Mortality from Stroke in Young People in Brazzaville

Introduction: Cerebrovascular accidents (CVA) are an absolute neurovascular emergency and the main cause of mortality and acquired disability in adults. In the Congo, stroke is the leading cause of mortality and the leading cardiovascular emergency, with a hospital frequency of between 49.74% and 56.2%. The aim of the study was to identify the mortality factors associated with stroke in young people in Brazzaville. Patients and Methods: This is a longitudinal analytical study conducted from February to period from February to September 2019 in the neurology, general intensive care and medical emergency departments of the Brazzaville University Hospital (CHUB). All subjects aged 18 - 55 years of completed age, admitted for arterial stroke confirmed by brain imaging, were included. Study variables were: age, gender, socioeconomic level, laterality, time to admission and CT scan, vascular risk factors, history of cardiomyopathy, atrial fibrillation, TIA (transient ischemic attack) or stroke, NIHSS (National Institutes of Health Stroke Scale) score, Glasgow score, blood pressure, temperature, heart rate, occurrence or non-occurrence of complications, blood glucose, creatinine, lipid profile and blood count. Data were analyzed using SPSS 21 software. Descriptive analyses were performed using SPSS 21 software. Results: 103 patients were included in the study, of whom 45 (43.7%) had ischemic stroke and 58 (56.3%) with hemorrhagic stroke. Mortality was high at 29.1% in our study, and mainly concerned hemorrhagic strokes (73.7%). Two-week mortality in our study accounted for 63.33% of total lethality. After simple logistic regression, the factors associated with death within two weeks were age between 40 - 44 years (OR (odds ratio) = 2.95;p = 0.01), hemorrhagic stroke (OR = 1.41;p = 0.07), mass effect (OR = 3.26;p < 0.01), ventricular flooding (OR = 2.86;p < 0.001), Glasgow score (OR = 2.95 (0.92 - 9.43);p = 0.06), NIHSS score on admission > 15 (OR = 5.89 (2.90 - 11.95);p < 0.001) and bronchopulmonary infection (OR = 30, 95 (4.04 - 236.88), p < 0.001). From multivariate logistic regression, only NIHSS score on admission > 15 emerged as a predictor of death within two weeks (OR = 5.89 (2.90 - 11.95);p Conclusion: This study confirms the basic data of the African literature concerning stroke, as several factors were identified as independent factors associated with mortality.

Clinical and Therapeutic Aspects of Migraine in Brazzaville

Introduction: Migraine is the most common primary headache, and can cause significant disability. There are two types, migraine without aura and migraine with aura. The diagnosis of migraine is essentially clinical. Worldwide prevalence was estimated at 11.6% in 2009. In Africa, it is estimated at 10.4%. Objective: To describe the clinical and therapeutic aspects of migraine in Brazzaville. Patients and Methods: This was a door-to-door cross-sectional study conducted from 1st May to 1 st July 2018 in the city of Brazzaville. Subjects over 18 with clearly expressed consent were included. The questionnaire covered demographic characteristics, diagnostic criteria for migraine according to the IHS, treatments taken. The degree of disability was determined using the Migraine Disability Assessment Scale (MIDAS). Statistical analysis was performed using SPSS 22.0 for MAC. Results: Of the 1017 subjects interviewed in this study, 115 (39.9%) had migraine, including 73 women (63.47%) and 42 men (36.52%). In the group of migraine sufferers, the number of cases of definite migraine was 61 (53.04%) and that of probable migraine 54 (46.95%). For 81 migraine sufferers (70.43%), stress was the triggering factor. The frequency of attacks was weekly and monthly for 30 (26.1%) and 19 (16.5%) sufferers respectively. The location of the migraine was unilateral in 38% of cases and tilted in 24.3%. The intensity of the attack was described as moderate and severe in 41.7% and 57.4% of subjects respectively. Phonophobia/photophobia accompanied the migraine in 65.2% of cases. One hundred and eight subjects were treated. Of these, 106 (98.1%) were on medication. Eleven (10.37%) had received a medical prescription, and ninety-seven (89.8%) were self-medicating. Five and three subjects were under the care of a general practitioner and a neurologist respectively. Conclusion: Migraine is a frequent pathology in Brazzaville. Its preponderance among young people and women calls for the implementation of effective prevention strategies for these already vulnerable social groups. The form without aura was the most common type. Visual aura was the most common type. Headache-related symptoms were dominated by phonophotophobia, followed by nausea and vomiting. Almost all migraine sufferers were self-medicating, and very few were under the care of a doctor. First-line analgesics and NSAIDs were the mainstay of treatment.

