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Hyperhomocysteinemia and Associated Biological Markers in a Congolese Population of Type 2 Diabetes Mellitus in brazzaville

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Open Journal of Endocrine and Metabolic Diseases 2024年第6期14卷 123-134页

作者： V. R. Ikia Monde A. L. M. Boumba E. Mokondjimobe H. Poaty G. Loubano-Voumbi W. F. Ondongo A. G. Mayindou Kimbangu K. Onanga F. Elilie Mawa Ongoth E. Bouenizabila C. Andres H. G. Monabeka Biochemistry Laboratory service University Hospital Center Brazzaville Congo Faculty of Health Sciences Marien NGOUABI University Brazzaville Congo Research Area of Pointe-Noire National Institute for Research in Health Sciences (IRSSA) Pointe-Noire Congo Microbiology and Molecular Biology Department Loandjili General Hospital Pointe-Noire Congo LOMO Research university Kinshasa DRC Department of Statistics Health Information and Epidemiology Surveillance Departmental Directorate of Health Care and Services Brazzaville Congo Department of Endocrinology University Hospital Center Brazzaville Congo Department of Biochemistry and Molecular Biology Bretonneau Regional University Hospital Tours France

The search for new biomarkers predictive of type 2 diabetes currently constitutes a research avenue in Bioclinical. Total homocysteine remains a preferred target due to its involvement in the occurrence of degenerative complications in type 2 diabetics. The aim of this work was to study hyperhomocysteinemia and other biochemical markers associated with T2D in the Congolese population. This was an analytical case-control study carried out between October 2022 and October 2023. The study population consisted of 150 subjects including 100 T2D patients and 50 control subjects. The main clinical data were collected on a pre-established form. Homocysteine determination was carried out by the sandwich ELISA method. The other biochemical markers were measured by colorimetric enzymatic methods. Hyperhomocysteinemia was present in 27.3% (41/150) of the entire study population. Type 2 diabetics had a frequency of hyperhomocysteinemia of 36% (36/100) and control 10% (5/50) (p = 0.001). The mean hyperhomocysteinemia concentration was 31.9 μmol/l with extremes ranging from 18 to 103 μmol/l. Means of biological markers between diabetics and controls showed a statistically significant difference (p = 0.01). The risk factors associated with this HHcy were: sex (OR = 3.5), age (OR = 9.4), sedentary lifestyle (OR = 3.4) and glycosylated hemoglobin (OR = 12) with a p-value <0.05 respectively. Our results suggest that hyperhomocysteinemia can be considered as a predictive biomarker in the bioclinic of Congolese type 2 diabetic patients.

关键词： Hyperhomocysteinemia Biological Markers T2DM brazzaville

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Multiplex Rapid Test with Acceptable Diagnosis Performance as a Solution to Increase Diagnosis of Hepatitis B and C Viruses in Pregnant Women in an Area of High Prevalence of Both Hepatitis Viruses Associated with HIV

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Open Journal of Medical Microbiology 2024年第1期14卷 50-65页

作者： Catherine Boni-Cisse Nina Esther Onstira Ngoyi Hermione Dahlia Mossoro-Kpinde Noella Packo Rabi Senekian Hermann Ndoidet Koutou Coretha Bokia-Baguida Christelle Luce Bobossi-Gadia Arthur Simplice Sombot-Ndicky Daniel Yvon Gonessa Freddy Samuel Ngbonga Konzapa Voulou Christian Diamant Mossoro-Kpinde Alassane OUATTARA National Center of Medical Oncology and Radiotherapy Abidjan Ivory Cost Department of Microbiology UFR of Medical Sciences University of Cocody Abidjan Ivory Cost Laboratory of Bacteriology-Virology of Teaching hospital Center of brazzaville Brazzaville Republic of Congo Faculty of Health Sciences Marien NGOUABI University Brazzaville Republic of Congo Department of Labor Medicine Service of HIV and STDs Control in the Workplace Bangui Central African Republic (CAR) Faculty of Health Sciences University of Bangui Bangui Central African Republic National Reference Center of Sexually Transmitted Diseases and Antiretroviral Therapy Bangui Central African Republic National Laboratory of Clinical Biology and Public Health Bangui Central African Republic Medicine Department District Hospital of Alindao Alindao Ouaka Prefecture Central African Republic Doctoral School of Sciences and Technology University of Bangui Bangui Central African Republic Coordination of Specialized Study of Clinical Biology University of Bangui Bangui Central African Republic Doctors without Borders hospital Sica BanguiCRA Laboratory of Medical Analysis of Teaching hospital Center Mother Elisabeth DOMITIEN of Bimbo Bimbo Central African Republic

