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Knowledge, Attitudes and Perceptions of Colorectal Cancer Screening in Brazzaville

Open Journal of Gastroenterology 2024年第11期14卷 414-430页

作者： Clausina Mikolélé Ahoui Apendi Jhonsial Joseph Bovane Molami Aranud Mongo-Onkouo Jile Florient Mimiesse Monamou Rody Stéphane Ngami mardochée motoula latou Ngala Akoa Itoua-Ngaporo Marlyse Ngalessami Mouakosso Céline Sandra Adoua Deby Gassaye Blaise Irenée Atipo 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

Objective: assess the knowledge, attitudes, and perceptions of Brazzaville residents on colorectal cancer and its screening. Population and Methods: a CAP-type cross-sectional study was conducted from June 1 to October 31, 2022, with 803 workers approached at their place of service. Information was collected using a questionnaire administered to participants. The variables studied concerned knowledge, attitudes, and perceptions about colorectal cancer. SPSS software, along with Chi-square and Fisher tests, was used for data entry and analysis. Odds ratios were calculated to determine the strength of the association between variables. Results: The average age of the participants was 33.5 ± 10 years, with a sex ratio of 0.9. There were 231 health workers. The main sources of information were health personnel (78.2%) and the internet (52.6%). The site of the pathology was known to 87% of participants. About 40% identified age, genetic predispositions, and a diet rich in animal fats as risk factors. No signs of the disease were known by 50% of the participants. Colonoscopy was known as a screening method by 40% of participants. Seventy-five percent were willing to participate in a CRC awareness campaign, but only 5% agreed to a screening colonoscopy, although 96% recognized its usefulness. Overall, the level of knowledge was insufficient in 70.4% of cases;attitudes were adapted in 55.7% of cases, and perceptions were adapted in 97.3% of cases. Factors influencing knowledge included young age (p = 0.006), a good level of education, being a healthcare worker, and high socio-economic level. Conclusion: colorectal cancer and its screening are poorly understood by the population. Awareness activities must be organized to improve knowledge and promote screening and early diagnosis of CRC.

关键词： Colorectal Cancer Screening Knowledge Attitudes Perceptions Brazzaville

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

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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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Midwives’s Knowledge and Practice in Preventing Mother-to-Child Transmission on Hepatitis B Virus in Brazzaville in 2023

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Open Journal of Gastroenterology 2023年第12期13卷 439-446页

作者： Rody Stéphane Ngami Philestine Clausina Ahoui Apendi Mikolélé Marlyse Ngalessami Mouakosso Michelle Nzoumba Jackson Albert Otia Pérès mardochée motoula latou Ngala Akoa Itoua-Ngaporo Samantha Potokoué Sékangué Jile Florient Mimiesse Arnaud Mongo Onkouo Deby Gassaye Blaise Irénée Atipo Ibara Department of Gastroenterology and Internal Medicine University Hospital Center Brazzaville Republic of Congo Faculty of Health Sciences Marien Ngouabi University Brazzaville Republic of Congo Department of Gynecology and Obstetrics University Hospital Center Brazzaville Republic of Congo

Background: Maternal-fetal transmission is the most frequent mode of hepatitis B virus (HBV) contamination in Africa. Prevention of mother-to-child transmission (PMTCT) of hepatitis B is still poorly understood, and training of the health workers involved, such as midwives, is rare. Objective: The aim of this study was to assess the knowledge and practices of midwives prevention of HBV’ mother-to-child transmission (PMTCT) in Brazzaville. Patients and Methods: This was a cross-sectional analytical study conducted in Brazzaville from June 1 to July 31, 2023. Midwives present at the time of the survey in the various Brazzaville health centers visited and who agreed to answer the questionnaire during a face-to-face interview with the investigator were included. Univariate analyses were performed using epi info7.2 software. Pearson’s chi-square and Student’s t-tests were used to compare proportions and means, which were significant at the 0.05 level. Results: At the end of our study, 93 midwives out of 127 agreed to take part in the study, i.e. a participation rate of 73.2%. Their median age was of 41.7 years, a median professional experience of 13.7 years, and they worked mainly in primary health care facilities. Global knowledge of HBV PMTCT was satisfactory in 51 (54.3%) midwives. Knowledge of the HBV vaccine was significantly related to professional experience (p = 0.0167). PMTCT practice was poor in 48 (51.6%) cases. Overall, the practice of PMTCT was statistically associated with the midwives’ place of practice (p = 0.0262). Conclusion: Midwives had good knowledge but insufficient practice of PMTCT in Brazzaville. Training and awareness-raising are needed to reduce mother-to-child transmission of HBV.

