Open Journal of Gastroenterology最新文献

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Seroprevalence, Importance of Rapid Testing and Factors Associated with HBsAg Carriage in Pregnancy in Three Referral Maternity Hospitals in Mono (Benin), in 2020 2020年Mono(贝宁)三家转诊妇产医院妊娠期HBsAg携带的血清阳性率、快速检测的重要性和相关因素

Open Journal of Gastroenterology

Pub Date : 2023-01-01 DOI: 10.4236/ojgas.2023.139026

Aboudou Raïmi Kpossou, Djima Patrice Dangbemey, Véronique Mèdessè Tognifodé, Barnard Acakpo, Jean Sehonou, Josiane Angeline Tonato Bagnan

Introduction Difficulties in accessing the screening test for viral hepatitis B in maternity wards could be a factor in underestimating the prevalence of anti-HBV antibodies. The rapid diagnostic orientation test (RDOT) could improve seroprevalence and obstetrical prognosis. The aim of this study was to use the rapid diagnostic orientation test (RDOT) to determine the seroprevalence of HBs antigen carriage in pregnant women while highlighting the associated factors. Methods This was a cross-sectional and descriptive study that took place from October to December 2020 (three months) in three (03) reference maternities in western Benin (Mono). Consenting pregnant women received in prenatal consultation had been screened by RDOT. Positive cases were confirmed by ELISA test. The follow-up of these cases made it possible to establish the obstetrical prognosis. Results Of 201 women studied, 11 (5.5%) were positive for RDOT HBV and confirmed by the ELISA test. The factors associated with HBsAg carriage during pregnancy were multiple sexual partnerships (p = 0.01), female circumcision (p = 0.0001), and ignorance of prior HBV serological status (p = 0.0001). No influence of hepatitis B on pregnancy was noted. Conclusion The seroprevalence of hepatitis B in pregnancy was intermediate in the reference maternities of western Benin. The associated factors were multiple sexual partnerships, female circumcision and unawareness of prior HBV status. Free RDOT in maternity wards would improve early detection and management of viral hepatitis B in pregnancy.

在产科病房获得病毒性乙型肝炎筛查试验的困难可能是低估抗hbv抗体流行率的一个因素。快速诊断定向试验(RDOT)可以改善血清阳性率和产科预后。本研究的目的是利用快速诊断定向试验(RDOT)确定妊娠妇女携带HBs抗原的血清阳性率，并强调相关因素。方法:这是一项横断面描述性研究，于2020年10月至12月(3个月)在贝宁西部(Mono)的3个(03)参考产妇中进行。RDOT对产前咨询中同意的孕妇进行了筛查。阳性病例经酶联免疫吸附试验证实。对这些病例的随访使得确定产科预后成为可能。结果201例妇女中，11例(5.5%)RDOT HBV阳性，经ELISA检测证实。与妊娠期HBsAg携带相关的因素是多性伴侣(p = 0.01)、女性包皮环切术(p = 0.0001)和对既往HBV血清学状态的无知(p = 0.0001)。未发现乙型肝炎对妊娠的影响。结论贝宁西部参考产妇妊娠期乙型肝炎血清阳性率处于中等水平。相关因素有多个性伴侣、女性包皮环切术和不知道先前的HBV状态。产科病房免费RDOT将改善妊娠期病毒性乙型肝炎的早期发现和管理。

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引用次数: 0

Barcelona Clinic Liver Cancer Classification and Treatment of Hepatocellular Carcinoma in a Côte d’Ivoire University Hospital 巴塞罗那诊所肝癌分类和科特迪瓦大学医院肝细胞癌的治疗

Open Journal of Gastroenterology

Pub Date : 2023-01-01 DOI: 10.4236/ojgas.2023.1310029

Kissi Anzouan-Kacou Henriette Ya, Bangoura Aboubacar Demba, Kouame Dimitri, Doffou Stanislas Adjeka, Mahassadi Kouame Alassan, Yao Bathaix Fulgence Mamert, Attia Alain Koffi

引用次数: 0

Prevalence, Pattern and Risk Factors of Soil Transmitted Helminth Infections amongst Children in a Tertiary Institution in South East, Nigeria 尼日利亚东南部一所高等教育机构儿童土壤传播蠕虫感染的流行、模式和风险因素