Background and Objective: HIV, hepatitis B virus (HBV) and hepatitis C virus (HCV) are very widespread in the world, however, less than 20% of the people affected are diagnosed and treated. This study aimed to determine the prevalence of HIV, HCV and HBV co-infections in pregnant women at Bangui Community university hospital and the cost of screening. Methods: A cross-sectional study involving consenting pregnant women who came for antenatal care was performed. HIV, HCV antibodies and HBV antigens were detected using Exacto Triplex? HIV/HCV/HBsAg rapid test, cross-validated by ELISA tests. Sociodemographic and professional data, the modes of transmission and prevention of HIV and both hepatitis viruses were collected in a standard sheet and analyzed using the Epi-Info software version 7. Results: Pregnant women aged 15 to 24 were the most affected (45.3%);high school girls (46.0%), and pregnant women living in cohabitation (65.3%) were the most represented. Twenty-five (16.7%) worked in the formal sector, 12.7% were unemployed housewives and the remainder in the informal sector. The prevalence of HIV, HBV, and HCV viruses was 11.8%, 21.9% and 22.2%, respectively. The prevalence of co-infections was 8.6% for HIV-HBV, 10.2% for HIV-HCV, 14.7% for HBV-HCV and 6.5% for HIV-HBV-HCV. All positive results and 10% of negative results by the rapid test were confirmed by ELISA tests. The serology of the three viruses costs 39,000 FCFA (60 Euros) by ELISA compared to 10,000 FCFA (15.00 Euros) with Exacto Triplex? HIV/HCV/AgHBs (BioSynex, Strasbourg, France). Conclusion: The low level of education and awareness of hepatitis are barriers to development and indicate the importance of improving the literacy rate of women in the Central African Republic (CAR). Likewise, the high prevalence of the three viruses shows the need for the urgent establishment of a national program to combat viral hepatitis in the CAR.

关键词： HIV-HCV-HBV Co-Infection Multiplex Immunochromatographic Rapid Test Central Africa Serology Test Cost Diagnostic Accessibility

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Recurrent Sigmoid Volvulus after Sigmoidectomy: 3 Clinical Cases

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Surgical Science 2023年第12期14卷 712-719页

作者： Murielle Etiennette Julie Note Madzele Didace Massamba Miabaou Pierlesky Elion Ossibi Moïse service Yanguedet Noé Henschel Motoula Latou Prude Pertinie Avala Giresse Bienvenu Tsouassa Wa Ngono Meddi Bhodého Monwongui Carmich Nzaka Moukala Department of Digestive Surgery University Hospital Center of Brazzaville Brazzaville Republic of the Congo Faculty of Health Sciences Marien Ngouabi University Brazzaville Republic of the Congo

Introduction: Recurrent sigmoid volvulus is a medical and surgical emergency. It is the recurrence of a twisting of the sigmoid loop around its mesenteric axis initiating an occlusion by strangulation. The risk factors of colonic volvulus are: a dolichosigmoid, a chronic constipation, a tumor, …In Western countries, recurrences of sigmoid volvulus after surgery are rare and due to a non resection of a dolicho-megacolon. Most African studies do not report any recurrence of sigmoid volvulus after sigmoidectomy. This work aims to describe three original cases of recurrence of sigmoid volvulus after sigmoidectomy recorded at the university hospital of brazzaville and to analyze their causes and surgical management. Clinical Observation: We studied the cases of three male patients, whose average age was 73 years, each of them having a history of chronic constipation and sigmoidectomy for sigmoid volvulus with an average delay of recurrence of 5.3 years. They all underwent emergency laparotomy for acute intestinal obstruction on scarred abdomen. The surgery permitted to unfold a recurrent volvulus of the sigmoid associated with circumferential scar fibrosis on the volvulated sigmoid loop. A second colectomy was performed. The histological results of the surgical specimens were normal for two patients and revealed signs of tissue necrosis for the third patient. The postoperative outcome was without incident for two patients. The third patient died after developing a septic shock. Conclusion: Recurrent sigmoid volvulus after sigmoidectomy is rare. The etiological factors for our three patients were incomplete sigmoidectomy during the first operation and chronic constipation.