Hydrolytic and Antimicrobial Activities of Bacteria Isolated from Fermented Peppers Sold in Markets at Brazzaville, Republic of the Congo

Microorganisms are omnipresent in all environments and play mainly the role of transformers, thanks to the multiple enzymes they are able to produce. In order to valorize fermented foods in the Republic of the Congo, this work aimed to characterize and study some properties of microorganisms isolated from samples of peppers sold in three markets of Brazzaville. A numeration of the total aerobic mesophilic flora (TAMF) was made in a solid medium, allowing the evaluation of each sample’s microbial concentration. The microbial mass varied from 2.8 × 105 CFU/g for the Ouénzé sample to 1.8 × 104 CFU/g for the Total sample and 2 × 104 CFU/g for the Moungali market sample. The evaluation of the enzymatic properties of the Bacillus isolates showed that 68.42% were capable of producing cellulases and 78.94% were capable of producing amylases and proteases. Antimicrobial activities revealed that 63.15% of the isolates were able to secrete inhibitory substances against E. coli and Staphylococcus aureus. Molecular analysis by PCR amplification, sequencing of the 16S rRNA gene and BLAST bioinformatics analysis provides newly identified bacteria strains with new accession numbers in GenBank: Bacillus thuringiensis MBCBR322 (OP474008), Bacillus megaterium MBCBJ1822 (OP476493), Bacillus thuringiensis MBCBR222 (OP476494), Priestia megaterium MBCBJ2022 (OP476495) and Lactobacillus paraplantarum MBCBR1522 (OP476496). Multiple sequences alignment of identified sequences with their homologs of GenBank has shown high similarities. The phylogenetic inference assay has provided the two groups of strains observed in this study, and the two groups are very coherent with the phylogeny of the reference.

Current Status of Congenital Toxoplasmosis in Brazzaville, Republic of the Congo

Toxoplasmosis is a parasitic infection caused by Toxoplasma gondii, which is transmitted by contact with animals carrying the parasite, or by eating contaminated food such as undercooked meat or raw fruit and vegetables. Toxoplasmosis is often benign, but can be serious in pregnant women. In order to assess the prevalence of congenital toxoplasmosis in Brazzaville, Republic of Congo, 464 women aged between 16 and 42 were surveyed in 3 health facilities, including one public hospital (Blanche Gomez) and two private medical centers (OCH medical and ultrasound practice and Luiz laboratory). A total of 1868 samples were taken and analyzed using the ELFA method on mini vidas, an enzyme-linked immunosorbent assay for fluorescence detection. The results showed that out of 1392 samples obtained from 464 pregnant women, 693 samples from 231 pregnant women were positive, i.e. a frequency of 49.78%. Analysis of the immunological profile showed 48.70% IgG and 1.07% IgG associated with IgM. The different frequencies varied from one health facility to another: 53.96% at Blanche Gomez Hospital, 53.76% at Luiz Laboratory and 31% at OCH. Seroprevalence by age group showed 57.14% in pregnant women aged 16 to 25, 52.77% in pregnant women aged 26 to 35 and 21.62% in pregnant women aged 36 to 42. A frequency of 52.65% was observed in pregnant women in contact with soil and 49.78% in pregnant women consuming vegetables, while 66.66% of women in contact with cats were positive for toxoplasmosis. IgG avidity assays showed a frequency of 74% for high avidity and 3.75% for low avidity. This study enabled us to diagnose 9 cases of seroconversion, including 6 cases of congenital toxoplasmosis. Among the 6 cases, 4 children showed toxoplasmosis with sub-clinical signs of IgG persistence at one year of age, including one with thrombocytopenia associated with jaundice and 2 others with hepatomegaly associated with hypertransaminase and hyperbilirubinemia. The maternal-fetal transmission rate was 66.66%, with an incidence of congenital toxoplasmosis of 1.29 per 464 births.In conclusion, the results of this study show the impact of toxoplasmosis on public health, and demonstrate the importance of quarterly pregnancy monitoring and compliance with hygienic and dietary measures, which are very important for prevention, early detection and management of contaminated pregnant women during prenatal monitoring, thereby reducing the consequences for newborns.

