University Hospital Of Brazzaville Research Articles

Vaginal Candidiasis in Women of Childbearing Age at the University Hospital of Brazzaville: Prevalence and Associated Factors

Introduction: Vaginal candidiasis is a fungal disease caused by a yeast type Candida. It affects more than 75% of women during the period of genital activity. Changes in vaginal pH due to various factors lead to the onset of the infection. Objective: Determine the prevalence of vaginal candidiasis in women of childbearing age and look for associated factors or risk for its occurrence. Patients, Materials and Method: We conducted a cross-sectional analytical study from July to October 2019. It concerned all patients aged 15 to 49 years, received at the Parasitology-mycology and parasitic immunology laboratory of the University Hospital of Brazzaville for an analysis of the vaginal sample. For each vaginal sample, a direct examination and culture on Sabouraud Chloramphenicol medium with and without Actidione were performed. A questionnaire was completed specifying age, medical and surgical history, symptoms and risk factors. Statistical analysis was performed by SPSS 20 using Chi-square test and Student's test and multivariate logistic regression was performed. The test was significant when p Ë‚ 0.05. Results: Among 152 samples analyzed, 88 were positive on direct examination (48.7%) and 34 were positive after culture (22.4%). It concerned patients of mean age 32 years (24 years, 40 years), living with one sexual partner (79.4%), never had abortions (64.7%). We found the use of antibiotics (2.9%), corticosteroid therapy (5.9%) and diabetes (6.6%). Among the women included in the study, 32.4% were pregnant. 38.2% of patients used intimate bath and 14.7% used community bath towels; 23.5% wore synthetic underwear; 26.5% of tight clothing and 26.4% had wrong cleaning mode after defecation (p = 0.003). Symptoms associated with vaginal candidiasis were significantly leucorrhoea (38.2%; p = 0.000), burning sensation (22.4%; p = 0.003) and vulvar pruritus (35.5%; p = 0.016). The risk factors associated with the occurrence of vaginal candidiasis were the presence of leucorrhoea and the wrong cleaning mode after defecation associating both front to back / back to front. Patients with leucorrhoea had a 4.21 folds higher risk of vaginal candidiasis, while those with wrong cleaning mode front to-back / back-to-front had a 28.97 folds higher risk. Conclusion: Vaginal candidiasis is common in women of childbearing age with poor hygienic conditions. The associated factors identified are those found in the literature, among which, leucorrhoea and cleaning mode combined from front to back / back to front.

Oncogenic human papillomavirus in breast cancer: molecular prevalence in a group of Congolese patients.

BackgroundSince the work of Band et al. in 1990 (Proc. Natl. Acad. Sci. USA 87:463–467), several studies have suggested a possible link between the pathogenesis of breast cancer and viral infection. Infection with oncogenic HPV has been one of the viruses implicated in breast cancer cases worldwide.ObjectiveTo investigate the presence of HPV DNA in archived paraffin-embedded breast cancer cases at the University Hospital of Brazzaville and to assess the association between viral HPV infections and clinicopathological features.MethodsA total of 40 formalin-fixed paraffin-embedded (FFPE) biopsies were retrospectively collected and available information was recorded. HPV detection and genotyping were performed by real-time PCR by GeneXpert technology (Cepheid, Sunnyvale, USA).Results The mean age was 51.1±11.4 years (range 22–75 years; median was 47). Overall, HPV DNA was detected in six (15%) breast carcinoma samples. HPV-16, the most common genotype was identified in 83.7 % of all samples. HPV porting with clinicopathological features showed no significant difference (P>0.05). However, a statistically significant difference was observed between HPV infection and SBR grade (P=0.05).Conclusion Our study described a high prevalence of HPV-HR in breast cancer cases in the Congolese woman. Future type case-control studies are necessary to better describe the potential role of HPV in the occurrence of breast cancer in Congo.

QUELLES ETIOLOGIES POUR LINSUFFISANCE RENALE AIGUE DANS LE SERVICE DE NEPHROLOGIE DU CHU DE BRAZZAVILLE?

