The African population is composed of a variety of ethnic groups, some of them very different. Some studies suggest that ethnic variation may influence dating. The aim of the present study was to establish reference values for fetal age assessment in Cameroon using two different ethnic groups (Fulani and Kirdi), and to determine the effect of maternal morphometry. This was a prospective cross-sectional study of 200 healthy pregnant women from Cameroon. The participants had regular menstrual periods and singleton uncomplicated pregnancies, and were recruited after informed consent. The head circumference (HC), outer-outer biparietal diameter (BPD) and femur length (FL) were measured using ultrasound at 12–22 weeks of gestation. Differences in demographic factors and fetal biometry between ethnic groups were assessed by t- and Chi-square tests. Compared to the Fulani women, Kirdi were 2 years older (P = 0.005), 3 cm taller (P = 0.001), 6 kg lighter (P < 0.0001), had higher ponderal index (P = 0.001), but were not different with regard to parity. There was no effect of weight (P = 0.20 (FL), 0.22 (HC), 0.39 (BPD)), height (P = 0.22 (FL), 0.58 (HC), 0.83 (BPD)), maternal age (P = 0.1 (BPD), 0.17 (FL), 0.34 (HC)), and BMI (P = 0.2 (HC), 0.33 (BPD), 0.6 (FL)) on fetal biometry. Compared with other relevant European charts we found them in agreement with charts from Norway (HC, BPD, FL) and England (HC, BPD); statistical analysis methods are similar in these three studies. The present study shows that ethnic differences had no significant effect on second-trimester fetal size. The current dating charts are in agreement with charts based on other populations and for all practical purposes applicable in a variety of populations, since ethnic differences hardly influence fetal biometry until after 22 weeks of gestation.
Background: HIV testing is encouraged, but in many countries testing is rarely free of charge except during campaign periods. Aim: To study experiences from four years of campaign week for HIVtesting in the town of Ngaoundere, Cameroon. Data have been collected and recorded from handwritten protocols in 2001, from pre- and post-counselling sheets in 2002, and from laboratory protocols in 2003-4. Results: Seropositivity tended to increase with increasing age, female sex, number of sexpartners last five years and with low educational level. Different dimensions of knowledge about HIV was associated with less seropositivity. One of five persons tested never came back to know their result, but seropositivity in this group was not higher than for those who returned. Overall HIV prevalence during the last three years of campaign testing was 9.0%, a little higher than WHO national figures for Cameroon. Conclusions: HIV campaigns including testing may stimulate interest and knowledge about HIV, which is important to lower HIV incidence. The HIV vulnerability of females was confirmed. Campaigns did not easily attract less educated persons, and campaign testing prevalence therefore could be expected to be lower than HIV prevalence in the local population. On the other hand, people with high risk behaviour may be over-represented, increasing campaign testing prevalence. Most symptomatic persons receiving a positive test did not come back for medical follow-up.
Abstract Background The African population is composed of a variety of ethnic groups, which differ considerably from each other. Some studies suggest that ethnic variation may influence dating. The aim of the present study was to establish reference values for fetal age assessment in Cameroon using two different ethnic groups (Fulani and Kirdi). Methods This was a prospective cross sectional study of 200 healthy pregnant women from Cameroon. The participants had regular menstrual periods and singleton uncomplicated pregnancies, and were recruited after informed consent. The head circumference (HC), outer-outer biparietal diameter (BPDoo), outer-inner biparietal diameter and femur length (FL), also called femur diaphysis length, were measured using ultrasound at 12–22 weeks of gestation. Differences in demographic factors and fetal biometry between ethnic groups were assessed by t- and Chi-square tests. Results Compared with Fulani women (N = 96), the Kirdi (N = 104) were 2 years older (p = 0.005), 3 cm taller (p = 0.001), 6 kg heavier (p < 0.0001), had a higher body mass index (BMI) (p = 0.001), but were not different with regard to parity. Ethnicity had no effect on BPDoo (p = 0.82), HC (p = 0.89) or FL (p = 00.24). Weight, height, maternal age and BMI had no effect on HC, BPDoo and FL (p = 0.2–0.58, 0.1–0.83, and 0.17–0.6, respectively). When comparing with relevant European charts based on similar design and statistics, we found overlapping 95% CI for BPD (Norway & UK) and a 0–4 day difference for FL and HC. Conclusion Significant ethnic differences between mothers were not reflected in fetal biometry at second trimester. The results support the recommendation that ultrasound in practical health care can be used to assess gestational age in various populations with little risk of error due to ethnic variation.
Vesico-vaginal fistulae are common in the northern parts of Cameroon. Their prevalence is related to early childbirth, a phenomenon common in these areas. They are also related to home deliveries and obstructed labour. We report here four cases of vesico-vaginal fistula seen over a three months period among primiparous teenagers at the Norwegian hospital, Ngaoundere, Cameroon. Les fistules vesico-vaginales sont frequentes dans les trois provinces du nord Cameroun. Elles sont associees aux accouchements precoces, une situation bien connue dans cette zone. La frequence des fistules est aussi influencee par les accouchements a domicile et le travail obstructif. Nous presentons ici quatre cas de fistul vesico-vaginale observes a l'hopital Norvegien de
Ngaoundere parmi les primipares jeunes pendant une periode de trois mois. Keywords : Fistula - Labour - Childbirth. Clinics in Mother and Child Health Vol. 3(2) 2006: pp. 599-602
Optimal starting point for antiretroviral treatment (ART) has been uncertain. Parallel group, single blind, randomised controlled study of adult HIV positive patients consulting at the Protestant Hospital, Ngaoundere, Cameroon in 2007-8. Simple randomisation of patients in WHO clinical stage 1-2 to start of ART early or deferred, i.e. when CD4 counts dropped below 350 versus 250 cells/mm3, or when they reached clinical stage 3-4. Clinical follow-up every three months were offered for all patients. Main outcomes were clinical stage, CD4 differences and mortality. Of 424 consulting patients, most were excluded, mainly because they were already in WHO stage 3-4. Forty-four patients were randomised. In the ‘early’ group two patients died and five were lost to follow-up. In the ‘deferred’ group, six patients died and nine were lost to follow-up (Hazard ratio for death by early compared to deferred treatment 0.26, 95% confidence interval 0.05-1.29). Of the patients lost to follow-up, three patients in the ‘early’ group and four patients in the ‘deferred’ group were known to be alive when the study ended. Fourteen patients in the early group and 11 in the deferred group started ART. Twenty-two patients were evaluated clinically six to seven months after the study period was terminated. Except for one patient with AIDS, these were all still in clinical stage 1-2. In our small sample, relative risk for death did not differ significantly, but deferred treatment seemed to carry no increased survival or other clinical advantage. During the study period, other studies made WHO change its guidelines to conform to our early treatment. The tendency in our study lends support to this policy. ISRCTN22114173
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