Le Traitement Medical De La Stenose Hypertrophique Du Pylore A Cotonou (Benin): A propos de deux cas.

La fréquence globale de la sténose hypertrophique du pylore se situe entre 1 et 3 pour 1000 naissances vivantes et concerne 5 fois plus le garçon que la fille. Son traitement, toujours chirurgical, était une pyloromyotomie extramuqueuse mise au point par Fredet en 1907 et Ramsted en 1911. La morbidité était de 1 à 16 % avec une mortalité inférieure à 0,4 % en Occident. La morbidité et la mortalité restent lourdes en Afrique car le traitement chirurgical de la sténose hypertrophique du pylore dans les paysdéfavorisés demeure hypothéqué par des conditions difficiles de prise en charge. A l’instar des études indiennes, serbes et japonaises, les auteurs rapportent 2 cas de sténose hypertrophique dupylore traités efficacement par l’atropine en intraveineuse à Cotonou

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

A922 Sequential measurement of 1 hour creatinine clearance (1-CRCL) in critically ill patients at risk of acute kidney injury (AKI)

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