Open Journal of Gastroenterology

Pub Date : 2023-01-01 DOI: 10.4236/ojgas.2023.138025

Okoro Jude Chidi, Ezeogu Joseph, Ogbonna Ikechukwu Frank

Introduction: Soil-transmitted helminthic infection (STHI) is a common public health challenge of children in the most deprived communities in low income countries. In the long-term, STHI can cause developmental and growth disorders leading to future learning defect. Objective: Our aim was to determine the prevalence and pattern of soil-transmitted helminthic infection among children attending a tertiary hospital in Imo State, Nigeria. Patients and Method: The study involved a cross-sectional survey of 268 children, aged 7 months to 18 years seen in a tertiary health facility in Nigeria; from August to December 2022. Data were collected using a structured questionnaire and stool samples were analyzed for intestinal helminths using the Kato-Katz method. Results: The prevalence of soil-transmitted helminthic infection (STHI) was 38.4%. Of all STHIs, Ascaris lumbricoides was the commonest geohelminth observed, 81 (62.1%). Multiple infections were noted in 25 (62.4%) of the specimen. The prevalence of soil-transmitted helminthic infection amongst subjects’ 5 - 9 years was high and least in children older than 15 years. This difference was not statistically significant (p = 0.3407). Statistically significant relationship was detected between STHI and low socioeconomic class. Conclusion: The high prevalence rate of soil-transmitted helminthic infection amongst the subjects is disturbing. This high rate justifies strengthening a structured and routine deworming amongst children in order to improve outcome.

土壤传播蠕虫感染(STHI)是低收入国家最贫困社区儿童面临的共同公共卫生挑战。从长远来看，STHI会导致发育和生长障碍，从而导致未来的学习缺陷。目的:我们的目的是确定在尼日利亚伊莫州一家三级医院就诊的儿童中土壤传播的蠕虫感染的流行程度和模式。患者和方法:该研究对268名儿童进行了横断面调查，年龄在7个月至18岁之间，在尼日利亚的一家三级卫生机构就诊;从2022年8月到12月。使用结构化问卷收集数据，并使用Kato-Katz方法分析粪便样本中的肠道蠕虫。结果:土壤传播蠕虫感染率为38.4%。其中蚓类蛔虫最多见，共81只(62.1%)。多发感染25例(62.4%)。5 ~ 9岁儿童土壤传播寄生虫感染率最高，15岁以上儿童最低。差异无统计学意义(p = 0.3407)。STHI与低社会经济阶层之间存在显著的统计学关系。结论:调查对象土壤传播性寄生虫感染率高，令人担忧。如此高的驱虫率证明有必要在儿童中加强有组织的常规驱虫，以改善结果。

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引用次数: 0

Risk Factors of Liver Cirrhosis in Chad: Large Proportion of Cases without Clear Etiology 乍得肝硬化的危险因素:很大一部分没有明确病因的病例

Open Journal of Gastroenterology

Pub Date : 2023-01-01 DOI: 10.4236/ojgas.2023.1311031

Ali Mahamat Moussa, Pascal Pineau, Mayanna Habkreo, Moussa Hassan Elefi, Tahir Mahamat Saleh, Maire Dehainsala, Mahamat Ali Hachim, Adama Ahmed N’Gare, Adoum Abderrazak Fouda, Bessimbaye Nadlaou, Adawaye Chatté

Background: In comparison to other forms of chronic liver diseases, cirrhosis is generally poorly studied in sub Saharan Africa. In Chad, more particularly, no data are available despite the burden of liver diseases considered as the first cause of hospitalizations in the country. Methods: We conducted a retrospective analysis of 268 patients with liver cirrhosis attending care at the University Reference Hospital between 2007 and 2016. Results: This series of liver cirrhoses was characterized by a weak mal predominance (M:F = 1.7). The age of onset occurs significantly earlier in women than in men (40.6 ± 12.0 vs. 44.4 ± 13.4, p = 0.0171). The principal risk factor was persistent infection with hepatitis B virus (49% of cases) followed distantly by infection with hepatitis C virus (13%) and excessive alcohol consumption (10%). Men were more frequently carrying HBV surface antigen than women (65.6% vs 35.9% p = 0.0019). HBV-associated liver cirrhosis was overall more severe than diseases from other causes. A large proportion of cirrhosis (30%), observed primarily in women (48.1% vs 24.1%, p = 0.0036), was considered are cryptogenic. Conclusions: The etiological spectrum of liver cirrhosis remains to be properly defined in Chad. This lack of knowledge prevents the implementation of an efficient policy of prevention. A significant effort should be secured to characterize hitherto neglected infectious, lifestyle or genetic risk factors responsible of this form of terminal disease and improve subsequently liver health of local populations.

