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Spontaneous Infection of Ascites Fluid at the National and University Hospital Hubert Koutoukou Maga in Cotonou: Prevalence and Associated Factors

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Open Journal of Gastroenterology 2024年第1期14卷 1-10页

作者： Aboudou Raïmi Kpossou Comlan N’dehougbèa Martin Sokpon Chloé Andréa Obekandon Opè Mahouton Jacques Tovizounkou Kadiatou Diallo rodolph koffi vignon Jean Séhonou University Clinic of Hepato-Gastroenterology National and University Hospital Hubert Koutoukou Maga (CNHU-HKM) Cotonou Benin University Clinic of Internal Medicine CNHU-HKM Cotonou Benin Department of Internal Medicine Donka National Hospital Conakry Guinea

Background: Spontaneous ascites fluid infection (SAFI) is an extremely serious and frequently encountered complication in cirrhotic patients. We aimed to determine the prevalence of SAFI and the factors associated with it in the largest hospital in Cotonou. Methods: This was a retrospective descriptive and analytical study conducted from January 2013 to July 2019, at the National and University Hospital Hubert Koutoukou Maga (CNHU-HKM) in Cotonou, Benin. All patients followed in the University Clinic of Hepato-Gastroenterology and diagnosed with SAFI were included. Results: Eighty-two patients were included, predominantly males (69.5%), with a mean age of 51.5 ± 14.5 years. Among them, 32 had SAFI, i.e., a prevalence of 39%. Of the 32 cases of SAFI, the culture of ascites fluid was positive in 6 cases (18.7%). The most frequent germ found in SAFI was Escherichia coli (5 patients, 83.3%). The factors associated with SAFI in this study were: abdominal pain (p = 0.004), increased bilirubinemia (p = 0.009), decreased prothrombin level 20 (p = 0.001). Conclusion: SAFI was common in cirrhotic patients in the department. Certain clinical and paraclinical factors were associated with it, as was the severity of cirrhosis. Early diagnosis and aetiological management of cirrhosis could reduce its frequency.

关键词： Ascites Infection Cirrhosis Cotonou

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Updated Review on the Panorama of Liver Diseases in Benin

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Open Journal of Gastroenterology 2023年第1期13卷 33-42页

作者： Jean Sehonou Aboudou Raïmi Kpossou Celia Rosemonde Ablavi Mouzouvi Comlan N’déhougbèa Martin Sokpon rodolph koffi vignon Hepato-Gastroenterology Department National and University Hospital Hubert Koutoukou Maga (CNHU-HKM) Cotonou Benin Republic Faculty of Health Sciences University of Abomey-Calavi Cotonou Benin Republic Galenic Pharmacy and Pharmaceutical Technology Laboratory Pharmacy Teaching and Research Unit Faculty of Health Sciences Cotonou Benin Republic

Introduction: The aim of this work was to take stock of the epidemiological aspects of liver diseases in Benin. Methods: Two methods were used: documentary research and collection of the position of gastroenterologists on the subject. For the literature search, the sources interviewed were Medline, African Journal On Line (AJOL), Google and Google scholar. Additional searches were made on the websites of European gastroenterology societies (AFEF, EASL). A collection of the opinions of gastroenterologists, most of them members of the Beninese Society of Hepato-gastroenterology was made. Results: From a nosological point of view, the most frequent and serious liver diseases in Benin are mainly infectious: viral hepatitis B and C (9.9% and 4.12% of the general population in 2013). Bacterial liver diseases (ascites fluid infections and tuberculosis of the liver) come in 3rd position after cirrhosis and hepatocellular carcinoma. Amoebic abscesses of the liver tend to regress. The toxic causes are dominated, in addition to alcoholic liver diseases (steatosis, cirrhosis), by drug lesions: two fatal cases of hepatotoxicity by artesunate-amodiaquine combination and asymptomatic and transient cytolysis in 23.8% of 63 children less than 5 years old treated with arthemether-lumefantrine combination have been described. Phytotherapy, alone or in combination with modern drugs, can in some cases be hepatotoxic. Plants with recognized medicinal virtues (may be harmful to the liver (Senna, Moringa oleifera, tamarind). Chronic aflatoxicoses secondary to the consumption of contaminated food (maize, cassava or peanuts) are relatively under-documented. Overload diseases (in particular alcoholic or non-alcoholic fatty liver) are on the increase (3.19% of 662 ultrasounds in 1995 against 14.5% of 411 in 2011 in Cotonou) partly due to the demographic and nutritional transition underway in Benin. These diseases, often blamed on spells cast, lead to hospital deaths from cirrhosis or hepatocel

