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Open Journal of Gastroenterology 2024年第5期14卷 192-201页

作者： Mamadou Diakité Kouassi Olivier Claver Koffi Amadou Koné Akoun Fabrice Aké Oury Diallo Ahmadou Stellart jean M. Brou anassi jean-baptiste okon Department of Medicine and Hepato-Gastroenterology Teaching Hospital of Bouak&#233 Bouak&#233 C&#244te d&#8217Ivoire Faculty of Medical Sciences Alassane Ouattara University Bouak&#233 C&#244te d&#8217Ivoire

Background and Objectives: The indication for treatment in HBsAg-positive patients with low viral load and normal transaminases requires an assessment of fibrosis. In resource-limited settings, free hepatic fibrosis evaluation tests can aid in therapeutic decision-making. Our study aims to demonstrate the utility of assessing hepatic fibrosis using non-invasive markers (APRI and FIB-4) in patients with chronic B viral hepatitis without cytolytic activity and low viral replication in our context. Patients and Methods: This is a retrospective cross-sectional study conducted between January 2018 and December 2021 at the University Hospital Center of Bouaké. Included were all patients aged ≥18 with normal transaminases (Results: Our study included 241 patients, with a mean age of 36.19 years (±10.52 years) and a male predominance of 52%. The mean FibroScan® value was 6.44 ± 2.3 kPa, and 68 patients (28.22%) had fibrosis >7 kPa. To exclude significant fibrosis (FS Conclusion: A significant proportion of HBV-infected patients with normal ALT and low viral load have active liver disease. Both FIB-4 and APRI biological scores are useful in identifying individuals without significant fibrosis with a good negative predictive value (>50%).

关键词： HBV Infection APRI FIB-4 Impulse Elastography BouakéUniversity Hospital

Helicobacter pylori Infection and Gastroduodenal Lesions: Prevalence and Associated Factors in Cote d’Ivoire

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Open Journal of Gastroenterology 2022年第2期12卷 27-35页

作者： Mamadou Diakité Amadou Koné Akoun Fabrice Aké Kouassi Olivier Claver Koffi anassi jean baptiste okon Kadidiatou Diallo Department of Medicine and Hepato-Gastroenterology Teaching Hospital of Bouaké Bouaké Cote d’Ivoire Faculty of Medical Sciences Alassane Ouattara University Bouaké Cote d’Ivoire

Objective: The objective is to determine the prevalence of Helicobacter pylori (Hp) infection and highlight the determinants of the infection as well as the gastric histopathological lesions associated with this infection. Methods: This is a retrospective study carried out from August 01, 2015 to December 31, 2020 in Bouaké. It included all patients with gastric and/or duodenal lesion on upper gastrointestinal endoscopy in whom gastric biopsies and histopathology results are available. Results: The study involved 510 patients (301 men and 209 women). The prevalence of Hp was 66.47% (339/510 patients). The presence of Hp was not significantly related to age and gender. Epigastralgia was the most common indication with no significant difference between the positive and negative Hp groups (65.37% vs 34.63%, p = 0.35). A significant difference was only observed for duodenal ulcers (84.31% Hp+ vs 15.69% Hp-, p = 0.004). Regarding histological lesions: Chronic and active gastritis was strongly related to the presence of Hp (p < 0.05). Intestinal metaplasia and gastric atrophy were not significantly associated with the presence of Hp. These precursor lesions of gastric cancer (metaplasia and atrophy) were, however, significantly related to chronic gastric disease with p = 0.02 and p Conclusion: The prevalence of Hp is high in Bouaké. Our study confirms the link between Hp infection and chronic and active gastritis.

关键词： Helicobacter Pylori Gastritis Atrophy Intestinal Metaplasia

Appropriateness of colonoscopy in Cocody teaching hospital center in 2010: A prospective study using criteria established by the European panel on the appropriateness of gastrointestinal endoscopy (EPAGE)

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Open Journal of Gastroenterology 2012年第4期2卷 193-199页

作者： Constant Assi Marie jeanne Lohouès-Kouacou Emile Allah-Kouadio Christian Jomo Njossu anassi jean-baptiste okon Stanislas Doffou Siaka Koné Ganda Soumaré Amadou Koné Amadou Ouattara Dramane Soro Mamadou Diakité Benoit-Mathieu Camara Department of Gastroenterology Faculty of Medical Sciences Cocody Teaching Hospital Center AbidjanCote d’Ivoire

