Introduction: Infant and child mortality is a worldwide concern, but developing countries such as Mali are more affected. The aim of this study was to investigate morbidity and factors associated with mortality in chi...Introduction: Infant and child mortality is a worldwide concern, but developing countries such as Mali are more affected. The aim of this study was to investigate morbidity and factors associated with mortality in children aged 1 month to 15 years. Methodology: This was a cross-sectional study which took place from January 1 to December 31, 2020 covering children aged 1 month to 15 years hospitalized at the Kalaban-Coro CSRéf. Data were entered into Excel and analyzed using SPSS version 20 software. Results: Five hundred children aged 1 months to 15 years were included. The age range 1 to 5 years (53.6%) and male sex (58.2%) were the most represented. Malaria (72.2%), acute respiratory infections (6.2%) and diarrhea/dehydration (3%) were the main morbidities. Mortality was estimated at 10.6%, and the two main causes of death were malaria (56.6%) and acute respiratory infections (7.54%). Univariate analysis revealed a statistically significant association between the dependent variable (death) and age (p Conclusion: This study confirms the high rate of infant and child morbidity and mortality in our health facilities. Strengthening human resources and intensifying behavior-change communication can help reverse the trend.展开更多
Introduction: In Cote d’Ivoire, the paediatrician has to face a diagnosis and management problem in front of pediatric heart disease, with consequent a high lethality. Objective: To describe the epidemiological, diag...Introduction: In Cote d’Ivoire, the paediatrician has to face a diagnosis and management problem in front of pediatric heart disease, with consequent a high lethality. Objective: To describe the epidemiological, diagnostic, therapeutic and progressive aspects of childhood cardiopathy for the improvement of prognosis and professional practice. Materials and methods: This was a multicenter retrospective and descriptive study conducted from January 2011 to March 2016 in two main hospitals universities, one located in Abidjan and the other in Bouaké. It concerned children aged 0 to 15 admitted for cardiac disease diagnosed on clinical and/or echocardiographic arguments. The variables studied were the epidemiological, diagnostic, therapeutic and evolutionary aspects. Results: A total of 49.760 admissions including 228 infantile heart disease cases (congenital 113, acquired 51, indeterminate 64) are overall prevalence of 4.6‰. They involved 106 boys and 122 girls. In 74.6% of cases, the age was between 0 and 2 years. Respiratory distress 73.7% was the main reason for consultation. The main congenital heart diseases (CHD) are ventricular septal defect (VSD) (31%), atrial septal defect (ASD) (20.4%), atrioventricular canal (AVSD) (12.4%) and tetralogy of Fallot (TOF) (11.5%). As for acquired forms (AHD), rheumatic mitral insufficiency (41.2%) and tuberculous pericarditis (15.7%) were the two main causes. Treatment progress is marked by stabilization (71.1%) and death (14%). Death was significantly associated with low socioeconomic status (p = 0.01) and with complication (p 0.001). Conclusion: Infantile heart diseases are relatively less frequent and serious in Cote d’Ivoire. To improve the prognosis, close collaboration between the pediatrician and the cardiologist is required for early diagnosis and management.展开更多
Introduction: Violence in hospital is a major Public Health issue. In Cote d’Ivoire, acts of violence against health professionals exist and may sometimes take a dramatic turn. Objective: To research the causes of th...Introduction: Violence in hospital is a major Public Health issue. In Cote d’Ivoire, acts of violence against health professionals exist and may sometimes take a dramatic turn. Objective: To research the causes of this violence for the purpose to prevent them. Materials and Methods: This is a cross-sectional, descriptive study conducted in the Obstetrics & Gynecology and Pediatrics departments at the University Teaching Hospital of Bouaké from 26 January 2016 to 24 February 2016. It included 129 health workers who gave their consent. The data collection was done through individual interviews followed by a focus group according to the socio-professional category. Results: Out of 129 health professionals included, 100 were a victim of violence i.e. a frequency of 77.5%. Most of the violence occurred during “on-call hours” (55.8%) in the emergency units (34.8%). The violence was verbal (52.5%), physical (28.6%), moral and psychological (11.6%), theft (7.3%). The aggression was mainly related to patient’s care (32.1%), visiting hours (26%) and the low level of understanding of the person (16.5%). The victim’s immediate feelings were dominated by frustration (26.7%), discouragement (21.3%) and insecurity (18.3%). The victims received a medical assistance in 9% of cases. To prevent this violence, the staff mainly offered to raise awareness about violence (27.6%) and the respect for hospital staff (25%). Conclusion: Violence against health professionals is common and has negative impacts on staff and hospital activity. Its prevention requires a holistic approach centered on awareness. Keywords: Violence, Hospital, Pediatrics, Staff, Cote d’Ivoire.展开更多
