TITLE:
Ulcerative Colitis in Sub-Saharan Africa: Analysis of 24 Cases in Dakar (Senegal)
AUTHORS:
Mamadou Ngoné Gueye, Sokhna Niang Diop, Salamata Diallo, Gnagna Diouf, Cheikh Ahmadou Bamba Cissé, Marème Polèle Fall, Mame Aissé Thioubou, Marie Louise Bassène, Daouda Dia, Mouhamadou Mbengue
KEYWORDS:
Ulcerative Colitis, Sub-Saharan Africa, Toxic Megacolon, 5 ASA, Azathioprine
JOURNAL NAME:
Open Journal of Gastroenterology,
Vol.10 No.6,
June
4,
2020
ABSTRACT: Introduction: The aim of our study was to determine the socio-demographic, diagnostic and therapeutic aspects of ulcerative
colitis (UC) in one of the largest gastroenterology departments in
Senegal. Patients and Method: This was a retrospective and descriptive
study based on the analysis of the records of patients hospitalized in the Hepato-Gastroenterology
Department of the Grand Yoff General Hospital (Dakar, Senegal) between January
2013 and December 2019. All cases of UC were collected. Clinical, biological,
endoscopic and histological data were
collected, as well as treatment options. Results: We observed 24
cases, representing a prevalence of 0.87% of inpatients. The mean age of
patients was 36 (ranged 18 to 73) and sex ratio 0.9 (13 females). The mean diagnostic
delay was 1.6 years (ranged 4 months to 5 years). The clinical symptomatology was dominated by diarrhea with
blood and mucus (18 cases). The Litchiger score on admission averaged 8
and 5 patients (20.8%) had severe acute
colitis. Colonoscopy showed pancolonic involvement (Montreal E3) in 11 cases
(45.8%) and severe endoscopic lesions (stage 3 of the Mayo endoscopic
subscore) in 10 cases (41.6%). Therapeutically, 17 patients (70.8%) were
initially treated with corticosteroids. Background therapy was 5-ASA in 17 patients (70.8%) and azathioprine in 7 patients
(29.2%). Two cases of death (8.3%) were observed following colectasia with
colonic perforations before emergency
surgery could be performed. Conclusion: UC in our study was primarily
among young adults with a slight female predominance. Diagnosis is often late.
The lack of biotherapy requires close collaboration with surgeons for the
management of severe forms.