12 research outputs found
The Perception and Practices of Black African Subjects Toward Hemorrhoidal Disease: The Relevant Effects of Beliefs and Misconceptions in Côte d’Ivoire, West Africa
No full textAlassan Kouame Mahassadi,1– 3 Hyacinthe Chepig Motcheyo,2 Dimitri Hatrydt Kouame,1– 3 Fulgence Mamert Yao-Bathaix1– 3 1Gastroenterology and Medicine Unit, Yopougon Teaching Hospital, Abidjan, Côte d’Ivoire; 2Gastroenterology and Endoscopy Unit, Abobo General Hospital, Abidjan, Côte d’Ivoire; 3Departement des maladies de l’appareil digestif, Faculty of Medicine, Felix Houphouët Boigny University, Abidjan, Côte d’IvoireCorrespondence: Alassan Kouame Mahassadi, Email [email protected]: The perception of black African subjects toward hemorrhoidal disease is surrounded by myths and misconceptions in sub-Saharan Africa. This study aimed to determine the magnitude of knowledge, attitudes, and practices (KAPs) of black African subjects toward hemorrhoidal disease and the impact of knowledge on their attitudes and practices.Methods: A cross-sectional KAP survey was conducted through convenience sampling of 735 participants (mean age, 38.8 years; men, 59.2%) from urban and rural areas in Côte d’Ivoire. They received an auto questionnaire of 25 items on Likert scales depicting their KAP toward hemorrhoidal disease. A mean score of KAP < 50 points was considered low. Logistic and linear regression models were used to determine the factors associated with self-reported hemorrhoidal disease and the impact of knowledge on attitudes and practices.Results: The overall Cronbach score was 0.75, and the sample proportions of self-reported or symptom-based hemorrhoidal disease were 44.4% (9% CI: 41– 48) and 21.2% [95% CI: 18.4– 24.4], respectively. The overall mean (SD) scores of KAP were low: 49 (34.4), 43.4 (18.7), and 33.6 (21.7), respectively. The attitudes and practices of the participants remained unchanged regardless of their knowledge. Hemorrhoidal disease was negatively associated with attitudes (beta = − 3.1, p = 0.02) or practices (beta = − 3.4, p < 0.05). Overall, the participants agreed that hemorrhoidal disease led to sexual dysfunction (85.2%) and infertility (67.1%). They preferred indigenous (52.4%) over modern treatments (30.2%) and perceived surgery for hemorrhoidal disease to be dangerous (24.4%) and not recommended (56.6%).Conclusion: Knowledge did not change the attitudes and practices of black African subjects toward hemorrhoidal disease.Keywords: hemorrhoidal disease, myths, misconception, sub-Saharan Afric
Factors Associated with Hepatic Fibrosis During Metabolic Steatopathy In Abidjan
Get PDFRÉSUMÉ
Introduction. Le faible nombre d’études sur les facteurs de risque de la fibrose hépatique dans la stéatopathie métabolique (NAFLD) en Afrique subsaharienne nous a conduit à initier ce travail dont le but était de déterminer les facteurs associés à la fibrose hépatique au cours de la NAFLD diagnostiquée par l’élastométrie impulsionnelle (Fibroscan©) chez le noir africain. Méthodes. Nous avons inclus 51 patients recrutés au sein du CHU de Cocody et au siège de la Société Générale des Banques de Côte d’Ivoire dans la ville d’Abidjan. Tous les patients ont effectué un Fibroscan®. Il existait une fibrose significative lorsque F>=2. La stéatose était présente si S >215dB/m. Les tests de Chi 2 et de la régression logistique ont été utilisés. Ils étaient significatifs lorsque p<0,05. Résultats. La NASH était présente chez 54,1% (n=28), la NAFL chez 46,9% (n=23). 58,7% des patients NAFLD (n=30) avaient une fibrose significative. 96 % des patients avaient un IMC ≥ 25kg/m². 56,9% des patients présentaient une stéatose modérée à sévère. Les facteurs de risque associés à la survenue de fibrose significative en analyse uni variée étaient : le sexe masculin, l’âge supérieur à 40 ans, le surpoids, l’obésité, les grades de stéatose légère et modérée, l’obésité tronculaire et le cholestérol total. L’obésité tronculaire était le seul facteur indépendamment associé à la survenue de la fibrose hépatique en analyse multi variée. Conclusion. L’obésité est le principal facteur de risque de survenue de fibrose et de stéatose chez les patients NAFLD.
