Browsing by Author "Kuaban, Christopher"
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- ItemOpen AccessHIV testing, HIV status and outcomes of treatment for tuberculosis in a major diagnosis and treatment centre in Yaounde, Cameroon: a retrospective cohort study(BioMed Central Ltd, 2012) Pefura Yone, Eric; Kuaban, Christopher; Kengne, AndreBACKGROUND:Human immuno-deficiency virus (HIV) infection and tuberculosis are common and often co-occurring conditions in sub-Saharan Africa (SSA). We investigated the effects of HIV testing and HIV status on the outcomes of tuberculosis treatment in a major diagnosis and treatment centre in Yaounde, Cameroon. METHODS: Participants were 1647 adults with tuberculosis registered at the Yaounde Jamot's Hospital between January and December 2009. Multinomial logistic regression models were used to relate HIV testing and HIV status to the outcomes of tuberculosis treatment during follow-up, with adjustment for potential covariates. RESULTS: Mean age of participants was 35.5 years (standard deviation: 13.2) and 938 (57%) were men. Clinical forms of tuberculosis were: smear-positive (73.8%), smear-negative (9.4%) and extra-pulmonary (16.8%). Outcomes of tuberculosis treatment were: cure/completion (68.1%), failure (0.4%), default (20.1%), death (5.2%) and transfer (6.3%). Using cure/completion as reference, not testing for HIV was associated with adjusted odds ratio of 2.30 (95% confidence interval: 1.65-3.21), 2.26 (1.29-3.97) and 2.69 (1.62-4.46) for the risk of failure/default, death and transfer respectively. The equivalents for a positive test among those tested (1419 participants) were 1.19 (0.88-1.59), 6.35 (3.53-11.45) and 1.14 (0.69-1.86). CONCLUSIONS: Non-consent for HIV testing in this setting is associated with all unfavourable outcomes of tuberculosis treatment. However been tested positive was the strongest predictor of fatal outcome. Efforts are needed both to improve acceptance of HIV testing among patients with tuberculosis and optimise the care of those tested positive.
- ItemOpen AccessInfluence of HIV infection on the clinical presentation and outcome of adults with acute community-acquired pneumonia in Yaounde, Cameroon: a retrospective hospital-based study(BioMed Central Ltd, 2012) Yone, Eric Walter; Balkissou, Adamou; Kengne, Andre; Kuaban, ChristopherBACKGROUND: The impact of HIV infection on the evolution of acute community-acquired pneumonia (CAP) is still controversial. The aim of this study was to investigate possible differences in the clinical presentation and in-hospital outcomes of patients with CAP with and without HIV infection in a specialised service in Yaounde. METHODS: Medical files of 106 patients (51 men) aged 15years and above, admitted to the Pneumology service of the Yaounde Jamot Hospital between January 2008 and May 2012, were retrospectively studied. RESULTS: Sixty-two (58.5%) patients were HIV infected. The median age of all patients was 40years (interquartile range: 31.75-53) and there was no difference in the clinical and radiological profile of patients with and without HIV infection. The median leukocyte count (interquartile range) was 14,600/mm3 (10,900-20,600) and 10,450/mm3 (6,400-16,850) respectively in HIV negative and HIV positive patients (p=0.002). Median haemoglobin level (interquartile range) was 10.8g/dl (8.9-12) in HIV negative and 9.7g/dl (8-11.6) in HIV positive patients (p=0.025). In-hospital treatment failure on third day (39.5% vs. 25.5.1%, p=0.137) and mortality rates (9% vs. 14.5%, p=0.401) were similar between HIV negative and HIV positive patients. CONCLUSION: Clinical and radiological features as well as response to treatment and in hospital fatal outcomes are similar in adult patients hospitalised with acute community-acquired pneumonia in Yaounde. In contrast, HIV infected patients tend to be more anaemic and have lower white cell counts than HIV negative patients. Larger prospective studies are needed to consolidate these findings.
- ItemOpen AccessSensitisation to Blattella germanica among adults with asthma in Yaounde, Cameroon: a cross-sectional study(BioMed Central Ltd, 2014) Pefura-Yone, Eric; Kengne, Andre; Afane-Ze, Emmanuel; Kuaban, ChristopherBACKGROUND: German cockroach or Blattella germanica is commonly found in homes across the inter-tropical region. The contribution of sensitisation to Blattella germanica in people with asthma in sub-Saharan Africa has not received attention. The aim of this study was to assess the prevalence and investigate the predicting factors of sensitisation to Blattella germanica in patients with asthma in Yaounde, Cameroon. METHODS: This was a cross-sectional study conducted between January 2012 and June 2013. All patients (aged 15years and above) with asthma, receiving care at the Yaounde Jamot Hospital and the CEDIMER medical practice during the study period and who had received a prick skin testing for perennial aeroallergens were included in the study. RESULTS: The final sample comprised 184 patients including 123 (66.8%) women. The median age (25th-75th percentiles) was 38 (24-54) years. Prick skin test for Blattella germanica was positive in 47 (25.5%) patients. Sensitisation to Blattella germanica was associated with a sensitisation to mite in 41 (87.2%) patients, a sensitisation to Alternaria in 18 (38.3%) patients, and a sensitisation to cat or dog dander in 7 (14.9%) patients. Independent predicting factors of a sensitisation to Blattella germanica were the sensitisation to Blomia tropicalis [adjusted odd ratio (95% confidence interval) 4.10 (1.67-10.04), p=0.002] and sensitisation to Alternaria [3.67 (1.53-7.46), p=0.003]. CONCLUSIONS: Sensitisation to Blattella germanica is present in about a quarter of adult patients with asthma in Yaounde. Sensitisation to Alternaria and Blomia tropicalis appears to be a powerful predicting factor of sensitisation to Blattella germanica in this setting.