Anthropometric measurements of children attending a vaccination clinic in Yaounde, Cameroon

Background

Growth faltering is a frequent public health problem in children and anthropometric measurements are useful tools for follow-up and early diagnosis. This problem has not been studied in the Cameroonian setting, that''s why we undertook this study.

Objectives

To have a synopsis of the nutritional status in apparently healthy children attending a vaccination clinic and show the importance of anthropometric measurements in routine child health care.

Design

A retrospective study.

Patients and Participants

1351 children aged (6–24months), who attended the vaccination clinic of the Yaounde Gynaeco-Obstetric and Pediatric Hospital over a 6 month period, were enrolled in the study.

Method

The registers of the vaccination clinic of the above hospital were retrospectively reviewed from 1^st March to 31^st August 2005. The following parameters were noted: age, height, weight, mid-upper arm circumference (MUAC), and Z scores calculated for the following indicators: weight for age (WAZ), weight for height (WHZ), and height for age (HAZ).

Results

Our results show that 12 children (1.1percent) in the 0–6 months age group and 4 (1.6 percent) in the 6–12 months age group had WAZ less than -2 indicating underweight. Also 10 children (0.9 percent) and 2 (0.8 percent) in the 0–6 and 6–12 months age groups respectively had WHZ less than −2, indicating wasting. HAZ was less than −2 in 70 children (6.4 percent) and in 8 (3.2 percent) in the 0–6 and 6–12 months age groups respectively indicating stunting. The MUAC was less than 12.5 cm in 6 children (2.4 percent).

Conclusions

From our results, we conclude that growth faltering is common in supposedly healthy children attending our vaccination clinic. Anthropometric measurements are thus recommended and should be encouraged in routine child care settings for early diagnosis of growth retardation and to provide useful interventions.     

The Empiric Use of Palm Kernel Oil in Neonatal Skin Care： Justifiable or Not？

Palm kernel oil is a vegetable oil derived from Elaeis guineensis and widely used in neonatal settings for skin care.It is a good emollient with a beneficial effect in moisturizing the skin and preventing transdermal heat and water loss.However,it’s putative roles in the prevention or treatment of fatty acid deficiency is still controversial.So is its function in the improvement of neurological development from its long-chain polyunsaturated fatty acids? We set out in this review to verify whether its empiric use in this context has any scientific justification and is recommendable.Although there is evidence that it has emollient and moisturizing properties necessary for softening the skin and restoring elasticity,controversy subsists on its other nutritional and neurodevelopmental properties.     

Neonatal mortality in a referral hospital in Cameroon over a seven year period: trends,associated factors and causes

Background

The fourth Millennium Development Goals targets reduction by 2/3 the mortality rate of under-fives by 2015. This reduction starts with that of neonatal mortality representing 40% of childhood mortality. In Cameroon neonatal mortality was 31‰ in 2011.

Objectives

We assessed the trends, associated factors and causes of neonatal deaths at the Yaounde Gynaeco-Obstetric and Pediatric Hospital.

Methods

The study was a retrospective chart review. Data was collected from the hospital records, and included both maternal and neonatal variables from 1st January 2004 to 31st December 2010.

Results

The neonatal mortality was 10%. Out-borns represented 49.3% of the deceased neonates with 11.3% born at home. The neonatal mortality rate followed a downward trend dropping from 12.4% in 2004 to 7.2% in 2010. The major causes of deaths were: neonatal sepsis (37.85%), prematurity (31.26%), birth asphyxia (16%), and congenital malformations (10.54%). Most (74.2%) of the deaths occurred within the first week with 35% occurring within 24hours of life. Mortality was higher in neonates with birth weight less than 2500g and a gestational age of less than 37 weeks. In the mothers, it was high in single parenthood , primiparous and in housewives and students.

Conclusion

There has been a steady decline of neonatal mortality since 2004.Neonatal sepsis, prematurity, birth asphyxia and congenital malformations were the major causes of neonatal deaths. Neonatal sepsis remained constant although at lower rates over the study period.     

Neonatal mortality in a referral hospital in Cameroon over a seven year period: trends,associated factors and causes

Background

The fourth Millennium Development Goals targets reduction of the mortality rate of under-fives by 2/3 by the year 2015. This reduction starts with that of neonatal mortality representing 40% of childhood mortality. In Cameroon neonatal mortality was 31% in 2011.

Objectives

We assessed the trends, associated factors and causes of neonatal deaths at the Yaounde Gynaeco-Obstetric and Pediatric Hospital.

Methods

The study was a retrospective chart review. Data was collected from the hospital records, and included both maternal and neonatal variables from 1^st January 2004 to 31^st December 2010.

