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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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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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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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Prevalence of Children Vaccinated against Viral Hepatitis B in Brazzaville

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Open Journal of Pediatrics 2024年第2期14卷 426-434页

作者： Lucie Charlotte Ollandzobo Ikobo Farrèche Colombe Missidi Hostaud Bienvenu Atipo-Ibara Arnaud Mongo Onkouo Clausina Philestine Ahoui Apendi jile Florent mimiesse Blaise Irénée Atipo Ibara Faculty of Health Sciences Marien Ngouabi University Brazzaville Republic of the Congo Infant Paediatrics Department Brazzaville University Hospital Brazzaville Republic of the Congo Gastroenterology and Internal Medicine Department Brazzaville University Hospital Brazzaville Republic of the Congo

Introduction: Viral hepatitis B (VHL) is a public health problem, particularly in sub-Sahara Africa. The aim of this study was to assess vaccination coverage against HBV in children in Brazzaville. Patients and Methods: This was a cross-sectional analytical study conducted in Brazzaville health centres from January to September 2019. It involved children aged between six months and six years who received a vaccination against HBV. Sampling was exhaustive and based on stratified sampling. Results: The overall prevalence of children vaccinated against HBV in Brazzaville was 96.2%. It was insufficient in the Talangai health district (79%). The pentavalent vaccine was administered to 97.7% of children, 85% of whom had received all three doses. The reasons for incomplete vaccination were parents’ ignorance of HVB (85.6%) and of vaccination (14.3%). Conclusion: Although the prevalence of vaccinated children is high in Brazzaville, it is still insufficient in some health districts, particularly Talangai, because parents are unaware of the disease and of vaccination. Pentavalent is the only vaccine available in the national vaccination programme, which is why an effective national vaccination policy needs to be put in place. .

关键词： Prevalence Vaccination Viral Hepatitis B Child 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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Helicobacter Pylori Infection: Epidemiological, Clinical and Endoscopic Aspects in Brazzaville

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Open Journal of Gastroenterology 2023年第4期13卷 131-139页

作者： Bienvenu H. Atipo-Ibara Anicet Boumba Lucie C. Atipo Ibara Ollandzobo Ikobo Arnaud Mongo-Onkouo jile F. mimiesse monamou Ngala A. Itoua-Ngaporo Donatien Moukassa Blaise I. Atipo Ibara Jean-Rosaire Ibara Faculty of Health Sciences Marien Ngouabi University Brazzaville Republic of the Congo Hugues Dieudonné Loemba Molecular Biology Laboratory Pointe-Noire Republic of the Congo Pointe-Noire Research Zone National Institute for Research in Health Sciences (IRSSA) Pointe-Noire Republic of the Congo Department of Gastroenterology and Internal Medicine CHU Brazzaville Brazzaville Republic of the Congo Department of Anatomical Pathology Edith Lucie Bongo Odimba General Hospital Oyo Republic of the Congo

Introduction: Helicobacter pylori infection is a real health problem worldwide. It is the most common chronic bacterial infection in the world, and is particularly prevalent in developing countries. Objective: To determine the frequency of Helicobacter pylori infection and to study the epidemiological, clinical and endoscopic characteristics associated with this infection in Brazzaville. Patients and Methods: This was a descriptive cross-sectional study conducted from January to November 2020, i.e. 11 months. This work focused on 100 symptomatic patients over 18 years old referred for upper GI endoscopy. Gastric biopsies for biological study by urease test and molecular study by real time PCR technique were taken. Results: With a mean age of 46.32 ± 15.20 years, the frequency of Hp infection was 91%, with a female predominance of 53%. The sex ratio was 0.92. The average age was 46.32 ± 15.20 years. Carriage of the infection was more important in households with more than 3 persons, in patients consuming public tap water and in those using both types of sanitary facilities. Endoscopy was indicated for epigastralgia in 93.1% of cases. About 56.14% of the infected patients had normal mucosa versus 12.28% with ulcerated lesions and 22.81% with gastritis. Conclusion: The prevalence of Helicobacter pylori infection is significant in Congo, justifying early detection in order to improve management.

关键词： Helicobacter pylori Carriage Chronic Gastritis Gastric Ulcer Brazzaville

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Lymphadenectomy for Colorectal Cancer: Experience of the Brazzaville Teaching Hospital

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Surgical Science 2022年第3期13卷 79-90页

