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Surgical Treatment of Hemorrhoidal Disease at Brazzaville University Hospital Center

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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Knowledge Attitude and Practice of Viral Hepatitis B and C Screening by General Practitioners in Brazzaville

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Open Journal of Gastroenterology 2020年第12期10卷 311-316页

作者： Rody Stéphane Ngami Sonia Opomba philestine clausina mikolele ahoui apendi Arnaud Mongo-Onkouo Jile Florient Mimiesse Ngala Akoa Itoua-Ngaporo Marlyse Ngalessami Céline Sandra Adoua 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

The involvement of general practitioners in the early detection of viral hepatitis B and C must be paramount. The objectives of this work were to assess GPs’ knowledge, attitude and practice with regard to screening for viral hepatitis B and C. We carried out a cross-sectional analytical study among GPs recruited by simple random sampling from the list of GPs in the city of Brazzaville. The judgement criteria were knowledge and practice of screening for viral hepatitis B and C, assessed according to a Likert scale divided into 3 categories: very good, good and bad. One hundred and twenty-one general practitioners were included, including 48 women and 73 men, with a sex ratio of 1.52;the average age was 33 years;52.89% of them worked in the private sector with an average period of activity of 4 years. The majority of the doctors had a good knowledge (69.42%) and a bad practice (56.20%) of screening for viral hepatitis B and C. The duration of activity was the factor linked to knowledge of viral hepatitis B and C (p = 0.006) while age was the factor linked to the practice of screening for viral hepatitis B and C (p = 0.0366). In conclusion, in Brazzaville, general practitioners’ knowledge of screening for viral hepatitis B and C is good in general, but the practices are poor and require targeted in-service training.

关键词： Viral Hepatitis B and C Screening General Practitioners Brazzaville

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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: 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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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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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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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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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 in Brazzaville: Comparative Study of Two Identification Tests

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Open Journal of Gastroenterology 2019年第11期9卷 223-227页

作者： Ngala Akoa Itoua-Ngaporo Lucie C. A. I. O. Ikobo Arnaud Mongo-Onkouo Jile Florent Mimiesse Monamou clausina philestine ahoui apendi Rody Stéphane Ngami Marlyse Ngalessami Mouakosso Deby Gassaye Blaise Irenée Atipo Ibara Jean-Rosaire Ibara Department of Hepatogastroenterology and Internal Medicine of Brazzaville University Hospital Center Brazzaville Congo Faculty of Health Sciences Marien Ngouabi University Brazzaville Congo Department of Infant Pediatrics of Brazzaville University Hospital Center Brazzaville Congo

Objective: To determine the place of two identification tests for Helicobacter pylori infection available in Congo. Materials and Methods: This was a comparative study carried out in two digestive endoscopy centers in Brazzaville from 1 January to 31 May 2018. Symptomatic patients referred for upper gastrointestinal endoscopy were included systematically. The frequency of infection was determined from two identification tests, namely the rapid urease test in gastric biopsies and the detection of antigen (Ag) for the germ in the stool. The criterion for judging the presence of the germ in each patient was the positivity of at least one of the two tests. The McNEMAR X2 test (p < 0.05) was used for the comparison of averages. Results: During the study period, 137 consenting patients were included, including 62 men and 75 women. The overall incidence of Helicobacter pylori (Hp) infection was 79.6% (109/28). Of the 137 patients, 18 were urease positive only;6 were looking for Hp Ag in the stool, and 85 were in the two tests. The frequency of infection was 75.2% (103/137) with the rapid urease test and 66.4% (91/137) with the Hp Ag test in stool. The rapid urease test proved more reliable in the diagnosis of Helicobacter pylori infection than the stool antigen test.

关键词： Helicobacter Pylori Identification Tests Brazzaville

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Viral Hepatitis B: Seroprevalence and Genetic Diversity in Blood Donors North of Congo

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Open Journal of Gastroenterology 2019年第12期9卷 239-245页

作者： Arnaud Mongo-Onkouo Amelia Dzia Lepfoundzou Dinghat Ornela Marlyne Yvonne ahoui apendi clausina philestine Jile Florent Mimiesse Monamou Ngala Akoa Itoua-Ngaporo Rody Stéphane Ngami Mouakosso Marlyse Ngalessami Céline Sandra Adoua Deby Gassaye Blaise Irénée Atipo Ibara Jean-Rosaire Ibara Department of Hepatogastroenterology and Internal Medicine Of Brazzaville Universty Hospital Center Brazzaville Congo Faculty of Health Sciences Marien Ngouabi University Brazzaville Cong Department of Metabolic Diseases of Brazzaville University Hospital Center Brazzaville Congo

Introduction: Viral hepatitis B is the most formidable and confusing of all viral hepatitis, given its cirrhogenic and carcinogenic potential. The objective of the study is to characterize the molecular profile of hepatitis virus B in northern Congo. Materials and Methods: This was a descriptive and cross-sectional study that was carried out between January and September 2014, that is 9 months, in the establishments of the National Center for Blood Transfusion (CNTS) of the 4 departments of the north of the Congo. Epidemiological, serological and molecular variables (HBsAg, HBV DNA, genotypes and subtypes) were studied. The HBs antigen was searched by rapid test and confirmed by ELISA. For all positive donors, conventional and specific gene extraction and amplification techniques were performed for the identification of genotypes and subtypes from the serum. Results: A total of 892 donors were included. The average age was 35.36 ± 12.36 years with extremes ranging from 18 to 65 years old. The sex ratio (M/F) was 3.3. The prevalence of HBV was 8.6%. The viral DNA of HBV was amplified in 83.1%. Four genotypes were found: E (40.6%), A (3.1%), B (3.1%) and C (1.6%). Two cases of co-infection were identified: E/A (15.6%) and B/C (1.6%). Subgenotypes A1, B2 and C1 were highlighted. Conclusion: The prevalence of HBV is high, HBV infection remains a major public health problem for blood donors in Congo. Genotypes E, A, B, C as well as subtypes A1, B2, C1 have been identified in northern Congo.

关键词： HBV Molecular Biodiversity Subgenotypes North Congo

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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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