One hundred nineteen children, either French or from the Ivory Coast, aged 1-8 years, were submitted to pancreatic function testing by duodenal aspiration. Trypsin, chymotrypsin, lipase, phospholipase, amylase, volume, bicarbonate, chloride, and calcium were estimated before and after an intravenous injection of 1 CU secretin + 3 CHR units pancreozymin per kilogram of body weight. Sixty-two patients were normal European children, and 11 were normal African children. Twenty-five African children presented with kwashiorkor and 10 African children had presented with kwashiorkor but had recovered at the time of the test. Three cases of recurrent kwashiorkor are also included. In the normal group of African children, phospholipase concentration, volume, and bicarbonate were significantly decreased but chymotrypsin and trypsin concentrations were not, when compared to the normal European population. In kwashiorkor patients, lipase, amylase, phospholipase, and chymotrypsin concentration were significantly decreased compared to normal Africans. Trypsin, volume, and bicarbonate were not affected. These modifications disappeared after refeeding. In cases of recurrent kwashiorkor, all enzymes, including trypsin, were decreased. Calcium was never modified. These modifications were very different from those observed in chronic alcoholic and hypercalcemic pancreatitis. In a two-year study, chronic calcifying pancreatitis (CCP) was diagnosed in 14 patients (13 males), hospitalized in Abidjan. The mean age at onset of the disease was 41 years (SD 12.71), which is very similar to European cases. The most frequent cause was alcoholism, as in Occidental countries. The nutrition of the population was low in protein, calories being provided mostly by manioc, but no apparent symptoms of malnutrition were observed in the parents of our patients.(ABSTRACT TRUNCATED AT 250 WORDS)

En Côte d'Ivoire, malgré une prévalence d'environ 12% du VHB et 5% du VHC, le dépistage et la prise en charge des hépatites virales B et C demeurent très limités. Une étude qualitative a été menée en 2013 à Abidjan pour évaluer les modalités de dépistage et de prise en charge de ces infections.Les résultats révèlent la méconnaissance des hépatites tant dans la population générale que parmi les soignants non spé-cialistes. L'offre et la demande de dépistage sont restreintes et la formation insuffisante du personnel de santé engendre des occasions manquées. Seuls les donneurs de sang sont systé-matiquement dépistés, mais la prévention par la vaccination et la prise en charge sont peu effectives, faute de moyens financiers. Officiellement, les traitements sont disponibles, mais inaccessibles du fait de leur coût élevé, en l'absence de couverture maladie universelle. Le Programme National de Lutte contre les Hépatites Virales, créé en 2008, ne dispose pas du budget nécessaire pour pratiquer dépistage, prise en charge, prévention et campagnes de sensibilisation. L'absence de mobilisation financière internationale, comme celle qu'a connue l'épidémie de VIH, est vécue comme une injustice, tant par les médecins spécialisés qui ont les compétences pour traiter la maladie mais pas les moyens de les mettre au service des patients, que par les personnes porteuses d'une hépatite chronique B et/ou C.Il apparaît donc urgent de dynamiser et renforcer la lutte contre les hépatites B et C en Côte d'Ivoire.Mots clés Hépatite B · Hépatite C · Côte d'Ivoire · Dynamisation de la lutte Abstract In Ivory Coast screening and monitoring of hepatitis B and C remain very limited despite a HBV prevalence of about 12% and one of about 5% for HCV. A qualitative study was conducted in 2013 in Abidjan in order to evaluate conditions for testing and monitoring of these infections.Results show a lack of knowledge regarding hepatitis both in the general population and among non specialist health caretakers. Offer and demand of testing are limited, and insufficient health staff training is a source of missed opportunities. Only blood donors are systematically tested, although proposed prevention by vaccination against hepatitis B and monitoring are rarely followed up due to lack of funds. Treatments are officially available, but inaccessible because of their high cost in the absence of universal health insurance. The National Program against Viral Hepatitis (Programme National de Lutte contre les Hépatites Virales) launched in 2008 does not have the necessary budget to undertake screening, monitoring, prevention and sensitization campaigns. Lack of international financial mobilization, contrary to what occurred for the HIV epidemic, is experienced as a great injustice both by medical specialists who are competent to treat the disease but lack the means to put them at patients' disposal, and by patients suffering from chronic hepatitis B and/or C. It seems thus urgent to revitalize and to strengthen the fight against hepatitis B and C in Ivory Coast.

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