Prevalence of Children Vaccinated against Viral Hepatitis B in Brazzaville

Introduction: Viral hepatitis B (VHL) is a public health problem, particularly in sub-Sahara Africa. The aim of this study was to assess vaccination coverage against HBV in children in Brazzaville. Patients and Methods: This was a cross-sectional analytical study conducted in Brazzaville health centres from January to September 2019. It involved children aged between six months and six years who received a vaccination against HBV. Sampling was exhaustive and based on stratified sampling. Results: The overall prevalence of children vaccinated against HBV in Brazzaville was 96.2%. It was insufficient in the Talangai health district (79%). The pentavalent vaccine was administered to 97.7% of children, 85% of whom had received all three doses. The reasons for incomplete vaccination were parents’ ignorance of HVB (85.6%) and of vaccination (14.3%). Conclusion: Although the prevalence of vaccinated children is high in Brazzaville, it is still insufficient in some health districts, particularly Talangai, because parents are unaware of the disease and of vaccination. Pentavalent is the only vaccine available in the national vaccination programme, which is why an effective national vaccination policy needs to be put in place. .

Acute Kidney Injury in the Nephrology Department of the Brazzaville University Hospital: Epidemiological, Clinical and Evolutionary Aspects

Introduction: Acute kidney injury (AKI) is defined as a sudden and reversible deterioration in renal function. It is a life-threatening condition in hospitalized patients. Our objectives were to determine the prevalence of AKI in a nephrology department, list the causes, describe the evolutionary profile and identify the factors associated with death. Patients and Methods: We reviewed the records of patients hospitalised between 1 January 2016 and 31 October 2020 in the nephrology department of Brazzaville University Hospital. We included patients aged at least 18 years whose discharge diagnosis included the item AKI. Study variables were socio-demographic data, clinical and paraclinical signs, stage and type of AKI, etiology and evolutionary profile. Results: Of the 1823 patients hospitalised, 244 (13.38%) were hospitalised for AKI. Of these, 60.2% were boys and 39.8% girls, with an average age of 47 19 years. The average consultation time was 10 6.5 days. AKI was stage 3 in 69.57% of cases. It was functional, organic and obstructive in the order of 55.28%, 36.02% and 8.69%. Dialysis was indicated in 62 patients (38.51%) and performed in 24 patients (14.9%). In-hospital mortality was 27.95%, with an average hospital stay of 9.6 5.8 days. Metabolic acidosis and anemia were the main causes of death in 14.28% and 4.35% of patients respectively. Factors associated with death were male sex, socioeconomic level, coma, indication for dialysis and absence of dialysis, with a p Conclusion: AKI is more common in young adult males. Mortality is relatively low. Improving prognosis requires early management and access to dialysis.

Polymyomectomy during Cesarean Section at the University Hospital Center of Brazzaville (Congo): About a Case and Review of the Literature

Introduction: Myomectomy during cesarean section has long been a controversial subject. The increased risk of intraoperative hemorrhage and potential hysterectomy has led many teams to contraindicate it, postponing it three to six months after delivery, thus giving more time for uterine involution, myoma shrinkage and reducing operative time and blood loss. Clinical Observation: We report the case of a polymyomectomy after use of a segmental tourniquet and bilateral ligation of the hypogastric arteries during a cesarean section for hemorrhagic placenta previa at the end of a spontaneous pregnancy of 28 weeks of amenorrhea in a 42-year-old nulliparous primigravida patient. Conclusion: Polymyomectomy during cesarean section is possible and requires knowledge of preventive hemostasis techniques and surgical experience.

