Therapeutic Route of Patients with Cirrhosis in Bangui

Abstract

Introduction: Cirrhosis is the final stage in the development of any chronic liver disease. The objective of our study was to determine the therapeutic route of patients with cirrhosis. Patients and Methods: This was a one-year cross-sectional study of consenting patients of both sexes with cirrhosis who were hospitalized for the first time. The study took place from October 1, 2013 to September 30, 2014. The diagnosis of cirrhosis was based on clinical, biological and morphological arguments. Results: In total, 1028 patients were hospitalized, including 202 for cirrhosis (19.6%). One hundred and four patients (10.1%) met our inclusion criteria. These were 70 men (67.3%) and 34 women (32.7%). The sex ratio was 2.05. The average age was 43.74 ± 13.74 years. In 68 cases (65.4%), cirrhosis was considered a supernatural disease and in 36 cases (34.6%) was a natural disease. At the first signs, 88 patients (84.6%) had consulted (traditional healer in 34 cases, pastor in 25 cases, marabout in 16 cases and general practitioner in 13 cases). The pastor prayed to 25 patients (24%). The traditional healer made the patients ingest herbal preparations (n = 18), associated or not with scarification (n = 4) and/or enema (n = 28). The marabout recited Quranic verses written on a board, then washed and ingested in 16 cases (15.4%). The general practitioner prescribed treatment to the 13 patients (12.5%). The various treatments received had led to hepatic encephalopathy (21 cases), digestive hemorrhage (15 cases), abdominal pain (3 cases), jaundice (3 cases), increased abdominal bloating (21 cases). The patients had consulted the specialist within an average of 74 ± 15.3 days. The average time to hospital was 21 days ± 13. Conclusion:

Hepatitis B Virus in Cirrhosis and Primary Livers Cancers

“…This observation had already been made in Bangui [28] [35], as well as by other authors in Brazzaville [36] and Cotonou [30]. The low socio-economic level observed is linked to a low human development index, a characteristic of low-income countries where social inequalities are immense [37].…”

“…The most frequent modes of decompensation were ascites (87.50%), jaundice (81.25%), hepatocellular carcinoma (36.87%) and hepatic encephalopathy (29.38%). They were reported with varying frequency in other studies in Bangui [24] [28] [34] [35] [37], Bamako [11], Pointe Noire in Congo [27], Cotonou [30] and Kinshasa [31]. The majority of our patients (62.94%) had WHO performance status 3, indicating advanced disease.…”

“…[33] and Burkina Faso [36]. The delay in consulting a doctor is probably linked to the use of traditional medicine, self-medication, poverty, religious convictions and occult beliefs, as reported in the study on the therapeutic itinerary of patients with cirrhosis [37]. Cirrhosis represented 94.11% of cases and HCC 5.89% of cases in our series.…”