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Plummer-Vinson Syndrome: A Rare Entity in Sub-Saharan Africa

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Open Journal of Gastroenterology 2019年第6期9卷 109-112页

作者： Ngalessami-Mouakosso Marlyse itoua-ngaporo ngala akoa Ahoui-Apendi Clausina Mongo-Onkouo Arnaud Mimiesse-Monamou Jile Florient Rody Stéphane Ngami Deby-Gassaye Atipo Ibara Blaise Irénée Ibara Jean-Rosaire Department of Gastroenterology and Internal Medicine University Hospital of Brazzaville Brazzaville Congo Faculty of Health Sciences of Marien Ngouabi University of Brazzaville Brazzaville Congo

Plummer-Vinson syndrome (PVS) is a rare condition characterized by classical triad;high dysphagia, iron-deficiency anemia and oesophageal ring formation. We report a case of PVS in a 62-year-old patient admitted to the department of gastroenterology and internal medicine for high dysphagia. The clinical examination showed anemic syndrome, general impairment and polyarthritis. Biological examinations concluded to iron deficiency anemia. The endoscopy had observed a circular ring immediately above Killian’s mouth ruptured during the examination. The patient was treated with iron and proton pump inhibitors. The oesophageal symptomatology regressed completely from the second day of treatment.

关键词： Plummer Vinson Dysphagia Iron Deficiency Anemia Oesophagealring Africa

Role of <i>Helicobacter pylori</i>Infection in Recurrent Abdominal Pain of the Child in Brazzaville

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Open Journal of Pediatrics 2020年第4期10卷 587-599页

作者： Ollandzobo Ikobo Lucie Charlotte Ahombo Niotsebe Lydie Bénédicte Mongo-Onkouo Arnaud Ahoui Apendi Clausina Rochelvie itoua ngaporo ngala akoa Mimiesse Mounanou Jile Florent Tchidjo Ngamo Lynda Déby Gassaye Mabiala Babela Jean Robert Atipo Ibara Blaise Irénée Ibara Jean-Rosaire Faculty of Health Sciences Marien Ngouabi University of Brazzaville Brazzaville Congo Infants Pediatric ward Brazzaville University Teaching Hospital Brazzaville Congo Gastroentérology and Internal Medicine Ward Brazzaville University Teaching Hospital Brazzaville Congo

The Helicobacter pylori (Hp) infection is a public health problem, especially in developing countries. However, the responsibility of Hp for the occurrence of recurrent abdominal pain is still unclear. Objectives: To determine the prevalence of Helicobacter pylori (Hp) infection in children with recurrent abdominal pain (RAP) in Brazzaville and to establish the relationship between Hp infection and RAP. Patients and Methods: We conducted a cross-sectional case-control study, between March and September 2018, including 106 children with RAP and 218 children without RAP, aged 2 to 17 years old, received in health centres in Brazzaville. All the children were subjected to detection of Hp fecal antigen by qualitative immuno-chromatography in the faeces. Results: The prevalence of Hp infection among children with RAP in Brazzaville was 43.4%. The female sex was most represented in both populations, with a sex ratio of 0.84 in the infected population. Compared with controls, these were children with a mean age of 8.13 ± 4.57 years. Infected children with RAP were unschooled in 66.7% (n = 31) of cases (p < 0.05). Those using potty were 63% (n = 29). Handwashing before meals and after using the toilet was not done in 66.7% (n = 31) and 56.5%

关键词： Helicobacter pylori Recurrent Abdominal Pain Fecal Antigen Child Brazzaville

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

Knowledge Attitude and Practice of Viral Hepatitis B and C Screening by General Practitioners in Brazzaville

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Open Journal of Gastroenterology 2020年第12期10卷 311-316页

作者： Rody Stéphane Ngami Sonia Opomba Philestine Clausina Mikolele Ahoui Apendi Arnaud Mongo-Onkouo Jile Florient Mimiesse ngala akoa itoua-ngaporo Marlyse Ngalessami Céline Sandra Adoua Deby Gassaye Blaise Irénée Atipo Ibara Jean-Rosaire Ibara Department of Gastroenterology and Internal Medicine Brazzaville University Hospital Brazzaville Republic of the Congo Faculty of Health Sciences Marien Ngouabi University Brazzaville Republic of the Congo

