This is a retrospective, descriptive and single-center analytical study involving 1000 patients who underwent upper gastrointestinal endoscopy with a FUJI video endoscope EG-200 and a 2500 series processor. Of these patients, 292 received a biopsy for pathological analysis (affordability).

- All patients who underwent upper gastrointestinal endoscopy during the study period.

- All patients who have had the necessary means for accessibility to the pathological anatomy examination.

- We defined as significant lesions: esophageal varices, benign esophageal strictures, esophageal tumor, gastric tumor and gastro-duodenal ulcer.

- All patients with only a colonoscopy and a rectoscopy.

- All patients who have had a control upper gastrointestinal endoscopy.

- All patients on treatment of proton pump inhibitors.

- Demographic criteria: age (±50 years), sex, consumption of tobacco, non- steroidal anti-inflammatory drugs (NSAIDs), and HIV status.

- Clinical criteria: epigastralgia, heartburn, vomiting, gastrointestinal bleeding, weight loss, dysphagia.

- Endoscopic lesions: esophageal varices, benign esophageal strictures, peptic ulcers, esogastric cancers.

- Anatomopathological criteria: the staining technique was carried out as follows:

1) The gastric biopsy sample is stored in 10% formalin.

2) The sample will be dehydrated with ethanol for one hour and then lightened with xylol for 30 minutes and finally an impregnation with liquid paraffin for one hour.

3) Embed the tissues in a paraffin block which will be cut with a microtome.

4) Make a microtome cut.

5) Do the staining itself with HEMATOXYLINE EOSIN to establish the pathological diagnosis:

- Harris hematoxylin bath for 2 minutes.

- rinse in running water quickly.

- acid alcohol bath for 1 mn (bleach).

- lithiumcarbonate bath for 1 mn.

- rinse with running water quickly.

- 1% eosin bath for 2 minutes.

6) To color with GIEMSA for the research of Helicobacter pylori:

- The Giemsahistological kit is used or else the Giemsa used in parasitology is diluted to 1/10th.

- Cover the slide containing gastric tissue for five minutes then wash and dry.

- The reading will be done under a microscope at magnifications between 40× and 100×.

NB: All these steps can be carried out in part automatically using a PLC.

The following figure (Figure 1) shows the distribution of patients by sex.

This graph shows that more women came to the consultation (55%) compared to men (45%).

Figure 2 below shows the distribution of patients by age.

This graph shows us the very high percentage of people under 50 who came to the consultation (66%) compared to those over 50 (34%).

Figure 3 below shows the distribution of patients according to symptoms.

From this graph, we can see that the dominant symptom in consultation was epigastralgia (89.2%), followed by vomiting (6.8%), Gastro-intestinal bleeding (5.8%), Heartburn (5.5%), Loss of weight (4.9%) and at last dysphagia (2.2%). We have to mention that we could notice some patients showing many of these symptoms at the same time.

Figure 4 below shows the distribution of patients according to the endoscopic lesions observed.

Figure 4 shows that inflammatory pathologies were the lesions most frequently encountered on endoscopy among which gastritis (82%), esophagitis

(60%). Ulcerative pathologies come at the second time, gastric ulcers (4.7%), Duodenal ulcers (7.2%) and tumors come at the third, gastric tumor (3.9%), Esophageal tumor (0.7%). We then noticed 21.5% of significant lesions (esophageal varices, benign esophageal strictures, esophageal tumor, gastric tumor and gastro-duodenal ulcer).

It emerges from this figure (Figure 5) that Helicobacter pylori gastritis was the most described lesion either 61.30% compared to chronic non-specific gastritis 28.77%. Gastric adenocarcinoma was observed in 3.42% of cases.

This figure (Figure 6) shows a high prevalence of Helicobacter pylori 63% on the biopsy samples taken.

S: Significant.

S: Significant.

In our study, we noticed that more women (55%) came for consultation compared to men (45%). Our results are different from those of Ibara et al. at Brazzaville who received 50.73% of men and 49.26% of women in consultation [8]. However, our results are similar to those of Lawson-Ananissoh et al. in Togo in 2014 which received 57.49% of women in consultation compared to 42.51% [7].

This result could be explained by the fact that women are more inclined to come for consultation at the first sign.

We noticed a very high percentage of people under 50 in consultation (66%) compared to those over 50 (34%). Our results are superimposable on those of Lawson-Ananissoh et al. in Togo where the most represented age group was between 25 years and 44 years old [7].

This could be explained by the structure of the population of developing countries with a high proportion of young subjects in the population.

In our series, we found that the dominant symptom in the consultation was epigastralgia (89.2%). Our results join those of Ndjitoyap Ndam et al. in Cameroon in whom epigastralgia (52.77%) represented half of the symptoms [9]; as well as those of Hountondjia et al. in Benin who noted 43.55% of epigastralgia [6]. The results of Lawson-Ananissoh et al. in Togo go in the same direction with a frequency of epigastralgia at 60.68% [7].

