Archive | September 2013

Poorly Treated Sore Throat May Lead To Heart Disease- Prof. Kingue

By Leocadia Bongben

Cameroonians may have to be more careful with sore throats as poorly treated or untreated, they lead to heart disease.

Binka Yong had a sore throat recently, her mother decided to give her ginger to eat. A friend advised her to use salty warm water, another, honey.

These and many more are the wrong treatments for sore throats.

Prof. Samuel Kingue, Cardiologist, vice-president of the Cameroon Cardiac Society, warns, “We should not play with sore throats, they should be treated with antibiotics, amoxicillin and ampicillin which effectively kill the germs”.

“Though not all sore throats are caused by bacteria, treatment with antibiotics is a good way of preventing complications in the heart called rheumatic heart disease”.

“Rheumatic heart diseases occur in children who suffer from untreated sore throats and this may lead to heart failure”, Kingue states.

He regrets that the only treatment in severe cases is heart surgery with the exorbitant cost involved.

Heart diseases caused by the complication of untreated or poorly treated sore-throats is one of the major causes of heart diseases in Cameroon besides congenital heart diseases-children born with heart malformations.

Roughly 5 percent of babies born in the world suffer from congenital heart diseases, and persons above 20 years are more exposed to diseases such as hypertension.

It is estimated that out of every 1000 adult persons, five are living heart diseases and for every 1000 children three are living with cardio-vascular diseases.

This means about 140000 Cameroonians live with cardiovascular diseases, Sister Appolonia Budze, Public Relations/Communication officer of the Shisong Cardiac Centre, says.

The Shisong Cardiac Centre screens about 5000 patients every year besides massive screenings. Cardiovascular diseases are third cause of mortality in Cameroon after malaria and HIV/AIDS.

Despite the lack of specific statistics on cardiovascular diseases in Cameroon, Kingue says on the whole, Cameroonians are in good health but a percentage are either sick or carry some diseases, hypertension and diabetes and other complications.

“Hypertension is a situation in which the blood pressure rises to an abnormal level which the heart cannot stand for a long time. Having hypertension that has not been treated for a long time can lead to heart or renal failure”, he says.

Around 20-40 per cent of Cameroonian adults suffer from hypertension and a small percentage treated. Given the picture of cardiovascular diseases, cardiologists focus on prevention.

Prevention of Cardiovascular Diseases
As the world is celebrating the world heart day, on September 29 the Cameroon Cardiac Society and the Shisong Cardiac Centre are involved sensitization of the public.

At the age of 40 and above, Cameroonians need to have their blood pressure and sugar level checked once every year, and screened for heart diseases, cardiologists advise.

There are screenings for hearts diseases through-out the country but that of the Shisong Cardiac Centre is billed for September 27 and 28 and in Bafoussam, October 2 and 3.

It is good to screen so as to avoid a situation where the disease becomes complicated such that even surgery cannot help, Budze advises.

Kingue emphasizes that if a person feels shortness of breath, palpitation and chest pain, the person should consult a cardiologist.

Some people whose blood pressure is normal may not yet be sick, but, can be exposed with age, and this happens in people with a family history of hypertension, he adds.

The population is encouraged to prevent the occurrence of heart diseases by changing life styles.

First, it is advised to practice sports as physical exercises are good for health and avoid putting on weight. Avoid eating too much fats, drinking too much alcohol, Cameroonians drink too much and this is not good for health, stop smoking and avoid stress, experts say.

Budze stresses on the mode of cooking the food such that fats is reduced though taste maybe sacrificed. If this is done in the family, children’s taste can be trained to adjust to a different kind of diet and build a healthier population.

But, in a situation where heart diseases are diagnosed, treatment is available in general hospitals in the country and at the Shisong Cardiac Centre.

Treatment: First ever Defibrillator Implant in Central Africa
As part of control and management of heart diseases the Shisong Cardiac Centre carried out the first ever implant of Intra-cardiac Cardioverter Defibrillator, ICD.

This is the first such implantation in Cameroon and Central Africa carried out September 10, 2013.
Intracardiac Cardioverter Defibrillator Implant

An ICD is a battery-like device. This was implanted into the left collarbone bone area of 50 year old Gilbert to resolve the relevant heart disease—hypertrophic cardiomyopathy.

This is a genetic disease characterized by the thickening of the walls of the heart such that the patient develops life-threatening arrhythmia—irregular heart beat and palpitation.

This is manifested in fits of unconsciousness, Sister Appolonia Budze explains.

Kingue, the Vice President of the Cameroon Cardiac Society explains that when the heat beats too fast disturbing the normal function, leading to loss of consciousness, the ICD is implanted to deliver a certain amount of electricity to the heart and it completely stops the rhythm disturbance.

“ICD is a modern high technology treatment and we are proud of Shisong, which is now able to perform this”, Kingue says.

Dr. Jacques Cabral Tantchou, specialist in Cardiostimulation and Clinical Arrhythmias carried out the implant with the assistance of Dr. Anastase Dzudzie Cardiologist at the Douala General Hospital and Secretary General of Cameroon’s Cardiac Society.

