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Introduction: Diabetes and chronic liver diseases such as viral hepatitis C (HVC) are global public health problems. The combination of the 2 increases the risk of cirrhosis and hepatocellular carcinoma., Objective: The aim of this study was to investigate viral hepatitis C in adult diabetics in referral health centers in Cotonou., Methods: This was a descriptive and analytical cross-sectional study with prospective data collection from July to October 2023 at the Clinique Universitaire d'Endocrinologie Métabolisme Nutrition of the CNHU-HKM, and at the Banque d'insuline d'Akpakpa. A rapid test was used to diagnose hepatitis C and the C viral load determined by PCR. Hepatic fibrosis was assessed by the APRI (ASAT to platelet ratio Index) score., Results: A total of 281 patients were included, with a mean age of 60.4±11.2 years, ranging from 22 to 88 years, and a sex ratio of 0.6. Anti-HCV antibodies were positive in 5 patients, for a prevalence of 1.7%, including 2 with detectable HCV RNA PCR (0.7% of the study population). Factors associated with HCV were, in bivariate analysis, hepatic cytolysis (p=0.005), prothrombin level (p=0.015), APRI score (p=0.003) and insulin therapy (p=0.030). In multivariate analysis, surgical history (p=0.045) and insulin therapy (p=0.030) were statistically associated with the presence of anti-HCV antibodies in diabetics., Conclusion: Viral hepatitis C is fairly common in adult diabetics, especially those with a history of surgery or on insulin therapy. Screening of diabetics for viral hepatitis C would be useful to reduce the morbidity and mortality associated with this association., Competing Interests: The Authors declare that no competing interest exists, (Copyright © 2024 by West African Journal of Medicine.)

Introduction: The increasing incidence and high mortality of colorectal cancer (CRC) make it a major public health concern in developing countries., Objective: The aim of this work was to study the epidemiological, diagnostic, therapeutic, and prognostic aspects of colorectal cancers from 2013 to 2023 in Cotonou., Methods: This was a descriptive, analytical study with retrospective data collection, covering CRC patients managed in specialized centers in Cotonou (university clinics of visceral surgery, internal medicine and hepatogastroenterology at CNHU-HKM and the Cotonou Cancer Center)., Results: Total of 194 CRC cases were identified out of 13857 patients seen during the study period (1.4%), with a peak incidence in 2023. The median age was 53, with an interquartile range of [64-40]; 25% of subjects were under 40. The sex ratio was 1.3 (110 men and 84 women). The median time to diagnosis was 8.4 months. Constipation (78.8%), abdominal pain (71.5%), and haematochezia (61.8%) were the main clinical presentation, and occlusive forms in 27.5%. Tumor location was recto-sigmoid in 51.5%. CRC was stage III or IV in 60.4%, with 38.7% metastases. The main treatments applied were curative surgery (8.3%), palliative surgery (68.8%) and palliative chemotherapy (68.8%). Median overall survival was 22.5 months, with a 5-year survival rate of 5%. Factors predictive of death were duration of progression before diagnosis (p<0.001), World Health Organization performance status index (p=0.001), and absence of chemotherapy treatment (p=0.026)., Conclusion: CRC is increasingly common in Cotonou, and has a very poor prognosis. Early diagnosis and appropriate treatment could improve prognosis., Competing Interests: The Authors declare that no competing interest exists, (Copyright © 2024 by West African Journal of Medicine.)