Context: Acute kidney failure (AKI) is a sudden and reversible deterioration of kidney function. It is of various etiologies which are decisive for its management. Goals: Determine the frequency of AKI determine the types the different stages and aetiologies of AKI in the nephrology service of the university hospital of Brazzaville(UHB). Patients and Methods: This was a retrospective and descriptive study. We reviewed the files of patients hospitalized between January 1, 2016 and October 31, 2020 in the nephrology department of the UHB. Were included, patients aged at least 18 years with a discharge diagnosis of AKI. The study variables were socio-demographic data, stages the type of AKI and the aetiologies. Results: Out of 1,823 hospitalized patients, 244 were hospitalized for an AKI (13.38%), of which 164 had met the inclusion criteria. These were 60.2% boys and 39.8% women, with an average age of 47 ± 19 years. AKI was stage 3 in 69.5%. It was functional in 55.2% of cases with sepsis as the main cause (19.2%) organic (36%) with the main cause of NTA (25.5%) and obstructive in 8.7% of patients. Conclusion: In the nephrology department of the UHB, AKI preferentially affects young adult males. The severe form is common, functional AKI secondary to dehydration or sepsis is the main mechanism of occurrence.

Male Sexual Disorders of Patients with Cancer in Medical Oncology Service in University Hospital of Brazzaville

Considered as taboo, sexual difficulties and couple intimacy remain rarely tackled by patients and again less by the oncologist practicians. It might seem that faced with the vital stake of disease, this kind of worries seem to be frivolous, indeed shameful to be tackled. The current study had an objective to assess the impacts of cancer on male sexuality followed and treated in medical service in University Hospital of Brazzaville. Studying male sexual disorder of patients with cancer in medical oncology service in university hospital of Brazzaville. It was a retrospective study, from April 1^st to July 31^st 2018. All patients with cancer aged at least 18 years old with a performance of WHO between 0-2 were included. About one hundred (100) patients we examined whose eighty four (84) men, it appears that the most sexual disorder found is the one of craving, then the one of orgasm. Certain troubles had a link with the onset of cancer (p<5). The men presented a great number of sexual disorder had a cancer of digestive type (47.6%), urogenital (22.6%) and soft tissue (19%). In terms of received treatments: surgery-chemotherapy (men 22%), chemotherapy only (21.4%), surgery only (19%). The global frequency of sexual disorders to all patients is 98.4% in medical oncology service. It is important to consider those sexual disorders at the time of the care of those patients according to their repercussion on life quality during and after all treatment even in the absence of all progressive nature of disease. The most sexual disorder found is the one of craving.

Accidental Ingestion of Petroleum in Children at the University Hospital of Brazzaville

Introduction: Petroleum ingestion is a health problem in Africa and can be responsible for significant mortality. Objectives: Improving the management of accidental petroleum ingestion in children, describe the socio-demographic characteristics, clinical, therapeutic and evolutionary profile of children hospitalized for accidental ingestion of petroleum and identify the factors associated with the occurrence of petroleum pneumopathy. Patients and Methods: We conducted a cross-sectional analytical study with retrospective collection from January 2016 to December 2015, i.e. in 24 months in the Pediatric Intensive Care and Infant Pediatrics departments at the University Hospital of Brazzaville. We included children who accidentally ingested petroleum. The variables studied were epidemiological, clinical, therapeutic, radiological and evolutionary. The statistical tests used were Pearson’s Chi2 and Odds ratio. The materiality threshold was set at 5%. Results: Out of 8013 children hospitalized, 78 (1%) had accidentally ingested petroleum, including 49 (62.8%) boys and 29 (37.3%) girls with an average age of 20 months. They were between 13 and 30 months old n = 44 (56.4%). The mothers were between 25 and 35 years old n = 49 (62.8%), no profession n = 31 (39.7%) and secondary education level n = 49 (62.8%). The mode of ingestion was self-ingestion (75.6%). The place of occurrence was the family home (92.3%). The motive of admission was breathlessness n = 59 (75.6%). An auscultation anomaly was noted n = 46 (59%), a pneumopathy n = 43 (55.1%). The treatment consisted of oxygen therapy n = 51 (65.4%), antibiotic therapy n = 70 (89.7%). The factors associated with the occurrence of a pneumopathy were: maneuvers performed and the existence of a cough. The lethality was 3.8%. Conclusion: The high frequency of accidental petroleum ingestions in children with an outcome often marked by pulmonary complications and the related case fatality rate requires primary preventive measures that rely on information, communication for behavior change with an emphasis on careful storage of toxic products and to refrain from harmful actions when faced with petroleum intoxication.

