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Working in Psychiatry: Staff Perception of the Brazzaville Hospital and University Center

Open Journal of Psychiatry 2020年第2期10卷 39-44页

作者： Mbou Essie Darius Gandou Paul Mouanga Alain Matini Prefina Gontran Ondzotto Ntsiba Honoré ibara jean-rosaire Faculty of Health Sciences Marien Ngouabi University Brazzaville Republic of the Congo General Management of Health Care Services Ministry of Public Health Brazzaville Republic of the Congo Department of Psychiatry Brazzaville Hospital and University Centre Brazzaville Republic of the Congo

Background: In Congo-Brazzaville, there is a lake of mental healthcare provider and facilities specialized on psychiatric care: only two psychiatrists and one psychiatric department around the country. Poor appreciation of their role and work environment can negatively impact the esteem of psychiatric staff and lead to stigma and discrimination towards patients. Aims: The study aimed to assess the perception of the staff of the only psychiatric service in Congo. Material and methods: We conducted a cross-sectional descriptive, prospective survey;conducted among the psychiatric staff of the Brazzaville University Hospital in September 2019. An anonymous individual questionnaire was administered to collect: 1) socio-professional data, 2) perceptions (assignment, role, workload and working conditions), and 3) identify the main problems of the service. Averages and frequencies were calculated on Epi info 7.***.2.6. Results: Thirty out of 42 staff had responded (71.4%);16 were male and at their first psychiatric assignment (28/30), with an average age of 44.7 ± 7 and seniority of 8.4 ± 8.3 years. Among them: one psychiatrist, two psychologists, and 19 nurses. Their assignment in psychiatry was well perceived in 93.3% (27/30), as well as their role (the importance of psychiatric care and psychiatry). Working conditions were perceived as poor: precarious hygiene (93.3%), cohabitation with dangerous patients (82.1%), heavy workload due to lack of staff (100%). Of their professional future, 23.3% (7/30) were considering leaving. Conclusion: Almost all psychiatric staff had a good perception of their role and psychiatry, but not of the working conditions. Local measures to improve working conditions must be carried out to improve the attractiveness of psychiatry and the quality of care.

关键词： Psychiatric Health Care Provider Working Conditions Perception Brazzaville

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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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Antiretroviral Therpay Induced Liver Toxicity among Immunecompromised HIV Patients at Chu Brazzaville

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Open Journal of Gastroenterology 2019年第8期9卷 135-140页

作者： Florient Jile Mimiesse Clausina Ahoui-Apendi Ngala Akoa Itoua-Ngaporo Ursula Ingride Koukha Lucie Charlotte Atipo ibara Ollandzobo Arnaud Mongo-Onkouo Marlyse Ngalessami-Mouakosso Céline Adoua jean Bruno Mokoko Rody Stéphane Ngami Deby-Gassaye Eric Rutaganda Blaise Irénée Atipo ibara ibara jean-rosaire Faculty of Health Sciences Marien Ngouabi University Brazzaville Congo Gastroenterolgy service University Hospital of Brazzaville Brazzaville Congo Infant pediatric service University Hospital of Brazzaville Brazzaville Congo Medical Depertment University Teaching Hospital Kigali Rwanda College of Medicine and Health Sciences University of Rwanda Kigali Rwanda

Introduction: Human immunodeficiency virus (HIV) infection is a public health problem of concern. Anti-retroviral therapy (ART) is associated with multiple side effects. This study aimed at identifying the different hepatic manifestations of antiretroviral therapy and the responsible molecules. Patients and Methods: This was an eight months period prospective descriptive study, from January 1st to August 31st, 2015, conducted in the Department of Gastroenterology and Internal Medicine at the Brazzaville University Teaching Hospital. Study participants were treatment-na?ve HIV patients who were initiated on ART treatment during the study period. Patients with liver disease, liver cytolysis prior to initiation of therapy, and those with alternative therapy that may cause hepatotoxicity were excluded. The sample size was 110 patients. Results: The age was ranging from 25 to 70 years with a mean age of 47.5 ± 7.5 years. During the six months of follow-up, the alarming hepatic signs were observed in 26.36% of cases (n = 29) in the 3rd month of treatment. There was no observed alarming sign in the 6th month of follow-up. The cytolytic pattern was observed in 54.55% of cases (n = 60) in the 3rd month. The cholestatic pattern was observed in 6.36% of cases (n = 7) in the 3rd month. Triple therapy combination of Zidovudine, Lamivudine and Nevirapine (AZT + 3TC + NVP) was the most used in 57.27% (n = 63) with a statistically significant p value to the occurrence of cytolytic pattern (p Conclusion: Drug induced liver toxicity occurs in a significant number of patients starting ART. The prevalence of hepatic events was high at the third month of treatment and the triple therapy of Zidovudine, Lamivudine and Nevirapine (AZT + 3TC + NVP) was the most incriminated.

