Assessment of Practice of Colonoscopy in Pediatrics in Brazzaville, Congo

Background: In Congo, there is no pediatric gastroenterology department and the activity of colonoscopy has never been evaluated. The aim of this study is to report the indications and the results of pediatric colonoscopy in Brazzaville. Methods: A retrospective study was conducted from January 2016 to August 2017 by analyzing reports of colonoscopy performed in the gastroenterology department in Brazzaville. Sex, prescribers, indications and results of colonoscopy were the variables study. Results: over the 19-month period, 489 colonoscopies have been performed, in which 13 (2.7%) colonoscopies were performed in children under 17 years, with an average age of 9.8 ± 4.6 (8 males and 6 females) and the extreme ranging from 1 - 17 years. The sex ratio (H/F) was 1.6. The prescribers were gastroenterologist (n = 4), pediatrician (n = 4), surgeons (n = 2), general practitioners (n = 2), pediatric students (n = 1). Chronic bowel inflammatory diseases and polypectomy was the most frequent conditions for colonoscopy indication. Seven (7) colonoscopies were normal. 4 cases were recto-polyps, and 2 cases were ulcerative colitis. Conclusion: pediatric colonoscopy is a powerful diagnostic and therapeutic means. The pediatricians should think about it to improve the management of children with digestive symptoms that meet the indications of pediatric colonoscopy.

Seroprevalence and Molecular Biodiversity of Hepatitis B and Delta Virus Infections in the Republic of Congo

Hepatitis B virus (HBV) infection is a major public health problem in the world. In Congo, studies on the prevalence of HBV infection are common but HDV infection is rare. Objective: Contribute to improve the management and prevention of HBV and HDV infections. Patients and Methods: This was a descriptive and cross-sectional study conducted from January to August 2016 in the health services of the various departments of Congo and at the national public health laboratory in Brazzaville. All patients with HBsAg surface antigen who were at least 18 years old and who consented to the study were included. The HBs antigen was first tested by a rapid test then confirmed by ELISA. All HBsAg positive patients were subsequently subjected to a second ELISA test for Delta antibody. The techniques of extraction and conventional and specific gene amplification were carried out on plasma for the identification of the genotypes of the two viruses. The data analysis was done with EpiInfo V7 software. The proportions were compared using the Chi-square test or the Fisher test at the significance level of 5%. Results: 1618 subjects were included, of whom 180 were positive for HBsAg, a frequency of 11.12%. The sex ratio (M/F) was 0.77%, the mean age was 40.2 ± 15.6 years with extremes ranging from 18 to 88 years. Of the 180 HBsAg positive, 22 were anti-VHD positive, a frequency of 12.22%. HBV DNA was amplified in 83.8% (151/180), HDV RNA in 63.6% (14/22). For HBV, three genotypes were identified: E (46.9%), A (43.7%) and D (9.4%), however for VHD three genotypes D1, D5, D8 were identified. Conclusion: Co-infection of hepatitis B and Delta viruses is common in Congo. The management and prevention of hepatitis B must take into account the reality of this co-infection.

Seroprevalence and Molecular Biodiverisity of Hepatitis C Infection in Congolese Diabetics

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