La cirrhose et ses complications à l’hôpital universitaire de l’Amitié de Bangui : étude du coût de la prise en charge

Abstract

We conducted in the hepato-gastroenterology and internal medicine service at the University Hospital “Amitié” of Bangui, a prospective study lasting one year on 102 patients hospitalized for the first time for cirrhosis. The study assessed the cost of management of cirrhosis in order to contribute to the improvement of care. The cost of care was calculated by adding the cost of transport of the patient to the hospital, consultation, days of hospitalization, laboratory tests, morphological examinations, drug treatments. The main complications of cirrhosis were ascites (n=69), gastrointestinal bleeding (n=52), jaundice (n=43), infection of ascites (n=39), the hepatic encephalopathy (n=31), hepatocellular carcinoma (n=14), hepatorenal syndrome (n=2). The overall average cost depending on complications was 194,170 CFA francs (€ 236) in case of ascites, 213,610 CFA francs (€ 325.64) in case of gastrointestinal bleeding, 290,940 CFA francs (€ 443.36) if digestive hemorrhage with infection of ascites and hepatic encephalopathy, 236,160 CFA francs (€ 360.47) in hepatocellular carcinoma with jaundice and ascites, 250,940 CFA francs (€ 382.56) in the case of hepatorenal syndrome with ascites. The overall cost of care for uncomplicated cirrhosis was 184,255 CFA francs (€ 280.9). The cost of hospital care of the patient was provided by the parents in 48 cases (47%), the patient himself in 23 cases (22.5%), the patient and his parents in 27 cases (26.5%), the company in 4 cases (4%).

Conclusion

The cost of treatment of cirrhosis is above the income of patients, which requires very often the parents’ involvement in the absence of national structure of security care. It is therefore important that the political authorities create a system of care for chronic diseases, especially cirrhosis and prevention of it’s causes.     

Prévalence de la rectocolite hémorragique dans le centre d’endoscopie digestive de l’hôpital Aristide-Le-Dantec de Dakar

Introduction

In Sub-Saharan Africa, ulcerative colitis (UC) has been considered as quite inexistent for a long time. Today, with development of endoscopy, more and more cases are reported in south countries. Aim: The aim of our study was to determine the prevalence and clinical aspects of UC in the digestive endoscopy unit of Universitary Hospital Aristide-Le-Dantec in Dakar.

Method

That was a retrospective study of low endoscopy reports over a period of seven years (from January 2001 to December 2007). We included all patients in whom endoscopic diagnosis of UC was confirmed by histology. Results: Among 2,667 endoscopy exams, there were 32 cases of ulcerative colitis means 1.2%. Mean age was 33.8 years. Female predominance was noted with sex ratio at 0.68. Average duration was 4.8 years. Clinical manifestations were mainly glairy or bloody diarrhoea (62.5%), proctorrhagia (31.2%) and abdominal pains (25%). Endoscopic exam founded usual elementary lesions of UC. Forms with intermediate extent represented 75% of cases. Histologic aspect was characteristic with transmucous inflammation and modification of crypts architecture.

Conclusion

Existence of UC is real in tropical areas of Africa where it is hidden by infectious colitis. Digestive endoscopy and histologic examination lead to diagnosis.     

Connaissance et couverture vaccinale contre le virus de l’hépatite B,des étudiants de l’université de Ouagadougou

Abstract

The aim of this study was to assess the level of knowledge of hepatitis B and it’s immunization coverage among students of the university of Ouagadougou.

Materials and methods

A cross-sectional study was conducted from 1^st to 15^th, April 2015. It involved students coming from the university of Ouagadougou selected by proportional stratified random sampling. Data were collected through an anonymous self-administered questionnaire.

Results

Five hundred students among 507 respondents agreed to take part to the study. The average age was 24 years ± 2 years. Four hundred fifty seven (91,4% of sample students) had heard about hepatitis B before. One hundred twenty four students (24,8%) had a good knowledge of this disease. Enrollment in Faculty of Health Sciences (Odds ratio (OR)=22,4 and p=0,000), being a scholarship beneficiary (OR=8 and p=0,000), living on campus (OR=2,6 and p=0,001) and the high level of education (OR=1,4 and p=0,02) were associated with good knowledge of the disease. The overall immunization coverage was 1,4% and that of students in the faculty of Health Sciences is 6%. Enrollment in this faculty (OR= 8,8 and p=0,001), being a scholarship beneficiary (OR=5,5 and p=0,000) and having good knowledge of hepatitis B (OR=3,6 and p=0,003) were associated with immunization.