Bronchogenic Cyst in a 23-Month-Old Infant at the University Hospital of Brazzaville

Bronchogenic Cyst in a 23-Month-Old Infant at the University Hospital of Brazzaville

Cardiac Tamponade: Epidemioclinical, Therapeutic and Evolutionary Aspects at the University Hospital of Brazzaville

Objectives: Contribute to improving the management of cardiac tamponade in Congo. Background: Cardiac tamponade is an acute or subacute compression of the heart chambers by pericardial effusion responsible for uncertain prognosis for patients. The objective of this study is to help improve the management of patients with cardiac tamponade. Patients and Methods: We conducted a retrospective and descriptive study at the University Hospital of Brazzaville, from January 2015 to December 31, 2019. Included were all patients hospitalized for cardiac tamponade. Epidemioclinical, therapeutic and evolutionary data were analyzed. Results: An overall of 14 patients were divided into 9 men (64.2%) and 5 women (35.7%), i.e. a sex ratio of 1.8. The mean age of patients was 34.2 ± 15.1 years old (18 years to 64). The most represented comorbidity was hypertension (n = 2; 14.3%). The most frequent clinical sign was dyspnea (n = 14; 100%). The ECG showed diffuse and concordant repolarization disturbances (n = 14; 100%), sinus tachycardia (n = 13; 92.8%), microvoltage (n = 12; 85.7%). Cardiomegaly was constant (n = 14; 100%). In terms of transthoracic ultrasound, we found: diastolic compression of the right ventricle (RV) (n = 12; 85.7%), dilation of the inferior vena cava (IVC) (n = 12; 85.7%). Treatment consisted of crystalloid vascular filling in all patients, pericardial puncture (n = 7; 50%), surgical drainage (n = 12; 85.7%), anti-tuberculosis drugs (n = 11; 78, 6%), antimitotics could be administered in one case (n = 1; 7.2%). Two cases of death were recorded, i.e. 14.3%. Conclusion: Cardiac tamponade, although it is a rare condition, remains a serious pathology and difficult to manage in our context.

Profile of patients with pancreatic cancer and diabetes mellitus at the University Hospital of Brazzaville

Introduction: pancreatic cancer a poor prognosis disease for which there is no screening. Its association with diabetes is not uncommon and may influence the evolutionary profile. The aim of this study was to describe the profile of diabetic patients who could benefit from pancreatic cancer screening. Methods: we conducted a retrospective cross-sectional study in the gastroenterology department of the University Hospital of Brazzaville, from January 2010 to December 2019. Epidemiological variables (age, sex, alcoholism, smoking), tumor variables (symptoms, site, size, density, extension) and time of occurrence of both entities were analyzed using Epi info software. Results: A total of 35 patients were hospitalized for pancreatic cancer, of whom 17 were men and 15 women, for a sex ratio of 1.21. The mean age of the patients was 60.3 ± 13 years. Fifteen patients (43.75%) were diabetic, all classified as type 2. Among them, the diagnosis of diabetes of 10 patients (66.7%) preceded pancreatic cancer diagnosis and delay between the two pathologies was on average 3.4 years ± 5.3 months. Diabetes was observed in 11 patients older than 60 years. The difference was significant (OR = 4.8; 95% CI [1.1 - 22.8]; p = 0.0226). The other epidemiological variables studied were not related to the two pathologies. Conclusion: we propose a screening for pancreatic cancer when diabetes is discovered to patients from 60 years old, whatever their sex, especially during the first 3 years after the discovery of diabetes.

