Facteurs associes aux décès des nouveau-nés suspects d’infections bactériennes au Centre Hospitalier Universitaire Pédiatrique Charles de Gaulle de Ouagadougou, Burkina Faso

RésuméIntroduction: il s'agit d'étudier les facteurs associés au décès des nouveau-nés suspects d'infections bactériennes au centre hospitalier universitaire pédiatrique Charles de gaulle de Ouagadougou. Méthodes: nous avons mené une étude de cohorte rétrospective du 1er janvier 2009 au 31 décembre 2012 au centre hospitalier universitaire pédiatrique Charles de gaulle de Ouagadougou. Résultats: la fréquence hospitalière des nouveau-nés suspects d'infection bactérienne sur était de 62,8%. L'âge médian à l'admission était de trois jours et le sex ratio de 1,1.Parmi ces nouveau-nés, 351 (22,8%) ont bénéficié d'au moins un examen bactériologique, et 28 (8%) ont eu la confirmation de l'origine bactérienne de l'infection. Au cours de la période néonatale, 138(9%) nouveau-nés sont décédés avec un taux de létalité précoce et tardive respectivement de 9,6% et 8,3%. Le lieu de résidence, le mode d'admission, le nombre de consultations prénatales, le poids de naissance, la présence de signes de gravité et l'année d'admission étaient les facteurs de risque indépendants associés au décès. Conclusion: les facteurs associés au décès devraient être pris en compte dans les interventions de santé pour réduire la mortalité néonatale.English abstractIntroduction: the aim of this study was to analyze factors associated with death in newborns suspected of bacterial infections in pediatric teaching hospital of Charles de Gaulle Ouagadougou. Methods: we conducted a retrospective cohort study from 1 January 2009 to 31 December 2012 in pediatric teaching hospital of Charles de Gaulle Ouagadougou. Results: the hospitalization rate for newborns suspected of bacterial infection was 62.8%. The average age at admission was three days and the sex ratio was 1.1. Of these newborns, 351 (22.8%) underwent at least one bacteriological examination, and 28 (8%) had confirmation of bacterial infection. During the neonatal period, 138 (9%) newborns died with early and late case fatality rate of 9.6% and 8.3% respectively. Place of residence, mode of admission, number of prenatal consultations, birth weight, presence of severe signs and year of admission were independent risk factors associated with death.Conclusion: factors associated with death should be taken into account in health interventions to reduce neonatal mortality.Key words: Newborn, bacterial infection, bacteriology, risk factors, deat

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

Le syndrome de Pepper: à propos de deux cas observés au Centre Hospitalier Universitaire Pédiatrique Charles de Gaulle de Ouagadougou (Burkina Faso)

Le syndrome de Pepper est une forme métastatique hépatique du neuroblastome. C’est une entité spécifique du nourrisson de moins de six mois qui a la particularité de pouvoir régresser de façon spontanée avec un pronostic favorable dans 80% des cas. A cause de sa rareté, nous rapportons deux cas du syndrome de Pepper observés au Centre Hospitalier Universitaire Pédiatrique Charles de Gaulle de Ouagadougou (Burkina Faso). Il s’agissait de deux nourrissons de sexe féminin chez qui la symptomatologie de la maladie se traduisait par une augmentation du volume abdominal, une hépatomégalie et des signes de lutte respiratoire. L'échographie a permis de poser le diagnostic par l’aspect nodulaire du foie dans les deux cas et la détermination de la tumeur primitive dans un cas. Le dosage des catécholamines urinaires a confirmé un cas. L’évolution était fatale chez les deux patientes du fait des complications de compression par le foie, des complications de la chimiothérapie dans l’un des cas et l’absence de traitement dans l’autre cas.Mots clés: Neuroblastome, syndrome de Pepper, enfantEnglish Title:  Pepper’s syndrome: report of two cases at the Charles de Gaulle University Pediatric Hospital Center, Ouagadougou (Burkina Faso)English AbstractPepper’s syndrome is a neuroblastoma that metastasizes to the liver. It affects infants younger than six months of age. It can regress spontaneously and is associated with a favorable prognosis in 80% of cases. Given its rarity, we here report two cases of Pepper’s syndrome observed at the Charles de Gaulle university pediatric hospital center, Ouagadougou (Burkina Faso). Our study involved two female infants in whom the disease manifested as an increase in abdominal volume, hepatomegaly and signs of respiratory distress. Ultrasound enabled diagnosis, which was based on the nodular appearance of the liver in both cases and determination of the primary tumor in one case. Urinary catecholamine test confirmed the diagnosis in one case. Both patients died from complications related to liver compression, chemotherapy (in one of the cases) and lack of treatment (in the other case).Keywords: Neuroblastoma, Pepper’s syndrome, infan

