Aims. To determine the usefulness of platelet count (PC), spleen diameter (SD) and platelet count/spleen diameter ratio (PC/SD ratio) for the prediction of oesophageal varices (OV) and large OV in black African patients with cirrhosis in Côte d'Ivoire. Materials and Methods. Study was conducted in a training sample (111 patients) and in a validation sample (91 patients). Results. Factors predicting OV were sex: (OR = 0.08, P = 0.0003), PC (OR = 12.4, P = 0.0003), SD (OR = 1.04, P = 0.002) in the training sample. The AUROCs (±SE) of the model (cutoff ≥ 0.6), PC (cutoff < 110500), SD (cutoff > 140) and PC/SD ratio (cutoff ≤ 868) were, respectively; 0.879 ± 0.04, 0.768 ± 0.06, 0.679 ± 0.06, 0.793 ± 0.06. For the prediction of large OV, the model's AUROC (0.850 ± 0.05) was superior to that of PC (0.688 ± 0.06), SD (0.732 ± 0.05) and PC/SD ratio (0.752 ± 0.06). In the validation sample, with PC, PC/SD ratio and the model, upper digestive endoscopy could be obviated respectively in 45.1, 45.1, and 44% of cirrhotic patients. Prophylactic treatment with beta blockers could be started undoubtedly respectively in 36.3, 41.8 and 28.6% of them as having large OV. Conclusion. Non-invasive means could be used to monitor cirrhotic patients and consider treatment in African regions lacking endoscopic facilities.

Background. Hepatitis B virus (HBV) infection is a leading cause of liver disease worldwide. Hepatitis B surface antigen (HBsAg) rapid diagnostic tests (RDTs) could be an ideal tool for a large-scale HBV screening in settings with high endemicity but limited infrastructure. The aim of this study was to evaluate the diagnosis performance of such RDTs for screening HBV infection in Ivory Coast. Methods. From September 2018 to January 2019, a cross-sectional phase I evaluation study of RDTs was conducted in three laboratories of Abidjan (CeDReS, CNTS and IPCI), on a panel of 405 whole blood samples and 699 plasmas. Four HBsAg RDTs (Determine™ HBsAg, SD Bioline HBsAg WB®, Standard Q HBsAg® and Vikia HBsAg®) were evaluated. The diagnostic performance (sensitivity and specificity) was calculated in comparison to the reference sequential algorithms of two EIA tests (Dia.Pro HBsAg® one version ULTRA and Monolisa™ HBsAg ULTRA). Results. The Determine™ HBsAg and Vikia HBsAg® tests performed well, with 100% of sensitivity, specificity both on plasma and on whole blood. For SD Bioline HBsAg WB® and Standard Q HBsAg®, the specificities were 99.8% and the sensitivities 99.3% and 97.1% respectively. Finally, there were a total of 19 false negative results: 3 with SD Bioline HBsAg WB® and 16 with Standard Q HBsAg®. Conclusion. Determine HBsAg® from Alere and Vikia HBsAg® from Biomérieux are the most suitable RDTs for screening for HBV in Ivory Coast. A phase II evaluation must be initiated.

Intérêt du gradient de concentration sérum-ascite en albumine dans le diagnostic des varices oesophagiennes chez le cirrhotique africain, Abidjan (Côte d'Ivoire)Interest serum-ascites albumin concentration gradient in the diagnosis of esophageal varices in cirrhotic African, Abidjan (Côte d'Ivoire) Résumé Buts : Déterminer la corrélation entre le gradient de concentration sérum-ascite en albumine (GASA) et la prédic-tion des varices oesophagiennes (VO) et autres paramètres de l'hypertension portale (HTP) à savoir signes rouges, grades des varices, varices cardiotubérositaires et les gastropathies d'HTP chez le cirrhotique noir africain en Côte d'Ivoire. Patients et méthode : Etude transversale rétrospective portant sur 113 dossiers médicaux de patients présentant une ascite liée à l'HTP. La fibroscopie digestive haute pour la recherche de signes d'HTP. Le dosage des protéines dans le sérum et le liquide d'ascite a été réalisé par les méthodes chimiques courantes. La sensibilité et la spécificité obtenues par l'aire sous la courbe ROC (Receiver-Operating-Characteristic). Résultats : A 1,1 g/dl, le GASA prédisait les VO avec une sensibilité (53,3%), une spécificité (80%) pour une performance diagnostique faible (64%). A partir de 1,5 g/dl du SAAG, la spécificité était maximale (100%) mais on relevait 40% de faux-négatifs. Pour une valeur-seuil de -1,240 g/dl, la performance diagnostique du GASA était meilleure avec une sensibilité (96%), une spécificité (55%) pour une performance diagnostique à 84%. Conclusion : La valeur seuil du GASA efficace pour la détection des VO était inférieure chez les sujets africains en raison des facteurs nutritionnel et infectieux fréquents dans ces pays à faible revenu. Mots clés Varices oesophagiennes · Gradient · Albumine · Cirrhose · AfriqueAbstract Aims: To determine the correlation between the concentration Serum Ascites Albumin Gradient (SAAG) and the prediction of esophageal varices (VO) and other parameters of portal hypertension (PHT), namely red signs grades varicose veins, varicose veins and cardio tuberosity, the gastropathie portal hypertension among African blacks cirrhotic Ivory Coast. Patients and Methods: A retrospective cross-sectional study of 113 medical records of patients with ascites associated with PH. The gastroscopy to search for signs of HTP. The protein assay in serum and ascitic fluid produced by standard chemical methods. The sensitivity and specificity obtained by the area under the ROC curve (Receiver-Operating-Characteristic). Results: 1.1 g/dl, the SAAG predicted VO with a sensitivity (53.3%), specificity (80%) for low diagnostic accuracy (64%). From 1.5 g/dl of SAAG, specificity was highest (100%) but fell 40% false-negative. For a threshold value of -1.240 g/dl, the diagnostic performance of SAAG was better with a sensitivity (96%), specificity (55%) for a diagnostic accuracy of 84%. Conclusion: The threshold value of SAAG effective for the detection of VO was lower among African because of frequent nutritional and infectious factors in these low-in...