Aims: 1) To assess the feasibility of EPAGE criteria in clinical practice;2) To assess appropriateness colonoscopy using EPAGE criteria;3) To compare colonoscopy appropriateness and endoscopic lesions. Method: Hundred thirtynine consecutive patients explored by colonoscopy were included. The appropriateness of colonoscopy was evaluated by EPAGE criteria. Results: EPAGE criteria were applicable among 127 patients (91% of the cases). Colonoscopies were appropriate, uncertain and inappropriate in respectively 40%;27% and 24% of the cases. Rate of abnormal colonoscopies was significantly different between the 3 groups (p = 0.03). Cancers were diagnosed exclusively in the groups with appropriate and uncertain colonoscopies (11% and 5%). Colonic adenomas were observed in the three groups (appropriate (7%), uncertain (5%) and inappropriate (6%)). Subjects with uncertain indication were older (58.25 years;p = 0.035). Conclusion: EPAGE criteria are feasible in clinical practice in Cocody’s teaching hospital center. Colonoscopies are generally appropriate in our hospital. However, within sight of the significant number of normal colonoscopies and discovered lesions in uncertain indication, colonoscopy cannot concern exclusively calculation of a score of appropriateness.

关键词： Colonoscopy Appropriateness EPAGE Score Colorectal Cancer Cote d’Ivoire

Prevalence of HBs Ag among blood donors in Transfusion Center, Abidjan (Ivory Coast)

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Open Journal of Gastroenterology 2013年第3期3卷 165-169页

作者： N’guessan N’dri Amani Sroboua Thot’o anassi jean-baptiste okon Constant Assi Emile Allah-Kouadio Dramane Soro Mamadou Diakité Amadou Koné Siaka Koné Marie jeanne Lohouès-Kouacou Benoit-Mathieu Camara Department of Gastroenterology Faculty of Medical Sciences Cocody Teaching Hospital Center Abidjan Cote d’Ivoire

Aim: To study the prevalence of HBsAg among persons without risk factors for hepatitis B. Patients and Methods: Cross-sectional study (28 January to 31 December 2010) about 4310 new volunteers blood donors consecutively recruited. Among all, a risk factor for hepatitis B was investigated (standardized questionnaire and clinical examination). Blood of all blood donors without risk factors of hepatitis B (n = 3823) were systematically collected for HBsAg, hepatitis C antibody, syphilis serology and human immunodeficiency virus serology. The blood was analyzed with a third generation ELISA (Abbott Murex). Results: HBsAg was positive in 179 persons (4.68% [95% CI 4% - 5%]). It was associated with hepatitis C antibodies (0.28% (n = 11)), syphilis antibodies (0.68% (n = 26)) or anti-human immunodeficiency virus antibodies (0.2% (n = 8)). In multivariate analysis, age 30 to 39 years (1.545 [95% CI 1.074 to 2.222]), male sex (2.426 [95% CI 1.550 to 3.799]) and positive syphilis serology (14.344 [95% CI 5.161 to 39.865]) were associated with presence of HBsAg. Conclusion: The prevalence of HBsAg among adult without risk factors for hepatitis B was not negligible. Also, it is essential to maintain routine screening before any vaccination against hepatitis B in adult. Our study is not for an immunization against hepatitis B only targeting risk populations in adult.

关键词： HBsAg Prevalence Risk Factor Adult Abidjan

Predictive Factors for Viral B and C Infection in Health Workers in a University Hospital in Ivory Cost

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Open Journal of Gastroenterology 2018年第10期8卷 377-385页

作者： okon anassi jean-baptiste Koné Amadou Diakité Mamadou Aké Fabrice Thot’o Amani Sroboua N’dri N’guessan Hepato-Gastroenterology Department University Hospital Center Bouaké Ivory Coast

Purpose: To evaluate the serological status of hepatitis B and C and to identify the risk factors for viral B and C infection in health workers at the university hospital. Material and Method: Mono-centric cross-sectional study carried out at Bouaké University Hospital from March 2nd to May 16th, 2016, concerning the health staff of the Bouaké University Hospital. Cross-sectional study mono-centric concerning the serological status of viral hepatitis B and C from the period from March 2nd to May 16th, 2016 of the health staff of the University Hospital of Bouaké. It has benefited from data from PNLHVi (national program against viral hepatitis) as part of its awareness campaign. The data were analyzed by SPSS software version 20.0. Results: Of the 1107 health workers, 632 had been included, representing a participation rate of 57.1%. The average age of the staff was 37.8 years with extremes ranging from 18 to 66 years. The sex ratio (H/F) was 0.8. Accidents with blood exposure were noted in 52.4% of cases. The maximum vaccine coverage was 16.1%. The prevalence of HBsAg was 8.4%. Contact with HBV was present in 3/4 of the staff. Anti HCV Ab was positive in 1.4% of the staff. Males, age over 50 and over 20 years of seniority were associated with HBV. Also, HBV infection was significantly higher in boys and girls (81.7%), nurses (78.3%) and nursing aides (73.8%), (p = 0.022). HCV infection was significantly correlated with emergency services. Conclusion: Age, gender, seniority, paramedic qualification, and high risk of exposure to body fluids were correlated with viral B infection while emergency department membership was a factor risk of HCV infection.

