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A Budd-Chiari Syndrome Due to C Protein Deficiency: A Case Report at YaoundéGeneral Hospital (Cameroon)

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Open Journal of Gastroenterology 2024年第4期14卷 117-124页

作者： antonin Wilson Ndjitoyap Ndam gilles Gael Aghoagni Gouajio Armel Awana Tenone Danah Larry Tangie Ngek Mathurin Kowo Firmin Andoulo Ankouane Elie Claude Ndjitoyap Ndam Department of Internal Medicine Faculty of Medicine and Biomedical Sciences University of Yaoundé 1 Yaoundé Came-roon Department of Internal Medicine and Peadiatrics Faculty of Health Sciences University of Buéa Buéa Cameroon Department of Biomedical Sciences Faculty of Sciences University of Ngaoundéré Ngaoundéré Cameroon

Primary Budd-Chiari syndrome (BCS) is a spontaneously fatal disease characterized by an obstruction of the hepatic venous outflow tract due to thrombosis or a primary disease of the venous wall. The primary form of BCS is extremely rare. This is a disease mainly affecting young adults of both sexes. Clinical manifestations are variable;they can be asymptomatic, acute, or subacute but mostly chronic. Several causes have been identified, such as myeloproliferative syndrome, antiphospholipid syndrome, paroxysmal nocturnal hemoglobinuria, and inherited thrombotic disorders. Data on primary BCS in Sub-Saharan Africa is rare as most publications available are case reports. In these reports, the causes are unknown with poor prognosis in most cases often leading to patient death. We herein present a case report of a male patient diagnosed with a primary BCS at Yaoundé General Hospital (Cameroon) caused by a Protein C deficiency who presented with ascites decompensating liver cirrhosis. Treatment was based on anticoagulants, diuretics and laxatives administration. Two years after the diagnosis, the patient is alive with clinical and paraclinical improvement.

关键词： Budd-Chiari Syndrome Hepatic Veins Liver Cirrhosis Protein C Deficiency Cameroon

Prevalence of Hepatitis B and Associated Factors in the Garoua Central Prison, Cameroon: A Cross-Sectional Study

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Open Journal of Gastroenterology 2024年第5期14卷 174-183页

作者： Mohamadou Abdou Galdima Adamou Dodo Balkissou Guy Roger Nsenga Djapa Winnie Tatiana Bekolo Nga gilles Aghoagni antonin Wilson Ndjitoyap Ndam Ali Abas Mathurin Pierre Kowo Firmin Ankouane Andoulo Dominique Noah Noah Oudou Njoya Servais Albert Fiacre Eloumou Bagnaka Faculty of Medicine and Biomedical Sciences University of Garoua Garoua Cameroon Garoua Regional Hospital Garoua Cameroon Faculty of Medicine and Pharmaceutical Sciences University of Dschang Dschang Cameroon Faculty de Medicine and Pharmaceutical Sciences University of Douala Douala Cameroon Faculty of Health Sciences University of Buea Buea Cameroon Faculty of Medicine and Biomedical Sciences University of Yaound&#233 1 Yaound&#233 Cameroon

Introduction: Hepatitis B virus (HBV) infection is a major public health problem in Cameroon. Garoua city is the headquarters of the North Region of Cameroon, where the HBV prevalence is among the highest of the country. The aim of this study was to determine the prevalence of HBsAg carriage and associated factors among persons incarcerated in the Garoua Central Prison. Methods: It was a cross-sectional study conducted from July 1 to July 31, 2023 at the Garoua Central prison. We included all prisoners willing to participate in the study and who gave their verbal consent. We collected data using a pre-established data entry form and we used rapid test for blood screening for HBV surface antigen (HBs Ag) with ELISA confirmation. Data were analyzed using the R® software for Windows. After the univariate analysis, we selected associated variables to HBV infection with p-value p-value was set at 5%. Results: We included 1389 prisoners out of which 97.6% were male. The median age (IQR) of the study population was 28 (23 - 35) years. The median (IQR) duration of incarceration was 12 (6 - 26) months and the mean (±sd) number of incarcerations was 1.24 (±0.6). HBV prevalence was estimated at 14.8% (95% CI: 13.0 - 16.7). Upon uni- and multivariate analysis, no risk factor was significantly associated with viral hepatitis B infection in our study population. Conclusion: The prevalence of Hepatitis B was high in the Garoua Central Prison, but there were no additional risk factors for HBV infection. There is a need to include the Garoua Central Prison and by the way other prisons in the country in the chronic viral hepatitis care program.

