Bronhilda Tifuh T^1,2,3, Yannick Mboue-Djieka², Anastase Dzudie^3,4, Doualla Marie S⁴,Leopold N Aminde^3,5, Simeon Pierre Choukem^2,4

Authors’ affiliations

1. Mboppi Baptist Hospital Douala,
2. Health and Human Development (2HD) Research Network,
3. Clinical Research Education Networking and Consultancy (CRENC) Research Network,
4. Douala General Hospital, University of Queensland, Brisbane, Australia.

Corresponding author: Simeon Pierre CHOUKEM, email: Cette adresse e-mail est protégée contre les robots spammeurs. Vous devez activer le JavaScript pour la visualiser.

Abstract

Background: Rheumatoid arthritis (RA) has been associated with a high cardiovascular risk due to chronic inflammation and development of traditional cardiovascular risk factors. High blood pressure (BP) is the major cause of stroke, heart and renal disease in sub-Saharan Africa (SSA). Whether the BP profile of patients with RA in SSA differs from that of normal subjects is unknown. We aimed at studying the BP profile of patients RA and compared to normal subjects.

Methods: This was a comparative cross-sectional study on 20 participants with RA, age and sex-matched with 20 healthy participants. All participants underwent a 24-hour Ambulatory BP monitoring (ABPM). Data were analyzed using Epi Info version7.

Results: Majority of the participants were females (16, 80 % per group), the median age (interquartile range) of participants was 41 (30.5 – 49) years. The median Body Mass index was not different in both groups (P>0.05). There was no significant difference in Systolic BP dippers, non-dippers and reverse dippers in both groups (p >0.05). There were more diastolic BP dippers in the RA group (65% vs. 30%, p=0.027). Prevalent nocturnal and masked hypertension was similar in both groups (p>0.05). We did not find any factors independently associated with non-dipping systolic (diastolic) BP or nocturnal hypertension.

Conclusion: Our study demonstrated that compared to healthier participants, individuals with RA present with diastolic BP dipping pattern but similar other patterns of BP profile. Large epidemiological studies are warranted to further explore these findings. 

Keywords: Rheumatoid arthritis, blood pressure profile, nocturnal hypertension, masked hypertension.

Tim Divine B^1,2,3, Lambed Tatah², Valirie Agbor-Ndip⁴, Anastase Dzudie^3,5, Simeon Pierre Choukem^2,5

Author affiliations:

1. Baptist Hospital Mutengene,
2. Health and Human Development (2HD) Research Network,
3. Clinical Research Education Networking and Consultancy (CRENC) Research Network,
4. Ibal Oku sub-divisional hospital, ⁵Douala General Hospital

Corresponding author: Simeon Pierre CHOUKEM email: Cette adresse e-mail est protégée contre les robots spammeurs. Vous devez activer le JavaScript pour la visualiser.

Abstract

Background: Hypertension frequently occurs in patients with diabetes and their coexistence significantly increases risk of cardiovascular disease morbidity and mortality.  Our objective was to assess the prevalence, awareness, treatment and control of hypertension in patients with diabetes attending primary health care facilities in Cameroon.

Methods: This was a cross-sectional study in 25 rural primary health care facilities in the North-West Region of Cameroon during December to March, 2017. Adults (≥ 21 years) with diabetes and followed up in these facilities were recruited via multistage sampling. Blood pressures and anthropometric parameters were measured using standard procedures. Hypertension control was assessed according to the eight Joint National Committee and the American Diabetes Association guidelines. Factors associated with blood pressure control were investigated using logistic regression models.

Results: One hundred and sixty-five participants were included, with a mean age of 60.5 years and male to female ratio of 1:1.5. The majority (n=160, 97%) had type 2 diabetes. The prevalence of hypertension was 80.6% (95% CI = 74.5 – 86.7). Among these, 89.5 % were aware of their status and 89.1% of those aware of their status were on antihypertensive medication. Calcium channel blockers and thiazide type diuretics were the most prescribed medication in 48.2% and 56.9% of cases respectively. Only 34.7% (95% CI = 27.3 – 42.2) of treated participants had their BPs controlled to target. Only calcium channel blockers were significantly associated with good BP control.

Conclusion: Four out of every five adults with diabetes in our study had hypertension. Though awareness and treatment rates were high, control remained low. This implies that there is need for a more comprehensive approach towards management of hypertension in patients with diabetes in primary health care facilities in Cameroon.

Keywords: Hypertension, Diabetes, Prevalence, Control, Primary health care, Cameroon

Nganou-Gnindjio, Chris Nadège¹; Kenmogne, Héloïse Guidelle*²; Hamadou, Ba¹; Kamdem, Félicité^3,4,5; Mfeukeu-Kuate, Liliane¹; Tankeu, Aurel¹; Bediang, Georges Wilfred¹; Menanga, Alain Patrick¹; Kingue, Samuel¹. 