关键词： Viral Hepatitis B Midwifery Knowledge and Practice

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Charactistics of Anemia in Cirrhotics in the Gastroenterology Department at Brazzaville University Hospital

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Open Journal of Gastroenterology 2024年第11期14卷 402-413页

作者： Clausina Mikolélé Ahoui Apendi Daulores Sylavnie Abena ebembe Ngala Akoa Itoua-Ngaporo Jenny Carmela Angala Andzi Arnaud Mongo-Onkouo Jile Florient Mimiesse Monamou Rody Stéphane Ngami mardochée motoula latou Marlyse Ngalessami Mouakosso Céline Sandra Adoua Deby Gassaye Blaise Irenée Atipo 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

Objective: Study of the frequency of anemia, its characteristics and its relationship with different epidemiological, diagnostic and prognostic parameters of cirrhosis. Patients and methods: This was a retrospective descriptive study from January 2016 to December 2019 in the Gastroenterology and Internal Medicine department at the Brazzaville University Hospital. It concerned all cirrhotics hospitalized during the study period and presenting anemia. The epidemiological, diagnostic, and prognostic data studied were collected from medical records. The characteristics of anemia on the blood count were defined based on WHO values. The information collected was entered and processed with excel 8.0 and ePI data 3.1 software. The Pearson chi2 test at the significance level ≤ 5% was used to compare the results. Results: We collected 102 files of cirrhotic patients during the study period. There were 63 men and 39 women, a sex ratio of 1.6. Among these patients, 77 presented anemia, i.e., a frequency of 75.5% with a male predominance (57.2%). Anemia increased without a significant relationship with age and was more severe in young female subjects (42.8%). The normochromic normocytic character was the most observed (52%). Anemia was more frequent in post-hepatitic cirrhosis, representing 67.5% of cases of anemia. It worsened during digestive bleeding, with the abundance of ascites and the severity of hepatic encephalopathy (p > 0.05). It was significantly associated with the drop in prothrombin level (63.6%), hypoalbuminemia (64.9%), and the Child-Pugh score (p < 0.05).

关键词： Anemia Cirrhosis CHU Brazzaville

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Cardiovascular Disorders in Cirrhosis at the Brazzaville Teaching Hospital in 2022

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Open Journal of Gastroenterology 2023年第11期13卷 369-376页

作者： Rody Stéphane Ngami Philestine Clausina Mikolele Ahoui Apendi Relda Itoko Okombi Christian Kouala Landa Marlyse Ngalessami Mouakosso Bénédicte Ahombo Niotsombe Ngala Akoa Itoua-Ngaporo Pérès mardochée motoula latou Jile Florient Mimiesse Monamou Arnaud Mongo-Onkouo Deby Gassaye Blaise Irénée Atipo Ibara Department of Gastroenterology and Internal Medicine University Teaching Hospital Brazzaville Republic of the Congo Faculty of Health Sciences Marien Ngouabi University Brazzaville Republic of the Congo Department of Cardiology and Internal Medicine University Teaching Hospital Brazzaville Republic of the Congo

