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Risk Factors for Mortality Upper Digestive Haemorrhages at the University Hospital Centre of Brazzaville

Open Journal of Gastroenterology 2020年第12期10卷 341-348页

作者： Rody Stéphane Ngami Pétula Moulene Jile Florient Mimiesse Arnaud Mongo-Onkouo Ngala Akoa Itoua-Ngaporo Marlyse Ngalessami Péres Mardochée Motoula Latou Céline Sandra Adoua Philestine Clausina Mikolele Ahoui Apendi Deby Gassaye Blaise Irénée Atipo ibara jean-rosaire ibara Department of Gastroenterology and Internal Medicine Brazzaville University Hospital Brazzaville Congo Faculty of Health Sciences Marien Ngouabi University Brazzaville Congo

In the absence of interventional endoscopy, the treatment of upper digestive haemorrhages (HDH) at Brazzaville University Hospital is essentially medicinal. The objective of this work was to identify the risk factors for HDH mortality at Brazzaville University Hospital by conducting a retrospective prognostic case-control study over a period of 2 years, from January 2017 to December 2018. The 180 patients included in the study for an HDH were divided into 2 groups according to their evolutionary modality: deceased patients (cases) and non deceased patients (controls). The mortality risk factors were studied by logistic regression. Mortality related to upper digestive haemorrhages was 36.6%;the risk factors for death were age between 30 and 60 years with a (OR: 9.79;95% CI [1.24 - 76.83];p = 0.003);male sex (OR: 2.03;95% CI [1.03 - 4];p = 0.0393);late consultation beyond 24 hours (OR: 6.30;95% CI [2.12 - 18.72];p = 0.0009), blood transfusions (OR: 3.5;95% CI [1.66 - 7.40];p = 0.0001). Protective factors were haemoglobin greater than 7 g/dL (OR: 0.28;95% CI [0.14 - 0.54];p = 0.0001);treatment with proton pump inhibitors (OR: 0.36;95% CI [0.15 - 0.84];p = 0.0191). In conclusion, the reduction of the still high mortality rate in our country requires taking into account the identified risk factors and the acquisition of endoscopic haemostasis equipment.

关键词： Upper Digestive Haemorrhage Mortality Haemostasis Brazzaville

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Working in Psychiatry: Staff Perception of the Brazzaville Hospital and University Center

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Open Journal of Psychiatry 2020年第2期10卷 39-44页

作者： Mbou Essie Darius Gandou Paul Mouanga Alain Matini Prefina Gontran Ondzotto Ntsiba Honoré ibara jean-rosaire Faculty of Health Sciences Marien Ngouabi University Brazzaville Republic of the Congo General Management of Health Care Services Ministry of Public Health Brazzaville Republic of the Congo Department of Psychiatry Brazzaville Hospital and University Centre Brazzaville Republic of the Congo

Background: In Congo-Brazzaville, there is a lake of mental healthcare provider and facilities specialized on psychiatric care: only two psychiatrists and one psychiatric department around the country. Poor appreciation of their role and work environment can negatively impact the esteem of psychiatric staff and lead to stigma and discrimination towards patients. Aims: The study aimed to assess the perception of the staff of the only psychiatric service in Congo. Material and methods: We conducted a cross-sectional descriptive, prospective survey;conducted among the psychiatric staff of the Brazzaville University Hospital in September 2019. An anonymous individual questionnaire was administered to collect: 1) socio-professional data, 2) perceptions (assignment, role, workload and working conditions), and 3) identify the main problems of the service. Averages and frequencies were calculated on Epi info 7.***.2.6. Results: Thirty out of 42 staff had responded (71.4%);16 were male and at their first psychiatric assignment (28/30), with an average age of 44.7 ± 7 and seniority of 8.4 ± 8.3 years. Among them: one psychiatrist, two psychologists, and 19 nurses. Their assignment in psychiatry was well perceived in 93.3% (27/30), as well as their role (the importance of psychiatric care and psychiatry). Working conditions were perceived as poor: precarious hygiene (93.3%), cohabitation with dangerous patients (82.1%), heavy workload due to lack of staff (100%). Of their professional future, 23.3% (7/30) were considering leaving. Conclusion: Almost all psychiatric staff had a good perception of their role and psychiatry, but not of the working conditions. Local measures to improve working conditions must be carried out to improve the attractiveness of psychiatry and the quality of care.