Clandestine Abortion Complicated by Intestinal Evisceration by Vaginal Route: About a Case at the University Hospital of Brazzaville

Introduction. Clandestine abortion, performed under unfavorable conditions, is fraught with complications that can affect both the genitals and extra genitals. Illegal in some developing countries, abortion is responsible for high maternal mortality, of which it is the third cause. Clinical observation. We report the case of a 16-year-old adolescent girl admitted for pelvic pain and genital bleeding with extragenital exteriorization of an intestinal loop following an abortive endo-uterine maneuver, at the end of 16 weeks of amenorrhea depending on the date of the last period. After laparotomy, there was a uterine perforation of the antero-inferior surface with ileo-jejunal evisceration, requiring the performance of an intestinal resection with end-to-end anastomosis and hysterorrhaphy. Conclusion. The complications of clandestine abortions are still relevant in our country, despite the awareness of family planning and contraceptive measures. The lack of a legal framework governing the medical care of abortion leaves free rein to unqualified personnel on the one hand or to artisanal practice on the other, thus exposing them to the risk of high maternal morbidity and mortality.

Impact of the Covid-19 Pandemic on Severe Childhood Malaria at the University Hospital of Brazzaville

Introduction: Malaria management has been a source of concern for health systems since the advent of the Covid-19 pandemic. Objective: To assess the impact of the Covid-19 pandemic on severe childhood malaria in Brazzaville. Material and Method: A quasi-experimental intervention/non-intervention study was carried out between March and October 2020 in the pediatric departments of the Brazzaville University Hospital. Children aged three months to 15 years hospitalized were the target population. Two groups were formed: the “intervention” group, that of children hospitalized between March and October 2020 and the “control” group that of those hospitalized between January and August 2015. The study variables were epidemiological, clinical, biological and therapeutic. Chi-square and T-Student tests were used. The impact of the intervention was assessed by the absolute risk difference. Results: Of 1392 children hospitalized, 199 (14.6%) had severe malaria with an average age of 6.94 years. These were children under 5 years old n = 95 (47.7%) of low socioeconomic level n = 145 (72.9%) seen on average after 4.6 +/? 2.4 days. Repeated convulsions (56.8%) and anemia (20.1%) were the main reasons for hospitalization. These were isolated forms (n = 146; 73.4%) of which n = 84 (42.2%) neurological and n = 62 (31.2%) anemic. The lethality was 13.1%. Delayed consultation, fever, repeated convulsions, pallor, respiratory distress, sickle cell anemia, thrombocytopenia and hypoglycemia are associated with death. The risk difference for signs of severity between the two periods was 16.6 for repeated convulsions; 14.3 for severe anemia. The relative risk between the two studies was 1.8. Conclusion: The increase in morbidity and mortality in severe malaria since the beginning of the Covid-19 pandemic encourages the maintenance of the balance between the management of the Covid-19 pandemic and that of other worrying health problems.

Associated factors of obstructive sleep apnea syndrome in hypertensive patients at Brazzaville (Republic of the Congo)

To determine the frequency of obstructive sleep apnea syndrome (OSAS) in hypertensive patients and report the associated factors. This cross-sectional study was conducted from March to August 2019 (6 months), in hypertensive outpatient followed up at the University Hospital of Brazzaville. The diagnosis criteria of OSAS were those of Berlin questionnaire. A total of 315 patients were included, 210 women (64.9%). The mean age was 58.5 ± 12.4 years. The standard of living was high in 59 cases (18.7%). Medical history was: hospitalization ( n = 209, 66.3%), diabetes ( n = 95, 30.2%), heart failure ( n = 57, 18.1%). Lifestyle habits were: sedentarity ( n = 181, 57.5%), excessive alcohol intake ( n = 97, 30.8%). Normal blood pressure ( n = 86, 27.3%), severe obesity ( n = 23, 7.3%), obdominal obesity ( n = 230.73%). Anomalies in the Berlin questionnaire were represented by snoring ( n = 197, 62.5%), tiredness upon waking ( n = 127, 40.3%), tiredness during the day ( n = 97, 30.8%), breathing pauses ( n = 75, 23.8%) and falling asleep at the wheel ( n = 22, 7%). The frequency of OSAS was 75.8% ( n = 239). The factors associated with OSA were: excessive alcohol intake ( n = 86, 36% OR 3.3, 95% CI 1.6-6.6, P < 0.01), severe obesity ( n = 20, 8.3%, OR 7, 95% CI 1.6-35, P = 0.01), abdominal obesity ( n = 185, 77.4%, OR 2.3, 95% CI 1.3-4, P = 0.002). OSAS is a real problem among hypertensive patients at Brazzaville. This fact requires its systematic screening, and the implementation of polysomnography, a more efficient means of diagnosis for appropriate treatment.