Assessment of the Level of Knowledge about Chronic Renal Failure in 271 Hypertensive Patients in Brazzaville

Background and Objectives: Chronic kidney disease (CKD) is now a global public health problem. In low- and middle-income countries such as the Congo, access to dialysis is low and inequitable. The prevention of CKD involves raising awareness among patients at risk, such as those suffering from arterial hypertension (AH), by improving their knowledge of CKD. The objectives of our work were to determine the level of knowledge about CKD among hypertensive patients and to identify the factors associated with a low level of knowledge. Methodology: We conducted a 3-month descriptive and analytical cross-sectional study from 1 August to 30 October 2023 in 3 large public hospitals in Brazzaville (capital of the Republic of Congo). We included: hypertensive patients aged 18 and over who had freely consented to participate in our study and were able to answer the questions on the survey form. Patients with known hypertension who had been followed for less than 3 years and those with known chronic renal failure were not included. Results: The mean age was 58.4 ± 14.4 years (29 - 88 years). There were 121 men and 150 women (sex ratio = 0.8). All the patients were educated;37.2% with a higher level of education and 13.6% with primary education. 24 patients (9%) had a good level of knowledge about CKD and 153 (56%) had poor knowledge. A good level of knowledge was associated with the duration of hypertension, intellectual level and the existence of associated heart disease. Conclusion: Our study reveals a significant lack of knowledge about chronic kidney disease among hypertensive patients in Brazzaville.

Biological Profile and Cardiovascular Risk in Patients Receiving Neuroleptics at the Psychiatric Department of the University Hospital Center of Brazzaville

Several studies report the problem of cardiovascular tolerance of treatments with neuroleptics, given the important number of morbidities in patients with mental illnesses. This preliminary work aimed to describe the epidemiological and biological profile of patients taking neuroleptics and followed in the psychiatry department of Brazzaville University Hospital, from the angle of cardiovascular risk. Fifty (50) patients (17 men and 33 women), with a mean age of 33.9 10.7 years, were included. Epidemiological data (sex, age, tobacco or alcohol consumption) were collected on pre-established survey forms. Biochemical (total cholesterol, HDL-c, triglycerides and atherogenicity index) and inflammatory parameters (ultra-sensitive CRP, troponin I and NT-ProBNP) were investigated using enzymatic and indirect immunofluorescence technical, respectively. The results obtained showed that 54% of patients were obese, 94% were non-smokers, and 12% had high blood pressure. 10% of patients had high total cholesterol levels and 90% had HDL cholesterol levels below 60 mg/dl. Triglycerides and atherogenicity index were significantly elevated in relation to Body Mass Index (BMI). Ultrasensitive CRP was elevated in 38% of patients. In conclusion, this study revealed an association between lipid parameters (triglycerides and atherogenicity index) in relation to BMI in patients taking neuroleptics followed in the Psychiatry Department of University Hospital Center of Brazzaville.

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

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.

Associated Factors with Early Sexual Intercourse among In-School Adolescents in Brazzaville

Background: Early sexual intercourse (ESI) is a global public health problem. In Congo, associated factors with ESI have been under-studied. Objective: To analyse factors associated with early sexual intercourse among in-school adolescents in Brazzaville. Method: A cross-sectional analytic study with three-stage random sampling was carried out from March 2 to June 2, 2022 in Brazzaville secondary and high schools. Adolescents in the selected schools were interviewed about their sexual and social behaviour, and their family and school environment. Multivariate analysis using logistic regression was used to identify factors associated with ESI. The significance level of the p-value was set at 5% and the confidence interval at 95%. Results: Of a total of 1100 adolescents surveyed, 800 (72.7%) had ESI, 98% of them were female. The main reason for early initiation of sexual intercourse was curiosity (81.8%). Non-use of condoms and multiple sexual partnerships were noted respectively in 98.7% and 68.7% of adolescents who had experienced ESI. Female gender (p Conclusion: The prevalence of ESI is high, and the factors identified in this study may help to reduce it.

