Consultations des Adolescentes à l’Hôpital Gynéco-Obstétrique et Pédiatrique de Yaoundé : Aspects Épidémiologiques et Cliniques à Propos de 335 Cas

Félix Essiben, Esther JN Meka, Valere Mve Koh, Sibell Simo, Julius Sama Dohbit, Pascal Foumane

Abstract



RÉSUMÉ
Background. La santé des adolescents est une préoccupation actuelle. L’objectif de notre étude était d’analyser les problèmes de santé des adolescentes en milieu hospitalier. Méthodologie. Pendant 3 mois, nous avons mené une étude transversale rétrospective à la clinique des adolescents de l’Hôpital Gynéco-Obstétrique et Pédiatrique de Yaoundé.  Les caractéristiques sociodémographiques et cliniques de 335 adolescentes ayant consulté sur une période de 12 mois, du 1er janvier au 31 décembre 2016, ont été décrits. Résultats. La tranche d’âge de 15 à 19 ans était la plus représentée (88%).  Parmi ces adolescentes, 20,6% étaient mariées et 66,6% des élèves. Les motifs de consultation les plus fréquents étaient : la consultation prénatale (22,1%), les douleurs pelviennes (18,5%) et le saignement vaginal (17,3%). L’âge moyen du 1er coït était de 15 ans ± 1an.  La prévalence du VIH était de 4,8%. Parmi ces adolescentes, 21,5% avaient plus d’un partenaire sexuel, 12,8% déclaraient avoir déjà été victime d’une agression sexuelle, 22,4% avaient eu au moins un avortement, 44% consommaient de l’alcool et 10,5% du tabac, 50,4% avaient des dysménorrhées et 31,0% utilisaient une méthode moderne de contraception. Les diagnostics les plus fréquents étaient : les dysménorrhées (16,2%), les tumeurs bénignes du sein (12%), les troubles menstruels (11,6%). Un quart des patientes avaient été mises sous contraceptifs (24,5%). Conclusion. Les problèmes de santé des adolescents étaient dominés par des troubles du cycle menstruel et les conséquences d’une sexualité précoce. Le suivi psychosocial est un atout considérable de la prise en charge.
ABSTRACT
Background. Adolescents’ health constitutes a significant issue of interest. The objective of our study was to analyze the health challenges of adolescents in the hospital milieu. Patients and methods. We carried out a 3-month long retrospective cross-sectional study at the adolescent clinic of the Yaounde Gynaeco-Obstetrical and Paediatric Hospital. This enabled us describe the socio-demographic and clinical characteristics of 335 adolescents who consulted between January 1 to December 31, 2016. Results. The 15-19 years old age range was the most represented (88%). Amongst these, 20.6% were married, and 66.6% were college students. The most frequent presenting complaints included: antenatal consultations (22.1%), pelvic pains (18.5%), per-vaginal bleeding (17.3%). The mean age at coitarche was 15years±1year. The HIV prevalence stood at 4.8%. Amongst the adolescents, 21.5% had more than one sexual partner, 12.8% declared to have survived sexual harassment, 22.4% had had at least an abortion, 44% and 10.5% consumed alcohol and tobacco respectively. Also, 51.4% complained of dysmenorrhoea, and 31% used a modern contraceptive method. The most frequent diagnosis included dysmenorrhoea (16.2%), benign breast tumours (12%), menstrual irregularities (11.6%). A quarter of these patients were administered a modern contraceptive method (24.5%). Conclusion. Adolescent health challenges are made up mostly of menstrual cycle irregularities as well as the consequences linked to their sexual activity. Psychosocial follow-up is a considerable asset for management.

Keywords


adolescentes; consultations; santé des adolescents;Yaoundé

Full Text:

PDF (Français)

References


World Health Organization, Commonwealth Medical Association Trust and UNICEF (2006) Maternal, Newborn, Child and Adolescent Health. Orientation Programme on Adolescent Health for Health-Care Providers. https://www.who.int/maternal_child_adolescent/documents/9241591269/en

Unicef. Adolescent demographics. October2019. https://data.unicef.org/topic/adolescents/demographics/

Sawyer S, Afifi R, Bearinger L, Blakemore S, Dick B, Ezeh A, et al. Adolescence: A foundation for future health. Lancet. 2012; 379(9826):1630–40. [PubMed: 22538178]

UNFPA. State of the world population 2014: The power of 1.8 billion adolescents, youth and the transformation of the future. New York: UNFPA; 2014.

Patton GC, Coffey C, Cappa C, Currie D, Riley L, Gore F, Degenhardt L, Richardson D, Astone N, Sangowawa AO, Mokdad A, Ferguson J. Health of the world's adolescents: a synthesis of internationally comparable data. Lancet. 2012 Apr 28;379(9826):1665-75. doi: 10.1016/S0140-6736(12)60203-7. Epub 2012 Apr 25.

Reed E, Miller E, Raj A, Decker MR, Silverman JG. Teen dating violence perpetration and relation to STI and sexual risk behaviours among adolescent males. Sex Transm Infect. 2014; 90(4):322–4. [PubMed: 24578579]

Cutter-Wilson E, Richmond T. Understanding teen dating violence: Practical screening and intervention strategies for pediatric and adolescent healthcare providers. Curr Opin Pediatr. 2011 ; 23(4):379–83. [PubMed: 21670679]

Biddlecom AE, Munthali A, Singh S, Woog V. Adolescents' views of and preferences for sexual and reproductive health services in Burkina Faso, Ghana, Malawi and Uganda. Afr J Reprod Health. 2007; 11 (3):99–110. Epub 2008/05/07. PMID: 18458737; PubMed Central PMCID: PMC2367115.

