Emmanuel Armand Kouotou

The spectrum of skin diseases in a rural setting in Cameroon (sub-Saharan Africa)

BackgroundSkin disorders are generally considered to be more prevalent in the rural areas of Cameroon. This study was carried out to verify this assumption by describing the spectrum of skin disorders in a rural setting of Cameroon.MethodsWe carried out a community-based clinical skin examination of 400 consenting subjects from 4 villages of Cameroon: Nyamanga (27%), Yebekolo (24%), Mbangassina (23%) and Bilomo (26%).ResultsThe overall prevalence of skin diseases in our sample was 62% {95% CI: 57.2%, 66.8%} (248/400). The commonest skin disorders were: fungal infections (25.4%), parasitic infestations (21.4%), atrophic skin disorders (11.7%), hypertrophic skin disorders (9.7%), disorders of skin appendages {acne} (8.9%), benign neoplasm (6.5%), bacterial skin infections (5.2%), pigmentation disorders (4.8%), and dermatitis/eczema (4.0%). Skin infections and infestations constituted 52.82% of all skin disorders. The overall prevalence of infectious and parasitic infestation was 32.75% {95%CI: 28.17%, 37.59%} (131/400) as against 29.25% {95%CI: 24.83%, 33.98%} (117/400) for non-infectious disorders.Among people with skin infections/parasitic infestations, those with fungal infections and onchocercal skin lesions were the most prevalent, accounting for 48.1% (63/131) and 35.1% (46/131); and an overall prevalence of 15.75% {95%CI: 12.3%, 19.7%} (63/400) and 11.5% {95%CI: 8.5%, 15.0%} (46/400) respectively.There was secondary bacterial infection in 12.1% {95%CI: 8.31%, 16.82%} (30/248) of subjects with skin diseases. Hypertrophic and atrophic disorders of the skin were mainly keloids (9.68%), scarification marks (6.05%) and burn scars (5.65%). Skin diseases like dermatitis and eczema (4.03%), malignant tumours and pigmentation disorders were rare in our sample.The proportion of subjects diagnosed with skin disorders after examination (62.8%) was significantly higher than the proportion of 40.8% that declared having skin diseases (p < 0.0001).ConclusionThe prevalence of skin diseases in the rural Mbam valley is alarming, dominated by easily treatable or preventable skin infections and their magnitude is highly neglected by the community, contrasting with findings in the urban setting. Similar studies are needed in other ecological/demographic settings of the country in order to construct a better understanding of the epidemiology of skin disorders. This would lead to the development of national policies to improve skin care.

Burden of human scabies in sub-Saharan African prisons: Evidence from the west region of Cameroon

There is little data on the profile and magnitude of scabies in sub‐Saharan African prisons. The present study aimed to assess the prevalence and determinants of scabies in prisons of the west region of Cameroon.

Prevalence and Clinical Profile of Drug Eruptions among Antiretroviral Therapy-Exposed HIV Infected People in Yaoundé, Cameroon

Background Prevalence and incidence of drug eruptions vary around the world and are influenced by some key factors including HIV infection. Objective This study aimed to find the peculiarities of drug eruptions in people living with HIV (PLHIV) and on antiretroviral therapy (ART). Methods This was a retrospective cross-sectional study including ART-taking PLHIV, aged 15+ years, followed up between January 2010 and December 2014 at the day-care unit of the Yaoundé Central Hospital, and who presented with drug eruptions after ART initiation. Results Of 6,829 ART-experiencing PLHIV, 41 presented with drug eruptions, giving a prevalence of 0.6%. The M/F sex ratio equaled 0.17. The mean age was 41.07 ± 11.36 years. Benign drug eruptions accounted for 83.3%. Milder forms were essentially maculopapular exanthema (36.6%), fixed pigmented erythema (7.3%), and urticaria (4.9%). Severe forms were represented by multiform erythema (4.9%), toxic epidermal necrolysis (2.4%), and drug hypersensitivity syndrome (2.4%). The Zidovudine + Lamivudine + Efavirenz ART-protocol was received by 48.8% of patients and 69% of patients were receiving Cotrimoxazole prophylaxis. Nevirapine, Efavirenz, Zidovudine, and Cotrimoxazole were suspected as the potential causes in 43.7%, 4.8%, 2.4%, and 26.8% of cases, respectively. Conclusion Drug eruptions seem infrequent among ART-exposed HIV infected adult Cameroonians.

