Objective: The aim of this work was to identify the risk factors for the occurrence of prematurity at CHUPB. Materials and Methods: a case-control study was performed between February and June 2021 at CHUPB. Our study...Objective: The aim of this work was to identify the risk factors for the occurrence of prematurity at CHUPB. Materials and Methods: a case-control study was performed between February and June 2021 at CHUPB. Our study population consisted of premature infants who were matched to full-term newborns on a 1:1 basis. The variables studied were maternal characteristics (age, marital status, education level, and occupation) as well as pregnancy (maternal history, prenatal care), delivery (maternal fever, rupture of membranes), and newborns (gestational age, sex, and weight). The chi<sup>2</sup> test with a significance level of p 0.05 and the adjusted odds ratio were used. Results: A total of 609 newborns were hospitalized, 219 of whom were premature (36%), of whom 100 premature infants meeting the inclusion criteria were enrolled. Maternal age 18 years was noted in 20% of cases (adjusted OR = 2.94 [0.86 - 10.06]) versus 5% of controls. Low educational level was noted in 47% (adjusted OR = 4.33 [1.88 - 9.96]) of cases versus 14% of controls. The risk factors identified were previous preterm delivery (adjusted OR = 0.06 [0.00 - 0.80]), maternal fever before labor (adjusted OR = 0.43 [0.20 - 0.90]), and premature rupture of membrane (RPM), (adjusted OR = 0.32 [0.16 - 0.64]). There was no association between marital status and insufficient prenatal visits (ANC) in relation to the occurrence of prematurity. Conclusion: The reduction of preterm births requires improved monitoring of pregnancy, delivery and care of the newborn. But primary prevention lies in improving the living conditions of the population.展开更多
<strong>Background:</strong> <span style="font-family:""><span style="font-family:Verdana;">The neonatal mortality rate in the Central African Republic (CAR) is 42.3 pe...<strong>Background:</strong> <span style="font-family:""><span style="font-family:Verdana;">The neonatal mortality rate in the Central African Republic (CAR) is 42.3 per 1000 live births in 2017, indicating that CAR is with the highest number of newborn deaths. </span><b><span style="font-family:Verdana;">Objective:</span></b><span style="font-family:Verdana;"> T</span></span><span style="font-family:Verdana;">he objective is t</span><span style="font-family:""><span style="font-family:Verdana;">o clarify the risk factors of neonatal deaths in this area. </span><b><span style="font-family:Verdana;">Methodology:</span></b><span style="font-family:Verdana;"> A case-control study with retrospective data collection. Targets were newborns >7 days, hospitalized and dead (cases), and newborns admitted after the respective case during the study period and discharged before the 7</span><sup><span style="font-family:Verdana;">th</span></sup><span style="font-family:Verdana;"> day of life. This study was carried out between 2016 and 2018 in the neonatal unit of the “Complexe Hospitalier Universitaire Pédiatrique de Bangui” (CHUPB), the only national hospital for newborns care in the CAR. </span><b><span style="font-family:Verdana;">Results:</span></b><span style="font-family:Verdana;"> We included 902 newborns, with 451 cases of early neonatal death and 451 controls. 4168 newborns were admitted to the neonatology unit with 621 early death cases;a lethality rate of 14.9%. Early neonatal deaths factors were: newborns with low birth weight (OR = 22.59;95% CI [15.93 - 32.04];</span></span><span style="font-family:""> </span><span style="font-family:Verdana;">P < 0.001);mothers who did not attend antenatal care (OR = 5.54;95% CI [3.95 - 7.79];P < 0.001), home delivery (OR = 0.70;95% CI [0.03 - 0.15];P < 0.001);young maternal age <</span><span style="font-family:""> </span><span style="font-family:Verdana;">25 years (OR = 2.08;95% CI [1.58 - 2.73];P < 0.001);non-medical transport (OR = 2.14;95% CI [1.03 - 4.46];P = 0.03);origin from remote areas (OR = 5.25;95% CI [3.95 - 6.98];P < 0.001);isolated prematurity (P <</span><span style="font-family:""> </span><span style="font-family:Verdana;">0.01);anoxo-ischemic encephalopathy (OR = 12.72;95% CI [6.54 - 34.73];P <</span><span style="font-family:""> </span><span style="font-family:""><span style="font-family:Verdana;">0.01);delivery by cesarean section (OR = 0.59;95% CI [0.41 - 0.84];P < 0.001);preterm delivery (OR = 29.36;95% CI [20.12 - 42.81];P < 0.001), and maternal lower education (OR = 5.65;95% CI [4.08 - 7.81];P < 0.001). </span><b><span style="font-family:Verdana;">Conclusion:</span></b><span style="font-family:Verdana;"> The early neonatal mortality rate remains high in this area. Controlling the factors mentioned above might lead to improving the survival of newborns.</span></span>展开更多
