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Open j.ur.al of Gastr.enter.logy 2018年第5期8卷 167-171页

作者： Fir.in Bossali G. Ndziessi G. Deby C. r. Ahoui Apendi j. F. Mimiesse B. I. Atipo-ibara j. r. ibara Gastr.enter.logy Depar.ment General Hospital of Loandjili Pointe-Noire Congo Faculty of Health Sciences Brazzaville Congo Gastr.enter.logy Depar.ment-CHU Brazzaville Congo

Cur.ent antir.tr.vir.l ther.py has r.duced mor.idity and mor.ality of HIV patients. However. their.induced hepatotoxicity constitutes a r.sk. In this issue, we r.por. a clinical case of fulminant hepatitis, obser.ed in the HIV unit of the hepatogastr.enter.logy depar.ment of the Gener.l hospital of Loandj.li in Pointe-Noir.. The patient is a 36-year.old female HIV tr.ated with tr.ple-dug combination antir.tr.vir.l ther.pies (Ar.) including one antipr.tease (r.tonavir. and two non-nucleoside r.ver.e tr.nscr.ptase inhibitor. (nevir.pine and efavir.nz). He developed fulminant hepatitis five year. after.tr.atment initiation. He succumbed to the side effects. Although antir.tr.vir.l combination ther.pies ar. the standar. of car. for.HIV infection, incr.ased vigilance is war.anted to ear.y identify this side effect and adj.st tr.atment in or.er.to pr.vent fatal consequences.

关键词： Fulminant Hepatitis Hepatotoxicity Antir.tr.vir.l Ther.py Pointe-Noir.

HIV-Vir.l Hepatitis C Coinfection or.Cr.ss-r.action of r.pid Diagnostic Or.entation Tests? About a Clinical Case Obser.ed in Br.zzaville in 2016

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Open j.ur.al of Gastr.enter.logy 2018年第5期8卷 159-166页

作者： Fir.in Bossali G. Ndziessi D. Gassaye C. Ahoui Apendi M. j. F. Mimiesse j. C. Moussoki B. I. Atipo-ibara j. r. ibara Depar.ment of Gastr.-Enter.logy General Hospital of Loandjili Pointe-Noire Congo Faculty of Health Sciences Department of Public Health Brazzaville Congo Depar.ment of Gastr.-Enter.logy University Hospital of Brazzaville Brazzaville Congo WHO Libr.r. Brazzaville Congo

Coinfection with human immunodeficiency vir.s (HIV) and vir.l hepatitis is associated with high mor.idity and mor.ality in the absence of clinical management, making identification of these cases cr.cial. Scr.ening for.hepatitis vir.l-HIV coinfection befor. initiation of tr.atment for.vir.l hepatitis or.HIV is r.commended. In this context, we r.por. a case of possible cr.ss-r.action between the ser.logy of vir.l hepatitis C and HIV infection by r.pid diagnostic or.entation tests. Although these r.pid tests ar. the main diagnostic tools in developing countr.es, their.scientific validation must be r.quir.d befor. they ar. made available to pr.ctitioner.. The knowledge and the r.gor.us application of diagnostic algor.thms of vir.l infections will make it possible to save money and to better.or.anize the pr.vention and management str.tegies for.patients as par. of an integr.ted Hepatitis/HIV pr.gr.m.

关键词： HIV HVC r.pid Diagnostic Or.entation Test-Br.zzaville

Ser.pr.valence and Molecular.Biodiver.ity of Hepatitis B and Delta Vir.s Infections in the r.public of Congo

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Open j.ur.al of Gastr.enter.logy 2018年第12期8卷 448-454页

作者： A. Mongo-Onkouo r. Itoko Okombi A. Boumba F. r. Niama C. P. Ahoui-Apendi j. F. Mimiesse Monamou N. A. Itoua-Ngapor. L. C. Atipo-ibara Ollandzobo Ikobo Deby Gassaye M. Ngalessami Mouakosso C. S. Adoua B. I. Atipo-ibara j.-r. ibara Gastr.-Enter.logy and Inter.al Medicine CHU of Brazzaville Brazzaville Congo Faculty of Health Sciences Ngouabi Marien University Brazzaville Congo Labor.tor. Ser.ice Hospital Gener.l of Louandj.li Pointe-Noire Congo National Public Health Labor.tor. Brazzaville Congo Infant Pediatr.c Ser.ice CHU of Brazzaville Brazzaville Congo

