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Prevalence of the hepatitis B surface antigen in a population of workers in Cameroon

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Open Journal of Gastroenterology 2013年第8期3卷 323-327页

作者： Firmin Ankouane Andoulo Michèle Tagni-Sartre dominique noah noah Roger Djapa Elie Claude Ndjitoyap Ndam Medical Center “La Cathédrale” Yaounde Cameroon University Hospital of Yaounde Department of Internal Medicine and Specialties Faculty of Medicine and Biomedical Sciences University of Yaounde I Yaounde Cameroon Yaounde General Hospital Department of Internal Medicine and Specialties Faculty of Medicine and Biomedical Sciences Uni- versity of Yaounde I Yaounde Cameroon

Hepatitis B surface antigen prevalence in populations of blood donors in Cameroon is estimated at 6%-16%. As such, the Objective of this study was to determine the prevalence of Hepatitis B surface antigen in a population of bank employees, who represent a sample closer to the general population. In tests carried out both Yaounde and Douala in December 2011, we detected the hepatitis B surface antigen among 267 workers, including 151 men and 116 women of a median age of 37 years. The Results obtained revealed that the overall prevalence stood at 7.1%, with a 9.9% prevalence ratio in men, three times higher than that in women (3.4%). Subjects aged 20-29 years and senior staffs were more affected (each of them recording 8.1%). Potential nosocomial risks were detected mostly at the level of dental care (52.8%). Among the other risks of exposure, scarification (53.6%) was more frequent. A univariate analysis revealed an insignificant relationship with tattoos (OR 2.6, 95% CI 0.5-10.8, p = 0.2). These results led to the Conclusion that Hepatitis B surface antigen carrier prevalence in a population of workers in Cameroon is not different from that of blood donors. It is mainly due to early vertical and horizontal contamination.

关键词： Hepatitis B Virus HBs Antigen Chronic Carrier Prevalence Cameroon

HBs antigene prevalence in blood donors and the risk of transfusion of hepatitis b at the central hospital of yaounde, cameroon

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Open Journal of Gastroenterology 2011年第2期1卷 23-27页

作者： dominique noah noah Richard Njouom Aimé Bonny P. Pirsou J. Meli M. Biwole Sida 不详

Parenteral transmission of hepatitis B virus (HBV) during blood transfusion is not insignificant. Although blood transfusion safety has greatly improved over the last 15 years, the transfusion risk of HBV remains high in developing countries. In the context where blood transfusion safety is limited in some hospitals in Cameroon, the development of good and quality practice for blood donation, based on the use of the most sensitive techniques for the detection of infectious risk of blood donation should be a priority of health authorities. The aim of this paper is to document the epidemiology of HBV infection in the population of blood donors and to assess the risk of infection during blood transfusions at the Central Hospital Yaoundé (CHY), Ca- meroon. Methods: During a seven months period, 1000 volunteer donors were recruited prospectively at the blood bank of the CHY. Those included in the study were people aged from 18 years to 55 years without any particular medical history. Data collection was done through an investigation form. Samples were first analysed at the CHY and then Centre Pasteur of Cameroon. Results: Of the 1000 samples tested 108 (10.8%) were positive for HBs Ag. The male and the female sex represented 83.1% and 16.9% respectively. According to the age groups, 56.2% were 18 to 27 years, 30.5% were 28 years to 37 years, 10.4% were 38 years to 47 years and 29% were 48 years to 55 years. The 892 negative sera were analyzed for total anti-HBc antibodies of which 75.78% were positive and 24.56% negative. The 676 samples positive for anti-HBc antibody were retested for HBs Ag using enzyme immunoassay with a confidence level of 95%, between 52 and 82 positive tests were still positive, a proportion that vary between 7.64% and 12.14% (9.89% ± 2.25%). Conclusion: The prevalence rate of 10.8% found in our series is consistent with data in Cameroon. The infectious risk of transmission of HBV among blood donors remains a major problem (9.89% ± 2.25%) related t