Our series shows that inflammatory pathologies were the leading lesions encountered on endoscopy. Ulcerative pathologies came second with gastric ulcers at 4.7% and duodenal ulcers at 7.2%. Finally, cancerous pathologies are in third place with gastric cancers at 3.9% and esophageal cancer at 0.7%.

Our results corroborate those of Ndjitoyap Ndam et al. who found a predominance of inflammatory pathologies at 54.65%, followed by ulcer pathologies at 31.65% and finally tumor pathologies at 2.97% [9]. The results of Lawson-Ana- nissoh et al. go in the same direction with a predominance of inflammatory pathology at 56.3%; followed by ulcer pathology at 13.89% and finally tumor pathology at 2.01%.

This high predominance of inflammatory pathology in tropical environments could be related to the Helicobacter pylori infection which is very widespread in developing countries, but also with the multiple aggressive factors for the gastric mucosa, in particular self-medication with products gastro-toxic, and bad eating habits.

We notice that the gastric tumor is significantly associated with age greater than 50 years with a P-value equal to 0.000, this corroborates the results of Ibar et al. who found a mean age of onset of the gastric tumor at 51.1 years [8]; as well as those of Hountondjia et al. in whom the majority of patients with gastric tumor were aged between 55 and 69 years [6]. Diarra et al. in Mali in 2014 joined us with an average age of onset of gastric tumor at 56.51 years [10]. Bougougla et al. in Togo in 2014 are not left with an average age of onset of gastric tumor at 58.8 years [11], as well as Mellouki et al. in Morocco in 2014 who found an average age of onset at 58 years [12].

All this could be explained by the fact of the infection with Helicobacter pylori which was recognized as a type I carcinogen by the international agency for research on cancer in 1994 [13] and involved in around 80% of stomach cancers [14] after almost 30 years of evolution of the infection [15].

Our analysis showed that gastric tumor was significantly correlated with male sex with a P-value of 0.013. Our results join those of Mellouki et al. in Morocco in 2014 who found a clear male predominance with a P-value of less than 0.05 [12], as well as those of Diarra et al. who found a sex ratio of 1.6 in favor of men [10]. The male predominance was also found by Bougougla et al. who found a sex ratio of 2.5 in favor of men [11].

This distribution would be due to more frequent consumption of tobacco in males in our environment and constitutes a cofactor of gastric carcinogenesis.

Our series highlights the fact that the esophageal tumor was significantly correlated with the male sex with a P-value equal to 0.029. This result is superimposable on that of Hountondjia et al. who found that the tumor of the esophagus was the prerogative of humans (21 out of 25 cases) [6].

All of this could be explained by chronic alcoholism and smoking, which are common in humans and which are risk factors for cancer of the esophagus.

We note in our series that peptic ulcer was significantly correlated with age greater than 50 years with a P-value equal to 0.007. But our results do not match those of Diarra et al. in Bamako in 2009 who found that the most represented age group was between 30 years and 49 years old with a rate of 47.8% [16]. Ibar et al. noted an average age of 41.33 years [17].

This discrepancy can be explained by the fact that the peptic ulcer is the result of the imbalance between the stressors and the protective factors of the stomach; the occurrence of these factors is not dependent on age.

It was clear from our study that peptic ulcer disease was significantly correlated with taking NSAIDs (P-value of 0.001) and smoking (P-value of 0.007).

Our results agree with those of Ibar et al., who found smoking in 16% of patients and taking NSAIDs in 46% of ulcer patients, thus being major sources of peptic ulcer disease [17].

All this could be explained by the fact that NSAIDs are drugs that are heavily consumed in self-medication. These drugs produce a weakening of the mucous membrane defenses which can promote, reactivate or complicate the ulcer.

Our series showed that esophageal varices were significantly correlated with male sex with a P-value of 0.049. Our result corroborates that of Lawson-Ananissoh et al. in Togo who found an association of male esophageal varices with a P-value of 0.000 [7].

This result could be explained by the fact that esophageal varices are endoscopic signs of portal hypertension, the main cause of which is cirrhosis, which affects both men and women [18].

We note from our study that mycosis of the esophagus was significantly correlated with HIV status with a P-value of 0.000, which is 63% of seropositive patients.

Our results are close to those of Ngatcha et al. in Rabat in 2014 who found, out of a total of 68 seropositive, 19 cases of mycotic esophagitis, which is 37% of cases [19].

All this is explained by the fact thatCandida albicans are the main cause of opportunistic infections of the esophagus in HIV. Patients often develop dysphagia and odynophagia [20].