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Prevalence of Hepatitis B and Associated Factors in the Garoua Central Prison, Cameroon: A Cross-Sectional Study

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Open Journal of Gastroenterology 2024年第5期14卷 174-183页

作者： Mohamadou Abdou Galdima Adamou Dodo Balkissou guy roger nsenga djapa Winnie Tatiana Bekolo Nga Gilles Aghoagni Antonin Wilson Ndjitoyap Ndam Ali Abas Mathurin Pierre Kowo Firmin Ankouane Andoulo Dominique Noah Noah Oudou Njoya Servais Albert Fiacre Eloumou Bagnaka Faculty of Medicine and Biomedical Sciences University of Garoua Garoua Cameroon Garoua Regional Hospital Garoua Cameroon Faculty of Medicine and Pharmaceutical Sciences University of Dschang Dschang Cameroon Faculty de Medicine and Pharmaceutical Sciences University of Douala Douala Cameroon Faculty of Health Sciences University of Buea Buea Cameroon Faculty of Medicine and Biomedical Sciences University of Yaound&#233 1 Yaound&#233 Cameroon

Introduction: Hepatitis B virus (HBV) infection is a major public health problem in Cameroon. Garoua city is the headquarters of the North Region of Cameroon, where the HBV prevalence is among the highest of the country. The aim of this study was to determine the prevalence of HBsAg carriage and associated factors among persons incarcerated in the Garoua Central Prison. Methods: It was a cross-sectional study conducted from July 1 to July 31, 2023 at the Garoua Central prison. We included all prisoners willing to participate in the study and who gave their verbal consent. We collected data using a pre-established data entry form and we used rapid test for blood screening for HBV surface antigen (HBs Ag) with ELISA confirmation. Data were analyzed using the R® software for Windows. After the univariate analysis, we selected associated variables to HBV infection with p-value p-value was set at 5%. Results: We included 1389 prisoners out of which 97.6% were male. The median age (IQR) of the study population was 28 (23 - 35) years. The median (IQR) duration of incarceration was 12 (6 - 26) months and the mean (±sd) number of incarcerations was 1.24 (±0.6). HBV prevalence was estimated at 14.8% (95% CI: 13.0 - 16.7). Upon uni- and multivariate analysis, no risk factor was significantly associated with viral hepatitis B infection in our study population. Conclusion: The prevalence of Hepatitis B was high in the Garoua Central Prison, but there were no additional risk factors for HBV infection. There is a need to include the Garoua Central Prison and by the way other prisons in the country in the chronic viral hepatitis care program.

关键词： Hepatitis B Prison Associated factors Cameroon

Factors Associated with Antibody Levels among Children Aged 15 to 59 Months Vaccinated against Hepatitis B during the Expanded Program on Immunization in Cameroon

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Open Journal of Gastroenterology 2023年第2期13卷 91-98页

作者： Antonin Wilson Ndjitoyap Ndam Alpha Hamed Béchir Ndam Mefire Winnie Bekolo guy roger nsenga djapa Suzanne Ngo Um Sap Paul Koki Ndombo Elie Claude Ndjitoyap Ndam Department of Internal Medicine and Specialities Faculty of Medicine and Biomedical Sciences University of Yaoundé 1 Yaoundé Cameroon Department of Clinical Sciences Faculty of Medicine and Pharmaceutical Sciences University of Douala Douala Cameroon Department of Internal Medicine and Specialities Faculty of Medicine and Biomedical Sciences University of Dschang Dschang Cameroun Department of Paediatrics Faculty of Medicine and Biomedical Sciences University of Yaoundé 1 Yaoundé Cameroon

Background: the hepatitis B virus infection remains a major public health problem worldwide. It can lead to a liver cirrhosis and/or hepatocellular carcinoma. The World Health Organisation (WHO) has recommended the implementation of generalised vaccination programs against hepatitis B. In Cameroon, this vaccine was introduced in the expanded program on immunization (EPI) in 2005, but few studies have assessed the immune response. Objective: the general objective of this study was to identify factors associated with antibody levels among children aged from 15 to 59 months vaccinated against hepatitis B during the EPI in Cameroon. Method: this was a cross-sectional study carried out from December 2021 to June 2022 in a paediatric centre of Yaoundé (Cameroon). We analysed the antibody level in children vaccinated against hepatitis B within the framework of the EPI. We enrolled children who had received a series of 3 intramuscular doses of hepatitis B vaccine at 6, 10 and 14 weeks after birth. Some children could receive a 4th booster dose between 12 months. The antibody level was assessed by measuring the anti-HBs in such children, aged 15 - 59 months. A good immunization was defined as a serum level of anti-HBs antibody level above 100 IU/mL;a poor immunization, for an anti-HBs antibody level between 10 and 100 IU/mL;and a non-immunization, for an anti-HBs antibody level < 10 IU/mL. Association between explored factors and poor or non-immunization was evaluated through the Chi square test. The significance threshold was defined at p < 0.05. Results: sixty subjects were included in the study with a slight female majority: 31 cases (52%). The average age was 38.5 ± 15.7 months (range 15 - 59 months). We found 32 (53%) cases of good immunization;21 (35%) of poor immunization;and 7 children (12%) with a non-immunization. The only factor associated with poor or non-immunization was the age between 37 - 59 months (p = 0.016). Conclusion: Anti HBs Antibody levels

关键词： Hepatitis B Vaccination Children Antibody Levels Immunization Cameroon

Evaluation of Non-Invasive Markers of Liver Fibrosis in Chronic Hepatitis B Patients in a Sub-Saharan African Setting: Transient Elastography versus APRI, FIB4, GTT/Platelet Scores