关键词： Viral Hepatitis Drug-Induced Hepatitis Benin Viral Hepatitis Toxic Hepatitis

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Functional Constipation in the General Population in Cotonou:Prevalence and Associated Socio-Demographic Factors

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Open Journal of Gastroenterology 2018年第9期8卷 306-316页

作者： Jean Sehonou Aboudou Raimi Kpossou Comlan N’dehougbea Martin Sokpon Hugues Cataria Colette Azandjeme koffi rodolph vignon Department of Gastroenterology and Hepatology National University Hospital Center-Hubert Koutoukou Maga(CNHU-HKM)CotonouBenin Regional Institute of Public Health(IRSP) OuidahBenin

Background: Constipation is considered rare in sub-Saharan Africa because of the high fiber content of the local diet. However, certain factors could intervene in this pathology. The purpose of this study was to assess the prevalence of constipation in the general population in Cotonou and to determine the associated socio-demographic factors. Methods: This was a cross-sectional descriptive and analytical study conducted from July to August 2017 in 7 districts of the township of Cotonou, according to a cluster sampling. We included anyone over the age of 15 living in the city of Cotonou for at least 6 months. Constipation was either self-reported or functional (meeting the Rome IV criteria). Results: A total of 1058 participants were included: 574 men (sex ratio of 1.2), mean age of 29 years [range 15 - 92]. Self-reported constipation was noted in 512 patients (48.5%). It was functional in 256 cases (24.2%). In the latter category, there was a predominance of women (138, 53.9%), of secondary education (46.5%), of self-employed professionals (50.4%), from the Ouémé-Plateau (41.8%). Were associated with the occurrence of functional constipation (univariate analysis), age ≥ 60 years (p = 0.049), female gender (p = 0.003), and subjects living alone (166, 64.8%) vs. those living in a relationship (90, 35.2%, p = 0.001). Conclusion: Constipation was not as rare in Cotonou. It was more common in women, subjects over 60 years old or living alone.

关键词： Constipation General Population Prevalence Associated Factors Cotonou

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Effectiveness and Safety of Tenofovir Disoproxil Fumarate in Patients Treated for Hepatitis B in the National University Hospital of Cotonou

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Open Journal of Gastroenterology 2018年第6期8卷 213-222页

作者： Jean Sehonou Aboudou Raimi Kpossou Samuel Guido Comlan N’dehougbea Martin Sokpon koffi rodolph vignon Jacques Vigan Department of Gastroenterology and Hepatology National University Hospital Center-Hubert Koutoukou Maga(CNHU-HKM)of CotonouCotonouBenin Department of Nephrology-Hemodialysis CNHU-HKM of CotonouCotonouBenin

