Authors: Ngami RS, Mikolélé Ahoui Apendi PC, Mimiesse Monamou JF, Mongo-Onkouo A, ItouaNgaporo NA, Motoula Latou PM, Ngalessami Mouakosso M, Adoua Céline Sandra, Ibobi Mauria Gilga, Deby Gassaye, Atipo Ibara B.
Chronic inflammatory bowel disease (IBD) is rarely described in sub-Saharan Africa. The aim of this study was to evaluate the evolutionary profile of a series of 26 cases of IBD at the Brazzaville university hospital in 2023.
Patients and Methods: This was a cross-sectional analytical study conducted in the Gastroenterology department of Brazzaville university hospital over a 13-year period. IBD was diagnosed on the basis of clinical (chronic diarrhoea, rectal discharge), morphological (intestinal parietal thickening), endoscopic (acute or chronic lesions) and histological criteria. Severe forms were defined by the fact of having a pancolitis and ano-perineal lesions. The Wilcoxon test was used to compare variables at a threshold of 0.05.
Results: A total of 26 patients were included, representing 0.2% of hospitalizations. The sex ratio was 1.9. The median age was 37 (IQR 24-51), and nine patients were under 30. IBD included Crohn's disease (CD), ulcerative colitis (UC) and indeterminate forms in 10, 8 and 8 cases respectively. The median duration of symptoms before diagnosis was 2.2 years (IQR 0.1-6). Twelve patients had a severe form, including two cases of severe acute colitis. Undernutrition was observed in 16 patients, including 13 cases of severe undernutrition. By 2023, 17 out of 26 patients had been lost to follow-up, 5 had died and 4 were regularly monitored. The median time to death was 3.3 months (IQR 1.4-3.8). The presence of ano-perineal lesions (p=0.0143) and disease severity (p=0.019) were factors associated with death.
Conclusion: Keeping IBD patients in the care circuit is a multidisciplinary challenge to reduce the proportion of patients lost to follow-up, and improving their management.