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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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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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Impact of Tension-Type Headaches in the Workplace in Brazzaville

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Neuroscience & Medicine 2024年第2期15卷 77-91页

作者： Happhia Dinah Boubayi motoula latou Josué Euberma Diatewa Ghislain Armel Mpandzou Prince Eliot Galieni Sounga Bandzouzi Jean Brice Mouendenguia Karen Lise Obondzo Aloba Paul Macaire Ossou-Nguiet Faculty of Health Sciences Universit Marien Ngouabi Brazzaville Congo Department of Neurology Brazzaville University Hospital Congo Department of Neurology Loandjili General Hospital Pointe-Noire Congo

Introduction: Tension-type headaches are the most widespread of the primary headache disorders. Due to their high prevalence, tension-type headaches represent a major public health problem with an enormous socio-economic burden. Determining their impact remains a challenge. Objective: To assess the impact of occupational tension-type headache in Brazzaville and identify associated factors. Population and Methods: This was an analytical case-control study conducted in public and private companies in the city of Brazzaville over a period of four (04) months. The case population consisted of cephalalgic employees;the control population was drawn from the same companies and was free of tension-type headaches. Study variables were divided into socio-professional, clinical and individual impact variables. Individual impact variables were represented by: the HIT-6 score, which incorporates a very broad conception of disability, covering several domains, namely: severity of pain during attacks and the restrictive and limiting nature of attacks. Results: Individual impact was severe in 18 (62.1%) men and 11 (37.9%) women. Mean age was 36.3 6.14 years for cases with severe impact. The mean duration of headache was 40.3 32.7 months for cases with severe impact. Tension headache evolved in attacks in 22 (75.9%) cases with severe impact, and continuously in seven (24.1%) cases. The average number of attacks per month was 2.52 1.04 for cases with severe impact. Cases with severe impact included 14 (48.3%) with chronic headache and 15 (51.7%) with episodic headache. Pain of severe intensity present in 48.3% of cases was associated with a severe impact of tension-type headache: OR = 151.66 [2.36 - 44245.95] and p-value = 0.037. At least one days absence from work per year was observed in 47.4% of our cases. The number of days off work per year due to tension-type headache had an interquartile range between 0 and 3 days and extremes from 0 to 14 days. It was the consequence of a sev

关键词： Impact Tension Headache Workplace

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Mortality from Stroke in Young People in Brazzaville

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World Journal of Neuroscience 2024年第1期14卷 37-55页

作者： motoula latou Happhia Dinah Boubayi Josué Euberma Diatewa Ghislain Armel Mpandzou Prince Eliot Galieni Sounga Bandzouzi Elizeth Richtellah Fouti Kouapele Karen Lise Obondzo Aloba Paul Macaire Ossou-Nguiet Faculty of Health Sciences Université Marien Ngouabi Brazzaville The Republic of the Congo Department of Neurology Brazzaville University Hospital Brazzaville The Republic of the Congo Department of Neurology Loandjili General Hospital Pointe-Noire The Republic of the Congo

Introduction: Cerebrovascular accidents (CVA) are an absolute neurovascular emergency and the main cause of mortality and acquired disability in adults. In the Congo, stroke is the leading cause of mortality and the leading cardiovascular emergency, with a hospital frequency of between 49.74% and 56.2%. The aim of the study was to identify the mortality factors associated with stroke in young people in Brazzaville. Patients and Methods: This is a longitudinal analytical study conducted from February to period from February to September 2019 in the neurology, general intensive care and medical emergency departments of the Brazzaville University Hospital (CHUB). All subjects aged 18 - 55 years of completed age, admitted for arterial stroke confirmed by brain imaging, were included. Study variables were: age, gender, socioeconomic level, laterality, time to admission and CT scan, vascular risk factors, history of cardiomyopathy, atrial fibrillation, TIA (transient ischemic attack) or stroke, NIHSS (National Institutes of Health Stroke Scale) score, Glasgow score, blood pressure, temperature, heart rate, occurrence or non-occurrence of complications, blood glucose, creatinine, lipid profile and blood count. Data were analyzed using SPSS 21 software. Descriptive analyses were performed using SPSS 21 software. Results: 103 patients were included in the study, of whom 45 (43.7%) had ischemic stroke and 58 (56.3%) with hemorrhagic stroke. Mortality was high at 29.1% in our study, and mainly concerned hemorrhagic strokes (73.7%). Two-week mortality in our study accounted for 63.33% of total lethality. After simple logistic regression, the factors associated with death within two weeks were age between 40 - 44 years (OR (odds ratio) = 2.95;p = 0.01), hemorrhagic stroke (OR = 1.41;p = 0.07), mass effect (OR = 3.26;p 15 (OR = 5.89 (2.90 - 11.95);p <