Introduction: Viral hepatitis B (VHB) is a serious and global public health issue, particularly in sub-Saharan Africa where it is endemic. The objective of this work was to evaluate the effectiveness and safety of tenofovir disoproxil fumarate (TDF) in the treatment of chronic VHB in Cotonou. Methods: This was a descriptive cross-sectional study with a retrospective collection of data from January 1st, 2015 to December 31st, 2016 (24 months) and prospective from May to August 2017 (4 months). Chronic VHB patients treated with TDF for at least 6 months were included. The non-detectability of HBV DNA and the normalization of aminotransferases defined the virological and biochemical responses, respectively. The evaluation of the treatment response on liver fibrosis was done by using APRI score. Renal impairment was assessed by a reduction in glomerular filtration rate according to MDRD (Modifications of the Diet in Renal Disease) formula below 90 mL/min/1.73 m2. Results: In all, 42 patients treated with TDF were included. The average age was 46.7 ± 13.8 years. The study population was predominantly male with a sex ratio of 2.5. Among the 42 patients treated with TDF for an average of 60 weeks (24 to 96 weeks), 36 patients (85.7%) had a virological response;21 patients (50%) had a biochemical response. Virologic response was 70% at week 24 (W24), 92.6% at W48, 87.5% at W72 and 100% at W96 without significant difference between W24 and W48;between W48 and W72 then between W72 and W96. There was a regression of fibrosis and cirrhosis but not significantly. Renal involvement occurred in 3 out of 19 cases (15.8%) including a case of chronic end stage renal failure and 2 cases of mild chronic renal failure. Conclusion: The treatment with TDF is effective and globally safe in our patients with chronic viral hepatitis B in Cotonou.

关键词： Chronic Viral Hepatitis B Tenofovir Efficacy Safety Cotonou

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Viral Hepatitis C during a Screening Campaign in General Population of Benin: Seroprevalence and Associated Factors

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Open Journal of Epidemiology 2021年第2期11卷 178-188页

作者： Moussiliou Noel Paraiso Aboudou Raïmi Kpossou Comlan N’dehougbèa Sokpon Hervé Lawin Cédric Bigot rodolph koffi vignon René Keke Regional Institute of Public Health Ouidah Benin Faculty of Health Sciences University of Abomey-Calavi Abomey-Calavi Benin National and University Hsopital Hubert Koutoukou Maga of Cotonou Cotonou Benin

Introduction: Hepatitis C is a global public health problem. The purpose of this study was to determine the prevalence and factors associated with hepatitis C virus (HCV) antibody carriage during mass screening in several localities throughout Benin. Methods: This was a descriptive and analytical cross-sectional study with prospective data collection. This collection took place from 20 to 28 July 2019 at a free voluntary hepatitis C screening organized in Benin by Rotary Clubs in 23 sites throughout the country. A rapid diagnostic orientation test was used for the detection of anti-HCV antibodies. Results: A total of 9035 voluntary participants were included, mostly of Beninese nationality (99.0%), with a median age of 27 years, of whom 51.1% (4619/9035) were single and mainly schoolchildren, pupils or students (37.9%;3426/9035). HCV seroprevalence was 1.0% (87/9035) [95% CI = 0.8% - 1.2%]. This infection was associated with age greater than 42 years (ORa = 2.71;95% CI: 1.06 - 6.95), p Conclusion: HCV antibody seroprevalence is relatively low in the study population: 1%. Factors associated with HCV antibody carriage were age, occupation and diabetic history.

关键词： Hepatitis C Virus Epidemiological Profile Benin

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Treatment of Hepatitis C with Pegylated Interferon Alpha-2a and Ribavirin:Experience from Benin

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Open Journal of Gastroenterology 2018年第8期8卷 275-283页

作者： Aboudou Raimi Kpossou Jean Séhonou Gbénagnon Micael Geraud Adjigbe rodolph koffi vignon Khadidjatou Sake Alassan Nicolas Kodjoh Department of Gastroenterology and Hepatology National University Hospital Center-Hubert Koutoukou Maga(CNHU-HKM)CotonouBenin Internal Medicine Unit University and Departmental Hospital of Borgou-AliboriParakouBenin Clinic Les Archanges Seme KpodjiBenin