关键词： Prevalence Risk Factors Viral Hepatitis B Viral Hepatitis C Health Personnel

Interest of SAAG in Etiological Diagnosis of Ascites in African Black

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Open Journal of Gastroenterology 2018年第10期8卷 337-347页

作者： okon anassi jean baptiste Soro Dramane Doffou Stanislass Diakite Mamadou Koné Amadou Aké Fabrice Thot’o Amani Sroboua N’dri N’guessan Hepato-Gastroenterology Department University Hospital Center Bouaké Ivory Coast Hepato-Gastroenterology Department University Hospital Center Abidjan Ivory Coast

Purpose: To show the interest of the serum-ascites concentration gradient in albumin (SAAG) in the etiological diagnosis of ascites in African black. Materiel and Methods: This was a monocentric observational and analytical study performed on patients over 15 years old and hospitalized in the Hepato-Gastroenterology department of Cocody from January 1st, 2010 to March 31st, 2017 for ascites. The cytology and chemistry of the ascites fluid and the protidogram were performed. The main outcome measure was the prediction of portal hypertension (PHT) or non-portal hypertension related causes of ascites from SAAG. Results: The hospital prevalence of ascites was 11%. There were 82 women (46.9%) and 93 men (53.1%) with a sex ratio (M/F) of 1.1. SAAG was low in 68.6% of cases and high in 31.4% of cases. The most common etiologies were post-viral cirrhosis (74%), HCC (16.60%) and peritoneal tuberculosis (13.7%) respectively. In the case of high SAAG, 91% of ascites related to PHT were observed, but also 77.5% of a low SAAG corresponded to ascites related to PHT (p = 0.024) with Se = 35% Sp = 84% and accuracy = 44%. All patients with peritoneal tuberculosis had a SAAG low of less than 1.1 g/dl significantly (p = 0.002). SAAG had a diagnostic performance of 89% in peritoneal tuberculosis at the cutoff value of ?1.24 g/dl (AUROC = 0.91, Se = 96%, Sp = 86%) while in post viral hepatitis cirrhosis at a threshold of 0.58 g/dl the diagnostic performance was 60% (AUROC = 0.69, Se = 53%, Sp = 79%). Conclusion: The simple technical SAAG, allowing to distinguish the ascites linked to the PHT and the ascites not bound to the PHT, can be used like a method of diagnosis of the etiologies of the ascites especially in the peritoneal tuberculosis in the African countries low income.

关键词： SAAG Ascites Peritoneal Tuberculosis Cirrhosis PHT

Predictive Values of Platelets Count and Spleen Diameter in the Diagnosis of Esophageal Varices in Black African Cirrhotic Patients

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Open Journal of Gastroenterology 2020年第12期10卷 317-328页

作者： jean baptiste okon Fabrice Ake Mamadou Diakite Olivier Kouadio Koffi Amadou Kone Hepato-Gastroenterology Department University Hospital Center of Bouake Bouake Ivory Coast

Background: Gastrointestinal hemorrhage from ruptured esophageal varices is of concern in Africa where gastrointestinal fibroscopy for diagnosis is lacking. Purpose: To determine the performance of the length of the spleen, of the platelet count in the diagnosis of esophageal varices (OVs) by specifying the diagnostic thresholds in order to facilitate the prophylaxis of varicose hemorrhages in black African cirrhotic patients. Material and Method: This was a prospective study with a descriptive and analytical aim on cirrhotic patients hospitalized at the university hospital of Bouake (Ivory Coast) from 2017 to 2019. The patients included in the study were the cirrhotic of black race hospitalized having carried out an abdominal ultrasound with measurement of the spleen diameter (SD), an eso-gastro-duodenal endoscopy, and a blood count with platelet count (PC). The first primary endpoint was the diagnosis of esophageal varices in cirrhosis. Cirrhosis was retained by the combination of clinical, biological, ultrasound and endoscopic arguments. The OVs were distributed according to size and the presence of red signs. The platelet count, and the measurement of the spleen to calculate the PC/SD ratio were the second endpoint. The secondary endpoints studied were, the viral and ethyl etiologies of the cirrhosis, the Chlid-Pugh prognostic score. Performance was assessed using the ROC curve. The difference was significant for p less than 0.05. Results: The study included 101 patients;they were 79 men (78.2%) and 22 women (21.8%). The mean age of the cirrhotic patients was 48 ± 14. Esophageal varices were present in (n = 93;92%) of cases. The different etiologies were hepatitis B virus (HBV) (n = 65;78.3%), hepatitis C virus (HCV) (n = 21;25, 3%), and alcohol (n = 6;7.2%). Platelet count (PC) 130 mm) and PC/SD rat

