Background: There has been a progressive increase in hypertension among children and adolescents over the years. Hypertension in childhood is influenced by various risk factors including; childhood obesity, lifestyle and hereditary factors. This study is aimed at assessing the prevalence of hypertension and elevated blood pressure (BP); as well as the associated factors to hypertension among primary school children in a rural setting in the, Centre Region of Cameroon.Methods: A cross sectional study was carried out from November 2017 to May 2018 in 13 primary schools in Mbankomo subdivision. A two staged cluster sampling technique was used to select participants: the first stage we conveniently selected 13 out of 71 (18%) primary schools in the study area by probability proportionate to size since the subdivision does not have an equal number of primary schools in the rural and semi-urban areas. In the second stage, we also used probability proportional to size to randomly select participants from the 13 clusters because the classes did not have equal number of students. We randomly selected 13% pupils enrolled in each class of the 13 schools. BP and anthropometric measurements were taken, together with socio-demographic characteristics, lifestyle and past history. Results:The overall prevalence of hypertension among the 822 pupils sampled was 1.6% (with 1.5% in stage I and 0.1% in stage II) and that of elevated BP was 8.1%, with a systolic predominance of 1.6%. SBP and DBP had a significant positive correlation with age (r=0.17; P=0.000 and r=0.07; P=0.000 respectively) and BMI (r=0.18; P=0.000 and r=0.11; P=0.000 respectively). The associated risk factors for hypertension were: the pupil's age >10 years (95% CI: 1.2581-33.1841; P=0.0254), family history of overweight (95% CI:1.6906-32.9401; P=0.008), and excess weight (95% CI: 2.5094-40.7063; P=0.0011), and being born at term (P=0.0004) as a protecting factor.Conclusions: This study revealed a high prevalence of hypertension among primary school children in rural areas, with a number of preventable risk factors. Considering the risk factors found, children should be educated on proper nutrition, and the need for physical exercises at home and in school to avoid overweight and obesity.

Background: Statistics on birth injuries in Cameroon are scarce, despite its frequency in postnatal consultations; we sort to find its prevalence and contributing factors, the different clinical presentations and treatment methods. Methodology: This was a retrospective, descriptive study. Data on maternal characteristics, neonatal factors, the place of birth and qualification of birth attendant, age at diagnosis, clinical presentation and management were considered. Results: Among the 14,284 newborns that were consulted from January 2003 to February 2014, 263 (1.84%) had birth injuries. The average age at diagnosis was 12 days. The contributing factors were: advanced maternal age, macrosomia, vaginal and instrumental delivery. Birth attendants were mostly nurses and the health center was the place of birth for 57.4% of patients. The main clinical presentations were: obstetric brachial plexus palsy (70.6%), fracture of the clavicle (22.5%) and fracture of the humerus (4.80%). Physiotherapy and orthopedic treatment were methods used with favorable outcome. Conclusion: The frequency of birth injury is relatively high in our context. The diagnosis is late, birth attendants need to be trained and systematic examination of all newborns in delivery room encouraged.

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BackgroundVaccination is a major, but simple and cost effective public health intervention in the prevention of infectious diseases, especially in children. Nowadays, many children still miss scheduled vaccines in the Extended Program of Immunization (EPI) or are being vaccinated after the recommended ages.This study was aimed at assessing vaccination completeness and timeliness in children aged 0 to 11 months attending the vaccination clinic of the Yaounde Gynaeco-Obstetric and Pediatric Hospital.MethodsThis was an observational cross-sectional study over a period of 3 months (1st February to 30th April 2016). 400 mothers were interviewed and their children’s vaccination booklets analyzed. Information on the children and the parents was collected using a pretested questionnaire. Data analysis was done using SPSS version 20 software. Bivariate and multivariate analysis with logistic regression was done to assess the determinants of completeness and timeliness.ResultsA total of 400 mother-infant pairs were sampled. The vaccination completeness rate was 96.3%. This rate varied between 99.50% for BCG and 94.36% for IPV. Most of the children were born at the Yaounde Gynaeco-Obstetric and Pediatric hospital where they were regularly receiving their vaccines. The proportion of correctly vaccinated infants was 73.3%. The most differed vaccines were BCG, PCV13 and IPV. Factors influencing immunization completeness were the father’s profession and the mother’s level of education.ConclusionsDespite the high immunization coverage, some children did not complete their EPI vaccines and many of them took at least one vaccine after the recommended age.Electronic supplementary materialThe online version of this article (10.1186/s12887-017-0954-1) contains supplementary material, which is available to authorized users.

MUAC predicts death better than WHZ in children with SAM.