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Open Journal of Gastroenterology 2023年第6期13卷 209-224页

作者： Servais Albert Fiacre Bagnaka Eloumou Tatiana Winnie Bekolo Nga Antonin Ndjitoyap Ndam Gael Gilles Aghoagni Gouajio guy roger nsenga djapa Cynthia Kila Shang Agnes Malongue Dominique Noah Noah Firmin Ankouane Andoulo Christian Tzeuton Henry Namme Luma Faculty of Medecine and Pharmaceutical Sciences University of Douala Douala Cameroon Department of Internal Medicine Gynecologic and Pediatric Hospital of Douala Douala Cameroon Douala General Hospital Douala Cameroon Faculty of Medicine and Biomedical Sciences University of Yaoundé I Yaoundé Cameroon Faculty of Health Sciences University of Buea Buea Cameroon Faculty of Medicine and Pharmaceutical Sciences University of Dschang Dschang Cameroon

Background: Non-invasive markers which use routine laboratory tests are less expensive and highly needed to assess and stage liver fibrosis in chronic hepatitis B patients in Sub-Saharan Africa. We aimed at evaluating liver fibrosis, using the Aspartate aminotransferase to Platelet Ratio Index (APRI), Fibrosis Index Based on 4 factors (FIB4), and Gamma-glutamyl transpeptidase to Platelet Ratio (GPR) in chronic hepatitis B patients with transient elastography as the reference so as to choose an alternative to transient elastography. Method: We carried out a cross-sectional study using the records of patients who attended the Douala General Hospital and Marie O Polyclinic Douala from 2012 to 2017. Non-invasive tests were compared with Transient Elastography. The Spearman coefficient was used to determine correlation. The sensitivity, specificity, positive predictive values and negative predictive values were used to get the optimal cut-off values. The diagnostic accuracy was estimated by calculating the area under the Receiver Operating Characteristic Curve (ROC). P Results: Of the 243 patient records studied, the median age or interquartile range (IQR) was 35 (29 - 42) years with a male predominance of 73.7%. More than 60% of the study population had normal transaminases. Significant fibrosis was found in 88 (36.2%) patients and 32 (13.7%) patients had cirrhosis. APRI had the best cut-off values and highest area under the ROC Curve, for significant fibrosis and cirrhosis with 0.55 (0.823 95% CI [0.769 - 0.869], P Conclusion: APRI, had the best diagnostic properties to detect liver fibrosis and cirrhosis in patients with Chronic Hepatitis B in Douala. The cut-off values are 0.55 and 0.65 for significant fibrosis and cirrhosis respectively.

关键词： Chronic Hepatitis B Liver Fibrosis Non-Invasive Tests Cross Sectional Douala

Diagnosis of Helicobacter pylori Infection in Low Out-Outcome Country: Rapid Urease Test, Serological Test, versus Direct Microbiological Examination with Gram Stain

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Open Journal of Gastroenterology 2023年第6期13卷 199-208页

作者： Winnie Tatiana Bekolo Nga guy roger nsenga djapa Kelly Ilinga Meme Mamende Antonin Wilson Ndjitoyap Ndam David Sepo Sepo Agnès Malongue Firmin Ankouane Andoulo Oudou Njoya Henry Luma Namme Elie Claude Ndjitoyap Ndam Carole Else Eboumbou Servais Albert Fiacre Eloumou Bagnaka Faculty of Medicine and Pharmaceutical Sciences University of Douala Douala Cameroon Department of Medecine Douala General Hospital Douala Cameroon Faculty of Medicine and Pharmaceutical Sciences University of Dschang Dschang Cameroon Faculty of Medicine and Biomedical Sciences University of Yaounde I Yaounde Cameroon Department of Internal Medecine Douala Military Hospital Douala Cameroon

Introduction: Helicobacter pylori is a gram-negative bacillus responsible for numerous gastroduodenal pathologies, and this infection is a public health problem. The prevalence of infection with this bacterium remains high in countries with limited resources. Diagnosis relies mainly on numerous invasive and noninvasive methods. The aim of this work was to evaluate the different indirect diagnostic methods using bacterial cultures. Methods: We conducted a cross-sectional and analytical study from January to May 2022 in the gastroenterology departments of Douala General Hospital and Douala Military Hospital. All patients aged 18 years and older who were in the gastroenterology consultation and agreed to participate were included in our study. Sociodemographic, clinical, and paraclinical data were collected. Urease, liquid urea, and culture tests were performed from the specimens obtained by fibroscopy. Serological tests were performed on the blood sample. Results: 101 patients were included, 58 were female and 43 were male, for a sex ratio of 1.3. The mean age was 44.2 ± 16 years. The prevalence of infection was 90.5%, 44.1%, 40.6% and 21.8% for serology, direct microbiological examination, RUT (rapid urea test) and culture, respectively. Comparison of the different tests showed sensitivity and specificity of 67.1% and 64%, respectively, for RUT, 100% and 73.7%, respectively, for direct microbiological examination, and 100% and 14.8%, respectively, for serology. The positive and negative predictive values were 39.5% and 100% for serology, 39% and 85% for RUT, and 55.6% and 100% for direct microbiological examination, respectively. Conclusion: The prevalence of Helicobacter pylori infection depends on the type of test used. Direct examination is more reliable than RUT and serology.

关键词： Helicobacter pylori Diagnostic Tests Sensitivity Specificity Positive and Negative Predictive Value