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epidemiological and Paraclinical Aspects of Helicobacter pylori Infection among Hepatitis B Virus Carriers in the Republic of Congo

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Open Journal of Gastroenterology 2024年第5期14卷 184-191页

作者： Jile Florient Mimiesse Monamou nuptia Kanoha elenga ngala Itoua ngaporo Clausina Ahoui Apendi Marlyse ngalessami Mouakosso Arnaud Mongo Onkouo Mauria Ibobi Rody Stéphane ngami Mardoché Motoula Latou Hostaud atipo ibara Céline Sandra Adoua Déby Gassaye blaise irénée atipo ibara Department of Gastroenterology and Internal Medicine Brazzaville University Hospital Brazzaville The Republic of Congo Faculty of Health Sciences Marien Ngouabi University Brazzaville The Republic of Congo

Objective: Describe the epidemiological and paraclinical aspects of HP infection in hepatitis B virus carriers. Population and Method: This was a descriptive cross-sectional study running from January 1 to August 30, 2019, a period of 8 months. It took place in the Hospital Centers of the two major cities of Congo (Brazzaville and Pointe-noire). The target population of our study consists of patients carrying HBV under antiviral treatment or not. Patients aged at least 18 years and consenting with a biological and morphological assessment were included. We did not include in our study patients taking or having taken antibiotics and/or PPIs less than 4 weeks ago. We excluded all patients who did not deposit fresh stools and those in whom stool extraction could not be done manually. The variables studied covered sociodemographic, clinical and paraclinical aspects. Data entry was done using excel 8.0 software. Statistical analysis was carried out with SPSS 20.0 software. Results: During our study, we included 169 patients. The frequency of HPAG in the stools of HBV carriers in our study population was 63.9% (n = 109). Male patients represented 69% (n = 75) and female patients represented 31% (n = 34). The average age of the patients is 43.92 ± 13.51 years with extremes of 18 years and 80 years. Concerning profession, unemployed patients and those working in the private sector were the most represented in respectively 28.4% (n = 31) and 22.9% (n = 25) without statistical link. Households comprising between 4 - 10 people and the use of public latrines were the risk factors most represented in respectively 69% (n = 75) and 88% (n = 96) without statistical link. Clinically, hepatomegaly and signs of portal hypertension were most represented in 53% (n = 58) and 47% (n = 51). Biologically, HBV DnA was detectable in 60.5% of cases (n = 66).

关键词： Helicobacter pylori Hepatitis B Virus Congo

Surgical Treatment of Hemorrhoidal Disease at Brazzaville University Hospital Center

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Surgical Science 2024年第3期15卷 159-168页

作者： Murielle etiennette Julie note Madzele Pierlesky elion Ossibi Rody Stéphane ngami Didace Massamba Miabaou Clausina Philestine Mikolele Ahoui Apendi noé Henschel Motoula Latou Bhodeho Medy Monwongui Giresse Bienvenu Tsouassa Wa ngono Prude Pertinie Avala Carmich nzaka Moukala Cédrick Du Bonheur Alima Koya blaise irénée atipo-ibara Digestive Surgery Department Brazzaville University Hospital Center Brazzaville Congo Faculty of Health Sciences Marien Ngouabi University Brazzaville Congo Gastroenterology and Internal Medicine Department Brazzaville University Hospital Center Brazzaville Congo

Introduction: Hemorrhoidal disease is a common pathology and its surgical treatment is based, among other things, on pedicular resection after failure of medical and instrumental treatment. The aim of this study is to analyze the epidemiological, clinical, therapeutic and evolving aspects of hemorrhoidal disease at the stage of surgical treatment at the University Hospital Center of Brazzaville. Patients and Methods: We conducted a retrospective and descriptive study carried out from January 2020 to December 2021, a 24 months period, in the Digestive surgery department of the University Hospital Center of Brazzaville. It concerned patients who underwent a surgical procedure for hemorrhoidal disease. Results: 21 cases were collected, representing a hospital frequency of 2.3%, with a sex ratio of 4.3 in favor of men. The average age of patients was 42.2 ± 11.9 years. The symptoms were mainly proctalgia, mass sensation and rectal bleeding. We recorded five cases (19.1%) of hemorrhoidal thrombosis and 16 cases (80.9%) of hemorrhoidal prolapse including 12 cases requiring manual integration (Goligher grade III) and four irreducible permanent cases (Goligher grade IV). The Grade III prolapse was associated with a polyp in one patient and with posterior anal fissure in another patient. Out of the 21 patients, 14 underwent a tripedicular hemorrhoidectomy according to Milligan and Morgan. Two patients underwent mono- and bipedicular hemorrhoidectomy with resection of associated lesions and five patients underwent emergency thrombectomy. The outcome was favorable for all our patients. The average length of hospital stay was 1.5 ± 2.1 days. Conclusion: In the event of failure of medical and instrumental treatment, the hemorrhoidal cure according to Milligan and Morgan is the surgical treatment of reference for hemorrhoidal disease at the University Hospital Center of Brazzaville.