Epidemiological and Clinical Patterns of Kaposi Sarcoma: A 16-Year Retrospective Cross-Sectional Study from Yaoundé, Cameroon

Background: The burden of Kaposi sarcoma (KS) is increasing fast among HIV-infected populations, but the disease remains desperately underexplored in Cameroon, where the burden of HIV is high. Methods: This is a retrospective cross-sectional study carried out over a period of 16 years (January 2001 to December 2016) at the HIV day care unit of the Central Hospital of Yaoundé, Cameroon. The diagnosis was based on clinical aspects and histological confirmation, and we used a preconstructed questionnaire for data collection through patients’ electronic and physical files. Results: Among 14,220 files reviewed, 316 cases of KS were identified, yielding a cumulative incidence of 2.2%. In the end, 266 patients (55% male) were included in this study. The patients’ age ranged from 17 to 72 years, with a mean of 37.8 ± 9.5 years. KS was the presenting manifestation of HIV in 89.8% of the cases. Cutaneous lesions occurred more often (81.6%), mainly located on the lower limbs (47.7%); mucous lesions were found in 15.8% of the patients, while 8 patients (3.0%) had associated visceral lesions. The lesions predominantly were lymphedemas (28.6%) and papulonodules (21.1%). At the diagnosis of KS, the median CD4 count was 175 cells/mm3 (interquartile range 80.5–288.5), and 150 patients (56.6%) had CD4 counts < 200 cells/mm3. Conclusions: KS is frequent among our HIV-infected patients; it seems to occur most often at a younger adult age and represents one of the presenting manifestations of HIV/AIDS in our context. It seems to equally affect men and women, occurring more often when CD4 counts are < 200 cells/mm3.

Herpes zoster: clinical, therapeutic, and outcome aspects among HIV-infected patients in Yaoundé, Cameroon

Introduction: Addressing the scarcity of data on therapeutic and evolutional aspects of herpes zoster in Cameroon, the present study aims to describe the clinical, therapeutic and evolutional profiles of herpes zoster among HIV-infected patients in Yaoundé, Cameroon. Material and methods: From March to May 2015, we conducted a descriptive cohort study at the daycare unit of the Yaoundé Central Hospital, Cameroon. All HIV infected patients visiting the unit, diagnosed with herpes zoster during dermatology consultations, and volunteering to participate in the study were included. They were subsequently followed up at 15 days, at one, and two months. Results: Overall, 38 patients (78.9% females) were enrolled. The mean age was 39.7 ± 12.6 years. Herpes zoster enabled the diagnosis of HIV infection in 60.5% of cases. The median CD4 count equaled 186 (interquartile range, 70-316) cells/mm3. At presentation, 26 patients (68.4%) were presented with acute dermatologic lesions, predominantly localized on the chest (34%). All patients complained of pain at the initial visit. Acyclovir was prescribed to twenty patients (52.6%) for 10 days. A decline in the proportion and intensity of pain was noticed over time, though there was no significant difference between those on acyclovir and their acyclovir-naïve counterparts (p > 0.05). Conclusions: This study confirms herpes zoster as a mode of revelation of HIV infection in our context, though its prevalence may be low. Herpes zoster-related pain may be of moderate to severe intensity; therefore, it requires more attention when managing affected patients. HIV AIDS Rev 2017; 16, 3: 163-168 DOI: https://doi.org/10.5114/hivar.2017.70709

Knowledge, attitudes and practices of the medical personnel regarding atopic dermatitis in Yaoundé, Cameroon.

BackgroundAtopic dermatitis (AD) is a chronic, relapsing and pruritic inflammatory skin disease whose management remains unclear to most non-dermatologists. This study aimed to assess the knowledge, attitudes and practices (KAP) of the medical staff regarding AD in Yaoundé, Cameroon.MethodsThis was a cross-sectional study conducted from January to April 2014 in 20 health facilities located in Yaoundé, the capital city of Cameroon. All medical staff who provided their consent were included in the study. A score was established for each of the KAP categories, and subsequently grouped into 4 classes considering a score <50, 50-<65, 65-<85 or ≥85%, respectively.ResultsWe enrolled 100 medical personnel, 62% of whom were females. Overall, the level of knowledge on AD was moderate (65%). Allergy was the main cause of AD, stated by 64% of participants. Only 43% personnel cited the genetic cause. Asthma was mentioned by 78% as an associated pathology. Regarding attitudes, the majority (84%) thought that AD is equally common among Black and Caucasian populations; 42% of participants believed that evolution is favorable when appropriate medical treatment is prescribed. These attitudes were considered wrong (64%). Similarly, the general level of practice was inadequate: 50%.ConclusionLevels of knowledge, attitudes and practices of the medical staff regarding AD were poor, implying that management of this condition is non optimal in our setting.

Profil épidémio-clinique des atteintes dermatologiques chez le noir africain en hémodialyse chronique

