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Evaluation of the “Helicobacter pylori” Eradication Rate by Bismuth Quadritherapy or Concomitant Quadritherapy in Black Africans

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Open Journal of Gastroenterology 2024年第3期14卷 69-79页

作者： dia.lo Mamadou Sarifou Youssouf Oumarou Yaogo Abdoulatif dia.lo Kadiatou dia.lo djenabou Wann Thierno Amadou Bah Mamadou Lamine Yaya dia.lo Ahmed Tidiane diakhaby Mamadou Kanté Mamadou Aliou Sylla Djibril Hepato-Gastroenterology Department of the Donka National Hospital CHU Conakry Guinea Faculty of Health Sciences and Techniques Gamal Abdel Nasser University Conakry Guinea Internal Medicine Department Centre Hospitalier Universitaire Communautaire de Bangui Bangui Central African Republic Hepato Gastroenterology Department Angré University Hospital Abidjan Ivory Coast Department of Internal Medicine Donka National Hospital CHU Conakry Guinea

Introduction: Gastric infection by “Helicobacter pylori” remains a topical issue due to the evolving scientific data concerning its pathophysiology, the diseases and pathologies concerned, which now extend beyond the gastric or digestive sphere, and the treatment methods faced with the development of antibiotic resistance. diagnosis of infection involves two inseparable aspects: identification of the bacterium itself and identification of the endoscopic and histological lesions caused by the bacterium. Objective: To evaluate the rate of eradication of Helicobacter pylori infection by bismuth quadruple therapy and concomitant treatment. Patients and methods: This was a prospective, cross-sectional, analytical study of all outpatients in the hepato-gastroenterology department during the study period from 1 January 2022 to 30 November 2023. All patients had undergone oeso-gastroduodenal fibroscopy and the diagnosis was made by histological examination of the gastric biopsy. Results: Our 113 patients comprised 68 men and 46 women. The sex ratio was 1.48 in favour of men. The mean age of our patients was 40.28 years, with extremes of 13 and 80 years. The clinical signs that prompted oeso-gastroduodenal fibroscopy were as follows: epigastralgia (69.91%), dyspepsia (14.16%), vomiting (7.08%), gastro-oesophageal reflux (6.19%) and altered general condition with weight loss (2.65%). The endoscopic lesions were: gastropathy (antral, fundic and diffuse: antro-fundial) (69.02%), bulbar ulcer (6.19%), gastric ulcer (5.31%). Helicobacter pylori infection was associated with chronic gastritis in all our patients;it was mild in 50%, moderate in 41% and severe in 9%. The eradication rate of Helicobacter pylori according to the treatment protocol used was 92.30% for bismuth quadruple therapy and 94.12% for concomitant quadruple therapy. Conclusion: The eradication rate of Helicobacter pylori in our study was 92.30% and 94.12% respectively for bismuth quadritherapy and concomitant the

关键词： “Helicobacter pylori” Eradication Quadritherapy Antibiotics Conakry

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Evaluation of Hepatic Fibrosis and Hepatic Steatosis by Pulse Elastography (FIBROSCAN/CAP) in Asymptomatic Patients about 170 Cases at the Donka CHU National Hospital in Conakry

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Open Journal of Gastroenterology 2024年第4期14卷 125-138页

作者： Mamadou Sarifou dia.lo Oumarou Youssouf Abdoulatif Yaogo djenabou dia.lo Kadiatou dia.lo Thierno Amadou Wann Ahmed Tidiane dia.lo Mamadou Lamine Yaya Bah Mamdou diakhaby Mamadou Aliou Kanté Djibril Sylla Department of Hepato-Gastroenterology The Donka National Hospital Conakry Guinea Faculty of Health Sciences and Techniques Gamal Abdel Nasser University Conakry Guinea Internal Medicine Department Centre Hospitalier Universitaire Communautaire de Bangui Bangui Central African Republic Department of Hepato Gastroenterology Angr&#233 University Hospital Abidjan Ivory Coast Department of Internal Medicine Donka National Hospital Conakry Guinea

