Background Lactational breast abscesses are uncommon in the puerperium but when they do develop, delays in specialist referral may occur especially in resource low settings. There is a dearth of studies regarding lactational breast abscesses in Cameroon. We aimed to estimate the incidence of lactational breast abscess and describe its management by percutaneous aspiration at the Douala General Hospital, Cameroon. Methods We conducted an observational prospective study of 25 breastfeeding women at the Douala General Hospital from January 1, 2015, to October 31, 2015. Participants were consenting breastfeeding women who completed a baseline questionnaire after diagnosis of lactational breast abscesses and underwent percutaneous needle aspiration under local anaesthesia. Data were analyzed by using descriptive statistics. Results The estimated incidence of lactational breast abscesses was 0.74% (28/3792). The age range of babies at the onset of breast abscess was 4 to 35 weeks; mean 28.3 ± 10.85 weeks. Forty-four per cent of participants underwent three lactational abscess aspirations and in 24 to 28% of them, it took 8 to 9 days for the abscess to resolve. In 72% of participants, treatment was with needle aspiration plus flucloxacillin. Seventy-six per cent of participants continued breastfeeding after abscess treatment. Conclusion The estimated incidence of lactational breast abscess at the Douala General Hospital is 0.74%. Percutaneous needle aspiration under local anaesthesia is an effective treatment for superficial lactational breast abscesses in most cases with or without ultrasound guidance and should be recommended worldwide as first line treatment. Further research is needed to understand the outcome of local infiltration of antibiotics on the abscess cavity.
Background: Pregnant women receive antenatal care (ANC) to ensure favorable pregnancy outcomes. Despite the high ANC coverage rate registered nationally in Cameroon; rural women, women with no formal education and those in the most deprived quintile still face difficulties in having access to quality ANC. The impact of the aforementioned factors on ANC use in the Muea Health Area (MHA) is unknown. The objective of this study was to determine the proportion of women attending ANC and the factors influencing ANC attendance in the MHA. Materials and Methods: This was a community based, analytical, cross sectional survey that involved pregnant women and women with children less than two years old who gave an informed consent or assent. Data were collected using a semi structured questionnaire. EPI info Version 7 and Stat Pac for Windows version 12 © 1998-2011 (Stat Pac Inc, Bloomington, USA) were used for data analysis. Associations were considered statistically significant for p values less than 0.05. Results: Two hundred and twenty women were interviewed. The mean age was 25 years (SD 5.28). Ninety-nine percent of women had at least one ANC visit meanwhile 84.8% had at least four ANC visits. Only 27.2% of women booked for ANC in the first trimester. Rural (Maumu) residence was associated with inappropriate ANC attendance (attending less than four times) (χ 2 = 18.5; p = 0.001). Semi urban women (87%; 95% C.I. = 85.10% -89.0%) were more likely to attend four or more sessions than rural (Maumu) women (60.7%; 95% C.I. = 44.2% -77.3%) (p = 0.001). Participant's educational
Background Tuberculosis (TB) and HIV co-infection challenges treatment and worsens the outcome of TB treatment. This study aimed to assess the outcome of TB treatment and factors facilitating treatment success among people living with HIV/AIDS in Fako Division of the South West Region of Cameroon. Methods A hospital-based retrospective cohort study was conducted by manually reviewing medical records of HIV/TB co-infected patients from January 2010 to September 2017. A structured data collection form was used to review the medical records of HIV patients co-infected with TB aged 10 years and older. Patients with incomplete files were dropped from the study. Treatment success was defined as the sum of patients who were declared cured and those who had completed treatment, as per the World Health Organization’s recommendations. Data were analyzed using Statistical Package for Social Sciences version 21. Bivariate and multivariate logistic regression model was carried out to identify factors facilitating successful TB treatment outcome. Significance was obtained through adjusted odds ratio with its 95% confidence interval and a p<0.05. Results A total of 2,986 files were reviewed but 2,928 (98.1%) were retained. Out of the 2,928 medical files of adult TB patients reviewed, 1,041 (35.6%, [95% CI 33.8%-37.3%]) were HIV/TB co-infected. The 1,041 co-infected patients had a mean age of 37.07 (SD of10.02) years and 56.3% were females. The treatment outcome of TB patients were 795(76.4%) cured, 23(2.2%) treatment completed, 99(9.5%) were lost to follow-up, 16 (1.5%) failed, 72(6.9%) died and 36(3.5%) transferred out. A successful treatment outcome was achieved in 818(78.6%,[95% CI: 76.0%–81.0%]) patients. Being a female [COR 1.61, 95% CI: 1.19–2.17, p = 0.002], receiving TB treatment in 2014 [COR 2.00, 95% CI: 1.11–3.60, p = 0.021] and 2015 [COR 2.50, 95% CI: 1.39–4.50, p = 0.002], having relapsed TB infection [COR 0.46, 95% CI: 0.23–0.93, p = 0.031], receiving ART [COR 1.95, 95% CI: 1.28–2.97, p = 0.002] and Cotrimoxazole [COR 2.03, 95% CI: 1.12–3.66, p = 0.019] were factors significantly associated with successful treatment. After adjusting for confounders, successful treatment outcome were associated with being a female [AOR 1.6; 95% CI: 1.21–2.22, p = 0.001], diagnosis of TB in 2014 [AOR 1.90; 95% CI: 1.04–3.45, p = 0.036] and 2015 [AOR 2.43; 95% CI: 1.33–4.43, p = 0.004]. Conclusion There is a high TB treatment success rate among HIV/TB co-infected patients in our setting, although below the target set by the WHO. Specific interventions aimed at enhancing patient outcomes are recommended.
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