Cirrhosis is a liver disease that can lead to cardiovascular lesions that are often asymptomatic but potentially fatal. Objective: The aim of this study was to evaluate electrical and echographic cardiovascular abnormalities during cirrhosis at the Brazzaville University Hospital. Patients and Methods: We conducted a cross-sectional analytical study over a 2-year period at the Brazzaville Universitary Hospital. Cirrhotic patients at least 18 years of age who had undergone electrocardiogram and echocardiography were included. Patients with cardiac cirrhosis, hepatocellular carcinoma or spontaneous bacterial peritonitis were excluded. The outcome variables were cardiac electrical and echographic abnormalities. Data were analyzed using epi info 7.2 software. Pearson’s chi-square, Fisher’s exact and Student’s exact tests were used to compare proportions and means at a significance level of 0.05. Results: A total of 76 cirrhotic patients were recruited out of 186 patients, i.e. 40.9% of cirrhotic patients. There were 48 men and 28 women, for a sex ratio of 1.7. The median age was 56 (IQR 41.5 - 69.0). QTc prolongation, microvoltage and sinus tachycardia were the most frequent electrical disorders, respectively in 19 (29.7%), 11 (17.2%) and 11 (17.2%) cases. electrical disorders were statistically related to cirrhosis stage (p = 0.0364). The most frequent ultrasound disorders were left ventricular systolic failure 11 (28.9%) and dilated cardiomyopathy 8 (21.1%). Seven (9.2%) patients had high pulmonary arterial pressure. Death, observed in 12 cases (15.8%), was statistically linked to the presence of echocardiographic disorders (p = 0.0089) and congestive heart failure (p = 0.0001). Conclusion: The search for cardiac disorders should be systematic during decompensated cirrhosis to detect potentially fatal abnormalities.

关键词： Cirrhosis eCG echocardiography Cardiovascular Disorders

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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

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Humoral Response and Tolerance of Vaccination against SARS-CoV-2 in Adults Senegalese Patients Undergoing Hemodialysis: A Multicenter Prospective Study

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Open Journal of Nephrology 2024年第1期14卷 70-80页

作者： Lot Nehemie motoula latou Moustapha Mbow Modou Ndongo Gnagna Faye Gora Lo Sidy Mohamed Seck Department of Nephrology and Dialysis Military Hospital of Ouakam Dakar Senegal Immunology Laboratory Military Hospital of Ouakam Dakar Senegal Department of Nephrology and Dialysis Regional Hospital of Kedougou Kedougou Senegal Department of Nephrology Idrissa Pouye General Hospital Dakar Senegal Bacterioloy and Virology Laboratory CMIA Dakar Senegal IRL-3189 eSS/UGB/CNRS/UCAD/CNRST/USTB Faculty of Health Sciences University Gaston Berger Saint-Louis Senegal

Introduction: Following the COVID-19 pandemic, vaccination has been proposed in several countries as the main preventive measure despite very limited data, particularly in dialysis patients. We conducted this study to assess the immunological response to vaccination in Senegalese hemodialysis patients. Patients and Methods: We conducted a prospective study, in two dialysis centers in Dakar from March 30th to August 30th, 2021 including patients on hemodialysis for >6 months, vaccinated against SARS-CoV-2 according to the vaccination schedule recommended by WHO. A vaccine response was considered positive when seroconversion was observed after one dose of vaccine. The clinical efficacy of immunization was defined as the absence of new COVID-19 infection in patients who received a complete vaccination. Results: Among the 81 patients included in the study, 7.4% had anti-Spike IgM antibodies before their first vaccination. Seroprevalence of IgM antibodies was 38.3% one month after the first vaccine dose (at M1) and 8.6% one month after the second dose (at M4). Anti-Spike IgG antibodies were present in 40.3% of patients before vaccination, in 90.1% at M1, and in 59.7% at M4. Among patients previously infected with SARS-CoV-2, 10.2% had IgM antibodies at M0, 31.6% at M1, and 10.5% at M4 post-vaccination. Similarly, seroprevalences of IgG antibodies in this subgroup were 31.5%, 61.3%, and 50.0% respectively at M0, M1, and M4 post-vaccination. A comparison of seroconversion rates between M0 and M4 showed significant differences only for IgG in COVID-19 naive patients. Mean duration in dialysis and the existence of previous COVID-19 infection were associated with patients’ vaccinal response after the two doses. Age, gender and the use of immunosuppressive treatment did not influence post-vaccinal antibody production. Conclusion: Vaccination against COVID-19 in Senegalese hemodialysis patients induced a low seroconversion rate but it was well tolerated. M

关键词： SARS-Cov2 Vaccination Humoral Response Tolerance Hemodialysis Senegal

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Acute Genital Peritonitis in Brazzaville, Congo

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Surgical Science 2019年第10期10卷 368-376页

作者： Massamba Miabaou Didace Mbongo Jean Alfred Note Madzélé Murielle motoula latou Noé Itoua Clautaire Massamba Alphonse Digestive Surgery Department Brazzaville University Hospital Brazzaville Congo Gynecology-Obstetrics Department Brazzaville University Hospital Brazzaville Congo Laboratory of Numerical Analysis Computer Science and Applications (LANIA) Faculty of Sciences and Technology Marien Ngouabi University Brazzaville Congo.

