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Profile of patients with pancreatic cancer and diabetes mellitus at the University Hospital of Brazzaville

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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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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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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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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Recurrent Iron Deficiency Anemia Revealing Chronic Gastritis with <i>Helicobacter pylori</i>

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Open Journal of Gastroenterology 2021年第2期11卷 47-51页

作者： jile florient mimiesse Ngala Itoua-Ngaporo Arnaud Mongo Onkouo Clausina Ahoui Apendi Lucie Atipo Ibara Ollandzobo Marlyse Ngalessami Mouakosso Mardoché Perez Motoula Rody Stéphane Ngami Sandra Celine Adoua Firmin Bossali Deby Gassaye Blaise Irénée Atipo Ibara Jean-Rosaire Ibara Faculty of Health Sciences Marien Ngouabi University Brazzaville Congo Department of Gastroenterology and Internal Medicine University Hospital of Brazzaville Brazzaville Congo

We report a clinical case of a 21-year-old patient with iron deficiency anemia related to Helicobacter pylori (H. pylori) infection. The pan gastritis due to H. pylori and an unexplained iron deficiency anemia has recently been proposed although still discussed. Among the possible causes the role played by this bacterium remains controversial. The diagnosis had been mentioned in view of the recurrence of anemia and confirmed by endoscopic biopsy. Anemia was corrected by iron supplementation associated with a specific treatment of this germ.

关键词： Iron Deficiency Anemia Helicobacter pylori Pangastritis

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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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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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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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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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Prevalence of Hepatitis C Virus Infection and Risk Factors among Pregnant Women in Pointe Noire, Republic of Congo

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Journal of Biosciences and Medicines 2019年第8期7卷 84-93页

作者： Brunel M. Angounda Serge O. Mokono Ngala Itoua-Ngaporo Jourdain B. Nziengue M’vouala jile F. mimiesse Clausina M. Ahoui Apendi Gabriel Ahombo Blaise I. Atipo Ibara Jean Rosaire Ibara Faculty of Science and Technology Marien NGOUABI University Brazzaville Congo National Center of Blood Transfusion Brazzaville Congo Faculty of Health Sciences Marien NGOUABI University Brazzaville Congo Hospital and University Center of Brazzaville Brazzaville Congo

Background: Hepatitis C virus (HCV) is a public health problem and is highly endemic in Sub-Saharan Africa. This study was carried out to determine the prevalence and potential risk factors of hepatitis C virus in pregnant women. Methods: This was a cross-sectional study involving pregnant women who attended at seven antenatal clinics in Pointe Noire, from June to November 2018. Structured questionnaires were used to obtain participants data. Samples were screened for HCV infection by using 4th ELISA methods and data analysis was done by Epi-info version 7.0 statistical software. Results: A total of 150 pregnant women were included, out of which 11 (7.3%) were positive for HCV. The high proportion of HCV was found in age group 25 - 34 years (45.4%), educated (81.1%), professional (36.4%) and 54.6% were in second trimester gestational stage. Moreover, 54.6% of HCV positive patients had scarification and 45.5% had a history of surgery. There was not a statistically significant association between demographics characteristics, risks factors and HCV seropositivity (p > 0.05). Conclusion: This study showed a high prevalence of HCV infection and confirmed that this infection is a public health problem in pregnant women in Pointe Noire.

关键词： Pregnancy HCV Risk Factors

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