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Problem Cameroon has a severe shortage of human resources for health (HRH) and those that are available are concentrated in urban areas. Approach As the result of a national emergency plan for the years 2006-2008, innovative strategies and a multisectoral partnership--led by the Ministry of Public Health and supported by diverse national and international organizations-- were developed to address the shortages and maldistribution of-IRH in Cameroon. Local setting At the time that the emergency plan was developed, Cameroon had health services of poor quality, an imbalance between HRH training and employment, a maldistribution of HRH between urban and rural areas and a poor allocation of financial resources for HRH. It also lacked an accreditation system for use in the training of health workers. Relevant changes Between 2007 and 2009, the number of active health workers in Cameroon increased by 36%, several new institutions for higher education in health care and training schools for paramedical staff and midwives were opened, and a national strategy for universal health coverage was developed. Lessons learnt In the improvement of HRH, strong leadership is needed to ensure effective coordination and communication between the many different stakeholders. A national process of coordination and facilitation can produce a consensus-based view of the main HRH challenges. Once these challenges have been identified, the stakeholders can plan appropriate interventions that are coordinated, evidence-based and coherent. [TEXT NOT REPRODUCIBLE IN ASCII] [TEXT NOT REPRODUCIBLE IN ASCII] Probleme Le Cameroun souffre d'une grave penurie de ressources humaines pour la sante (RHS) et le peu de personnel disponible se concentre dans les zones urbaines. Approche Suite a un plan d'urgence national pour la periode 2006-2008, des strategies novatrices et un partenariat muItisectoriel--dirige par le ministre de la Sante publique et soutenu par diverses organisations nationales et internationales--ont ete developpes pour falte face a la penurie et a la mauvaise repartition des RHS au Cameroun. Environnement local A repoque ou le plan d'urgence a ete developpe, le Cameroun souffrait de services de sante de mauvaise qualite, d'un desequilibre entre la formation et ['emploi des RHS, d'une mauvaise repartition des RHS entre les zones urbaines et rurales et d'une affectation inadequate des ressources financieres des RHS. On manquait egalement d'un systeme d'homologation pouvant etre utilise dans la formation des agents de sante. Changements signiflcatifs Entre 2007 et 2009, le nombre d'agents de sante actifs au Cameroun a augmente de 36%, plusieurs instituts supefieurs de formation en soins de sante et ecoles de formation paramedicale et de sages femmes ont vu le jour et une nouvelle strategie a ete developpee pour la couverture sanitaire universelle. Lecons tirees Dans ramelioration des RSH, un leadership fort est necessaire pour assurer une coordination et une communication efficaces entre les nombreux acteurs en place. Un processus national de coordination et de facilitation peut produire une approche consensuelle des principaux defis des RHS. Une fois ces defis identifles, les acteurs cles peuvent planifler des interventions appropfiees, coordonnees, coherentes et fondees sur les faits. [TEXT NOT REPRODUCIBLE IN ASCII] Situacion Camerun padece una escasez grave de recursos humanos para la salud (RHS) y los recursos disponibles se concentran en las zonas urbanas. Enfoque Como resultado de un plan de emergencia nacional para los anos 2006-2008, se desarrollaron estrategias novedosas y una asociacion multisectorial, dirigida por el Ministerio de sanidad publica y respaldada por diversas organizaciones nacionales e internacionales a fin de hacer frente a la escasez y la mala distribucion de los RHS en Camerun. Marco regional La situacion de Camerun cuando se desarrollo el plan de emergencia era la siguiente: servicios sanitarios de muy poca calidad, desequilibrio entre la formacion y el empleo de los RHS, mala distribucion de los RHS entre las zonas urbanas y rurales y una asignacion irregular de los recursos financieros para los RHS. Tambien carecia de un sistema de acreditacion en la formacion de personal sanitario. Cambios importantes Entre 2007 y 2009, el numero de trabajadores sanitarios activos en Camerun aumento un 36%, se inauguraron numerosos centros de formacion superior en el ambito de la salud y de formacion de personal paramedico y matronas y se desarrollo una estrategia nacional para una cobertura sanitaria universal. Lecciones aprendidas Para conseguir mejorar los RHS es necesario un liderazgo fuerte que garantice una coordinacion y comunicacion eficaces entre las distintas partes interesadas. Un proceso de coordinacion y asesoramiento nacional puede dar lugar a una vision de los principales desafios de los RHS basada en el consenso. Una vez que se han identificado dichos desafios, las partes interesadas pueden planificar intervenciones adecuadas, coordinadas, coherentes y basadas en las pruebas cientificas., Background Although Cameroon has an acute shortage of human resources for health (HRH), it lacks the economic resources to support the mass recruitment of new health workers. Only 27% of [...]