Ahmed F, Bankole A, Biddlecom A, Munthali A, Ouedraogo C, Woog V. Healthcare seeking and utilization by adolescents for reproductive health problems in sub-Saharan Africa: The Alan Guttmacher Institute,USA; 2005 15.01.10.

OMS. Santé de la mère, du nouveau-né, de l’enfant et de l’adolescent. https://www.who.int/maternal_child_adolescent/topics/adolescence/health_services/fr/

Essiben, F., Didjo, C., Mve, K.V., Ngo Um, M.E.J., Nsahlai, C. and Foumane, P. (2019) Adolescent Sexual Behavior in an Urban Area of a Re- source-Limited African Country, Cameroon. Open Journal of Obstetrics and Gynecology, 9, 923-935. https://doi.org/10.4236/ojog.2019.96090

Foumane P, Chiabi A, Kamdem C, Monebenimp F, Dohbit JS, Mbu RE. Sexual activity of adolescent school girls in an urban secondary school in cameroon. J Reprod Infertil. 2013;14(2):85–89.

Makenzius M, Larsson M. Early onset of sexual intercourse is an indicator for hazardous lifestyle and problematic life situation. Scand J Caring Sci. 2013;27(1):20-6.

Bumbuliene Z, Alisauskas J. Sexual behavior and high-risk human papillomavirus in 15- to 22-year old Lithuanian women. Acta Obstet Gynecol Scand. 2012;91(4):511-3.

De Muylder X. [The sexual health of adolescent girl]. Louvain Med. 2004;123(2):52-9. French

Langille DB, Asbridge M, Flowerdew G, Allen M. Associations of sexual risk-taking with having intercourse before 15 years in adolescent females in Cape Breton, Nova Scotia, Canada. Sex Health. 2010;7(2):199-204.

Bankole A, Biddlecom A, Guiella G, Singh S, Zulu E. Sexual behavior, knowledge and information sources of very young adolescents in four sub-Saharan African countries. Afr J Reprod Health. 2007; 11(3):28–43. Epub 2008/05/07. PMID: 18458739; PubMed Central PMCID: PMC2367131.

Muluneh AA, Nigussie TS, Gebreslasie KZ, Anteneh KT, Kassa ZY. Prevalence and associated factors of dysmenorrhea among secondary and preparatory school students in Debremarkos town, North-West Ethiopia. BMC Womens Health. 2018 Apr 24;18(1):57. doi: 10.1186/s12905-018-0552-x.

Ameade EPK, Amalba A, Mohammed BS. Prevalence of dysmenorrhea among University students in Northern Ghana; its impact and management strategies. BMC Womens Health. 2018 Feb 13;18(1):39. doi: 10.1186/s12905-018-0532-1.

Miiro G, Rutakumwa R, Nakiyingi-Miiro J, Nakuya K, Musoke S, Namakula J, Francis S, Torondel B, Gibson LJ, Ross DA, Weiss HA. Menstrual health and school absenteeism among adolescent girls in Uganda (MENISCUS): a feasibility study. BMC Womens Health. 2018 Jan 3;18(1):4. doi: 10.1186/s12905-017-0502-z.

DHS-MICS (2011) Demographic and Healthsurvey and Multiple Indicators Cluster. Survey in Cameroon. http://www.statistics-cameroon.org/downloads/EDS-MICS11/DHSMICS_2011_preliminary_report.pdf

NACP/GHS. 2008 HIV Sentinel Survey Report: Quarterly Technical Bulletin on HIV/AIDS-STIs in Ghana. National AIDS/STI Control Programme (NACP), National AIDS Commission, Ghana Health Service 2009.

Sobze Sanou M, Fokam J, Guetiya Wadoum R, Russo G, Onohiol JF, Djeunang DB, Nkamedjie PP, Zambou NF, Zefack Y, Galletta A, Arduini M, Franca E, Panà A, Colizzi V. Condom perception and prevention of HIV/AIDS infection in Cameroon: appraisal of knowledge, attitudes and practices among level one students of the University of Dschang. Ig Sanita Pubbl. 2013 Mar-Apr;69(2):183-94.

Baiocchi M, Friedberg R, Rosenman E, Amuyunzu-Nyamongo M, Oguda G, Otieno D, Sarnquist C. Prevalence and risk factors for sexual assault among class 6 female students in unplanned settlements of Nairobi, Kenya: Baseline analysis from the IMPower & Sources of Strength cluster randomized controlled trial. PLoS One. 2019 Jun 6;14(6):e0213359. doi: 10.1371/journal.pone.0213359. eCollection 2019.

Enquête démographique et de santé (EDS) 2018. Indicateurs Clés. Institut National de la Statistique. Ministère de la Santé Publique Yaoundé, Cameroun. The DHS Program ICF Rockville, Maryland, USA. Mai 2019. https://dhsprogram.com/pubs/pdf/PR116/PR116.pdf


Refbacks

  • There are currently no refbacks.


Creative Commons License
This work is licensed under a Creative Commons Attribution 3.0 License.

********************************************************************************************