3 research outputs found
Fréquence des néphropathies congénitales au Centre hospitalier universitaire de Donka à Conakry: Frequency of congenital nephropathies in the University Hospital of Donka in Conakry
Context and objective. The real extent of congenital nephropathies is little known in Africa and in particular in Guinea. The objective of this study was to determine the prevalence of congenital nephropathies in the University Hospital of Donka. Methods. This was a descriptive retrospective study enrolling patients admitted for congenital nephropathy at both pediatric and pediatric surgery departments of Donka, between January 1st, 2007 and June 30th, 2012. The parameters of the study were epidemiological, clinical and paraclinical data. Results. Of 34,448 patients recorded during the period studied, 26 had congenital nephropathies. They encompassed nephroblastoma (n=17), SJPU (n=6), hydronephrosis on left multikystic kidney (n=1), multikystic kidney in ptosis (n=1) and renal ectopia (n=1). Male sex was preponderant (21/26) with a sex ratio of 4.2/1. The 29 day-old to 2 year-old children were more affected. Conclusion. Congenital nephropathies appear less frequently in this hospital probably due to the absence of optimal facilities. The early diagnosis of congenital nephropathies should be made during the antenatal time, which would be a key to a better management of these conditions in affected children.
Contexte et objectif. Lâampleur rĂ©elle des nĂ©phropathies congĂ©nitales est peu connue en Afrique et notamment en GuinĂ©e. Lâobjectif de cette Ă©tude Ă©tait de dĂ©terminer la frĂ©quence des nĂ©phropathies congĂ©nitales rencontrĂ©es. MĂ©thodes. Cette Ă©tude documentaire de type descriptif sur la nĂ©phropathie congĂ©nitale, a Ă©tĂ© conduite entre les 1er janvier 2007 et 30 juin 2012, dans les services de pĂ©diatrie et de chirurgie pĂ©diatrique de Donka. Les paramĂštres dâinteret englobaient les donnĂ©es Ă©pidĂ©miologiques, cliniques et paracliniques. RĂ©sultats. Parmi les 34.448 dossiers colligĂ©s, 26 prĂ©sentaient une nĂ©phropathie congĂ©nitale. Il sâagissait des nĂ©phroblastomes (n=17), des syndromes de jonction pyĂ©lo-urĂ©tĂ©rale (n=6), dâune hydronĂ©phrose sur rein multikystique gauche (n=1), dâun rein multikystique en ptose (n=1) et dâune ectopie rĂ©nale (n=1). Le sexe masculin Ă©tait prĂ©pondĂ©rant (21/26) avec un sexe ratio de 4,2/1. Les enfants de 29 jours Ă 2 ans Ă©taient les plus touchĂ©s. Conclusion. Les nĂ©phropathies congĂ©nitales sont paraissent moins frĂ©quentes dans cette institution hospitaliĂšre, Ă cause du manque dâun plateau technique diagnostique optimal. Le diagnostic prĂ©coce des nĂ©phropathies congĂ©nitales devrait ĂȘtre fait dans la pĂ©riode prĂ©natale ce qui permettrait une meilleure prise en charge des enfants affectĂ©s
Improving malaria control in West Africa: interruption of transmission as a paradigm shift.
With the paradigm shift from the reduction of morbidity and mortality to the interruption of transmission, the focus of malaria control broadens from symptomatic infections in children â€5 years of age to include asymptomatic infections in older children and adults. In addition, as control efforts intensify and the number of interventions increases, there will be decreases in prevalence, incidence and transmission with additional decreases in morbidity and mortality. Expected secondary consequences of these changes include upward shifts in the peak ages for infection (parasitemia) and disease, increases in the ages for acquisition of antiparasite humoral and cellular immune responses and increases in false-negative blood smears and rapid diagnostic tests. Strategies to monitor these changes must include: (1) studies of the entire population (that are not restricted to children â€5 or â€10 years of age), (2) study sites in both cities and rural areas (because of increasing urbanization across sub-Saharan Africa) and (3) innovative strategies for surveillance as the prevalence of infection decreases and the frequency of false-negative smears and rapid diagnostic tests increases
Sahel, savana, riverine and urban malaria in West Africa: Similar control policies with different outcomes.
The study sites for the West African ICEMR are in three countries (The Gambia, Senegal, Mali) and are located within 750 km of each other. In addition, the National Malaria Control Programmes of these countries have virtually identical policies: (1) Artemisinin Combination Therapies (ACTs) for the treatment of symptomatic Plasmodium falciparum infection, (2) Long-Lasting Insecticide-treated bed Nets (LLINs) to reduce the Entomololgic Inoculation Rate (EIR), and (3) sulfadoxine-pyrimethamine for the Intermittent Preventive Treatment of malaria during pregnancy (IPTp). However, the prevalence of P. falciparum malaria and the status of malaria control vary markedly across the four sites with differences in the duration of the transmission season (from 4-5 to 10-11 months), the intensity of transmission (with EIRs from unmeasurably low to 4-5 per person per month), multiplicity of infection (from a mean of 1.0 to means of 2-5) and the status of malaria control (from areas which have virtually no control to areas that are at the threshold of malaria elimination). The most important priority is the need to obtain comparable data on the population-based prevalence, incidence and transmission of malaria before new candidate interventions or combinations of interventions are introduced for malaria control