Epidemiological, Clinical, Therapeutic, and Evolutionary Aspects of Chronic End-Stage Renal Failure in the Nephrology Department of the University Hospital of Brazzaville in 2023

Objective: Chronic end-stage renal failure is a major public health problem in developing countries and is poorly documented. The objective of this study was to describe the epidemiological, diagnostic, therapeutic, and evolutionary aspects of patients admitted for end-stage renal failure to the Department of Nephrology at the University Hospital of Brazzaville. Patients and Methods: This was a descriptive cross-sectional study collecting prospective data that took place over 10 months. We included 128 patients who were exhaustively identified. Sociodemographic, clinical, therapeutic and developmental data were collected using a standardized and pretested pre-established survey form. The EPI info software enabled the analysis and processing of the data. Results: We reported a male predominance with a sex ratio of 2.5. The median age was 50 years. The first cause found was diabetes (55%) followed by hypertension (46%). The majority of patients had a dialysis emergency and half could not be dialyzed for financial reasons. Conclusion: Our results highlighted that certain epidemiological parameters of end-stage renal failure are constantly changing, such as frequency, while others remain static, including the main etiologies, gender, and age. However, mortality continues to increase and deserves more attention.

Management of Spontaneous Intracerebral Haemorrhage (sICH) at the University Hospital of Brazzaville (CONGO)

Spontaneous intracerebral haemorrhage (sICH) is characterised by bleeding within the brain parenchyma, without any accompanying vascular malformation, parenchymal abnormality or coagulation disorder. The study aimed to depict the management of sICH at the University Hospital of Brazzaville (UHB). It was an observational, descriptive, and cross-sectional analysis. Data collection was conducted retrospectively, covering the period from January 1, 2020 to August 31, 2022, spanning two years and eight months. The study examined socio-demographic, diagnostic, therapeutic, and evolutionary variables. We included 274 cases. We observed 160 men (58.4%) and 114 women (41.6%), resulting in a sex ratio of 1.4. The mean age was 55.3 ± 11.4 years, with ages ranging from 31 to 93 years. The detection of sICH was typically a result of experiencing motor deficits (59.5%) or disorders of consciousness (37.2%). The weightiness of one half of the body was the most common reason for seeking medical advice. Hematoma was capsulo-lenticular in 159 cases (58%) and capsulo-thalamic in 63 cases (23%). Hematomas were <30 ml in 162 cases (59.1%) and >30 ml in 112 cases (40.9%), and associated with hydrocephalus in 11.7% of cases. Conservative medical treatment was administered in 257 cases (94.2%) while surgical treatment was performed in 16 cases (5.8%). The surgical techniques used were external ventricular drainage (EVD) in 2 cases, ventriculo-peritoneal shunt in 5 cases, and hematoma evacuation in 10 cases. Death occurred before the 7th day of hospitalisation in 73 cases (57.8%) and after in 46 cases (42.2%). The median time to death was four days (Q1 = 2 days;Q3 = 7 days), with extremes of 0 and 216 days. .

Helicobacter Pylori Infection: Epidemiological, Clinical and Endoscopic Aspects in Brazzaville

Introduction: Helicobacter pylori infection is a real health problem worldwide. It is the most common chronic bacterial infection in the world, and is particularly prevalent in developing countries. Objective: To determine the frequency of Helicobacter pylori infection and to study the epidemiological, clinical and endoscopic characteristics associated with this infection in Brazzaville. Patients and Methods: This was a descriptive cross-sectional study conducted from January to November 2020, i.e. 11 months. This work focused on 100 symptomatic patients over 18 years old referred for upper GI endoscopy. Gastric biopsies for biological study by urease test and molecular study by real time PCR technique were taken. Results: With a mean age of 46.32 ± 15.20 years, the frequency of Hp infection was 91%, with a female predominance of 53%. The sex ratio was 0.92. The average age was 46.32 ± 15.20 years. Carriage of the infection was more important in households with more than 3 persons, in patients consuming public tap water and in those using both types of sanitary facilities. Endoscopy was indicated for epigastralgia in 93.1% of cases. About 56.14% of the infected patients had normal mucosa versus 12.28% with ulcerated lesions and 22.81% with gastritis. Conclusion: The prevalence of Helicobacter pylori infection is significant in Congo, justifying early detection in order to improve management.

