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Assessment of Liver Fibrosis in HBsAg-negative and Anti HBc Positive Patients

Open Journal of Gastroenterology 2024年第10期14卷 331-339页

作者： Kounpiélimé sosthène somda Aboubacar Coulibaly Oyétoundé Taofick Amanda Sandrine Marie Odile Soudre Lawagoulé Joseph Emile Ky Christiane Bere Arsène Roger Sombie Department of Hepato-Gastroenterology Yalgado Ouedraogo University Hospital (CHU-YO) Ouagadougou Burkina Faso Department of Medicine University Joseph KI-ZERBO Ouagadougou Burkina Faso

Background: Surface antigen (HBsAg) is the mean marker of hepatitis B virus infection. During the course of the infection, some patients lose the HBsAg and only the presence of anti-HBc antibody indicates previous contact with the virus. Among these patients, some have detectable viral load (occult infection) but most without viral replication. There is no guideline regarding these patients. The aim of this study was to assess hepatic fibrosis in patients with only the hepatitis B virus contact marker “total anti-HBc”. Patients and methods: it was a descriptive and analytical cross-sectional study, conducted in three private hospitals from January to August 2022. Were included HBsAg-negative and HBc-positive patients, consulting in Gastroenterology departments. Noninvasive methods (APRI, FIB-4 and FIBROSCAN) were used to evaluate liver stiffness because of their easy accessibility and low-cost. The hepatic fibrosis was considered significant when the score determined by APRI, FIB-4 and FIBROSCAN® tests was respectively greater than 1.5;2.67 and 8 kPa corresponding to fibrosis level 2 (F2). Results: A total of 63 HBsAg-negative/total HBcAg-positive patients were included. The mean age was 49.9 ± 13.4 years. The male/female sex ratio was 1.78. Of the 63 patients, 19 had significant liver fibrosis (30.1%) among which 9 patients had HCC. The FIB-4 score outperformed the APRI score in assessing liver fibrosis, with a sensitivity of 84.2%, a specificity of 100% and a negative predictive value of 93.6%. In univariate analysis, there was a significant association between the occurrence of significant liver fibrosis and age over 40 years, dyslipidaemia, obesity, alcohol consumption, smoking, herbal medicine, negative anti-HBs immunological status and detectable viral load. Conclusion: Our study revealed a high prevalence of significant to severe hepatic fibrosis in anti-HBc positive patients. In most of the cases, the fibrosis was severe. Progression to HCC has also been pos

关键词： Anti HBc Positives Liver Fibrosis Sub-Saharan Hepatitis B Virus

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Liver Damage during Dengue Fever in Ouagadougou

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Open Journal of Gastroenterology 2022年第9期12卷 221-231页

作者： Alice Nanelin Guingané Judith Ouango Abdoulaye Sourabié Christiane Couna Bere Roger Sombié Alain Bougouma Abdel Karim Sermé Aboubacar Coulibaly sosthène somda Department of Hepato-Gastroenterology CHU Bogodogo Burkina Faso Hepato-Gastroenterology Department CHU Yalgado Ouédraogo Burkina Faso