关键词： Hepatitis B Prison Associated factors Cameroon

Management of Endoscopic Portal Hypertension Lesions in Cirrhotic Patients in a Country with Limited Resources: About 603 Cases in the City of Douala in Cameroon

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Open Journal of Gastroenterology 2023年第12期13卷 429-438页

作者： Winnie Tatiana Bekolo Nga Aghoani gilles Machékam-Matanga Olga antonin Ndjitoyap Agnès Malongue Mathurin Kowo Dominique Noah Noah Oudou Njoya Firmin Ankouane Andoulo Luma Henry Namme Servais Albert Fiacre Eloumou Bagnaka Department of Internal Medicine the Douala General Hospital Douala Cameroon Faculty of Medicine and Pharmaceutical Sciences University of Douala Douala Cameroon Faculty of Medicine University of Buea Buea Cameroon Faculty of Medicine and Biomedical Sciences University of Yaoundé I Yaoundé Cameroon

Introduction: Portal hypertension (HTP) is a morbi-mortality factor in cirrhotic patients. It is responsible for endoscopic lesions and has digestive hemorrhage as the main complication. The objective of the study was to study the management of endoscopic lesions of portal hypertension in a country with limited resources. Methodology: This was a cross-sectional and analytical study conducted in 04 hospitals in the city of Douala, Cameroon, over a period of 08 years from 1 January 2014 to 31 December 2022. Included were cirrhotic patients with viral hepatitis with endoscopic lesions of PH. The data collected were sociodemographic, clinical, paraclinical, therapeutic and evolutionary. Data analysis was done using SPSS software version 25.0. Logistic regression allowed the search for prognostic factors with a significance threshold of p Results: We included 603 patient records. They were mainly male patients (56.1%) with an average age of 47.6 ± 6.3 years. The Child Pugh score was ranked B in 53.7% of cases. Digestive hemorrhage was the main complication in 66.8% of cases. We had grade 2 esophageal varices in 61.5% of cases. The main treatments were prescription of propanolol (63.3%) and ligation of esophageal varices (53.3%). The average number of ligation sessions was 2.1 ± 1.8 with an interval between sessions of 28 ± 2.8 days. Prevention of rupture of esophageal varices was secondary in 66.5% of cases (n = 452). The rate of hemorrhagic recurrence was 9.3%. Hospital mortality was 15.1%. Recurrence of hemorrhage was associated with PT Conclusion: The management of HTP lesions was based on the prescription of beta-blockers and the ligation of esophageal varices. Factors associated with mortality were hemorrhagic recurrence, low PT and Child Pugh C score.

关键词： Portal Hypertension Cirrhosis Endoscopic Lesions PEC Cameroon

Evaluation of Non-Invasive Markers of Liver Fibrosis in Chronic Hepatitis B Patients in a Sub-Saharan African Setting: Transient Elastography versus APRI, FIB4, GTT/Platelet Scores

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Open Journal of Gastroenterology 2023年第6期13卷 209-224页

作者： Servais Albert Fiacre Bagnaka Eloumou Tatiana Winnie Bekolo Nga antonin Ndjitoyap Ndam Gael gilles Aghoagni Gouajio Guy Roger Nsenga Djapa Cynthia Kila Shang Agnes Malongue Dominique Noah Noah Firmin Ankouane Andoulo Christian Tzeuton Henry Namme Luma Faculty of Medecine and Pharmaceutical Sciences University of Douala Douala Cameroon Department of Internal Medicine Gynecologic and Pediatric Hospital of Douala Douala Cameroon Douala General Hospital Douala Cameroon Faculty of Medicine and Biomedical Sciences University of Yaoundé I Yaoundé Cameroon Faculty of Health Sciences University of Buea Buea Cameroon Faculty of Medicine and Pharmaceutical Sciences University of Dschang Dschang Cameroon

Background: Non-invasive markers which use routine laboratory tests are less expensive and highly needed to assess and stage liver fibrosis in chronic hepatitis B patients in Sub-Saharan Africa. We aimed at evaluating liver fibrosis, using the Aspartate aminotransferase to Platelet Ratio Index (APRI), Fibrosis Index Based on 4 factors (FIB4), and Gamma-glutamyl transpeptidase to Platelet Ratio (GPR) in chronic hepatitis B patients with transient elastography as the reference so as to choose an alternative to transient elastography. Method: We carried out a cross-sectional study using the records of patients who attended the Douala General Hospital and Marie O Polyclinic Douala from 2012 to 2017. Non-invasive tests were compared with Transient Elastography. The Spearman coefficient was used to determine correlation. The sensitivity, specificity, positive predictive values and negative predictive values were used to get the optimal cut-off values. The diagnostic accuracy was estimated by calculating the area under the Receiver Operating Characteristic Curve (ROC). P Results: Of the 243 patient records studied, the median age or interquartile range (IQR) was 35 (29 - 42) years with a male predominance of 73.7%. More than 60% of the study population had normal transaminases. Significant fibrosis was found in 88 (36.2%) patients and 32 (13.7%) patients had cirrhosis. APRI had the best cut-off values and highest area under the ROC Curve, for significant fibrosis and cirrhosis with 0.55 (0.823 95% CI [0.769 - 0.869], P Conclusion: APRI, had the best diagnostic properties to detect liver fibrosis and cirrhosis in patients with Chronic Hepatitis B in Douala. The cut-off values are 0.55 and 0.65 for significant fibrosis and cirrhosis respectively.

关键词： Chronic Hepatitis B Liver Fibrosis Non-Invasive Tests Cross Sectional Douala