Genital peritonitis is rare in daily surgical practice in Congo-Brazzaville. Clandestine abortions are incriminated. The purpose of the study is to analyze the epidemiological, etiological, diagnostic and therapeutic aspects of genital peritonitis. A retrospective and case series study was realized in departments of Digestive Surgery and Gynecology-Obstetrics of the University Hospital of Brazzaville. The inclusion criteria for the diagnosis of peritonitis were abdominal pain, fever, transit disturbances and signs of peritoneal irritation. The parameters studied were: age, etiological circumstances, anatomical lesions, type of surgical treatment and evolution. During the study period (July 1, 2015-December 31, 2017), 306 patients were admitted to both departments for acute generalized peritonitis. Among them, a genital cause was incriminated in 18 (5.9%) patients. The mean age was 27.6 ± 3.1 years. At the parity and gestational level, 93% of patients had at least two pregnancies, but not more than the second trimester. In addition, 50% of the patients had an induced miscarriage, due to uterine and intestinal lesions. Induced miscarriages accounted for half of etiological circumstances. Physical examination of the abdomen revealed abdominal contracture in 61.1% of cases. Main visceral lesions were uterine perforation (55.5%) followed by rupture of tubo-ovarian abscess (38.9%). The operative follow-up was simple in 83.33% of cases. In conclusion, genital peritonitis remains unfrequented. Median laparotomy has been the main therapeutic approach in our context where emergency laparoscopic surgery is not yet common.

关键词： Peritonitis Abortion Uterine Perforation

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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:e="font-family:Verdana;"> 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

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epidemiological and Paraclinical Aspects of Helicobacter pylori Infection among Hepatitis B Virus Carriers in the Republic of Congo

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Open Journal of Gastroenterology 2024年第5期14卷 184-191页

作者： Jile Florient Mimiesse Monamou Nuptia Kanoha elenga Ngala Itoua Ngaporo Clausina Ahoui Apendi Marlyse Ngalessami Mouakosso Arnaud Mongo Onkouo Mauria Ibobi Rody Stéphane Ngami mardoché motoula latou Hostaud Atipo Ibara Céline Sandra Adoua Déby Gassaye Blaise Irénée Atipo Ibara Department of Gastroenterology and Internal Medicine Brazzaville University Hospital Brazzaville The Republic of Congo Faculty of Health Sciences Marien Ngouabi University Brazzaville The Republic of Congo

Objective: Describe the epidemiological and paraclinical aspects of HP infection in hepatitis B virus carriers. Population and Method: This was a descriptive cross-sectional study running from January 1 to August 30, 2019, a period of 8 months. It took place in the Hospital Centers of the two major cities of Congo (Brazzaville and Pointe-Noire). The target population of our study consists of patients carrying HBV under antiviral treatment or not. Patients aged at least 18 years and consenting with a biological and morphological assessment were included. We did not include in our study patients taking or having taken antibiotics and/or PPIs less than 4 weeks ago. We excluded all patients who did not deposit fresh stools and those in whom stool extraction could not be done manually. The variables studied covered sociodemographic, clinical and paraclinical aspects. Data entry was done using excel 8.0 software. Statistical analysis was carried out with SPSS 20.0 software. Results: During our study, we included 169 patients. The frequency of HPAG in the stools of HBV carriers in our study population was 63.9% (n = 109). Male patients represented 69% (n = 75) and female patients represented 31% (n = 34). The average age of the patients is 43.92 ± 13.51 years with extremes of 18 years and 80 years. Concerning profession, unemployed patients and those working in the private sector were the most represented in respectively 28.4% (n = 31) and 22.9% (n = 25) without statistical link. Households comprising between 4 - 10 people and the use of public latrines were the risk factors most represented in respectively 69% (n = 75) and 88% (n = 96) without statistical link. Clinically, hepatomegaly and signs of portal hypertension were most represented in 53% (n = 58) and 47% (n = 51). Biologically, HBV DNA was detectable in 60.5% of cases (n = 66).

关键词： Helicobacter pylori Hepatitis B Virus Congo

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