Heart failure is a major health problem with an increasing incidence and a gloomy prognosis; with alteration of quality of life and high mortality. Despite its high prevalence, few studies have been done in our setting on the health related quality of life of patients with heart failure. Health related quality of life (HRQoL) can be defined as the functional effect of illness and it's consequent therapy upon a patient as perceived by the patient. HRQoL is a strong and independent predictor of all cause mortality and heart failure hospitalizations irrespective of symptom class and with both reduced and preserved ejection fraction. To assess the evolution of HRQoL of newly diagnosed patients with heart failure. This was a prospective longitudinal study carried out at the cardiology ward and outpatient clinics of the Yaoundé General and Central hospitals from September 2021 to September 2022. We included all newly diagnosed patients with heart failure. HRQoL was evaluated using the Kansas City Cardiomyopathy Questionnaire before beginning medical therapy, 1 month and 6 months afterwards. Data analysis was performed using SPSS version 26. Odds ratio and its confidence interval at 95% were used to assess the degree of association of variables with improvement in HRQoL. The level of significance was taken at P -value less than 0.05. A total of 100 patients were included. The mean age of our study participants was 59.5 ± 15.8 years. Heart failure with reduced ejection fraction was the most frequent type of heart failure with a prevalence of 53%. Regarding functional status, 42% of participants belonged to NYHA class IV. Hypertension was the most common etiology of heart failure. Our study participants had a poor to fair health related quality of life (mean KCCQ overall summary score 40.7 ± 29.5). Among those on medical therapy, 79.4% and 82.4% had an improvement in HRQoL after 1 month and 6 months of medical therapy respectively. Angiotensin converting enzyme inhibitor was a factor associated with an improvement in quality of life (OR: 12.50; 95%CI: 1.25–124.46; P = 0.021). Patients with dyslipidemia (OR: 0.10; 95%CI: 0.01–0.76; P = 0.031) and diabetes (OR: 0.07; 95%CI:0,01–0,66; P = 0,029) had lower chances of improving their HRQoL within 6 months of medical therapy. Health related quality of life is poor is most newly diagnosed patients with heart failure. There is a significant improvement within 6 months of medical therapy. [ABSTRACT FROM AUTHOR]

Background: High 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.Methods: We 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.Results: We 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.Conclusion: This 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. [ABSTRACT FROM AUTHOR]

The automatic measurement of the Ankle-Brachial Index (ABI) constitutes a reliable, simple, safe, rapid, and inexpensive alternative diagnostic screening test compared with the Doppler method for peripheral arterial disease (PAD). We aimed to compare the diagnostic performance of automatic ABI measurement tests to Doppler ultrasound for PAD in patients aged ≥ 65. This was an experimental comparative study of Doppler ultrasound's performance to the automated ABI test in diagnosing PAD in patients aged ≥ 65 years followed up at the Yaoundé Central Hospital, Cameroon, between January to June 2018. An ABI threshold < 0.90 defined a PAD. We compare the sensitivity, and specificity of the high Ankle-Brachial Index (ABI-HIGH), low Ankle-Brachial Index (ABI-LOW), and the mean Ankle-Brachial Index (ABI-MEAN) for both tests. We included 137 subjects with an average age of 71.7 ± 6.8 years. In the ABI-HIGH mode, the automatic device had a sensitivity of 55% and a specificity of 98.35% with a difference between the two techniques of d = 0.024 (P = 0.016). In the ABI-MEAN mode, it had a sensitivity of 40.63% and a specificity of 99.15%; d = 0.071 (P < 0.0001). In the ABI-LOW mode, it had a sensitivity of 30.95% and a specificity of 99.11%; d = 0.119 (P < 0.0001). Compared to the Doppler method, the ABI-HIGH mode of the automatic measuring device had better diagnostic performance and can thus be used as a screening test for PAD patients aged ≥ 65 years in our context. [ABSTRACT FROM AUTHOR]