关键词： Drug Induced Liver Toxicity HIV Anti-Retroviral Therapy Brazzaville

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Evolutionary and Pronostic Aspects of Cirrhosis at the University Hospital of Brazzaville (Congo)

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Open Journal of Gastroenterology 2020年第1期10卷 23-29页

作者： Jile Florient Mimiesse Ngalessami Mouakosso Marlyse Ahoui Apendi Clausina Mongo Onkouo Arnaud Atipo-ibara Ollandzobo Lucie Firmin Bossali Akoa Ngala Itoua-Ngaporo Rody Stéphane Ngami Mahoungou Gael Honal Deby Gassaye Atipo ibara Blaise Irénée ibara jean-rosaire Faculty of Health Sciences Marien Ngouabi University Brazzaville Congo Gastroenterology Service University Hospital of Brazzaville Brazzaville Congo

Introduction: cirrhosis is a serious pathology that leads to complications whose management remains difficult in our country. This study aimed to evaluate the evolutionary aspects of cirrhosis at the Brazzaville University Hospital. Patients and methods: this was a retrospective study over a period of 18 months (from January 2015 to July 2016), performed in the Gastroenterology Department of the Brazzaville University Hospital. All patients regularly followed for decompensated cirrhosis were included. The studied variables were the epidemiological, clinical and paraclinical characteristics, the occurrence of complications, the survival, and the causes of death. Univariate analysis was used to determine prognostic factors based on the Child Pugh score. Results: There were 43 patients, including 32 men and 11 women, with a mean age of 52 ± 9.5 years. Viral hepatitis B was the most common etiology (39.5%). Child Pugh stage C was found in 60.5%. Oesophageal varices were present in 93% of cases. Survival at 18 months was 72%. In univariate analysis, two variables were significantly associated with decreased survival, including Child Pugh stage C and esophageal varices (grade II and III). Conclusion: cirrhosis remains a worrying pathology because the diagnosis is often made at the stage of often serious complications putting at risk of vital prognosis.

关键词： Cirrhosis Evolution Brazzaville

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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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Role of <i>Helicobacter pylori</i>Infection in Recurrent Abdominal Pain of the Child in Brazzaville

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Open Journal of Pediatrics 2020年第4期10卷 587-599页

作者： Ollandzobo Ikobo Lucie Charlotte Ahombo Niotsebe Lydie Bénédicte Mongo-Onkouo Arnaud Ahoui Apendi Clausina Rochelvie Itoua Ngaporo Ngala Akoa Mimiesse Mounanou Jile Florent Tchidjo Ngamo Lynda Déby Gassaye Mabiala Babela jean Robert Atipo ibara Blaise Irénée ibara jean-rosaire Faculty of Health Sciences Marien Ngouabi University of Brazzaville Brazzaville Congo Infants Pediatric ward Brazzaville University Teaching Hospital Brazzaville Congo Gastroentérology and Internal Medicine Ward Brazzaville University Teaching Hospital Brazzaville Congo

The Helicobacter pylori (Hp) infection is a public health problem, especially in developing countries. However, the responsibility of Hp for the occurrence of recurrent abdominal pain is still unclear. Objectives: To determine the prevalence of Helicobacter pylori (Hp) infection in children with recurrent abdominal pain (RAP) in Brazzaville and to establish the relationship between Hp infection and RAP. Patients and Methods: We conducted a cross-sectional case-control study, between March and September 2018, including 106 children with RAP and 218 children without RAP, aged 2 to 17 years old, received in health centres in Brazzaville. All the children were subjected to detection of Hp fecal antigen by qualitative immuno-chromatography in the faeces. Results: The prevalence of Hp infection among children with RAP in Brazzaville was 43.4%. The female sex was most represented in both populations, with a sex ratio of 0.84 in the infected population. Compared with controls, these were children with a mean age of 8.13 ± 4.57 years. Infected children with RAP were unschooled in 66.7% (n = 31) of cases (p < 0.05). Those using potty were 63% (n = 29). Handwashing before meals and after using the toilet was not done in 66.7% (n = 31) and 56.5%

关键词： Helicobacter pylori Recurrent Abdominal Pain Fecal Antigen Child Brazzaville

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Hepatic Steatosis in Patients with Metabolic Syndrome at the Brazzaville University Hospital Center

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Open Journal of Gastroenterology 2020年第6期10卷 119-127页

作者： Clausina Ahoui-Apendi Ngala Akoa Itoua-Ngaporo Arnaud Mongo-Onkouo Moubié Malanda Merveille Jile Florient Mimiesse Nestor Andzouana Bahamognoua Régis Moyikoua Rody Stéphane Ngami Ngalessami Mouakosso Marlyse Deby Gassaye Blaise Irénée Atipo ibara ibara jean-rosaire Department of Gastroenterology and Internal Medicine CHU Brazzaville Brazzaville Congo Faculty of Health Sciences Marien Ngouabi University of Brazzaville Brazzaville Congo Department of Metabolic and Endocrine Diseases CHU Brazzaville Brazzaville Congo Radiology Department Brazzaville University Hospital Brazzaville Congo

Objective: To study the epidemiological, clinical and paraclinical particularities of fatty liver disease in patients with metabolic syndrome. Patients and Method: This was a cross-sectional and analytical study carried out over a period of seven months, from February 1 to September 30, 2019, in the outpatient services of Gastroenterology and Metabolic and Endocrine Diseases of the Brazzaville University Hospital. It interested all patients with metabolic syndrome, according to the criteria of the FID harmonized in 2009, namely known diabetic and hypertensive patients, having abdominal obesity. Results: The variables studied were socio-demographic, clinical, morphological and biological. The search for fatty liver was done using an abdominal ultrasound. Results: During the study period, 124 patients with metabolic syndrome were included. The average age of the population was 52.8 ± 12 years with extremes ranging from 30 and 84 years. The population was mainly female with a Sex-Ratio of 2.54 (F/M). The frequency of fatty liver disease was 38.7%. The frequency of dyslipidemia was high in the study. Conclusion: The prevalence of hepatic steatosis is high in patients with metabolic syndrome at Brazzaville University Hospital. The gender, lack of occupation and high level of education were the factors associated with fatty liver disease.

关键词： Fatty Liver Metabolic Syndrome Brazzaville

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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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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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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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