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Therapeutic Route of Patients with Cirrhosis in Bangui

Open Journal of Gastroenterology 2020年第4期10卷 88-96页

作者： Serges Magloire Camengo Police Peggy Gué rendo Georges Service Benoî t Elowa Gaé tan Adouaka Eveline Mofini armelo thibaut yangba kalebanga Nathalie Philomè ne Boua-Akelelo Bernard Bessanguem Joseph Rogevr Molowa Kobendo Department of Hepato-Gastroenterology and Internal Medicine of “Amitié Sino-Centrafraine” University Hospital Center Bangui Central African Republic Department Venerology Dermatology National University Hospital Center Bangui Central African Republic Department of Internal Medicine “Maman Elisabeth Domitien” University Hospital Center Bimbo Central African Republic

Introduction: Cirrhosis is the final stage in the development of any chronic liver disease. The objective of our study was to determine the therapeutic route of patients with cirrhosis. Patients and Methods: This was a one-year cross-sectional study of consenting patients of both sexes with cirrhosis who were hospitalized for the first time. The study took place from October 1, 2013 to September 30, 2014. The diagnosis of cirrhosis was based on clinical, biological and morphological arguments. Results: In total, 1028 patients were hospitalized, including 202 for cirrhosis (19.6%). One hundred and four patients (10.1%) met our inclusion criteria. These were 70 men (67.3%) and 34 women (32.7%). The sex ratio was 2.05. The average age was 43.74 ± 13.74 years. In 68 cases (65.4%), cirrhosis was considered a supernatural disease and in 36 cases (34.6%) was a natural disease. At the first signs, 88 patients (84.6%) had consulted (traditional healer in 34 cases, pastor in 25 cases, marabout in 16 cases and general practitioner in 13 cases). The pastor prayed to 25 patients (24%). The traditional healer made the patients ingest herbal preparations (n = 18), associated or not with scarification (n = 4) and/or enema (n = 28). The marabout recited Quranic verses written on a board, then washed and ingested in 16 cases (15.4%). The general practitioner prescribed treatment to the 13 patients (12.5%). The various treatments received had led to hepatic encephalopathy (21 cases), digestive hemorrhage (15 cases), abdominal pain (3 cases), jaundice (3 cases), increased abdominal bloating (21 cases). The patients had consulted the specialist within an average of 74 ± 15.3 days. The average time to hospital was 21 days ± 13. Conclusion: Cirrhosis is diagnosed at the complication stage due to inappropriate treatment by pastors, marabouts and the general practitioner. The population must be made aware of the early use of health care facilities.

关键词： Therapeutic Route Cirrhosis Bangui

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Prevalence of HBsAg and Antibodies to Hepatitis C Virus among Female Sex Workers in Bangui

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Open Journal of Gastroenterology 2020年第6期10卷 144-150页

作者： Serges Magloire Camengo Police Nathalie Philomène Boua-Akélélo Georges Service Eveline Mofini Benoît Elowa armelo thibaut yangba kalebanga Bernard Bessanguem Marcel Mbeko Simaléko Peggy Guérendo Henri Diemer Jospeh Roger Molowa Kobendo Department of Hepato-Gastroenterology and Internal Medicine of “Amitié Sino-Centrafraine” University Hospital Center Bangui Central African Republic Department of Internal Medicine “Maman Elisabeth Domitien” University Hospital Center Bimbo Central African Republic National Reference Center for Sexually Transmitted Infections and Antiretroviral Therapy Bangui Central African Republic Department of Public Health Faculty of Health Sciences University of Bangui Bangui Central African Republic Department Venerology Dermatology National University Hospital Center Bangui Central African Republic

Introduction: Hepatitis B virus (HBV) and Hepatitis C Virus (HCV) infection is a public health problem. Sex workers remain a vulnerable group. Objective: To determine the prevalence of HBsAg and hepatitis C virus (HCV) antibody transport among female sex workers (FSW) in Bangui. Patients and Methods: All FSW carriers of HBsAg and/or anti-HCV Antibodies were collected in a 6-month cross-sectional analytical study. The HBsAg research used the Monolisa HBsAg® (BioMérieux®) technique, sandwich ELISA. HCV serology consisted of the search for anti HCV antibodies by monolisa HCV (BioMérieux®), Elisa of the sandwich type. HIV serology used two Elisa tests (Genscreen® and Vironostika®). Data analysis was done using Epi Info 3.5.1 software. The Chi2 test was used for comparison with a signif

关键词： HBsAg Anti HCV Antibodies Female Sex Workers Bangui

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High Prevalence of Hepatitis B Virus Infection Compared to Human Immunodeficiency Virus among Blood Donors in Bangui

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Open Journal of Gastroenterology 2020年第6期10卷 137-143页