关键词： Brazzaville Mortality Stroke Young Subjects

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Clinical and Therapeutic Aspects of Migraine in Brazzaville

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World Journal of Neuroscience 2024年第1期14卷 56-71页

作者： motoula latou Happhia Dinah Boubayi Josue Diatewa Prince Eliot Galieni Sounga Bandzouzi Ghislain Armel Mpandzou Héloïse Stéphanie Ongoly Ikora Karen Lise Obondzo Aloba Paul Macaire Ossou-Nguiet Faculty of Health Sciences Marien Ngouabi University Brazzaville The Republic of the Congo Department of Neurology Brazzaville University Hospital Brazzaville The Republic of the Congo Department of Neurology Loandjili General Hospital Pointe-Noire The Republic of the Congo

Introduction: Migraine is the most common primary headache, and can cause significant disability. There are two types, migraine without aura and migraine with aura. The diagnosis of migraine is essentially clinical. Worldwide prevalence was estimated at 11.6% in 2009. In Africa, it is estimated at 10.4%. Objective: To describe the clinical and therapeutic aspects of migraine in Brazzaville. Patients and Methods: This was a door-to-door cross-sectional study conducted from 1st May to 1 st July 2018 in the city of Brazzaville. Subjects over 18 with clearly expressed consent were included. The questionnaire covered demographic characteristics, diagnostic criteria for migraine according to the IHS, treatments taken. The degree of disability was determined using the Migraine Disability Assessment Scale (MIDAS). Statistical analysis was performed using SPSS 22.0 for MAC. Results: Of the 1017 subjects interviewed in this study, 115 (39.9%) had migraine, including 73 women (63.47%) and 42 men (36.52%). In the group of migraine sufferers, the number of cases of definite migraine was 61 (53.04%) and that of probable migraine 54 (46.95%). For 81 migraine sufferers (70.43%), stress was the triggering factor. The frequency of attacks was weekly and monthly for 30 (26.1%) and 19 (16.5%) sufferers respectively. The location of the migraine was unilateral in 38% of cases and tilted in 24.3%. The intensity of the attack was described as moderate and severe in 41.7% and 57.4% of subjects respectively. Phonophobia/photophobia accompanied the migraine in 65.2% of cases. One hundred and eight subjects were treated. Of these, 106 (98.1%) were on medication. Eleven (10.37%) had received a medical prescription, and ninety-seven (89.8%) were self-medicating. Five and three subjects were under the care of a general practitioner and a neurologist respectively. Conclusion: Migraine is a frequent pathology in Brazzaville. Its preponderance among young people and women call

关键词： Migraine Clinic Therapeutics Brazzaville

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Laparoscopic Appendectomies at Brazzaville University Hospital

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Surgical Science 2024年第4期15卷 183-194页

作者： Murielle Etiennette Julie Note Madzele Pierlesky Elion Ossibi Bhodeho Medi Monwongui Didace Massamba Miabaou Giresse Bienvenu Tsouassa Wa Ngono Prude Pertinie Avala Gilles Niengo Outsouta Noé Henschel motoula latou Carmich Nzaka Moukala Cédrick Du Bonheur Alima Koya Gilbert Fabrice Otiobanda Digestive Surgery Department Brazzaville University Hospital Brazzaville Republic of the Congo Faculty of Health Sciences Marien Ngouabi University Brazzaville Republic of the Congo General Intensive Care Unit Brazzaville University Hospital Brazzaville Republic of the Congo