Background: Viral hepatitis C (HCV) is common in Benin. Untreated, it can be complicated by cirrhosis and hepatocarcinoma, which are sources of death. The objectives of this work were twofold: 1) to evaluate the effectiveness and safety of treatment with classic dual interferon pegylated alpha-2a (IFN) and ribavirin therapy in Benin, and 2) to present problems related to financial accessibility to this treatment. Methods: This was a cross-sectional, descriptive and analytical study, with a retrospective collection of data from November 1, 2010 to December 31, 2015 and prospective collection from January 1, 2016 to July 31, 2016 (7 months). We included all patients treated with IFN + ribavirin for hepatitis C at CNHU/HKM. Sustained virological response (SVR) was defined as undetectable viral load C 6 months after stopping treatment. Safety was appreciated by the search for clinical and hematological adverse effects. Results: One hundred and six patients were followed for HCV, of whom 58 (54.7%) undergoing treatment (26 under standard dual therapy and 32 under direct-acting antivirals). Of the 26 patients under-conventional dual therapy, 12 (46.1%) were genotype 1, 13 (50%) genotype 2 and one (3.9%) genotype 4. In conventional dual therapy, SVR was achieved in 15 (57.7%) patients, including the genotype 4 patient, 4 out of 12 (33.3%) genotype 1 patients, and 10 out of 13 (76.9%) for genotype 2 patients. The most common side effects with this treatment were severe asthenia (23 cases), flu-like symptoms (22 cases), weight loss (21 cases) and neutropenia (22 cases), anemia and thrombocytopenia (20 of 26 cases). The overall cost of treatment per patient was 11,800,624 FCFA for genotypes 1 and 4;and 7,835,048 FCFA for genotype 2. Conclusion: The treatment of HCV with IFN + ribavirin in Benin is effective for genotype 2. But its adverse effects are manifold and its cost is high. The switch to direct-acting antivirals (more effective, better tolerated and less expensive) was

关键词： Hepatitis C Pegylated Interferon Alpha-2a Ribavirin Effectiveness Safety Cost

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Typical Gastroesophageal Reflux Disease in the General Adult Population in Cotonou: Prevalence and Associated Socio-Demographic Factors

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Open Journal of Gastroenterology 2021年第2期11卷 29-38页

作者： Aboudou Raïmi Kpossou rodolph koffi vignon Sewedo Aurel Chavelin Gnahoui Comlan N’déhougbèa Martin Sokpon Carin Ahouada Colette Azandjèmè Jean Séhonou Hepato-Gastroenterology Department National and University Hospital Hubert Koutoukou Maga (CNHU-HKM) Cotonou Benin Republic Medicine Department Allada Zone Hospital Allada Benin Republic Regional Institute of Public Health (IRSP) Ouidah Benin Republic

Introduction: Gastroesophageal Reflux Disease (GERD) is a common benign condition with a worldwide prevalence of between 5% and 45% in the adult population. Its prevalence in the general population is little known in Africa. The aim of this work was to study the prevalence of typical GERD in the general adult population of a large city and the associated socio-demographic factors. Patients and Methods: This was a prospectively collected, descriptive and analytical cross-sectional study that was conducted over a one-month period (June 2018). We included any person residing in the city of Cotonou for at least 6 months, aged 15 years or older, who had given consent for the study. The two-stage cluster sampling technique was used. The dependent variable was the typical gastroesophageal reflux defined by the heatburn-regurgitation association. Results: We had included 728 subjects. Of these, 255 had a typical GERD, i.e. a prevalence of 35%. The mean age of the respondents was 31.9 ± 13.2 years with extremes of 15 and 88 years. There were 379 men (52.1%) with a sex ratio of 1.08. The study population was represented respectively by artisans (29.3%), students (26.6%) and traders/dealers (20.3%). In terms of marital status, there were as many married and single subjects (48.2%). In addition, 47% of the study population had a body mass index of less than 25 kg/m

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Hepatitis D in Patients Infected with Hepatitis B Virus in Cotonou:Characteristics and Risk Factors

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Open Journal of Gastroenterology 2020年第2期10卷 31-44页