Objective: To describe the growth profile of breastfeeding babies following early introduction of infant formulas to improve the feeding pattern of the young infant. Methodology: This is a longitudinal descriptive stu...Objective: To describe the growth profile of breastfeeding babies following early introduction of infant formulas to improve the feeding pattern of the young infant. Methodology: This is a longitudinal descriptive study conducted in 2 medical clinics in Abidjan from 11-Jun-2013 to 15-Dec-2016 on 100 healthy newborn babies with the introduction of infant formulas before 6 months of life. The anthropometrics parameters were compared to those of WHO. Results: The exclusive breastfeeding rate was 5%. Ablactation occurred within 12 months in 95% of cases. All Infants have doubled and tripled their birth weight at 3 and 9 months respectively. The height and the head circumference at birth increased by 50% and 37% respectively at 12 months. Compared to WHO growth charts, the weight gain for the girls at 3 months was 12.4% higher and for the boys was 7.3% higher at 6 months. On the other hands, the statural gain at 12 months was 50% lower than the WHO standards while the head circumference was 37.8% and 45.5% higher than the WHO standards in boys and girls respectively. At 3 months, the prevalence of stunting was 26.1% for boys and 13.3% for girls. Lastly, at 12 months, the BMI showed 10% overweight and 19% obesity. Conclusion: Breastfeeding associated with an early introduction of infant formulas increases the risk of malnutrition of the young infant. We advise to avoid it and recommend an exclusive breastfeeding.展开更多
Congenital nephrotic syndrome (CNS) is defined as the presence of proteinuria > 50 mg/kg/24h associated with a protein concentration g/L or albuminemia 30 g/L in an infant less than 3 months old. The CNS is rare, o...Congenital nephrotic syndrome (CNS) is defined as the presence of proteinuria > 50 mg/kg/24h associated with a protein concentration g/L or albuminemia 30 g/L in an infant less than 3 months old. The CNS is rare, of various clinical forms dominated by the Finnish type caused by a mutation of the NPHS1 gene located on chromosome 19. The edematous syndrome is the most common mode of discovery. We report a case discovered in an infant of 50 days admitted for ascites of great abundance. The aim of this study was to describe the main epidemiological, diagnostic, therapeutic and evolutionary aspects of this syndrome. Improving the prognosis of this condition requires advocacy with the political authorities of Cote d’Ivoire to provide Teaching Hospital for the resources needed to perform kidney transplantation.展开更多
Introduction: Medication error (ME) is a common cause of childhood morbidity and mortality reported in developed countries. It has not yet been described in the pediatric services in Cote d’Ivoire. Objective: To eval...Introduction: Medication error (ME) is a common cause of childhood morbidity and mortality reported in developed countries. It has not yet been described in the pediatric services in Cote d’Ivoire. Objective: To evaluate ME in pediatrics for the improvement of professional practice. Materials and Methods: This was a cross-sectional, descriptive and analytical study conducted in the service of pediatrics at the University Teaching Hospital (CHU) of Bouaké from January 11 to February 25, 2016. It involved 204 children hospitalized and treated with drugs. The variables studied were the prescription, dispensing and administration of the drugs. Results: A total of 483 prescriptions notes were recorded for 733 therapeutic lines, i.e. 2.3 prescriptions notes and 3.6 lines per child. The overall prevalence of ME was 31% (prescription 83%, dispensing 0%, administration 11%). The prescription error concerned the illegible writing (20%), the omission of the stamp & signature (47%), the omission of the date (33%), weight (66%), age (25%) and name of the child (9%).The drug name and the dosage were incorrect in 99% and 1% respectively. Regarding the administration error, care was provided by a person without a nursing qualification in 65.5% of cases. On the patient’s care record, the care giver’s name was omitted in 100%, the child’s name in 57% and the date in 47%. The route of administration and the administered dose were each incorrect in 5%. The student nurses and assistant nurse caregivers committed more prescription errors than doctors and nurses and midwives (p= 0,000 X2 = 44.91). Administration error was not significantly related to the service, the socio-professional category, the gender and the age of the patient. Conclusion: EM is common in pediatrics at the University Teaching Hospital (CHU) of Bouaké. To prevent it, it is necessary to strengthen the staff’s capacity to prescribe and administer the drug in children.展开更多
Cote d’Ivoire ranks third among African countries with the highest neonatal mortality rate (38‰). Perinatal asphyxia is one of the major causes of neonatal mortality. In its severe form, it imposes an efficient neon...Cote d’Ivoire ranks third among African countries with the highest neonatal mortality rate (38‰). Perinatal asphyxia is one of the major causes of neonatal mortality. In its severe form, it imposes an efficient neonatal resuscitation in the birth room. This can only be done when the proven competence of the staff in charge of the newborn and the availability of the appropriate equipment are met. What is the situation in the birth facilities of these two challenges for the response to the high rate of neonatal mortality in Cote d’Ivoire? Method: It is a cross-sectional study, which took place from March 28 to July 28, 