关键词： Hemorrhoidal Disease Surgery Milligan and Morgan

Knowledge, Attitudes and Practices of Persons Infected with the Hepatitis B Virus on Their Own Disease

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Open Journal of Gastroenterology 2022年第4期12卷 119-127页

作者： Arnaud Mongo-Onkouo ngala Akoa Itoua-ngaporo Clausina Philestine Ahoui Apendi Jile Florent Mimiesse Monamou Rody ngami Marlyse ngalessami Mouakosso Mardoché Motoula Latou Deby Gassaye blaise irénée atipo ibara Jean-Rosaire ibara Department of Hepatogastroenterology and Internal Medicine Brazzaville Hospital and Universitary Center Brazzaville Congo Faculty of Health Sciences Marien Ngouabi University Brazzaville Congo

Introduction: Viral hepatitis B is a communicable disease that is preventable by vaccination. Knowledge of transmission routes and prevention methods could play a key role in limiting and reducing the spread of the disease. Aim: This was a prospective study that was carried out from July 1 to September 30, 2018 in the department of gastroenterology and internal medicine in people carrying the hepatitis B virus. All patients were asked about their knowledge, attitudes and practices regarding viral hepatitis B. Materials and Methods: This was a cross-sectional study, collecting prospective data, which was carried out from July 1 to September 30, 2018 in the gastroenterology department of CHUB (University Hospital of Brazzaville). eligible for the study were all patients who consulted or were followed in the ward for HBV infection during the study period. All patients were asked about their knowledge, attitudes and practices regarding viral hepatitis B. After obtaining informed consent, we asked patients about knowledge, attitudes and practices towards the hepatitis B virus. The data was collected on a pre-established survey sheet respecting anonymity and confidentiality. CSPro 7 software and SPSS 17 software were used for data entry and analysis. Chi-square was used to compare the percentages. These were expressed with their 95% confidence intervals [95% CI]. A value of p 0.005 was considered significant. Results: Forty-two patients were included in the study, these were 66.7% (n = 28) men and 33.3% (n = 14) women. The average age was 38.76 ± 10.9 years. 45.2% of them (n = 19) were single and 59.5% (n = 25) had the next highest level of education. Thirty-nine patients had no knowledge of the source of their contamination;the sexual route was the most cited (61.9%). Alcohol consumption was rated badly by 38 patients (90.5%);of these 22 (52.4%) thought it worsened the disease. Lack of knowledge of an HBV carrier in the family was noted in 33 (78.6%) patients;20 (47.6%)

关键词： Viral Hepatitis B Knowledge Attitudes Practices Carriers Brazzaville

Ingestion of Caustics by Children in Brazzaville (COnGO)

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Open Journal of Pediatrics 2018年第3期8卷 283-291页

作者： Lucie Charlotte atipo-ibara Ikobo Ollandzobo Clausina Ahoui-Apendi Jile Florient Mimiesse-Monamou Jean Robert Mabiala Babela Deby-Gassaye &nbsp blaise irénée atipo ibara Jean-Rosaire ibara Faculty of Health Sciences Marien Ngouabi University Brazzaville Congo Infant Pediatric Service University Hospital of Brazzaville Brazzaville Congo Gastroenterology and Internal Medicine Service University Hospital of Brazzaville Brazzaville Congo