Dengue fever is widespread in all tropical and subtropical areas of the world and is the main public health problem posed by arboviroses. In Burkina Faso, an outbreak of dengue serotype “DENV-2”, which is responsible for severe forms of dengue, has been reported. In this study, we will discuss liver damage during this disease. The aim of this study was to describe the sociodemographic, diagnostic, therapeutic and evolutionary aspects of dengue patients with hepatic cytolysis. Patients and Methods: This was a prospective cross-sectional study of dengue disease in 2 facilities in the city of Ouagadougou. The study was spread over a period of 3 months from August to November 2019. The study population consisted of all patients hospitalised for dengue with a positive AgNS1 and/or IgM rapid diagnostic test (RDT) and presenting signs of liver damage. Results: During our study period we recruited 134 patients with dengue fever of which 93 or 69.4% had at least one elevated transaminase. The sex ratio was 1.90 and the average age was 35 years. Symptoms of liver damage were rare with right hypochondrial pain in 4.30% of cases and jaundice in 1.07% of cases. Dengue haemorrhagic fever was found in 5 patients. IgG was negative in 77.42%. The majority of patients (44% or 47.31%) had at least one transaminase value elevated to the upper limit of normal (ULN);and a minority, 14 patients or 15.06%, had transaminases above 10 ULN. A small proportion of patients had hepatocellular failure 26.92% with a lowered prothrombin level. Ninety-four per cent (94.62%) of the patients received analgesics. Level 1 analgesic (paracetamol) was the most widely administered, particularly in 76 patients (86.36%). More than half of the patients (57.14%) had a length of stay of less than or equal to 3 days and the outcome was favourable in 91.40%. Conclusion: Dengue virus causes alterations in the liver parenchyma. The degree of liver damage is variable. As clinical symptoms are almost non-existent, th

关键词： Dengue Fever Liver Damage Cytolysis Hemorrhagic Fever

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Sociodemographic Factors of Alcohol Consumption in a Population of Hospitalized Patients in Ouagadougou (Burkina Faso)

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Open Journal of Gastroenterology 2017年第3期7卷 96-104页

作者： Zanga Damien Ouattara Mali Koura Abdel Karim Serme Kounpilélimé sosthène somda Aboubacar Coulibaly Steve Léonce Zoungrana Appolinaire Sawadogo Hepato-Gastroenterology Unit CHU Ouahigouya UFR/SDS CUP Ouahigouya Burkina Faso Hepato-Gastroenterology Unit CHU-SS Bobo Dioulasso Burkina Faso Hepato-Gastroenterology Unit CHU-YO Ouagadougou Burkina Faso

The prevalence of excessive alcohol consumption is high in our context. The fight against this scourge requires accurate identification of sociodemographic factors for a better communication strategy. Objective: To determine the sociodemographic factors associated with alcohol consumption in a population of hospitalized patients. Methods: A cross-sectional study was conducted during two months in 14 hospital departments of the University Hospital CHU-Yalgado Ouédraogo (CHUYO) in Ouagadougou, by interview and document review. All patients hospitalized for less than a year, aged 18 at least and consenting were included. Excessive alcohol consumption was defined as consumption ≥210 g/week in men and 140 g/week in women according to WHO, a score ≥8 in men and in women ≥7 by AUDIT Questionnaire, a score ≥2 according to the DETA questionnaire. Socio-demographic factors as age, sex, religion, educational level, marital status, occupation and salary status were filled for all patients. Results: A total of 391 patients were included. The average age was 44 ± 16.26 years and the sex ratio of 1.34. Among them, 135 (34.53%) were consumers of alcohol. The prevalence of excessive consumption ranged from 7.92% to 10.49%. A statistically significant relationship was found between alcohol consumption and sex (p 0.03), religion (p 0.01) and education level (p 0.01). On the contrary, no significant relationship was found between alcohol consumption, age, marital status and occupation. The salary status “employee” appears to promote the consumption of alcohol by some tools. Conclusion: The excessive consumption of alcohol is common in our population especially by educated men of non-Muslim religion. This hypothesis should be corroborated in a study within the general population to better set control strategies against this scourge.