Introduction: Helicobacter pylori (H. pylori) infection is common in developing countries such as Benin. This germ may cause the development of gastroduodenal diseases, ranging from gastritis to gastric cancer. Several studies on this bacterium carried out in Benin have used serology, anatomopathological examination of biopsies or antigen detection test on stool sample collections. The purpose of this study was to assess the prevalence of H. pylori infection and factors associated with H. pylori infection using a respiratory test. The bacterium could cause chronic inflammation of the gastric mucosa and peptic ulcer disease or, more rarely, gastric cancer or lymphoma., Methods: we conducted a prospective, descriptive study of 150 patients who performed carbon-14 urea breath test. Only patients admitted for respiratory test and who gave their consent were included. A survey was completed by all patients during the study. Simple univariate logistic regression analysis identified factors associated with H. pylori infection at a threshold of 0.05. Multivariate analysis included in the model all variables with a p-value less than 0.20. Manual top-down procedure was used until the final model was obtained, which allowed the retention of adjusted odds ratios for factors associated., Results: the average age of patients was 44.4±15.8 years, ranging from 5 to 84 years; men accounted for 54% of the study population. Of the 150 subjects, 82 (57.8%) had higher education level, compared with 8 (5.6%) who were not educated, 116 (80.6%) lived with a partner, 24 (36%) lived in a room with more than 10 people and 84 (59.6%) were christians. The main reasons why respiratory tests were performed were: poorly systematized abdominal pain (53.3%; 70/150), epigastric induced pain (35.3%; 53/150), epigastralgia (20.7%; 31/150), ulcer syndrome (16%; 24/150). Respiratory test showed that the prevalence of H. pylori in the study population was 34.7% (52/150). In multivariate analysis, the variables significantly associated with H. pylori infection were: mean age [aOR (95% CI) = 1.02; OR (95% CI) = 1.00-1.05 and p = 0.01] and prior treatment for H. pylori eradication [aOR (95% CI) = 4.79; OR (95% CI) = 1.50-13.86 and p = 0.006]. No comorbidity was associated with H. pylori infection in our series., Conclusion: the prevalence of H. pylori using this method was low (34.7%). It was significantly associated with mean age and prior treatment for H. pylori eradication., Competing Interests: Les auteurs ne déclarent aucun conflit d'intérêts., (Copyright: Aboudou Raïmi Kpossou et al.)

Introduction: hepatitis C is a public health problem worldwide, in particular in sub-Saharan Africa. The purpose of this study is to determine the seroprevalence of hepatitis C virus antibodies and associated factors during a voluntary general population screening program in Benin., Method: we conducted a descriptive and analytical cross-sectional study in 4 big cities of 4 different departments in Benin in July 2016. All volunteers of all ages, residing in these targeted cities, who gave their informed consent were included in the study. ImuMed HCV Rapid Diagnostic Test (Healgen Scientific LLC, USA) was used. Logistic regression analysis was also used to identify factors associated with hepatitis C virus infection., Results: a total of 2809 volunteers with an average age of 25.9 ± 16.5 years (ranging from 0 to 86 years) were included in the study; 53.9% (1514/2809) of them were men and 46.1% (1295/2809) were women. More than half of the study population consisted of single (59.1%; 1612/2726); 41.3% (1074/2809) were pupils or students. VHC Seroprevalence was 1.5% (42/2809). In multivariate analysis, the variables significantly associated with anti-HCV carriage were: be 60 years old and older (aOR: 46.9, 95% CI 10.2-216.0; p<0.0001) and a history of alcoholism (aOR: 6.3; 95% CI 95% 3.3-12.1; p < 0.0001)., Conclusion: in the general population, the seroprevalence of anti-HCV antibodies was 1.5%. HCV infection mainly occurred in people aged 60 years and older and in those with a history of alcoholism., Competing Interests: Les auteurs ne déclarent aucun conflit d'intérêts., (Copyright: Aboudou Raïmi Kpossou et al.)