Ingestion of caustics by children is serious because of the increase in their frequency and the difficulties due to their management. Objective: To improve the management of caustic lesions in Pediatric Department at the University Hospital of Brazzaville. Patients and Methods: Prospective study was conducted from January 2014 to December 2015 in the Pediatric Departments of the UHB and centers of digestive endoscopy in Brazzaville. All children who ingested a caustic product and hospitalized were included after obtaining parental’s consent. The studied parameters were: Age, sex, nature and quantity of the caustic, the family’s attitude, clinical signs, endoscopic results according to Zagar’s classification, therapeutic modalities and evolution. Results: 8292 children were hospitalized and 68 because of the ingestion of caustic, a frequency of 0.8%. The average age was 23.6 months [2 months - 16 years]. The male sex was predominant (57.4%). Ingestion was accidental in 88.2% and voluntary in 11.8%. Factors favoring ingestion were storage methods (81.5%) and parental’s inattention or negligence (10.8%). Bleach was the most incriminated caustic (54.4%) followed by caustic soda (29.4%). The estimated quantity ingested was assumed to be minimal in 61.7%. Unsuitable acts were practiced by the family before the medical consultation in 66.1%. The dominant symptoms were digestive (47%) and neurological (25%). The average time to perform endoscopy was 48 hours in 88.2%. endoscopy revealed lesions in 51.7%, the different stages were I (12 cases), II (16 cases) and III (3 cases). The mains factors of gravity were inappropriate gestures (85%) and the non-respect of the fasting (9%). Proton pump inhibitors were used in 50%. The evolution was favorable for in 73.5%. Conclusion: Ingestion of caustics by children is most often accidental favored by the inadequate packaging and storage. Prevention is about educating people in order to reduce their frequency.

关键词： Caustic Lesions Child Brazzaville

Midwives’s Knowledge and Practice in Preventing Mother-to-Child Transmission on Hepatitis B Virus in Brazzaville in 2023

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Open Journal of Gastroenterology 2023年第12期13卷 439-446页

作者： Rody Stéphane ngami Philestine Clausina Ahoui Apendi Mikolélé Marlyse ngalessami Mouakosso Michelle nzoumba Jackson Albert Otia Pérès Mardochée Motoula Latou ngala Akoa Itoua-ngaporo Samantha Potokoué Sékangué Jile Florient Mimiesse Arnaud Mongo Onkouo Deby Gassaye blaise irénée atipo ibara Department of Gastroenterology and Internal Medicine University Hospital Center Brazzaville Republic of Congo Faculty of Health Sciences Marien Ngouabi University Brazzaville Republic of Congo Department of Gynecology and Obstetrics University Hospital Center Brazzaville Republic of Congo

Background: Maternal-fetal transmission is the most frequent mode of hepatitis B virus (HBV) contamination in Africa. Prevention of mother-to-child transmission (PMTCT) of hepatitis B is still poorly understood, and training of the health workers involved, such as midwives, is rare. Objective: The aim of this study was to assess the knowledge and practices of midwives prevention of HBV’ mother-to-child transmission (PMTCT) in Brazzaville. Patients and Methods: This was a cross-sectional analytical study conducted in Brazzaville from June 1 to July 31, 2023. Midwives present at the time of the survey in the various Brazzaville health centers visited and who agreed to answer the questionnaire during a face-to-face interview with the investigator were included. Univariate analyses were performed using epi info7.2 software. Pearson’s chi-square and Student’s t-tests were used to compare proportions and means, which were significant at the 0.05 level. Results: At the end of our study, 93 midwives out of 127 agreed to take part in the study, i.e. a participation rate of 73.2%. Their median age was of 41.7 years, a median professional experience of 13.7 years, and they worked mainly in primary health care facilities. Global knowledge of HBV PMTCT was satisfactory in 51 (54.3%) midwives. Knowledge of the HBV vaccine was significantly related to professional experience (p = 0.0167). PMTCT practice was poor in 48 (51.6%) cases. Overall, the practice of PMTCT was statistically associated with the midwives’ place of practice (p = 0.0262). Conclusion: Midwives had good knowledge but insufficient practice of PMTCT in Brazzaville. Training and awareness-raising are needed to reduce mother-to-child transmission of HBV.

关键词： Viral Hepatitis B Midwifery Knowledge and Practice

Cardiovascular Disorders in Cirrhosis at the Brazzaville Teaching Hospital in 2022

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Open Journal of Gastroenterology 2023年第11期13卷 369-376页

作者： Rody Stéphane ngami Philestine Clausina Mikolele Ahoui Apendi Relda Itoko Okombi Christian Kouala Landa Marlyse ngalessami Mouakosso Bénédicte Ahombo niotsombe ngala Akoa Itoua-ngaporo Pérès Mardochée Motoula Latou Jile Florient Mimiesse Monamou Arnaud Mongo-Onkouo Deby Gassaye blaise irénée atipo ibara Department of Gastroenterology and Internal Medicine University Teaching Hospital Brazzaville Republic of the Congo Faculty of Health Sciences Marien Ngouabi University Brazzaville Republic of the Congo Department of Cardiology and Internal Medicine University Teaching Hospital Brazzaville Republic of the Congo