Background: Non-traumatic coma is the most common pediatric medical emergency. Its clinical diagnosis is easy. The difficulty lies in finding the etiology. Objective: To determine the prevalence and clinical profiles ...Background: Non-traumatic coma is the most common pediatric medical emergency. Its clinical diagnosis is easy. The difficulty lies in finding the etiology. Objective: To determine the prevalence and clinical profiles of non-traumatic Coma at the Centre Hospitalier Universitaire Pédiatrique de Bangui (CHUPB). Methodology: This was a descriptive and analytical cross-sectional study conducted between January 1 and June 31, 2021, at CHUPB. Children aged 1 month to 15 years, admitted to the emergency room with a Glasgow score less than or equal to 8 without any traumatism were included. The variables studied were sociodemographic, clinical and paraclinical. Data were entered and analyzed using SPSS 20.0 statistical software. The statistical test used was Pearson’s chi<sup>2</sup>, any p-value Results: Of 8551 children hospitalized during the study period, 370 were hospitalized for non-traumatic coma: 4.32%. They were divided into 57.5% (n = 213) boys and 42.44% (n = 157) girls, giving a sex ratio of 1.35. Their mean age was 35.95 ± 27.21 months. Children aged 1 to 24 months represented 54.59% (n = 202) of cases. The mean time to the consultation was 2.91 days ± 1.8. Fever 86.48% (n = 320) and convulsions 80% (n = 296) were the main reasons for consultation. Coma stages II - III and IV represented 52.44% (n = 194), 42.97% (n = 159) and 4.59% (n = 17) respectively. Neuromalaria (29.72%;n = 110), meningitis-meningoencephalitis-encephalitis (30%;n = 111), sepsis (19.72%;n = 73) and acidosis Coma (5.40%;n = 20) were the main etiologies. Conclusion: Non-traumatic coma is common at CHUPB. Infections were the main etiology, particularly cerebral malaria. The reduction of its frequency requires, among others, the strengthening of the national monitoring malaria program. The strengthening of the technical platform for a good etiological diagnosis constitutes the other axis of prevention.展开更多
Background: In sub-Saharan Africa, one in 13 children died before their fifth birthday. Objective: To study mortality among children hospitalized in the intensive care unit of the CHUPB. Methodology: This was a retros...Background: In sub-Saharan Africa, one in 13 children died before their fifth birthday. Objective: To study mortality among children hospitalized in the intensive care unit of the CHUPB. Methodology: This was a retrospective, descriptive study over a 12-month period. Included were children aged 1 month to 15 years hospitalized in the intensive care unit and who died during the period. The data were entered and analyzed through the Epi Info software. The statistical test used was Pearson’s chi<sup>2</sup>. Results: The overall mortality rate was 21.49%. The sex ratio was 1.14 and the mean age was 3.17 ± 2.21 years. Children 5 years of age accounted for 78.49% (n = 197) of cases. Deaths were more frequent in January, April and December. The mean time to consultation was 6.91 ± 1.8 days. Fever 78.48% (n = 197), diarrhea/vomiting 35.45% (n = 89) and convulsions 26.29% (n = 66) were the main reasons for consultation. Prior to admission, treatment was administered in 73.38% (n = 184) of children. The main diagnoses of death were: septic shock 29.08% (n = 73), hypovolemic shock post AEG 17.13% (n = 43), severe malaria 10.76% (n = 27) and meningitis 6.38% (n = 16). Death was early in 66.53% (n = 167) of cases. It was influenced by male sex, origin of residence, rural residence, herbal medicine and the occurrence of deaths during the shifts after 16 hours. Conclusion: Mortality in pediatrics remains a concern in our practice. It is related to conditions that are mostly preventable by vaccination, information, education and communication.展开更多