The in-hospital prevalence, type, treatment, and outcome of Congenital Heart Disease (CHD) has not been described in our setting. We carried out a cross-sectional study in two teaching hospitals in Yaounde-The Yaounde University Teaching Hospital and the Chantal Biya Foundation (Mother-Child center). We retrospectively reviewed the records of all echocardiography confirmed cases of CHD seen between 2012 and 2018. A total of 105 patients (53 males and 52 females) were included in this study. The most frequent age groups were 1 to 6 months. The in-hospital prevalence of CHD was 8.7%. A heart murmur was the most frequent index sign in 97.1% followed by pneumonia in 41% of patients. Trisomia 21 was associated with 6.7% of cases. Non-cyanotic CHD was the most frequent in (74.4%), and these were mainly ventricular septal defect (42.9%) and atrial septal defect (25.7%) of all CHD. Tetralogy of Fallot was the most frequent cyanotic CHD in 13.3% of all cases. Complications due to CHD was seen in 38.1% of cases, and this mainly pulmonary hypertension in 22 (53.7%) cases. Surgical treatment was performed in 41.9% (all abroad) with a favorable outcome in all cases. CHD represents 8.7% of in-hospital pediatric admissions, and these were mainly acyanotic. Few patients had surgical correction abroad with a good outcome in all cases. [ABSTRACT FROM AUTHOR]

Arterial hypertension is one of the main cardiovascular risk factors. Hypertensive heart disease refers to heart conditions caused by high blood pressure. Aortic regurgitation and Aortic Root Systolic Excursion (ARSE), which are parameters altered early in the course of the disease can be used to rapidly evaluate the heart function of patients presenting with severe hypertension. To describe patients presenting with severe hypertension, and to find the prevalence of aortic regurgitation, and of an abnormal ARSE. This was a cross sectional study including patients with severe hypertension attending cardiology outpatient consultation in two tertiary hospitals of Yaoundé, Cameroon. Clinical data were recorded and echocardiography were done by two experienced cardiologists to evaluate cardiac function. Ninety-two patients were recruited. The mean age was 60.8 ± 13.1 (23–96) years. The median blood pressure values were 189 (IQR 180–207) for systolic and 114 (103–123) for diastolic. The main antihypertensive medication class used were calcium channel blockers. In this sample 16(17.4%; 95% CI: 9.8–25) patients had aortic regurgitation, 6(6.5%; 95% CI: 2.2–12) patients had an abnormal ARSE and 16(17.4%; 95% CI: 9.8–25) patients had a left ventricular systolic dysfunction given by a left ventricular ejection fraction <50% calculated using biplane Simpson's method respectively 6.5% (95% CI: 2.2–12), 17.4% (95% CI: 9.8–25) and 17.4% (95% CI: 9.8–25). A low prevalence of aortic regurgitation and ARSE were found in this sample of patients with severe hypertension. These results suggest that aortic regurgitation and an abnormal ARSE are probably linked more to the duration that to the severity of hypertension. [ABSTRACT FROM AUTHOR]