关键词： Non-Invasive Methods Platelets Count Spleen Diameter Esophageal Varices

Factors Associated with the Applicability of EPAGE (European Panel on the Appropriateness of Gastrointestinal Endoscopy) and the Suitability of Indications for Eso-Gastroduodenal Endoscopy in a West African Country

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Open Journal of Gastroenterology 2021年第10期11卷 173-183页

作者： jean baptiste okon Fabrice Ake Mamadou Diakite Olivier Koffi Kouadio Amadou Kone University Hospital Center of Bouake Bouake Ivory Coast

Background: EGDF’s reference examination for exploring the digestive tract has seen steadily increasing demands over the past few years. The exam can be expensive and often poorly tolerated. Its prescription must take the cost/be- nefit and its relevance into account. The EPAGE criteria were developed to allow the appropriate selection of endoscopic procedures. Objective: To determine the factors associated with the applicability and appropriateness of the EGDF indications by the EPAGE criteria in our context in order to limit the number of inadequate EGDFs. Material and Method: Prospective cross- sectional study on the applicability of EPAGE (European Panel on the Appropriateness of Gastrointestinal Endoscopy) and the relevance of the indications for Eso-Gastro-Duodenal Fibroscopy (EGDF) according to the criteria of the EPAGE in two large public hospitals located in the central region of Ivory Coast over a period of 8 months from September 2019 to May 2020. The following parameters (age, sex, history and comorbidities of th

关键词： EPAGE EGDF Indications Relevance Ivory Coast

Mortality Factors for Cirrhotics in an Ivorian University Hospital (Ivory Coast)

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Open Journal of Gastroenterology 2020年第9期10卷 231-241页

作者： jean baptiste okon Mamadou Diakite Fabrice Ake Olivier Koffi Kouadio Amadou Kone Hepato-Gastroenterology Department University Hospital Center of Bouake Bouake Ivory Coast

Background: Cirrhosis, an ineluctable development of chronic liver disease, still has high mortality throughout the world despite many advances in physiopathology and therapy. This high mortality is closely related to the unpredictable course of cirrhosis with numerous complications. Objective: To evaluate the predictive factors of death during cirrhosis. Materials and methods: This is an observational, descriptive study on cirrhotic patients hospitalized in the hepatology unit of the Center Hospitalier Universitaire in Bouake (Ivory Coast) during the period from January 01, 2018 to December 31, 2019. The study focused on the data collected in the medical files (paper format) of hospitalized cirrhotics and the death register of the service. The diagnosis of cirrhosis and the death of the cirrhotic were the main criteria for judgment. The secondary criteria defined were: history of cirrhosis, reasons for consultation, clinical signs, biological signs, complications of cirrhosis and the treatment received. The relationship between the parameters was expressed as an odds ratio (OR) with a 95% confidence interval (CI) and the significance threshold fixed at p 0.05. Results: The study retained 206 files of

关键词： Cirrhosis Hepatocellular Carcinoma Mortality CHU Bouake

Duodenal Metastases of Malignant Melanoma: One Case Report

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Open Journal of Gastroenterology 2015年第8期5卷 111-114页

作者： Soro Dramane Ouattara Amadou okon anassi jean baptiste Koné Siaka Assi Constant Allah-Kouadio Emile N’dah K. Justin Ndjitoyap Ndam Antonin Wilson Diallo Djeinabou Lohoues-Kouacou Marie jeanne d’Arc Camara Benoit Mathieu Service d’Hépato-Gastroentérologie CHU Cocody Abidjan Cote d’Ivoire Service d’Hépato-Gastroentérologie CHU Bouaké Bouaké Cote d’Ivoire Service d’Anatomie Pathologique CHU Cocody Abidjan Cote d’Ivoire

The duodenal metastases of a malignant melanoma are rare. We report a case at a 86-year-old, hypertense patient, without tumoral history, who was hospitalized in our department for a change of the general state and an anaemia ferriprive without found home (foyer) of display. In the clinical examination, we had found anemia syndrome, nodules under cutaneous about 2 cm in diameter at the level of the thorax, of the belly, the members and of the lower lip partners in a painless left adenopathy axillary about 3 cm in diameter and an absence of méléna in the rectal touch. The gastroscopy had highlighted polypoides ulcéro-bourgeonnantes hurts with a blackish pigmentation by places at the level of the bulb and of the second duodenum. In the histology of biopsie fragments, we noted a fuso-cellular proliferation and epithelioid with deposits of melanin. The positivity of antibodies anti-protein S100 and anti HMB45 in the immunohistochemical study allowed confirming the diagnosis. The gastroduodenal hurts, persons suffering from a liver complaint and lungworts in the scanner testify of a terminal metastatic scattering. The death arose two months later, in a picture of circulatory collapse further to a high digestive bleeding of big abundance.

关键词： Duodenal Metastases Malignant Melanoma