Epidemiological Clinical Profile of Chronic Kidney Disease in Adults under 50 at the University Hospital of Brazzaville

Introduction: Chronic Kidney Disease (CKD) is a major global public health problem. In Congo, we have very few studies on it. Patients and Methods: We carried out an analytical cross-sectional study with retrospective data collection including patients aged 18 to 49 years, hospitalized for CKD in the nephrology department of University Hospital of Brazzaville, during the period from January 1, 2016 to August 31, 2020. The variables considered were socio-demographic, clinical, paraclinical, therapeutic and evolutionary. The statistical test used was Pearson’s chi-square test. Results: CKD in those under 50 represented 21.1% of admissions and 35.6% of CKD. The mean age was 35.9 ± 8.4 years. There was a male predominance with a sex ratio of 1.27. Hypertension was the most common comorbidity (49.2%), followed by HIV (13.6%) and diabetes mellitus (13.2%). Stage 5 CKD was most prevalent (82.7%). Indeterminate kidney disease was in the order of 55.9%. The low socioeconomic level (74.9% of cases) hampered the achievement of dialysis in 66.3% of patients for whom this treatment was indicated. Failure to perform dialysis significantly influenced the occurrence of death (p-value = 0.005). Conclusion: CKD is common among people under 50 and more affects males with a high mortality rate due to lack of access to dialysis. The main causes are hypertension and HIV.

Morbidity and Mortality in Adolescents at the University Hospital of Brazzaville

Introduction: Adolescent morbidity and mortality is a health concern. Objective: To determine morbidity, identify the causes of morbi-mortality and the factors associated with adolescent mortality in Brazzaville. Patients and Methods: A retrospective, descriptive and analytical study was carried out at the Brazzaville Hospital and University Center between January 2015 and December 2016. Adolescents hospitalized in clinical services whose records were workable were included. The Epidemiological, clinical and evolutionary variables were analyzed. The statistical test used was the khi-two, the significance level set at 0.05. Results: In total, Out of 67,488 hospitalized patients, 2062 were adolescents: 3% including 891 (43.2%) boys and 1171 (56.8%) girls mean age 14.8 ± 2.92 years, seen in average 9.38 days after the onset of symptoms. Childbirth 415 (20.1%), malaria 309 cases (14.9%), major sickle cell crisis 223 (10.8%) and traumatic injuries 166 cases (8.05%) are the main causes of morbidity. One death was recorded in n = 193 (9.4%), of which n = 104 (5.0%) in the first 48. Tumors, malaria and status epilepticus are the leading causes of death. The female sex, the age between 15 and 19 years, the young age of the father, the higher level of education of the adolescent and the low socio-economic level of the parents are associated with the death. Conclusion: Adolescent morbidity is worrying and mortality is significant. It is important that policies on this issue be developed with an emphasis on the main causes of morbi-mortality, including malaria control and sex education.

Adult Kidney Cancer: Epidemiology, Diagnostic and Therapeutic Aspects of Brazzaville University Hospital

Objective: to report epidemiological, diagnostic and therapeutic aspects. Patients and Methods: This was a retrospective study conducted in the urology-Andrology Department of Brazzaville Hospital and University Center, from January 1, 2000, to December, 31, 2018. Results: Its overall incidence of kidney cancer was 1.4%. The mean age of the patients was 50,8±15.33 years with an H/F sex ratio of 1.3. Forty-seven patients were from Brazzaville and 12 patients from the rural area. There were 13 and nine (figure 1) among farmers and traders respectively. Three risk factors were found. These were tobacco in 57.14% of cases, HBP in 28.57% of cases and obesity in 14.29% of cases. Hematuria was the most common symptom in 49.1%. Kidney ultrasound (76.27%) coupled with the computer tomography scan (94.91%) made it possible to make the diagnosis. Expanded nephrectomy was performed in 55 patients (96.36%) with an under-capital approach. The average length of hospitalization was 9.6 days±4.15 with extremes of 5 to 21 days. Clear cell carcinoma (CCC) was the most common histological type in 75% of cases. In 6 months, survival was 81.3% and in 12 months 37.3%. Conclusion: Adult kidney cancer is an infrequent condition at the University Hospital of Brazzaville. Its diagnosis is made with the couple ultrasound/computer tomography scan; Expanded nephrectomy remains the reference treatment.