Several studies on the prognosis of masked hypertension suggest that it portends risks for cardiovascular morbidity and mortality that are comparable to the risks of sustained hypertension. obese individuals could have an increased risk of developing masked hypertension, data on the topic are scarce in our context. The aim of this study was to investigate the prevalence and associated factors of masked hypertension in obese patients in Yaoundé. We carried out a cross-sectional study from January to September 2017 at the National Obesity Center of the Yaoundé Central Hospital. Masked hypertension was defined when the mean 24-hour Systolic Blood Pressure was greater than or equal to 130 mmHg and/or the mean 24 hour Diastolic Blood Pressure was greater than or equal to 80 mmHg with normal office blood pressure. Logistic regression was used to examine the relationship of masked hypertension with associated factors. Among the 90 participants included, 67.8% were females. Mean age (± SD) was 46 (± 8) years. The mean clinical measurements were 120 ± 9.4 mm Hg and 75.5 ± 7.9 mm Hg respectively for the systolic and the diastolic blood pressure. On 24-hour Ambulatory measurement, the mean was 123.9 ± 14.4/74.7 ± 8.9 mm Hg respectively for the systolic/diastolic blood pressure. The prevalence of masked hypertension was 33.3%. Masked hypertension was significantly associated with high-normal office blood pressure [odds ratio (OR) =2.90, P = 0.02] and to dyslipidemia [OR = 3.60, P = 0.01], but not to male sex, diabetes, physical activity, tobacco/alcohol. Our findings suggest that the prevalence of masked hypertension is high and that physicians should consider ambulatory blood pressure monitoring for obese individuals with high-normal office blood pressure and/or dyslipidemia. [ABSTRACT FROM AUTHOR]

Background Left atrial remodelling (LAR) is a common finding in patients with chronic hypertension and increases the risk of adverse cardiovascular events. However, early changes in the left atrial size and association microalbuminuria are poorly elucidated. Objective To assess early left atrial structural remodelling in hypertensive patients and determine its correlation with microalbuminuria. Methodology Fifty-two patients diagnosed with hypertension for less than a year were matched for age sex to forty healthy controls. Patients with pre-existing, cardiovascular disease, kidney disease and diabetes were excluded. The left atrial endocardial border was traced to get atrial length, transverse diameter, surface area and volume while the anteroposterior diameter was obtained on the parasternal long axis by M-Mode echocardiography. Early morning urine was analysed for microalbuminuria. Results The hypertensive patients and controls were comparable for age and sex, but had significantly higher body mass indices, Left ventricular mass (LVM) and an altered diastolic function. Hypertensive patients had significant increase in the left atrial longitudinal diameter (50.0 mm versus 47.4, = 0.045 mm), surface area (17.9 cm 2 versus 15.5 cm 2 , P = 0.003) and volume (52.4 mL versus 43.8 mL, P = 0.002). Fourteen hypertensive patients (26.9%) had left atrial enlargement compared to 1(2.5%) in the control group. Diastolic dysfunction ( P = 0.008) was the only independent predictor of LA size and LAE. There was a no correlation between microalbumin and left atrial size. Conclusion Changes in the left atrial size in the early phase of hypertension are characterised by an increase in the left atrial length, surface area and volume. Left atrial remodelling in hypertension is an evidence of the chronicity of diastolic dysfunction. Microalbuminuria does not predict left atrial remodelling. [ABSTRACT FROM AUTHOR]