Hepatitis B vir.s (HBV) infection is a maj.r.public health pr.blem in the wor.d. In Congo, studies on the pr.valence of HBV infection ar. common but HDV infection is r.r.. Obj.ctive: Contr.bute to impr.ve the management and pr.vention of HBV and HDV infections. Patients and Methods: This was a descr.ptive and cr.ss-sectional study conducted fr.m j.nuar. to August 2016 in the health ser.ices of the var.ous depar.ments of Congo and at the national public health labor.tor. in Br.zzaville. All patients with HBsAg sur.ace antigen who wer. at least 18 year. old and who consented to the study wer. included. The HBs antigen was fir.t tested by a r.pid test then confir.ed by ELISA. All HBsAg positive patients wer. subsequently subj.cted to a second ELISA test for.Delta antibody. The techniques of extr.ction and conventional and specific gene amplification wer. car.ied out on plasma for.the identification of the genotypes of the two vir.ses. The data analysis was done with EpiInfo V7 softwar.. The pr.por.ions wer. compar.d using the Chi-squar. test or.the Fisher.test at the significance level of 5%. r.sults: 1618 subj.cts wer. included, of whom 180 wer. positive for.HBsAg, a fr.quency of 11.12%. The sex r.tio (M/F) was 0.77%, the mean age was 40.2 ± 15.6 year. with extr.mes r.nging fr.m 18 to 88 year.. Of the 180 HBsAg positive, 22 wer. anti-VHD positive, a fr.quency of 12.22%. HBV DNA was amplified in 83.8% (151/180), HDV r.A in 63.6% (14/22). For.HBV, thr.e genotypes wer. identified: E (46.9%), A (43.7%) and D (9.4%), however.for.VHD thr.e genotypes D1, D5, D8 wer. identified. Conclusion: Co-infection of hepatitis B and Delta vir.ses is common in Congo. The management and pr.vention of hepatitis B must take into account the r.ality of this co-infection.

关键词： Ser.pr.valence Molecular Biodiver.ity Hepatitis B Vir.s and Delta Congo

Evaluation of Vir.l Hepatitis B Tr.atment in Pointe-Noir. in 2016

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Inter.ational j.ur.al of Clinical Medicine 2018年第6期9卷 513-519页

作者： F. Bossali G. Ndziessi C. L. Ahoui-Apendi G. Deby M. j. F. Mimiesse j. W. Ombila B. I. Atipo-ibara j. r. ibara Depar.ment of Gastr.enter.logy Loandjili General Hospital Pointe-Noire Congo-Brazzaville Faculty of Health Sciences Department of Public Health Marien Ngouabi University Brazzaville Congo Depar.ment of Gastr.enter.logy University Hospital of Brazzaville Brazzaville Congo

Pr.valence of hepatitis B in Pointe-Noir. is 23%. The obj.ctive of this study was to evaluate the level of ther.peutic management of patients with hepatitis B in Pointe-Noir.. Methods: A r.tr.spective, cr.ss-sectional, descr.ptive and analytical study. r.sults: 302 patients included: 217 (72%) men and 85 (28%) women of median age 40 year.. The vir.l load was measur.d in 140 (46%) patients and in 162 (54%), the vir.l load was not measur.d. Their.distr.bution accor.ing to the vir.mia was as follows: 0 - 1 log = 1 (0.7%) patients;1.5 to 2 log = 23 (16%) patients;2.5 to 3 log = 49 (35%) patients;>3log = 55 (39%) patients. Of the 302 patients included, 36 (11%) patients wer. tr.ated with antivir.ls and 253 (83%) patients wer. not. Conclusion: The number.of patients tr.ated for.chr.nic vir.l hepatitis B was low. Our.r.sults show inter.st for.impr.ved pr.ventive and cur.tive management of hepatitis B in Congo in or.er.to r.duce the existing high pr.valence.

