Résection endoscopique des polypes colorectaux pédiculés en utilisant un lasso largable au fil catgut chromé : une alternative a la polypectomie conventionnelle? A propos d’une série de cas

L'intérêt de l'endoscopie dans la résection des polypes colorectaux a été rapporté dans plusieurs études. Les techniques de résection endoscopique sont multiples et maîtrisées dans les pays occidentaux. La technique de mucosectomie endoscopique et celle de la pose d'une anse largable en nylon (endoloop) ont élargi le champ des lésions résécables par endoscopie. Toutefois, malgré cette évolution, la vulgarisation de la polypectomie n'est pas effective. En Afrique subsaharienne, la prise en charge de ces polypes de grande taille nécessite souvent une intervention chirurgicale à ciel ouvert ou une évacuation sanitaire onéreuse dans un pays en Occident. Nous rapportons une nouvelle approche de polypectomie endoscopique des polypes pédiculés colorectaux, en utilisant un lasso largable au fil catgut chromé 2/0. Les polypes pédiculés étaient situés soit au niveau du sigmoïde soit au rectum. Après avoir passé le lasso autour du pédicule, le n'ud du lasso est serré autour de celui-ci pour strangulation. En moyenne 6 jours après la procédure, le polype est récupéré dans les selles. Une colonoscopie de contrôle est nécessaire pour confirmer la résection du polype. Cette technique peu coûteuse et accessible, devrait être vulgarisée dans les pays en voie de développement avec des plateaux techniques pauvres. Elle a ses limites et ses inconvénients qui doivent être connus de l'opérateur.Key words: Polypes coliques, catgut, polypectomie endoscopique, coloscopie, endoloop, Cameroun, Afrique subsaharienn

Prevalence of Helicobacter pylori infection in 103 patients with gastroesophageal reflux, erosive esophagitis or Barrett’s esophagus in Yaoundé, Cameroun

Introduction : la relation entre l’infection à Helicobacter pylori (H. pylori) et le reflux gastrooesophagien (RGO) est complexe. Certaines études épidémiologiques ont suggéré un rôle protecteur de l’infection à H. pylori dans le développement du RGO et que son éradication conduirait à l’augmentation de la fréquence du RGO. Cet article évalue la prévalence de l’infection à H. pylori parmi les patients présentant un RGO sans lésion, une oesophagite érosive ou un oesophage de Barrett. Matériels et méthodes : entre janvier et mai 2015, 103 patients consécutifs avec des symptômes de RGO quotidiens ou hebdomadaires d’au moins un an ont été évalués au Centre Médical la Cathédrale de Yaoundé, Cameroun. Tous les patients ont subi une anamnèse, un examen physique, une endoscopie digestive haute avec biopsies antrales et un test rapide à l’uréase kit commercial HelicotecUT® plus (Strong Biotech Corp., Taipei 115, Taïwan). Toutes les analyses statistiques ont fait appel aux logiciels Epi-Info 3.5.1 et SPSS Statistics version 16.0 (IBM, Chicago, USA). Résultats : L’étude portait sur 43 hommes et 60 femmes (âge moyen de 46,5 ± 15,3 ans – extrême : 14-79 ans). La prévalence de l’infection à H. pylori était de 39,8 % (IC à 95 % : 30,4- 49,3). H. pylori était positif chez 34,6 % de patients avec une oesophagite érosive contre 41,6 % chez les patients avec RGO à endoscopie négative (p = 0,533). Parmi les 41 patients H. pylori positif, seuls neuf (22,0 %) avaient une oesophagite érosive, toutes de grade 1 de Savary-Miller. Conclusion : la prévalence de l’infection à H. pylori est faible parmi les patients camerounais atteints de RGO. L’atteinte sévère de la muqueuse oesophagienne est rare parmi les patients H. pylori positif comparés aux patients H. pylori négatif. Cependant, nos données ne permettent pas avec évidence de définir la relation entre l’infection à H. pylori et le RGO dans notre contexte endémique à H. pylori. Des études ultérieures sont attendues.Introduction: The relationship between the Helicobacter pylori (H. pylori) infection and gastroesophageal reflux disease (GERD) is complex. Some epidemiological studies have suggested a protective role of the H. pylori infection in the development of GERD and its eradication would lead to the increase in GERD frequency. This article assesses the prevalence of the H. pylori infection among patients with GERD without injury, erosive esophagitis or Barrett’s esophagus. Materials and methods: Between January and May 2015, 103 consecutive patients with daily or weekly GERD symptoms for at least one year were assessed at the Medical Center “la Cathédrale” of Yaoundé, Cameroon. All patients underwent anamnesis, physical examination, upper GI endoscopy with antral biopsies and rapid urease test HelicotecUT® plus commercial kit (Strong Biotech Corp., Taipei, Taiwan). All statistical analyzes have used the software Epi-Info 3.5.1 and the SPSS version 16.0 (IBM, Chicago, USA). Results: The study included 43 men and 60 women with an average age of 46.5 ± 15.3 years (range: 14-79 years). The prevalence of the H. pylori infection was 39.8% (95% CI: 30.4 to 49.3). H. pylori was positive in 34.6% of patients with erosive esophagitis against 41.6% in patients with endoscopy-negative GERD (p = 0.533). Among the 41 H. pylori positive patients, only nine (22.0%) had erosive esophagitis, all of Savary-Miller grade 1. Conclusion: The prevalence of the H. pylori infection is low among the Cameroonian patients with GERD. Severe damage to the esophageal mucosa is rare among H. pylori positive patients compared to H. pylori negative ones. However, our data do not enable us have proof in defining the relationship between the H. pylori infection and GERD in our H Pylori endemic context. Further studies are awaited