Electrophoresis of Proteins in the Biochemistry Laboratory of the University Hospital of Brazzaville

Background and aim: The electrophoresis of serum proteins is one of the examinations requested at the Biochemistry laboratory, with a view to highlight various pathologies. The aim of our study is to analyze the different electrophoretic profiles encountered in our current practice. Methods: This is a retrospective study of 350 serum samples collected at the biochemistry laboratory of the University Hospital Center (CHU) of Brazzaville. The electrophoresis of serum proteins was carried out on a Minicap Flex Piercing machine from Sebia. Results: One hundred and ninety-five (195) sera from women and 155 sera from men were collected from patients aged 12 to 85 years. Ninety-one, or 26% of PSE were normal. Two hundred and fifty nine or 74% were pathological. Inflammation was noted in 194 (55%) of cases of which 145 (41%) were chronic and 49 (14%) acute. Forty-two (12%) of our patients had beta-gamma block and 11 (3%) others presented with nephrotic syndrome. Monoclonal peaks were observed in 12 patients (3%). Conclusion: This study highlights the plurality of different electrophoretic profiles, with a predominance of profiles emanating from the Gastro-Enterology department. It nevertheless reveals the question of relevance in the request for these examinations, since no clinical information is documented for the attention of the clinical practitioner.

Psychological Experience of Children and Adolescents with Homozygous Sickle Cell Disease in Brazzaville

Introduction: Sickle cell disease, the most frequent hemoglobinopathy, is one of many causes of psychological repercussions. Objectives: To determine the prevalence of psychological disorders in children/adolescents living with sickle cell disease and to identify the associated factors. Patients and Method: An analytical cross-sectional study was conducted from June to September 2019 at the national sickle cell center and at the mother-child consultation of the University Hospital of Brazzaville. Children/adolescents aged six to 19 years old followed for sickle cell disease were included. Psychological disorders were assessed using the Diagnostic and Statistical Manual of Mental Disorders “DSM-5” which assesses depression and anxiety disorders, the Rosenberg Self-Esteem Scale, and the Brief Illness Perception Questionnaire which assesses representations of chronic diseases. SPSS 20.0 software was used for statistical analysis. Results: Out of 201 children/adolescents included, a drop in self-esteem was noted: 76.1%, anxiety 29.9%, depression 5.5% and a negative impact on daily life in all cases. These were significant negative consequences 39.3%. Advanced age, duration of illness, delay in school and puberty, use of upper-level analgesics, number of complications and hospitalizations, and occurrence of complications were associated with psychological disorders. Conclusion: The frequency of psychological disorders during the experience of the child/adolescent living with sickle cell anemia, requires that education, behaviour change communication be strengthened in order to improve the quality of care.

Aspects épidémiologiques, cliniques et évolutifs des traumatisés graves admis en réanimation polyvalente du Centre Hospitalier Universitaire de Brazzaville, République du Congo

Contexte : Le traumatisé grave (TG) est un patient ayant subi un traumatisme violent quelles que soient les lésions apparentes. Aucune donnée épidémiologique n’a été retrouvée au Congo-Brazzaville. L’objectif était de décrire les aspects épidémiologiques, cliniques et évolutifs des TG au CHU de Brazzaville (CHU-B).&#x0D; Matériels et méthodes : L’étude était rétrospective en 30 mois sur 82 TG en réanimation. Les variables épidémiologiques, cliniques et évolutives étaient analysées sur Excel 2016.&#x0D; Résultats : L’âge moyen était de 37,2 ± 16,4 ans (sex-ratio : 4,1). Les patients étaient transférés des urgences dans 48,8 %. Les accidents de la voie publique (82,9 %) constituaient la circonstance traumatique la plus fréquente. Le Glasgow moyen était de 10,1 ± 4,1. La détresse respiratoire et l’état de choc étaient respectivement observés dans 35,4 % et 17,1 %. La tête (76,8 %) et le thorax (41,5 %) étaient les régions les plus touchées. Les complications étaient retrouvées dans 34,1 %. Le taux de mortalité était de 42,7 %. La détresse neurologique (62,9 %) était la principale cause de décès. La durée médiane d’hospitalisation était de 5 jours.&#x0D; Conclusion : Le TG occupe 5,7 % des admissions en réanimation. Il touche une population juvénile masculine victime d’AVP. La tête et le thorax étaient les plus touchés. La mortalité est très élevée.