INTRODUCTION Dermatologic manifestations are common among patients on chronic hemodialysis and may represent systemic involvement. Our study aims to determine the epidemiological and clinical profile of skin damages in black patients living in Yaounde, Cameroon. METHODS We conducted a cross sectional study including all patients receiving chronic haemodialysis treatment for at least 3 months in two hemodialysis centers in Yaounde from February to May 2014. Patients underwent an interview and a dermatological examination. Chi-squared tests and Students t-test (or equivalents) were used for statistical analysis, with significance level at p <0.05. RESULTS A total of 112 patients (78 (69.9%) men) with an average age of 48.6 ± 13 years and a mean duration of dialysis of 46,3 ± 37 months were included in the study. Skin lesions were present in 94 (83.9%) patients. Xerosis (63.3%), pruritus (37.5%), melanoderma (34.8%), acne (12.5%) and half and half nails (10.7%) were the most common dermatologic manifestations. Xerosis was associated with anuria (p = 0.0001) and advanced age (p = 0.032); melanoderma was associated with anuria (p = 0.042) and time spent on dialysis (p = 0.027) while half and half nails were associated with young age (p = 0.018) and biweekly dialysis (p = 0.01 ). CONCLUSION Skin damages are frequent and dominated by xerosis, pruritus and melanoderma in patients on chronic hemodialysis living in Yaounde. Biweekly dialysis, advanced age, anuria and time spent on dialysis were associated factors.Introduction Les manifestations dermatologiques sont fréquentes chez les hémodialysés chroniques et traduiraient une atteinte systémique. Notre objectif était de déterminer le profil épidémio-clinique sur peau noire à Yaoundé au Cameroun. Méthodes Il s’agissait d’une étude transversale, menée de Février à Mai 2014 dans les deux centres d’hémodialyse de Yaoundé, incluant tout hémodialysé chronique depuis au moins 3 mois, et chez qui étaient conduits un interrogatoire et un examen dermatologique. Les tests de Chi carré et t de Student (ou équivalents) ont été utilisés pour l’analyse statistique, avec le seuil de signification fixé à p<0,05. Résultats Au total, 112 patients (dont 78 (69,9%) hommes) d’un âge moyen de 48,6 ± 13 ans et une durée moyenne en dialyse de 46,3 ± 37 mois étaient recrutés. Les lésions dermatologiques étaient présentes chez 94 (83,9%) patients. La xérose cutanée (63,3%), le prurit (37,5%), la mélanodermie (34,8%), l’acné (12,5%) et les ongles équi-segmentés (10,7%) étaient les principales manifestations dermatologiques. La xérose était associée à l’anurie (p=0,0001) et à l’âge avancé (p=0,032) ; la mélanodermie à l’anurie (p=0,042) et à l’ancienneté en dialyse (p=0,027) alors que les ongles équi-segmentés étaient associés au jeune âge (p=0,018) et aux dialyses bihebdomadaires (p=0,01). Conclusion Les atteintes dermatologiques sont fréquentes et dominées par la xérose, le prurit et la mélanodermie chez l’hémodialysé chronique à Yaoundé. La sous dialyse, l’âge avancé, l’anurie et l’ancienneté en dialyse étaient les facteurs associés.

CO 08 : La gale humaine en milieu carcéral d’Afrique subsaharienne : cas de la région de l’ouest du Cameroun

Introduction La gale humaine reste d’actualite en milieux communautaires. Cette etude avait pour but d’etablir le profil epidemiologique et clinique de la gale humaine chez les detenus en milieu carceral camerounais. Materiel et methodes Il s’agissait d’une etude transversale et analytique menee de juin a aout 2014 dans trois prisons de la Region de l’Ouest Cameroun. Tous les detenus juges non dangereux et consentant etaient recrutes selon un echantillonnage consecutif. Le diagnostic de gale humaine etait retenu sur la base des donnees anamnestiques et cliniques. Les donnees recueillies etaient analysees sous le logiciel Epi Data version 3.1. Resultats Nous avons collige 755 detenus dont 738 hommes (97,7%) avec un âge moyen de 32 ± 12 ans. La prevalence de la gale etait de 32,1% avec une morbidite plus elevee dans les prisons surpeuplees (p = 0,048). Le sexe masculin (p = 0,0042), le niveau d’instruction bas (p = 0,002), le partage de vetements (p Conclusion La gale reste un probleme d’actualite et constituerait un marqueur de precarite dans notre milieu carceral.

Skin Care Habits of Dermatology Patients in Yaounde - Cameroon

Introduction: Black and satinee skin has been a beauty quality in our environment. Then bleaching became very popular in our communities but not much is known about skin habits. The objective of this study was to identify skin care habits of patients in Yaounde. Patients and Methods: This study took place in the dermatology clinic of the Yaounde General Hospital, including all patients seen from October 2001 to September 2002. The skin care habits were compared with respect to sex and age. The level of statistical significance was p < 5%. Results: During the study period, 714 medical files (418 females and 296 males) were reviewed. In men as well as in women, savon de Marseille and antiseptic soap were respectively the first and second most used bathing soaps. However, women had a statistically significant preference for bleaching, super fat and exfoliative soaps (78.0% vs 22.0%, 69.0% vs 31.0%, 87.0% vs 13.0%) with respect to men. Users of antiseptic soaps had eczemas (35%). Only 16.0% of women did not apply daily body lotions as against 84% of men (p = 0.0001). The use of bleaching lotion (13% overall) was clearly more widespread in women than in men (87.0% vs 13.0%; p = 0.0001). The use of topical corticosteroids was associated with acne. Conclusion: A relatively high proportion of our patients use bleaching products and antiseptic soaps. The use of antiseptic soaps and the additional of topical steroids in commercial preparations may become a serious health problem if left uncontrolled.