Epidemiology of hepatitis C: related hepatocellular carcinoma in Cameroon

Introduction: hepatocellular carcinoma (HCC) is a global public health problem. Hepatitis C virus (HCV) infection accounts for close to 24% of HCC in developing countries especially when associated with cirrhosis. There exists no vaccine against HCV to prevent the occurrence of HCV-related HCC. A sound knowledge of the epidemiology and prevention of the initial infection is vital. The aim of our study was to determine the epidemiologic profile of HCV-related HCC in Cameroon to improve its’ management. Methods: it was a prospective study of histologically proven HCV-related HCC seen in two University Centers in Yaounde, Cameroon from March 2012 to January 2013. Demographic data (age, gender), alcohol abuse (>80g/day), presence of cirrhosis, tobacco abuse and parenteral exposition were analyzed. Results: twenty-six patients with histologically proven HCV–related HCC were included (18 men (69.2%) and 8 women (30.8%); mean age +/- SD, 61.46+/-10.18 years). A total of 22 (84.6%) patients had a parenteral exposition, 02 (7.7%) patients were alcoholics and 06 (23.1%) patients were smokers. The proportion of patients with cirrhosis was 69.2% against 30.8% cirrhosis-free. Patients with cirrhosis were relatively younger than those cirrhosis-free (mean age +/- SD, 59.05+/-10.05 years vs 66.87+/- 8.72 years, p=0.06). HCV-related HCC was more prevalent in 60 years and above patients (53.8%, 95%CI: 33.4-73.4). The relative risk of HCC among alcoholics patients was high (RR: 1.5, 95%CI: 1.13-1.99, p<0.05). Conclusion: in Cameroon, HCV-related HCC is more prevalent among age older than 60 years, a finding which is relatively less to that found in western countries, male gender is twice more at risk than female gender and cirrhosis frequency is less compared to that observed elsewhere. HCV and alcohol play a synergistic role in the occurrence of HCC in our environment

Skin whitening among Cameroonian female university students: knowledge, attitudes, practices and motivations

Abstract Background Lack of data on skin whitening (SW) among Cameroonian female university students prompted us to undertake the present study which aimed at assessing the knowledge, attitudes, practices and motivations of female university students vis-a-vis SW. Methods This was a cross-sectional study conducted from January to April 2013 in 4 university campuses of Yaoundé, Cameroon. Any female student regularly registered in one of the study sites, who was present at the campus when the investigator visited and volunteered to participate in the study was enrolled. Results Overall, we recruited 620 female students, their ages ranging from 16 to 46 years with a mean of 21.3 ± 2.9 years. Only 87 participants (14%) found that SW was a good practice. One hundred and sixty nine respondents (27.3%) were currently practicing SW with no age difference when compared to their counterparts (p = 0.09). The desire to have a uniform body skin color was the prevailing reason motivating the practice of SW (39.1%), followed by the need to have a soft skin (29%). Assessment of levels of knowledge regarding advantages of the black skin and deleterious effects of SW showed excellent scores (≥75% of good answers) only in 6.1 and 0.5% of cases respectively, with no difference between those practicing SW or not (all p values > 0.05). Conclusion The practice of SW is common among Cameroonian female university students who should therefore be educated on the advantages of the black skin and the harmful effects of SW

Prevalence and Clinical Profile of Drug Eruptions among Antiretroviral Therapy-Exposed HIV Infected People in Yaoundé, Cameroon

Background. Prevalence and incidence of drug eruptions vary around the world and are influenced by some key factors including HIV infection. Objective. This study aimed to find the peculiarities of drug eruptions in people living with HIV (PLHIV) and on antiretroviral therapy (ART). Methods. This was a retrospective cross-sectional study including ART-taking PLHIV, aged 15+ years, followed up between January 2010 and December 2014 at the day-care unit of the Yaoundé Central Hospital, and who presented with drug eruptions after ART initiation. Results. Of 6,829 ART-experiencing PLHIV, 41 presented with drug eruptions, giving a prevalence of 0.6%. The M/F sex ratio equaled 0.17. The mean age was 41.07 ± 11.36 years. Benign drug eruptions accounted for 83.3%. Milder forms were essentially maculopapular exanthema (36.6%), fixed pigmented erythema (7.3%), and urticaria (4.9%). Severe forms were represented by multiform erythema (4.9%), toxic epidermal necrolysis (2.4%), and drug hypersensitivity syndrome (2.4%). The Zidovudine + Lamivudine + Efavirenz ART-protocol was received by 48.8% of patients and 69% of patients were receiving Cotrimoxazole prophylaxis. Nevirapine, Efavirenz, Zidovudine, and Cotrimoxazole were suspected as the potential causes in 43.7%, 4.8%, 2.4%, and 26.8% of cases, respectively. Conclusion. Drug eruptions seem infrequent among ART-exposed HIV infected adult Cameroonians