Tantchou explains that the condition that warrants ICD- arrhythmias (irregular sensed beats of the heart) begin to occur from middle age due to the weakening of the cardiovascular system. He stresses that “persons above 40 should have their heart checked annually”.

Besides ICD, the most common treatment found in other centres in general Hospitals is the implantation of pace makers.
Pace makers are electrical devices implanted in patients whose heart beat is very slow, Kingue says.

Challenges
Though it is possible to get treatment for heart diseases, the cost remains a major challenge for the Cameroon population. The cost for open heart surgery is estimated at FCFA 3million, FCFA 1.2million for implants among others.

Despite the training of cardiologists, the number is not enough, 30-40 cardiologists for a population of 20,000 million.

The implementation of the Abuja declaration in which 15 per cent of the national budget is dedicated to the Ministry of Health maybe the part of the solution to the general health situation in Cameroon. Then, government can provide subvention for the treatment of heart diseases.

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Cameroon Would Continue To Ration Antiretroviral Drugs –Mama Fouda

By Leocadia Bongben

HIV/AIDS patients in Cameroon continue to groan due to the insufficient supply of antiretroviral drugs as the Minister of Public Health Andre Mama Fouda tells news conference the country would continue to ration antiretroviral drugs.

Instead of getting a usual molecule administered to patients, they would get a different molecule and there are fears that some may not even get the drugs.

The country has been grappling with antiretroviral drug stock-out for some time and there have been fears that the patients may die faster due to the insufficient supply of the life sustaining drugs.

Accompanied by the Global Fund for Malaria Tuberculosis and HIV/AIDS representatives on an evaluation mission of Global Fund funded programmes in Cameroon, Mama Fouda stressed that the rationing of antiretroviral drugs would continue until November and for the situation to normalise in December.

“We are still in a period of stock rationing that is why HIV/AIDS patients in Cameroon cannot yet have a supply of antiretroviral drugs for a period of three months. We are going to continue rationing until November and in December the situation would get better”
The reason for the rationing he said, “Laboratories are functioning with zero stock, and now that the request for the supply of the drugs has been made, there is a deadline for the drugs to arrive in Cameroon”.

But, Mama Fouda says there is no need to get alarmed by the rationing. However, a nurse in one of the private hospitals has said the situation is embarrassing as they do not know what to tell patients.

“Patients are often advised to take their drugs at the same hour every day with the rationing the hospitals do not know what to tell the patients”. Nonetheless, some NGOs have been advising patients to eat a balanced diet as drugs are being rationed.

Mama Fouda in August did not make clear this situation when he announced the in addition to the FCFA 5billion special allocation to purchase antiretroviral drugs and the contribution of partners amounting to FCFA 20 billion, painting the a picture of a country shielded from stock-outs in October 2014.

For the civil society involved in the fight against HIV/AIDS, there has always been the problem of treatment of antiretroviral drugs, but in the past months, the problem was serious, that is from January and was acute for the past six months.

Endelle Paul Patrick, Assistant in the Department of Research Development and Communication, Positive Generation, says, “The reason for stock-outs is that government is not financing the fight against HIV/AIDS and health generally, the finances are not commensurate to the level of treatment”.

“We cannot count on external finances when even European countries are undergoing economic crisis, it is normal that they reduce their finances and that others withdraw though some are still giving”.

The civil society wants government to take control of the fight against HIV/AIDS and provide strong financial engagements.
In 2001, the Cameroon government alongside other countries took the engagement through the Abuja Declaration to dedicate 15 per cent of the budget to health.

Positive Generation and The Coalition for 15 per cent of the budget to health, every year go to the national assembly to lobby for government to attribute the 15 per cent of the budget to health.

Things could get better with the allocation of 15 per cent to health, Endelle argues.

The Global Fund Head of African Department, Lelio Marmora agreed that there are financial, technical, capacity and recurrent stock-outs problems.
Global Fund Represebtatives, Lelio Marmora, Tina Draser

There are different causes and to have 125,000 patients on anti-retroviral drugs is a success to the Global Fund.

However, if 860,000 persons are HIV positive and only 125, 000 are on antiretroviral drugs, the success cannot be that good.

“It is difficult to get all the drugs and to manage the dosage, and stock-outs are less and less frequent”. There would always be problems he said and urged the partners to work together to surmount the problems.

However, he maintained that there is need to make a systemic analysis of how the response to the problem of HIV/AIDS fight functions in Cameroon.

“I know there are problems and there would continue to be problems, that is why there is need for all to work together to look for solutions”.

Giving an appraisal of the three programmes, Marmora said of the FCFA 300million dollars earmarked, 230million dollars has already been disbursed.

The Global Fund observes a zero tolerance to corruption, though when a huge amount of money is managed there is bound to be acts of corruption but the Global fund has a mechanism of traceability of funds and can know what is happening to the funds.

Comparing the prevalence rate in 2004 at 5.5 and in 2011 it dropped to 4.3 per cent, Marmora said this is an impact though many argue that this is in part because some of the patients have died.

The fight against Malaria saw the distribution of 8 million long lasting treated mosquito bed nets, and 10 million more would be distributed in 2014. For the Tuberculosis programme that seems to be functioning well according to the Minister, FCFA 17 billion dollars has been allocated to the programme.