2016, in three health districts of Cote d’Ivoire (Bouaké, Gagnoa, Yopougon). Public health structures offering delivery activities were selected. Based on a fact sheet, the practitioners present have been interviewed and a direct observation of the organization and equipment set up to perform neonatal resuscitation in the birth room has been done. In addition, an observation grid made it possible to evaluate the practical skills of providers in neonatal resuscitation on a newborn mannequin. The data were entered using the Epi-Info 7 software. Based on the data collected, we determined the numbers and frequencies of the responses of the target agents of the survey. Results: The membership structures included 46 first contact health facilities (FCHFs) and 4 reference hospitals (HRs). The heating system, mucus suction, oxygen, timers and self-inflating balloons were available in HR and in six, eight, four, 34 and 10 FCHFs respectively. The 253 midwives surveyed came from Bouaké (86), Gagnoa (62) and Yopougon (105). They had a seniority of at least eight years. Their knowledge for newborns’ care was acquired in initial training (75% of cases). They knew the golden minute in 95.6% of the cases. Inadequacies in the recognition of risk situations, useful equipment and in the execution of neonatal resuscitation steps were noted. Conclusion: The survival of the newborn is still very worrying in Cote d’Ivoire. An analysis of the results of this survey shows that many challenges remain not only at the structural level but also at the level of quality of care.展开更多
Authors report a case of beta thalassemia combined with hematological malignant (ATLL) in a 40-year-old female, cashier screened HTLV-1 positive;followed since her 10 years old for the account of thalasso-sickle cell ...Authors report a case of beta thalassemia combined with hematological malignant (ATLL) in a 40-year-old female, cashier screened HTLV-1 positive;followed since her 10 years old for the account of thalasso-sickle cell disease at the adult referal center of sickle cell disease in Martinique. Therapeutic management consisted of systemic chemotherapy, intrathecally-administered preventive chemotherapy combined with a treatment based on bisphosphonate and corticosteroid.展开更多
<strong>Background:</strong><span style="font-family:""><span style="font-family:Verdana;"> Birth Asphyxia (BA) is one of the leading causes of neonatal death in develo...<strong>Background:</strong><span style="font-family:""><span style="font-family:Verdana;"> Birth Asphyxia (BA) is one of the leading causes of neonatal death in developing countries. In Togo, 30.55% of neonatal deaths were related to BA and caused by several risk factors. The purpose of this piece of work is to analyse the antepartum, intrapartum, and foetal risk factors of BA. </span><b><span style="font-family:Verdana;">Methods:</span></b><span style="font-family:Verdana;"> This is a case control study, conducted from 1</span><sup><span style="font-family:Verdana;">st</span></sup><span style="font-family:Verdana;"> December 2019 to 28</span><sup><span style="font-family:Verdana;">th</span></sup><span style="font-family:Verdana;"> February 2020 in obstetrics wards and at neonatal intensive care of paediatric ward at the Sylvanus Olympio university teaching hospital (CHU-SO) in Lomé, Togo. Neonates diagnosed with BA (Apgar score < 7 at 5</span><sup><span style="font-family:Verdana;">th</span></sup><span style="font-family:Verdana;"> minute) were considered as “cases” (N = 200) while neonates born either with normal vaginal delivery or by cesarean section having no abnormality were considered as “control” (N = 200). </span><b><span style="font-family:Verdana;">Results: </span></b><span style="font-family:Verdana;">The prevalence rate of BA was 9.13%. Age (p = 0.0391), gravidity (p = 0.0040), type of facility for prenatal follow-up (p < </span></span><span style="font-family:Verdana;">0.0001), use of Long-lasting impregnated mosquito nets (LLIN) (p </span><span style="font-family:Verdana;">< </span><span style="font-family:Verdana;">0.0001), notion of maternal fever (p </span><span style="font-family:Verdana;">< </span><span style="font-family:Verdana;">0.0001) </span><span style="font-family:Verdana;">and chronic pathology (p < </span><span style="font-family:Verdana;">0.0001) were related to occurrence of BA. Significant antepartum risk factors observed were age < 25 years (OR = 1.15;CI 95% [0.66 - 1.98], p = 0.0391), primigravidity (OR = 1.82;95% CI [0.86 - 3.85], 0.0040), prenatal follow-up in a</span><span style="font-family:Verdana;"> private one (OR = 1.62;CI95% [1.03 - 12.55], p < </span><span style="font-family:Verdana;">0.0001), non-use of LLIN (OR = 2.50;CI 95% [1.61 - 3.88], p </span><span style="font-family:Verdana;">< </span><span style="font-family:Verdana;">0.0001), maternal fever (OR = 3.73;CI 95% [2.33 - 5.97], p < 0.0001) and existence of maternal chronic pathology (OR = 36.0, 95% [4.94 - 262.60], p </span><span style="font-family:Verdana;">< </span><span style="font-family:Verdana;">0.0</span><span style="font-family:Verdana;">001). Significant intrapartum risk factors were PRM (OR = 7.89;CI 95% [2.62 - 14.02], p < </span><span style="font-family:Verdana;">0.0001), abnormal AF (OR = 5.40;CI 95% [2.57 - 11.38],], p </span><span style="font-family:Verdana;">< </span><span style="font-family:Verdana;">0.0001), long labour (OR = 2.11;CI 95% [1.34 - 3.34],], p = 0.0004), use of oxytocin (OR = 2.14;CI 95% [1.3</span><span style="font-family:Verdana;">8 - 3.32], p = 0.0003), and spontaneous vaginal (OR = 1.76;CI 95% [1.14 - 2.72,], p = 0.0008]). Significant Foetal risk factors were male gender (OR = 1.55;CI 95% [1.03 - 2.33], p = 0.0423), preterm babies (OR = 8.83;CI 95% [3.79 - 20.60], p < </span><span style="font-family:Verdana;">0.0001) and baby </span><span style="font-family:Verdana;">birth weight < 2500 gr (OR = 2.96;CI 95% [1.82 - 4.79], p < </span><span style="font-family:""><span style="font-family:Verdana;">0.0001). The Sarnat score had shown anoxo-ischemic encephalopathy stage III (19.00%), corresponding to 87.80% of case fatality rate (p < 0.0001). </span><b><span style="font-family:Verdana;">Conclusion: </span></b><span style="font-family:Verdana;">Various risk factors lead to BA in Lomé. </span></span><span style="font-family:Verdana;">Early identification of high-risk cases with improved antenatal and perinatal care can decrease the high mortality of BA in Togo.</span>展开更多
The Hepatic sinusoidal obstruction syndrome (HSOS), also known as veno-occlusive disease (VOD), is a well-known complication of haematopoietic stem cell transplantation, of the treatment of Wilms tumor and rhabdomyosa...The Hepatic sinusoidal obstruction syndrome (HSOS), also known as veno-occlusive disease (VOD), is a well-known complication of haematopoietic stem cell transplantation, of the treatment of Wilms tumor and rhabdomyosarcoma and maintenance therapy of acute lymphoblastic leukemias. Its occurrence is rare in other cancers of the child. We report the observation of a 7-year-old girl with Burkitt’s lymphoma who developed a severe HSOS during her second induction treatment with dexamethasone, cisplatin, cytosine arabinoside. The evolution was fatal. This observation shows that the diagnosis of HSOS should not be excluded in the absence of the risk factors usually described.展开更多
Introduction: Neonatal mortality remains a major public health concern. According to the World Health Organisation (WHO), the number of newborns dying each year has fallen from 5 million in 1990 to 2.4 million in 2019...Introduction: Neonatal mortality remains a major public health concern. According to the World Health Organisation (WHO), the number of newborns dying each year has fallen from 5 million in 1990 to 2.4 million in 2019. The aim of our study was to describe the main morbid conditions and their lethality in newborns admitted to the paediatric ward of the CSREF in Commune V. Methodology: We conducted a 12-month prospective descriptive and analytical study from August 2020 to July 2021. Results: During the 12 months of the study, out of 2654 neonates admitted to hospital, 216 met our inclusion criteria, i.e. 8%. Newborns admitted in the first few hours of life represented 99.54% of cases. Full-term newborns accounted for 65.74% of the total. Forty-eight percent of newborns had hypothermia on admission. The most common diagnosis was asphyxia in 55.56% of cases, followed by neonatal infection in 27.78% and prematurity in 10.65%. Death was recorded in 22.2% of cases. Asphyxia was the main cause of neonatal death, followed by prematurity in our context. Conclusion: Improving the prognosis of newborn babies will require a thorough understanding of neonatal pathologies and the implementation of a pre- and perinatal prevention policy.展开更多
Background: Liquid pericarditis is a frequent cause of hospitalization in developing countries. Objective: of this study was to describe the etiological and evolutionary aspects of fluid pericarditis in pediatric card...Background: Liquid pericarditis is a frequent cause of hospitalization in developing countries. Objective: of this study was to describe the etiological and evolutionary aspects of fluid pericarditis in pediatric cardiology at ICA. Methods: This was a retrospective study of 42 cases of fluid pericarditis diagnosed among 202 children hospitalized over a five-year period (1st January 2009 to 31st December 2014). All patients with pericardial effusion were included in the study. Results: Prevalence was estimated at 20.8% of hospitalizations, sex ratio was 1.1 with a female predominance (52%) and the mean age at 9.2 years (11 days to 15 years). The etiologic varieties identified were: tuberculosis 22 cases, 52%, rheumatic pericarditis 6 cases or 14.3%, chronic parietal endocarditis 5 cases (11.9%), bacterial pericarditis with trivial germ 3 cases (7.1% 3 cases (7.1%), post-surgery syndrome 2 cases (4.8%), umbilical post-catheterization 1 case (2.4%). HIV serology was positive in 11.9% of cases. The progression was favorable in 55% of the cases with 10% of deaths. Conclusion: Fluid pericarditis in children is a severe condition that is clearly on the rise today, especially in immunocompromised patients. Optimal management of fluid pericarditis in children is the best guarantee to avoid short-term tamponade and in the medium term constriction.展开更多
