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Open Journal of Blood Diseases 2020年第2期10卷 41-47页

作者： lydie ocini ngolet Vulliez Renucci Nkounkou Blaise Atipo Ibara Alexis Elira Dokekias Department of Medical Hematology University Hospital of Brazzaville Brazzaville The Republic of the Congo Department of Internal Medicine and Gastroenterology Unit University Hospital of Brazzaville Brazzaville The Republic of the Congo

Background: There are no consensual diagnosis criteria to make diagnosis of sickle cell intrahepatic cholestasis and identify its 2 variants. Here we delineate the frequency of the complication in its severe form and describe its clinical features. Methods: We included in the study all the patients with sickle cell disease who were presenting fever, jaundice, pain in the upper right quadrant and filling up the biological criteria of the severe sickle cell intrahepatic cholestasis (serum direct bilirubin ≥ 78.5 mg/dL). Patients with evidence of viral hepatitis or gallstones were not included in the study. Results: Sixty-two patients with an average age of 21.5 years (range 18 and 25 years) meet the inclusion criteria, minimum serum direct bilirubin: 82 versus 528 for the maximum. The liver cytolysis was major and ranged from 310 to 1550 UI/L. Forty-nine patients (83.9%) did not develop any organ failure. The symptoms and biological abnormalities resolved with supportive treatment within 7 days. The global lethality was 16.1% associated with liver failure. Conclusion: Severe sickle cell intrahepatic cholestasis is more frequent than we thought and was mainly represented by borderline clinical feature. Early intervention may reduce the progression to organ failure stage and ultimate death.

关键词： Sickle Cell Disease Serum Direct Bilirubin Borderline Clinical Feature

Evolution of the Outcomes of Children with Acute Leukemia in Congo

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Open Journal of Blood Diseases 2022年第1期12卷 1-9页

作者： lydie ocini ngolet Simo Josué Luokdom Alexis Fortuné Bolenga Liboko Firmine Olivia Galiba Atipo Tsiba Alexis Elira Dokekias Department of Medical Hematology Teaching Hospital Brazzaville Congo Pharmacy Department University of Mountains Banganté Cameroon Department of Oncology Teaching Hospital Brazzaville Congo

Background: To lower the mori-mortality related to the aggressiveness of acute leukemia’s chemotherapy regimens, we have implemented in 2017 two low toxicity chemotherapy regimens and new supportive care strategies. The aim of the study is to evaluate our new treatments. Materials and Method: A retrospective study was carried out from January 2014 to May 2021 in the hematology department of the teaching hospital in Brazzaville. The study concerned 47 children diagnosed with acute leukemia. Participants were divided into two groups: acute leukemia diagnosed before 2017 (group 1: 23 children) and after 2017 (group 2: 14 children). They were compared using the chi-square. Results: The median age was 10.0 ± 5.01 years. Features and outcomes of group 2 were better. The median duration of symptoms was shorter: 2.45 ± 2.87 months (p = 0.036). The Karnosky score was higher (p = 0.002) and white blood cell count lower (p = 0.331). Both groups started the treatment with a delay of 6 days. The induction treatment was completed in 69.6% before 2017 versus 93.3% after. The rate of relapse was more important for group 1: 85.7% versus 14.3% (p = 0.01). Conclusion: Trainings of professionals have improved the characteristics outcomes of our patients and should be pursued. Considering the high relapse rate, our protocol will need to be intensified.

关键词： Childhood Acute Leukemia Outcomes

Correlation between Pubertal Delay in Adolescents with Homozygous Sickle Cell Disease and Socio-Demographic, Clinical Factors

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Open Journal of Endocrine and Metabolic Diseases 2023年第10期13卷 173-190页

作者： Nestor Ghislain Andzouana Mbamognoua John Claude Edzan Farel Ongoth Elilie Mawa Judicael Kambourou lydie ocini ngolet Henri Germain Monabeka Department of Metabolic and Endocrine Diseases Brazzaville University Hospital Brazzaville Congo Faculty of Health Sciences Marien Ngouabi University Brazzaville Congo Pediatric Intensive Care Department Brazzaville University Hospital Brazzaville Congo Hematology Department Brazzaville University Hospital Brazzaville Congo

Introduction: Pubertal development is a process leading to the acquisition of reproductive capacities. Among the factors that inhibit pubertal development are chronic diseases including sickle cell anemia, which is a public health problem. Objectives: Describe the sociodemographic and clinical characteristics of adolescents with sickle cell disease. Report the prevalence of abnormalities of pubertal development. Identify associated factors that delay pubertal development. Patients and Methods: This was a multicenter analytical cross-sectional study over 7 months at the National Reference Center for Sickle Cell Disease and, at the Brazzaville University Hospital. It concerned adolescents with sickle cell disease aged between 10 to 19 years. The study focused on the sociodemographic characteristics of adolescents, the natural history of sickle cell anemia and the evaluation of secondary sexual characteristics using the Tanner classification. Nutritional status was assessed by calculating body mass index (BMI) and height/age and weight/age ratios. Results: Of the 347 adolescents included, the average age of the adolescents was 15.1 ± 2.5 years, 56.5% had normal puberty, 42.6% had delayed puberty and 0.9% had impuberty. The associated factors were under-nutrition with less than 3 meals/day (p = 0.0000), social status with more marked pubertal delay in orphans (p = 0.00127), more than 5 hospitalizations per year (p = 0.0013), pubertal delay was statistically significant in adolescents who had more than 3 vaso-occlusive crises (p = 0.0000), and those who had more than 5 blood transfusions since the discovery of the disease (p = 0.0127). Conclusion: The factors that hinder pubertal development in sickle cell patients are intrinsic (sickle cell anemia with its complications) and extrinsic (environmental: diet, social status). The appearance of secondary sexual characteristics is delayed on average by two years compared to the general population.