Introduction: Acute appendicitis represents an urgent surgical condition, requiring the removal of the vermiform appendix. Laparoscopy is the standard surgical approach. This study aimed to outline the epidemiological, clinical, therapeutic, and outcome characteristics of patients undergoing laparoscopic surgery for acute appendicitis. Patients and Methods: A descriptive, retrospective analysis was carried out in the Emergency and Digestive Surgery departments of the University Hospital Center of Brazzaville, spanning two years from January 1, 2021, to December 31, 2022. The study included all patients who underwent laparoscopic surgery for non-complicated acute appendicitis. Results: The study included 12 cases of non-complicated acute appendicitis treated with urgent laparoscopy. The mean age of the patients was 37 ± 8.9 years, with a sex ratio of 0.7. The predominant symptom leading to consultation was pain in the right iliac fossa, with an average time to consultation of 6.4 ± 5.7 hours. Patient histories included diabetes in one case, obesity in two cases, and one case of prior abdominoplasty. During surgery, a phlegmonous appendix was observed in nine patients. The average duration of hospital stay was 3.6 ± 1.3 days, with all patients experiencing uncomplicated recoveries. Conclusion: The practice of emergency laparoscopic appendectomy is still relatively infrequent in our setting and presents an ongoing challenge.

关键词： Acute Appendicitis Appendectomy Laparoscopy Emergency

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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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Surgical Treatment of Hemorrhoidal Disease at Brazzaville University Hospital Center

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Surgical Science 2024年第3期15卷 159-168页

作者： Murielle Etiennette Julie Note Madzele Pierlesky Elion Ossibi Rody Stéphane Ngami Didace Massamba Miabaou Clausina Philestine Mikolele Ahoui Apendi Noé Henschel motoula latou Bhodeho Medy Monwongui Giresse Bienvenu Tsouassa Wa Ngono Prude Pertinie Avala Carmich Nzaka Moukala Cédrick Du Bonheur Alima Koya Blaise Irénée Atipo-Ibara Digestive Surgery Department Brazzaville University Hospital Center Brazzaville Congo Faculty of Health Sciences Marien Ngouabi University Brazzaville Congo Gastroenterology and Internal Medicine Department Brazzaville University Hospital Center Brazzaville Congo

Introduction: Hemorrhoidal disease is a common pathology and its surgical treatment is based, among other things, on pedicular resection after failure of medical and instrumental treatment. The aim of this study is to analyze the epidemiological, clinical, therapeutic and evolving aspects of hemorrhoidal disease at the stage of surgical treatment at the University Hospital Center of Brazzaville. Patients and Methods: We conducted a retrospective and descriptive study carried out from January 2020 to December 2021, a 24 months period, in the Digestive surgery department of the University Hospital Center of Brazzaville. It concerned patients who underwent a surgical procedure for hemorrhoidal disease. Results: 21 cases were collected, representing a hospital frequency of 2.3%, with a sex ratio of 4.3 in favor of men. The average age of patients was 42.2 ± 11.9 years. The symptoms were mainly proctalgia, mass sensation and rectal bleeding. We recorded five cases (19.1%) of hemorrhoidal thrombosis and 16 cases (80.9%) of hemorrhoidal prolapse including 12 cases requiring manual integration (Goligher grade III) and four irreducible permanent cases (Goligher grade IV). The Grade III prolapse was associated with a polyp in one patient and with posterior anal fissure in another patient. Out of the 21 patients, 14 underwent a tripedicular hemorrhoidectomy according to Milligan and Morgan. Two patients underwent mono- and bipedicular hemorrhoidectomy with resection of associated lesions and five patients underwent emergency thrombectomy. The outcome was favorable for all our patients. The average length of hospital stay was 1.5 ± 2.1 days. Conclusion: In the event of failure of medical and instrumental treatment, the hemorrhoidal cure according to Milligan and Morgan is the surgical treatment of reference for hemorrhoidal disease at the University Hospital Center of Brazzaville.