Trauma to the male genitalia is not very common and mainly affects a young population. There is probably a particular instinct in men to defend their external genitalia;indeed, in the flaccid state, the penis is littl...Trauma to the male genitalia is not very common and mainly affects a young population. There is probably a particular instinct in men to defend their external genitalia;indeed, in the flaccid state, the penis is little exposed, and fairly well protected and its mobility allows it to move with the impact of trauma and thus reduce the vulnating force. Open trauma is rare, as is testicular dislocation, the most common being closed trauma. Testicular trauma is an uncommon accident that affects young people. Trauma is most often caused by road and traffic accidents. Animal bites are rare, as is genital self-mutilation related to a psychiatric disorder. Surgical exploration is the rule except in cases of moderate testicular trauma. Our objective was to report our experience in an emergency context where treatment is poorly codified and to review the literature. We recorded four patients with external genitalia trauma managed in the urology department from April 2013 to March 2022. Our patients were children with open genitalia trauma following a traffic accident, scrotal injuries were encountered in three patients, and additional penile injuries in one patient. All patients were treated surgically. The follow-up was straightforward.展开更多
文摘Introduction: Infant and child mortality is a worldwide concern, but developing countries such as Mali are more affected. The aim of this study was to investigate morbidity and factors associated with mortality in children aged 1 month to 15 years. Methodology: This was a cross-sectional study which took place from January 1 to December 31, 2020 covering children aged 1 month to 15 years hospitalized at the Kalaban-Coro CSRéf. Data were entered into Excel and analyzed using SPSS version 20 software. Results: Five hundred children aged 1 months to 15 years were included. The age range 1 to 5 years (53.6%) and male sex (58.2%) were the most represented. Malaria (72.2%), acute respiratory infections (6.2%) and diarrhea/dehydration (3%) were the main morbidities. Mortality was estimated at 10.6%, and the two main causes of death were malaria (56.6%) and acute respiratory infections (7.54%). Univariate analysis revealed a statistically significant association between the dependent variable (death) and age (p Conclusion: This study confirms the high rate of infant and child morbidity and mortality in our health facilities. Strengthening human resources and intensifying behavior-change communication can help reverse the trend.
文摘Introduction: In Cote d’Ivoire, the paediatrician has to face a diagnosis and management problem in front of pediatric heart disease, with consequent a high lethality. Objective: To describe the epidemiological, diagnostic, therapeutic and progressive aspects of childhood cardiopathy for the improvement of prognosis and professional practice. Materials and methods: This was a multicenter retrospective and descriptive study conducted from January 2011 to March 2016 in two main hospitals universities, one located in Abidjan and the other in Bouaké. It concerned children aged 0 to 15 admitted for cardiac disease diagnosed on clinical and/or echocardiographic arguments. The variables studied were the epidemiological, diagnostic, therapeutic and evolutionary aspects. Results: A total of 49.760 admissions including 228 infantile heart disease cases (congenital 113, acquired 51, indeterminate 64) are overall prevalence of 4.6‰. They involved 106 boys and 122 girls. In 74.6% of cases, the age was between 0 and 2 years. Respiratory distress 73.7% was the main reason for consultation. The main congenital heart diseases (CHD) are ventricular septal defect (VSD) (31%), atrial septal defect (ASD) (20.4%), atrioventricular canal (AVSD) (12.4%) and tetralogy of Fallot (TOF) (11.5%). As for acquired forms (AHD), rheumatic mitral insufficiency (41.2%) and tuberculous pericarditis (15.7%) were the two main causes. Treatment progress is marked by stabilization (71.1%) and death (14%). Death was significantly associated with low socioeconomic status (p = 0.01) and with complication (p 0.001). Conclusion: Infantile heart diseases are relatively less frequent and serious in Cote d’Ivoire. To improve the prognosis, close collaboration between the pediatrician and the cardiologist is required for early diagnosis and management.
文摘Introduction: Violence in hospital is a major Public Health issue. In Cote d’Ivoire, acts of violence against health professionals exist and may sometimes take a dramatic turn. Objective: To research the causes of this violence for the purpose to prevent them. Materials and Methods: This is a cross-sectional, descriptive study conducted in the Obstetrics & Gynecology and Pediatrics departments at the University Teaching Hospital of Bouaké from 26 January 2016 to 24 February 2016. It included 129 health workers who gave their consent. The data collection was done through individual interviews followed by a focus group according to the socio-professional category. Results: Out of 129 health professionals included, 100 were a victim of violence i.e. a frequency of 77.5%. Most of the violence occurred during “on-call hours” (55.8%) in the emergency units (34.8%). The violence was verbal (52.5%), physical (28.6%), moral and psychological (11.6%), theft (7.3%). The aggression was mainly related to patient’s care (32.1%), visiting hours (26%) and the low level of understanding of the person (16.5%). The victim’s immediate feelings were dominated by frustration (26.7%), discouragement (21.3%) and insecurity (18.3%). The victims received a medical assistance in 9% of cases. To prevent this violence, the staff mainly offered to raise awareness about violence (27.6%) and the respect for hospital staff (25%). Conclusion: Violence against health professionals is common and has negative impacts on staff and hospital activity. Its prevention requires a holistic approach centered on awareness. Keywords: Violence, Hospital, Pediatrics, Staff, Cote d’Ivoire.