Introduction: Fibroscan is a recent, non-invasive and non-irradiating diagnostic method. It is based on the principle of ultrasound, which enables liver tissue elasticity to be quantified using a probe, and fibrosis to be assessed. Fibroscan measures both elasticity correlated with hepatic fibrosis and CAP correlated with steatosis. The aim of this study was to evaluate hepatic fibrosis and steatosis using pulse elastometry (Fibroscan/CAP). Methods: This was a descriptive and analytical cross-sectional study in which 170 patients were included. It was conducted from October 1 2021 to December 31 2023, i.e. 27 months, in an outpatient clinic in the hepato-gastroenterology department of the Donka national hospital of the CHU Conakry. Results: Of the 170 patients identified, 87 were male (51%) and 83 female (49%), giving a M/F sex ratio of 1.04. The average age of our patients was 40. The 30 - 50 age group was the most affected, with a frequency of 58.23% (n = 99), followed by the 50 age group with a frequency of 29.41% (n = 50). Hepatomegaly, steatotic liver on ultrasonography, transaminase elevation and obesity were the main indications, respectively: (21.76%), (17.65%), (14.71%), and (13.53%). The examinations were requested by hepatogastroenterologists (47.06%), diabetologists (35.88%) and general practitioners (29%). Of the 170 patients, 100 patients (58.82%) had no significant fibrosis F0F1, 39 (22.94%) had moderate fibrosis F2, 20 patients (11.76%) had severe fibrosis F3 and 11 patients (6.47%) had fibrosis F4. Hepatic steatosis: 62 patients (36.47%) had no S0 steatosis;29.41% had S1 steatosis, 20% had S2 steatosis and 24 patients (14.11%) had S3 steatosis. Abdominal ultrasound revealed a normal liver in 67.05% of patients, hepatic steatosis in 29.41% and non-decompensated cirrhosis in 6 cases. Thus, 108 patients had the parameters required to calculate the Fatty Liver Index (FLI), steatosis was present in 20% of our patients, while 29.41% had an undetermined st

关键词： Cirrhosis Fibrosis Fibroscan/CAP Non-Alcoholic Hepatic Steatosis Steatosis CHU Conakry

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Causes and Prognosis of Cases of Acute Obstructive Renal Failure Managed at the Donka National Hemodialysis Center

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Open Journal of Nephrology 2024年第2期14卷 136-146页

作者： Amadou Yaya dia.lo Mamadou Mouctar dia.lo Mamadou dian Barry Kadiatou Mamadou Bobo Barry Saikou Oumar dia.lo djenabou dia.lo Soriba Bangoura Mamadou Malal dia.lo Thierno Mamadou Oury dia.lo Mohamed Lamine Kaba Alpha Oumar Bah Department of Nephrology-Hemodialysis CHU Donka Conakry Guinea Faculty of Health Sciences and Techniques Gamal Abdel Nasser University of the Republic of Guinea Conakry Guinea Department of Urology-Andrology CHU Ignace Deen Conakry Guinea

Introduction: Acute obstructive renal failure (AORF) is a frequent clinical situation, secondary to obstruction of the urinary excretory tract. Whatever the cause, urinary tract obstruction suddenly opposes glomerular filtration and is responsible for tubulointerstitial lesions. It accounts for 10% of acute renal failure (ARF). The aim of this study was to identify the causes and prognosis of cases of acute obstructive renal failure managed at the Centre National d’hémodialyse Donka. Material and Methods: This was a prospective descriptive study lasting 6 months, from September 1, 2022 to February 29, 2023. All patients undergoing haemodialysis for acute obstructive renal failure who agreed to participate in the study and whose medical records were complete were included. Results: During the course of the study, we registered 97 haemodialysis patients, including 20 cases (20.62%) of acute obstructive renal failure. The mean age of the patients was 57.8 ± 10.54 years, with a male predominance of 11 cases (55%) and a sex ratio of 1.22. The reasons for consultation were dominated by physical asthenia 11 cases (55%), lumbar pain 9 cases (50%), vomiting 6 cases (30%) and acute urine retention 6 cases (30%). Arterial hypertension 16 cases (80%) and urinary tract infection 10 cases (50%) were the most common antecedents. The etiologies of RAOI were dominated by lithiasis 10 cases (50%), neoplasia 6 cases (30%) and benign prostatic hypertrophy 3 cases (15%). mean creatinine was 1267.60 ± 710.76 μmol/l with extremes of 243 μmol/l and 2822 μmol/l, mean urea was 39.56 ± 18.36, hyperkalemia in 14 cases (70%) and hyponatremia in 8 cases (40%). After hemodialysis, 9 cases (45%) recovered renal function, 4 cases (20%) became chronic and 7 cases (35%) died. Conclusion: The frequency of AKI remains non-negligible in our department, and early detection and prompt management would considerably reduce the morbidity and mortality associated with this pathology.