关键词： Psychiatric Health Care Provider Working Conditions Perception Brazzaville

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Varioliform Gastritis after Ibuprofen Poisoning

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Open Journal of Gastroenterology 2018年第3期8卷 103-106页

作者： Atipo ibara Blaise Irénée Mongo Onkouo Arnaud Ahoui Apendi Clausina Atipo ibara Ollandzobo Lucie Charlotte Mimiesse Monamou Jile Florient Itoua-Ngaporo Akoa Ngala Deby Gassaye Bossali Firmin ibara jean-rosaire Faculty of Medical Sciences Marien Ngouabi University Brazzaville Congo Department of Gastroenterology and Internal Medicine Brazzaville University Hospital Centre Brazzaville Congo Paediatric Service Brazzaville University Hospital Centre Brazzaville Congo

Diffuse varioliform gastritis is a rare attack of the gastric mucosa occurring mostly on atopic ground. This report is based on the observation of a 16-year-old girl with diffuse varioliform gastritis discovered after an internal medical examination via endoscope after attempting a suicidal act by overdosing herself with Ibuprofen. After the medical examination of the patient. Despite the quantity of ingested ibuprofen and presence of Helicobacter pylori on the biopsie, the particularity of this study is that there is no exudative lesion of the gastric mucosa. With hélicobacter pylori eradication evolution was favorable.

关键词： Varioliform Gastritis Ibuprofen Teenager

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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 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

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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

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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

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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

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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

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Quality of Life of Chronic Kidney Disease Patients in the Republic of the Congo

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Open Journal of Nephrology 2021年第4期11卷 495-505页

作者： Gael Honal Mahoungou Daniel Tony Eyeni Sinomono Yannick Dimi Nyanga Tanee Fomum Steve Ondziel Opara Helena Botokoto Bothard jean Lucien Mobengo Richard Loumingou Blaise Iréné Atipo ibara Department of Nephrology University Hospital of Brazzaville Brazzaville Republic of the Congo Faculty of Heath Sciences University Marien Ngouabi Brazzaville Republic of the Congo Department of Urology University Hospital of Brazzaville Brazzaville Republic of the Congo Department of Gastroenterology University Hospital of Brazzaville Brazzaville Republic of the Congo

Background: Chronic kidney disease could impair the quality of life of patients regardless of the stage of the disease. So far, there is no data on this subject in the Congolese population. The objective of this study was to assess the quality of life of patients with chronic kidney disease in Congo. Patients and methods: We conducted a cross-sectional, descriptive study of 91 patients followed in the department of nephrology and in dialysis centers in Brazzaville, Pointe-Noire and Oyo from July 1st to November 30th, 2020, i.e. five months. We used the Kidney disease quality of life short form health survey score (KDQOL-SF 36) to assess the quality of life of patients and a questionnaire was used to determine socio-demographic, clinical and therapeutic features. Data analysis was done on SPSS 2.2 software. Result: The average age was 51.9 ± 15 years. The sex ratio M/F was 2.03. The average time of patient follow-up was 15 months;90% of them had hypertension. The overall average score of specific dimensions was 52 ± 18;disease burden was the dimension most affected;that of the generic dimensions was 34 ± 25 with the limitation of physical activity dimension being the most affected. No patient had received psychological follow-up. Conclusion: This study indicates the value of a systematic assessment of the quality of life of patients with chronic kidney disease as well as the need for assistance for these patients in different areas of their life.

关键词： Chronic Kidney Disease Quality of Life KDQOL

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Proteinuria in Children Living with HIV on Highly Active Antiretroviral Therapy (Haart)

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Open Journal of Pediatrics 2020年第2期10卷 255-262页

作者： Lucie Charlotte Ollandzobo Ikobo Roland Bienvenu Ossibi ibara Neli Yvette Ngakengni Laren Babomi Gaston Ekouya Bowassa Linda Tchidjo Ngamo Steve Vassili Missambou Mandilou Sabrina Nadia Bouithy Evrard Romaric Nika jean Robert Mabiala Babela Faculty of Health Sciences Marien Ngouabi University of Brazzaville Brazzaville Republic of Congo Pediatric Services Brazzaville University Hospital Brazzaville Republic of Congo Infectious Diseases Service Brazzaville University Hospital Brazzaville Republic of Congo Department of Neonatology Brazzaville University Hospital Brazzaville Republic of Congo Department of Internal Medicine and Cardiology Talangai Hospital Brazzaville Republic of Congo

Objective: To determine the prevalence of proteinuria in children living with HIV (CLHIV) and identify associated factors. Patients and methods: This was a cross-sectional, descriptive and analytical study carried out from April to August 2017 in the HIV care centres in Brazzaville and Pointe-Noire. The study included CLHIV with dipstick urinalysis test “Combur10 Test® M”. Results: Thirty seven CLHIV on HAART presented a proteinuria, 21.8%. Children were male gender in 21 cases (56.8%) and female gender in 16 cases (43.2%). Mean age was 10.9 ± 3.9 years. The children were infected with type 1 virus in 35 cases (94.6%), vertical transmission in all the cases (100%). Children were living with HIV for about 2 to 4 years of average n = 18 (48.6%) and they were WHO clinical stage 2 in 18 cases (48.6%). 13 children (35%) had CD4 level 3. All CLHIV (100%) were on HAART thus 20 (37.7%) on the combination of zidovudine (AZT), lamivudine (3TC) and nevirapine (NVP). This combination AZT, 3TC, NVP was a protective factor regarding the occurrence of proteinuria (OR: 0.43;IC (95%). Conclusion: Proteinuria

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