<strong>Introduction: </strong><span><span><span style="font-family:;" "=""><span style="font-family:Verdana;">Countries with limited resources ha...<strong>Introduction: </strong><span><span><span style="font-family:;" "=""><span style="font-family:Verdana;">Countries with limited resources have real difficulties in separating craniopagus twins. Separation surgery cannot be considered there due to lack of technological conditions and appropriate means. </span><b><span style="font-family:Verdana;">Objective: </span></b><span style="font-family:Verdana;">To show the benefits of an Italian-Central African humanitarian collaboration, after two years follow-up, aiming to improve the first childhood years of craniopagus twins, born in the Central African Republic and separated in Rome. </span><b><span style="font-family:Verdana;">Case Report: </span></b><span style="font-family:Verdana;">The two female conjoined craniopagus twin, born at term on June 29, 2018 in Mbata located about 96 km from Bangui (CAR), were referred to the neonatology unit of the CHUPB on their 3</span><sup><span style="font-family:Verdana;">rd</span></sup><span style="font-family:Verdana;"> day of life. The mother was 31-year-old, gravida 4 and para 5. Prenatal cares were quantitatively and qualitatively poorly followed. The diagnosis of posterior conjoined craniopagus twins associated with early neonatal infection was retained. After seven days of antibiotics and regression of infectious symptoms, the newborns were kept in the neonatology unit for a closer follow-up, pending the completion of administrative procedures for a medical evacuation as part of the international humanitarian activities of the Pediatric Hospital of the Holy Seat in collaboration with the Pediatric Teaching Hospital in Bangui. Finally, the twins were transferred to the Bambino Gesu Hospital in Rome on September 10, 2018 where the 3D images confirmed the total posterior fusion. Between May 2019 and June 2020 thirty hours of interventions allowed a step-by-step separation of the twins, with a gradual rerouting of the shared blood supply, remodeling and re-creating a skin to cover the skull bones. No postoperative complications were recorded;the twins recovered satisfactorily after 6 months of separation and are awaiting discharge at their origin country where the CHUPB team will continue monitoring. </span><a name="_Hlk76798579"></a><b><span style="font-family:Verdana;">Conclusion: </span></b><span style="font-family:Verdana;">The successful separation of total posterior craniopagus twins remains historically scarce and the guarantee of success has been based on detailed and well planned surgical management.</span></span></span></span>展开更多
文摘Objective: The aim of this work was to identify the risk factors for the occurrence of prematurity at CHUPB. Materials and Methods: a case-control study was performed between February and June 2021 at CHUPB. Our study population consisted of premature infants who were matched to full-term newborns on a 1:1 basis. The variables studied were maternal characteristics (age, marital status, education level, and occupation) as well as pregnancy (maternal history, prenatal care), delivery (maternal fever, rupture of membranes), and newborns (gestational age, sex, and weight). The chi<sup>2</sup> test with a significance level of p 0.05 and the adjusted odds ratio were used. Results: A total of 609 newborns were hospitalized, 219 of whom were premature (36%), of whom 100 premature infants meeting the inclusion criteria were enrolled. Maternal age 18 years was noted in 20% of cases (adjusted OR = 2.94 [0.86 - 10.06]) versus 5% of controls. Low educational level was noted in 47% (adjusted OR = 4.33 [1.88 - 9.96]) of cases versus 14% of controls. The risk factors identified were previous preterm delivery (adjusted OR = 0.06 [0.00 - 0.80]), maternal fever before labor (adjusted OR = 0.43 [0.20 - 0.90]), and premature rupture of membrane (RPM), (adjusted OR = 0.32 [0.16 - 0.64]). There was no association between marital status and insufficient prenatal visits (ANC) in relation to the occurrence of prematurity. Conclusion: The reduction of preterm births requires improved monitoring of pregnancy, delivery and care of the newborn. But primary prevention lies in improving the living conditions of the population.
