Epidemiological, Clinical, and Diagnostic Aspects of Urinary Tract Infection in Newborns at the Departmental Teaching Hospital of Borgou-Alibori (DTH-B/A) in Benin

To study epidemiological and diagnostic aspects of urinary tract infection (UTI) in newborns at the Departmental Teaching Hospital of Borgou-Alibori (DTH-B/A). This was a cross-sectional study conducted from April 1, 2019 to September 30, 2019 and concerned all newborns admitted to the neonatal unit of DTH-B/A. According to the National Agency for Health Accreditation and Evaluation (NAHAE)recommendations of 2002, all symptomatic newborns who did not have a visible malformation outside the genitourinary system and whose parents gave their consent were included in the study. The census was exhaustive despite the calculated minimum size of 109 newborns. Urine sedimentation and cytobacteriological examination of urine samples, taken in adhesive bags after local disinfection, demonstrated presence of pathogenic microbes. Sensitivity of detected microbes was studied to different antibiotics. Interpretive reading of antibiograms was established according to the Standards of the French Society of Microbiology (FEMS), edition 2012. If UTI was confirmed, an abdominopelvic ultrasound was performed in search for a malformative uropathy as a contributing factor in newborns. A standardized survey was developed for data collection. The data entered were analyzed using the Epi info software, version 3.5.4. In all, 124 newborns were included in the study. UTI accounted for 8.06% of all neonatal infections and 2.15% of admissions. The average age of onset was 7.8 days, with a gender ratio of 1:1. The main clinical manifestations were jaundice and respiratory distress. Microbes involved were Staphylococcus aureus (6/10), Escherichia coli (2/10), and Klebsiella oxytoca (2/10). The resistance of microbes to antibiotics was generally high. No abnormalities were revealed in the ultrasound. Although neonatal UTI is not a rare infection, bacterial resistance is of concern

Epidemiological, Clinical, Therapeutic, and Evolutionary Aspects of Acute Kidney Damage during Severe Malaria in Children at the Borgou Departmental Teaching Hospital (Benin)

Malaria is an endemic pathology with several complications, including kidney damage. The objective of this work was to study kidney damage during severe malaria in children at the pediatrics department of the Borgou Departmental Teaching Hospital (Borgou DTH), Benin in 2021. This was a longitudinal study carried out over 4 months from June 1, 2021 to September 30, 2021 (with 1 month of recruitment from June 1 to July 1, 2021) at the pediatric department of the Borgou DTH. The study included children aged 1 month–15 years, hospitalized for Plasmodium falciparum malaria with at least one clinical manifestation of malaria severity established by the World Health Organization in 2000 and whose parents had given their informed consent. The damage was established by urinary sedimentation using urine dipstick and urinary cap and serum creatinine. Acute kidney injury (AKI) was intended and classified according to the Kidney Disease Improving Global Outcomes (KDIGO) criteria. The dependent variable was the presence of at least one clinical, biological, and functional impairment. Follow-up was regular for up to 3 months. Lost to follow-up were excluded. Predictors of occurrence were identified. Statistical difference was considered significant at P < 0.05. Of the 164 children hospitalized for severe malaria during the study period, 72 had at least one renal impairment, with a frequency of 43.90%. The average age of the children was 44.93 months. On urine dipstick, 76.39% of the patients had hemoglobinuria and 55.56% had albuminuria. Urinary cap revealed 44% granular cylindruria and 32% crystalluria. AKI was detected in 4.54% patients. Recovery was complete in all follow-up cases. The predictors of kidney damage were coma ( P = 0.017), jaundice ( P = 0.007), thrombocytopenia ( P = 0.021), and long hospital stay ( P = 0.008). Kidney damage in severe malaria is frequent. Early diagnosis and prompt treatment are fundamentals of rapid and complete recovery of kidney functions

Associated factors for maternal-foetal complications in pregnant women with sickle cell disease at the departmental University Hospital of Borgou and Alibori (Benin)

