Tinyami Erick Tandi

Globally, hip fractures represent a significant and growing public health concern, particularly as the elderly population increases. The timing for surgery following hospitalization for hip fractures is a crucial indicator of acute quality care following recommended surgical guidelines of within two days to minimize complications and mortality. However, factors influencing delayed surgery and its outcomes remain debated. This study, used a national administrative database in South Korea, aimed to examine surgery performed within two days of hospitalization and investigate factors affecting delayed surgical interventions and associated outcomes. Of the hip fracture patients analyzed, 40.6% underwent surgery within two days of hospitalization. Factors associated with delayed surgery included: male patients (OR 1.190; 95% CI 1.022 ~ 1.385), medical aid beneficiary (OR 1.385; 95% CI 1.120 ~ 1.713), higher comorbidity index (OR 1.365; 95% CI 1.163 ~ 1.603, OR 1.612, 95% CI 1.327 ~ 1.958), weekends admission (OR 2.384; 95% CI 2.804 ~ 2.729), admission via outpatient department (OR 1.298, 95% CI 1.071 ~ 1.574). ORIF (OR 0.823, 95% CI 0.691 ~ 0.980) was associated with a significantly low risk of late surgery. While early surgery did not significantly impact in-hospital mortality or complications, it was associated with short and postoperative lengths of stay. This study underscores the need for prompt surgical intervention, particularly in high-risk patient populations, as well as highlights the importance of further research to elucidate the relationship between the timing of surgery and postoperative outcomes.

Background Cardiovascular disease is a major leading cause of morbidity and mortality in sub-Saharan Africa and Cameroon. This burden is rooted by major modifiable and non-modifiable risk factors that have not been intensively investigated among these populations. This study aimed to determine the levels of knowledge and awareness of heart disease amongst adults within the capital city of Cameroon. Methods A community-based cross-sectional study was conducted by administering a semi-structured questionnaire among 468 Cameroonian aged 25–64 years. egression models were used to identify significant predictors of respondent’s knowledge and awareness, perceived risk and self-efficacy to heart disease. Results 38.5% (180 out of 468) of respondents had a good level of knowledge on heart disease. High blood pressure, stress, smoking, being overweight, lack of physical exercise, alcohol, family history of heart disease, high cholesterol and aging were identified as risk factors. Respondents were aware of heart disease 378(81%), reported having two or more risk factors 345(74%), perceived themselves at high risk to heart disease 339(72.4%) and had a high efficacy to reduce their risk of heart disease 397(86%). Male gender (OR 1.4: 1.01–2, p = 0.032), being aware of heart disease (OR 1.62: 1–2.5, p = 0.032), college education (OR 2.7: 1.5–6.2, p = 0.021), high perceived susceptibility (OR 1.7: 1.2–2.7, p = 0.018) and having no risk factors (OR 2.7: 1.3–5.6, p = 0.01) predicted good knowledge of heart disease. Conclusion Educational programs aiming at increasing the awareness and translating knowledge into effective actions among populations should be empowered and strengthened based on the influencing predictors.

The increasing number of surgeries following hip fractures is increasing medical costs globally. Prompt surgical interventions in hip fractures is to achieve the most favorable outcomes and minimizes the risk of complications. A retrospective review and analyzes using the Korean National Hospital Discharge In-depth Injury Survey database was used to identify the distribution within 2 days of hospitalization, the factors of after 2 days’ surgery in hip fractures, defined as patients having an injury code with a diagnosis of hip fracture and a hip fracture-related operation during 2015–2019. The proportion of patients in the two groups were compared using the chi-square test. In the analysis of factors associated with late surgery, multiple logistic regression analysis was performed. The mean hospital stay for hip fracture patients before surgery was 3.58 days with 40.6% of patients having surgery within 2 days of hospitalization. When multiple logistic regression was performed, male (OR 1.190), Medicaid beneficiary (OR 1.385), higher comorbidity (OR 1.365, OR1.612), weekends admission (2.384), Outpatient Hospitalization status (1.298), ORIF (0.823) were reasons for the late surgery. As the operation was delayed, the total length of stay (OR 1.028) and the length of stay after stay (OR 1.005) were extended. Late surgery did not affect death and complications in the hospital. However, the entire hospital stay of the patient and postoperative hospital stay were extended. Therefore, providers should establish a system for surgery as soon as possible after hospitalization of hip fracture patients and support measures.

This study presents a descriptive account of ratings based on psychometric variables of perceived twenty-five health risk factors, their information sources and the confidence in the information sources among Cameroonians nationwide. Health risk factors such as HIV/AIDS, natural disasters, terrorism, unprotected sex, unemployment, alcohol consumption, street crime, cigarette smoking, poverty, malaria, cholera and motorcycle accidents were among the greatest perceived health risk factors by the population. On the other hand, female genital mutilation and natural health products were ranked the lowest posing health risk factors among Cameroonians. Also, women perceived more health risks than men, with large differences in the perceived risks of unemployment and chronic diseases. Respondents across the regions younger than forty years old reported greater concerns over health risk factors than those over forty years old. Media organisations, health and professional groups were reported as the main sources of information as well as greater confidence in information obtained from health personnel compared with other information sources among the population. The results obtained from this study showed public concern over several health risk factors, and policies directed towards the effective communication and management strategies of health risks within the communities aimed at the development of health prevention/promotion programmes of the nation should be encouraged.

Cameroon is classified by the World Health Organization (WHO) as having a critical shortage of health personnel. This is further complicated by the geographic distributional inequalities of the national health workforce. This shortfall impedes Cameroons’ progress of improving the human resources for health (HRH) to meet up with the Millennium Development Goals (MDGs) by 2015. However, it is unknown whether the health workforce of Cameroon is distributed equally across geographic regions. Additionally, indicators other than population levels have not been used to measure health care needs. This study aimed to assess the adequacy, evenness of distribution and challenges faced by the health workforce across the different regions of Cameroon. National health personnel availability and distribution were assessed by use of end-of-year census data for 2011 obtained from the MoPH data base. The inequalities and distribution of the workforce were estimated using Gini coefficient and Lorenz curve and linear regression was used to determine the relation between health personnel density and selected health outcomes. Alternative indicators to determine health care needs were illustrated using concentration curves. Significant geographic inequalities in the availability of health workforce exist in Cameroon. Some regions have a higher number of physicians (per person) than others leading to poor health outcomes across the regions. 70 % of regions have a density of health personnel-to-population per 1,000 that is less than 1.5, implying acute shortage of health personnel. Poor working and living conditions, coupled with limited opportunities for career progress accounted for some documented 232 physicians and 205 nurses that migrated from the public sector. Significant distributional inequality was noticed when under-five infant mortality and malaria prevalence rate were used as indicators to measure health care needs. Our results show an absolute shortage of public health personnel in Cameroon that is further complicated by the geographic distributional inequalities across the regions of the nation. Cameroon aims to achieve universal health coverage by 2035; to realize this objective, policies targeting training, recruitment, retention and effective deployment of motivated and supported health workforce as well as the development and improvement of health infrastructures remain the major challenge.