[Hepatitis B: cross-sectional study of knowledge and immunization among students at University of Cocody, Ivory Coast]. / Connaissance et couverture vaccinale contre l'hépatite virale B (HVB) : étude transversale parmi les étudiants de l'université de Cocody, Côte d'Ivoire.

BACKGROUND: To evaluate knowledge about hepatitis B and vaccination coverage among students at Cocody's University, Ivory Coast. MATERIALS AND METHODS: A cross-sectional study was conducted during the academic year 2005-2006 (2557 students). Parameters were collected by interview using a survey chart. Factors influencing knowledge and vaccination against hepatitis B were analyzed by logistic regression. RESULTS: The majority of students (n=1174, 69.4% [95% CI 68-71]) knew about hepatitis B. Only 17.5% and 26.1% of students respectively were aware of sexual and blood transmission. None of the students were aware of maternal-fetal transmission. Factors associated with knowledge of hepatitis B were enrollment in health sciences (Odds Ratio=24.19 [95% CI 8.65-76.63]) and having a scholarship (Odds Ratio=2.34 [95% CI 1.54-3.56]). Vaccination coverage against hepatitis B was low (Odds Ratio=3.7% [95% CI 3-4]). Factors associated with vaccination were: knowledge of hepatitis B (Odds Ratio=6.83 [95% CI 4.57-10.27]), enrollment in health sciences (Odds Ratio=3.59 [95% CI 2.60-4.96]), marriage (Odds Ratio=2.04 [95% CI 1.13-3.64]) and having a scholarship (Odds Ratio=1.60 [95% CI 1.09-2.35]). CONCLUSION: Knowledge and vaccination coverage against hepatitis B among students at Cocody's University is low. Students should be given information about hepatitis B and access to free vaccination. Students enrolled in health sciences should be vaccinated before admission because of specific risks of contamination, for themselves and for their patients.

Evolution of glomerular filtration rate in HIV-infected, HIV-HBV-coinfected and HBV-infected patients receiving tenofovir disoproxil fumarate.

We aimed to compare the evolution of estimated glomerular filtration rate (eGFR) in HIV-, HIV-HBV- and HBV-infected patients treated with tenofovir disoproxil fumarate (TDF). Three groups of patients receiving TDF > 12 months were recruited: 194 HIV-infected patients, 85 HIV-HBV-coinfected patients and 50 HBV-infected patients. eGFR was estimated using the Modification of the Diet in Renal Disease (MDRD) equation. Multivariate regression models were constructed to estimate factors associated with eGFR decrease from baseline. A total of 329 patients were studied. Median follow-up was 2.7 years. Median eGFR decrease was -4.9 (-16.6 to +7.2) mL/min/1.73 m(2) . After multivariate stepwise regression analysis, age (P = 0.0002), non-African origin (P < 0.0001), baseline eGFR (P < 0.0001) and TDF duration (P = 0.02) were associated with eGFR decrease in the whole population, while hypertension, diabetes and type of infection were not. Age (P < 0.0001), non-African origin (P = 0.0004), baseline eGFR (P < 0.0001) and TDF duration (P = 0.007) remained associated with eGFR decline in HIV and HIV-HBV-infected patients, while other variables including HIV risk factor, CDC stage, CD4 and HIV-RNA levels were not. Age (P = 0.03), non-African origin (P = 0.004), baseline eGFR (P < 0.0001) and baseline HBV-DNA > 2000 IU/mL (P = 0.04) were associated with eGFR decline in HBV and HIV-HBV-infected patients, while other variables including HBV risk factor and fibrosis stage were not. Estimated glomerular filtration rate decline under TDF therapy appears mainly associated with older age, non-African origin, higher baseline eGFR and longer TDF administration but not with the type of viral infection. Regular follow-up of renal function, especially tubular function is recommended during TDF therapy.

[Pediatric colonoscopy at the University Hospital of Cocody (Ivory Coast)]. / Coloscopie pédiatrique: expérience du centre hospitalier universitaire de Cocody (Côte d'Ivoire).

No published data are available on pediatric colonoscopy in Ivory Coast (and only one report on pediatric gastroscopy). We conducted a retrospective study of all colonoscopy reports of procedures performed from 1 September, 1991, to December 31, 2010, at the University Hospital of Cocody in Abidjan (Ivory Coast) and examined the epidemiological aspects, conditions of performance, indications, and results of colonoscopy in patients younger than 18 years. Eleven of the total of 1 159 colonoscopies were performed in in this age group (0.94%). The mean age of these 8 girls and 3 boys was 15 years (range: 10 to 17 years). All patients had been referred by a gastroenterologist. Bowel preparation was performed in all with a water enema. Premedication was performed exclusively with midazolam. A pediatric colonoscope was used. The colonoscopy was incomplete in 36% of cases (n=4). Rectal bleeding was the main indication. Results were abnormal in 72% of cases (n=8) and the lesions found were juvenile polyps, ulcerative colitis, sigmoid varices, rectocolitis due to a caustic product, and adenomatous polyps. The results of the examination were normal in 3 children. No complications were reported. In conclusion, although the pediatric colonoscopy practice at the University Hospital of Cocody in Abidjan is extremely small, its therapeutic and diagnostic yields are high, particularly in cases of rectal bleeding. Physicians (general practitioners and pediatricians) managing children should not hesitate to ask for a colonoscopy when appropriate.

[Diagnosis of hematochezia in Abidjan Cocody University Hospital (Ivory Coast)]. / Diagnostic des rectorragies au centre hospitalier universitaire de Cocody à Abidjan (Côte d'Ivoire)

AIM: To determine the prevalence of endoscopic lesions, according to age and location, in patients with rectal bleeding who underwent total colonoscopy. METHODS: Retrospective observational study examining records from the hepatogastroenterology department at the Cocody University Hospital (Abidjan) of colonoscopies for rectal examination from September 1, 1991, through August 15, 2007. The data collected and analyzed from the records included age, sex and colonoscopy results. A p value less than 0.05 was considered statistically significant. RESULTS: Of 1,158 colonoscopies, 270 (23.3%) were performed for hematochezia: 105 women (mean age: 48.8 years ± 19.9 years, range: 10-96 years) and 165 men (mean age: 46 ± 14.2, range: 21-83 years) with a sex-ratio (M/F) of 1.57. Because colorectal cancer seems to occur at a younger age in Africa, patients were divided into two groups (aged 45 years: 139 [51.5%] and above 45 years: 131 [48.5%]). The abnormalities found were consistent with anal pathologies (16.3%), polyps (10.4%), diverticular disease (11.1%), colorectal inflammatory lesions (21.5%) and carcinoma (7%). Diverticula were significantly more common in those older than 45 years and inflammatory lesions in the younger group (p < 10(-3)). More than two thirds of the significant lesions were found in the distal colon (p < 10(-3)). CONCLUSION: The predominance of distal colon lesions suggests that exploration by flexible sigmoidoscopy can be performed in patients with low to moderate risk of colorectal cancer, with total colonoscopy reserved for the population at high risk.