INTRODUCTION: The aim of the study was to investigate the occurrence, the aetiology and the management of congestive heart failure in the cardiac centre of the St. Elizabeth catholic general hospital Shisong in Cameroon. METHODS: Between November 2002 and November 2008, a population of 8121 patients was consulted in the referral cardiac centre of St. Elizabeth Catholic General Hospital. Of these patients, 462 were diagnosed with congestive heart failure according to the modified Framingham criteria for the diagnosis of heart failure. Complementary investigations used to confirm and establish the aetiology of the disease were the chest X-ray, electrocardiography, bi-dimensional Doppler echocardiography. RESULTS: The results showed that the occurrence of congestive heart failure in our centre was 5,7%. Congestive heart failure was diagnosed in 198 females and 264 males, aged between 8 and 86 years old (42.5, plus or minus 18 years old). Post rheumatic valvulopathies (14.6%) and congenital heart diseases (1.9%) were the first aetiologic factor of congestive heart failure in the young, meanwhile cardiomyopathies (8,3%) in elderly followed by hypertensive cardiomyopathy (4.4%). Congestive heart failure was also seen in adults with congenital heart diseases in 0.01%. In this zone of Cameroon, we discovered that HIV cardiomyopathy (1.6%) and Cor pulmonale (8%) were represented, aetiological factors not mentioned in previous studies conducted in urban areas of Cameroon. The mean duration of hospital stay for the compensation treatment was thirteen days, ranging between 7 and 21 days), the mortality being 9.2%. All the medications recommended for the treatment of congestive heart failure are available in our centre but many patients are not compliant to the therapy or cannot afford them. Financial limitation is causing the exacerbation of the disease and premature death. CONCLUSION: Our data show a high incidence of congestive heart failure mainly due to post rheumatic valvulopathies in young patients in our centre. National program to fight against rheumatic fever and complications are of great urgency in our country. The compensation treatment of congestive heart failure is challenging in our milieu, characterized by poor compliance and financial limitations

Aim To determine clinical characteristics and mode of treatment of patients with heart failure in Yaounde military hospital (YMH). Methods Data of patients with heart failure (HF) followed on a period of 6 months in YMH were used to determine clinical characteristics and mode of treatment. Results A total of 72 patients were consecutively studied comprising 45 men (62.5%) and 27 women (37.5%) aged 62.8±16.5 and 61.1±19.4 years, respectively. All the patients presented with NYHA functional class III or IV. Alcohol was the most common etiological factor of HF (66.7%) hypertension was the most common risk factor for HF (37.5%) while only 16.7% of the patients were smokers. Global heart failure was the common presentation (60.9%). Left bundle branch was present in 47% of electrocardiograms while 8.7% of the patients were in atrial fibrillation. Dilated cardiomyopathy was the common lesion (80%). Most patients presented with severe left ventricular (LV) systolic dysfunction (66.6%). Male subjects had worse LV systolic dys-function compare to women without significant difference (56.3% vs 43.8% p=0.8). Diabete was not associated with severe LV dysfunction (78.9% on non diabetic vs 6.3% of diabetic patients). Current recommended pharmacology therapies were used in most of the cases. Diuretics were used in 100% while ACE inhibitors were in 91.3% of cases. 52.4% of patients had beta blockers. Conclusion Most heart failure patients in Cameroon present in the sixth decade with severe heart failure. All the recommended therapies are not available in our country. [ABSTRACT FROM AUTHOR]

Abstract Background The epidemic surge in hypertension in sub-Saharan Africa is not matched by clinical trials of antihypertensive agents in Black patients recruited in this area of the world. We mounted the Newer versus Older Antihypertensive agents in African Hypertensive patients (NOAAH) trial to compare, in native African patients, a single-pill combination of newer drugs, not involving a diuretic, with a combination of older drugs including a diuretic. Methods Patients aged 30 to 69 years with uncomplicated hypertension (140 to 179/90 to 109 mmHg) and ≤2 associated risk factors are eligible. After a four week run-in period off treatment, 180 patients have to be randomized to once daily bisoprolol/hydrochlorothiazide 5/6.25 mg (R) or amlodipine/valsartan 5/160 mg (E). To attain blood pressure Results At the time of writing of this progress report, of 206 patients enrolled in the run-in period, 140 had been randomized. At randomization, the R and E groups were similar (P ≥ 0.11) with respect to mean age (50.7 years), body mass index (28.2 kg/m2), blood pressure (153.9/91.5 mmHg) and the proportions of women (53.6%) and treatment naïve patients (72.7%). After randomization, in the R and E groups combined, blood pressure dropped by 18.2/10.1 mmHg, 19.4/11.2 mmHg, 22.4/12.2 mmHg and 25.8/15.2 mmHg at weeks two (n = 122), four (n = 109), eight (n = 57), and 12 (n = 49), respectively. The control rate was >65% already at two weeks. At 12 weeks, 12 patients (24.5%) had progressed to the higher dose of R or E and/or had α-methyldopa added. Cohort analyses of 49 patients up to 12 weeks were confirmatory. Only two patients dropped out of the study. Conclusions NOAAH (NCT01030458) demonstrated that blood pressure control can be achieved fast in Black patients born and living in Africa with a simple regimen consisting of a single-pill combination of two antihypertensive agents. NOAAH proves that randomized clinical trials of cardiovascular drugs in the indigenous populations of sub-Saharan Africa are feasible.

