L, wells 1.90mgF/L, boreholes 2.80mg F/L while 51.2% of the population presented with mild fluorosis and 23.7% severe fluorosis. CONCLUSION The prevalence of dental fluorosis was extremely high. Consumption of ground water was the major risk factor of dental fluorosis.

Background: Waste is a source of potentially dangerous microorganisms for users of healthcare facilities, and its accumulation is a risk factor for infectious agent dissemination. Objective: The first aim of the present study was to identify and quantify aerobic bacteria around solid waste accumulation sites at the “Université des Montagnes” Teaching Hospital. The second one was to assess bacteria susceptibility to common conventional antibacterial agents. Methods: Soil samples and airborne bacteria were collected at various distances from the target solid waste accumulation sites. Bacteria isolation and susceptibility tests were thereafter conducted according to standard protocols. Results: Isolated organisms (123 bacterial isolates) included Staphylococcus spp (48%), Gram-positive rods (32%) and Gram-negative rods (20%). Polymorphism and bacterial loads were highest at the sampling locations closer to the accumulation sites and decreased with increasing distances from these sites. Overall findings revealed that variations of polymorphism and bacterial loads is likely associated with anthropogenic activities. In addition, susceptibility rates for Staphylococcus were high. Conclusion: Together with the overall bacterial population distribution trends, the high susceptibility rates recorded deserve better understanding in future research initiatives for optimal hospital hygiene.