Background: According to the World Health Organization, about 5% of children world-wide of 14-year-old and under have a moderate to severe developmental disability, and up to 15% of children under 5-year-old are developmentally delayed. Purpose: To determine the prevalence, socio-demographic profile, aetiologies, and the clinical presentation of developmental delay in children less than 6-year-old at the child neurology unit in a university-affiliated hospital in Yaounde. Materials and methods: It was a crosssectional descriptive study carried out in Yaounde Gynaeco-Obstetric and Paediatric Hospital (Cameroon) from August to December 2012. Children aged between 5 -72 months with a developmental quotient less than 70 were enrolled. Developmental delay (DD) was diagnosed and classified using the Denver developmental screening test (DDST). Data concerning the child (age, gender, severity of DD), the mother (age, age at conception, educational level, marital status), history of pregnancy and delivery, perinatal and postnatal events, results of para-clinical explorations (EEG, CT-scan, genetic tests), the severity of DD and the probable or demonstrate cause of DD were recorded on a standardized questionnaire. The chisquare test was used to compare variables. Results: During the study period, 2171 children aged 5 -72 months consulted the paediatric department of the hospital, 296 were examined at the child neurology unit of which 153 had a developmental quotient less than 70, giving a hospital prevalence of 7.0% and a prevalence of 51.7% at the child neurology unit. The mean age was 26.6 ± 18.0 months and there were 56% males. The main reason for consulting was tonus disorder (43.8%) and the developmental area of parental concern was the motor domain (90.2%). Regarding the clinical presentation, 75.2% of our population were children with cerebral palsy. DD was severe, mild, moderate and profound respectively in 14.2%, 13.5%, 12.2%, and 11.1%. Gross DD represented 90.2% of all DD children. The causes of DD were hypoxic-ischemic encephalopathy (41.8%), epilepsy (13.7%), sequelae of meningitis (6.5%), sequelae of kernicterus (6.5%), and infectious embryofoetopathies (5.2%). Conclusion: Developmental delay is frequent in paediatric neurology, with perinatal disorders being the leading aetiologies in Cameroon. Prevention of perinatal hypoxic-ischemic encephalopathy risk factors needs to be reinforced.

Introduction: Exclusive breastfeeding is fundamental for the good health and development of the mother and the child. According to the World Health Organization (WHO), breastfeeding after childbirth should be initiated within 30 minutes. For a number of reasons, WHO recommendations on guiding principles for infants and young children feeding are often not followed. Objective: To determine the reasons for the delayed initiation of breastfeeding in newly delivered women. Means and Method: We carried out a mixed cross-sectional study over a period of six months from December 1 st 2018 to May 31 st 2019, at the Yaoundé Gynaeco-Obstetric and Pediatric Hospital. We included all mothers with full-term or premature babies weighing ≥ 2000 grams and those whom initiated breastfeeding more than one hour after delivery. The mother's reasons for delaying breastfeeding initiation were recorded using a dictaphone and data were accurately extracted for analysis. Results: We interviewed 153 mothers. Their mean age was 27.9 ± 6.2 years. The main reasons for delaying breastfeeding initiation were caesarean delivery (22%), the belief in "spoiled milk" (21%), lack of knowledge about the time to initiate breastfeeding (21%), baby asleep (18%), and lack of instruction given to the mother by the health staff (2%). Conclusion: Delayed breastfeeding was common in our context. Improving the quality of breastfeeding involves communication, to break beliefs about spoiled milk, and strengthening mothers' knowledge for optimal breastfeeding processes in accordance with WHO's guidelines.

BackgroundSevere malaria is a leading cause of morbidity and mortality in under-fives in sub-Saharan Africa. Recently quinine has been replaced by artesunate as the first-line drug in the treatment of severe malaria in Cameroon. Artesunate has been shown to be cost-effective in African children, but whether these findings are transferable to Cameroonian children remains to be explored.ObjectivesTo conduct a cost-analysis of four different regimens used in the treatment from the perspective of the healthcare payer.MethodsAn economic evaluation alongside a randomized comparative study was conducted in children aged 3 months to 15 years, admitted at the Ebolowa Regional Hospital with severe malaria due to Plasmodium falciparum. Patients were randomized to receive one of the four treatment alternatives. Group 1 (ARTES) received parenteral artesunate at 2.4 mg/kg at H0, H12, H24 and then once daily; Group 2 (QLD) received a loading dose of quinine base at 16.6 mg/kg followed 8 h later by an 8-hourly maintenance dose of 8.3 mg/kg quinine base; Group 3 (QNLD3) received 8.3 mg/kg quinine base every 8 h, and Group 4 (QNLD2) received 12.5 mg/kg quinine base every 12 h. The main outcome measure for effectiveness of treatment was the parasite reduction rate. Based on a healthcare perspective, an evaluation of direct medical costs was done, including costs of anti-malarials, nursing care materials, adjuvant treatment, laboratory investigations, hospitalisation and professional fees. Guided by a cost minimalization approach, the relative costs of these treatment alternatives was compared and reported.ResultsOverall cost was higher for ARTES group at $65.14 (95% CI $57.68–72.60) than for quinine groups ($52.49–$62.40), but the difference was not statistically significant. Cost of the anti-malarial drug was significantly higher for artesunate-treated patients than for quinine-treated patients, whereas cost of hospitalization was significantly lower for artesunate-treated patients than for quinine-treated patients. Incremental analysis of ARTES against QLD as a baseline resulted in an ICER of $46.8/PRR24 and suggests ARTES as the most cost effective of all four treatment options.ConclusionArtesunate is a cost effective malaria treatment option relative to quinine alternatives with the lowest incremental cost per unit of effectiveness. Trial registration clinicaltrials.gov identifier: NCT02563704. Registered 19 September 2015, retrospectively registered