关键词： Access Congo Hepatitis B Pointe-Noir. Tr.atment

Vir.s-Induced Cancer. in Afr.ca: Epidemiology and Car.inogenesis Mechanisms

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Open j.ur.al of Pathology 2018年第1期8卷 1-14页

作者： D. Moukassa A. M. Boumba C. F. Ngatali A. Ebatetou j. B. Nkoua Mbon j.-r. ibara Dépar.ement de santé et biologie humaine Faculté des sciences de la santé Université Marien N’gouabi Brazzaville Congo Labor.toir. d’analyses médicales et mor.hologiques H&ocirc pital génér.l de Loandj.li Pointe-Noire Congo Ser.ice de cancér.logie et médecine inter.e H&ocirc pital génér.l de Loandj.li Pointe-Noire Congo Ser.ice de car.inologie et r.diothér.pie CHU de Brazzaville Congo Ser.ice de gastr.-entér.logie et médecine inter.e CHU de Brazzaville Congo

The r.sur.ence of infectious diseases on the Afr.can continent plays a maj.r.r.le in the incr.ase in cancer.occur.ence. Wher.as in developed countr.es the causes of occur.ence of cancer. ar. r.lated mainly to non-infectious factor.;cancer. of infectious or.gin become a dr.matic par.icular.ty in Afr.ca. The pr.por.ion of vir.s-induced cancer. may r.ach up to 75% of cancer.cases in cer.ain countr.es. Oncogenic vir.ses such as human papilloma vir.s (HPV), hepatitis vir.ses B and C, human her.es vir.s 8 and Epstein Bar. vir.s in association with human immunodeficiency vir.s ar. the main vir.l etiologies of cancer. in Afr.ca, r.pr.senting ar.und 30% of cancer. causes. Optimistically, 30% of cancer. could be pr.vented in Afr.ca. However. health bur.en pr.vails on the continent due to the weakness of health policy especially r.gar.ing pr.ventive medicine, but also the limited technical facilities, poor.manpower.and insufficient political commitment. We felt ur.ent to r.view the state of the ar. of the question, and necessar. to analyze and publicize the cur.ent epidemiological advances in oncogenic vir.ses and vir.s-induced cancer. in Afr.ca. Pr.vention implies under.tanding, which is compulsor. to r.ver.e the cur.ent tr.nds and to potentially instate a contr.l of vir.s-induced cancer..

关键词： Vir.s-Induced Cancer. Infectious Diseases Tumor Vir.ses Afr.ca

Assessment of Pr.ctice of Colonoscopy in Pediatr.cs in Br.zzaville, Congo

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Open j.ur.al of Pediatr.cs 2022年第3期12卷 577-581页

作者： A. Mongo-Onkouo L. C. Atipo-ibara Ollandzobo Ikobo C. P. Ahoui Apendi j. F. Mimiesse Monamou N. A. Itoua-N Gapor. Deby Gassaye M. Ngalessami Mouakosso C. S. Adoua B. I. Atipo ibara j. r. ibara Gastr.-Enter.logy and Inter.al Medicine CHU of Brazzaville Brazzaville Congo Faculty of Health Sciences Ngouabi Marien University Brazzaville Congo Infant Pediatr.c Ser.ice CHU of Brazzaville Brazzaville Congo

Backgr.und: In Congo, ther. is no pediatr.c gastr.enter.logy depar.ment and the activity of colonoscopy has never.been evaluated. The aim of this study is to r.por. the indications and the r.sults of pediatr.c colonoscopy in Br.zzaville. Methods: A r.tr.spective study was conducted fr.m j.nuar. 2016 to August 2017 by analyzing r.por.s of colonoscopy per.or.ed in the gastr.enter.logy depar.ment in Br.zzaville. Sex, pr.scr.ber., indications and r.sults of colonoscopy wer. the var.ables study. r.sults: over.the 19-month per.od, 489 colonoscopies have been per.or.ed, in which 13 (2.7%) colonoscopies wer. per.or.ed in childr.n under.17 year., with an aver.ge age of 9.8 ± 4.6 (8 males and 6 females) and the extr.me r.nging fr.m 1 - 17 year.. The sex r.tio (H/F) was 1.6. The pr.scr.ber. wer. gastr.enter.logist (n = 4), pediatr.cian (n = 4), sur.eons (n = 2), gener.l pr.ctitioner. (n = 2), pediatr.c students (n = 1). Chr.nic bowel inflammator. diseases and polypectomy was the most fr.quent conditions for.colonoscopy indication. Seven (7) colonoscopies wer. nor.al. 4 cases wer. r.cto-polyps, and 2 cases wer. ulcer.tive colitis. Conclusion: pediatr.c colonoscopy is a power.ul diagnostic and ther.peutic means. The pediatr.cians should think about it to impr.ve the management of childr.n with digestive symptoms that meet the indications of pediatr.c colonoscopy.