文摘Objective: To describe the growth profile of breastfeeding babies following early introduction of infant formulas to improve the feeding pattern of the young infant. Methodology: This is a longitudinal descriptive study conducted in 2 medical clinics in Abidjan from 11-Jun-2013 to 15-Dec-2016 on 100 healthy newborn babies with the introduction of infant formulas before 6 months of life. The anthropometrics parameters were compared to those of WHO. Results: The exclusive breastfeeding rate was 5%. Ablactation occurred within 12 months in 95% of cases. All Infants have doubled and tripled their birth weight at 3 and 9 months respectively. The height and the head circumference at birth increased by 50% and 37% respectively at 12 months. Compared to WHO growth charts, the weight gain for the girls at 3 months was 12.4% higher and for the boys was 7.3% higher at 6 months. On the other hands, the statural gain at 12 months was 50% lower than the WHO standards while the head circumference was 37.8% and 45.5% higher than the WHO standards in boys and girls respectively. At 3 months, the prevalence of stunting was 26.1% for boys and 13.3% for girls. Lastly, at 12 months, the BMI showed 10% overweight and 19% obesity. Conclusion: Breastfeeding associated with an early introduction of infant formulas increases the risk of malnutrition of the young infant. We advise to avoid it and recommend an exclusive breastfeeding.
文摘Congenital nephrotic syndrome (CNS) is defined as the presence of proteinuria > 50 mg/kg/24h associated with a protein concentration g/L or albuminemia 30 g/L in an infant less than 3 months old. The CNS is rare, of various clinical forms dominated by the Finnish type caused by a mutation of the NPHS1 gene located on chromosome 19. The edematous syndrome is the most common mode of discovery. We report a case discovered in an infant of 50 days admitted for ascites of great abundance. The aim of this study was to describe the main epidemiological, diagnostic, therapeutic and evolutionary aspects of this syndrome. Improving the prognosis of this condition requires advocacy with the political authorities of Cote d’Ivoire to provide Teaching Hospital for the resources needed to perform kidney transplantation.
文摘Introduction: Medication error (ME) is a common cause of childhood morbidity and mortality reported in developed countries. It has not yet been described in the pediatric services in Cote d’Ivoire. Objective: To evaluate ME in pediatrics for the improvement of professional practice. Materials and Methods: This was a cross-sectional, descriptive and analytical study conducted in the service of pediatrics at the University Teaching Hospital (CHU) of Bouaké from January 11 to February 25, 2016. It involved 204 children hospitalized and treated with drugs. The variables studied were the prescription, dispensing and administration of the drugs. Results: A total of 483 prescriptions notes were recorded for 733 therapeutic lines, i.e. 2.3 prescriptions notes and 3.6 lines per child. The overall prevalence of ME was 31% (prescription 83%, dispensing 0%, administration 11%). The prescription error concerned the illegible writing (20%), the omission of the stamp & signature (47%), the omission of the date (33%), weight (66%), age (25%) and name of the child (9%).The drug name and the dosage were incorrect in 99% and 1% respectively. Regarding the administration error, care was provided by a person without a nursing qualification in 65.5% of cases. On the patient’s care record, the care giver’s name was omitted in 100%, the child’s name in 57% and the date in 47%. The route of administration and the administered dose were each incorrect in 5%. The student nurses and assistant nurse caregivers committed more prescription errors than doctors and nurses and midwives (p= 0,000 X2 = 44.91). Administration error was not significantly related to the service, the socio-professional category, the gender and the age of the patient. Conclusion: EM is common in pediatrics at the University Teaching Hospital (CHU) of Bouaké. To prevent it, it is necessary to strengthen the staff’s capacity to prescribe and administer the drug in children.