关键词： Infectious Risk HBV CHY

Rectal bleeding in adults over 20 years: Endoscopic investigations and results in current hospital practices in Yaoundé, Cameroon

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Open Journal of Gastroenterology 2013年第6期3卷 298-302页

作者： Firmin Ankouane Andoulo dominique noah noah Roger Djapa Michele Tagni Sartre Elie Claude Ndjitoyap Ndam Kathleen Ngu Blacket CHU Yaounde Department of Internal Medicine and Specialties Faculty of Medicine and Biomedical Sciences University of Yaounde I Yaounde Cameroon La Cathédrale Medical Centre Yaounde Cameroon Yaounde Central Hospital Department of Internal Medicine Faculty of Medicine and Pharmaceuticals Sciences University of Douala Douala Cameroon Yaounde General Hospital Department of Internal Medicine and Specialties Faculty of Medicine and Biomedical Sciences Uni- versity of Yaounde I Yaounde Cameroon

Introduction: In order to identify the modes of investigation and the results of the assessment of rectal bleeding in the Cameroonian adult, we retrospectively analysed the records of 287 patients aged above 20 years diagnosed with rectal bleeding with the aim to know the prescription patterns according to age, the diagnostic performance of tests and the results. Methodology: Between the 1st of January 2009 and the 30th of June 2010, we examined patients at the University Teaching Hospital and the “La Cathédrale” Medical Centre in Yaounde. Age, sex, endoscopic tests and results were evaluated. Results: 287 protocols met our selection criteria, sex ratio (M/F) 2.4/1, median age 46 years interquartile range [36, 55]. Normal tests were 57 (19.2%). Main lesions: haemorrhoids (42.4% CI95 36.7 -48.3), colorectal cancer (10.8% CI95 7.5 -14.9), anal fissure (8.8% CI95 5.8 -12.6) and colorectal polyps (8.4% CI95 5.5 -12.2). The prevalence of significant lesions (polyps and cancer) recorded 7% for those under age 40. 20.5% in those were between 40?-50 years, and 28.9% for those over 50 years. For anoscopies, 44.4% were under 40 years, 39.3% of cases of sigmoidoscopy affected those between 40 -50 years and colonoscopy affected 54% of those over 50 years. For the diagnostic yield, 26.2% had a significant lesion for flexible sigmoidoscopy and only 16.7% and 1.6% for colonoscopy and anoscopy respectively. Conclusion: The study shows that anoscopy and sigmoidoscopy are the main initial tests conducted in Cameroon in the assessment of rectal bleeding in adults of less than 50 years and they are quite sufficient. Haemorrhoids and colorectal cancer are the main pathologies.

关键词： Rectal Bleeding Colon Polyps Colorectal Cancer Sigmoidoscopy Colonoscopy Cameroon

Prevalence of HBs Antigen, and HCV and HIV Antibodies in a Young Male Population in Cameroon

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Open Journal of Gastroenterology 2015年第12期5卷 185-190页

作者： dominique noah noah Firmin Ankouane Andoulo Brice Valery Moussima Essoh Georges Nko’O Ayissi Servais Albert Fiacre Eloumou Bagnaka Magloire Biwole Sida Faculty of Medicine and Pharmaceutical Sciences University of Douala Douala Cameroon Gastroenterology Service of the Yaounde Central Hospital Yaounde Cameroon Faculty of Medicine and Biomedical Sciences University of Yaounde 1 Yaounde Cameroon Hepatology and Gastroenterology Department Yaounde University Teaching Hospital (CHU) Yaounde Cameroon Douala General Hospital Douala Cameroon