Les leucémies aiguës lymphoblastiques de l’enfant à Ouagadougou (Burkina Faso): résultats de la prise en charge selon le protocole du Groupe Franco-Africain d’Oncologie Pédiatrique 2005

Introduction: La leucémie aiguë lymphoblastique (LAL) de l'enfant est une pathologie de plus en plus diagnostiquée dans notre service. Dans les pays développés, le traitement de cette hémopathie maligne permet de guérir près de 80% des enfants. Dans les pays en développement, peu d'études sont consacrées aux leucémies aiguës chez l'enfant. Les résultats du traitement des cancers de l'enfant sont décevants dans la plupart des pays africains avec un taux de survie de l'ordre de 10 à 15%. Le but de cette étude était d'étudier les aspects clinique s, biologiques, thérapeutiques et évolutifs des cas de LAL de l'enfant. Méthodes: Il s'agissait d'une étude rétrospective sur dossiers des enfants hospitalisés pour LAL entre Novembre 2009 et Octobre 2011 dans l'unité pilote d'oncologie pédiatrique du Centre Hospitalier Universitaire Pédiatrique Charles De Gaulle de Ouagadougou (Burkina Faso). Etaient inclus, les enfants pris en charge selon le protocole du Groupe Franco-Africain d'Oncologie Pédiatrique (GFAOP) 2005. Résultats: Au total, neuf cas de LAL étaient hospitalisés pendant les deux années étudiées. L'âge moyen des patients était 10,77 ans ± 2,82 ans. On notait une prédominance masculine. Le délai moyen d'hospitalisation était 43,11 jours ± 39,54 jours. Les principaux signes d'appel étaient l'altération de l'état général et la fièvre. Le syndrome tumoral et d'insuffisance médullaire étaient présents chez la quasi - totalité des patients. Six des neuf patients présentaient une LAL de type 1 au myélogramme. Huit patients ont bénéficié de la chimiothérapie selon le protocole du GFAOP 2005. L'évolution était favorable chez deux patients avec une rémission, quatre patients étaient en échec de traitement. Six patients sont décédés. Conclusion: Grâce à des campagnes d'information qui contribueront à amener la population à consulter précocement, au renforcement des capacités du personnel qui permettra un diagnostic précoce des LAL, la construction d'un centre d'oncologie pédiatrique suffisamment équipé et une subvention par l'Etat burkinabè des médicaments anticancéreux, la prise en charge de la LAL chez l'enfant permettraient d'obtenir de meilleurs résultats

Impact of multivitamin and mineral supplements on mortality and nutritional status of hospitalized severely malnourished HIV/AIDS infected children.

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Impact of HIV/AIDS on mortality and nutritional recovery among hospitalized severely malnourished children before starting antiretroviral therapy.