Background: Sickle cell disease is one of the most common genetic disorders in the world, with a high prevalence in Africa. It is a pathology that threatens the maternal-fetal prognosis in case of pregnancy. The objective of this study was to describe the maternal-foetal complications and to identify the factors associated with maternal-foetal complications in sickle cell pregnant women (SP).Methods: This was a descriptive cross-sectional study with retrospective data collection over a period of 4 years (01 January 2015 to 31 August 2019). The study population was All SP who had given birth in the maternity ward of the UH of Borgou/Alibori.Results: We recorded 130 SP out of 10087 admissions, either a frequency of 1.3%. There were 119/130 exploitable files. Maternal complications during pregnancy were: vaso-occlusive crises 79%; severe anaemia 27.7%; hyponatremia 10.1%; vasculo-renal syndromes 18.4%; infections 74.8%. The foetal complications during pregnancy were: Preterm births 38.6%, in utero deaths 17.6%, low birth weight 54.7%. Early neonatal mortality was 8.4% (8/95). There was a 4.2% (5/119) of maternal deaths. Low educational level of the SP, SS genotype, insufficient antenatal follow-up and antenatal follow-up outside the specialized center for the care of sickle cell pregnant women (SCCSP) were the factors associated with maternal-foetal complications in the SP.Conclusions: The association of pregnancy and sickle cell disease is frequent in West Africa, particularly in Benin, and is characterised by numerous maternal-foetal complications that are associated with certain factors

Kidney Injury in Children Infected with HIV, Followed at the Teaching Hospital of Borgou (Benin): Epidemiological and Clinical Aspects

The history of kidney disease associated with HIV infection dates back to the years of HIV breakthrough. The objective was to study kidney damage in children infected with HIV at the Teaching Hospital of Borgou (Benin) in 2019. This was a cross-sectional, descriptive, analytical, matching-type study carried out from June 1, 2019 to September 30, 2019 at the pediatrics department of Teaching Hospital of Borgou (Benin). The study included HIV-positive children, followed in consultations, and whose parents gave their consent. The biological markers were demonstrated with urine dipstick. Glomerular filtration rate was calculated using the Schwartz test and classified according to stages. The dependent variable was the presence of at least one impairment (biological or functional). Sample size was determined by Schwartz’s method on the basis of one case for two controls. Sociodemographic, clinical, biological, and therapeutic data were collected. Comparisons were made using the Chi- square test or Fisher’s exact test. The identification of associated factors was possible using a multiple logistic regression model at 5% threshold. In total, we included 117 children, including 39 HIV-positive children. The average age was 8 ± 4.81 years and the gender ratio was 1:17. The frequency of kidney damage was 76.5%. Permanent proteinuria and at least two crosses on urine dipstick were present in 20.5%, leukocyturia in 2.6%, and proximal tubular dysfunction in 5.1%. Glomerular hyperfiltration was found in 38.5%, acute kidney injury in 38.5%, and chronic kidney injury in 5.1%. Associated factors were age (P = 0.004), presence of opportunistic infections (P = 0.00), and treatment adherence (P = 0.004). Kidney damage is common in HIV-positive children. Careful follow-up is necessary to avoid complications

Declines in Pediatric Bacterial Meningitis in the Republic of Benin Following Introduction of Pneumococcal Conjugate Vaccine: Epidemiological and Etiological Findings, 2011-2016.

BACKGROUND: Pediatric bacterial meningitis (PBM) remains an important cause of disease in children in Africa. We describe findings from sentinel site bacterial meningitis surveillance in children <5 years of age in the Republic of Benin, 2011-2016. METHODS: Cerebrospinal fluid (CSF) was collected from children admitted to Parakou, Natitingou, and Tanguieta sentinel hospitals with suspected meningitis. Identification of Streptococcus pneumoniae (pneumococcus), Haemophilus influenzae, and Neisseria meningitidis (meningococcus) was performed by rapid diagnostic tests, microbiological culture, and/or polymerase chain reaction; where possible, serotyping/grouping was performed. RESULTS: A total of 10 919 suspected cases of meningitis were admitted to the sentinel hospitals. Most patients were 0-11 months old (4863 [44.5%]) and there were 542 (5.0%) in-hospital deaths. Overall, 4168 CSF samples were screened for pathogens and a total of 194 (4.7%) PBM cases were confirmed, predominantly caused by pneumococcus (98 [50.5%]). Following pneumococcal conjugate vaccine (PCV) introduction in 2011, annual suspected meningitis cases and deaths (case fatality rate) progressively declined from 2534 to 1359 and from 164 (6.5%) to 14 (1.0%) in 2012 and 2016, respectively (P < .001). Additionally, there was a gradual decline in the proportion of meningitis cases caused by pneumococcus, from 77.3% (17/22) in 2011 to 32.4% (11/34) in 2016 (odds ratio, 7.11 [95% confidence interval, 2.08-24.30]). Haemophilus influenzae meningitis fluctuated over the surveillance period and was the predominant pathogen (16/34 [47.1%]) by 2016. CONCLUSIONS: The observed decrease in pneumococcal meningitis after PCV introduction may be indicative of changing patterns of PBM etiology in Benin. Maintaining vigilant and effective surveillance is critical for understanding these changes and their wider public health implications