Introduction: According to WHO estimates, 57% of cases of liver cirrhosis and 78% of primary liver carcinoma are caused by a hepatitis B or C virus. This study aimed to assess the prevalence of these diseases and HIV among a young male population, according to region. Methods: This was a descriptive cross-sectional study conducted from 17 February to 31 March 2014 in the ten administrative regions of Cameroon. The study included male subjects of Cameroonian nationality aged at least 18 and at most 23, and living in the regions concerned. It excluded subjects that did not match the age, gender, and nationality criteria. For each subject, 10 ml of blood was collected in a dry tube. After centrifugation at 3000 RPM for 5 minutes, the serum was collected for the detection of viral infections. For subjects that tested positive, a confirmatory test was conducted. Results: In total, 4367 subjects were selected, with an average age of 20.46 (+/- 1.17) years. The prevalence of hepatitis B virus stood at 13.01% (with 95% CI: 12.03% - 14.05%). That of viral hepatitis C was 0.30% (95% CI: 0.17% - 0.52%). Co-infection with hepatitis B and C viruses was 0.05% (95% CI: 0.01% - 0.18%). The prevalence of HIV infection was 1.01% (95% CI: 0.74% - 1.36%). Conclusion: The overall prevalence of HBsAg in the population of young males is high. It tallies with the early vertical and horizontal modes of transmission that prevail in our environment.

关键词： Hepatitis B Virus Hepatitis C Virus HIV Infection Young Male Population Cameroon

Assessing GastroPanel serum markers as a non-invasive method for the diagnosis of atrophic gastritis and <i>Helicobacter pylori</i>infection

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Open Journal of Gastroenterology 2012年第3期2卷 113-118页

作者： dominique noah noah Marie Claire Okomo Assoumou Servais Albert Fiacre Eloumou Bagnaka Guy Pascal Ngaba Ivo Ebule Alonge Lea Paloheimo Oudou Njoya Biohit Helsinki Finland District Hospital of Bonassama Faculty of Medicine and Pharmaceuticals Sciences University of Douala Douala Cameroon Douala General Hospital Faculty of Medicine and Pharmaceuticals Sciences University of Douala Douala Cameroon Faculty of Medicine and Biomedical Sciences University of Yaounde Yaounde Cameroon University Teaching Hospital Yaounde Yaounde Cameroon Yaounde Central Hospital Faculty of Medicine and Pharmaceuticals Sciences University of Douala Douala Cameroon

Gastric colonization by Helicobacter pylori increases the risk of gastric disorders, including atrophic gastritis which can be diagnosed based on levels of serum biomarkers like Gastrin and Pepsinogen. We therefore examined the efficacy of a serological-based method namely GastroPanel Blood kit, in diagnosing and scoring gastritis associated to Helicobacter pylori infection. Patients with dyspeptic symptoms were prospectively recruited on voluntary basis at the Yaounde Central Hospital and University Teaching Hospital, from March to July 2011. The degree of atrophy was classified according to levels in patient serum of pepsinogens I and II (PGI and PGII) and Gastrin 17 (G17) and compared with histological profiles as reference method. A specific ELISA test was used for the detection of H. pylori IgG antibodies. In total, 86 volunteers from 21 to 83 years old (mean = 46.4 ± 3.3) were enrolled, including 74.4% of women and 25.6% of men. The prevalence of gastritis was statistically similar between Gastro Blood Panel test and histology used as reference method (89.5% versus 83.7%: p > 0.20). Diagnosis based on serum makers showed high sensitivity (93.1%) in comparison with the reference method. However, the serological based method has diagnosed more atrophic gastritis than the reference (17.4% versus 7.0%: p 0.05). Furthermore, the prevalence of H. pylori infection did not differ significantly between serological method (84.9%) and reference method (81.4%). These results suggest that diagnosis of atrophic gastritis and H. pylori infection obtained with an optional serological method (GastroPanel) is in a strong agreement with the biopsy findings, and thus can be a useful non endoscopic assessment of stomach mucosal atrophy in patients with dyspepsia.