ABSTRACT
Introduction. Metabolic steatopathy (NAFLD) is the hepatic manifestation of metabolic syndrome. The low number of studies on the evaluation of fibrosis in sub-Saharan black Africa led us to initiate this work, the aim of which was to determine the factors associated with fibrosis in course of NAFLD diagnosed by impulse elastometry (Fibroscan©) in black African subjects. Methods. We included 51 patients recruited within the Cocody University Hospital and at the headquarters of the Société Générale des Banques de Côte d'Ivoire in the city of Abidjan. All patients underwent a Fibroscan®. There was significant fibrosis when F>=2. Steatosis was present if S >215dB/m. Chi square and logistic regression tests were used. They were significant when p<0.05. Results. NASH was present in 54.1% (n=28), NAFL in 46.9% (n=23). 58.7% of NAFLD patients (n=30) had significant fibrosis with a predominance for NASH patients. 96% of patients had a BMI ≥ 25kg/m². 56.9% of patients presented moderate to severe steatosis. The risk factors associated with the occurrence of significant fibrosis in univariate analysis were: male sex, age over 40 years, overweight, obesity, grades of mild and moderate steatosis, truncal obesity and total cholesterol. Truncal obesity was the only factor independently associated with the occurrence of hepatic fibrosis in multivariate analysis. Conclusion. Impulse elastometry (Fibroscan®) is a non-invasive method for assessing and stratifying hepatic fibrosis and steatosis. Obesity is the main risk factor for the occurrence of fibrosis and steatosis in NAFLD patients
Determinants of in-Hospital Mortality in a Gastroenterology Unit in Cote d'Ivoire (West Africa): An Advocacy for a Social Security Policy
No full textBackground: The in-hospital mortality is a major concern in Africa. The study is aimed at providing the determinants of in-hospital mortality of patients admitted in the gastroenterology and medicine unit (GMU) of the teaching hospital of Yopougon (Abidjan, Ivory Coast). Patients and Methods: A retrospective cohort of 341 patients (males: 53%, mean age: 43 years) admitted in the GMU during 2009 were studied. Socio-demographic, clinical, biological characteristics of patients were retrieved. Survival probability and determinants of in-hospital mortality were respectively determined by the Kaplan Meier curve and Cox model. Results: Among the 341 patients admitted, 79 (23.2%) died in the GMU. The in-hospital mortality rate was 4.3 (95%IC: 3.3-5.2) death per 100 patients-day. The main diagnoses were HIV/AIDS (15%), cirrhosis (14.4%), hepatocellular carcinoma (13.5%), tuberculosis (12.6%) and gastroenteritis (7.9%). Survival probabilities were higher in patients with Financial support (FS) to face medical fees (log rank test = 10.7, P=.001), with no comorbidities (log rank test= 4.5, P=.03) compared to those without, and when diagnoses were established than unknown (log rank test=11. 5, P=.001). In multivariate analysis, prothrombin time <65% (aHR=2.6, P=.02), creatinine level (aHR: 1.02, P=.02), HIV/AIDS or tuberculosis (aHR=0.44, P=.01), non malignant digestive diseases (aHR=0.34, P=.01) and FS (aHR=0.45, P<.02) were significantly associated with mortality in GMU. Conclusion: This study demonstrated that patients with HIV/AIDS or tuberculosis, non malignant digestive diseases or FS had a better outcome. However those with impairment of renal and liver functions had a high risk of death in the GMU
Diagnostic accuracy of biochemical markers of fibrosis in black African patients with chronic hepatitis B
No full textProfil épidémiologique et clinique des patients porteurs d’infection gastrique à Helicobacter pylori dans l’unité d’endoscopie digestive du centre hospitalier universitaire de Yopougon.