关键词： Alcohol Sociodemographic Factors

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Treatment of HBeAg-negative Chronic Hepatitis B Patients with Nucleos(t)ide Analogues in Burkina Faso

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Open Journal of Gastroenterology 2016年第12期6卷 387-396页

作者： Kounpiélimé sosthène somda Abdel Karim Sermé Aboubacar Coulibaly Steve Léonce Zoungrana Inès Compaoré Serges Kouamou Damien Ouattara Roger Sombié Alain Bougouma Hepato-Gastroenterology Unit Teaching Hospital Yalgado Ouédraogo Ouagadougou Burkina Faso Gastroenterology Unit UFR/SDS CUP Ouahigouya Burkina Faso

The treatment of chronic hepatitis B (CHB) has increased significantly in recent years. In patients affected by HBeAg-negative CHB, it is necessary to distinguish the inactive carriers (low viral DNA 2000 IU/mL, normal ALT, histological lesions absent or minimal) who does not need treatment, and patients suffering from active CHB (DNA > 2000 IU/ml, high transaminases or fluctuating, significant fibrosis and/or necro-inflammatory activity > 1) who must be treated. The main purpose of treatment is to obtain a long-lasting viral suppression to improve the histological lesions and reduce the risk of evolution towards cirrhosis, liver failure and hepatocellular carcinoma (HCC). It about an indefinite treatment (unless HBsAg seroclearance) expensive and often inaccessible for the majority of our patients. Our study aimed to report the results of four years follow-up of HBeAg-negative patients treated by Nucleos(t)ide analogues (NAs) in Ouagadougou (Burkina Faso). It was a clinical observational study with 133 patients including 95 men;the average age was 41.2 years, completing the criteria of treatment. One hundred and twelve patients were treated by tenofovir (TDF), fourteen by lamivudine and seven co-infected HIV/HBV patients by Atripla® (combination TDF, Emtricitabine and Efavirenz). Virological and biochemical responses were respectively 100% and 94% after 4 years. The rate of HBsAg seroclearance was 1.5%. Twelve of fourteen patients (85.7%) had lamivudine resistance and no cases of resistance in the TDF and Atripla® groups. One co-infected patient developed HCC during treatment. Among patients treated by TDF, two cases of hypophosphatemia were noticed and no case of kidney failure. The treatment of CHB is certainly progressing;updated guidelines (EASL, AASLD) exist but should be adapted to the African context.

关键词： Chronic Hepatitis B HBeAg-negative Nucleos(t)ide Analogues Tenofovir Lamivudine Burkina Faso

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Patient Experience at Endoscopy Centers in Three West African Countries during the COVID-19 Pandemic

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Open Journal of Gastroenterology 2023年第4期13卷 161-169页

作者： Alice Nanelin Guingané Euloge Houndonougbo Jamila Abdouramane Soli Léonce Steve Zoungrana Sandrine Soudré Aboubacar Coulibaly sosthène somda Roger Sombié Appolinaire Sawadogo Alain Bougouma Service d’hépato-Gastroentérologie CHU Bogodogo Ouagadougou Burkina Faso Service d’hépato-Gastroentérologie Hopital saint jean de Dieu Tanguiéta Bénin Service d’hépato-Gastroentérologie Hopital général de référence de Niamey Niamey Niger Service d’hépato-Gastroentérologie CHU Ouahigouya Ouagadougou Burkina Faso Service d’hépato-Gastroentérologie CHU Tengandogo Tengandogo Burkina Faso Service d’hépato-Gastroentérologie CHU Yalgado Ouédraogo Ouagadougou Burkina Faso Service d’hépato-Gastroentérologie CHU Sourou Sanou Bobo-Dioulasso Burkina Faso