文摘<strong>Background:</strong> <span style="font-family:""><span style="font-family:Verdana;">The neonatal mortality rate in the Central African Republic (CAR) is 42.3 per 1000 live births in 2017, indicating that CAR is with the highest number of newborn deaths. </span><b><span style="font-family:Verdana;">Objective:</span></b><span style="font-family:Verdana;"> T</span></span><span style="font-family:Verdana;">he objective is t</span><span style="font-family:""><span style="font-family:Verdana;">o clarify the risk factors of neonatal deaths in this area. </span><b><span style="font-family:Verdana;">Methodology:</span></b><span style="font-family:Verdana;"> A case-control study with retrospective data collection. Targets were newborns >7 days, hospitalized and dead (cases), and newborns admitted after the respective case during the study period and discharged before the 7</span><sup><span style="font-family:Verdana;">th</span></sup><span style="font-family:Verdana;"> day of life. This study was carried out between 2016 and 2018 in the neonatal unit of the “Complexe Hospitalier Universitaire Pédiatrique de Bangui” (CHUPB), the only national hospital for newborns care in the CAR. </span><b><span style="font-family:Verdana;">Results:</span></b><span style="font-family:Verdana;"> We included 902 newborns, with 451 cases of early neonatal death and 451 controls. 4168 newborns were admitted to the neonatology unit with 621 early death cases;a lethality rate of 14.9%. Early neonatal deaths factors were: newborns with low birth weight (OR = 22.59;95% CI [15.93 - 32.04];</span></span><span style="font-family:""> </span><span style="font-family:Verdana;">P < 0.001);mothers who did not attend antenatal care (OR = 5.54;95% CI [3.95 - 7.79];P < 0.001), home delivery (OR = 0.70;95% CI [0.03 - 0.15];P < 0.001);young maternal age <</span><span style="font-family:""> </span><span style="font-family:Verdana;">25 years (OR = 2.08;95% CI [1.58 - 2.73];P < 0.001);non-medical transport (OR = 2.14;95% CI [1.03 - 4.46];P = 0.03);origin from remote areas (OR = 5.25;95% CI [3.95 - 6.98];P < 0.001);isolated prematurity (P <</span><span style="font-family:""> </span><span style="font-family:Verdana;">0.01);anoxo-ischemic encephalopathy (OR = 12.72;95% CI [6.54 - 34.73];P <</span><span style="font-family:""> </span><span style="font-family:""><span style="font-family:Verdana;">0.01);delivery by cesarean section (OR = 0.59;95% CI [0.41 - 0.84];P < 0.001);preterm delivery (OR = 29.36;95% CI [20.12 - 42.81];P < 0.001), and maternal lower education (OR = 5.65;95% CI [4.08 - 7.81];P < 0.001). </span><b><span style="font-family:Verdana;">Conclusion:</span></b><span style="font-family:Verdana;"> The early neonatal mortality rate remains high in this area. Controlling the factors mentioned above might lead to improving the survival of newborns.</span></span>
文摘Background: Non-traumatic coma is the most common pediatric medical emergency. Its clinical diagnosis is easy. The difficulty lies in finding the etiology. Objective: To determine the prevalence and clinical profiles of non-traumatic Coma at the Centre Hospitalier Universitaire Pédiatrique de Bangui (CHUPB). Methodology: This was a descriptive and analytical cross-sectional study conducted between January 1 and June 31, 2021, at CHUPB. Children aged 1 month to 15 years, admitted to the emergency room with a Glasgow score less than or equal to 8 without any traumatism were included. The variables studied were sociodemographic, clinical and paraclinical. Data were entered and analyzed using SPSS 20.0 statistical software. The statistical test used was Pearson’s chi<sup>2</sup>, any p-value Results: Of 8551 children hospitalized during the study period, 370 were hospitalized for non-traumatic coma: 4.32%. They were divided into 57.5% (n = 213) boys and 42.44% (n = 157) girls, giving a sex ratio of 1.35. Their mean age was 35.95 ± 27.21 months. Children aged 1 to 24 months represented 54.59% (n = 202) of cases. The mean time to the consultation was 2.91 days ± 1.8. Fever 86.48% (n = 320) and convulsions 80% (n = 296) were the main reasons for consultation. Coma stages II - III and IV represented 52.44% (n = 194), 42.97% (n = 159) and 4.59% (n = 17) respectively. Neuromalaria (29.72%;n = 110), meningitis-meningoencephalitis-encephalitis (30%;n = 111), sepsis (19.72%;n = 73) and acidosis Coma (5.40%;n = 20) were the main etiologies. Conclusion: Non-traumatic coma is common at CHUPB. Infections were the main etiology, particularly cerebral malaria. The reduction of its frequency requires, among others, the strengthening of the national monitoring malaria program. The strengthening of the technical platform for a good etiological diagnosis constitutes the other axis of prevention.
