Objective: assess the knowledge, attitudes, and perceptions of Brazzaville residents on colorectal cancer and its screening. Population and Methods: a CAP-type cross-sectional study was conducted from June 1 to Octobe...Objective: assess the knowledge, attitudes, and perceptions of Brazzaville residents on colorectal cancer and its screening. Population and Methods: a CAP-type cross-sectional study was conducted from June 1 to October 31, 2022, with 803 workers approached at their place of service. Information was collected using a questionnaire administered to participants. The variables studied concerned knowledge, attitudes, and perceptions about colorectal cancer. SPSS software, along with Chi-square and Fisher tests, was used for data entry and analysis. Odds ratios were calculated to determine the strength of the association between variables. Results: The average age of the participants was 33.5 ± 10 years, with a sex ratio of 0.9. There were 231 health workers. The main sources of information were health personnel (78.2%) and the internet (52.6%). The site of the pathology was known to 87% of participants. About 40% identified age, genetic predispositions, and a diet rich in animal fats as risk factors. No signs of the disease were known by 50% of the participants. Colonoscopy was known as a screening method by 40% of participants. Seventy-five percent were willing to participate in a CRC awareness campaign, but only 5% agreed to a screening colonoscopy, although 96% recognized its usefulness. Overall, the level of knowledge was insufficient in 70.4% of cases;attitudes were adapted in 55.7% of cases, and perceptions were adapted in 97.3% of cases. Factors influencing knowledge included young age (p = 0.006), a good level of education, being a healthcare worker, and high socio-economic level. Conclusion: colorectal cancer and its screening are poorly understood by the population. Awareness activities must be organized to improve knowledge and promote screening and early diagnosis of CRC.展开更多
Objective: Study of the frequency of anemia, its characteristics and its relationship with different epidemiological, diagnostic and prognostic parameters of cirrhosis. Patients and methods: This was a retrospective d...Objective: Study of the frequency of anemia, its characteristics and its relationship with different epidemiological, diagnostic and prognostic parameters of cirrhosis. Patients and methods: This was a retrospective descriptive study from January 2016 to December 2019 in the Gastroenterology and Internal Medicine department at the Brazzaville University Hospital. It concerned all cirrhotics hospitalized during the study period and presenting anemia. The epidemiological, diagnostic, and prognostic data studied were collected from medical records. The characteristics of anemia on the blood count were defined based on WHO values. The information collected was entered and processed with Excel 8.0 and EPI data 3.1 software. The Pearson chi2 test at the significance level ≤ 5% was used to compare the results. Results: We collected 102 files of cirrhotic patients during the study period. There were 63 men and 39 women, a sex ratio of 1.6. Among these patients, 77 presented anemia, i.e., a frequency of 75.5% with a male predominance (57.2%). Anemia increased without a significant relationship with age and was more severe in young female subjects (42.8%). The normochromic normocytic character was the most observed (52%). Anemia was more frequent in post-hepatitic cirrhosis, representing 67.5% of cases of anemia. It worsened during digestive bleeding, with the abundance of ascites and the severity of hepatic encephalopathy (p > 0.05). It was significantly associated with the drop in prothrombin level (63.6%), hypoalbuminemia (64.9%), and the Child-Pugh score (p < 0.05).展开更多
<span style="font-family:Verdana;">The involvement of general practitioners in the early detection of viral hepatitis B and C must be paramount. The objectives of this work were to assess GPs</span&...<span style="font-family:Verdana;">The involvement of general practitioners in the early detection of viral hepatitis B and C must be paramount. The objectives of this work were to assess GPs</span><span style="font-family:Verdana;">’</span><span style="font-family:Verdana;"> knowledge, attitude and practice with regard to screening for viral hepatitis B and C. We carried out a cross-sectional analytical study among GPs recruited by simple random sampling from the list of GPs in the city of Brazzaville. The judgement criteria were knowledge and practice of screening for viral hepatitis B and C, assessed according to a Likert scale divided into 3 categories: very good, good and bad. One hundred and twenty-one general practitioners were included, including 48 women and 73 men, with a sex ratio of 1.52;the average age was 33 years;52.89% of them worked in the private sector with an average period of activity of 4 years. The majority of the doctors had a good knowledge (69.42%) and a bad practice (56.20%) of screening for viral hepatitis B and C. The duration of activity was the factor linked to knowledge of viral hepatitis B and C (p</span><span style="font-family:;" "=""> </span><span style="font-family:Verdana;">=</span><span style="font-family:;" "=""> </span><span style="font-family:Verdana;">0.006) while age was the factor linked to the practice of screening for viral hepatitis B and C (p</span><span style="font-family:;" "=""> </span><span style="font-family:Verdana;">=</span><span style="font-family:;" "=""> </span><span style="font-family:Verdana;">0.0366). In conclusion, in Brazzaville, general practitioners</span><span style="font-family:Verdana;">’</span><span style="font-family:Verdana;"> knowledge of screening for viral hepatitis B and C is good in general, but the practices are poor and require targeted in-service training.</span>展开更多