Phylogeography and resistome of pneumococcal meningitis in West Africa before and after vaccine introduction.

Despite contributing to the large disease burden in West Africa, little is known about the genomic epidemiology of Streptococcus pneumoniae which cause meningitis among children under 5 years old in the region. We analysed whole-genome sequencing data from 185 S. pneumoniae isolates recovered from suspected paediatric meningitis cases as part of the World Health Organization (WHO) invasive bacterial diseases surveillance from 2010 to 2016. The phylogeny was reconstructed, accessory genome similarity was computed and antimicrobial-resistance patterns were inferred from the genome data and compared to phenotypic resistance from disc diffusion. We studied the changes in the distribution of serotypes pre- and post-pneumococcal conjugate vaccine (PCV) introduction in the Central and Western sub-regions separately. The overall distribution of non-vaccine, PCV7 (4, 6B, 9V, 14, 18C, 19F and 23F) and additional PCV13 serotypes (1, 3, 5, 6A, 19A and 7F) did not change significantly before and after PCV introduction in the Central region (Fisher's test P value 0.27) despite an increase in the proportion of non-vaccine serotypes to 40 % (n=6) in the post-PCV introduction period compared to 21.9 % (n=14). In the Western sub-region, PCV13 serotypes were more dominant among isolates from The Gambia following the introduction of PCV7, 81 % (n=17), compared to the pre-PCV period in neighbouring Senegal, 51 % (n=27). The phylogeny illustrated the diversity of strains associated with paediatric meningitis in West Africa and highlighted the existence of phylogeographical clustering, with isolates from the same sub-region clustering and sharing similar accessory genome content. Antibiotic-resistance genotypes known to confer resistance to penicillin, chloramphenicol, co-trimoxazole and tetracycline were detected across all sub-regions. However, there was no discernible trend linking the presence of resistance genotypes with the vaccine introduction period or whether the strain was a vaccine or non-vaccine serotype. Resistance genotypes appeared to be conserved within selected sub-clades of the phylogenetic tree, suggesting clonal inheritance. Our data underscore the need for continued surveillance on the emergence of non-vaccine serotypes as well as chloramphenicol and penicillin resistance, as these antibiotics are likely still being used for empirical treatment in low-resource settings. This article contains data hosted by Microreact

Epilepsy and Malaria in Children Aged 1 to 15 Years in Parakou in 2018: Case-Control Study

International audienceObjective: To study the link between malaria and epilepsy in children in Parakou district. Methods: This case-control studyincluded children 1-15 years of age with epilepsy. Each case of epilepsy was matched to 2 controls for age, sex and neighborhoodof residence. The exposure variables were a history of malaria (number and type), family history of epilepsy and other past medicalhistory. The odds ratios (OR) and their confidence interval were used to estimate association. Results: A total of 123 childrenincluding 41 children with epilepsy and 82 controls were included. The overall average number of malaria episodes per year inboth groups combined was 1.8 + 0.9 episodes. In the multivariate analysis, cerebral malaria (OR: 50.35 [5.28-480.30]), familyhistory of epilepsy (OR: 12.17 [2.15-69.01]) and number of malaria episodes (OR: 13.27 [4.53-98.48]) were associated.Conclusion: This study supports the association between cerebral malaria and the onset of epilepsy