BackgroundDepression is an important contributor to the global burden disease that affects people of communities all over the world. With high level of demands in academics and psychosocial pressure, medical students during their course of training tend to become depressed, leading to problems later in professional life and compromising patient care. In Cameroon, there is lack of data on the prevalence of depression and its impact on medical students. To determine the prevalence and predisposing factors associated with depression among medical students in Cameroon (preclinical and clinical). We also evaluated the impact of depression on self-reported academic performance.MethodsA cross sectional study was carried out in all 4 state medical schools in 4 different regions from December 2015 to January 2016. Diagnosis of depression, major depression and its associated factors were assessed using the 9-Item-Patient Health Questionnaire (PHQ-9) and a structured questionnaire respectively. We included 618 medical students (response rate: 90.4%).ResultsAbout a third of them (30.6%, 95% CI: 22.8–36.7) were found to have major depressive disorder (PHQ Score ≥ 10). With regards to the severity of depression, 214 (34.6%), 163 (26.4%), 21 (3.4%), and 5 (0.80%) students were classified as having mild, moderate, moderately severe and severe depression respectively. The presence of a chronic disease (OR: 3.70, 95% CI: 1.72–7.94, p = 0.001), major life events (OR: 2.17, 95%CI: 1.32–3.58, P = 0.002), female gender (OR: 1.59, 95% CI: 1.06–2.37, p = 0.024) and being a student at the clinical level (OR: 4.26, 95% CI: 2.71–6.71, p < 0.001) were independently associated with depression. There was no association between depression and self-reported academic performance, (OR: 1.2, 95% CI: 0.9–1.7, p = 0.080).ConclusionThe prevalence of major depressive disorders among medical students in Cameroon is high and is associated with the presence chronic disease, major life events, female gender and being a student at the clinical level. So we recommend clinicians attending to medical students with demographic features suggestive of greater risk of depression, to make an in depth investigation on the possible presence of depression. Despite this high prevalence of major depression among medical students, it was not associated with self-reported academic performance.

IntroductionThe incidence of breast cancer (BCa) in Cameroon is on the rise and accounts for a leading cause of mortality. An understanding of the knowledge and practices on breast cancer and breast self-examination (BSE) among teachers are important first steps which will guide the designing of interventions aimed at raising awareness across the general population.MethodsWe conducted a cross-sectional study in April 2016 involving 345 consenting female undergraduate students in the Higher Teachers Training College, Bambili, Cameroon. Data was collected using a pretested self-administered questionnaire and analysed using descriptive methods.ResultsThe mean age of the respondents was 22.5±3.2years and a vast majority (n = 304, 88.1%) had heard about BCa primarily from the television/radio (n=196, 64.5%). Overall, less than a quarter (n=65, 21.4%) of respondents who had heard about BCa had sufficient knowledge on its risk factors and signs/symptoms. A plurality (53.3%) thought BCa can be prevented via vaccination while over a third (38.7%) opined that BCa can be treated spiritually. Less than half (47%) of respondents who had heard about BCa had heard about BSE amongst which only 55 (38.5%) had ever practiced it.ConclusionThough most students are aware of the existence of breast cancer, their overall knowledge on its risk factors and clinical presentation is insufficient with a concomitant low practice of BSE. These highlighted gaps warrants intensification of sensitization campaigns and educational programmes in order to raise knowledge levels and enhance prevention strategies that would aid in reducing the burden of breast cancer in Cameroon.

BackgroundSeveral studies have reported on factors influencing adolescent pregnancies and the associated outcomes, but evidence from a systematic review is limited, especially in sub-Saharan Africa where the greater burden lies. Establishment of accurate epidemiological data on the rates of adolescent pregnancy, its predictors, and adverse outcomes (maternal and neonatal) may have important implications towards attainment of the Sustainable Development Goals.MethodsThis will be a systematic review of studies reporting predictors of adolescent pregnancy and adverse outcomes in sub-Saharan Africa published between January 2000 and December 2017. The following databases will be searched: PubMed/MEDLINE, Excerpta Medica Database (EMBASE), SCOPUS, Popline, Africa Wide Information, African Index Medicus, Google scholar and the Cochrane library. Three authors will independently screen all potential articles for eligibility as guided by the selection criteria. The Stata statistical software will be used in analysing the data. Appropriate meta-analytic techniques will be used to pool prevalence estimates from studies with similar features, overall and by major subgroups as warranted. Heterogeneity of studies will be evaluated by the χ 2 test on Cochrane’s Q statistic. Publication bias will be sorted for using funnel plot analysis and Egger’s test. Qualitative synthesis will be used where data are insufficient to produce a quantitative synthesis. This protocol is reported according to Preferred Reporting Items for Systematic Reviews and Meta-Analysis Protocols (PRISMA-P) 2015 guidelines.DiscussionThis systematic review and meta-analysis is expected to serve as a template for designing adolescent-friendly preventive and control programmes to help curb the ever-growing burden of adolescent pregnancies, and as a guide for future research.Systematic review registrationPROSPERO CRD42017070773 Electronic supplementary materialThe online version of this article (10.1186/s13643-017-0650-0) contains supplementary material, which is available to authorized users.