The involvement of general practitioners in the early detection of viral hepatitis B and C must be paramount. The objectives of this work were to assess GPs’ knowledge, attitude and practice with regard to screening for viral hepatitis B and C. We carried out a cross-sectional analytical study among GPs recruited by simple random sampling from the list of GPs in the city of Brazzaville. The judgement criteria were knowledge and practice of screening for viral hepatitis B and C, assessed according to a Likert scale divided into 3 categories: very good, good and bad. One hundred and twenty-one general practitioners were included, including 48 women and 73 men, with a sex ratio of 1.52;the average age was 33 years;52.89% of them worked in the private sector with an average period of activity of 4 years. The majority of the doctors had a good knowledge (69.42%) and a bad practice (56.20%) of screening for viral hepatitis B and C. The duration of activity was the factor linked to knowledge of viral hepatitis B and C (p = 0.006) while age was the factor linked to the practice of screening for viral hepatitis B and C (p = 0.0366). In conclusion, in Brazzaville, general practitioners’ knowledge of screening for viral hepatitis B and C is good in general, but the practices are poor and require targeted in-service training.

关键词： Viral Hepatitis B and C Screening General Practitioners Brazzaville

Profile of patients with pancreatic cancer and diabetes mellitus at the University Hospital of Brazzaville

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Open Journal of Gastroenterology 2021年第6期11卷 105-111页

作者： Rody Stéphane Ngam Evariste Bouenizabila Arnaud Mongo-Onkouo Jile Florient Mimiesse ngala akoa itoua-ngaporo Motoula Latou Pérès Mardochée Relda Itoko Okombi Philestine Clausina Mikolele Ahoui Apendi Deby Gassaye Blaise Irénée Atipo Ibara Jean-Rosaire Ibara Department of Gastroenterology and Internal Medicine Brazzaville University Hospital Brazzaville Republic of the Congo Faculty of Health Sciences Marien Ngouabi University Brazzaville Republic of the Congo

Introduction: pancreatic cancer a poor prognosis disease for which there is no screening. Its association with diabetes is not uncommon and may influence the evolutionary profile. The aim of this study was to describe the profile of diabetic patients who could benefit from pancreatic cancer screening. Methods: we conducted a retrospective cross-sectional study in the gastroenterology department of the University Hospital of Brazzaville, from January 2010 to December 2019. Epidemiological variables (age, sex, alcoholism, smoking), tumor variables (symptoms, site, size, density, extension) and time of occurrence of both entities were analyzed using Epi info software. Results: A total of 35 patients were hospitalized for pancreatic cancer, of whom 17 were men and 15 women, for a sex ratio of 1.21. The mean age of the patients was 60.3 ± 13 years. Fifteen patients (43.75%) were diabetic, all classified as type 2. Among them, the diagnosis of diabetes of 10 patients (66.7%) preceded pancreatic cancer diagnosis and delay between the two pathologies was on average 3.4 years ± 5.3 months. Diabetes was observed in 11 patients older than 60 years. The difference was significant (OR = 4.8;95% CI [1.1 - 22.8];p = 0.0226). The other epidemiological variables studied were not related to the two pathologies. Conclusion: we propose a screening for pancreatic cancer when diabetes is discovered to patients from 60 years old, whatever their sex, especially during the first 3 years

关键词： Pancreatic Cancer Diabetes Mellitus Association

Hepatic Steatosis in Patients with Metabolic Syndrome at the Brazzaville University Hospital Center

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Open Journal of Gastroenterology 2020年第6期10卷 119-127页

