EPIDEMIOLOGIC FEATURES OF ACUTE APPENDICITIS IN A TROPICAL AFRICAN POPULATION

BACKGROUND: The true incidence rate of
appendicitis in Cameroon and the magnitude of etiological factors in
appendicitis are unknown.

AIM: To describe the epidemiology of acute
appendicitis in the Northwestern region of Cameroon.

MATERIALS
AND METHODS: A
retrospective population-based cohort study was conducted to assess the
demographic features, incidence and seasonal variation of acute appendicitis
using the medical database of two Mission Hospitals in the Northwestern Region,
Cameroon from January 2006 to January 2016. The National Institute of
Statistics, Bamenda Regional Office, Bui-Division -Population Data of
Cameroon in 2016 was used to estimate the standardized annual incidence of
appendicitis in the locality. Hospital A is a 200-bed Mission Hospital (with 50
surgical beds), while Hospital B is a 250-bed Mission Hospital (with 70
surgical beds). Pathologically confirmed specimens of appendicitis were analyzed
against demographic data of the patients. Data analysis was done using simple
percentages, Student t or Chi-square tests and
calculations were also aided with the Number Cruncher Statistical (NCSS, LLC
Kaysville) software where applicable.

RESULTS: During the decade, a
total of 772 out of 784 cases of appendicitis recorded during the observed
period were confirmed histologically from both hospitals (56% from Hospital A
and 44% from Hospital B). With a local
population whose disease or specimens would most probably end up in this
hospital pathology department estimated at 1,753,460 the standardized incidence
rate of appendicitis was 3.85 per 100,000 per annum. Fifty-two percent were
males and 48% were females. The appendicitis cases were made up 0.94%, 1.53%,
and 2.86% of the total hospital admissions in 2006, 2007, and 2010,
respectively. There has been an increasing incidence in both sexes almost in a
similar pattern. The overall mean age
was 28.64 years (M 28.94 and F 28.43 years) with 6% below the age of ten and
1.5% above 60 years. The highest incidence in males and females occurred in the
second and third decades, respectively. Incidences were higher during the rainy
season (April to September) 68%, P < 0.05), with peaks from June to
August, when 42.5% of all cases presented.

CONCLUSION: Appendicitis is very uncommon in
northwest Cameroon. The increasing incidence of the disease in both sexes in
this region may be due to the change to a Western lifestyle. The age
distribution has a similar pattern in both sexes and 85% are 40 years or less,
although the incidence is marginally higher in males. Higher prevalence of
infections and allergens from pollens in the rainy season could contribute to a
higher incidence of appendicitis.