Street adolescents in low income setting exposed to hepatitis B and C, and disadvantaged by lifestyle: a Togolese cross-sectional study.

BACKGROUND: In Togo, few data are available on viral hepatitis in street adolescents, a vulnerable population due to their lifestyle. The aim of this study was to describe the lifestyle of street adolescents (sexual practices and drug use), to estimate the prevalence of hepatitis B and C viruses, and to describe their HBV immunization profile in Togo. METHODS: A cross-sectional study was conducted in Lomé (Togo) in July 2021. Street adolescents aged between 13 and 19 years were included. A questionnaire was used to document lifestyle. ELISA tests were performed for Hepatitis B surface antigen (HBsAg), Hepatitis B core and surface antibodies (anti-HBc, anti-HBs), and antibodies against hepatitis C virus (anti-HCV). RESULTS: A total of 299 adolescents (5.4% female) with a median age of 15 years (IQR: 14-17) were included. Of these, 70.6% (211/299) were sexually active and 70.6% (149/211) had not used a condom during their last sexual intercourse. Drug use was reported by 42.1% of the adolescents. The most used substances were cannabis (39.0%), cocaine (36.6%), glue solvents (19.5%), and tramadol (11.4%). However, cocaine use may have been overestimated due to information bias. Current HBV infection (HBsAg+) was detected in 3.7% (95%CI: 1.9-6.5) of the adolescents. Isolated anti-HBc + was present in 5.3%. All three HBV markers (HBsAg, anti-HBs, and anti-HBc) were negative in 71.6% of adolescents. Anti-HCV was detected in 4.7% of adolescents. CONCLUSION: Nearly one in 10 street adolescents has markers for HBV contact/current infection, and approximately 72% of street adolescents may still be infected with HBV, as they have no HBV markers. HCV is also circulating in this population. Given the reported high-risk sexual practices and high levels of drug use, there is an urgent need to develop integrated strategies to prevent infections, including HBV, and drug dependence in this population.

Doenças digestivas em idosos e fatores associados à duração da permanência na unidade Hepatologia e Gastroenterologia do Hospital Universitário de Ensino de Lomé (Togo) / Digestive diseases in elderly and factors associated with length of stay in the hepatology and gastroenterology unit of the campus teaching hospital of lome (togo)

ABSTRACT BACKGROUND: The digestive pathologies are frequent in the elderly and often have a latent and atypical symptomatology. OBJECTIVE: To assess the epidemiological and evolutionary current data on digestive diseases in the elderly, and look for factors associated with length of hospital stay. METHODS: Retrospective study of 10 years, including patients aged 60 and over hospitalized for digestive diseases in the Gastroenterology Department of the Campus Teaching Hospital of Lome, Togo. RESULTS: Of 5933 hospitalized patients, there were 1054 patients (17.8%) aged 60 years and over with a digestive pathology (526 men and 528 women). The average age was 69.5 years ±7.9 ranging from 60 to 105 years. The average length of hospital stay was 7.45 days ±6.2 ranging from 1 to 44 days. HIV prevalence was 2.4%. In order of decreasing frequency, there were hepatobiliary pathologies (54.3%) with a predominance of cirrhosis and liver cancer, eso-gastroduodenal pathologies (23.1%) with predominance of ulcers, gastric cancer and esophageal cancer, intestinal pathologies (8.7%) with a predominance of food poisoning, pancreatic pathologies (4.2%) with a predominance of pancreatic cancer and peritoneal pathologies (1.4%). Gastric cancer was the second digestive cancer found after liver cancer. Pancreatic head cancer was the second disease after gastric cancer which need a transfer in a surgical ward (P=0.031). There were 204 deaths (19.4%). The longest duration of hospitalization was due to gastric cancer (9.16 days). CONCLUSION: Hepatobiliary diseases were the most frequent and associated with a high death rate and a long hospital stay.

RESUMO CONTEXTO: As patologias digestivas são frequentes no idoso e têm geralmente uma sintomatologia latente e atípica. OBJETIVO: Avaliar os dados epidemiológicos e de evolução sobre as doenças digestivas nos idosos, e procurar fatores associados ao período de permanência hospitalar. MÉTODOS: Estudo retrospectivo de 10 anos, incluindo pacientes com idades de 60 ou mais, hospitalizados para doenças digestivas no Departamento de Gastroenterologia do Hospital Universitário de Ensino de Lomé, Togo. RESULTADOS: De 5933 pacientes hospitalizados, havia 1054 pacientes (17,8%) com idade de 60 anos ou mais com uma patologia digestiva (526 homens e 528 mulheres). A idade média foi de 69,5 anos ± 7,9 variando de 60 a 105 anos. A duração média da estadia hospitalar foi de 7,45 dias ±6,2 variando de 1 a 44 dias. A prevalência do HIV foi de 2,4%. Em ordem de diminuição da frequência, houve patologias hepatobiliares (54,3%) com predominância de cirrose e câncer hepático, patologias do esôfago-gastroduodenal (23,1%) com predominância de úlceras, câncer gástrico e câncer esofágico, patologias intestinais (8,7%) com predominância de intoxicação alimentar, patologias pancreáticas (4,2%) com predominância de câncer pancreático e patologia peritoneal (1,4%). O câncer gástrico foi o segundo câncer digestivo encontrado após o câncer de fígado. Câncer de cabeça pancreática foi a segunda doença após o câncer gástrico, que necessitou transferência para a enfermaria cirúrgica (P=0,31). Houve 204 mortes (19,4%). A maior duração da internação foi devido ao câncer gástrico (9,16 dias). CONCLUSÃO: As doenças hepatobiliares foram as mais frequentes e associadas a uma elevada taxa de mortalidade e a uma longa estadia hospitalar.