关键词： Acute Obstructive Renal Failure Hemodialysis Prognosis Donka

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Biermer’s Disease at the Donka National Hospital in Guinea—Epidemio-Clinical, Therapeutic and Evolutionary Aspect in the Internal Medicine Department

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Open Journal of Internal Medicine 2023年第3期13卷 218-224页

作者： Thierno Amadou Wann Mamadou Sarifou dia.lo djenabou dia.lo Kadiatou dia.lo Mamadou Lamine Yaya Bah Mamadou diakhaby Mohamed Cissoko Amadou Kaké Djibril Sylla Department of Internal Medicine Teaching Hospital of Conakry Conakry Guinea Department of Hepato-Gastroenterology University Hospital of Conakry Conakry Guinea

Introduction: Biermer’s disease is an autoimmune disease characterized by a lack of absorption of vitamin B12 in connection with the production of antibodies (A) destroying the intrinsic factor (IF) which allows the absorption of vitamin B12 (cobalamin). These clinical manifestations are polymorphic and severe in our context. The objective of this work is to identify the epidemiological-clinical, therapeutic and evolutionary characteristics of Biermer’s disease in Guinean population. Materials and methods: This was a retrospective of patient files followed for Biermer’s disease at the internal medicine department of Donka National Hospital from January 2012 to December 2021. Results: Eight patients were included including 5 women and 3 men. The average age of the patients was 48 years old. The diagnostic delay was 3.6 years on average. All our patients had bioclinical anemia (8 cases, i.e. 100%) followed by epigastralgia in 4 cases (50%), neurological damage such as sensitive polyneuropathy in 3 cases (37.5%). Four patients had acquired melanoderma (50%). Hypovitaminosis B12 was found in 4 patients. The myelogram performed in three patients (37.5%) found medullary megaloblastosis. One patient had Hashimoto’s disease associated with Biermer’s disease in endoscopy, (FOGD) found fundica trophy on macroscopy in 4 cases (50%). Treatment consisted of B12 vitamin therapy in all cases with a favorable clinical and biological outcome. Conclusion: Biermer’s disease remains common in Africa and is characterized at a younger age in addition to the severity of clinical and biological manifestations. The care consists of taking vitamin B12 which remains accessible in our context.

关键词： Biermer’s Disease Donka Aspects Epidemiological-Clinical Therapeutics

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Therapeutic Itinerary of Patients Living with Viral Hepatitis B and C in Guinea

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Open Journal of Gastroenterology 2022年第10期12卷 299-306页

作者： dia.lo Kadiatou Barry Fatoumata diaraye dia.lo Thierno Saidou dia.lo djenabou Sow Ousmane dia.lo Mamadou Sarifou Sylla Mariétou Salifou Sylla Djibril Leno Niouma Nestor dia.lo Alpha Amadou Sank Tounkara Thierno Mamadou Faculty of Health Sciences and Techniques Gamal Abdel Nasser University Conakry Guinea Department of Internal Medicine and Hepato-Gastroenterology National Hospital Donka Conakry Guinea National Programme for the Fight against HIV and Viral Hepatitis Ministry of Health and Public Hygiene Conakry Guinea Inter-Army Medical and Surgical Centre Conakry Guinea Department of Dermatology-MST National Hospital Donka Conakry Guinea

