The characteristics of viral hepatitis B and D co-infection are poorly documented in Chad. The aim of our study was to determine the prevalence of HBV/HDV co-infection and the characteristics of this co-infection. Materials and Methods: This was a retrospective study including all patients with chronic HBsAg carriers referred in our department from January 2014 to December 2018. Non-inclusion criteria were: absence of anti-HDV testing, presence of anti-viral hepatitis C or Human Immunodeficiency Virus antibodies or excessive alcohol consumption. The variables studied were age, sex, blood transaminase level, HBV DNA level, HDV RNA level, and liver fibrosis and activity score (Actitest Fibrotest). The prevalence of HDV and the characteristics of HDV/HBV co-infection were determined. Results: During the study period, 403 patients were seen in these two hospitals for chronic HBsAg carriage. Of these, 378 (75%) had performed the anti HDV assay. Anti-HDV antibodies were positive in 53 patients (14%). In multivariate analysis, HBV/HDV co-infected patients were less frequently HBeAg positive (5.4% vs. 28.1%; p = 0.0001), older (35 years vs. 32 years; p = 0.001), and more frequently had significant necrotic-inflammatory activity (3.9% vs. 3.2%; p = 0.031) compared with mono infected patients. Neither gender (76.9% male vs. 77.4% male; p = ns), nor viral load (median 530 IU/ml vs. 195 IU/ml; p = ns), nor significant liver fibrosis (35.1% vs. 47.1%; p = ns), nor transaminases (median 26 vs. 32 IU/ml) were different with mono infected patients. Conclusion: VHD is common in Chad. It is associated with increased hepatic necrotic-inflammatory activity.

Introduction: According to the WHO, Chad is located in an area of high endemicity for hepatitis B virus (HBV). The aim of this study was to analyze the virological profiles of chronic HBV carriers. Materials and Method: This was a retrospective and analytical study including outpatients with chronic HBV of any age received in Department of Internal Medicine and Gastroenterology of National General Reference Hospital of N'Djamena from 2013 to 2017. Results: During the study period, 401 chronic hepatitis B virus carriers (mean age was 35 years ± 11 years with sex ratio of 3.26) were seen in outpatient clinic with a frequency of 3.34% (401/11,988). HBeAg (+) patients were 12.8% and HBeAg negative 87.2%. HBeAg-negative patients were significantly older (p = 0.000) than those with HBeAg (+). The mean HBV-DNA level was higher in HBeAg (+) patients. The HBV-DNA level in HBeAg-positive patients was higher than in HBeAg-negative patients with a significant difference (p = 0.043). The mean ALT level was 45 IU/L in HBeAg (−) patients. It was 49 in HBeAg (+) patients. Conclusion: HBeAg (−) chronic hepatitis B is the most predominant form in our study. This observation is important because it can help to adapt the management strategies.

Background: the profile of chronic viral hepatitis B has been little studied in Chad. The factors predictive of the presence of hepatic fibrosis are not well known. The aim of the study was to determine the biological profile of chronic HBsAg carriers according to the new European classification of chronic hepatitis B.Method: This is a prospective cross-sectional study carried out in the gastroenterology outpatient department at the Renaissance Hospital in N’Djamena from January, 2018 to July, 2019. All patients with chronic HBsAg were included and documented for at least one year. Patients with hepatitis C, hepatitis D or HIV are known alcoholic patients and were excluded from the study. The biological profile was determined according to four forms; HBeAg positive chronic infection, HBeAg positive chronic hepatitis, HBeAg negative chronic infection, HBeAg negative chronic hepatitis and HBsAg negative phase. Factors associated with presence of significant liver fibrosis were founded by logistical regression.Results: The average age of the patients were 42.4 years old. The sex ratio was 1.43 in favor of men and a total number of 106 patients were included. The median of the transaminase concentrations were 24 IU/ml (AST) and 21 IU/ml (ALT). 61 patients had HBeAg negative chronic infection (59.8%) and 37 patients had HBeAg negative chronic hepatitis (36.2%). HBeAg positive chronic infection and HBeA positive chronic hepatitis were both seen in 2% of the cases. Significant liver fibrosis was independently associated with the ALT levels (Odds ratio=1.038 [1.009-1.068]; p=0.009).Conclusion: Chronic HBeAg-negative B infection is the main form found in chronic HBeAg-positive carriers. Transaminases are a predictive factor for the presence of hepatic fibrosis.

Introduction: Chronic hepatitis B virus infection is very common in sub-Saharan Africa and widely distributed worldwide. The purpose of this study was to determine the prevalence of hepatitis B virus in N'Djamena, Chad. Methodology: This was a cross-sectional study conducted in the city of N'Djamena. Three neighborhoods were randomly selected. The methodology applied was a two-stage probability survey with the neighborhoods as the primary unit and the squares (sectors) as the secondary unit. Persons from the selected households were screened for HBV infection. Results: Two hundred and ninety-nine (299) individuals were recruited in this study series. The majority were men (69.6%). The mean age was 29.5 ± 9 years with extremes of 15 to 45 years. The prevalence of those screened was 24.1% with a male predominance (54.1%). There was a statistically significant difference between HBsAg carriage and sex (p = 0.001). On the other hand, the difference between HBV carriage and education level was not statistically significant. In addition, few people had information on the modes of transmission of HBV and their serological status. Conclusion: Viral hepatitis B is a major global public health problem. However, most of the people recruited in this series were unaware of their status and very few had information on this disease.

Helicobacter pylori infection and resistance to antibiotics is a public health problem. The objective of this study was to determine the prevalence and rates of resistance to antibiotics used in the protocol for the management of patients with Helicobacter pylori infection. Spanning a period from February 2020 to February 2021, it was an observational diagnostic study on gastric biopsies and stool including 97 patients admitted for endoscopy. It was carried out according to standard methods of medical microbiology. Of 97 patients whose mean age was 46.10 years with extremes of 16 and 85 years, an infection prevalence of 60.82% was observed. 44.07% of infected patients were between 16 and 39 years old, 33.90% between 40 and 63 years old, and 22.03% between 63 and 85 years old. Significant differences were observed between the proportions of positive (81.44%) and negative (18.56%) cultures, between infection with H. pylori (75%) and other microbial agents (25.35%) with probabilities of 0.01 and 0.02 respectively. The most resistant antibiotics were: Metronidazole, Clarithromycin, Levofloxacin, Tetracycline and Amoxicillin with resistance rates of 74.58%, 16.95%, 13.56%, 8.47%, and 5.08% respectively.  The frequencies of antibiotic resistance revealed 74.58% for Metronidazole, 16.95% for Clarithromycin, 13.56% for Levofloxacin, 8.47% for Tetracycline, and 5.08% for Amoxicillin. This study made it possible to determine a significant proportion of H. pylori infection and to shed light on the resistance to the antibiotics used in the eradicating treatment of the bacteria. From this study, we retain that the prescription of Metronidazole is prohibited in Chad. Keywords: Helicobacter pylori, Resistance, Antibiotic, Chad.