Cirrhosis is a liver disease that can lead to cardiovascular lesions that are often asymptomatic but potentially fatal. Objective: The aim of this study was to evaluate electrical and echographic cardiovascular abnormalities during cirrhosis at the Brazzaville University Hospital. Patients and Methods: We conducted a cross-sectional analytical study over a 2-year period at the Brazzaville Universitary Hospital. Cirrhotic patients at least 18 years of age who had undergone electrocardiogram and echocardiography were included. Patients with cardiac cirrhosis, hepatocellular carcinoma or spontaneous bacterial peritonitis were excluded. The outcome variables were cardiac electrical and echographic abnormalities. Data were analyzed using epi info 7.2 software. Pearson’s chi-square, Fisher’s exact and Student’s exact tests were used to compare proportions and means at a significance level of 0.05. Results: A total of 76 cirrhotic patients were recruited out of 186 patients, i.e. 40.9% of cirrhotic patients. There were 48 men and 28 women, for a sex ratio of 1.7. The median age was 56 (IQR 41.5 - 69.0). QTc prolongation, microvoltage and sinus tachycardia were the most frequent electrical disorders, respectively in 19 (29.7%), 11 (17.2%) and 11 (17.2%) cases. electrical disorders were statistically related to cirrhosis stage (p = 0.0364). The most frequent ultrasound disorders were left ventricular systolic failure 11 (28.9%) and dilated cardiomyopathy 8 (21.1%). Seven (9.2%) patients had high pulmonary arterial pressure. Death, observed in 12 cases (15.8%), was statistically linked to the presence of echocardiographic disorders (p = 0.0089) and congestive heart failure (p = 0.0001). Conclusion: The search for cardiac disorders should be systematic during decompensated cirrhosis to detect potentially fatal abnormalities.

关键词： Cirrhosis eCG echocardiography Cardiovascular Disorders

Lymphadenectomy for Colorectal Cancer: experience of the Brazzaville Teaching Hospital

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Surgical Science 2022年第3期13卷 79-90页

作者： Pierlesky elion Ossibi Murielle etiennette Julie note Madzele noé Hensnel Motoula Latou Didace Massamba Miabaou Prude Pertinie Avala Jile Florient Mimiesse-Monamou Arnaud Mongo-Onkouo Rody Stéphane ngami Fabien Gael Mouamba eliane ndounga Alexis Fortuné Bolenga Liboko Régis Franck Moyikoua Freznel ngoma Mabonzo Apendi Philestine Clausina Ahoui Gilbert Fabrice Otiobanda blaise irénée atipo ibara Department of Digestive Surgery Brazzaville Teaching Hospital Brazzaville Congo Department of Gastroenterology Brazzaville Teaching Hospital Brazzaville Congo Anatomy and Pathological Cytology Department Brazzaville Teaching Hospital Brazzaville Congo Department of Oncology Brazzaville Teaching Hospital Brazzaville Congo Department of Radiology Brazzaville Teaching Hospital Brazzaville Congo Department of Intensive Care Brazzaville Teaching Hospital Brazzaville Congo

Introduction: Lymph node (Ln) metastasis are important biomarkers in the resection of colorectal cancer translating into accurate disease staging. It is therefore obvious that lymph node dissection in the curative treatment of colorectal cancer is a prognostic factor that influences survival and guides management strategy. This study aims to evaluate lymph node dissection in colorectal cancers (CRC) managed at the Teaching Hospital, Brazzaville, Congo. Patients and Method: We carried out a descriptive prospective study during a period of 18 months from October 2020 to March 2021 involving patients who underwent curative treatment for colorectal cancer at the visceral surgery department of the Brazzaville Teaching Hospital. Results: Thirty (30) cases of CRC were recorded out of 738 hospitalizations in the visceral surgery departments, which constitute 4.06% of the in-patient activity of the department during the period under study. Mean age was 55.13 years and a male predominance was observed with a sex ratio of 1.14. Colonic involvement was predominant in our series and was found in 22 of the patients. 25 patients underwent surgical resection while 5 patients could not undergo operative treatment. 17 out of the 25 patients underwent curative treatment, 6 were offered palliative care, whereas surgical abstention was decided in 2 patients. The average number of lymphadenectomies per patient was 16.43. Lymphadenectomy was greater than or equal to 12 in 88% of patients. nine patients had vascular emboli whereas 10 patients had perineural invasion. The tumor was staged as T3 in 15 patients;six patients had a negative lymph node and 11 patients had at least one lymph node invasion. Distant metastasis status could not be determined in 10 patients. Conclusion: Lymphadenectomy is a hallmark in the curative treatment of colorectal cancer as it allows for optimal staging. This represents a strong prognostic factor that defines adjuvant therapy and overall patient outcome.