Corona virus infection and the risk of contagiousness to medical personnel or patients during endoscopy necessitated further measures in the endoscopy rooms. The objective of this study was to assess the experience of patients in endoscopy rooms during the COVID-19 epidemic in West Africa. Patients and Methods: This was a multicenter cross-sectional study that took place over a period of 3 months (June to August 2020) in endoscopy centers in Burkina Faso, Benin and Niger. An online questionnaire was sent to patients who had performed upper digestive endoscopies, in 8 digestive endoscopy centers including private, public and religious structures. Depending on the choice of patients, questionnaires were either sent electronically or completed in the endoscopy room with the help of field investigators. The choice of centers was random from the list of centers and descriptive analyses were carried out. Results: A total of 294 patients responded to the online questionnaire. There were 37 lower and 257 upper gastrointestinal endoscopies. The female sex represented 52.1%. The wait times for obtaining an endoscopy appointment were considered satisfactory by 281 patients 95.6%. In the endoscopy departments, 112 patients, or 38.1%, were questioned about the risk factors for contamination of SARS-CoV-2. Among the risk factors found, 6 patients (2.0%) would have traveled abroad in the 2 weeks preceding the examination, 4 patients 1.4% had already been in contact with a subject at risk. The most frequent symptoms were chest pain (80 cases;27.2%), flu-like syndrome (29 cases;9.9%), cough (40 cases;13.6%), fever (46 cases;15.6%). In contrast, ageusia (7 cases;2.4%) and anosmia (5 cases;1.7%) were only found in very few patients. Twenty-two patients (7.5%) felt highly exposed to COVID-19 during the endoscopy examination and 144 patients (48.9%) rated the examination as satisfactory. Conclusion: Gastrointestinal symptoms initially described as rare are being reported with increasing

关键词： Endoscopy COVID-19 Patients Exposure Symptoms

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Prevalence and Factors Associated with Alcohol Consumption in Urban Schools in Burkina Faso

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Open Journal of Gastroenterology 2017年第6期7卷 187-196页

作者： Mali Koura Ivlabehire Bertrand Méda Zanga Damien Ouattara Couna Christiane Béré Somé Kounpilélimé sosthène somda Aboubacar Coulibaly Smaila Ouédraogo Appolinaire Sawadogo Hepato-Gastroenterology Unit CHU-SS Bobo-Dioulasso Burkina Faso IRSS/CNRST Ouagadougou Burkina Faso Hepato-Gastroenterology Unit CHU Ouahigouya Burkina Faso Hepato-Gastroenterology Unit CHU-YO Ouagadougou Burkina Faso Public Health Department CHU-YO Ouagadougou Burkina Faso

Background: In 2005, the World Health Assembly asked member states to develop effective strategies and programs to reduce the negative consequences of harmful use of alcohol. To develop effective policies, we must already understand the phenomenon of alcohol consumption. But in Francophone west Africa, there are very few studies on the prevalence of alcohol, consumption patterns and factors associated with this consumption. The objectives of this study were to estimate the prevalence of alcohol use in schools in Burkina Faso and to identify socio-demographic factors associated with episodes of “heavy drinking”. Method: A cross-sectional study was conducted in October 2013 in six secondary schools of Bobo-Dioulasso. Three hundred and sixty-two students randomly drawn by stratified cluster sampling were interviewed by using a self-administered questionnaire adapted from the model ESPAD and WHO AUDIT questionnaire. HED (Heavy Episodic Drinking) was defined as consuming at least six local measures of alcoholic beverages around the 30 days prior investigation. The search for factors was performed using logistic regression and estimating standard errors were adjusted for clustering data. Results: The prevalence of experimentation of alcohol was estimated to 45.6% [CI 95% = 40.4 - 50.7]. This prevalence was reduced to 34.8% [CI 95% = 29.9 - 39.7], 24.3% [CI 95% = 19.9 - 28.7] and 18% [CI 95% = 14 - 21.9] if one considered the use of alcohol at least once respectively in the 12 months, 30 days and 7 days before the survey. The prevalence of HED was 16% [CI95% = 12.2 - 19.8]. Independent factors associated with the HED were alcohol use by parents or friends and father’s occupation. Episodes of “heavy drinking” were 8.3 (CI 95% = 4.9 - 14) and 2.8 (CI 95% = 1.3 - 5.8) respectively more frequent among students whose parents and friends were drinking. neither religion nor sex nor age was not statistically associated with HED. Conclusion: This study confirms the high prevalence

关键词： Prevalence Heavy Drinking School Associated Factors

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Uterine Perforation after Pose of IUD, the Place of Abdomen Radiography without Preparation