Introduction: Les recommandations du comité Africain du guide pratique pour le diabète type 2 concernant l’utilisation de l’électrocardiogramme lors du suivi des sujets diabétiques type 2 sont non spécifiques. Nous avons évalué la prévalence et les déterminants des anomalies électrocardiographiques chez les sujets diabétiques suivis dans deux centres de référence au Cameroun. Patients et méthodes: 420 patients diabétiques type 2 (49 % hommes) recevant leur prise en charge chroniques a l’hôpital General de Douala et l’hôpital central de Yaoundé ont été inclus. Les anomalies électrocardiographiques ont été recherchées et reliées aux potentiels déterminants anamnestiques, cliniques et biologiques en utilisant un modèle de régression logistique. Résultats: L’âge moyen et la médiane de la durée du diagnostic du diabète étaient de 56,7 et 4 respectivement. Les principales (prévalence – %) anomalies électrocardiographiques étaient : anomalies de l’onde T (20,9 %), hypertrophie ventriculaire gauche selon le produit de Cornell (16,4 %), arythmie (16,2 %), cardiopathies ischémiques (13,3 %), troubles conductifs (11,9 %), prolongation du QT (10,2 %) et extrasystoles (4,8 %). Les variables de la pression artérielle (systolique, diastolique, et pression pulsée) étaient invariablement associées à toutes les anomalies. Conclusion: Les anomalies électrocardiographiques dans cette population sont dominées par les troubles de la repolarisation, les troubles conductifs et l’hypertrophie ventriculaire gauche et sont beaucoup plus liées aux variables de la pression artérielle qu’aux facteurs liés au diabète. [Copyright &y& Elsevier]

La maladie veineuse thromboembolique (MVTE) est un problème de santé publique et l'une des l'une des principales causes de décès cardiovasculaire dans le monde. C'est l'une des complications les plus fréquentes chez les patients hospitalisés, en particulier dans les pays à faible revenu. Les données épidémiologiques sur la MVTE sont rares voire inexistantes en Afrique subsaharienne. Nous avons mené une étude transversale descriptive dans trois hôpitaux de la ville de Yaoundé. Nous avons examiné rétrospectivement les dossiers des patients admis pour la MVTE de janvier 2013 à décembre 2017. Nous avons recueilli des données sur les caractéristiques sociodémographiques, les présentations cliniques, l'imagerie (doppler veineux/angioscanner pulmonaire) et les modalités évolutives. Nous avons inclus 93 patients (43 hommes) atteints de MVTE. Leur âge moyen était de 53,3 ± 16,6 ans. Il y avait 46 (49,5 %) cas de thrombose veineuse profonde (TVP), 36 (38,7 %) cas d'embolie pulmonaire (EP) et 11 (11,8 %) d'EP associés à une TVP. Les principaux facteurs de risque étaient l'obésité/surpoids (58,1 %), l'alitement prolongé (43 %), l'infection par le VIH (22,6 %), une hospitalisation antérieure (22,6 %) et un long voyage (19,4 %). La présentation clinique la plus fréquente de l'EP était la dyspnée (100 %), la tachypnée (87,2 %) et les douleurs thoraciques (70,2 %). Pour la TVP, la présentation la plus courante était la douleur du membre (93 %), la diminution du ballotement du mollet (86 %) et la tuméfaction du membre > 3 cm comparément au membre controlatéral (82,4 %). Il y a eu 9 (9,7 %) décès intrahospitaliers. La durée moyenne d'hospitalisation était de 20,7 ± 30,8 jours. Cette étude présente comme limite celle d'une étude rétrospective. On note cependant une prédominance féminine contraitrement aux données de Kamdem, Abah et Kingue. La population présentant une MVTE est plus jeune en Afrique subsaharienne et présente comme facteurs de risque de MVTE principalement de l'obésité, un alitement prolongé et une infection à VIH et une hospitalisation antérieure, ceci contrairement à la population occidentale ou le cancer est l'hospitalisation sont les principaux facteurs de risque. La MVTE est encore sous-diagnostiquée en Afrique subsaharienne. L'obésité/surpoids et l'alitement prolongé étaient les principaux facteurs de risque dans cette population. La dyspnée et la tachypnée constituaient la principale manifestation clinique de l'EP, tandis que la douleur des membres et la diminution du ballotement du mollet étaient les principaux symptômes de la TVP. La mortalité intrahospitalière est encore élevée. [ABSTRACT FROM AUTHOR]