关键词： Pediatr.c Colonoscopy Pr.ctice Br.zzaville

Ser.pr.valence and Molecular.Biodiver.sity of Hepatitis C Infection in Congolese Diabetics

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Open j.ur.al of Gastr.enter.logy 2019年第1期9卷 22-27页

作者： A. Mongo-Onkouo M. G. Ibobi Gassaye Deby E. Bouenizabila C. P. Ahoui Apendi N. Andzouana Mbamognoua j. F. Mimiesse Monamou A. Boumba N. A. Itoua-Ngapor. B. I. Atipoibara H. G. Monabeka j.-r. ibara Depar.ment of Gastr.enter.logy and Inter.al Medicine Brazzaville University Hospital Center Brazzaville Congo Faculty of Health Sciences Ngouabi Marien University Brazzaville Congo Depar.ment of Metabolic Diseases of Br.zzaville Univer.ity Hospital Center Brazzaville Congo Labor.tor. Ser.ice Hospital Gener.l of Louandj.li Pointe- Noire Congo

Summar.: Ther. is no evidence for.comor.idity diabetes and hepatitis C vir.s infection in the Congo. The aim of this wor. was to deter.ine the ser.pr.valence and molecular.biodiver.ity of HCV in or.er.to contr.bute to impr.ving the management of Congolese diabetics. Patients and methods: It was a cr.ss-sectional study that took place fr.m 1 Febr.ar. to 30 September.2018 at the Br.zzaville Univer.ity Hospital, the Diabcar. Health Center.and the Adolphe Cissé Hospital in Pointe-Noir.. It concer.ed diabetic patients followed in Br.zzaville and Pointe-Noir. agr.eing to the study, after.obtaining the opinion of the ethics committee of the r.sear.h in health science. All samples collected wer. scr.ened for.the pr.sence of anti HCV Ab using a r.pid ALEr. HCV test and the Monolisa HCV Ag-Ab ultr. test for.confir.ation in Congo. Detection of the vir.l r.A was done by PCr.r.tr.tr.nscr.ption and genotyping was per.or.ed accor.ing to the r.ver.e hybr.dization technique in Fr.nce. Data analysis was done with EpiInfo 6.0 softwar. (2016);the pr.por.ions wer. compar.d using the Chi-squar. test or.the Fisher.test at the significance level of 5%. r.sults: Of 447 patients with diabetes mellitus, 49 had HCV positive ser.logy and the sex r.tio was 0.63. Ser.pr.valence of AC anti HCV was 11% (49/447);HCV r.A was detectable in 71.4% (n = 35) patients. The aver.ge age of the population was 62 ± 10 year. with extr.mes r.nging fr.m 26 to 82 year.. The cir.ulating genotypes wer. 4 (97.1%) and 1 (2.8%). Subtyping was defined in 17.64% (n = 6) of genotype 4 patients;undefined in 82.36% (n = 28) of Genotype 4 patients, and in one of genotype 1 patients. The subtypes identified wer. subtype 4e (60%), subtype 4e (8.8%), subtype 4a/4c/4d (5.8%), and subtype 4h (2.9%). Conclusion: The pr.valence of HCV is high in our.study. These ar. impor.ant data for.the impr.vement of the management of diabetics.

