Les maladies digestives dans un service de médecine à Madagascar: étude rétrospective

Razafimahefa, Soloniaina Hélio; Rabenjanahary, Tovo Harimanana; Razanaparany, O. M.; Rakotozafindrabe, Andry Lalaina Rinà; Rakotoarivelo, R.; Ramanampamonjy, Rado Manitrala

doi:10.1007/s12157-012-0378-3

Cited by 3 publications

(8 citation statements)

References 23 publications

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“…Decompensated cirrhosis is a terminal liver disease, the evolution of which is characterized by the occurrence of frequent and potentially serious life-threatening complications. 1,2 It is a global public health problem, especially in sub-Saharan Africa due to the high mortality rate and the inaccessibility of treatment. [1][2][3] Cirrhosis accounts for approximately 2 million deaths per year worldwide.…”

Section: Introductionmentioning

confidence: 99%

“…1,2 It is a global public health problem, especially in sub-Saharan Africa due to the high mortality rate and the inaccessibility of treatment. [1][2][3] Cirrhosis accounts for approximately 2 million deaths per year worldwide. 1,4 In Madagascar, it represents the first digestive pathology encountered in hospitalization with 33.54% 2 and has a high mortality rate estimated at 26.5%.…”

Section: Introductionmentioning

confidence: 99%

“…[1][2][3] Cirrhosis accounts for approximately 2 million deaths per year worldwide. 1,4 In Madagascar, it represents the first digestive pathology encountered in hospitalization with 33.54% 2 and has a high mortality rate estimated at 26.5%. 3 Patients with decompensated cirrhosis have a very high risk of mortality, due to multiple complications.…”

Section: Introductionmentioning

confidence: 99%

“…3 Patients with decompensated cirrhosis have a very high risk of mortality, due to multiple complications. [1][2][3][4][5][6] Although liver transplantation significantly improves the survival of patients with decompensated cirrhosis, it is not widely used due to limited liver resources, high costs and immunological reactions to transplantation. 6 This procedure remains unavailable in Madagascar to this day.…”

Section: Introductionmentioning

confidence: 99%

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Factors Associated with in-Hospital Mortality in Malagasy Patients with Acute Decompensation of Liver Cirrhosis: A Retrospective Cohort

Razafindrazoto¹,

Randriamifidy²,

Ralaizanaka³

et al. 2023

HMER

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Section: Introductionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

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Factors Associated with in-Hospital Mortality in Malagasy Patients with Acute Decompensation of Liver Cirrhosis: A Retrospective Cohort

Razafindrazoto¹,

Randriamifidy²,

Ralaizanaka³

et al. 2023

HMER

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“…In Madagascar, 8.21% to 46% of gastrointestinal bleeding is due to ruptured esophageal varices [ 3 , 4 ]. Portal hypertension causes 15.38% deaths and cirrhosis, 22.73% [ 5 ].…”

Section: Introductionmentioning

confidence: 99%

Clinical mortality risk factors of variceal upper gastrointestinal bleeding in a Malagasy surgical intensive care unit