作者： Serges Magloire Camengo Police Bernard Bessanguem Eveline Mofini Benoît Elowa Georges Service Peggy Guéréndo armelo thibaut yangba kalebanga Nathalie Philomène Boua-Akélélo Tolmbaye Sem Fiacre Odilon Joseph Roger Molowa Kobendo Department of Hepatogastroenterology and Internal Medicine of “Amitié Sino-Centrafraine” University Hospital Center Bangui Central African Republic Department of Internal Medicine “Maman Elisabeth Domitien” University Hospital Center Bimbo Central African Republic Department of Venerology Dermatology National University Hospital Center Bangui Central African Republic

Introduction: Hepatitis B Virus (HBV) and Human Immunodeficiency Virus (HIV) infection is a public health problem worldwide, particularly in sub-Saharan Africa. Objective: to compare the epidemiological, clinical and biological characteristics of chronic HBV and HIV infection in blood donors at the National Center for Blood Transfusion (NCBT) in Bangui. Patients and Methods: This was an 8-month analytical cross-sectional study from August 10, 2011 to April 9, 2012. During this study, we consecutively enrolled consenting blood donors of both sexes in which the search for HBsAg and HIV infection was carried out. Results: During the study period, 850 blood donors were collected. HBsAg was found in 142 donors (16.7%), of whom 55 blood donors (6.5%) were coinfected with HIV. On the other hand, HIV serology was positive in 77 blood donors (9.1%) including 55 co-infected (6.5%) with HBV. In order to better compare the risk factors, we have not included HIV-HBV coinfected patients. Only 795 blood donors were selected for the risk factor study. There were 87 cases of HBsAg positive (10.9%) and 22 cases of HIV positive (2.8%). The average age of HIV and HBV infected patients was 25.7 and 26.2 years

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The Epidemiological, Clinical, Biological and Morphological Characteristics of Primitive Liver Cancers in Bangui

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Open Journal of Gastroenterology 2020年第4期10卷 97-105页

作者： Serges Magloire Camengo Police Georges Service Nathalie Philomè ne Boua-Akelelo Diane N’guilé Benoî t Elowa Timothé e Mobima Francky Kouandogui Bangué Eveline Mofini yangba kalebanga armelo thibaut Bessanguem Bernard Boniface Koffi Department of Hepatogastroenterology and Internal Medicine of “Amitié Sino-Centrafraine” University Hospital Center Bangui Central African Republic Department of Internal Medicine “Maman Elisabeth Domitien” University Hospital Center Bimbo Central African Republic Department of Radioloy and Medical Imaging of “Amitié Sino-Centrafraine” University Hospital Center Bangui Central African Republic Department of Radioloy and Medical Imaging of “Maman Elisabeth Domitien” University Hospital Center Bimbo Central African Republic Department Pathological Anatomy National Laboratory of Clinical Body and Public Health Bangui Central African Republic

Objective: To describe the epidemiological, clinical, biological and morphological aspects of primary liver cancer (PLC). Patients and Methods: We conducted a 38-month cross-sectional study in the Department of hepatogas-troenterology and Internal Medicine “Amitié Sino-Centrafraine” University Hospital Center in Bangui. Included in the study were all patients with a diagnosis of PLC. The PLC’s diagnostic arguments were the large tumor liver associated or not with the elevation of alpha-fetoprotein, the heteronodular liver hypervascularized on abdominal ultrasound. Data analysis was done using Epi Info 3.5.1 software. Results: We collected 115 cases of CPF among 2410 hospitalized patients (4.7%). There were 86 men and 29 women (sex ratio: 2.9). The average age was 50 years old. The main risk factors were alcohol consumption (72.2%) and chronic hepatitis B infection (67.4%). Frequent clinical signs were pain in the right hypochondrium and/or epigastric (93.86%), large tumor liver under examination (91.3%), weight loss (74.78%). The serum alpha-fetoprotein concentration was ≥ 400 ng/ml in 73% of the cases. The abdominal ultrasound found a heteronodular liver in all patients. The nodules were multiple hyperechoic in 66.1% of the cases. According to the Child-Pugh classification, the patients were classified as B (49.5%) and C (33.9%). The Okuda Classification ranked patients at stage 1 in 16.5% cases, stage 2 in 52.1% cases and stage 3 in 31.3% cases. According to the BCLC classification, 5.2% of patients were in stage A, 12.2% in stage B, 52.2 in stage C and 30.4% in stage D. Death was recorded during hospitalization in 89 cases (77.4%). Conclusion: CPF is a frequent and serious pathology in Bangui. Its diagnosis is often late, preventing curative treatment. The main causes are alcohol consumption and the hepatitis B virus. The population should be educated to reduce the incidence of this disease.

关键词： Primary Liver Cancer Epidemiology Clinical Morphology Bangui

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