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Open Journal of Gastroenterology 2017年第1期7卷 1-4页

作者： Abdel Karim Sermé Aboubacar Coulibaly Koumpielimé sosthène somda Dimitri Darankoum Delphine Napon/Zongo Soré Moussa Zanga Hector Godonou Kadidiatou Cissé Issiaka Ouedraogo Ali Ouedraogo Gastroenterology Service of the University Hospital Centre Yalgado Ouédraogo (CHUYO) Ouagadougou Burkina Faso Gastroenterology Service of the University Hospital Centre Sanou Sourou (CHUSS) Bobo Dioulasso Burkina Faso Medical Imaging Department of the Charles de Gaulle Pediatric University Hospital Center (CHUP-CDG) Ouagadougou Burkina Faso Gyneco-Obstetrics Service of the University Hospital Centre Yalgado Ouédraogo (CHUYO) Ouagadougou Burkina Faso

Uterine perforation is a serious complication after insertion of an intrauterine device (IUD). We report the case of a 34-year-old woman receiving in consultation for abdominal pain. In the interrogation there was a notion of IUD insertion for about a week. The gynecological examination did not find the thread of IUD and the ultrasound performed did not visualize an IUD. Radiography of the abdomen without preparation highlighted a compatible intrapelvic foreign thing like an IUD. The diagnosis of pelvic inflammatory disease by uterine perforation by an IUD was thus retained. We suggest in case of suspicion of uterine radio paque IUD perforation achieving radiography when the abdominal pelvic ultrasound is normal.

关键词： IUD Intra Uterine Perforation Diagnosis Treatment

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Ultrasound Pulse Elastometry: Assessment of One Year’s Practice in the Hepato-Gastroenterology Department of the Saint Camille Hospital in Ouagadougou

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Open Journal of Gastroenterology 2024年第11期14卷 379-385页

作者： Kounpiélimé sosthène somda Lawagoulé Joseph Emile Ky Constant Lawrence Coudjo Johnson Stella Line Emmanuella Paré Ben Moctar Abdou Djibo Toussaint Vébamba Abraham Ouédraogo Fanta Ousseini Mamadou Sarifou Diallo Sandrine M. O. B. Héma/Soudré Aboubacar Coulibaly Arsène Roger Sombié Department of Gastroenterology Yalgado Ouedraogo University Hospital Ouagadougou Burkina Faso Department of Medicine Joseph KI-ZERBO University Ouagadougou Burkina Faso Department of Gastroenterology Fada NGourma Regional Hospital Fada NGourma Burkina Faso Department of Gastroenterology Donka National Hospital Conakry Guinea Faculty of Health Sciences and Techniques Gamal Abdel Nasser University Conakry Guinea Department of Gastroenterology Tengandogo University Hospital Ouagadougou Burkina Faso

Aims: To review one year of ultrasound impulse elastometry in a hospital in Ouagadougou. Patients and Method: This is a retrospective descriptive study of data from one year’s use of impulse ultrasound elastometry. Ultrasound impulse elastometry was performed using the FibroScan® COMPACT 530. Fibrosis was considered significant when E (hepatic elasticity) ≥ 7.2 kPa (F2 fibrosis). The test was considered valid when the IQR/Median ratio ≤ 30% and there were at least 10 valid measurements. Results: A total of 1911 patients underwent FibroScan®. There were 1079 men, giving a sex ratio of 1.3. The mean age of the patients was 37.9 ± 12.2 years. The indication for FibroScan® was hepatitis B virus infection in 89% of cases. The validation criteria for FibroScan® were met in all patients. The mean value for elasticity was 7.9 kPa and for steatosis 212 dB/m. Fibrosis was non-significant in 75.5% of cases. More than half of our patients (56.7%) didn’t have steatosis, 24.8% had mild steatosis, 12.4% had moderate steatosis and 6.1% had severe steatosis. Conclusion: Ultrasound pulse elastometry plays an important role in monitoring chronic liver disease. It allows non-invasive diagnosis of hepatic fibrosis and steatosis. In our context, however, access to the test is limited by its availability only in large urban centers, and by its cost.