作者： Clausina Ahoui-Apendi ngala akoa itoua-ngaporo Arnaud Mongo-Onkouo Moubié Malanda Merveille Jile Florient Mimiesse Nestor Andzouana Bahamognoua Régis Moyikoua Rody Stéphane Ngami Ngalessami Mouakosso Marlyse Deby Gassaye Blaise Irénée Atipo Ibara Ibara Jean-Rosaire Department of Gastroenterology and Internal Medicine CHU Brazzaville Brazzaville Congo Faculty of Health Sciences Marien Ngouabi University of Brazzaville Brazzaville Congo Department of Metabolic and Endocrine Diseases CHU Brazzaville Brazzaville Congo Radiology Department Brazzaville University Hospital Brazzaville Congo

Objective: To study the epidemiological, clinical and paraclinical particularities of fatty liver disease in patients with metabolic syndrome. Patients and Method: This was a cross-sectional and analytical study carried out over a period of seven months, from February 1 to September 30, 2019, in the outpatient services of Gastroenterology and Metabolic and Endocrine Diseases of the Brazzaville University Hospital. It interested all patients with metabolic syndrome, according to the criteria of the FID harmonized in 2009, namely known diabetic and hypertensive patients, having abdominal obesity. Results: The variables studied were socio-demographic, clinical, morphological and biological. The search for fatty liver was done using an abdominal ultrasound. Results: During the study period, 124 patients with metabolic syndrome were included. The average age of the population was 52.8 ± 12 years with extremes ranging from 30 and 84 years. The population was mainly female with a Sex-Ratio of 2.54 (F/M). The frequency of fatty liver disease was 38.7%. The frequency of dyslipidemia was high in the study. Conclusion: The prevalence of hepatic steatosis is high in patients with metabolic syndrome at Brazzaville University Hospital. The gender, lack of occupation and high level of education were the factors associated with fatty liver disease.

关键词： Fatty Liver Metabolic Syndrome Brazzaville

Evolutionary and Pronostic Aspects of Cirrhosis at the University Hospital of Brazzaville (Congo)

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Open Journal of Gastroenterology 2020年第1期10卷 23-29页

作者： Jile Florient Mimiesse Ngalessami Mouakosso Marlyse Ahoui Apendi Clausina Mongo Onkouo Arnaud Atipo-Ibara Ollandzobo Lucie Firmin Bossali akoa ngala itoua-ngaporo Rody Stéphane Ngami Mahoungou Gael Honal Deby Gassaye Atipo Ibara Blaise Irénée Ibara Jean-Rosaire Faculty of Health Sciences Marien Ngouabi University Brazzaville Congo Gastroenterology Service University Hospital of Brazzaville Brazzaville Congo

Introduction: cirrhosis is a serious pathology that leads to complications whose management remains difficult in our country. This study aimed to evaluate the evolutionary aspects of cirrhosis at the Brazzaville University Hospital. Patients and methods: this was a retrospective study over a period of 18 months (from January 2015 to July 2016), performed in the Gastroenterology Department of the Brazzaville University Hospital. All patients regularly followed for decompensated cirrhosis were included. The studied variables were the epidemiological, clinical and paraclinical characteristics, the occurrence of complications, the survival, and the causes of death. Univariate analysis was used to determine prognostic factors based on the Child Pugh score. Results: There were 43 patients, including 32 men and 11 women, with a mean age of 52 ± 9.5 years. Viral hepatitis B was the most common etiology (39.5%). Child Pugh stage C was found in 60.5%. Oesophageal varices were present in 93% of cases. Survival at 18 months was 72%. In univariate analysis, two variables were significantly associated with decreased survival, including Child Pugh stage C and esophageal varices (grade II and III). Conclusion: cirrhosis remains a worrying pathology because the diagnosis is often made at the stage of often serious complications putting at risk of vital prognosis.