No full textContexte : La prévalence de l’infection gastrique à Helicobacter pylori (Hp) en milieu endoscopique à Abidjan en 1994 était de 74,45% ; majoritairement chez des hommes de moins de 40 ans admis pour épigastralgies chroniques.But : Décrire une décennie après l’étude d’Attia et al, dans le même service, le profil épidémiologique et clinique des patients infectés par Hp.Patients et Méthodes : Il s’agit d’une étude prospective qui s’est déroulée du 9 février au 9 août 2002 dans l’unité d’endoscopie du CHU de Yopougon. Durant cette période, 90 patients ont été tirés au sort et ont fait l’objet de biopsies gastriques systématiques au cours de l’endoscopie digestive pour diagnostic histologique de l’infection à Hp. Les paramètres étudiés étaient épidémiologiques et cliniques.Résultats : Parmi les 90 patients ayant eu des biopsies gastriques durant la période d’étude, 52 patients avaient une infection à Hp, soit une prévalence de 57,8%. Les hommes infectés par Hp étaient au nombre de 23 (sex-ratio 0,79). L’âge de nos patients infecté variait de 17 et 84 ans avec une moyenne de 37,5± 14,17 ans et une médiane de 34,5 ans. Les tranches d’âge les plus touchées étaient celles comprises entre 21 et 40 ans (57,7% des cas). Dans notre série, les employés de la fonction publique, les employés du privé et les femmes au foyer étaient les plus infectés (n= 22 ; 42,3%). Les épigastralgies constituaient le principal motif de l’examen endoscopique (82,7% des cas ; n=43). Respectivement 17,3% (n=9), 9,6% (n=5) et 12,6% (n=7) ont pris un médicament gastrotoxique, un antibiotique ou un antisécrétoire gastrique les 4 semaines qui précédaient l’examen endoscopique.Conclusion : Bien qu’elle ait diminué en une décennie, Hp reste endémique chez les patients vus en endoscopie digestive. Elle prédomine toujours chez les sujets de moins de 40 ans mais majoritairement chez les femmes se plaignant d’épigastralgies chroniques.Mots clés: Epidémiologie, profil clinique, Helicobacter Pylori, endoscopie, Abidjan English Title: Epidemiological and clinical profile of patients with Helicobacter pylori gastric infection in the digestive endoscopy unit of the Yopougon University Hospital CenterBackground: A 74.45% prevalence of helicobacter pylori (Hp) gastric infection had been reported in 1994 in Abidjan endoscopic unit. This infection was predominant in men under 40 years admitted for chronic epigastralgia.Aim: To describe try in the same department, ten years later, epidemiological and clinical profile of patients infected with Hp.Patients and methods: This is a prospective study that was conducted from February 9 to August 9, 2002 in the endoscopy unit of Yopougon University Hospital. During this period, 90 patients were treated and subjected to systematic gastric biopsies during digestive endoscopy for histological analysis. The studied parameters were epidemiological and clinical.Results: Among the 90 patients included, 52 had Hp infection (prevalence of 57.8%). Men infected with Hp were 23 (sex ratio 0.79). Age of infected patients varied to 17 and 84 years old with an average of 37.5 14.17 years and a median of 34.5 years. The age groups associated with these include between 21 and 40 years, 57.7% of the cases. In our series, public service employees, private employees and housewives were the most infected (n = 22, 42.3%). Epigastralgia was the main reason for endoscopic endamenic (82.7% of cases, n = 43). Respectively 17.3% (n = 9), 9.6% (n = 5) and 12.6% (n = 7) took a gastrotoxic drug, an antibiotic or an endoscopic gastric antisecretory.Conclusion: Although you have decreased in 10 years, Hp remains endemic in patients seen in digestive endoscopy. It still predominates in subjects under 40 years of age but mostly in women who complain of chronic epigastralgia.Keywords: Epidemiology, clinical profile, Helicobacter Pylori, endoscopy, Abidjan
Profil biologique des porteurs inactifs du virus de l’hépatite B à Abidjan
No full textEnglish Title: Biological profile of inactive carriers of the hepatitis B virus in Abidjan
L’objectif était de décrire le profil de FH chez les patients porteurs chroniques inactifs du VHB. Il s’agit d’une étude rétrospective transversale (février 2014 à Décembre 2017). Soixante-dix-sept dossiers de patients inactifs du VHB ont été colligés. Les paramètres recueillis étaient démographiques (âge sexe), biologiques (antigénémie HBs, charge virale B, plaquettes et transaminases sanguines) et élastométrique (valeur du fibroscan). La fibrose hépatique a été évaluée selon 4 tests (APRI, TREAT B, FIB 4 et Fibroscan (FS)).L’âge moyen était de 42,4 ans. Le sex ratio était à 1,43. La médiane des transaminases était respectivement de 24 UI/L et de 21 UI/L pour les ASAT et ALAT. Les dix patients ayant eu un dosage du génotype du VHB avaient tous un génotype E. Aucun patient dans notre étude n’avait de fibrose hépatique significative au score APRI. Respectivement 5,1%, 11,4%, 27,8% avaient une fibrose hépatique significative selon le score TREAT B, FS, FIB 4. Il existait une corrélation positive significative entre les transaminases et le score APRI et, entre le score APRI et le score FIB. Il n’existait pas de corrélation entre le FS et, le score FIB 4, le score APRI et le taux de transaminases ni entre les transaminases et le FIB 4. L’évaluation de la fibrose hépatique est nécessaire chez tout sujet porteur chronique du VHB AgHBe négatif quel que soit la charge virale et le taux des transaminases en Afrique noire. Le choix du test non invasif influence le diagnostic de fibrose hépatique significative et par conséquent l’initiation du traitement antiviral.
