Systolic blood pressure was measured at birth, every week till 6 months, then every month till 12 months in normal Cameroonian neonates in the two Yaounde teaching hospitals. Systolic arterial pressure in awake babies rose from a mean of 65.1 +/- 1.30 mmHg at birth to 80.59 +/- 2.16 mmHg at 6 weeks; 94.39 mmHg at 12 months. The majority of this rise (7 mmHg) took place during the first 2 weeks of life. Systolic blood pressure increased by an average 2.5 mmHg weekly in the first 6 weeks, 0.5 mmHg weekly from 6 weeks to 6 months, and 0.6 mmHg monthly from 6 to 12 months. Relationships between systolic blood pressure and various parameters, and systolic blood pressures trends are analysed. Systolic blood pressure was not influenced by birth weight, sex of children, or tribe of parents. There was a weak correlation between systolic blood pressure and body weight between 6 weeks and 6 months. Systolic blood pressure measurements taken at different ages were not correlated.
The administration of 0.5 g (IM) of desferrioxamine every 12 hr for 3 days with 25 mg/kg (total dose for three days) of chloroquine abated the parasitemia of Plasmodium falciparum infected individuals more rapidly than chloroquine alone. Two patients with in vitro evidence of total or partial resistance to chloroquine also were successfully treated with the combination of drugs, and were free of parasitized red cells by day 7. Further clinical trials and development of desferrioxamine in the treatment of P. falciparum are warranted.
BackgroundAll suspected cases of malaria should receive a diagnostic test prior to treatment with artemisinin-based combinations based on the new WHO malaria treatment guidelines. This study compared the accuracy and some operational characteristics of 22 different immunochromatographic antigen capture point-of- malaria tests (RDTs) in Cameroon to inform test procurement prior to deployment of artemisinin-based combinations for malaria treatment.MethodsOne hundred human blood samples (50 positive and 50 negative) collected from consenting febrile patients in two health centres at Yaoundé were used for evaluation of the 22 RDTs categorized as “Pf Only” (9) or “Pf + PAN” (13) based on parasite antigen captured [histidine rich protein II (HRP2) or lactate dehydrogenase (pLDH) or aldolase]. RDTs were coded to blind technicians performing the tests. The sensitivity, specificity, and predictive values of the positive and negative tests (PPV and NPV) as well as the likelihood ratios were assessed. The reliability and some operational characteristics were determined as the mean values from two assessors, and the Cohen’s kappa statistic was then used to compare agreement. Light microscopy was the referent.ResultsOf all RDTs tested, 94.2 % (21/22) had sensitivity values greater than 90 % among which 14 (63.6 %) were ‘Pf + PAN’ RDTs. The specificity was generally lower than the sensitivity for all RDTs and poorer for “Pf Only” RDTs. The predictive values and likelihood ratios were better for non-HRP2 analytes for “Pf + PAN” RDTs. The Kappa value for most of the tests obtained was around 67 % (95 % CI 50–69 %), corresponding to a moderate agreement.ConclusionOverall, 94.2 % (21/22) of RDTs tested had accuracy within the range recommended by the WHO, while one performed poorly, below acceptable levels. Seven “Pf + PAN” and 3 “Pf Only” RDTs were selected for further assessment based on performance characteristics. Harmonizing RDT test presentation and procedures would prevent mistakes of test performance and interpretation.Electronic supplementary materialThe online version of this article (doi:10.1186/s12936-016-1085-0) contains supplementary material, which is available to authorized users.
A prospective 6-month study in Yaounde evaluated 49 children aged from 2 months to 8 years, hospitalized with bacterial meningitis. They were randomly assigned to one of two initial treatment groups, either an ampicillin-chloramphenicol combination (group A) or chloramphenicol alone (group B). The majority of patients were infected with Haemophilus influenzae, and the majority of deaths were caused by Streptococcus pneumoniae. Altogether, 17.9% of Haemophilus influenzae isolates were ampicillin-resistant and 3.6% chloramphenicol-resistant. We found no isolate resistant to both antibiotics. Response to both treatments was similar in both groups. The theoretical risk of treatment failure with ampicillin was higher than with the ampicillin-chloramphenicol combination (p less than 0.05). There was no statistically significant difference between the risk of treatment failure with the ampicillin-chloramphenicol combination and the risk with chloramphenicol alone (p less than 0.05), but the latter was increased by the occurrence of chloramphenicol-resistant isolates of Streptococcus pneumoniae (11.1%). Although treatment with an ampicillin-chloramphenicol combination is four times more expensive than treatment with chloramphenicol alone, costwise it is also one-quarter the price of a third-generation cephalosporin (moxalactam). At present, the ampicillin-chloramphenicol combination can be suggested as the first choice for initial treatment considering both the epidemiological data and the cost/efficiency ratio in the area of Yaounde.
Plasma Renin Activity (PRA) was determined in a group of 50 Cameroonian newborns and 50 Cameroonian children aged 1-15 years under resting conditions in order to establish baseline values, and also to investigate the relationship between PRA distribution, and blood pressure levels, age, or body weight. Mean PRA values were 0.98 +/- 0.78 ng/ml/h at birth and 1.17 +/- 0.92 ng/ml/h in older children. These values did not correlate with birth weight, age, or blood pressure levels. These results are lower than figures reported in comparable groups of American white and black children, and also in European or Asian children.
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