关键词： Cirrhosis Evolution Brazzaville

Helicobacter Pylori Infection in Brazzaville: Comparative Study of Two Identification Tests

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Open Journal of Gastroenterology 2019年第11期9卷 223-227页

作者： ngala akoa itoua-ngaporo Lucie C. A. I. O. Ikobo Arnaud Mongo-Onkouo Jile Florent Mimiesse Monamou Clausina Philestine Ahoui Apendi Rody Stéphane Ngami Marlyse Ngalessami Mouakosso Deby Gassaye Blaise Irenée Atipo Ibara Jean-Rosaire Ibara Department of Hepatogastroenterology and Internal Medicine of Brazzaville University Hospital Center Brazzaville Congo Faculty of Health Sciences Marien Ngouabi University Brazzaville Congo Department of Infant Pediatrics of Brazzaville University Hospital Center Brazzaville Congo

Objective: To determine the place of two identification tests for Helicobacter pylori infection available in Congo. Materials and Methods: This was a comparative study carried out in two digestive endoscopy centers in Brazzaville from 1 January to 31 May 2018. Symptomatic patients referred for upper gastrointestinal endoscopy were included systematically. The frequency of infection was determined from two identification tests, namely the rapid urease test in gastric biopsies and the detection of antigen (Ag) for the germ in the stool. The criterion for judging the presence of the germ in each patient was the positivity of at least one of the two tests. The McNEMAR X2 test (p < 0.05) was used for the comparison of averages. Results: During the study period, 137 consenting patients were included, including 62 men and 75 women. The overall incidence of Helicobacter pylori (Hp) infection was 79.6% (109/28). Of the 137 patients, 18 were urease positive only;6 were looking for Hp Ag in the stool, and 85 were in the two tests. The frequency of infection was 75.2% (103/137) with the rapid urease test and 66.4% (91/137) with the Hp Ag test in stool. The rapid urease test proved more reliable in the diagnosis of Helicobacter pylori infection than the stool antigen test.

关键词： Helicobacter Pylori Identification Tests Brazzaville

Viral Hepatitis B: Seroprevalence and Genetic Diversity in Blood Donors North of Congo

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Open Journal of Gastroenterology 2019年第12期9卷 239-245页

作者： Arnaud Mongo-Onkouo Amelia Dzia Lepfoundzou Dinghat Ornela Marlyne Yvonne Ahoui Apendi Clausina Philestine Jile Florent Mimiesse Monamou ngala akoa itoua-ngaporo Rody Stéphane Ngami Mouakosso Marlyse Ngalessami Céline Sandra Adoua Deby Gassaye Blaise Irénée Atipo Ibara Jean-Rosaire Ibara Department of Hepatogastroenterology and Internal Medicine Of Brazzaville Universty Hospital Center Brazzaville Congo Faculty of Health Sciences Marien Ngouabi University Brazzaville Cong Department of Metabolic Diseases of Brazzaville University Hospital Center Brazzaville Congo

Introduction: Viral hepatitis B is the most formidable and confusing of all viral hepatitis, given its cirrhogenic and carcinogenic potential. The objective of the study is to characterize the molecular profile of hepatitis virus B in northern Congo. Materials and Methods: This was a descriptive and cross-sectional study that was carried out between January and September 2014, that is 9 months, in the establishments of the National Center for Blood Transfusion (CNTS) of the 4 departments of the north of the Congo. Epidemiological, serological and molecular variables (HBsAg, HBV DNA, genotypes and subtypes) were studied. The HBs antigen was searched by rapid test and confirmed by ELISA. For all positive donors, conventional and specific gene extraction and amplification techniques were performed for the identification of genotypes and subtypes from the serum. Results: A total of 892 donors were included. The average age was 35.36 ± 12.36 years with extremes ranging from 18 to 65 years old. The sex ratio (M/F) was 3.3. The prevalence of HBV was 8.6%. The viral DNA of HBV was amplified in 83.1%. Four genotypes were found: E (40.6%), A (3.1%), B (3.1%) and C (1.6%). Two cases of co-infection were identified: E/A (15.6%) and B/C (1.6%). Subgenotypes A1, B2 and C1 were highlighted. Conclusion: The prevalence of HBV is high, HBV infection remains a major public health problem for blood donors in Congo. Genotypes E, A, B, C as well as subtypes A1, B2, C1 have been identified in northern Congo.

关键词： HBV Molecular Biodiversity Subgenotypes North Congo