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Profiling lifetime episodes of upper gastrointestinal bleeding among patients from rural Sub-Saharan Africa where schistosoma mansoni is endemic
- Source :
- Pan African Medical Journal; Vol 24, No 1 (2016), The Pan African Medical Journal, The Pan African Medical Journal, Vol 24, Iss 296 (2016)
- Publication Year :
- 2016
- Publisher :
- African Field Epidemiology Network, 2016.
-
Abstract
- Introduction: severe severe chronic hepatic schistosomiasis is a common cause of episodes upper gastrointestinal bleeding (UGIB) in sub-Saharan Africa (SSA). However, there is paucity of data on clinical epidemiology of episodes of UGIB from rural Africa despite on going public health interventions to control and eliminate schistosomiasis. Methods: through through a cross sectional study we profiled lifetime episodes of upper gastrointestinal bleeding and associated factors at a rural primary health facility in sub-Saharan Africa were schistosomiasis is endemic. The main outcome was number of lifetime episodes of UGIB analyzed as count data. Results: from from 107 enrolled participants, 323 lifetime episodes of UGIB were reported. Fifty-seven percent experienced ≥ 2 lifetime episodes of UGIB. Ninety-four percent had severe chronic hepatic schistosomiasis and 80% esophageal varices. Alcohol use and viral hepatitis was infrequent. Eighty-eight percent were previously treated with praziquantel and 70% had a history of blood transfusion. No patient had ever had an endoscopy or treatment for prevention of recurrent variceal bleeding. Multivariable analysis identified a cluster of eight clinical factor variables (age ≥ 40, female sex, history of blood transfusion, abdominal collaterals, esophageal varices, pattern x periportal fibrosis, anemia, and thrombocytopenia) significantly associated (P-value < 0.05) with increased probability of experiencing two or more lifetime episodes of UGIB in our study. Conclusion: upper gastrointestinal bleeding is a common health problem in this part of rural SSA where schistosomiasis is endemic. The clinical profile described is unique and is important for improved case management, and for future research.The Pan African Medical Journal. 2016;24
- Subjects :
- Adult
Male
Rural Population
medicine.medical_specialty
Blood transfusion
Endemic Diseases
Cross-sectional study
Anemia
medicine.medical_treatment
Schistosomiasis
Esophageal and Gastric Varices
03 medical and health sciences
0302 clinical medicine
Esophageal varices
Risk Factors
Internal medicine
medicine
Animals
Humans
030212 general & internal medicine
hepatic schistososomiasis
Africa South of the Sahara
Upper gastrointestinal bleeding
lcsh:R5-920
Sub-Saharan Africa
business.industry
lcsh:Public aspects of medicine
Research
lcsh:RA1-1270
Schistosoma mansoni
General Medicine
Middle Aged
medicine.disease
3. Good health
Surgery
Praziquantel
Cross-Sectional Studies
Multivariate Analysis
Female
030211 gastroenterology & hepatology
lcsh:Medicine (General)
Gastrointestinal Hemorrhage
business
Viral hepatitis
medicine.drug
Subjects
Details
- Language :
- English
- ISSN :
- 19378688
- Database :
- OpenAIRE
- Journal :
- Pan African Medical Journal
- Accession number :
- edsair.doi.dedup.....6a63224873462e132b82c7badf4ac610