Introduction: The therapeutic pathway affects the patient who changes care facilities. This change is linked to factors such as financial means, geographical accessibility of care facilities, quality of care and the socio-cultural perception of the patient. In countries with limited resources such as Guinea, the therapeutic itinerary remains multiple and hampered by obstacles. The objective of this study was to describe the therapeutic itinerary of patients living with hepatitis B and C at the Donka National Hospital. Material and methods: This was a retrospective, descriptive study lasting 43 months (24 January 2017 - 27 August 2020);it focused on patients living with hepatitis B or C or viral cirrhosis. We collected sociodemographic, clinical and treatment history variables. The data were analysed with SPSS software version 21.0. Results: Out of 5400 patients, the proportion of viral hepatitis B or C represented 393 patients (7.3%). The mean age of our patients was 35 ± 10 years, with extremes of 16 - 77 years. The sex ratio was 2.5. Three hundred and forty-two patients (87%) had recourse to modern medicine, mostly in private facilities (50.6%). One hundred and twenty-five patients (31.8%) had received previous treatment, half of whom (57.6%) had received inappropriate treatment. The delay in treatment was long in 45% of cases. The main reasons for delaying treatment were feeling unwell in 33.3%;not knowing to consult a specialist in 29.9% and feeling that they were being treated with useful drugs in 24.3%. Conclusion: The lack of training of general practitioners on the management of viral hepatitis and the scarcity of awareness campaigns on viral hepatitis contributed to the inadequacy of the management.

关键词： Therapeutic Itinerary Hepatitis B Hepatitis C Guinea

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Epidemiological, Clinical and Biological Characteristics of Patients with Chronic Hepatitis B Infection Followed-Up at the University Hospital of Conakry, Guinea

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Open Journal of Gastroenterology 2020年第10期10卷 256-265页

作者： djenabou dia.lo Kadiatou dia.lo Alpha Mamadou dia.lo Mamadou Mansour dia.lo Thierno Amadou Wann Amadou Diouldé Doumbouya Ousmane Sow Youssouf Baldé Alpha Amadou Sank Dillo Department of Internal Medicine University Hospital of Donka Conakry Guinea Department of Endocrinology Diabetes and Metabolic Diseases University Hospital of Donka Conakry Guinea

Introduction: Very little information is available in Guinea on chronic hepatitis B infections. The objective of this study was to describe the epidemiological, clinical and biological features of patients who are chronic carriers of the hepatitis B virus. Patients and Methods: This is a retrospective study carried out from January 2017 to May 2020, based on the medical records of patients seen via consultation or hospitalized with a record of positive HBs antigen for more than 6 months. Clinical and paraclinical data were collected and analyzed. Results: Seven hundred and sixteen patients with a mean age of 35.6 ± 12.2 (sex ratio 2.05), were included. The HBs antigen was discovered incidentally in 36% of cases (n = 258). A history of dental care and surgical procedures was found in 46.3% (n = 290) and 21.1% (n = 138) of cases, respectively. The median value of ALAT enzymes was 34 (21 - 47) IU/L. HBeAg was positive in 20.8% (n = 55/265) of cases. The median B viral load was 458.5 (87 - 3827) IU/ml and 29% (n = 94) of patients had a viral load over 2000 IU/ml. Anti-HCV antibody was present in 10.4 % of cases (n = 39/374). HIV serology was positive in 2.7% (n = 8/298). A total of 19.4% (n = 139) of the patients had cirrhosis and 4.5% (n = 32) had hepatocellular carcinoma. Conclusion:

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Treatment of Chronic Viral Hepatitis with Pegylated Interferon in Ivory Coast

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Open Journal of Gastroenterology 2016年第3期6卷 65-74页

作者： Henriette Ya Kissi Anzouan-Kacou Aboubacar Demba Bangoura djenabou dia.lo Yacouba Adéhouni Adjeka Stanislas Doffou Hartrydt Dimitri Kouamé Alassan Kouamé Mahassadi Mamert Fulgence Yao Bathaix Alain Koffi Attia Aya Thérèse Ndri-Yoman Hepatogastroenterology Unit Yopougon Teaching Hospital Yopougon Ivory Coast Pharmacy Unit Yopougon Teaching Hospital Yopougon Ivory Coast