关键词： Hemorrhoidal Disease Surgery Milligan and Morgan

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Role of CD4+ and CD8+ T Lymphocyte in the Onset of Stroke in People Living with HIV in Pointe-Noire

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World Journal of Neuroscience 2022年第1期12卷 1-7页

作者： Prince Eliot Galieni Sounga Bandzouzi Ghislain Armel Mpandzou Josué Euberma Diatewa Dina Happia motoula-latou Charles Godefroy Koubemba Paul Macaire Ossou-Nguiet Donatien Moukassa Faculty of Health Sciences Marien N’Gouabi University Brazzaville Republic of Congo Department of Neurology Loandjili General Hospital Pointe-Noire Republic of the Congo Department of Neurology University Hospital Center of Brazzaville Brazzaville Republic of Congo

Objective: To determine the role of CD4+ and CD8+ T lymphocytes in the onset of stroke in people living with HIV. Methodology: This was a descriptive, cross-sectional study from January to July 2019, in the neurology department of loandjili general hospital, including any patient hospitalized for a first episode of stroke confirmed by brain scan. The study variables were: age, sex, CRP value, serum T cell CD4+, CD8+. The statistical analysis was carried out using the EPI info 7 software. Results: Twenty stroke patients were included. The relative frequency of HIV was 20%. The risk factors were potentiated by immunosuppression of CD4+ T cells. Sixty percent (60%) of the patients had a CD4+ count 3 and the mean CD4+ count was ±191/mm3. Stroke was the predominant mechanism of injury with a frequency of 70%, the only injury mechanism of stroke in patients with CD8+ T cell count > 800/mm3 (p = 0.04). Conclusion: Risk factors are potentiated by TCD4+ lymphocyte immunosupression, also CD8+ lymphocytes of immune system activation marker are a cardiovascular risk factor for living people with HIV.

关键词： CD4+ CD8+ T Lymphocytes HIV Stroke Pointe-Noire

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Cost of Stroke Care at Public Hospitals in Brazzaville and Implication of Third Parties in Stroke Care Expenditure

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World Journal of Neuroscience 2022年第2期12卷 82-92页

作者： Josué Euberma Diatewa Ghislain Armel Mpandzou Patrice Bruno Mokoko Dinah Happhia Boubayi motoula-latou Eliot Prince Galiéni Sounga-Banzouzi Paul Macaire Ossou-Nguiet Neurology Department University Hospital of Brazzaville Brazzaville Congo Faculty of Health Sciences Marien Ngouabi University Brazzaville Congo Neurology Department Loandjili General Hospital Pointe Noire Congo

Background: Among the main challenges of healthcare system throughout the world, there is stroke management. It is important to have data on the in-hospital costs of stroke care to help decision-makers to implement a health insurance system. Objectives: To evaluate the in-hospital costs of stroke care in Brazzaville;to determine the factors influencing the total mean in-hospital cost of stroke care;to identify third parties contributing to stroke care expenditure. Methods: This was a cross-sectional prospective and analytical study. It was carried out at 4 public hospitals in Brazzaville (University Hospital Center, Chinese and Congolese Friendship Hospital, Talangaï Hospital and Makélékélé Hospital), from May to August 2019 (4 months). It focused on patients who had a first episode of stroke confirmed by brain imaging and were at least 18 years old. The bottom-up approach was used to determine the in-hospital costs of stroke care. Results: This study included 109 patients who fulfilled inclusion criteria. Their mean age was 59.2 ± 13.7 years old, with limits of 35 and 90 years old. The total direct in-hospital cost of stroke care was 47,308,330 francs CFA (72,122 euro). The total mean in-hospital cost of stroke care was 1,389,590 francs CFA (2118 euro). The mean cost of intracerebral hemorrhage care was 510,988 francs CFA (779 euro) versus 373,457 francs CFA (569 euro) for cerebral arterial infarction care. The following factors affected the total mean cost of stroke care: type of hospital (p < 0.0001), length of hospital stay (p = 0.001), type of stroke (p = 0.01), stroke severity (p = 0.001) and complications (p = 0.001). The level of contribution to stroke care expenditure covered by third parties was: 78% for patient families;2.8% for community self-help associations. Conclusion: In Congo, the mean in-hospital cost of stroke care is elevated considering the guaranteed minimum wage of 70,000 francs CFA (107 euro). Five factors affect the total mean cost of

关键词： Stroke Hospital Cost Associated Factors Brazzaville

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