文摘Cote d’Ivoire ranks third among African countries with the highest neonatal mortality rate (38‰). Perinatal asphyxia is one of the major causes of neonatal mortality. In its severe form, it imposes an efficient neonatal resuscitation in the birth room. This can only be done when the proven competence of the staff in charge of the newborn and the availability of the appropriate equipment are met. What is the situation in the birth facilities of these two challenges for the response to the high rate of neonatal mortality in Cote d’Ivoire? Method: It is a cross-sectional study, which took place from March 28 to July 28, 2016, in three health districts of Cote d’Ivoire (Bouaké, Gagnoa, Yopougon). Public health structures offering delivery activities were selected. Based on a fact sheet, the practitioners present have been interviewed and a direct observation of the organization and equipment set up to perform neonatal resuscitation in the birth room has been done. In addition, an observation grid made it possible to evaluate the practical skills of providers in neonatal resuscitation on a newborn mannequin. The data were entered using the Epi-Info 7 software. Based on the data collected, we determined the numbers and frequencies of the responses of the target agents of the survey. Results: The membership structures included 46 first contact health facilities (FCHFs) and 4 reference hospitals (HRs). The heating system, mucus suction, oxygen, timers and self-inflating balloons were available in HR and in six, eight, four, 34 and 10 FCHFs respectively. The 253 midwives surveyed came from Bouaké (86), Gagnoa (62) and Yopougon (105). They had a seniority of at least eight years. Their knowledge for newborns’ care was acquired in initial training (75% of cases). They knew the golden minute in 95.6% of the cases. Inadequacies in the recognition of risk situations, useful equipment and in the execution of neonatal resuscitation steps were noted. Conclusion: The survival of the newborn is still very worrying in Cote d’Ivoire. An analysis of the results of this survey shows that many challenges remain not only at the structural level but also at the level of quality of care.
文摘Authors report a case of beta thalassemia combined with hematological malignant (ATLL) in a 40-year-old female, cashier screened HTLV-1 positive;followed since her 10 years old for the account of thalasso-sickle cell disease at the adult referal center of sickle cell disease in Martinique. Therapeutic management consisted of systemic chemotherapy, intrathecally-administered preventive chemotherapy combined with a treatment based on bisphosphonate and corticosteroid.
文摘<strong>Background:</strong><span style="font-family:""><span style="font-family:Verdana;"> Birth Asphyxia (BA) is one of the leading causes of neonatal death in developing countries. In Togo, 30.55% of neonatal deaths were related to BA and caused by several risk factors. The purpose of this piece of work is to analyse the antepartum, intrapartum, and foetal risk factors of BA. </span><b><span style="font-family:Verdana;">Methods:</span></b><span style="font-family:Verdana;"> This is a case control study, conducted from 1</span><sup><span style="font-family:Verdana;">st</span></sup><span style="font-family:Verdana;"> December 2019 to 28</span><sup><span style="font-family:Verdana;">th</span></sup><span style="font-family:Verdana;"> February 2020 in obstetrics wards and at neonatal intensive care of paediatric ward at the Sylvanus Olympio university teaching hospital (CHU-SO) in Lomé, Togo. Neonates diagnosed with BA (Apgar score < 7 at 5</span><sup><span style="font-family:Verdana;">th</span></sup><span style="font-family:Verdana;"> minute) were considered as “cases” (N = 200) while neonates born either with normal vaginal delivery or by cesarean section having no abnormality were considered as “control” (N = 200). </span><b><span style="font-family:Verdana;">Results: </span></b><span style="font-family:Verdana;">The prevalence rate of BA was 9.13%. Age (p = 0.0391), gravidity (p = 0.0040), type of facility for prenatal follow-up (p < </span></span><span style="font-family:Verdana;">0.0001), use of Long-lasting impregnated mosquito nets (LLIN) (p </span><span style="font-family:Verdana;">< </span><span style="font-family:Verdana;">0.0001), notion of maternal fever (p </span><span style="font-family:Verdana;">< </span><span style="font-family:Verdana;">0.0001) </span><span style="font-family:Verdana;">and chronic pathology (p < </span><span style="font-family:Verdana;">0.0001) were related to occurrence of BA. Significant antepartum risk factors observed were age < 25 years (OR = 1.15;CI 95% [0.66 - 1.98], p = 0.0391), primigravidity (OR = 1.82;95% CI [0.86 - 3.85], 0.0040), prenatal follow-up in a</span><span style="font-family:Verdana;"> private one (OR = 1.62;CI95% [1.03 - 12.55], p < </span><span style="font-family:Verdana;">0.0001), non-use of LLIN (OR = 2.50;CI 95% [1.61 - 3.88], p </span><span style="font-family:Verdana;">< </span><span style="font-family:Verdana;">0.0001), maternal fever (OR = 3.73;CI 95% [2.33 - 5.97], p < 0.0001) and existence of maternal chronic pathology (OR = 36.0, 95% [4.94 - 262.60], p </span><span style="font-family:Verdana;">< </span><span style="font-family:Verdana;">0.0</span><span style="font-family:Verdana;">001). Significant intrapartum risk factors were PRM (OR = 7.89;CI 95% [2.62 - 14.02], p < </span><span style="font-family:Verdana;">0.0001), abnormal AF (OR = 5.40;CI 95% [2.57 - 11.38],], p </span><span style="font-family:Verdana;">< </span><span style="font-family:Verdana;">0.0001), long