BackgroundMore than 80% of premature deaths due to cardiovascular disease (CVD) occur in low-and middle-income countries. However, access to, and affordability of medications remain a challenge in these countries.

Pulmonary hypertension (PH) is a devastating, progressive disease with increasingly debilitating symptoms and usually shortened overall life expectancy. This article reviews the global epidemiology of PH with focus on low-and middle-income countries (LMICs) and sub-Sahara African in particular. Although left ventricular heart disease is the most common cause globally, the main contributing risk factors in LMICs are chronic infectious diseases especially human immunodeficiency virus (HIV) and schistosomiasis. Other important risk factors of PH are rheumatic heart disease, untreated congenital heart disease (CHD), and sickle cell disease. Despite existing epidemiological data of PH risk factors suggesting a high prevalence in sub-Saharan Africa (SSA), the available literature is limited. International registries in LMICs like the pan African pulmonary hypertension cohort (PAPUCO) study are essential to provide information about the causes, treatment, outcome, and the natural course of PH in Africa and other parts of the world. In addition,there is a need to track diagnostic and management practices in order to develop suitable algorithms to diagnose PH in LMICs.

ObjectiveThis study aimed to describe the clinical characteristics of patients with infantile hypertrophic stenosis, management and its outcome in two tertiary care centres in Cameroon.ResultsA total of 21 patients were included from the two centres. The mean age at presentation was 5.2 ± 1.2 weeks, predominantly male with a male-to-female ratio of 4.25:1. The triad of vomiting, visible peristalsis and palpable mass was present in only 7 (33.3%) of the participants. The diagnosis was confirmed with ultrasounds in all participants. Ramstedt pyloromyotomy was done in all participants and in 9.5% of the participants it was complicated by intra-operative duodenal perforation whereas in the postoperative period the most common complications were vomiting (6, 28.6%), sepsis (2, 9.5%), and paralytic ileus (2, 9.5%). The mortality rate from the series is 9.5%. According to univariate logistic regression: severe dehydration [OR = 5.41, 95% CI = (3.11–6.97), p = 0.002], hypokalaemia [OR = 2.63, 95% CI = (1.02–5.91), p = 0.042] and surgical site infection [OR = 3.12, 95% CI (1.22–5.64), p = 0.023] were the main predictors of mortality whereas postoperative hospital length of stay > 5 days was significantly associated with surgical site infection [OR = 2.44, 95% CI = (1.12–6.44), p = 0.002] and postoperative nausea and vomiting [OR = 3.64, 95% CI = (1.18–6.64), p = 0.022].

PH, dominated by PHLHD, was common among adults attending this rural centre and was associated with a high mortality rate. Related co-morbidities and late clinical presentation reflect the poor socio-economic context. Improved awareness of PH among physicians could promote early diagnosis and management.

PURPOSE This study investigated the status of training and preparedness for oncology practice and research and degree of interprofessional collaboration among health care professionals in the six geopolitical regions of Nigeria. METHODS A convergent parallel mixed methods design was used. Three hundred seventeen respondents completed a three-part, online questionnaire. Self-rated competencies in oncology research (26 items), oncology practice (16 items), and interprofessional collaboration (nine items) were assessed with a one- to five-point Likert scale. Six key informant and 24 in-depth interviews were conducted. Descriptive statistics, analysis of variance, and pairwise t-test were used to analyze the quantitative data, whereas thematic analysis was used for the qualitative data. RESULTS Respondents were mostly female (65.6%) with a mean age of 40.5 ± 8.3 years. Respondents include 178 nurses (56.2%), 93 medical doctors (29.3%), and 46 pharmacists (14.5%). Self-assessed competencies in oncology practice differed significantly across the three groups of health care professionals ( F = 4.789, P = .009). However, there was no significant difference across professions for competency in oncology research ( F = 1.256, P = .286) and interprofessional collaboration ( F = 1.120, P = .327). The majority of respondents (267, 82.4%) felt that educational opportunities in oncology-associated research in the country are inadequate and that this has implications for practice. Key training gaps reported include poor preparedness in data analysis and bioinformatics (138, 43.5%), writing clinical trials (119, 37.5%), and writing grant/research proposals (105, 33.1%). Challenges contributing to gaps in cancer research include few trained oncology specialists, low funding for research, and inadequate interprofessional collaboration. CONCLUSION This study highlights gaps in oncology training and practice and an urgent need for interventions to enhance interprofessional training to improve quality of cancer care in Nigeria. These would accelerate progress toward strengthening the health care system and reducing global disparities in cancer outcomes.