Multifocal tuberculosis is rare in immunocompetent subjects. It is characterized by the involvement of at least two extra-pulmonary sites, associated or not with lung disease. It is often difficult to diagnose. We here report a case of multifocal tuberculosis in a non-immunocompromised black African subject at the Hubert Koutoukou Maga National Hospital and University Center (CNHU-HKM) in Cotonou, Benin. The study involved a 23-year-old man, with no particular previous history, admitted with diffuse abdominal pain associated with alteration of general state. Clinical examination showed severe malnutrition and medium-volume ascites. Imaging tests (chest X-ray, ultrasound and computed tomography (CT) scan) showed multiple lung, liver, pancreatic, bone, lymph nodes and colic lesions suggesting multimetastatic tumor. Colonoscopy then showed budding lesion of the cecum. GeneXpert test showed Koch´s bacilli. The anatomo-pathological examination of colic biopsies and GeneXpert sputum test confirmed multifocal tuberculosis. The patient received antituberculosis treatment and nutritional support. However he died. Multifocal tuberculosis is a serious disease that is difficult to diagnose. Then it is frequently mis-diagnosed in tropical areas, especially when it occurs in immunocompetent patients., Competing Interests: Les auteurs ne déclarent aucun conflit d´intérêts., (Copyright: Aboudou Raïmi Kpossou et al.)

Introduction: cancer is a major cause of death in the world. The purpose of this study is to evaluate the epidemiological, clinical, therapeutic and prognostic features of cancers of the pancreas (CP) at the National Hospital and University Center of Cotonou., Methods: we conducted a cross-sectional descriptive and analytical study with a prospective and retrospective data collection over a period of ten years, from 1 October 2009 to 31 October 2019., Results: out of 15.102 hospitalizations, we identified 72 cases of CP, reflecting a hospitalization rate of 0.5%. The average age of patients was 59 years. The sex-ratio (H/F) was 1.5. The main reason for consultation was abdominal pain. More than half (51.4%) of patients had metastatic tumor at the time of diagnosis. Histological evidence of adenocarcinoma was only reported in 15.1% of cases. The rate of operable patients was 37.5% while the rate of resectable patients was 2.7%. Palliative chemotherapy was given to 13.9% of patients. The average cost of treatment was 955.882,4 FCFA (23.9 times the Guaranteed Interprofessional Minimum Wage in Benin). Median overall survival was 6 months. Mortality rate was 86.9% (53/61), survival rate at one year was 31.4%, and zero at five years. Palliative surgery (p = 0.021) and chemotherapy (p = 0.023) improved patient survival., Conclusion: cancer of the pancreas, due to its non-specific signs and insidious outcome, is often diagnosed at a late stage. A metastatic tumor and the limited individual and institutional therapeutic possibilities lead to more pejorative prognosis., Competing Interests: Les auteurs ne déclarent aucun conflit d'intérêts., (Copyright: Aboudou Raïmi Kpossou et al.)

Introduction: hepatitis B is a global public health problem. The purpose of this study was to determine the prevalence of hepatitis B virus (HBV) and its associated factors based on data from a mass screening in several localities across Benin., Method: we conducted a cross-sectional descriptive and analytical study with prospective data collection. Data collection was carried out during voluntary free hepatitis B screening organized by the Rotary Club in 23 localities across Benin from the 20 th to 28 th July 2019. Rapid test for diagnostic orientation was used for the detection of HBs antigen., Results: a total of 9035 volunteers were included in the study. They were mostly of Benin origin (99%), with a mean age of 27 years; 51.1% of them were singles, mainly schoolchildren, pupils or students (37.9%). HBV seroprevalence was 6% (545/9035) [95%CI=5.5%-6.5%]. In univariate analysis, factors associated with HBs Ag colonization were: age, sex, marital status, education level, occupation and a history of diabetes, scarification and hepatitis C, while in multivariate analysis they were: sex, age and education level., Conclusion: HBV seroprevalence is 6% in the study population. HBV infection mainly affects male subjects over 17 years of age with secondary-level education., Competing Interests: Les auteurs ne déclarent aucun conflit d´intérêts., (Copyright: Aboudou Raïmi Kpossou et al.)