Introduction La maladie veineuse thromboembolique (MVTE) est un problème de santé publique, associée à une majoration de la durée et du coût d’hospitalisation, ainsi que de la mortalité. L’infection au virus de l’immunodéficience humaine (VIH) est une des étiologies de la MVTE. Les données locales sur les caractéristiques de la MVTE chez les sujets VIH positif sont rares. Patients et méthodes Nous avons mené une étude transversale descriptive et analytique de janvier 2013 et juillet 2017 dans trois hôpitaux de la ville de Yaoundé. Nous avons réexaminé les dossiers de patients admis pour MVTE. Les données concernant les présentations sociodémographiques et cliniques, l’imagerie (doppler veineux/angioscanner pulmonaire) et les modalités évolutives ont été recueillies. Résultats Nous avons inclus 73 (32 hommes) patients présentant une MVTE, avec un âge moyen de 53,4 ± 16,9 ans. Nous avons retrouvé 15 (20,5 %) personnes vivant avec le VIH (PVVIH) ayant une MVTE. Comparativement aux patients VIH négatif, les PVVIH étaient plus jeunes ( p < 0,001), avec une prédominance masculine (OR : 3,3 ; 0,9 < IC < 10,8), avaient moins de facteurs de risque de MVTE ( p = 0,007), une pression artérielle systolique plus basse ( p = 0,04), une fréquence respiratoire plus élevée ( p = 0,04) et un indice de masse corporelle plus bas ( p = 0,02), et localisation tronculaire plus fréquente ( p = 0,03) à l’angioscanner thoracique. Il n’y avait pas de différence dans la présentation clinique de la TVP par rapport aux patients VIH négatif. L’extension distale (OR : 3,8 ; 0,2 < IC < 66,2) et la localisation iliaque (OR : 3,5 ; 0,9 < IC < 13,9) étaient plus fréquentes chez les patients VIH positif. La syncope était plus fréquente chez les patients VIH positif présentant une EP (OR : 8,7 ; 0,7 < IC < 104,2). L’évolution hospitalière était favorable chez 64 (87,7 %) patients. Conclusion L’infection au VIH était retrouvée chez 20,5 % des patients. Les PVVIH étaient plus jeunes, avaient moins de facteurs de risque classique de MVTE, présentaient des pressions artérielles systoliques et un IMC plus bas que les sujets VIH négatif et une fréquence respiratoire plus élevée. La syncope était 8 fois plus fréquente chez les patients présentant une EP. Au plan paraclinique, la localisation tronculaire était plus fréquente à l’angioscanner chez les patients VIH positif. Il n’y avait pas de différence dans le profil évolutif et de complications entre les deux groupes, hormis une prédominance des infections chez les PVVIH. [ABSTRACT FROM AUTHOR]