Rakotondrainibe

Rahanitriniaina

Randriamizao

et al. 2020

African Journal of Emergency Medicine

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Background Variceal upper gastrointestinal bleeding is a dreadful complication of portal hypertension with a significant morbidity and mortality. Different prognostic scores can be used. However, in the local context of Madagascar, the completion of paraclinical investigations can be delayed by the limited financial means of patients. Hence, determining clinical mortality risk factors of variceal upper gastrointestinal bleeding could be interesting. The aim of the study was to evaluate the clinical mortality risk factors of variceal gastrointestinal bleeding (VUGIB). Method An observational, cohort retrospective study was conducted over an 8-year period (2010–2017), at the surgical intensive care unit of the J.R. Andrianavalona University Hospital, Antananarivo, in patients admitted for VUGIB confirmed by upper gastrointestinal endoscopy and whose clinical examination was performed at admission. The primary endpoint was intensive care unit (ICU) mortality. Univariate analysis and multivariate logistic regression analysis were performed to identify risk factors for ICU mortality, with OR defining odds ratio. A p value <0.05 was considered significant. Results 1920 patients were admitted for gastrointestinal bleeding of any digestive causes; the source of bleeding was variceal in 269 patients (14%). The predominantly male population (sex ratio = 2.5), aged 47.1 ± 13.7 years was mostly American Society of Anesthesiologists (ASA) 1 classification (58.4%). In 56.5% of patients, the gastrointestinal bleeding had not occurred before. The mortality rate was 16.0%. Three major clinical factors of mortality were identified: previous endoscopic band variceal ligation (OR = 12.57 [2.18–72.58], p = 0.005), tachycardia >120 bpm (OR = 2.91 [1.04–8.14], p = 0.041), and ascites (OR = 3.80 [1.85–7.81], p < 0.001). Conclusion Upper gastrointestinal bleeding may be life-threatening. The mortality scores are certainly useful; however, the identification of clinical factors is interesting in countries like Madagascar, pending the results of paraclinical investigations.

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Perioperative outcomes of the surgical management of achalasia in two tertiary Cameroonian hospitals: a cohort study

Kamla,

Bang,

Tochie

et al. 2024

BMC Gastroenterol

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Introduction Achalasia is a rare esophageal disease with potentially lethal complications. Knowledge of the outcomes of the different surgical treatment modalities for achalasia by Heller’s cardiomyotomy (HCM) helps to choose the safest and most effective option. However, data on the management of achalsia using a Heller myotomy is limited in Africa. Thus, our aim was to determine the perioperative morbidity, mortality and short-term functional outcomes of HCM in Cameroon. Methodology We conducted a cohort study throughout a 10-year chart review of patients who underwent HCM for achalasia and were followed up postoperatively for at least three months at two tertiary health centers in Cameroon. We analyzed demographic data, preoperative clinical and imaging data, treatment details, and outcomes at three to twelve months after HCM using the Eckardt score. Results We enrolled 29 patients with achalasia having a mean age of 24 ± 16 years and predominantly females (M/F of 1/3.8). The mean symptom duration was 51 ± 20 months. In 80% of cases, the diagnosis was made through a conventional x-ray contrast imaging or “barium swallow test” (93%) and/or an upper gastrointestinal endoscopy (86%). The gold standard diagnostic method via esophageal manometry was unavailable. Preoperatievly, all patients had symptoms suggestive of an active achalasia. HCM was performed via laparotomy in 75% as opposed to 25% laparoscopic HCM procedures. Dor’s anterior partial fundoplication was the main anti-reflux procedure performed (59%). Mucosal perforations were the only intraoperative complications in eight patients (2 during laparoscopy vs. 6 during laparotomy; p > 0.5) and were managed successfully by simple sutures. Postoperative complications were non-severe and occurred in 10% of patients all operated via laparotomy. The mean postoperative length of hospital stay was 7 ± 3 days for laparotomy vs. 5 ± 2 days for laparoscopy; p > 0.5. The perioperative mortality rate was nil. Overall, the short-term postoperative functional outcome was rated excellent; average Eckardt score of 1.5 ± 0.5 (vs. preoperative Eckardt Score of 9 ± 1; p < 0.0001). Conclusion Achalasia is diagnosed late in this resource-limited setting. HCM yields satisfactory outcomes, especially via laparoscopic management. An improvement in diagnostic esophageal manometry and mini-invasive surgical infrastructure and the required surgical training/skills are needed for optimal achalasia care.

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Les maladies digestives dans un service de médecine à Madagascar: étude rétrospective

Cited by 3 publications

References 23 publications

Factors Associated with in-Hospital Mortality in Malagasy Patients with Acute Decompensation of Liver Cirrhosis: A Retrospective Cohort

Factors Associated with in-Hospital Mortality in Malagasy Patients with Acute Decompensation of Liver Cirrhosis: A Retrospective Cohort

Clinical mortality risk factors of variceal upper gastrointestinal bleeding in a Malagasy surgical intensive care unit

Perioperative outcomes of the surgical management of achalasia in two tertiary Cameroonian hospitals: a cohort study

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