Results

The neonatal mortality was 10%. Out-borns represented 49.3% of the deceased neonates with 11.3% born at home. The neonatal mortality rate followed a downward trend dropping from 12.4% in 2004 to 7.2% in 2010. The major causes of deaths were: neonatal sepsis (37.85%), prematurity (31.26%), birth asphyxia (16%), and congenital malformations (10.54%). Most (74.2%) of the deaths occurred within the first week with 35% occurring within 24hours of life. Mortality was higher in neonates with birth weight less than 2500g and a gestational age of less than 37 weeks. In the mothers, it was high in single parenthood, primiparous and in housewives and students..

Conclusion

There has been a steady decline of neonatal mortality since 2004.Neonatal sepsis, prematurity, birth asphyxia and congenital malformations were the major causes of neonatal deaths. Neonatal sepsis remained constant although at lower rates over the study period.     

Risk Factors for Neonatal Mortality at the Yaounde Gynaeco-Obstetric and Pediatric Hospital,Cameroon

Objective: Neonatal mortality is a major health problem in sub-Saharan Africa and the risk factors are not well established. The objective of this study was to determine the risk factors for neonatal mortality at the Yaounde Gynaeco-Obstetric and Pediatric Hospital. Methods: We conducted a retrospective and analytic case-control study from the medical records of newborns admitted at the neonatal unit of this hospital between 1^st March 2003 and 31^st December 2012. 850 subjects were enrolled; that is 425 cases and 425 controls. Findings : The intra-hospital neonatal mortality rate was 9.83%. The main causes of neonatal mortality were in descending order: neonatal sepsis (60.2%), complications from prematurity (42.6%), birth asphyxia (37.4%), and congenital malformations (11.8%).The most prominent risk factors for neonatal mortality after multivariate analysis with logistic regression were: prolonged membrane rupture (OR: 3.8719, 95% CI: 2.3619-6.3471; P=0.0000), low birth weight (OR: 1.6240, 95% CI: 1.0108-2.6091; P=0.0450), Apgar score less than 7 at the 5th minute (OR: 6.8979, 95% CI: 4.0709-11.6883; P=0.0000), and congenital malformations (OR: 4.3307, 95% CI: 1.6120-11.6347; P=0.0037). Delivery by cesarean section (OR: 0.2644, 95% CI: 0.1478-0.4732; P=0.0000) and being born in this hospital (OR: 0.4409;95% CI: 0.2566-0.7576; P=0.0030) were protective. Conclusion: Neonatal mortality was influenced by both maternal and neonatal factors. This could be reduced through sensitization of pregnant women on the need of good quality antenatal visits, and capacitating the health personnel on the adequate management of high risk neonates.Key Words: Neonatal Mortality, Hospital, Risk Factors, Cameroon     

Neonatal streptococcus group B infection in Yaoundé (Cameroon). Epidemiologic and clinical aspects]

This study was designed to investigate epidemiologic and clinical features of neonatal group B streptococcal infections. Sixty cases seen over a 60-month period were reviewed. Incidence was 0.8% of admissions. Most affected infants were from low-income families (86.7% of mothers were unemployed and 73.5% of homes were without running water). Neonatal infection was delayed in most instances (76.67%). Fetid vaginal discharge (60%) and premature rupture of the membranes (35%) were the main findings upon history taking. Abnormal body temperature regulation (76.7%) was the most prominent clinical manifestation. Respiratory distress developed in 25% of patients. Meningeal involvement occurred in 73.3% of patients. Serotype B III was recovered in 31 of the 34 cases (91%) in which serotype was determined. Mortality rate was 21.7% and permanent sequelae occurred in 8.3% of patients.     

Severe forms of malaria in children in a general hospital pediatric department in Yaounde, Cameroon]

Severe forms of malaria in children are responsible for 1 million deaths yearly in young children in hyperendemic areas. The main objective of this study was to identify and compare common manifestations of different forms of severe malaria and to evaluate the prognosis for hospital treatment in an endemic area. 271 files of children admitted into hospital between March 1991 and September 1996 were analysed. These children were confirmed to have Plasmodium falciparum in their peripheral blood. 78 patients (29%) had the severe form of malaria. 43 patients (53%) were under 5 years of age. The 5 severe types identified were characterized by very high temperatures 28 cases (36%), cerebral malaria 20 cases (26%), prostration and weakness 15 cases (19%), severe anaemia 14 cases (18%) and haemoglobinuria 1 case (1.3%). Cerebral malaria and severe anaemia were more common in children under 5 years old. The average parasitemia was 16,366 +/- 1390 parasites per microlitre. Clearance of parasitemia was obtained on day 3 in almost all cases; 6 patients with very high temperatures presented neither sign of visceral complications nor convulsions. The average period in coma for cases of cerebral malaria was 1.7 days; 12 anaemic patients were transfused. There were no deaths. No abnormality was found on physical examination after an average hospitalisation of 5.3 days. An early diagnosis and adequate treatment of severe forms of malaria in children by qualified personnel will usually result in a favourable prognosis in our area.