Viral hepatitis is a serious public health problem affecting billions of people globally. Limited information is available on this issue inCote d'Ivoire. The objectives of this study were to determine the prevalence and factors associated with hepatitis B virus (HBV) and hepatitis C virus (HCV) during an active screening campaign in Abidjan. A cross-sectional study was conducted at Pasteur Institute of Cote d'Ivoire from July 2015 to February 2016. The ethical clearance for this study was obtained from the National Ethical and Research Committee. An informed written consent was obtained from the participants of the study and administered a questionnaire related to the socio demographical information and risk factors of a possible route transmission HBV and hepatitis C virus (HCV). Blood samples were collected for the detection of HBS Ag, Ab-HBc IgG and Ab-HCV. Serological analyses were performed by Cobase 601 (Roche R ). Data were analyzed by R software. A total of 1801 patients were recruited; among them 138 children (7.7%) aged from 0 to 15 years and 1663 adults (92.3%). The sex ratio was 1.2 (964/837). The overall prevalence of HBsAg was 30. 9% (557/1801) and 41.1% (702/1708) for Ab-HBc IgG. About HCV, the overall prevalence rate was 5.3% (95/1687), none of the children was HCV positive. The co-infection HBV/HCV rate was 0.95% (16/1687). HCV was associated with age and sexual risk behaviors. HBV was associated with gender, youth, sexual risk behaviors, and scarification. Our findings revealed a high prevalence of HBV. The measures to reduce the disease and its load transmission must be strengthened.

But : Déterminer la couverture vaccinale contre l'hépatite virale B et la prévalence de l'antigène HBs chez les sapeurs-pompiers. Matériels et méthodes : Il s'agissait d'une étude transversale réalisée lors d'une journée publique de dépistage volontaire et gratuit de l'antigène HBs. Tous les sapeurs-pompiers militaires qui se sont présentés ont été soumis à un questionnaire sous forme d'interview (âge, sexe, vaccination contre l'hépatite virale B), suivi d'une recherche de l'antigène HBs et du dosage des transaminases (alanine aminotransférase seuil 40 UI/ml). Lorsque l'antigène HBs était positif, tous les marqueurs sérologiques du virus de l'hépatite B étaient recherchés (Elisa Cobas™) ainsi que le dosage quantitatif de l'ADN du virus de l'hépatite B (PCR en temps réel seuil 16 UI/ml ; Taqman Roche™). Résultats : Deux cent quarante-quatre sapeurs-pompiers ont été reçus (moyenne d'âge : 45,69 ans [extrêmes : 26-67 ans] ; sex-ratio : 80,33). Respectivement, une, deux et trois doses de vaccin antihépatite virale B avaient été administrées à 17 (7 % [3,8-10,20]), 15 (6,1 % [3-9,1]) et cinq (2 % [1,98-3,75 IC 95 %]) personnes. L'antigène HBs a été retrouvé chez 32 des 244 personnes dépistées, réalisant une prévalence de 13,1 % (08,87-17,34 IC 95 %). Tous les patients antigène HBs positif étaient antigène HBe négatif, IgM anti-HBc négatif et anticorps anti-HBc totaux positif. Des transaminases supérieures à 40 UI/l et une charge virale supérieure à 2 000 UI/ml étaient retrouvées chez respectivement dix (31,25 %) et six (18,75 %) des 32 patients ayant l'antigène HBs positif. Conclusion : La couverture vaccinale contre l'hépatite virale B était faible, et la prévalence de l'antigène HBs élevée dans notre étude. Une vaccination contre le virus de l'hépatite B précédée d'un dépistage est à recommander chez les sapeurspompiers d'Abidjan. Pour citer cette revue : J. Afr. Hépatol. Gastroentérol. 5 (2011). Mots clés Ag HBs · Vaccins antihépatite B · Populations à risque d'hépatite B · Pompiers · Abidjan · Côte-d'IvoireAbstract Aim: To determine the vaccination coverage against hepatitis B virus and the prevalence of HBsAg among firefighters. Materials and methods: This was a cross-sectional study conducted during a day of voluntary testing for HBsAg. All fire brigade members who attended were subjected to a questionnaire in interview form (age, sex, vaccination against hepatitis B virus), followed by a determination of HBsAg and the assay of transaminases (alanine aminotransferase level 40 IU/ml). When HBsAg was positive, all serological markers of hepatitis B were sought (Cobas ™ Elisa) and quantitative determination of DNA hepatitis B (real-time PCR threshold 16 IU/ml; Roche Taqman™) Results: Two hundred and forty-four firefighters have been received (average age: 45.69 years [extreme: 26-67 years], sex ratio = 80.33). One, two and three doses of hepatitis B virus vaccine were administered to 17 (7% [3.8-10.20]), 15 (6.1% [3-9.1]) and five (2% [1.98-3.75 CI 95%]) individuals, respectively. Vaccination coverage against hepat...