Inflammatory Bowel Disease in Adults - Experience and Challenges in Gastroenterology Practices in Calabar, South-South Nigeria

BACKGROUND

Inflammatory bowel disease (IBD) is a chronic inflammatory disorder of the gastrointestinal tract that is reported to be rare in Africans. The objective of this study is to share the experience of our Gastroenterology practice in Calabar, Cross River State on IBD.

METHODS

This is a ten-year review of the records of patients visiting the Gastroenterology clinic of the University of Calabar Teaching Hospital and two private gastroenterology clinics in Calabar Municipality. The diagnosis of IBD was made based on clinical, laboratory, endoscopic, and histological data obtained.

RESULTS

Eight patients presented with features consistent with IBD. Six had ulcerative colitis while 2 had Crohn's disease. Seven patients had moderate disease with the main clinical features being recurrent mucoid bloody diarrhoea. All the patients had treatments with either sulphasalazine or mesalazine as well as azathioprine, steroids and antibiotics with variable response. One patient had strictures requiring a colostomy, while another developed colorectal cancer as complications of IBD.

CONCLUSION

Although IBD is uncommon in Nigeria, a high index of suspicion is important, especially in patients presenting with the recurrent passage of mucoid bloody stools. Hence, the role of colonoscopy and histology are invaluable in establishing the diagnosis.

Frequency of Hepatitis B and C Co-Infection in Chronic Liver Disease Patients in Calabar, Cross River State, Nigeria

Hepatitis B (HBsAg) and C (HCV) virus are becoming a significant causative factors in the aetiology of chronic liver disease (CLD) worldwide. However, the information on the frequency of HBsAg and HCV virus co-infection in CLD is sparsely reported in Nigeria. In this study, we assessed the frequency of HBsAg and HCV co-infection in CLD. One hundred and eleven subjects aged 19 - 76 years, comprising of 76 CLD patients and 35 apparently healthy subjects without CLD were tested for both HBsAg and HCV virus antibodies using ELISA test kits. Out of the 111 subjects recruited for this study, 76 (68.5%) were CLD patients tested positive for HBsAg and 35 (31.5%) tested negative for HBsAg and served as control. Out of the 76 CLD patients that tested positive for HBsAg, 34 (44.7%) of them also tested positive for HCV, thus, having co-infection with HBV. Incidence of co-infection was highest in those aged 36 - 45 years, and greater in males than females. Among the control group, 4 (11.4%) of the subjects (3 males and 1 female) tested positive for HCV, while 31 (88.6%) subjects (20 males and 11 females) tested negative. This work has shown that the co-infection with HBV and HCV among chronic liver disease patients and the incidence of HCV is high in our locality. Also, some of the supposed apparently healthy subjects in this study tested positive for HCV, hence the need for improving the awareness of this virus. It is therefore necessary to give immunization and test for HBsAg and HCV in both rural and urban areas.

Sensitivity comparison between rapid one-step test strip and ELISA methods in detection of HBsAg among selected chronic liver disease patients in University of Calabar Teaching hospital, Calabar, Nigeria

Background: Hepatitis B virus (HBV) is the eloquent hepatic infection that leads to hepatocellular carcinoma. This study aims to determine the frequency of HBV by screening selected chronic liver disease (CLD) patients alongside few apparently healthy subjects who might be carriers and pose a high risk in HBV transmission. This study also aims to compare the sensitivity between two diagnostic tests; one step rapid test strip device and Enzyme Linked Immunosorbent Assay (ELISA).Methodology: Serum of 111 subjects comprising of 76 CLD patients and 35 apparently healthy (control) subjects was screened for Hepatitis B surface Antigen (HBsAg).Results: Sero-positivity of the two methods of detecting HBsAg was higher in age group 26-35 years and the male folk was found higher in number than the females. The seropositivity of HBV was 28.8% and 81.1% while seronegativity was 71.2% and 18.9% for rapid test strip test device and ELISA test methods, respectively. All the CLD patients 76(100%) and 14 out of 35 of the apparently healthy subjects was positive for ELISA test method.Conclusion: In conclusion, comparing the two methods, ELISA test is more sensitive than one step rapid test strip device for detecting HBsAg in University of Calabar Teaching Hospital, Nigeria.Therefore, we recommend strongly, thatELISA method be used to confi rm test results obtained from the one step rapid test strip,when screen for CLD.DOI: http://dx.doi.org/10.3126/ajms.v6i5.11851 Asian Journal of Medical Sciences Vol.6(5) 2015 56-60