作者： Pierlesky Elion Ossibi Murielle Etiennette Julie Note Madzele Noé Hensnel Motoula Latou Didace Massamba Miabaou Prude Pertinie Avala jile florient mimiesse-monamou Arnaud Mongo-Onkouo Rody Stéphane Ngami Fabien Gael Mouamba Eliane Ndounga Alexis Fortuné Bolenga Liboko Régis Franck Moyikoua Freznel Ngoma Mabonzo Apendi Philestine Clausina Ahoui Gilbert Fabrice Otiobanda Blaise Irénée Atipo Ibara Department of Digestive Surgery Brazzaville Teaching Hospital Brazzaville Congo Department of Gastroenterology Brazzaville Teaching Hospital Brazzaville Congo Anatomy and Pathological Cytology Department Brazzaville Teaching Hospital Brazzaville Congo Department of Oncology Brazzaville Teaching Hospital Brazzaville Congo Department of Radiology Brazzaville Teaching Hospital Brazzaville Congo Department of Intensive Care Brazzaville Teaching Hospital Brazzaville Congo

Introduction: Lymph node (LN) metastasis are important biomarkers in the resection of colorectal cancer translating into accurate disease staging. It is therefore obvious that lymph node dissection in the curative treatment of colorectal cancer is a prognostic factor that influences survival and guides management strategy. This study aims to evaluate lymph node dissection in colorectal cancers (CRC) managed at the Teaching Hospital, Brazzaville, Congo. Patients and Method: We carried out a descriptive prospective study during a period of 18 months from October 2020 to March 2021 involving patients who underwent curative treatment for colorectal cancer at the visceral surgery department of the Brazzaville Teaching Hospital. Results: Thirty (30) cases of CRC were recorded out of 738 hospitalizations in the visceral surgery departments, which constitute 4.06% of the in-patient activity of the department during the period under study. Mean age was 55.13 years and a male predominance was observed with a sex ratio of 1.14. Colonic involvement was predominant in our series and was found in 22 of the patients. 25 patients underwent surgical resection while 5 patients could not undergo operative treatment. 17 out of the 25 patients underwent curative treatment, 6 were offered palliative care, whereas surgical abstention was decided in 2 patients. The average number of lymphadenectomies per patient was 16.43. Lymphadenectomy was greater than or equal to 12 in 88% of patients. Nine patients had vascular emboli whereas 10 patients had perineural invasion. The tumor was staged as T3 in 15 patients;six patients had a negative lymph node and 11 patients had at least one lymph node invasion. Distant metastasis status could not be determined in 10 patients. Conclusion: Lymphadenectomy is a hallmark in the curative treatment of colorectal cancer as it allows for optimal staging. This represents a strong prognostic factor that defines adjuvant therapy and overall patient outcome.

关键词： Lymphadenectomy Surgery Cancer Colorectal

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Ingestion of Caustics by Children in Brazzaville (CONGO)

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Open Journal of Pediatrics 2018年第3期8卷 283-291页

作者： Lucie Charlotte Atipo-Ibara Ikobo Ollandzobo Clausina Ahoui-Apendi jile florient mimiesse-monamou Jean Robert Mabiala Babela Deby-Gassaye Blaise Irénée Atipo Ibara Jean-Rosaire Ibara Faculty of Health Sciences Marien Ngouabi University Brazzaville Congo Infant Pediatric Service University Hospital of Brazzaville Brazzaville Congo Gastroenterology and Internal Medicine Service University Hospital of Brazzaville Brazzaville Congo

Ingestion of caustics by children is serious because of the increase in their frequency and the difficulties due to their management. Objective: To improve the management of caustic lesions in Pediatric Department at the University Hospital of Brazzaville. Patients and Methods: Prospective study was conducted from January 2014 to December 2015 in the Pediatric Departments of the UHB and centers of digestive endoscopy in Brazzaville. All children who ingested a caustic product and hospitalized were included after obtaining parental’s consent. The studied parameters were: Age, sex, nature and quantity of the caustic, the family’s attitude, clinical signs, endoscopic results according to Zagar’s classification, therapeutic modalities and evolution. Results: 8292 children were hospitalized and 68 because of the ingestion of caustic, a frequency of 0.8%. The average age was 23.6 months [2 months - 16 years]. The male sex was predominant (57.4%). Ingestion was accidental in 88.2% and voluntary in 11.8%. Factors favoring ingestion were storage methods (81.5%) and parental’s inattention or negligence (10.8%). Bleach was the most incriminated caustic (54.4%) followed by caustic soda (29.4%). The estimated quantity ingested was assumed to be minimal in 61.7%. Unsuitable acts were practiced by the family before the medical consultation in 66.1%. The dominant symptoms were digestive (47%) and neurological (25%). The average time to perform endoscopy was 48 hours in 88.2%. Endoscopy revealed lesions in 51.7%, the different stages were I (12 cases), II (16 cases) and III (3 cases). The mains factors of gravity were inappropriate gestures (85%) and the non-respect of the fasting (9%). Proton pump inhibitors were used in 50%. The evolution was favorable for in 73.5%. Conclusion: Ingestion of caustics by children is most often accidental favored by the inadequate packaging and storage. Prevention is about educating people in order to reduce their frequency.

关键词： Caustic Lesions Child 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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