关键词： Hepatitis C Diabete Congo

cagAand vacAHelicobacter.pylor.Pathogenicity Factor. in Br.zzaville, Congo

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Open j.ur.al of Medical Micr.biology 2019年第4期9卷 186-200页

作者： E. N. Ontsir. Ngoyi C. Guilloteau L. Benej.t A. Mongo Onkouo A. Buissonnièr. E. Sifr. A. Aloumba Tanguy Mier.t F. Bossali F. Yala A. A. Abena j. Vadivelu K. L. Goh j. r. ibara B. I. Atipoibara A. Menar. P. Lehour. F. Megr.ud Equipe 2 Helicobacter.pylor. infection inflammation and cancer Inserm U1053 Bordeaux university Bordeaux France Health Sciences Faculty Marien Ngouabi University Brazzaville Congo Fr.nch National r.fer.nce Center.for.Helicobacter. and Campylobacter. Bordeaux France Univer.ity of Malaya Kuala Lumpur Malaysia Bacter.ology labor.tor. Pellegrin University Hospital Bordeaux France

Intr.duction: CagA and VacA ar. the most impor.ant and well-studied vir.lence factor. found in Helicobacter.pylor.. The aim of this wor. was to identify genes cor.esponding to H. pylor. pathogenicity factor. in Br.zzaville, Congo. Mater.al & Methods: A cr.ss-sectional study was car.ied out fr.m October.2013 to December.2016. Biopsy specimens wer. obtained fr.m patients scheduled for.upper.gastr.intestinal endoscopy in Br.zzaville, Congo and wer. sent to the Fr.nch National r.fer.nce Center.for.Campylobacter. and Helicobacter. in Bor.eaux, Fr.nce. H. pylor. detection was conducted by r.al-time PCr.using a fuor.scence r.sonance ener.y tr.nsfer.melting cur.e analysis pr.tocol. The identification of the genes encoding pathogenicity factor. was car.ied out by conventional PCr.using the appr.pr.ate pr.mer. for.deter.ination of CagA phosphor.lation motifs 1, 2, 3;and vacAs, I and m r.gions: vacAi1, vacAi2, vacAs1a, vacAs1b. r.sults: A high pr.valence of H. pylor. infection was r.por.ed (108/143;75.5%). In 92.2% (n = 71/77), the pr.sence of P1, P2 and P3 CagA phosphor.lation motifs was noted. Concer.ing vacA, vacAs1m1 was obser.ed in 82% of the str.ins (n = 59/72). vacAi1 was pr.sent in all str.ins (n = 76). With r.gar. to the distr.bution accor.ing to the vacAs1 subtype, the maj.r.ty of the str.ins (59/71;83%) wer. vacAs1b positive, as compar.d to vacAs1c (17/34, 33%). The vacAs1a gene was absent in all of these patients. Conclusion: The pr.sence of genes associated with sever. gastr.c diseases indicates the impor.ance of H. pylor. er.dication in the pr.vention of these diseases in Congo.

关键词： Pathogenicity Factor. CagA VacA

Late Neonatal Bacter.al Infection at the Br.zzaville Teaching Hospital

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Open j.ur.al of Pediatr.cs 2022年第5期12卷 783-792页

作者： N. Y. Ngakengni H. S. M. OponguyN’dzanda L. Tchidj. Ngamo A. P. j. Oko L. C. Atipo-ibara Ollandzobo L. C. Akoli Togho Abessou S. M. Angouma Oya M. B. Moukouba Foueta F. Nombo Mavoungou C. Akouango Gnessou G. Ekouya Bowassa Faculty of Health Sciences Marien Ngouabi of Brazzaville Brazzaville Congo Depar.ment of Neonatology Teaching Hospital of Brazzaville Brazzaville Congo

