BackgroundHigh level of androgens found in congenital adrenal hyperplasia (CAH) seems to have a deleterious effect on heart function. We therefore evaluate cardiac function of children with CAH in comparison with a healthy group.MethodsWe carried out a case-control study in the single endocrinology unit of the Mother and Child Center of Chantal Biya’s Foundation. Cases were matched for age and genotypic sex to 2 healthy controls. We analyzed the ejection fraction (LVEF), fractional shortening and left ventricular mass; output and cardiac index; E and A waves velocities, E/A ratio and the mitral deceleration time and diameter of the left atrium; tricuspid annular plane systolic excursion and pulmonary artery systolic pressure were also measured.ResultsWe included 19 patients with a median age of 6.26 ± 3.75 years and 38 controls stackable distribution. The left ventricular mass of cases was greater than that of controls. A case of reversible cardiomyopathy on hormone replacement therapy was found.For the cases, the average ejection fraction was 71.95 ± 7.88%; the average fractional shortening was 40.67 ± 7.02%. All these values ​​were higher than those of controls, although the difference was not statistically significant. Diastolic left ventricular function was more impaired among the cases.Right ventricular function was similar in both groups. These abnormalities were highly correlated to the late age at diagnosis and duration of treatment.ConclusionThis study shows an altered cardiac function in CAH compared to healthy control and highlights importance of an early diagnosis of cases, a tight control of androgens levels and a regular monitoring of cardiac function.

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Objective: To determine the attributes of COVID-19 vaccines that influence vaccine acceptance using a DCE through a systematic review. Methods: A systematic search was carried out for articles published up to November 2021 in the PubMed, Psycinfo, Embase, Web of Science, and Global Index Medicus databases. The electronic search algorithm consisted of the terms (Covid-19) AND (Vaccine) AND (discrete choice experiment). Findings: A total of 39 records were retrieved of which 18 duplicates were identified and removed. Of the remaining 21 records, 10 were excluded because they did not use a DCE approach. 11 studies were included in the meta-analyses with a total of 42 795 participants from three WHO regions. We examined 13 attributes of COVID-19 vaccine that influenced acceptance; cost, vaccine efficacy, number of doses, risk of side effects, proof of vaccination, vaccination setting, duration of immunity, doctor recommendation, proportion of acquaintances vaccinated, region of vaccine manufacture, background knowledge of herd immunity, life attenuated or mRNA, speed of vaccination development. The four attributes reported to influence COVID-19 vaccine preferences most worldwide were; high vaccine efficacy, low risk of side effects, long duration of immunity and low number of doses of the vaccine. Conclusion: The most preferred COVID-19 vaccine attributes should be taken into account by vaccine manufacturers and public health policy makers for better introduction and acceptance of COVID-19 vaccine to the world. Keywords: COVID-19, Vaccine preferences, Discrete Choice Experiment.

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Background Puberty is reported to be impaired in children with Sickle Cell Anemia (SCA). We therefore, aimed to explore clinical and hormonal features of puberty in Cameroonian children with emphasis on the factors associated with delayed puberty during SCA.Methods During a case-control study, we included 64 children aged 8 to 18 years with SCA matched to healthy controls. We assessed height, weight, body mass index, body composition and Tanner stages. Hormonal measurements included Follicle Stimulating Hormone, Luteinizing Hormone and sex steroids (estrogens/ testosterone) with radio-immunologic assays. We used a non-parametric test (Mann U Whitney Wilcoxon) to compare the median values ​​between cases and controls. We looked into associations between severity criteria of SCA and delayed puberty through multivariate analysis.Results Delayed puberty was reported in 27.3% of girls and 10% of boys with SCA. Median age of menarche was delayed by 2 years compared to controls. SCA patients had low free fat mass compared to controls (p = 0.03). Abnormal levels of Antimullerian hormone were reported in cases. History of severe infection, acute chest syndrome as well as low hemoglobin level were associated with delayed sexual maturation in children with SCA.Conclusion Our study reveals delayed puberty in children with SCA. Moreover, puberty is affected by severity of the disease. This highlights importance of regular monitoring of puberty during follow-up of these children.

Introduction: COVID-19 is an infectious disease that has been causing a global pandemic since 2019. Although clinical forms are generally less severe in children than in adults, children nevertheless present polymorphous clinical forms and severe cases that can lead to death. Objective: To describe the clinical presentations found in the different waves of COVID-19, and to highlight the different factors of severity. Materials and Methods: We conducted a cross-sectional study with retrospective and prospective data collection which lasted 7 months (from November 2021 to June 2022) and covered a study period from 6 March 2020 to 22 June 2022, i.e. 27 months. All patients aged 0 to 18 years, suspected of having COVID-19, confirmed by real-time RT-PCR or an antigenic Rapid Diagnostic Test or antibody were included.These patients were to be managed in the Mother and Child Centre of the Chantal Biya Foundation, as well as in the Specialised Centre for the Management of COVID patients, annex number II of the Yaoundé Central Hospital. The results were analysed using IBM SPSS.23 software. Results: We included 163 patients in our study. No paediatric patients were registered during the 3 rd wave. The mean age of the patients in the study population was 13 ± 5 years with extremes from 15 days to 18 years. We had a female predominance with a sex ratio of 0.83. The most common comorbidity was asthma. The first wave presented mainly with respiratory symptoms such as dry cough and signs of respiratory distress. The second wave presented mainly with digestive symptoms such as diarrhoea, abdominal pain and vomiting. The fourth wave presented with ENT signs such as sore throat, and rhinorrhea. Factors associated with severity were mainly age less than five years (OR = 17.69), vomiting (OR = 6.50

Introduction: Neurological distress is life-threatening in most cases. Specific data on neurological pediatric emergencies in our environment are rare. We aim to describe the incidence and pattern of pediatric neurological emergencies. Patients and method:This was a descriptive cross-sectional study conducted at the Mother and Child Center of the Chantal Biya Foundation in Yaounde. We collected data from the registers of emergency room admission during the year 2020. Any child aged 0 to 18 years who presented with neurological distress main complaint was included.Results: A total of 5998 children were received in the emergency department during 2020, of which 640 (10.1%) were for neurological distress, the average age was 46±6 months with extremes of 1 day and 18 years. The sex ratio was 1.2. The main neurological symptoms that motivated the need of emergency care were convulsions (77.8%), consciousness disorders (8.9%), and behavioural disorders (6.8%). The most frequent diseases were: severe malaria (32.0%), meningitis, and meningoencephalitis (30.8%). The main comorbidities were cerebral palsy (0.9%), sickle cell disease (2.19%), diabetes (0.5%) and hydrocephalus (0.5%). Conclusion:This study clearly shows that neurological distress is a frequent reason for admission to the Mother and Child Center of the Chantal Biya Foundation emergency room. Their knowledge allows to anticipate and to improve the care offer.

Congenital lipodystrophy is a group of rare syndrome characterized by the absence of subcutaneous tissue. Affecting less per million live birth, this condition associate metabolic disturbance including severe insulin resistance and progeroid appearance. Diagnosis may be fortuitous or related to complications as presented in the present case series. Lipodystrophy can be generalized or localized. Acquired lipodystrophy is associated with some drugs like antiretroviral. Thus, the condition is well described in African HIV patients but data on congenital forms from Sub Saharan Africa are sparse, justifying the present report. We present four cases, with peculiar appearance associated with increased blood triglycerides. Two on four of the patients presented diabetes mellitus. Genetic testing was not available, questioning the actual guidelines of diagnosis for our context.