Mots clés : porteurs chroniques inactifs du VHB, fibrose hépatique, Fibroscan, TREAT B, APRI, FIB 4
Risks of Viral Hepatitis B Transmission in Mother-to-Infant of Pregnant Women Carriers of Chronic Viral Hepatitis B in Cote d’Ivoire
No full textAssessment of the Efficacy of Rifaximin in the Management of Irritable Bowel Syndrome (IBS)
No full textUsefulness of Noninvasive Predictors of Oesophageal Varices in Black African Cirrhotic Patients in Côte d'Ivoire (West Africa)
Get PDFAims. To determine the usefulness of platelet count (PC), spleen diameter (SD) and platelet count/spleen diameter ratio (PC/SD ratio) for the prediction of oesophageal varices (OV) and large OV in black African patients with cirrhosis in Côte d’Ivoire. Materials and Methods. Study was conducted in a training sample (111 patients) and in a validation sample (91 patients). Results. Factors predicting OV were sex: (OR=0.08, P=0.0003), PC (OR = 12.4, P=0.0003), SD (OR = 1.04, P=0.002) in the training sample. The AUROCs (±SE) of the model (cutoff ≥ 0.6), PC (cutoff 140) and PC/SD ratio (cutoff ≤ 868) were, respectively; 0.879 ± 0.04, 0.768 ± 0.06, 0.679 ± 0.06, 0.793 ± 0.06. For the prediction of large OV, the model’s AUROC (0.850 ± 0.05) was superior to that of PC (0.688 ± 0.06), SD (0.732 ± 0.05) and PC/SD ratio (0.752 ± 0.06). In the validation sample, with PC, PC/SD ratio and the model, upper digestive endoscopy could be obviated respectively in 45.1, 45.1, and 44% of cirrhotic patients. Prophylactic treatment with beta blockers could be started undoubtedly respectively in 36.3, 41.8 and 28.6% of them as having large OV. Conclusion. Non-invasive means could be used to monitor cirrhotic patients and consider treatment in African regions lacking endoscopic facilities
Efficacy of 4 quadruple therapy to eradicate Helicobacter pylori in the real life
Get PDFBackground: The effectiveness of rate of eradication Helicobacter pylori is unknown in Côte d'Ivoire in daily practice. Objectives : The aim ofour study was to assess the effectiveness of 4 quadruple therapies Materials and Methods : This was a retrospective multi center study carriedout in Abidjan. The medical records of naive patients over 18 years old treated with quadruple therapy [sequential (Q s), concomitant 10 (Qc10) or14 days (Qc14) or bismuth based therapy (Qb)]confirmed histologically on gastric biopsies were included. All had a histologic al check for theeradication of H pylori at least 4 weeks after the en d of treatment. The quadruple th erapy eradication rate has been determined. Results : Onehundred and seventy files were included. The overall eradication rate was 60.6% [53.3% 67.9% 95% CI]. It was 55.6% for Qs (30/54, [42.3%68.9% 95% CI]), 80% for Qc10 (8/10, [55.2% 100% 95% CI ]]), 58.3% for Qc14 (49/84, [47,756%, 68,844% 95% CI]) and 72.7% for Qb (16/22,[54,084%, 91,316% 95% CI]). The patients of the 4 protocols were comparable for age (p = 0.054); gender (p = 0.157); reason p = 0.173) andendoscopy result (p = 0.244); intensit y of antral (p = 0.542) and fundic (p = 0.744) H pylori infection in histology; frequency of side effects (p =0.131) and adherence to therapy (p = 0.564). Conclusion s : T he eradication rate of H pylori in daily practice was not optimal regardless of thequa druple therapy regimen used. A study of the resistance of H pylori to different antibiotics is necessary