作者： Aboudou Raimi Kpossou Frédéric Sogbo Alexandra Marilyn Oloukèmi Zomahoun Khadidjatou Sake Alassan rodolph koffi vignon Comlan N’déhougbèa Martin Sokpon Fadel Sourokou Jean Séhonou Nicolas Kodjoh Dissou Affolabi Faculty of Health Sciences University of Abomey-Calavi(UAC)Abomey-CalaviBenin National and University Hospital Hubert Koutoukou Maga(CNHU-HKM) CotonouBenin Department of Internal Medicine University and Departmental Hospital of BorgouParakouBenin International Clinic of Cotonou Aupiais CotonouBenin National Hepatitis Control Program Ministry of HealthCotonouBenin

Introduction: Hepatitis D virus (HDV) is a satellite virus of hepatitis B virus (HBV). The purpose of this work was to describe the epidemiological, clinical and biological characteristics of HBV/HDV co-infection and the factors associated with this co-infection in Cotonou. Methods: This was a cross-sectional, descriptive study with prospective data collection. It took place from June to October 2016 at CNHU/HKM and the Atinkanmey Polyclinic in Cotonou. Subjects over 15 years of age with HBsAg and untreated for hepatitis were included consecutively. Sociodemographic, clinical and biological characteristics were collected for each patient using only a standardized questionnaire. Then, a blood sample was taken for the determination of anti-HDV antibodies as well as the viral load of HBV. Results: A total of 156 subjects were included, predominantly male (sex-ratio = 2), and of median age 36 years. The majority were monogamous married (50%) or single (41.7%), and were from south of Benin (84.6%). Most subjects were asymptomatic (49.4%). The prevalence of total HDV antibodies was 3.9% (6/156). In subjects with total HDV antibodies, the prevalence of HDV IgM was 33.3%. Origin in northern Benin appears to be a risk factor for HDV infection (p = 0.042). Similarly, married subjects were statistically more infected with HDV than unmarried subjects (p = 0.002). Conclusion: The prevalence of HDV infection varies according to the origin of the patients and their marital status.

关键词： Viral Hepatitis B Viral Hepatitis D Prevalence Associated Factors

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Irritable Bowel Syndrome in General Population of Cotonou: Prevalence and Associated Factors

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Open Journal of Gastroenterology 2023年第3期13卷 117-130页

作者： Comlan N’déhougbèa Martin Sokpon Aboudou Raïmi Kpossou Spéro Ludwig Kpèssou Aden-Henri rodolph koffi vignon Jean Louis Savi de Tove Akuvi Claude Gildas Adossou Colette Sylvie Azandjèmè Jean Séhonou Hepato-Gastroenterology Department National and University Hospital Hubert Koutoukou Maga (CNHU-HKM) Cotonou Benin Clinique Santé du Sud Cotonou Benin Saint Vincent Hospital Worcester USA Regional Institute of Public Health (IRSP) Ouidah Benin

Introduction: Irritable bowel syndrome (IBS) is a known public health burden in western countries while only a few studies have been published on this disease in Africa. The objective of this study was to determine the prevalence of IBS in the general adult population of Cotonou (Benin), its associated risk factors and its impact on patients’ daily life. Method: This was a descriptive and analytical cross-sectional study conducted over one month. Data was collected via a questionnaire. IBS was defined by the Rome IV criteria. Results: A total of 768 participants were included, with a male predominance (sex ratio 1.8). The mean age of the participants was 30.6 years, with extremes of 15 to 76 years. The prevalence of IBS in our study was 4.2%. IBS-D was the most common subtype (34.4%). IBS symptoms were influenced by diet (46.9%), stress (31.3%) and lack of sleep (15.6%). In the univariate analysis, the risk factors associated with IBS were: Dendi and Otamari ethnicity (p = 0.015), low level of education (p = 0.047), family history of IBS (p = 0.026), smoking (p Conclusion: Despite IBS frequency, patients with IBS rarely seek medical attention. The public should therefore be informed about this condition to reduce its impact on their daily life.

关键词： IBS Rome IV Criteria Associated Factors Cotonou Benin

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