Incidence and Risk Factors of Surgical Site Infections in Urological Surgery at Brazzaville Teaching Hospital

Aim: To evaluate the incidence of surgical site infection in the Urology Department of Brazzaville teaching hospital. Methods: This was a prospective study performed in the Urology Department and operating room of the Brazzaville teaching hospital during six months from February 2nd to July 2nd 2017. The study concerned all patients who had undergone surgery, selected during the operating program and those who had been in emergency and then hospitalized in the urology department. These patients were followed for one month after the intervention date. Results: 209 patients were operated on of whom 48 had surgical site infection, a cumulative incidence of 22.96%. The average age of infected patients was 58.3 years ± 17.73 ds (extremes from 13 to 85 years). 43.75% infected patients had co-morbidity factors. The SSI rate was 70% in patients with positive urine culture. Urinary catheters were found in 33.33% of patients. The average length of preoperative hospital stay was two days. The rate of SSI in patients classified Asa I was 10.41%, Asa II 37.5% and Asa III 52.09%. The SSI rate was respectively 5.21%, 56.76% and 38.03%. The infected patients operated first in the operative program accounted for 10.42%. The group of patients who underwent prostatic surgery accounted for 42.58% of patients with an SSI rate of 47.91%. The practice of aseptic measures by staff was found in 70% of cases. The infection rate in patients with drain was 73.23%. The infection rate in patients with catheters was 54.26%. The SSI was superficial in 66.67% of cases, deep in 25% of cases and organ in 8.33% of cases. Escherichia coli was the most frequently isolated germ 50%. Conclusion: Surgical site infection (ISO) is a common feature in our practice. The advanced age of patients and comorbidity factors are associated with a high risk of occurrence of SSI. These infections were not inevitable, their incidence can be greatly reduced by specific preventive measures.

Prevalence rates and cardiometabolic determinants of diabetes mellitus and pre-diabetes with projected coronary heart disease at bank site of Brazzaville

Background: Aim: Congolese Bank employees are often inactive without valid information on the burden of dysglycemia and cardiometabolic risk. This study aims to assess the prevalence rates of diabetes mellitus (DM) and pre-diabetes and to identify the environmental, genetic and cardiometabolic risk factors associated with Type 2 diabetes mellitus (T2DM) and pre-diabetes among Congolese bank employees. Methods: In representative 126 bank employees from Brazzaville, Congo, Central Africa, Abdominal obesity, dyslipidemia and metabolic syndrome (MetS) were defined by IDF for Europe, NCEP-ATPIII and IDF criteria modified for Central Africa. Projected high 10-year total risk of coronary heart disease (CHD) ≥20% was calculated using Framingham scores. Results: Out of the employees, 16% and 21.4% had DM and pre-diabetes, respectively. The rate of T2DM among diabetics was estimated 90%. Aging, high total cholesterol, high LDL-cholesterol, high conicity index and longer urban residence after migration were significantly associated with pre-diabetes. Physical inactivity, smoking, excessive alcohol intake, abdominal obesity, female gender, low HDL-C, hypertension, CHD, projected high 10-year total CHD risk, age ≥ 55 years, urban residence, Southern area residence, high socioeconomic status, non married status, MetS/NCEP, MetS/IDF for Europe and MetS/IDF for Africa were significantly associated with T2DM.MetS/IDF for Africa was the only independent determinant of T2DM. Conclusion: Urgent prevention and intervention programme are needed to curb the alarming increase in DM, T2DM, pre-diabetes.

Epidemiology of Mortality in Polyvalent Intensive Care Unit at University Hospital of Brazzaville

