Clarisse Mapa-Tassou

Climate change and non-communicable diseases (NCDs) represent intersecting global health crises whose impacts are profoundly shaped by structural inequities within a globalized world. The convergen...

Background Diabetes mellitus (DM) is a non-communicable disease, and its morbidity and mortality are increasing in Cameroon. This study aimed to identify the factors that contribute to poor glycemic control among people living with DM at the Bafoussam Regional Hospital (BRH) and the Dschang Regional Hospital Annex (DRHA). Methods This was an observational study with two parts: a cross-sectional descriptive part and a case-control analytical part. It was conducted between March and May 2023 in both hospitals, focusing on people with type 2 diabetes mellitus (T2DM) who were recruited based on specific selection criteria. Poor glycemic control was defined as having a glycated hemoglobin (HbA1c) level ≥ 7%. The study’s cases were people with uncontrolled DM, while the controls were those with controlled DM, matched for sex and age. Data was collected through face-to-face questionnaires and a review of patient records. Multivariate analyses were conducted to identify factors associated with significant differences, with a p-value of less than 0.05 considered statistically significant. Results A total of 241 (102 men) people living with T2DM were included in this study. The median age was 61.03 years [IQR 53–71]. The median duration of DM was 7 years [IQR 3.5–11.5]. The rate of poor glycemic control was 71%. A DM duration between 5 and 10 years (aOR = 3.11 [95% CI 1.11–8.66]; p = 0.03) and nonadherence to treatment (aOR = 3.09 [95% CI 1.34–7.11]; p = 0.008) significantly increased the risk of poor glycemic control. Adherence to diet (aOR = 0.21 [95% CI0.09-0.51]; p < 0.001) significantly reduced the risk of poor glycemic control. Conclusion This study revealed a high rate of poor glycemic control at BRH and DRHA. Intermediate DM duration and poor treatment adherence were associated with poor glycemic control. These factors should be considered in developing interventions to improve diabetes control in Cameroon.

Osteoarthritis (OA) is a slowly evolving, multifactorial disorder that affects joints, particularly the knee. Periodontitis is an infection of the tissues supporting the teeth, leading to significant tooth loss. Recent studies suggest an association between Knee OA (KOA) and periodontitis, with the prevalence of periodontitis increasing with the severity of KOA. We aimed to determine the prevalence and distribution of periodontitis and the association between the severity of KOA and periodontitis in subjects living with KOA. A cross-sectional study was conducted in an outpatient clinic at the Rheumatology unit of the Douala General Hospital between October 2022 and June 2023. Data were collected using a questionnaire, an endo-buccal examination grid, radiological images and medical records. A multivariate analysis using logistic regression was performed, including the relevant variables in the bivariate analysis. We included 253 participants (201 women) with a median age of 63 years [54-70]. The mean visual analog scale was 52.7 ± 27.9 mm. The mean Lequesne index was 12.25 ± 5.03. Kellgren and Lawrence (K&L) grade 2 was predominant (61.7%), as was tricompartimental KOA (85.4%). The brushing method was appropriate for 40.3% of the participants, while more than a quarter (26.7%) were brushing their teeth for more than 3 min. The oral hygiene was good for only the third (33.6%) of the population. The prevalence of periodontitis was 62.5% [56.1-68]. Periodontitis was significantly associated with radiological K&L grade 4 (OR 5.39 [1.27-28.98]; p = 0.03), poor oral hygiene (OR 34 [7.46-277.71]; p < 0.001), visits to the dentist [in case of problems] (OR 8.54 [3.09-28.58]; p < 0.001) and brushing time (OR 21.93 [5.66-123.24]; p < 0.001). Many participants in this study had poor brushing habits, and only a few had good oral hygiene. Periodontitis is common in patients with KOA, affecting almost 2 patients out of three at the Douala General Hospital in Cameroon and is associated with the severity of KOA, poor oral hygiene and poor oral hygiene habits.

Background Osteoarthritis (OA) is a slowly evolving multifactorial disorder that affects joints, particularly the knee. Periodontitis is an infection of the tissues supporting the teeth, leading to significant tooth loss. Recent studies suggest an association between Knee OA (KOA) and periodontitis, with the prevalence of periodontitis increasing with the severity of KOA. We aimed to determine the prevalence and distribution of periodontitis and the association between the severity of KOA and periodontitis in subjects living with KOA. Patients and methods: A cross-sectional study was conducted in an outpatient clinic at the Rheumatology unit of the Douala General Hospital between October 2022 and June 2023. Data were collected using a questionnaire, an endo-buccal examination grid, radiological images and medical records. A multivariate analysis using logistic regression was performed, including the relevant variables in the bivariate analysis. Results We included 253 participants (201 women) with a median age of 63 years [54–70]. The mean VAS was 52.7 ± 27.9 mm. The mean Lequesne index was 12.25 ± 5.03. Kellgren and Lawrence (K&L) grade 2 was predominant (61.7%), as was tricompartimental KOA (85.4%). The prevalence of periodontitis was 62.5%. Periodontitis was significantly associated with radiological K&L grade 4 (OR: 5.39 [1.27–28.98]; p = 0.03), poor oral hygiene (OR: 34 [7.46277.71]; p < 0.001), visits to the dentist [in case of problems] (OR: 8.54 [3.09–28.58]; p < 0.001) and brushing time (OR: 21.93 [5.66-123.24]; p < 0.001). Conclusion Periodontitis is common in patients with KOA in Cameroon and is associated with the severity of KOA and poor oral hygiene.