Health research studies are increasingly focusing on digestive cancers because of their increasing frequency and severity. The objective of this work was to study the epidemiological aspects of primary digestive cancers in adults in three hospital centers in the commune of Cotonou. A total of 676 cases of digestive cancers were identified out of 25,093 patients received during the study period (2.7%). The mean age was 54 ± 14.1 years: [16-96] and the sex ratio was 2:1. The most frequent cancers were those of the liver (259; 38.3%) and colon-rectum (154; 22.8%). The next most common cancers in descending order were gastric cancer (12%), esophageal cancer (11.4%), pancreatic cancer (11.4%), anal cancer (1.9%), hail cancer (1.5%) and biliary cancer (0.7%). The average time to visit was 9 months. The main risk factors found were viral hepatitis B and C, alcoholism, diabetes, obesity, colonic polyps, smoking, excessive consumption of salt and dietary nitrates. Lethality was 58.4%, with cancers of the liver, colon-rectum, pancreas, and esophagus in descending order of mortality. The average overall survival was 10 months. Digestive cancers most often affect people in their fifties, who are usually men in Cotonou. They are dominated by liver cancer and colorectal cancer. Modifiable risk factors are often found. The control of these factors and early diagnosis could help improve the survival of patients affected., Competing Interests: The authors have no conflicts of interest to declare

Introduction: Constipation is rare in sub-Saharan Africa, due to the high intake of dietary fiber. The purpose of this work was to describe the different clinical features of functional constipation in the general population in Cotonou and to determine the impact of diet on its occurrence., Methods: This study was conducted from July to August 2017. Subjects were considered affected by functional constipation when criteria for Rome IV or Bristol stool scale were completed., Results: In total, 1058 participants were enrolled: (574 men, sex-ratio 1.2; average age 29 years). The prevalence of functional constipation was 24.2% (Rome IV) and 20.4% (Bristol stool scale). Clinical manifestations were dominated by the emission of hard or fragmented stools (90.6%), pushing efforts during defecation (78.9%), and feeling of incomplete evacuation (76.2%). Dietary habits among people affected by constipation were: at breakfast, maize meal + donut/peanuts (39.1%), lunch, corn dough (38.7%), at dinner, corn dough (57.4%), and as a snack banana (35.5%). There was no statistically significant relationship between constipation and morning meal (p=0.09), lunch meal (p=0.901), snack (p=0.09) or dinner (p=0.75) respectively., Conclusion: The emission of hard or fragmented stools was the most common clinical manifestation among people affected by constipation living in Cotonou. Dietary habits do not influence the occurrence of functional constipation in our case series., Competing Interests: Les auteurs ne déclarent aucun conflit d´intérêts., (© Jean Séhonou et al.)

Introduction: the association between the kidneys and hepatitis B is complex. This study aims to determine the prevalence and factors associated with renal disease in people living with hepatitis B virus (PLHBV) in Cotonou., Methods: we conducted a cross-sectional, descriptive and analytical study in the Hepatogastroenterology Department at the National University Hospital Center in Cotonou over the period May -August 2017. All the patients with positive hepatitis B surface antigen (HBS Ag) test hospitalized in the study period were included. The diagnosis of renal failure was retained in patients with glomerular filtration rate less than 90 mL/min/1.73 m 2 (estimated with MDRD Equation)., Results: the study involved 105 patients with positive hepatitis B surface antigen (HBS Ag) test Among them, 65 (61.9%) were under anti-HBV treatment ( 62 of them were under tenofovir ); 41 patients had renal failure (39%) with tubular involvement (2 cases) and glomerular involvement (4 cases). Renal function had got progressively worse over time in 22 patients (21%) and had improved in 6 patients (5.7%). Univariate analysis showed that factors associated with the occurrence of renal failure were: age greater than 50 years (p = 0.0125), high blood pressure (p = 0.0037), initially abnormal renal function (p < 0.0003) and co-medications (p = 0.0007). Anti-HBV treatment wasn't associated with the occurrence of renal failure (p = 0.2887)., Conclusion: the prevalence of renal failure in PLHBV was high (39%). Age, arterial hypertension, pre-existing renal failure and co-medications were identified as factors associated with decline in renal function in PLHBV., Competing Interests: Les auteurs ne déclarent aucun conflit d’intérêts.