关键词： Recurrent Volvulus Sigmoid Sigmoidectomy

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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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Hypertension and intracerebral hemorrhage in brazzaville

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World Journal of Cardiovascular Diseases 2013年第9期3卷 523-528页

作者： Thierry Raoul Gombet Paul Macaire Ossou-Nguiet Thibaut Naibe Gankama Bertrand Fikahem Ellenga-Mbolla Gilbert Fabrice Otiobanda Karen Obondzo-Aloba Benjamin Longo-Mbenza Department of Medicine Faculty of Health Sciences of Brazzaville Brazzaville Congo Service of Emergency University Hospital of Brazzaville Brazzaville Congo Department of Medicine Faculty of Health Sciences of Brazzaville Brazzaville CongoService of Cardiology University Hospital of Brazzaville Brazzaville Congo Department of Medicine Faculty of Health Sciences of Brazzaville Brazzaville CongoService of Neurology University Hospital of Brazzaville Brazzaville Congo Faculty of Health Sciences Walter Sisulu University Mthatha South Africa service of Cardiology university hospital of brazzaville Brazzaville Congo service of Neurology university hospital of brazzaville Brazzaville Congo service of Reanimation university hospital of brazzaville Brazzaville Congo

Hypertension is not only an important risk factor, but also an important cause of spontaneous intracerebral hemorrhage. Its high prevalence in Africa reflects a high incidence of cerebral hemorrhage ranging from 30% to 60% against 10% to 20% in industrialized countries. The aim of our study was to determine the role of hypertension before the onset of intracerebral hemorrhage and its variations during the first three months. This was a longitudinal study conducted at the university hospital of brazzaville from 1st January to 31st August 2012 with all patients admitted for intracerebral hemorrhage. Patients with subarachnoid or pure intraventricular hemorrhage were excluded. The study variables were: history of hypertension, knowledge of its history, treatment, blood pressure on admission and during the first 3 months and the relationship between blood pressure and evolution. Statistical analysis was performed using the software SPSSS 16.1. The significance level was set at p hospitalized for stroke, of which 82 (31.42%) were for intracerebral hemorrhage. The mean age was 55 ± 11 years and sex ratio of 2 men:1 woman. Hypertension was found in 80.5% of cases, of which 65.2% had known hypertension, but 82.6% had discontinued treatment. The mean systolic blood pressure was 194 ± 41 mm Hg and diastolic 104 ± 20 mm Hg. The location was deep in 85.71%. The normalization of blood pressure was obtained from the second week. After adjusting for confounders using logistic analysis, only uncontrolled hypertension was associated significantly and independently associated with a higher mortality rate (p = 0.042).

关键词： Hypertension Cerebral Hemorrhage 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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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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Proteinuria in Children Living with HIV on Highly Active Antiretroviral Therapy (Haart)

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Open Journal of Pediatrics 2020年第2期10卷 255-262页

作者： Lucie Charlotte Ollandzobo Ikobo Roland Bienvenu Ossibi Ibara Neli Yvette Ngakengni Laren Babomi Gaston Ekouya Bowassa Linda Tchidjo Ngamo Steve Vassili Missambou Mandilou Sabrina Nadia Bouithy Evrard Romaric Nika Jean Robert Mabiala Babela Faculty of Health Sciences Marien Ngouabi University of Brazzaville Brazzaville Republic of Congo Pediatric services Brazzaville University Hospital Brazzaville Republic of Congo Infectious Diseases service Brazzaville University Hospital Brazzaville Republic of Congo Department of Neonatology Brazzaville University Hospital Brazzaville Republic of Congo Department of Internal Medicine and Cardiology Talangai Hospital Brazzaville Republic of Congo