文摘Background: In sub-Saharan Africa, one in 13 children died before their fifth birthday. Objective: To study mortality among children hospitalized in the intensive care unit of the CHUPB. Methodology: This was a retrospective, descriptive study over a 12-month period. Included were children aged 1 month to 15 years hospitalized in the intensive care unit and who died during the period. The data were entered and analyzed through the Epi Info software. The statistical test used was Pearson’s chi<sup>2</sup>. Results: The overall mortality rate was 21.49%. The sex ratio was 1.14 and the mean age was 3.17 ± 2.21 years. Children 5 years of age accounted for 78.49% (n = 197) of cases. Deaths were more frequent in January, April and December. The mean time to consultation was 6.91 ± 1.8 days. Fever 78.48% (n = 197), diarrhea/vomiting 35.45% (n = 89) and convulsions 26.29% (n = 66) were the main reasons for consultation. Prior to admission, treatment was administered in 73.38% (n = 184) of children. The main diagnoses of death were: septic shock 29.08% (n = 73), hypovolemic shock post AEG 17.13% (n = 43), severe malaria 10.76% (n = 27) and meningitis 6.38% (n = 16). Death was early in 66.53% (n = 167) of cases. It was influenced by male sex, origin of residence, rural residence, herbal medicine and the occurrence of deaths during the shifts after 16 hours. Conclusion: Mortality in pediatrics remains a concern in our practice. It is related to conditions that are mostly preventable by vaccination, information, education and communication.
文摘<strong>Introduction: </strong><span><span><span style="font-family:;" "=""><span style="font-family:Verdana;">Countries with limited resources have real difficulties in separating craniopagus twins. Separation surgery cannot be considered there due to lack of technological conditions and appropriate means. </span><b><span style="font-family:Verdana;">Objective: </span></b><span style="font-family:Verdana;">To show the benefits of an Italian-Central African humanitarian collaboration, after two years follow-up, aiming to improve the first childhood years of craniopagus twins, born in the Central African Republic and separated in Rome. </span><b><span style="font-family:Verdana;">Case Report: </span></b><span style="font-family:Verdana;">The two female conjoined craniopagus twin, born at term on June 29, 2018 in Mbata located about 96 km from Bangui (CAR), were referred to the neonatology unit of the CHUPB on their 3</span><sup><span style="font-family:Verdana;">rd</span></sup><span style="font-family:Verdana;"> day of life. The mother was 31-year-old, gravida 4 and para 5. Prenatal cares were quantitatively and qualitatively poorly followed. The diagnosis of posterior conjoined craniopagus twins associated with early neonatal infection was retained. After seven days of antibiotics and regression of infectious symptoms, the newborns were kept in the neonatology unit for a closer follow-up, pending the completion of administrative procedures for a medical evacuation as part of the international humanitarian activities of the Pediatric Hospital of the Holy Seat in collaboration with the Pediatric Teaching Hospital in Bangui. Finally, the twins were transferred to the Bambino Gesu Hospital in Rome on September 10, 2018 where the 3D images confirmed the total posterior fusion. Between May 2019 and June 2020 thirty hours of interventions allowed a step-by-step separation of the twins, with a gradual rerouting of the shared blood supply, remodeling and re-creating a skin to cover the skull bones. No postoperative complications were recorded;the twins recovered satisfactorily after 6 months of separation and are awaiting discharge at their origin country where the CHUPB team will continue monitoring. </span><a name="_Hlk76798579"></a><b><span style="font-family:Verdana;">Conclusion: </span></b><span style="font-family:Verdana;">The successful separation of total posterior craniopagus twins remains historically scarce and the guarantee of success has been based on detailed and well planned surgical management.</span></span></span></span>