Clinical and Therapeutic Aspects of Viral Ocular Pathology in Brazzaville

Introduction: Viruses can act in two ways, either by a direct pathogenic effect, or indirectly by inducing immunosuppression and favoring the action of other so-called opportunistic viruses. This survey had a double objective, describe the clinical aspects of viral ocular pathology and state its principles of treatment. Materials and Methods: Descriptive cross-sectional study carried out over 2 years at the Ophthalmology department of the University Hospital of Brazzaville. Patients 18 years of age or older with viral ocular pathology were included. The diagnosis was made on the sole basis of anamnestic and / or clinical arguments. None of the viruses involved had been directly detected, with the exception of HIV. Biologically proven patients with a coinfection (bacteria, parasite, fungus) were excluded. HIV serology had been systematic. Four parameters were analyzed: type of virus, structures affected, pathologies diagnosed, anti viral treatments used. Results: Two hundred twenty-five (225) patients were included. The mean age was 44 ± 2.1 years. Sex ratio was 0.8. Viruses: Adenovirus (51.1%), Herpes zoster (19.5%), HIV (18.7%), Herpes simplex (7.5%), CMV (3.2%). Main structures affected: eyelid (86.2%), chorioretin (6.4%). Main pathologies: Adenovirus conjunctivitis (61.1%), shingles (16%), primary herpes simplex infection (8%) Keratitis (6.4%), chorioretinitis (6.4%), uveitis (2.1%). Anti viral treatments used: Valaciclovir, Ganciclovir and anti retroviral. Conclusion: Viral ocular pathology is dominated by Adenovirus conjunctivitis and infections due to 3 types of herpes viridae (Herpes zoster, Herpes simplex and CMV). These herpes viridae are generally responsible for opportunistic diseases following immunosuppression linked to HIV.

Measles in its Malignant form in a 12-Year-Old Girl Immunosuppressed by HIV at the University Hospital of Brazzaville

Measles is an eruptive and febrile disease that affects unvaccinated or under-vaccinated children, thus undermining the who-wanted goal of elimination. Its diagnosis is most often clinical and facilitated by the appearance of a maculopapulus rash associated with at least one element of the naso-oculo-respiratory catarrh in a context of no vaccination. Favourable in the absence of complications, the disease is formidable in its malignant form especially when it occurs in an immune-depressed field especially by HIV. The only cost-effective measure to prevent this disease, in the absence of a contraindication, remains vaccination.

Acute Generalized Peritonitis in Intensive Care Unit at University Hospital of Brazzaville, Republic of Congo: Etiological, Therapeutic Aspects and Issues

Aim: To determine etiological, therapeutic aspects and issues of AGP in intensive care unit (ICU) at University Hospital of Brazzaville (UHB). Materials and Methods: It was a retrospective and descriptive study carried out from January to December 2016 in ICU at UHB. We collected completed medical records of patients admitted and operated for AGP regardless of age or sex. The parameters studied were age, sex, admission’s reasons, etiologies, management, post-operative complications, length of hospital and mortality. Data were treated in Excel 2010 and Epi info 2007. Results: Thirty-one complete medical records were identified (mean age: 40.6 ± 22.0 years). The sex ratio was 2.4. Shock was the most common reason for admission with 67.7% of the cases. The etiologies of AGP were dominated by gastroduodenal perforating ulcer (41.9%) followed by complicated appendicitis (19.4%). The management of all patients was medico-surgical. The bi antibiotic ceftriaxone-metronidazole was administered in 29 patients (93.6%). 18 patients (59.1%) received vasopressor therapy. The complications had occurred among 9 patients i.e. 29% of the cases; parietal suppurations represented 44.5% of the complications. The average length of hospitalization was 5.2 ± 4.6 days. The overall mortality was 41.9%. Conclusion: In our study, the most frequent etiologies were gastroduodenal perforating ulcer and complicated appendicitis. They affected young patients. The complications were dominated by parietal suppurations. The mortality rate was high.