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 ...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.展开更多
<strong>Introduction</strong><span style="font-family:Verdana;"><strong>:</strong></span><span><span style="font-family:Verdana;"> pancreatic cancer ...<strong>Introduction</strong><span style="font-family:Verdana;"><strong>:</strong></span><span><span style="font-family:Verdana;"> 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. </span><b><span style="font-family:Verdana;">Methods:</span></b><span style="font-family:Verdana;"> 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. </span><b><span style="font-family:Verdana;">Results:</span></b><span style="font-family:Verdana;"> 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</span></span><span> </span><span style="font-family:Verdana;">-</span><span> </span><span><span style="font-family:Verdana;">22.8];p = 0.0226). The other epidemiological variables studied were not related to the two pathologies. </span><b><span style="font-family:Verdana;">Conclusion:</span></b><span style="font-family:Verdana;"> 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 after the discovery of diabetes.</span></span>展开更多
<strong>Objective:</strong> <span><span><span><span style="font-family:Verdana;">To study the epidemiological, clinical and paraclinical particularities of fatty liver dis...<strong>Objective:</strong> <span><span><span><span style="font-family:Verdana;">To study the epidemiological, clinical and paraclinical particularities of fatty liver disease in patients with metabolic syndrome. </span><b><span style="font-family:Verdana;">Patients and Method:</span></b><span style="font-family:Verdana;"> 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. </span><b><span style="font-family:Verdana;">Results: </span></b><span style="font-family:Verdana;">The variables studied were socio-demographic, clinical, morphological and</span><span style="font-family:Verdana;"> 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. </span><b><span style="font-family:Verdana;">Conclusion:</span></b><span style="font-family:Verdana;"> 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.</span></span></span></span>展开更多
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 di...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%) patients did not talk about their illness in their entourage or family because of the risk of stigma. Only 19% (n = 8) of patients will have their children vaccinated. The existence of a vaccine was known by 31 patients;the condom was the means of prevention cited by 21 patients. Those who were aware of the existence of a treatment were 33. Sexual abstinence was observed by seven patients. The doctor was the source of information for 22 patients. High level of education and male gender were associated with a good knowledge of prevention and treatment. Conclusion: The knowledge of patients carrying the hepatitis B virus is incomplete. Their attitudes and practices do not reduce the spread of the disease. Strengthening public awareness of viral hepatitis is necessary.展开更多
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 abnorm...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.展开更多
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 t...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.展开更多
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 hep...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.展开更多
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...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.展开更多
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 h...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.展开更多
文摘Objective: assess the knowledge, attitudes, and perceptions of Brazzaville residents on colorectal cancer and its screening. Population and Methods: a CAP-type cross-sectional study was conducted from June 1 to October 31, 2022, with 803 workers approached at their place of service. Information was collected using a questionnaire administered to participants. The variables studied concerned knowledge, attitudes, and perceptions about colorectal cancer. SPSS software, along with Chi-square and Fisher tests, was used for data entry and analysis. Odds ratios were calculated to determine the strength of the association between variables. Results: The average age of the participants was 33.5 ± 10 years, with a sex ratio of 0.9. There were 231 health workers. The main sources of information were health personnel (78.2%) and the internet (52.6%). The site of the pathology was known to 87% of participants. About 40% identified age, genetic predispositions, and a diet rich in animal fats as risk factors. No signs of the disease were known by 50% of the participants. Colonoscopy was known as a screening method by 40% of participants. Seventy-five percent were willing to participate in a CRC awareness campaign, but only 5% agreed to a screening colonoscopy, although 96% recognized its usefulness. Overall, the level of knowledge was insufficient in 70.4% of cases;attitudes were adapted in 55.7% of cases, and perceptions were adapted in 97.3% of cases. Factors influencing knowledge included young age (p = 0.006), a good level of education, being a healthcare worker, and high socio-economic level. Conclusion: colorectal cancer and its screening are poorly understood by the population. Awareness activities must be organized to improve knowledge and promote screening and early diagnosis of CRC.