背景:与其他形式的慢性肝病相比，撒哈拉以南非洲地区对肝硬化的研究通常较少。特别是在乍得，尽管肝病被认为是该国住院的首要原因，但没有可用的数据。方法:对2007年至2016年在大学参考医院就诊的268例肝硬化患者进行回顾性分析。结果:该系列肝硬化的特点是弱男性优势(M:F = 1.7)。女性发病年龄明显早于男性(40.6±12.0∶44.4±13.4,p = 0.0171)。主要危险因素是持续感染乙型肝炎病毒(49%的病例)，其次是感染丙型肝炎病毒(13%)和过度饮酒(10%)。男性携带HBV表面抗原的频率高于女性(65.6% vs 35.9% p = 0.0019)。hbv相关的肝硬化总体上比其他原因引起的疾病更严重。很大比例的肝硬化(30%)，主要见于女性(48.1% vs 24.1%， p = 0.0036)，被认为是隐源性的。结论:乍得肝硬化的病因谱仍有待明确。这种知识的缺乏妨碍了有效预防政策的执行。应作出重大努力，确定迄今为止被忽视的导致这种终末期疾病的传染、生活方式或遗传风险因素的特征，并随后改善当地人口的肝脏健康。

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引用次数: 0

Esophagitis Due to Actinomycosis in an Immunocompetent Patient with a History of SARS-Cov-2 Infection: Case Report 有SARS-Cov-2感染史的免疫正常患者放线菌病所致食管炎1例报告

Open Journal of Gastroenterology

Pub Date : 2023-01-01 DOI: 10.4236/ojgas.2023.1310028

Zamora Harvey, Hernández Gustavo, González Melina

We present an unusual case of esophageal actinomycosis that developed in a patient with normal immunity and a history of acute SARS-CoV-2 infection. We report a case of a 56-year-old female patient without chronic degenerative pathologies with a history of non-severe acute SARS-CoV-2 infection that occurred two months prior to her presentation, treated with prednisone and betamethasone orally and inhaled, respectively for 21 days. The pivotal symptom is dysphagia and definitive diagnosis requires a tissue culture of the affected organ or a biopsy that shows the classic sulfur granules. Currently, antibiotic treatment with beta-lactams, such as amoxicillin/clavulanic acid, is still effective, as it was in our patient.

我们报告了一例不寻常的食管放线菌病，发生在一名免疫正常且有急性SARS-CoV-2感染史的患者中。我们报告一例56岁女性患者，无慢性退行性病理，就诊前2个月有非严重急性SARS-CoV-2感染史，分别口服和吸入强的松和倍他米松治疗21天。关键症状是吞咽困难，明确的诊断需要受影响器官的组织培养或活检显示典型的硫颗粒。目前，使用-内酰胺类抗生素治疗，如阿莫西林/克拉维酸，仍然有效，就像我们的病人一样。

引用次数: 0

Factors Associated with Hepatic Steatosis in Black African Subjects with Chronic Viral Hepatitis B in Côte d’Ivoire 科特迪瓦非洲黑人慢性乙型肝炎患者肝脂肪变性相关因素研究

Open Journal of Gastroenterology

Pub Date : 2023-01-01 DOI: 10.4236/ojgas.2023.1310030

Kouamé Hatrydt Guillaume Dimitri, Kissi Anzouan-Kacou Henriette Ya, Gogan Patricia, Bangoura Aboubacar Demba, Doffou Stanislas Adjeka, Mahassadi Kouame Alassan, Yao Bathaix Fulgence Mamert, Attia Alain Koffi

引用次数: 0

Antiviral Therapy Eligibility and Low Treatment Coverage among Hepatitis B Virus Infected Patients in Tanzania 坦桑尼亚乙型肝炎病毒感染患者的抗病毒治疗资格和低治疗覆盖率

Open Journal of Gastroenterology

Pub Date : 2023-01-01 DOI: 10.4236/ojgas.2023.1310027

Semvua B. Kilonzo, Igembe Nkandala, Hyasinta Jaka, Leticia Marmo

Introduction: Limited access to treatment is a crucial factor contributing to the suboptimal control of hepatitis B virus (HBV) infection, especially in sub-Saharan African countries such as Tanzania. The eligibility for antiviral therapy is typically determined based on the extent of HBV replication and liver damage. However, there is insufficient data available regarding the actual treatment needs and the overall characteristics of HBV-infected individuals in Tanzania. Therefore, the aim of this study is to fill this knowledge gap and provide valuable insights to aid in the planning of treatment programs. Materials and Methods: We conducted a cross-sectional study at Bugando Medical Centre in northwest Tanzania, examining the data of 340 patients who were diagnosed with chronic HBV infection and attending the hepatitis clinic. Data on sociodemographic, clinical, and investigation details were collected through electronic files and subsequently analyzed. The eligibility for HBV antiviral treatment was assessed using the criteria established by the World Health Organization (WHO). Results: Out of the 340 patients included in the study, the majorities were males 252 (74.1%) and had a median age of 36 years. Most patients came from outside of Mwanza city. Twenty-percent had significantly elevated alanine transaminase, and over one-third had high DNA levels (>2000 IU/L). The prevalences of liver cirrhosis and significant liver fibrosis were 15% and 15.3%, respectively. None of the patients were on antiviral therapy for hepatitis B. A total of 64 (18.8%) patients met the criteria for treatment eligibility. Male sex, older age, residing outside Mwanza city, and anemia (all with p < 0.05) were factors associated with treatment eligibility in the multivariate analysis. Conclusion and Recommendations: The significant number of HBV-infected patients is suitable for antiviral therapy but none of them have initiated the treatment. The significance of these findings is to emphasize the need for enhancing hepatitis B services in Tanzania.