关键词： Diagnosis Atrophic Gastritis Helicobacter pylori Pepsinogen Gastrin

Management of Endoscopic Portal Hypertension Lesions in Cirrhotic Patients in a Country with Limited Resources: About 603 Cases in the City of Douala in Cameroon

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Open Journal of Gastroenterology 2023年第12期13卷 429-438页

作者： Winnie Tatiana Bekolo Nga Aghoani Gilles Machékam-Matanga Olga Antonin Ndjitoyap Agnès Malongue Mathurin Kowo dominique noah noah Oudou Njoya Firmin Ankouane Andoulo Luma Henry Namme Servais Albert Fiacre Eloumou Bagnaka Department of Internal Medicine the Douala General Hospital Douala Cameroon Faculty of Medicine and Pharmaceutical Sciences University of Douala Douala Cameroon Faculty of Medicine University of Buea Buea Cameroon Faculty of Medicine and Biomedical Sciences University of Yaoundé I Yaoundé Cameroon

Introduction: Portal hypertension (HTP) is a morbi-mortality factor in cirrhotic patients. It is responsible for endoscopic lesions and has digestive hemorrhage as the main complication. The objective of the study was to study the management of endoscopic lesions of portal hypertension in a country with limited resources. Methodology: This was a cross-sectional and analytical study conducted in 04 hospitals in the city of Douala, Cameroon, over a period of 08 years from 1 January 2014 to 31 December 2022. Included were cirrhotic patients with viral hepatitis with endoscopic lesions of PH. The data collected were sociodemographic, clinical, paraclinical, therapeutic and evolutionary. Data analysis was done using SPSS software version 25.0. Logistic regression allowed the search for prognostic factors with a significance threshold of p Results: We included 603 patient records. They were mainly male patients (56.1%) with an average age of 47.6 ± 6.3 years. The Child Pugh score was ranked B in 53.7% of cases. Digestive hemorrhage was the main complication in 66.8% of cases. We had grade 2 esophageal varices in 61.5% of cases. The main treatments were prescription of propanolol (63.3%) and ligation of esophageal varices (53.3%). The average number of ligation sessions was 2.1 ± 1.8 with an interval between sessions of 28 ± 2.8 days. Prevention of rupture of esophageal varices was secondary in 66.5% of cases (n = 452). The rate of hemorrhagic recurrence was 9.3%. Hospital mortality was 15.1%. Recurrence of hemorrhage was associated with PT Conclusion: The management of HTP lesions was based on the prescription of beta-blockers and the ligation of esophageal varices. Factors associated with mortality were hemorrhagic recurrence, low PT and Child Pugh C score.

关键词： Portal Hypertension Cirrhosis Endoscopic Lesions PEC Cameroon

Clinical Aspects and Precipitating Factors of Hepatic Encephalopathy Associated with Cirrhosis in a Cameroonian Population

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Open Journal of Gastroenterology 2019年第11期9卷 228-238页

作者： Mathurin Pierre Kowo Edgar Kenne Yimagou Firmin Ankouane Andoulo Antonin Wilson Ndjitoyap Ndam Bonaventure Jemea Servais Albert Fiacre Eloumou Bagnaka Patricia Ouamba Guekam Larissa Pessidjo Eric Tchoumi Leuwat dominique noah noah Oudou Njoya Faculty of Medicine and Biomedical Sciences The University of Yaoundé I Yaoundé Cameroon Research Laboratory on Viral Hepatitis and Health Communication Yaoundé Cameroon Internal Medicine Unit Yaounde University Teaching Hospital Yaoundé Cameroon Gastroenterology Unit Central Hospital Yaoundé Cameroon Faculty of Medicine and Pharmaceutical Sciences The University of Douala Douala Cameroon