labour (OR = 2.11;CI 95% [1.34 - 3.34],], p = 0.0004), use of oxytocin (OR = 2.14;CI 95% [1.3</span><span style="font-family:Verdana;">8 - 3.32], p = 0.0003), and spontaneous vaginal (OR = 1.76;CI 95% [1.14 - 2.72,], p = 0.0008]). Significant Foetal risk factors were male gender (OR = 1.55;CI 95% [1.03 - 2.33], p = 0.0423), preterm babies (OR = 8.83;CI 95% [3.79 - 20.60], p < </span><span style="font-family:Verdana;">0.0001) and baby </span><span style="font-family:Verdana;">birth weight < 2500 gr (OR = 2.96;CI 95% [1.82 - 4.79], p < </span><span style="font-family:""><span style="font-family:Verdana;">0.0001). The Sarnat score had shown anoxo-ischemic encephalopathy stage III (19.00%), corresponding to 87.80% of case fatality rate (p < 0.0001). </span><b><span style="font-family:Verdana;">Conclusion: </span></b><span style="font-family:Verdana;">Various risk factors lead to BA in Lomé. </span></span><span style="font-family:Verdana;">Early identification of high-risk cases with improved antenatal and perinatal care can decrease the high mortality of BA in Togo.</span>
文摘The Hepatic sinusoidal obstruction syndrome (HSOS), also known as veno-occlusive disease (VOD), is a well-known complication of haematopoietic stem cell transplantation, of the treatment of Wilms tumor and rhabdomyosarcoma and maintenance therapy of acute lymphoblastic leukemias. Its occurrence is rare in other cancers of the child. We report the observation of a 7-year-old girl with Burkitt’s lymphoma who developed a severe HSOS during her second induction treatment with dexamethasone, cisplatin, cytosine arabinoside. The evolution was fatal. This observation shows that the diagnosis of HSOS should not be excluded in the absence of the risk factors usually described.
文摘Introduction: Neonatal mortality remains a major public health concern. According to the World Health Organisation (WHO), the number of newborns dying each year has fallen from 5 million in 1990 to 2.4 million in 2019. The aim of our study was to describe the main morbid conditions and their lethality in newborns admitted to the paediatric ward of the CSREF in Commune V. Methodology: We conducted a 12-month prospective descriptive and analytical study from August 2020 to July 2021. Results: During the 12 months of the study, out of 2654 neonates admitted to hospital, 216 met our inclusion criteria, i.e. 8%. Newborns admitted in the first few hours of life represented 99.54% of cases. Full-term newborns accounted for 65.74% of the total. Forty-eight percent of newborns had hypothermia on admission. The most common diagnosis was asphyxia in 55.56% of cases, followed by neonatal infection in 27.78% and prematurity in 10.65%. Death was recorded in 22.2% of cases. Asphyxia was the main cause of neonatal death, followed by prematurity in our context. Conclusion: Improving the prognosis of newborn babies will require a thorough understanding of neonatal pathologies and the implementation of a pre- and perinatal prevention policy.
文摘Background: Liquid pericarditis is a frequent cause of hospitalization in developing countries. Objective: of this study was to describe the etiological and evolutionary aspects of fluid pericarditis in pediatric cardiology at ICA. Methods: This was a retrospective study of 42 cases of fluid pericarditis diagnosed among 202 children hospitalized over a five-year period (1st January 2009 to 31st December 2014). All patients with pericardial effusion were included in the study. Results: Prevalence was estimated at 20.8% of hospitalizations, sex ratio was 1.1 with a female predominance (52%) and the mean age at 9.2 years (11 days to 15 years). The etiologic varieties identified were: tuberculosis 22 cases, 52%, rheumatic pericarditis 6 cases or 14.3%, chronic parietal endocarditis 5 cases (11.9%), bacterial pericarditis with trivial germ 3 cases (7.1% 3 cases (7.1%), post-surgery syndrome 2 cases (4.8%), umbilical post-catheterization 1 case (2.4%). HIV serology was positive in 11.9% of cases. The progression was favorable in 55% of the cases with 10% of deaths. Conclusion: Fluid pericarditis in children is a severe condition that is clearly on the rise today, especially in immunocompromised patients. Optimal management of fluid pericarditis in children is the best guarantee to avoid short-term tamponade and in the medium term constriction.
文摘Trauma to the male genitalia is not very common and mainly affects a young population. There is probably a particular instinct in men to defend their external genitalia;indeed, in the flaccid state, the penis is little exposed, and fairly well protected and its mobility allows it to move with the impact of trauma and thus reduce the vulnating force. Open trauma is rare, as is testicular dislocation, the most common being closed trauma. Testicular trauma is an uncommon accident that affects young people. Trauma is most often caused by road and traffic accidents. Animal bites are rare, as is genital self-mutilation related to a psychiatric disorder. Surgical exploration is the rule except in cases of moderate testicular trauma. Our objective was to report our experience in an emergency context where treatment is poorly codified and to review the literature. We recorded four patients with external genitalia trauma managed in the urology department from April 2013 to March 2022. Our patients were children with open genitalia trauma following a traffic accident, scrotal injuries were encountered in three patients, and additional penile injuries in one patient. All patients were treated surgically. The follow-up was straightforward.