Authors’ affiliations:

1. Faculty of Medicine and Biomedical Sciences, University of Yaoundé I, Yaoundé, Cameroon
2. Higher Institute of Health Sciences, Université des Montagnes, Bagangte, Cameroon
3. Internal Medicine Service, Douala General Hospital, Douala, Cameroon;
4. Faculty of Medicine and Pharmaceutical Sciences, University of Douala, Douala, Cameroon;
5. Intensive Care Unit, Douala General Hospital, Douala, Cameroon

Corresponding author: Kenmogne Héloïse Guidelle, Cette adresse e-mail est protégée contre les robots spammeurs. Vous devez activer le JavaScript pour la visualiser.

Abstract

Background: Hypertension is the leading cardiovascular risk factor and Africa presents the highest prevalence worldwide with up to 46% of adults over 25 years affected. Level of awareness is low, resulting in poor therapeutic adherence and blood pressure (BP) control. We investigate the effect of therapeutic group education on adherence to treatment and BP control on uncontrolled hypertensive individuals in sub Saharan Africa.

Methods: we carried out a non-randomized control trial from October 2016 to June 2017 at the outpatient cardiology clinic of the Yaoundé Central Hospital, in Cameroon. We included adults with essential, uncontrolled hypertension. Every weeks during three months, educative sessions added to daily phone calls and text messages were done. Blood pressure, drug compliance, knowledge regarding hypertension, level of physical activity were evaluated at baseline and after intervention. The student test was used to compare data before and after intervention. A p value <0.05 was statistically significant.

Results: Overall, 17 participants with a mean age of 56.24 ± 8.14 years and an average duration of hypertension of 11.17 ± 9 years completed the intervention. SBP decreased by 30mmHg, DBP drooped by 11mmHg. Level of knowledge increased by (36.47%), adherence to treatment by 88.24% and drug compliance by 81.44%. Energy expenditure related to physical activity increased 100% of participants with a mean improvement of 625.41 MET. All patients were satisfied.

Conclusion: Therapeutic group education increased adherence to treatment and BP control amongst uncontrolled hypertensive patients in sub Saharan Africa

Key words: Therapeutic group education, hypertension, adherence, knowledge.

Christie E. Linonge^1,2,5, Anastase Dzudie^4,5,6, Eveline D. T. Ngouadjeu³, Yannick Mboue-Djieka², Charlotte Eposse⁷, Simeon-Pierre Choukem^1,2,4

Authors’ affiliations

1. Department of Internal Medicine and Pediatrics, Faculty of Health Sciences, University of Buea, Buea, Cameroon.
2. Health and Human Development (2HD) Research Network, P.O. Box 4856, Douala, Cameroon.
3. Faculty of Medicine and Pharmaceutical Sciences, University of Douala, Douala, Cameroon.
4. Department of Internal Medicine, Douala General Hospital, P.O. Box 4856, Douala, Cameroon.
5. Clinical Research Education, Networking and Consultancy (CRENC), Douala, Cameroon.
6. Department of Medicine, Faculty of Health Sciences, University of Cape Town, Cape Town, South Africa.
7. Department of Paediatrics, Douala Laquintinie Hospital.

Corresponding authors : Christie E. Linonge, Cette adresse e-mail est protégée contre les robots spammeurs. Vous devez activer le JavaScript pour la visualiser. , Simeon-Pierre Choukem, Cette adresse e-mail est protégée contre les robots spammeurs. Vous devez activer le JavaScript pour la visualiser.

Abstract

Background: Sickle cell disease (SCD) is characterized by a chronic inflammatory state and consequently target organ damage. It has been suggested that abnormal blood pressure (BP) profiles are associated with worse outcomes in patients with SCD but this is less documented. We aimed to assess the 24-hour BP profile in patients with SCD in sub-Saharan Africa.

Methods: We conducted a hospital-based, cross-sectional, comparative study from January to April 2017. Thirty-four SCD participants aged ≥ 10 years and 34 controls matched for age, sex and body mass index underwent 24 – hour ambulatory blood pressure monitoring (ABPM). Average clinic BP measurements, ABPM profiles, socio-demographic and biochemical characteristics from the two groups were assessed and compared. Data were analyzed using EpiInfo version 7.2.

Results: The prevalence of abnormal SBP and DBP dipping was higher in the SCD participants than in the control participants (52.9 % vs 23.5%, p = 0.012 and 41.2% vs 11.4%, p = 0.006 respectively). Masked hypertension was only found in the SCD participants (17.6 % vs 0 p = 0.025) and Nocturnal hypertension was more prevalent in the SCD participants (23.5 % vs 5.9 %, p = 0.039). Low estimated glomerular filtration rate was associated with systolic non-dipping in SCD participants (OR: 5.93, 95%CI: 1.00 – 19.64, p = 0.021).

Conclusion: Our results show that patients with SCD have higher abnormal profiles in 24-hour ABPM than in the healthy control subjects. These abnormalities underline an increased risk of target organ damage. ABPM therefore might be recommended for risk stratification of these patients.

Keywords: Sickle cell disease, blood pressure dipping, masked hypertension, nocturnal hypertension, Africa, Ambulatory blood pressure monitoring.