[Spontaneous bacterial peritonitis in Dakar, Senegal: study of 55 patients with cirrhosis]

To report the prevalence of spontaneous bacterial peritonitis (SBP) and its clinical and laboratory features in patients with cirrhosis followed at the Aristide Le Dantec Hospital in Dakar (Senegal).

From May through December, 2010, we prospectively included patients with cirrhosis and a first episode of ascites on clinical examination. Diagnostic abdominal paracentesis was performed in all cases to determine the macroscopic appearance of the fluid, protein concentration, and cell count, and to culture the ascitic fluid in a blood culture bottle. SBP was diagnosed when the fluid contained more than 250 polymorphonuclear leukocytes per cubic millimeter of fluid. The data were analyzed with Epi-Info software, version 3.5.2. Comparisons used Fisher's exact and Chi-square tests, with significance set at p < 0.05.

The study included 55 patients with cirrhosis, with a mean age of 45 years and a male/female sex ratio of 1.89 (36 men). The prevalence of SBP was 27.3%. Factors significantly associated with SBP were female gender, malnutrition, turbid appearance of the ascites, and neutrophilia. In samples from patients with SBP, the mean protein concentration was 20.7 g/L, the white cell count was 1797/mm(3), and the neutrophil count 1,102/mm(3). Ascitic fluid culture was positive in 20% of the SBP cases (n=3).

In Dakar, cirrhosis is found especially in young adults, and the prevalence of SBP in our population was 27.3%. Improved technical equipment would improve the hospital's ability to determine the causes of cirrhosis and identify the various germs responsible for SBP.