Evolution of hepatocellular carcinoma epidemiology in Côte d'Ivoire.

INTRODUCTION: Hepatocellular carcinoma is a major concern for Public health in West Africa. In Côte d'Ivoire, the bulk of our knowledge stems from studies conducted decades ago. Our aim was, thus, to assess whether the epidemiological features of this tumor changed recently. METHODS: Records from 863 patients diagnosed between 2007 and 2014 were analyzed. RESULTS: We observed major drifts concerning hepatocellular carcinoma with regards to the 1970-1980 period. Age at presentation is substantially delayed (49.4±14.1 years) whereas sex ratio decreased substantially (M:F=2.6). Patients seropositive for hepatitis B surface antigen and anti-hepatitis C virus represented 65% and 25% of cases whereas alcohol intake was reported in 36%. AFP level was above 400ng/mL in 36% of cases and tumors were already multinodular and/or metastatic at diagnosis in 77% and 26% of patients. Geographical and anthropological variations were observed with excesses of female cases affecting regions (Lagunes) or linguisitic groups (Kru). North-Mande speakers were more often identified as nonBnonC than others. DISCUSSION: Ivorian epidemiology of hepatocellular carcinoma was reshaped during the last decades. These changes, most likely due to the spread of hepatitis C virus, resulted in an older and feminized population of patients. We fear that the current and future prevalence of anti-HCV cases might thwart the expected benefits of anti-hepatitis B immunization. Appropriate measures should be taken to prevent further transmission of hepatitis C in the country.

[Causation and treatment of infectious leucorrhoea at the Cocody University Hospital (Abidjan, Côte d'Ivoire)]. / Etiologie et prise en charge thérapeutique des leucorrhées infectieuses au CHU de Cocody (Abidjan, Côte d'Ivoire).

OBJECTIVES: to determine the frequency of different bacteria causing infectious leucorrhoea and to calculate the percentage of cures after standard treatment. PATIENTS AND METHODS: This 7-month prospective descriptive study took place from October 2003 through April 2004 in the gynaecology department of Cocody University Hospital and in the department of sexually-transmitted infections of the Pasteur Institute of Côte d'Ivoire. After identification of the organism causing each case of leucorrhoea, we prescribed treatment according to a standard protocol. Vaginal samples were taken after treatment and tested to assess its success. RESULTS: The most frequent bacteria discovered, in descending order, were: Gardnerella vaginalis (47%), Candida albicans (29.4%), Chlamydia trachomatis (13.7%), Trichomonas vaginalis (6.9%), and Neisseria gonorrhoeae (2.9%). The overall cure rate was 87%. Treatment failure was most common for C. trachomatis (8 of 14 cases, 57.1%), N. gonorrhoeae (1 of 3 cases) and T. vaginalis (2 of 7 cases, 28.6%). Treatment was 100% effective for G. vaginalis and C. albicans. CONCLUSION: The fight against sexually-transmitted infections should be intensified, and patients and physicians cautioned about use of doubtful generic drugs.