Objective: To determine the prevalence of proteinuria in children living with HIV (CLHIV) and identify associated factors. Patients and methods: This was a cross-sectional, descriptive and analytical study carried out from April to August 2017 in the HIV care centres in Brazzaville and Pointe-Noire. The study included CLHIV with dipstick urinalysis test “Combur10 Test® M”. Results: Thirty seven CLHIV on HAART presented a proteinuria, 21.8%. Children were male gender in 21 cases (56.8%) and female gender in 16 cases (43.2%). Mean age was 10.9 ± 3.9 years. The children were infected with type 1 virus in 35 cases (94.6%), vertical transmission in all the cases (100%). Children were living with HIV for about 2 to 4 years of average n = 18 (48.6%) and they were WHO clinical stage 2 in 18 cases (48.6%). 13 children (35%) had CD4 level 3. All CLHIV (100%) were on HAART thus 20 (37.7%) on the combination of zidovudine (AZT), lamivudine (3TC) and nevirapine (NVP). This combination AZT, 3TC, NVP was a protective factor regarding the occurrence of proteinuria (OR: 0.43;IC (95%). Conclusion: Proteinuria

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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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Seroprevalence and Molecular Biodiverisity of Hepatitis C Infection in Congolese Diabetics

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Open Journal of Gastroenterology 2019年第1期9卷 22-27页

作者： A. Mongo-Onkouo M. G. Ibobi Gassaye Deby E. Bouenizabila C. P. Ahoui Apendi N. Andzouana Mbamognoua J. F. Mimiesse Monamou A. Boumba N. A. Itoua-Ngaporo B. I. Atipoibara H. G. Monabeka J.-R. Ibara Department of Gastroenterology and Internal Medicine Brazzaville University Hospital Center Brazzaville Congo Faculty of Health Sciences Ngouabi Marien University Brazzaville Congo Department of Metabolic Diseases of brazzaville university hospital Center Brazzaville Congo Laboratory service hospital General of Louandjili Pointe- Noire Congo

Summary: There is no evidence for comorbidity diabetes and hepatitis C virus infection in the Congo. The aim of this work was to determine the seroprevalence and molecular biodiversity of HCV in order to contribute to improving the management of Congolese diabetics. Patients and methods: It was a cross-sectional study that took place from 1 February to 30 September 2018 at the brazzaville university hospital, the Diabcare Health Center and the Adolphe Cissé hospital in Pointe-Noire. It concerned diabetic patients followed in brazzaville and Pointe-Noire agreeing to the study, after obtaining the opinion of the ethics committee of the research in health science. All samples collected were screened for the presence of anti HCV Ab using a rapid ALERE HCV test and the Monolisa HCV Ag-Ab ultra test for confirmation in Congo. Detection of the viral RNA was done by PCR retrotranscription and genotyping was performed according to the reverse hybridization technique in France. Data analysis was done with EpiInfo 6.0 software (2016);the proportions were compared using the Chi-square test or the Fisher test at the significance level of 5%. Results: Of 447 patients with diabetes mellitus, 49 had HCV positive serology and the sex ratio was 0.63. Seroprevalence of AC anti HCV was 11% (49/447);HCV RNA was detectable in 71.4% (n = 35) patients. The average age of the population was 62 ± 10 years with extremes ranging from 26 to 82 years. The circulating genotypes were 4 (97.1%) and 1 (2.8%). Subtyping was defined in 17.64% (n = 6) of genotype 4 patients;undefined in 82.36% (n = 28) of Genotype 4 patients, and in one of genotype 1 patients. The subtypes identified were subtype 4e (60%), subtype 4e (8.8%), subtype 4a/4c/4d (5.8%), and subtype 4h (2.9%). Conclusion: The prevalence of HCV is high in our study. These are important data for the improvement of the management of diabetics.

关键词： Hepatitis C Diabete Congo

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