ABSTRACT
OBJECTIVE: To describe the different gastrointestinal manifestations encountered in adult patients with HIV infection in a gastroenterology department in Togo. PATIENTS AND METHODS: This one-year (2011) prospective, descriptive study included all adult HIV-positive patients admitted to our department. Patients not known to be HIV-positive before admission were tested after informed consent. RESULTS: 82 (8.4% of departmental admissions) HIV-positive patients participated in the study. Their mean age was 38.78 years ± 9 years, and they were mainly women (sex-ratio = 0.82). The reasons for consultation were mainly asthenia (39%), weight loss (35.4%), and vomiting (34.1%). Their histories included tuberculosis (4%), jaundice (4%), and herpes zoster (2%). Nearly all (91%) had CD4 counts below 350 cells/L, and most (80%) were treated with antiretroviral agents (ARV) before admission. Most patients were also chronic alcoholics (72%) and took traditional herbal treatments (55%). General symptoms included deterioration of the general condition (77%) and conjunctival pallor (48%). Physical signs included ascites (32%) and hepatomegaly (29%). All patients were positive for HIV-1; 30% were co-infected with HBV and 1.2% with HCV. The main diagnoses were hepatobiliary diseases (46%), including cirrhosis (24.4%), acute toxic hepatitis (12%), and hepatocellular carcinoma (6.1%). Of the latter, one also had lung metastases. Esophageal diseases included candidal esophagitis (24%), and the gastric diseases, two gastric ulcers (2%) and one case of gastric cancer. The primary disease of the colon and small bowel was acute gastroenteritis (38%). Peritoneal conditions were all tuberculosis (7%), and pancreatic involvement was acute pancreatitis (2%).
Subject(s)
Gastrointestinal Diseases/etiology , HIV Infections/complications , Adult , Cross-Sectional Studies , Female , Gastrointestinal Diseases/epidemiology , Humans , Male , Prospective Studies , TogoSubject(s)
Health Knowledge, Attitudes, Practice , Hepatitis B , Hepatitis C , Students/psychology , Universities , Adolescent , Adult , Female , Hepatitis B/prevention & control , Hepatitis C/prevention & control , Humans , Male , Togo , Young AdultABSTRACT
The purpose of this report was to describe the profile of esogastroduodenal disease diagnosed by upper digestive tract endoscopy (UDTE) in a rural area of Togo. This prospective study combines data collected during two two-week screening campaigns carried out in the Kara region. Patients were informed of the presence of the endoscopy team by means of a bulletin on a rural radio station. All male and female patients 15 years or older were included. A total of 220 UDTE procedure reports were recorded and analyzed including 107 men and 113 women with a mean age of 37.7 years (range: 15-84 years). Disease was detected in 72 procedures mainly in the 21 to 41 year age group (47.2 %) with a higher proportion of men than women: 38% versus 27% respectively. The most frequent indications for UDTE were epigastralgia (47.7 %) including 39% of procedures leading to the discovery of disease and diffuse abdominal pain (21.8 %). The procedure was carried out for follow-up purposes in 19.1% of cases. The most common lesions were peptic ulcer (34.2%), inflammatory disease including esophagitis, gastritis, and bulboduodenitis (32.4%), gastroduodenal bile reflux (9.3%), pylorobulbar stenosis (5.5%), tumoral disease (3.7%), and esophageal varicosities (3.7%). This study based on UDTE diagnostic procedures provided insight into the profile of esogastroduodenal disease in rural Africa. These screening campaigns required special organization using appropriate equipment and personnel.
Subject(s)
Endoscopy, Gastrointestinal , Gastrointestinal Diseases/diagnosis , Adolescent , Adult , Aged , Aged, 80 and over , Female , Gastrointestinal Diseases/epidemiology , Humans , Male , Mass Screening , Middle Aged , Prospective Studies , Rural Population , Togo/epidemiology , Young AdultABSTRACT
But : Recenser les urgences rencontrees; leur diagnostics etiologiques et evaluer l'efficacite des approches therapeutiques. Methodologie : c'est une etude retrospective sur 1 an; de janvier a decembre 2004; sur les dossiers de malades admis pour urgences dans le service. Resultats : 65 dossiers de malades (49 hommes et 16 femmes) ages de 20 a 79 ans ont ete retenus. Le type de l'urgence rencontre a ete : hemorragie digestive (44 cas) dont 25 cas d'hemorragie digestive haute (HDH) et 19 cas de rectorragie ; douleur abdominale avec vomissement : 19 cas dont 4 malades avec arret des matieres et des gaz ; l'ingestion accidentelle de caustique : 2 cas. A l'admission un tableau de choc a ete retrouve chez 15 malades (5 en coma stade I ) qui ont d'emblee ete reanimes.11 malades ont ete transferes en chirurgie. Les etiologies des HDH ont ete dominees par les ulceres :16 cas (64) et les ruptures de varices oesophagiennes (RVO) : 7cas(28) ; celles des rectorragies par la rectocolite hemorragique ( RCH) : 8 cas (42;10) . Les etiologies des douleurs abdominales etaient tres diverses dominees par les occlusions; les gastrites; les ulceres gastro-duodenaux; les cancers du pancreas avec 4 cas (22;22) chacun. L'evolution clinique a ete marquee par 7 deces dont 6 par RVO . Conclusion : les urgences en gastro-enterologie sont frequentes dans le service d'HGE du CHUCampus de Lome (65 cas en 1 an). Elles sont dominees par les hemorragies digestives .Leur etiologie est souvent retrouve (98;45) par nos moyens d'exploration limites mais elles posent surtout un probleme de prise en charge therapeutique notamment les RVO dont la mortalite est tres elevee (85;71) en raison du manque de ressources therapeutiques endoscopiques (ligature; sclerotherapie) et medicamenteuses (molecules reduisant le debit splanchnique)
Subject(s)
Endoscopy, Gastrointestinal , Gastrointestinal HemorrhageABSTRACT
Objectifs : determiner le profil des pathologies oesogastroduodenales diagnostiquees par endoscopie oesogastroduodenale (EOGD) enmilieu rural au Togo. Methode : Il s'agit d'une etude prospective regroupant deux campagnes d'EOGD de deux semaines chacune. Les malades informes de la presence de l'equipe par radio rurale ont ete recrutes dans la population generale de la region de la Kara. Tous les patients des deux sexes ages de 15 ans au moins chez lesquels une EOGD a ete realisee ont ete inclus. Resultats : Deux cent vingt (220) comptes rendus d'EOGD ont ete enregistres et retenus dont 107 hommes et 113 femmes. Leur age moyen est 37;7 ans (extremes : 15-84 ans). Soixante douze EOGD se sont revelees pathologiques plus frequemment dans la tranche d'age de 21 a 40 ans (47;2) ainsi que chez les hommes (38) contre 27chez les femmes. L'epigastralgie (47;7) represente l'indication la plus frequente d'EOGD dont 39sont pathologiques; suivies des douleurs abdominales diffuses (21;8).Dans 19 ;1cas; il s'agit d'un controle. Les lesions les plus retrouvees sont l'ulcere gastroduodenal (34;2) suivi respectivement des pathologies inflammatoires (oesophagite; gastrite; bulboduodenite) avec 32;4; des reflux biliaires duodeno-gastriques (9;3); des stenoses pylorobulbaires (5;5); de la pathologie tumorale (3;7) et des varices oesophagiennes (3;7). Conclusion : Ce travail nous a permis grace a l'EOGD de degager le panorama de la pathologie oesogastroduodenale en milieu rural africain. Ces campagnes ont necessite une organisation originale qui repose sur un equipement et un personnel adequat
