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Epidemiological and Paraclinical Aspects of Helicobacter pylori Infection among Hepatitis B Virus Carriers in the Republic of Congo

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Open Journal of Gastroenterology 2024年第5期14卷 184-191页

作者： Jile Florient Mimiesse Monamou Nuptia Kanoha Elenga Ngala Itoua Ngaporo Clausina Ahoui Apendi marlyse ngalessami mouakosso Arnaud Mongo Onkouo Mauria Ibobi Rody Stéphane Ngami Mardoché Motoula Latou Hostaud Atipo Ibara Céline Sandra Adoua Déby Gassaye Blaise Irénée Atipo Ibara Department of Gastroenterology and Internal Medicine Brazzaville University Hospital Brazzaville The Republic of Congo Faculty of Health Sciences Marien Ngouabi University Brazzaville The Republic of Congo

Objective: Describe the epidemiological and paraclinical aspects of HP infection in hepatitis B virus carriers. Population and Method: This was a descriptive cross-sectional study running from January 1 to August 30, 2019, a period of 8 months. It took place in the Hospital Centers of the two major cities of Congo (Brazzaville and Pointe-Noire). The target population of our study consists of patients carrying HBV under antiviral treatment or not. Patients aged at least 18 years and consenting with a biological and morphological assessment were included. We did not include in our study patients taking or having taken antibiotics and/or PPIs less than 4 weeks ago. We excluded all patients who did not deposit fresh stools and those in whom stool extraction could not be done manually. The variables studied covered sociodemographic, clinical and paraclinical aspects. Data entry was done using Excel 8.0 software. Statistical analysis was carried out with SPSS 20.0 software. Results: During our study, we included 169 patients. The frequency of HPAG in the stools of HBV carriers in our study population was 63.9% (n = 109). Male patients represented 69% (n = 75) and female patients represented 31% (n = 34). The average age of the patients is 43.92 ± 13.51 years with extremes of 18 years and 80 years. Concerning profession, unemployed patients and those working in the private sector were the most represented in respectively 28.4% (n = 31) and 22.9% (n = 25) without statistical link. Households comprising between 4 - 10 people and the use of public latrines were the risk factors most represented in respectively 69% (n = 75) and 88% (n = 96) without statistical link. Clinically, hepatomegaly and signs of portal hypertension were most represented in 53% (n = 58) and 47% (n = 51). Biologically, HBV DNA was detectable in 60.5% of cases (n = 66).

关键词： Helicobacter pylori Hepatitis B Virus Congo

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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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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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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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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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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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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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