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Prevention and care of paediatric HIV infection in Ouagadougou, Burkina Faso: knowledge, attitudes and practices of the caregivers

International audienceAbstractBackgroundThe paediatric Human Immunodeficiency Virus (HIV) epidemic still progresses because of operational challenges in implementing prevention of mother-to-child HIV transmission (PMCT) programs. We assessed the knowledge, attitudes and practices (KAP) of children’s caregivers regarding mother-to-child transmission (MTCT) of HIV, paediatric HIV infection, early infant diagnosis (EID), and paediatric antiretroviral treatment in Ouagadougou, Burkina Faso.MethodsWe undertook a qualitative survey in the four public hospitals managing HIV exposed or infected children, in Ouagadougou in 2011. A sociologist used a semi-structured questionnaire to interview caregivers of children less than 5 years old attending the paediatrics wards on their KAP. Study participants were divided into four groups as follows:those who did not yet know their children’s HIV infection status, those who were waiting for their children’s HIV test results, those who were waiting for antiretroviral treatment, and those who were already on antiretroviral treatment.ResultsA total of 37 caregivers were interviewed. The mean age was 32.5 years, and 29 (78 %) were mothers. Twenty seven (73 %) caregivers had primary or higher level of education, and 15 (40 %) described their occupation as “housewife”. Overall, 36 (97 %) of caregivers knew that the main route of HIV transmission for infants was through MTCT and 14 (38 %) specified that it occurred during pregnancy or delivery. Five percent thought that MTCT of HIV occurred during conception. PMTCT interventions could help prevent infant HIV infection according to 32 (87 %) caregivers. Thirty five percent of caregivers stated EID as a prevention strategy. Fifty-four percent of the participants believed that replacement feeding option would prevent MTCT of HIV; 24 (65 %) stated that they would prefer medical practitioners seek caregivers’ consent before carrying out any HIV-test for their child, and that caregivers’ consent was not compulsory before antiretroviral treatment. All caregivers thought that it was necessary to treat HIV-infected children, although they did not know what interventions could be done.ConclusionsThis study highlighted the low level of caregivers’ knowledge on paediatric HIV prevention and care in Ouagadougou. Awareness programs targeting caregivers need to be strengthened in order to improve the uptake of HIV early infant diagnosis and care

Anaemia and zidovudine-containing antiretroviral therapy in paediatric antiretroviral programmes in the IeDEA Paediatric West African Database to evaluate AIDS

Introduction: There is a risk of anaemia among HIV-infected children on antiretroviral therapy (ART) containing zidovudine (ZDV) recommended in first-line regimens in the WHO guidelines. We estimated the risk of severe anaemia after initiation of a ZDV-containing regimen in HIV-infected children included in the IeDEA West African database. Methods: Standardized collection of data from HIV-infected children (positive PCR<18 months or positive serology ≥18 months) followed up in HIV programmes was included in the regional IeDEA West Africa collaboration. Ten clinical centres from seven countries contributed (Benin, Burkina Faso, Côte d'Ivoire, Gambia, Ghana, Mali and Senegal) to this collection. Inclusion criteria were age <16 years and starting ART. We explored the data quality of haemoglobin documentation over time and the incidence and predictors of severe anaemia (Hb<7g/dL) per 100 child-years of follow-up over the duration of first-line antiretroviral therapy. Results: As of December 2009, among the 2933 children included in the collaboration, 45% were girls, median age was five years; median CD4 cell percentage was 13%; median weight-for-age z-score was−2.7; and 1772 (60.4%) had a first-line ZDV-containing regimen. At baseline, 70% of the children with a first-line ZDV-containing regimen had a haemoglobin measure available versus 76% in those not on ZDV (p≤0.01): the prevalence of severe anaemia was 3.0% (n=38) in the ZDV group versus 10.2% (n=89) in those without (p<0. 01). Over the first-line follow-up, 58.9% of the children had ≥1 measure of haemoglobin available in those exposed to ZDV versus 60.4% of those not (p=0.45). Severe anaemia occurred in 92 children with an incidence of 2.47 per 100 child-years of follow-up in those on a ZDV-containing regimen versus 4.25 in those not (p≤0.01). Adjusted for age at ART initiation and first-line regimen, a weight-for-age z-score ≤−3 was a strong predictor associated with a 5.59 times risk of severe anaemia (p<0.01). Conclusions: Severe anaemia is frequent at baseline and guides the first-line ART prescription, but its incidence seems rare among children on ART. Severe malnutrition at baseline is a strong predictor for development of severe anaemia, and interventions to address this should form an integral component of clinical care

Reasons for hospitalization in HIV-infected children in West Africa

International audienc