关键词： Pulse Elastometry Hepatic Fibrosis Steatosis Non-Invasive Evaluation of Fibrosis Africa

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Upper Gastrointestinal Endoscopy at University Hospital Souro Sanou Bobo-Dioulasso (Burkina Faso), about 1022 Cases: Signs and Lesions Observed

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Open Journal of Gastroenterology 2017年第11期7卷 287-296页

作者： Mali Koura Delphine Passolguewindé Zongo Napon Zanga Damien Ouattara Kounpiélimé sosthène somda Aboubacar Coulibaly Steve Léonce Zoungrana Christine Couna Somé Bere Sandrine Hema Soudré Euloges Bébar Kamboulé Nogogna Zouré Honoré Zougmoré Inoussa Adama Zampou Appolinaire Sawadogo Gastroenterology Service of the University Hospital Souro Sanou Bobo-Dioulasso Burkina Faso Regional University Hospital of Ouahigouya Ouahigouya Burkina Faso Gastroenterology Service of the University Hospital Yalgado Ouédraogo Ouagadougou Burkina Faso Regional Hospital Kaya Kaya Burkina Faso National Hospital Blaise Compaoré Ouagadougou Burkina Faso

Upper gastrointestinal endoscopy is an excellent way for the diagnosis of high digestive pathology. We report the results of 1022 upper gastrointestinal endoscopy performed at Bobo-Dioulasso CHU-SS, in western Burkina Faso (West Africa). The aim of this study was to document the indications and lesions found in high endoscopy at the CHUSS. Patients and Methods: It was a cross-sectional study, prospective to describe the results of gastroscopy performed from 1st January 2015 to 30th June 2016 at the digestive endoscopy unit CHU-Souro Sanou Bobo-Dioulasso. Results: In the study period, 1022 upper gastrointestinal endoscopies were performed. The main indications were: The epigastric pain (48.6%), portal hypertension (10.7%) and gastroesophageal reflux disease (9.9%). The pathologies observed were dominated by gastropathies (48.11%), peptic ulcer (27%) and oesophageal varices (9.68%). Epigastralgias were the main circumstance for the discovery of: 52.3% of esophagitis, 49.17% of gastropathies and 46.12% of peptic ulcers. Histopathologically, the results of the 236 biopsies were dominated by gastritis (88.56%), stomach cancers (7.63%) and esophagus (3.81%). Conclusion: The main indication of the UGIE at the CHU-Souro Sanou in Bobo-Dioulasso was epigastralgia. The pathologies observed were dominated by gastropathy, esophagitis and PUD.

关键词： Upper Gastrointestinal Endoscopic Indications Lesions Observed Bobo-Dioulasso

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Crosstalk between androgen signaling and the chemokine receptor CXCR4:a novel strategy to promote myelin regeneration

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neural Regeneration Research 2025年第9期20卷 2581-2582页

作者： Marianne Bardy-Lagarde Narimène Asbelaoui Abdel Mouman Ghoumari UMR1195 “Diseases and Hormones of the Nervous System”Inserm and University Paris-SaclayKremlin-BicêtreFrance

Multiple sclerosis(MS)is the most common chronic disease of the central nervous system(CNS)in young adults and represents the first cause of severe handicap,originally non-traumatic(Oh et al.,2018).MS is chara cterized by the infiltration of auto reactive lymphocytes specific to myelin through the blood-brain barrier,which results in the appearance of inflammatory demyelinating lesions caused by the death of the central nervous system myelinating cells,oligodendrocytes(Oh et al.,2018).There is a prevalence sexual with a ratio of three times more affected women than men.

关键词： myelin CXCR4

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