关键词： Development Puberty Adolescent Sickle Cell Disease Homozygous Brazzaville

Epidemiological and Prognostic Aspects of Anemia during Heart Failure in Brazzaville (The Republic of the Congo)

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World Journal of Cardiovascular Diseases 2023年第7期13卷 396-403页

作者： Stéphane Méo Ikama Joffode Mobet Memougame Thibaut Oko Jospin Jospin Makani lydie ocini ngolet Bijou Moualengue Eric Gibrel Kimbally Kaky Thibaut Gankama Suzy Gisèle Kimbally Kaky Department of Cardiology University Hospital Center of Brazzaville Brazzaville The Republic of the Congo Department of Hematology Laboratory University Hospital Center of Brazzaville Brazzaville The Republic of the Congo Department of Clinical Hematology University Hospital Center of Brazzaville Brazzaville The Republic of the Congo

To improve the management of patients with heart failure and anemia at the University Hospital of Brazzaville, a cross-sectional study of patients diagnosed with heart failure condition (left or global heart failure) was conducted over a period of nine months from January 1 to September 30, 2017. A total of 171 patients were included during the study period. Study participants were divided into two groups: Group A included patients with an additional anemic condition (n = 57) and Group NA patients without anemia (n = 114). Anemia was defined as a hemoglobin rate of < 12 g/dL for men and <11 g/dL for women. All eligible patients admitted to the Department of Cardiology were included in the study. The frequency of anemia was 33.3%, with a mean hemoglobin level of 9.4 ± 1.5 g/dL. Men accounted for 46.9% of cases (n = 79) and women 53.8% (n = 92). The mean age of eligible patients was 57.5 ± 16.5 years. Of these, 46.2% (n = 75) had a secondary educational level and 53.8% (n = 92) had a low socioeconomic status. Heart failure was global in 153 cases (89.5%). Patients were on NYHA III-IV functional class in 112 cases (65.5%), with a statistically significant difference between anemic and non-anemic patients (p = 0.0001). The main underlying heart diseases were dilated cardiomyopathy (75.1%), hypertensive heart disease (10.5%), ischemic heart disease (6.5%), and valvular disease (4.7%). The comparison between the two groups (A and NA) showed a longer hospital length of stay (18.4 ± 8.9 versus 12.9 ± 7.6 days;p = 0.00001) and a higher mortality rate (4 versus 2 deaths). The re-hospitalization rate was more important in group A (n = 4) than in group NA (n = 1). Anemia is a common condition in patients with heart failure. It worsens the clinical features and prognosis.

关键词： Anemia Heart Failure Frequency Prognosis The Republic of the Congo

Aetiologic Factors of Anemia During Heart Failure in Brazzaville (The Republic of the Congo)

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World Journal of Cardiovascular Diseases 2023年第9期13卷 605-612页

作者： Stéphane Méo Ikama Joffode Mobet Memougame Jospin Makani Thibaut Oko Eric Gibrel Kimbally Kaky lydie ocini ngolet Bijou Moualengue Thibaut Gankama Suzy Gisèle Kimbally Kaky Department of Cardiology University Hospital Center of Brazzaville Brazzaville The Republic of the Congo Department of Hematology Laboratory University Hospital Center of Brazzaville Brazzaville The Republic of the Congo Department of Clinical Hematology University Hospital Center of Brazzaville Brazzaville The Republic of the Congo

To contribute to improving the management of patients with heart failure and anemia in Brazzaville, a prospective and descriptive study was conducted in the University Hospital of Brazzaville for nine months (January 1st to September 30, 2017). Included 57 patients hospitalized for left or global heart failure and presenting anemia. Anemia was defined by an haemoglobin level < 12 g/dL in men and <11 g/dL in women. Proportionings of the reticulocytes rate, serum iron, ferritin, erythrocyte sedimentation rate (ESR) and/or C-reactive protein (CRP), electrophoresis of proteins, and evaluation of renal function by glomerular filtration rate (GFR), as well as the treatments of heart failure, and the auxiliary therapeutic ones, in particular the antithrombotic drugs, allowed aetiologic research. They were 20 men (35%) and 37 women (65%), old on average of 59 ± 17 years. The average rate of haemoglobin was 11.4 ± 1.4 g/dL. Heart failure was de novo in 24 cases (42.1%), old in 33 cases (57.9%);it was global in 54 cases (94.7%).The maintenance treatment associated diuretics in 32 cases (97%), angiotensin-converting enzyme inhibitor (ACEI) or angiotensin II receptor blocker (ARB) in 31 cases (94%), beta-blockers in two cases (6.1%), digoxin in four cases (12.1%), aspirin in five cases (15.1%) and anti-vitamin K in four cases (12.1%). Anemia was microcytic hypochromic in 30 cases (52.6%), normocytic normochromic in 20 cases (35.1%), and macrocytic normochromic in one case (1.7%). The main aetiologic factors were hemodilution in 46 cases (80.7%), renal insufficiency in 30 cases (52.3%), inflammation in 29 cases (50.8%), and iron deficiency in one case (1.7%). The HIV serology, carried out in 11 cases, was negative. Anemia is a frequent comorbidity among heart failure patients. Aetiologic research remains difficult in our context, and its often multifactorial origin.

关键词： Anemia Heart Failure Aetiologies Congo