Alain Patrick Menanga

Prevalence and Risk Factors of Hypertension in Urban Areas of Cameroon: A Nationwide Population-Based Cross-Sectional Study.

Accurate estimates of the prevalence rate of hypertension and determinants in Cameroon are crucial to inform efficient prevention and control policies. The authors carried out a cluster‐specific cross‐sectional survey in urban areas of the 10 regions of Cameroon to assess the prevalence and risk factors of hypertension in Cameroonian adults using the WHO STEPwise approach to Surveillance (STEPS). Sociodemographic data were collected and blood pressure and glycemia were measured using standardized methods. Participants were adults of both sexes aged 16 years or older. A total of 15,470 participants were surveyed. The age‐standardized prevalence rate of hypertension was 29.7%. The awareness rate was 14.1%. Independent correlates of hypertension included higher age, male sex, obesity, hyperglycemia, and living in the Savannah zone. The prevalence of hypertension is high in urban areas of Cameroon, with very low awareness. Prevention and control strategies should emphasize on improvement and vulgarization of population opportunistic screening and education.

Kidney function, urinalysis abnormalities and correlates in equatorial Africans with sickle cell disease

Background Little is known about the renal profiles of individuals with sickle cell disease (SCD) in equatorial Africa, the global epicenter of SCD. We evaluated the kidney function, urinalysis abnormalities and their correlates in a group of Cameroonians homozygous for SCD. Methods This was a cross-sectional study of 4-month duration involving 72 homozygous SCD patients (39 men, 54%), recruited during routine visit or vaso-occlusive crisis at the Yaoundé Central Hospital in Cameroon. Clinical and laboratory data were used to evaluate the renal and urinalysis parameters, and potential effects of SCD-related clinical and hematological variables on those parameters investigated through linear and logistic regression models. Results The mean serum creatinine increased with increasing age, translating into a decreasing estimated glomerular filtration rate (eGFR) with age (P < 0.001). One patient (1.4%) had an eGFR of <60 mL/min and nine others (12.5%) had 60 ≤ eGFR ≤ 90 mL/min. The eGFR was lower in women and decreased with increasing systolic blood pressure. The prevalence of proteinuria (>200 mg/g) was 93% and the main urinalysis abnormalities were leukocyturia (77.8%), albuminuria (40.3%), hematuria (13.9%) and cristalluria (9.7%). None of the predictive clinical, hematological and urinary factors studied was associated with proteinuria or albuminuria, while hematuria and leukocyturia were associated with increasing age and male gender. Conclusions Cameroonians homozygous for SCD present a high prevalence of proteinuria and urinalysis abnormalities, and a slight renal impairment. Age, blood pressure variables and gender seem to be the main determinants. Urinalysis abnormalities and kidney function assessment should be an active pursuit in women with SCD.

OP48 The management of patients with diabetic kidney disease prior to specialized nephrology care. A 24 months review at the Yaounde General Hospital

Introduction: Several therapeutic strategies to slow the progression of kidney damage and reduce cardiovascular mortality exist for patients with diabetic kidney disease. However, the degree of implementation of these preventive strategies is unknown in Cameroon. We therefore sought to evaluate the care of type 2 diabetics with chronic kidney disease (CKD) prior to specialist nephrology care at the Yaounde General Hospital. Methods: Records of all incident type 2 diabetics with CKD seen in the nephrology unit from January 2009 to December 2010 were studied. All data was prospectively collected during the period under study. Relevant clinical and laboratory data obtained on the first nephrology visit was sought. GFR was estimated using the MDRD (4 variables) equation. Proteinuria evaluated by dipsticks. Data was analyzed with the aid of SPSSv10 software using usual statistical methods. Continuous data is expressed as Mean ± SD. Ethical clearance for the study was obtained from the hospital ethics board. Results: A total of 87 (65 M, 22 F) participants were included, 33% referred by endocrinologists, and 25.6% by cardiologists. Age = 62.05±8 yrs., diabetes vintage = 13.39±7.62 yrs, BMI = 26.45±3.98 kg/m2 (18.8% obese). The eGFR was 23.09±20.38 ml/min. (70.1% in CKD stage 4 and 5). Hypertension was present in 98.6% of participants. Seventy-two patients were receiving anti-diabetic drugs (34 insulin; 38 oral agents). HbA1C = 7.25±1.87%, SBP = 150.36±22.19 mmHg and DBP = 86.16±13.94 mmHg, proteinuria = 291±0.69 mg/dl (>2+ in 75%). Only 50% were on RAS blockers and 42% on statins. Optimal Blood pressure control = 4.6%, LDL cholesterol <1 g/dl = 48.3%, and HbA1C <7% = 34% of participants. Conclusion: Preventive strategies for kidney and cardiovascular disease in diabetic patients are underutilized by nonnephrologists in our setting; with patients referred late for nephrology care. These results highlight the need for a comprehensive educational program for healthcare givers involved in the care of diabetics.