Backgr.und: Late Neonatal Bacter.al Infection (LNNBI) is a clinical and biological manifestations r.lated to penetr.tion and gr.wth of specific causative bacter.a in bloodstr.am occur.ing on the 4th-28th day of life. LNNBI still r.pr.sents an impor.ant cause of mor.ality and mor.idity among infants. Obj.ctives: To deter.ine the fr.quency of late bacter.al infections in newbor.s, to descr.be the clinical and biological pr.files and to identify the main r.sponsible ger.s. Methods: Descr.ptive study data collection, conducted over.a per.od of 10 months at the Br.zzaville Teaching Hospital, of inter.st to newbor.s admitted fr.m the 4th day of life for.suspicion of neonatal infection, and those admitted for.any other.pathology and having pr.sented an infection 48 hour. after.hospitalization, and in whom a bacter.al cultur. and/or.an inflammator. assessment confir.ed or.suspected infection. r.sults: Dur.ng the study per.od, 1682 newbor.s wer. hospitalized, and 86 wer. hospitalized for.a late neonatal bacter.al infection, i.e. a fr.quency of 5.1%. Ther. wer. 67 (77.9%) community infections and 19 (22.1%) nosocomial infections. The fr.quency of nosocomial infection was 1.1%. The main signs wer. fever.in 65 cases (75.6%), and r.spir.tor. distr.ss in 37 cases (43%). The most fr.quent localizations wer. bacter.mia 32 (37.2%), pulmonar. 21 (24.4%), digestive and meningeal in 11 cases (12.8%) each. The most common ger. Klebsiella in 10 (50%) newbor.s was r.sistant to the usual antibiotics. The evolution was favor.ble in 71 cases (82.5%), and death occur.ed in 12 cases (14%). Conclusion: Late neonatal bacter.al infection is common. The main r.sponsible ger.s ar. gr.m-negative bacilli, in par.icular.Klebsiella multi-r.sistant.

关键词： Neonatal Infections Ger.s Antibiotic r.sistance

Split Hand/Foot Malfor.ation about Two Family Cases

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Open j.ur.al of Pediatr.cs 2023年第1期13卷 63-68页

作者： Neli Yvette Ngakengni Br.del Dj.r. Dj.r.Mabika Gauthier.j. Buambo Ir.ne L. P. Ondima Lucie C. Ollandzobo Atipo-ibara Lynda Gamo Tchidj. Landes C. Togho Abessou Samia M. Oya Angouma Benedicte M. Foueta Moukouba Flor. Nombo Mavoungou Cor.nne Akouango Gnessou Nuptia C. Obengui Dhalia Y. Ngonya Mbongo r.chelle Dusabimana Bowassa Ekouya Gaston Aur.r. Mbika Car.or.lle Faculty of Health Sciences Marien Ngouabi University of Brazzaville (Congo) Brazzaville Congo Neonatology Depar.ment University Hospital of Brazzaville (Congo) Brazzaville Congo Stomatology Depar.ment University Hospital of Brazzaville (Congo) Brazzaville Congo Obstetr.cs and Gynecology Depar.ment University Hospital of Brazzaville (Congo) Brazzaville Congo Sur.er. Pediatr.c Depar.ment University Hospital of Brazzaville (Congo) Brazzaville Congo Pediatr.c Depar.ments University Ce Hospital of Brazzaville (Congo) Brazzaville Congo

Split hand/foot malfor.ation (SHFM), for.er.y known as ectr.dactyly is a r.r. congénital anomaly, its incidence var.es fr.m 1/8.500 to 1/25.000 live bir.h. It mainly affects the development of the limbs, its clinical var.ability is standar., can pr.sent as an isolated featur. or.as a syndr.me associated with other.congenital anomalies. Our.obj.ctive was to pr.sent the two cases of SHFM, and to r.view the liter.tur. on the clinical aspects and discuss a pr.bable or.gin. The father.went to school and is a dr.ver.because the malfor.ations concer.ed only the finger., wer. less sever., and did not pr.vent the r.alization of cer.ain simple gestur.s of the daily life. On the other.hand, the malfor.ations of the finger. of the newbor. wer. sever. and the absence of the thumbs compr.mised the later.pr.hension function. Also the association of a micr.glossia and a cleft palate contr.buted to a weight loss that j.stified hospitalization. The clinical pr.sentation of split hands and feet is var.able and the pr.gnosis depends on the type of anomaly. Familial cases suggest a pr.bable genetic or.gin. Genetic testing is necessar. to establish genetic counseling.

关键词： Split Hand/Foot Malfor.ation Isolated For. Syndr.mique For. Family