Evaluation of the Nutritional and Hematological Status of Sickle Cell Children Monitored in the Pediatric Department of the University Hospital Center of Yalgado Ouedraogo

Objective: To assess the nutritional and hematological status of sickle cell children followed in the department of pediatrics of the Yalgado Ouédraogo University Hospital Centre (CHU-YO).Methodology: This was a cross-sectional study conducted from September 1, 2017, to February 28, 2018. All children with major sickle cell syndrome followed in the department of pediatrics at the CHU-YO and following their follow-up appointments were included in the study.Results: We included 230 children aged 11 months to 16 years with an average age of 8.5 years. The sex M/F ratio was 1.09. The SC heterozygotes were the most represented with 56.52%. The average hemoglobin level was 9.39 g/dl. The prevalences of wasting, stunting and underweight were respectively 23.04%, 15.65%, and 13.89%. In univariate analysis, the factors associated with emaciation was hyperleukocytosis (p=0.002).The factors associated with stunting were leukocytosis (p=0.01), severe anemia (p=0.01), SS phenotype (p=0.002), age range of 5-10 years (p=0.007), Secondary (P=0.007) and higher level (p=0.001) of father’s education, secondary (p=0.027) and higher level (p=0.034)of mothers’education , farmer(p=0.003) trader (p=0.042), and informal occupation of father (p = 0.002),and breastfeeding duration after 24 months (p=0.006). For underweight associated factors in univariate analysis were SS phenotype (p=0.003) and severe anemia (p=0.01).Conclusion: The prevalence of different types of malnutrition deficiency of sickle cell children followed at CHU-YO was high. It is important to strengthen the nutritional monitoring of children with sickle cell disease for better management of the disease

Effect of hydroxyapatite on the physicochemical characteristics of a gentamicin-loaded monoolein gel intended to treat chronic osteomyelitis

Many works have demonstrated the real potential of gentamicin-monoolein-water formulations as bioresorbable and sustained-release implants for the local treatment of the chronic osteomyelitis. In order to improve the efficacy of this type of implant, the incorporation of hydroxyapatite, a well-known osteointegrator material, is thought to be an interesting approach. Five formulations incorporating 0, 2.5, 5, 10, and 20% of hydroxyapatite were examined with regard to their physicochemical and in vitro drug release characteristics. The rheological, thermal (differential scanning calorimetric and thermogravimetric diffraction analysis), X-ray diffraction, and dissolution studies have showed that the presence of hydroxyapatite does not dramatically disturb the cubic liquid crystalline structure of the monoolein-water gel and their ability to progressively release the antibiotic. Implant 20% that was capable to release gentamicin sulfate over a period of four weeks without marked burst effect could be used as a more suitable biodegradable delivery system for the local management of chronic osteomyelitis

Facteurs associés à la mortalité chez les enfants malnutris aigus sévères du CHU Yalgado Ouédraogo, Ouagadougou

La malnutrition aigüe sévère (MAS) est responsable de 30 % des décès infanto-juvénile dans le monde. Sa prise en charge reste une préoccupation de santé publique dans les pays en développement comme le Burkina Faso. L’objectif de cette étude était de mesurer le taux de mortalité des enfants malnutris sévères hospitalisés au département de pédiatrie du Centre Hospitalier Universitaire Yalgado Ouédraogo et d’identifier ses déterminants. Nous avons mené une étude de cohorte rétrospective des enfants âgés de 6 à 59 mois, hospitalisés pour malnutrition aiguë sévère au CHU-YO entre le 1er janvier 2010 et le 31 décembre 2013. Nous avons utilisé un modèle de risque proportionnel de Cox pour identifier les facteurs associés à la mortalité au cours de l’hospitalisation. Au total 506 enfants ont été inclus dans notre étude à un âge médian de 16 mois [Intervalle interquartile (IIQ) = 10-24], le sex-ratio était de 1,30. Le taux de mortalité était de 12,10 % soit 0,60 décès/100 personnes jour. La présence de MAS avec oedèmes (Hazard Ratio ajusté (HRa) 2,20 [1,25-3,89]) ; une sérologie VIH positive (HRa = 9,21 [4,85-17,49]), ou inconnue(HRa = 6,80 [3,44-13,46]) et le traitement systématique incomplet (HRa : 1,98 [1,11-3,54]) étaient significativement associés à la mortalité des enfants malnutris aigus sévères. Le dépistage et le traitement précoce de l’infection à VIH et la prise en charge suivant les recommandations restent une condition pour l'amélioration du pronostic de la malnutrition aiguë sévère dans notre contexte.Mots-clés : malnutrition, mortalité, traitement, enfant, Ouagadougou