文摘Objective: Study of the frequency of anemia, its characteristics and its relationship with different epidemiological, diagnostic and prognostic parameters of cirrhosis. Patients and methods: This was a retrospective descriptive study from January 2016 to December 2019 in the Gastroenterology and Internal Medicine department at the Brazzaville University Hospital. It concerned all cirrhotics hospitalized during the study period and presenting anemia. The epidemiological, diagnostic, and prognostic data studied were collected from medical records. The characteristics of anemia on the blood count were defined based on WHO values. The information collected was entered and processed with Excel 8.0 and EPI data 3.1 software. The Pearson chi2 test at the significance level ≤ 5% was used to compare the results. Results: We collected 102 files of cirrhotic patients during the study period. There were 63 men and 39 women, a sex ratio of 1.6. Among these patients, 77 presented anemia, i.e., a frequency of 75.5% with a male predominance (57.2%). Anemia increased without a significant relationship with age and was more severe in young female subjects (42.8%). The normochromic normocytic character was the most observed (52%). Anemia was more frequent in post-hepatitic cirrhosis, representing 67.5% of cases of anemia. It worsened during digestive bleeding, with the abundance of ascites and the severity of hepatic encephalopathy (p > 0.05). It was significantly associated with the drop in prothrombin level (63.6%), hypoalbuminemia (64.9%), and the Child-Pugh score (p < 0.05).
文摘<span style="font-family:Verdana;">The involvement of general practitioners in the early detection of viral hepatitis B and C must be paramount. The objectives of this work were to assess GPs</span><span style="font-family:Verdana;">’</span><span style="font-family:Verdana;"> knowledge, attitude and practice with regard to screening for viral hepatitis B and C. We carried out a cross-sectional analytical study among GPs recruited by simple random sampling from the list of GPs in the city of Brazzaville. The judgement criteria were knowledge and practice of screening for viral hepatitis B and C, assessed according to a Likert scale divided into 3 categories: very good, good and bad. One hundred and twenty-one general practitioners were included, including 48 women and 73 men, with a sex ratio of 1.52;the average age was 33 years;52.89% of them worked in the private sector with an average period of activity of 4 years. The majority of the doctors had a good knowledge (69.42%) and a bad practice (56.20%) of screening for viral hepatitis B and C. The duration of activity was the factor linked to knowledge of viral hepatitis B and C (p</span><span style="font-family:;" "=""> </span><span style="font-family:Verdana;">=</span><span style="font-family:;" "=""> </span><span style="font-family:Verdana;">0.006) while age was the factor linked to the practice of screening for viral hepatitis B and C (p</span><span style="font-family:;" "=""> </span><span style="font-family:Verdana;">=</span><span style="font-family:;" "=""> </span><span style="font-family:Verdana;">0.0366). In conclusion, in Brazzaville, general practitioners</span><span style="font-family:Verdana;">’</span><span style="font-family:Verdana;"> knowledge of screening for viral hepatitis B and C is good in general, but the practices are poor and require targeted in-service training.</span>
文摘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.
文摘<strong>Introduction</strong><span style="font-family:Verdana;"><strong>:</strong></span><span><span style="font-family:Verdana;"> 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. </span><b><span style="font-family:Verdana;">Methods:</span></b><span style="font-family:Verdana;"> 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. </span><b><span style="font-family:Verdana;">Results:</span></b><span style="font-family:Verdana;"> 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</span></span><span> </span><span style="font-family:Verdana;">-</span><span> </span><span><span style="font-family:Verdana;">22.8];p = 0.0226). The other epidemiological variables studied were not related to the two pathologies. </span><b><span style="font-family:Verdana;">Conclusion:</span></b><span style="font-family:Verdana;"> 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 after the discovery of diabetes.</span></span>
文摘<strong>Objective:</strong> <span><span><span><span style="font-family:Verdana;">To study the epidemiological, clinical and paraclinical particularities of fatty liver disease in patients with metabolic syndrome. </span><b><span style="font-family:Verdana;">Patients and Method:</span></b><span style="font-family:Verdana;"> 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. </span><b><span style="font-family:Verdana;">Results: </span></b><span style="font-family:Verdana;">The variables studied were socio-demographic, clinical, morphological and</span><span style="font-family:Verdana;"> 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. </span><b><span style="font-family:Verdana;">Conclusion:</span></b><span style="font-family:Verdana;"> 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.</span></span></span></span>
文摘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%) patients did not talk about their illness in their entourage or family because of the risk of stigma. Only 19% (n = 8) of patients will have their children vaccinated. The existence of a vaccine was known by 31 patients;the condom was the means of prevention cited by 21 patients. Those who were aware of the existence of a treatment were 33. Sexual abstinence was observed by seven patients. The doctor was the source of information for 22 patients. High level of education and male gender were associated with a good knowledge of prevention and treatment. Conclusion: The knowledge of patients carrying the hepatitis B virus is incomplete. Their attitudes and practices do not reduce the spread of the disease. Strengthening public awareness of viral hepatitis is necessary.
文摘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.
文摘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.
文摘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.
文摘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.
文摘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.