引言:获得治疗的机会有限是导致乙型肝炎病毒(HBV)感染控制不佳的一个关键因素，特别是在坦桑尼亚等撒哈拉以南非洲国家。抗病毒治疗的资格通常是根据HBV复制和肝损伤的程度来确定的。然而，关于坦桑尼亚艾滋病毒感染者的实际治疗需求和总体特征的现有数据不足。因此，本研究的目的是填补这一知识空白，并提供有价值的见解，以帮助制定治疗方案。材料和方法:我们在坦桑尼亚西北部的Bugando医疗中心进行了一项横断面研究，检查了340名被诊断为慢性HBV感染并在肝炎诊所就诊的患者的数据。通过电子文件收集社会人口学、临床和调查细节数据，随后进行分析。使用世界卫生组织(WHO)制定的标准评估HBV抗病毒治疗的资格。结果:纳入研究的340例患者中，多数为男性252例(74.1%)，中位年龄36岁。大多数病人来自姆万扎市以外。20%的人谷丙转氨酶显著升高，超过三分之一的人DNA水平高(>2000 IU/L)。肝硬化和显著肝纤维化的患病率分别为15%和15.3%。所有患者均未接受乙肝抗病毒治疗，64例(18.8%)患者符合治疗资格标准。在多因素分析中，男性、年龄较大、居住在姆万扎市以外、贫血(p < 0.05)是影响治疗合格性的因素。结论与建议:相当数量的hbv感染者适合抗病毒治疗，但没有人开始治疗。这些发现的意义在于强调加强坦桑尼亚乙型肝炎服务的必要性。

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引用次数: 0

Hepatocellular carcinoma in Micronesians, a growing Pacific Islander population in the U.S. 密克罗尼西亚人的肝细胞癌，美国太平洋岛民人数不断增加。

Open Journal of Gastroenterology

Pub Date : 2018-01-01 Epub Date: 2018-06-29 DOI: 10.4236/ojgas.2018.86025

Eric M Wu, Brenda Y Hernandez, Linda L Wong

Aim: Micronesians are a rapidly growing population in Hawaii and the continental U.S. Hepatitis B is prevalent in Micronesia, but the consequences in those migrating to the U.S. are unclear. This study characterizes hepatocellular carcinoma in Micronesians with comparisons to other Pacific Islanders.

Methods: A retrospective evaluation was undertaken of 40 Micronesian and 142 Non-Micronesian Pacific hepatocellular carcinoma patients diagnosed in a large clinical practice in Hawaii from 1993-2017.

Results: All Micronesians were born outside of the U.S. Micronesians were younger at diagnosis (52.0 vs 60.2 years, had higher rates of hepatitis B (80% vs 31.2%), a family history of hepatocellular carcinoma (17.5% vs 4.4%) and more tumors <5 cm (64.1% vs 45.2%). Non Micronesian Pacific Islanders had higher rates of Hepatitis C (48.6% vs 22.5%) and hypertension (61.7% vs 32.4%). There was no difference in the proportions of screen-detected tumors, those meeting Milan criteria, tumor stage, or liver function. Micronesians had better 5-year survival rates (48% vs 16.7%).

Conclusion: Hepatocellular carcinoma in Micronesians is primarily Hepatitis B-related. Micronesians were equally likely to have hepatocellular carcinoma found with screening, undergo transplant and had better survival. Our study emphasizes the need for hepatitis B screening and hepatocellular carcinoma surveillance in Micronesians.

目的：密克罗尼西亚人在夏威夷和美国大陆是一个快速增长的人口。乙型肝炎在密克罗尼西亚流行，但对移民到美国的人的影响尚不清楚。这项研究描述了密克罗尼西亚人的肝细胞癌，并与其他太平洋岛民进行了比较。方法：对1993-2017年夏威夷一家大型临床诊所诊断的40名密克罗尼西亚人和142名非密克罗尼西亚人太平洋肝细胞癌患者进行了回顾性评估。结果：所有密克罗尼西亚人都出生在美国境外诊断（52.0年vs 60.2年）具有较高的乙型肝炎发病率（80%vs 31.2%）、肝细胞癌家族史（17.5%vs 4.4%）和更多的肿瘤。结论：密克罗尼西亚人的肝细胞癌主要与乙型肝炎有关。密克罗尼西亚人同样有可能通过筛查发现肝细胞癌，接受移植，并有更好的生存率。我们的研究强调了对密克罗尼西亚人进行乙型肝炎筛查和肝细胞癌监测的必要性。

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引用次数: 6

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