关键词： Lymphadenectomy Surgery Cancer Colorectal

Recurrent iron Deficiency Anemia Revealing Chronic Gastritis with <i>Helicobacter pylori</i>

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Open Journal of Gastroenterology 2021年第2期11卷 47-51页

作者： Jile Florient Mimiesse ngala Itoua-ngaporo Arnaud Mongo Onkouo Clausina Ahoui Apendi Lucie atipo ibara Ollandzobo Marlyse ngalessami Mouakosso Mardoché Perez Motoula Rody Stéphane ngami Sandra Celine Adoua Firmin Bossali Deby Gassaye blaise irénée atipo ibara Jean-Rosaire ibara Faculty of Health Sciences Marien Ngouabi University Brazzaville Congo Department of Gastroenterology and Internal Medicine University Hospital of Brazzaville Brazzaville Congo

We report a clinical case of a 21-year-old patient with iron deficiency anemia related to Helicobacter pylori (H. pylori) infection. The pan gastritis due to H. pylori and an unexplained iron deficiency anemia has rec... 详细信息

We report a clinical case of a 21-year-old patient with iron deficiency anemia related to em>Helicobacter pyloriem> (em>H. pyloriem>) infection. The pan gastritis due to em>H. pylori em>and an unexplained iron deficiency anemia has recently been proposed although still discussed. Among the possible causes the role played by this bacterium remains controversial. The diagnosis had been mentioned in view of the recurrence of anemia and confirmed by endoscopic biopsy. Anemia was corrected by iron supplementation associated with a specific treatment of this germ.

关键词： iron Deficiency Anemia Helicobacter pylori Pangastritis

Antiretroviral Therpay Induced Liver Toxicity among Immunecompromised HIV Patients at Chu Brazzaville

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Open Journal of Gastroenterology 2019年第8期9卷 135-140页

作者： Florient Jile Mimiesse Clausina Ahoui-Apendi ngala Akoa Itoua-ngaporo Ursula Ingride Koukha Lucie Charlotte atipo ibara Ollandzobo Arnaud Mongo-Onkouo Marlyse ngalessami-Mouakosso Céline Adoua Jean Bruno Mokoko Rody Stéphane ngami Deby-Gassaye &nbsp eric Rutaganda blaise irénée atipo ibara ibara Jean-Rosaire Faculty of Health Sciences Marien Ngouabi University Brazzaville Congo Gastroenterolgy service University Hospital of Brazzaville Brazzaville Congo Infant pediatric service University Hospital of Brazzaville Brazzaville Congo Medical Depertment University Teaching Hospital Kigali Rwanda College of Medicine and Health Sciences University of Rwanda Kigali Rwanda

Introduction: Human immunodeficiency virus (HIV) infection is a public health problem of concern. Anti-retroviral therapy (ART) is associated with multiple side effects. This study aimed at identifying the different hepatic manifestations of antiretroviral therapy and the responsible molecules. Patients and Methods: This was an eight months period prospective descriptive study, from January 1st to August 31st, 2015, conducted in the Department of Gastroenterology and Internal Medicine at the Brazzaville University Teaching Hospital. Study participants were treatment-na?ve HIV patients who were initiated on ART treatment during the study period. Patients with liver disease, liver cytolysis prior to initiation of therapy, and those with alternative therapy that may cause hepatotoxicity were excluded. The sample size was 110 patients. Results: The age was ranging from 25 to 70 years with a mean age of 47.5 ± 7.5 years. During the six months of follow-up, the alarming hepatic signs were observed in 26.36% of cases (n = 29) in the 3rd month of treatment. There was no observed alarming sign in the 6th month of follow-up. The cytolytic pattern was observed in 54.55% of cases (n = 60) in the 3rd month. The cholestatic pattern was observed in 6.36% of cases (n = 7) in the 3rd month. Triple therapy combination of Zidovudine, Lamivudine and nevirapine (AZT + 3TC + nVP) was the most used in 57.27% (n = 63) with a statistically significant p value to the occurrence of cytolytic pattern (p Conclusion: Drug induced liver toxicity occurs in a significant number of patients starting ART. The prevalence of hepatic events was high at the third month of treatment and the triple therapy of Zidovudine, Lamivudine and nevirapine (AZT + 3TC + nVP) was the most incriminated.

关键词： Drug Induced Liver Toxicity HIV Anti-Retroviral Therapy Brazzaville