Background: Hypertension affects a large proportion of the world’s population. There is a bidirectional association between hypertension and periodontal disease (PD). This study aimed to assess the oral health knowledge, attitudes and practices (KAP) of patients living with hypertension followed up at the Bafoussam Regional Hospital (BRH) and the Dschang Regional Annex Hospital (DRAH). Methods: This cross‐sectional study was conducted from February to April 2024 in two tertiary health facilities of the west Cameroon region, targeting hypertensive outpatients or followed up in cardiology and internal medicine who meet the inclusion criteria. Consecutive sampling was used to collect sociodemographic data, past history, and oral health KAP via a face‐to‐face questionnaire and medical records. The KAP were analyzed using the Essi and Njoya grid. Logistic regression was used to determine the factors associated with poor KAP ( p < 0.05). Results: A total of 367 people (143 males) with a median age of 62 years (IQR 53‐70) were recruited. The median duration of hypertension was 5 years (IQR 2‐10). Almost all participants (91.8%) had poor knowledge, 58.6% had harmful attitudes and 67.6% had inadequate practices. Living in an urban area (aOR: 0.43 [95% CI 0.19‐0.97]; p = 0.042) was negatively associated with poor knowledge. Recently diagnosed hypertension (aOR: 1.74 [95% CI 1.11‐2.76]; p = 0.015) and poor knowledge (aOR: 3.50 [95% CI 1.55‐7.92]; p = 0.003) were positively associated with harmful attitudes. Primary education (aOR: 1.32 [95% CI 1.05‐2.676]; p = 0.042) and low monthly income (aOR: 1.50 [95% CI 1.02‐3.14]; p = 0.046) were positively associated with harmful practices. Conclusion: Most participants had insufficient knowledge of oral health and adopted harmful practices. Highlighting the need for carers and decision‐makers to raise awareness and educate hypertensive patients about the relationship between their disease and oral health using the associated factors identified.

Physical activity (PA) can reduce the risk of non-communicable diseases like heart diseases and diabetes. However, exposure to poor air quality (AQ) when engaging in PA could negate the health benefits. The risk associated with air pollution is relatively severe during physical activities because a higher inhaled pollution dose is experienced during PA compared to when sedentary. We conducted a yearlong AQ monitoring using a commercial low-cost AQ device. The devices were deployed near a public space used for PA as part of a study to understand the health risks encountered by people informally appropriating public spaces for PA in Lagos, Nigeria and Yaoundé, Cameroon. The parameters monitored included CO, NO, NO₂, O₃, PM_2.5, PM₁₀, CO₂, pressure, temperature and relative humidity. We detected unique pollutant temporal profiles at the two locations, with a distinct weekday-to-weekend effect observed for the gaseous pollutants but not for the PM. Transboundary emissions related to the Harmattan haze dominated the background PM concentration in both cities in the dry season. Our findings underscore the importance of long-term AQ monitoring to inform action and offer insights into simple behavioural changes that can maximise the health benefits of PA while minimising the risk of air pollution exposure.

High sugar intake contributes to diet-related excess weight and obesity and is a key determinant for noncommunicable diseases (NCDs) in low- and middle-income countries (LMICs). The World Health Organization (WHO) gives specific advice on limiting sugar intake in adults and children. Yet, to what extent have policy ideas on sugar intake reduction originating at the global level found expression at lower levels of policymaking? A systematic policy document analysis identified policies issued at the African regional, South African national and Western Cape provincial levels between 2000 and 2020 using search terms related to sugar, sugar-sweetened beverages (SSBs), and NCDs. Forty-eight policy documents were included in the review, most were global and national policies and thus the focus of analysis. A policy transfer conceptual framework was applied. Global recommendations for effectively tackling unhealthy diets and NCDs advise implementing a mix of cost-effective policy options that employ a multisectoral approach. South African country-level policy action has followed the explicit global guidance, and ideas on reducing sugar intake have found expression in sectors outside of health, to a limited extent. As proposed in this paper, with the adoption of the SSB health tax and other policy measures, South Africa’s experience offers several learnings for other LMICs.

Rates of obesity and related non-communicable diseases are on the rise in sub-Saharan Africa, associated with sub-optimal diet and physical inactivity. Implementing evidence-based interventions targeting determinants of unhealthy eating and physical inactivity in children and adolescents’ immediate environments is critical to the fight against obesity and related non-communicable diseases. Setting priorities requires a wide range of stakeholders, methods, and context-specific data. This paper reports on a novel participatory study design to identify and address contextual drivers of unhealthy eating and physical inactivity of children and adolescents in school and in their home neighborhood food and built environments. We developed a three-phase mixed-method study in Cameroon (Yaoundé) and South Africa (Johannesburg and Cape Town) from 2020–2021. Phase one focused on identifying contextual drivers of unhealthy eating and physical inactivity in children and adolescents in each setting using secondary analysis of qualitative data. Phase two matched identified drivers to evidence-based interventions. In phase three, we worked with stakeholders using the Delphi technique to prioritize interventions based on perceived importance and feasibility. This study design provides a rigorous method to identify and prioritize interventions that are tailored to local contexts, incorporating expertise of diverse local stakeholders.

Given the complexity of global health crises such as the COVID-19 pandemic, it is typical for crisis-focused interventions to have a multiplicity of impacts. Some of these impacts may yield positive or negative externalities for health priorities that do not have the same perceived urgency. The interplay between COVID-19 prevention (a high priority, high perceived urgency issue) and non-communicable disease (NCD) prevention (a high priority, low perceived urgency issue) provides a good case in point. By analysing tweets during Nigeria’s COVID-19 lockdowns, we identified avenues for social media to help adapt crisis responses to a wider range of wellbeing concerns.