Browsing by Author "Noubiap, Jean J"
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- ItemOpen AccessGrand multiparity in rural Cameroon: prevalence and adverse maternal and fetal delivery outcomes(2019-07-05) Ajong, Atem B; Agbor, Valirie N; Simo, Larissa P; Noubiap, Jean J; Njim, TsiAbstract Background Grand multiparity is a major public health concern especially among developing countries and has been associated with higher risk of adverse maternal and fetal outcomes compared with women of lesser parity. There is a dearth of evidence on this subject in Cameroon, especially in the rural areas. We therefore carried out this study to document the prevalence and maternal and fetal delivery outcomes of grand multiparity in a rural Cameroonian setting. Methods We conducted a retrospective chart review of delivery records from two health facilities (the Oku District Hospital and Kevu Integrated Health Centre) in the Oku Health District over a period of eight years. Data was entered into and analyzed using Epi-Info version 7.0.8.3. The Chi-squared or Fisher’s exact test was used to compare categorical variables. The threshold of statistical significance was set at 5%. Results A total of 1755 delivery records met our inclusion criteria. The overall prevalence of grand multiparity was 27.0%. We found no significant difference in the rate of selected maternal and fetal delivery outcomes between grand multiparous women and those with lesser parity (p-value> 0.05). However, grand multiparous women were less likely to develop second-fourth degree perineal tears compared to their counterparts with lesser parity (odds ratio = 0.3, 95% confidence interval = 0.2–0.7, p = 0.001). Conclusion Our study depicts a high prevalence of grand multiparous delivery in this rural community. With the exception of severe perineal tear, grand multipara and their babies are as likely to develop adverse delivery outcomes as their counterparts with lesser parity. There is also the need to enhance existing government policies on reproductive health in rural areas.
- ItemOpen AccessPrevalence and determinants of comprehensive eye care in a group of patients with diabetes: a cross-sectional study in a sub-Saharan African setting(BioMed Central, 2018-02-27) Jingi, Ahmadou M; Noubiap, Jean J; Bilong, Yannick; Tankeu, Aurel T; Ebana Mvogo, CômeObjectives We aimed to investigate the determinants of comprehensive eye examination in diabetes patients. We conducted a cross-sectional study at the eye department of the Douala General Hospital. Adult patients with diabetes were consecutively interviewed on the history of their diabetes. Main outcomes were a first ever comprehensive eye examination including fundoscopy, and diagnosis-to-fundoscopy time. Results 52 patients were included of whom 59.6% were males with a mean age of 55.9 ± 10.9 years. 51.9% have had counselling on the risk of visual impairment and blindness due to diabetes, and 61.5% [95% CI 47–74.7] have had a comprehensive eye examination. Of those with a first ever fundoscopy, only 21.9% had the test performed within 1 year of diagnosis. Thus, after an average of 10 years of the diagnosis of diabetes, 13.5% (7/52) of patients have had a comprehensive eye examination within 1 year of diagnosis. Only dose with duration of diabetes of more than 10 years were 7–24 times more likely to have a comprehensive eye examination. In summary, patients with diabetes in this low-income setting do not receive a comprehensive eye care as recommended. Most patients will get an eye examination at least 10 years after the diagnosis of diabetes.
- ItemOpen AccessSickle cell disease, sickle trait and the risk for venous thromboembolism: a systematic review and meta-analysis(BioMed Central, 2018-10-04) Noubiap, Jean J; Temgoua, Mazou N; Tankeu, Ronni; Tochie, Joel Noutakdie; Wonkam, Ambroise; Bigna, Jean JoëlBackground Globally, sickle cell disease (SCD) is one of the most common haemoglobinopathy. Considered a public health problem, it leads to vessel occlusion, blood stasis and chronic activation of the coagulation system responsible for vaso-occlussive crises and venous thromboembolism (VTE) which may be fatal. Although contemporary observational studies suggest a relationship between SCD or sickle trait (SCT) and VTE, there is lack of a summary or meta-analysis data on this possible correlation. Hence, we propose to summarize the available evidence on the association between SCD, SCT and VTE including deep vein thrombosis (DVT) and pulmonary embolism (PE). Methods We searched PubMed and Scopus to identify all cross-sectional, cohort and case-control studies reporting on the association between SCD or SCT and VTE, DVT or PE in adults or children from inception to April 25, 2017. For measuring association between SCD or SCT and VTE, DVT, or PE, a meta-analysis using the random-effects method was performed to pool weighted odds ratios (OR) of risk estimates. Results From 313 records initially identified from bibliographic databases, 10 studies were eligible and therefore included the meta-analysis. SCD patients had significantly higher risk for VTE (pooled OR 4.4, 95%CI 2.6–7.5, p < 0.001), DVT (OR 1.1, 95% CI 1.1–1.2, p < 0.001) and PE (pooled OR 3.7, 95% CI 3.6–3.8, p < 0.001) as compared to non SCD-adults. A higher risk of VTE (OR 33.2, 95% CI 9.7–113.4, p < 0.001) and DVT (OR 30.7, 95% CI 1.6–578.2, p = 0.02) was found in pregnant or postpartum women with SCD as compared to their counterparts without SCD. Compared to adults with SCT, the risk of VTE was higher in adults with SCD (pooled OR 3.1, 95% CI 1.8–5.3, p < 0.001), and specifically in SCD pregnant or postpartum women (OR 20.3, 95% CI 4.1–102, p = 0.0003). The risk of PE was also higher in adults with SCD (OR 3.1, 95% CCI 1.7–5.9, p = 0.0004) as compared to those with SCT. The risk of VTE was higher in individuals with SCT compared to controls (pooled OR 1.7, 95% CI 1.3–2.2, p < 0.0001), but not in pregnant or postpartum women (OR 0.9, 95% CI 0.3–2.9, p = 0.863). Compared to controls, SCT was associated with a higher risk of PE (pooled OR 2.1, 95% CI 1.2–3.8, p = 0.012) but not of DVT (pooled OR 1.2, 95% CI 0.9–1.7, p = 0.157). Conclusion Individuals with SCD, especially pregnant or postpartum women, might have a higher risk of VTE compared to the general population. SCT might also increases the risk of VTE. However, currently available data are not sufficient to allow a definite conclusion. Further larger studies are needed to provide a definitive conclusion on the association between SCD, SCT and VTE.