Background: In the Ivory Coast, chronic infection by hepatitis B and C virus is the leading cause of cirrhosis and hepatocellular carcinoma. The absence of universal health coverage makes the treatment inaccessible to all. Objectives: To assess the efficacy of Pegylated Interferon in clinical practice in patients with chronic viral hepatitis B and C and determine the hematologic side effects. Patients and Methods: A descriptive retrospective study from January 2012 to November 2013 on a cohort of patients chronic carriers of hepatitis B virus (n = 11) treated with Pegylated Interferon to 180 mcg per week and hepatitis C virus (n = 30) treated with a combination therapy associating pegylated Interferon to 180 mcg per week and Ribavirin assayed according to the genotype. Results: Out of 1860 patients seen in hepatogastroenterology consultation 422 had viral hepatitis B or C that is a prevalence of 22.7% and 41 patients were treated (9.7%) by Pegylated Interferon. Among these 41 patients mentioned earlier, 30 had HCV (73.17%) with a case of HIV + HVC co-infection, 11 patients had HBV (26.83%) including 3 cases of HBV + HDV co-infection. Patients’ age ranged from 24 - 69 years with an average of 49.2 ± 12.2 years including 46.5 years for HBV and 51.9 years for HCV. The sex ratio was 1.56. The original transaminases were on average 93.37 IU/l for AST and 110.47 for ALT. The average RNA HCV was 1,685,331 IU/ml and the DNA HBV 33,312,767 IU/ml. Patients with HCV were of genotype 1 in 56.66%, genotype 2 in 40% and one case of genotype 4 (3.34%) from Central Africa. Fibrosis score at institution of treatment was significant (≥A2 and/or ≥F2) in 86.9% of cases of Fibrotest®, 100% of cases of Fibrometer®. We observed 48.8% of neutropenia < 750/mm3, 33.3% of anemia and 29.3% of thrombocytopenia < 100,000/mm3. There was no dose reduction of Pegylated Interferon and Ribavirin. For HBV there were 3 partial responses, 3 responders including 1 HBV + HDV co-infected non responder to H

关键词： HBV HCV Pegylated Interferon Ribavirine Africa

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Prevalence of Heartburn in Abidjan, a Black African Country, and Associated Factors

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Open Journal of Gastroenterology 2014年第4期4卷 175-180页

作者： Constant Assi Siaka Koné Antonin W. Ndam Ndjitoyap Amadou Ouattara Laté Mawuli Lawson-Ananissoh dia.lo djenabou Stanislas Doffou Jean-Kalpy Coulibaly Christian Ebela Dramane Soro Emile Allah-Kouadio Marie-Jeanne lohouès-Kouacou Beno?t-Mathieu Camara Division of Gastroenterology University Hospital of Cocody Abidjan Cote d’Ivoire

Aims: To determine the prevalence and risk factors of heartburn in Abidjan, a black African city. Patients and Methods: cross-sectional study from June 15 to September 30, 2003. One thousand nine hundred forty (1940) persons from five health zones of the city Abidjan were included after their informed consent. Socio demographic and clinical parameters were collected using a questionnaire in an interview format. Heartburn was defined as a discomfort or burning sensation extending from the sternal manubrium to the base of the neck. Factors related to the complaint were asked such as predisposing factors, habits (tobacco, alcohol and coffee intake) and body mass index. Stepwise multiple logistic regression analyses were used to examine associations between these factors and heartburn. Results: Among 1940 respondents (mean age 28 ± 9 years;sex ratio (M:F) 0.86), heartburn occurred in 433 persons (once a week in 9.2% of case (178 persons)). Five factors were statistically associated with heartburn: male sex (p = 0.025, OR = 0.555 [CI95% 0.331 - 0.930]), heartburn in a family member (p = 0.010, OR = 1.765 [95%CI 1.143 - 2.725]), constipation (p = 0.011, OR = 2.182 [95%CI 11,953,983]), right lateral decubitus (p = 0.001, OR = 6.247 [95%CI 2.079 - 18.775]) and after a meal (p = 0.000, OR = 2.643 [95%CI 1.594 4.383]). Conclusion: Heartburn is common in this black African population. Male sex appears to be less associated. Constipation, right lateral decubitus and after a meal are trigger factors for heartburn. Heartburn in a family member is a risk factor.

关键词： Gastro-Esophageal Reflux Disease Heartburn Regurgitation Abidjan Epidemiology Clinical

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