Aim: To describe the epidemiological aspects of the patients who died in polyvalent intensive care unit at University Hospital of Brazzaville. Materials and Methods: This was a retrospective, cross-sectional study carried out in intensive care unit of University Hospital of Brazzaville, during period from January 2013 to December 2014. All patients who died at the unit regardless of age or sex were included. The parameters studied were age, sex, origin, reason for admission, causes of death, time of death, and length of hospitalization. Data were treated in Excel 2010 and Epi info 2007. Results: During the study period, 419 deaths out of 1121 admissions were recorded, representing a mortality rate of 37.4%. The average age was 46.2 ± 19.7 years with extremes ranging from 14 months to 90 years. The sex ratio was 0.9. Most of the deceased patients came from medical emergencies in 37.6% of the cases. Infectious (17.9%) and neurological (17.4%) pathologies were the most likely to cause death followed by cardiovascular pathologies (12.2%). Causes of death were dominated by severe sepsis and septic shock with 93.4% of infectious pathologies and stroke in 80.8% of neurological pathologies. In 42.3% of cases, the death occurred in the 8:00 p.m. to 6:00 a.m. time period. The average length of hospitalization for the deceased patients was 1.4 ± 0.5 days. All parameters studied significantly associated with mortality (p Conclusion: The mortality rate of patients admitted to the polyvalent intensive care unit at University Hospital of Brazzaville was high at 37.4%. Most of these patients were aged 40 years and older, male, with infectious and/or neurological pathologies. All deaths occurred within 48 hours of admission.

Management of Ectopic Pregnancy at the Brazzaville Hospital and University Centre

Objective: To evaluate the current management of ectopic pregnancies (EPG) at the University Hospital Centre (UHC) in Brazzaville because the practice was usually limited to total salpingectomy by laparotomy. Patients and methods: This was a descriptive study, with retrospective data collection, conducted from July 30, 2015 to January 30, 2016. It included patient records admitted to the Obstetrical Gynecology Department of the Brazzaville University Hospital for an EP, a diagnosis made before visualization on ultrasound of an active embryo outside the uterine cavity or per laparoscopy, but often by exploratory laparotomy. Sociodemographic and clinical data, as well as the therapeutic modalities of the patients, were analyzed. Cases of women operated for EP in other health facilities and referred to the UHC for complication management and cases that were unusable were excluded. Results: We noted 39 EPs out of 4490 deliveries, representing a frequency of 0.86%. The average age of the patients was 28.9 years (extreme 18 - 46 years). The transfusion of labile blood products concerned 84.6% of patients. There was no therapeutic abstention;medical treatment was performed in 3 patients (7.7% of cases). Diagnostic and therapeutic laparoscopy was performed in 9 patients (23.1%) and laparotomy was used in 26 patients (66.7% of cases) in which 35 Salpingectomies (89.7% of cases) were performed. The immediate postoperative period was marked by anaemia (32 cases or 82.1%), surgical site infection (1 case or 2.6%) and parietal suppuration (1 case or 2.6%). Conclusion: The dissemination of therapeutic advances in the management of EP is also possible in African settings.

Epidemiology of Cardiovascular Diseases in Children at the Teaching Hospital of Brazzaville, Congo

Context: Several studies were conducted throughout the world on heart diseases in children;no data is available in Congolese child. Objective: To evaluate epidemiological profile of Congolese children and teenager carrying cardiovascular diseases. Methods: A descriptive and prospective study was carried out during 4 years in the pediatric department of teaching hospital of Brazzaville, near the children received in consultation of pediatric cardiology. Results: On 41,472 patients admitted in pediatric service, 526 patients were received in consultation for suspicion of heart diseases. Among them, 444 had cardiopathy (incidence of 10.7‰). It was about a congenital heart disease to 316 (60%) incidence of 7.6‰;Acquired heart disease to 128 (24.4%) incidence of 3.1‰. Among congenital heart defects observed frequency of patients with ASD was 20.3%, isolated in 10.1% of cases, and associated with ECD (11.8%). The VSD was observed in 30.1% of cases, and the Tetralogy of Fallot in 10.1% of cases. Among the acquired heart diseases, severe hypo kinetic dilated cardiomyopathy (DCM) was noted in 24.4% of cases. The rheumatic heart diseases accounted for 41.4% of cases. It was mitral regurgitation (33.6%), a mitral stenosis (1.6%). Pericarditis was objectified at 10.1% of the patients. The evolution was favorable for 43.3% of patients. An aggravation of symptoms was observed to 2.7% of patients. Mortality was 11.9% and 71.9% of deaths were observed to not operate carriers of congenital heart disease. 69.9% of dead patients were carrying a cyanogen heart disease. Left to right shunt represented 21.7% of the deaths. Conclusion: Heart diseases are real problem of public health for Congolese children.

Helicobacter Pylori Infection in Brazzaville: Comparative Study of Two Identification Tests

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.