Background: Hepatic Encephalopathy (HE), a common complication of cirrhosis, is associated with a pejorative prognosis. This study aims to describe the clinical presentation, precipitating factors and outcome of HE. Methods: This was a cross-sectional multicenter inpatient study in cirrhotic patients admitted for HE in four tertiary hospitals in Yaoundé (Cameroon) from December 2016 to May 2017. The diagnosis of HE was based on West Haven clinical criteria. The diagnosis of cirrhosis was made using clinical and/or biological, endoscopic and/or ultrasonography signs. Results: A total of 53 patients with HE (mean age: 49.9 ± 18.9 years, 35 Males) were included. The frequency of hospital admission for HE was 4.9%. HE grade III was the most common (37.7%), followed by grades I and II (26.4% and 26.4%, respectively). Grade IV was present in 9.4% of cases. According to the Child-Pugh score, 72.1% of the patients were at stage C and 27.9% at stage B. The main precipitating factors found were: constipation (38.5%), hyponatremia (35.9%), hepatocellular carcinoma (HCC) (31.7%), herbal medicine (28.3%), hypokalemia (25.6%), gastrointestinal bleeding (22.6%) and ascitic fluid infection (spontaneous bacterial peritonitis) (13.8%). In 5.7% of cases, no factor was identified. Mortality rate during hospitalization was 45.3% and was significantly associated with stage III (RR = 11.1;95% CI: 1.9 - 64.5;p = 0.003) and IV (RR = 24;95% CI: 1.6 - 40.9;p = 0.01) of HE;Child-Pugh C score (RR = 15.2;95% CI: 1.7 - 30.1;p = 0.003) and hypokalemia (RR = 12.2;95% CI: 1.3 - 19;p = 0.01). Conclusion: HE is a common complication during cirrhosis with a poor prognosis. In the majority of cases, a precipitating factor could be determined.

关键词： Hepatic Encephalopathy Liver Cirrhosis West Haven Criteria Child-Pugh 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

Indications, Yield and Outcome of Colonoscopy: A 7-Year Retrospective Study in a Resource-Limited Setting

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Open Journal of Gastroenterology 2019年第3期9卷 49-58页

作者： Gabin Ulrich Kenfack Servais Albert Fiacre Bagnaka Eloumou Winnie Tatiana Bekolo Nga Guy Sadeu Wafeu Paul Nkemtendong Tolefac Agnès Malongue Mathurin Pierre Kowo Christian Tzeuton Firmin Ankouane Andoulo Oudou Njoya Henry Namme Luma dominique noah noah Faculty of Medicine and Biomedical Sciences The University of Yaoundé I Yaoundé Cameroon Research Laboratory on Viral Hepatitis and Health Communication Yaoundé Cameroon Faculty of Medicine and Pharmaceutical Sciences The University of Douala Douala Cameroon Internal Medicine Unit Douala General Hospital Douala Cameroon “Les Capucines” Medical Center Douala Cameroon Deido District Hospital Douala Cameroon

Background and Aims: Diagnostic colonoscopy allows exploration of the colonic mucosa. Indications are multiple. The purpose of this work was to describe the indications and to report the lesions observed during colonoscopy at the General Hospital of Douala. Methods: This was a cross-sectional study with retrospective data collection over a period of 7 years (January 1, 2010 to January 31, 2017). The data collected from the reports were socio-demographic characteristics, indications and lesions observed at colonoscopy. Binary logistic regression allowed us to identify the independent risk factors associated with the presence of tumors and polyps. Results: We included 719 exams. The main indications were rectorrhagia (29.5%), abdominal pain (25.9%) and constipation (17.8%). A colonic lesion was found in 60.1% of cases. A colorectal tumor accounted for 10.3% of cases. Factors independently associated with colonic tumor were complete colonoscopy (aOR: 0.167 95% CI [0.096 - 0.289], p Conclusion: The presence of weight loss, abdominal or rectal mass should motivate the realization of a complete colonoscopy in search of a colorectal tumor. The most observed lesions remain hemorrhoids, polyps and diverticulosis of the colon.

关键词： Colonoscopy Indications Colorectal Tumor Limited Resources Cameroon