Prise en charge hospitalière de la malnutrition aigue sévère chez l’enfant avec des préparations locales alternatives aux F-75 et F-100: résultats et défis

Introduction: La mise en oeuvre des directives de l'OMS permettrait de réduire significativement la  mortalité hospitalière due à la malnutrition sévère. Cependant, elle n'est pas effective et la pénurie en  aliments thérapeutiques est l'une des principales causes. L'étude décrit notre expérience sur la prise en charge hospitalière de la malnutrition aigue sévère avec des laits alternatifs aux F75 et F100 composés localement.Méthodes: Il s'agissait d'un essai clinique non randomisé. La prise en charge des patients utilisait les laits composés localement et une évaluation quotidienne du gain pondéral était faite.Résultats: L'étude a porté sur 41 sujets âgés de 6 à 59 mois. Au total, 73,2% avaient le  kwashiorkormarasmique, 17,0% le kwashiorkor, 9,8% le marasme et 41,5% étaient infectés par le VIH. Nous avons noté une prise progressive du poids d'environ 10 g/kg/jour vers le 7ème jour et de 15 à 20  g/kg/jour en fin d'hospitalisation. Le taux de mortalité était de 21,9% soit une réduction de 8,4% des chiffres antérieurs. Conclusion: Malgré les obstacles financiers liés au coût des ingrédients, les  préparations lactées alternatives aux standards F75 et F100, sont adaptables dans notre contexte. En l'absence des formules standards de l'OMS et lorsque la référence vers une structure qui en disposent n'est pas possible, les préparations locales permettraient de réhabiliter efficacement les patients.  D'autres recherches pointues permettraient de tirer les ingrédients uniquement de notre environnement. Elles contribueraient ainsi à minimiser les couts des préparations et de favoriser la pérennisation des laits thérapeutiques locaux.Key words: Malnutrition sévère, laits thérapeutiques F75/F100, ingrédients locaux, enfant

Reviewing the Insights of Confinement and Social Distancing as Measures Involved in the Prevention of the COVID-19 Pandemic

Confinement and social distancing have been widely used in the prevention of the COVID-19 pandemic, as interventions consisting in reducing physical contact between individuals to prevent the spread of the disease. In order to demonstrate the pattern of these measures, we did a review of pertinent articles on the subject available online. We found that though confinement and social distancing significantly contributed to the mitigation of the COVID-19 infection in a number of countries worldwide, there however exist a dilemma in choosing between the expected benefits and adverse effects, especially when applied on a large scale. Thus considerations with regards to socio-anthropological and politico-economic impacts should be considered in order to protect citizens, especially the vulnerable. Besides, population information, education and communication helps to increase adherence and observation of recommendations. However, further improvements need to be implemented in other to render these measures more bearable and less restrictive while ameliorating their efficacy

USAGE OF A RAPID DIAGNOSTIC TEST FOR MALARIA IN CHILDREN

Background: Malaria is still the primary cause of pediatric deaths. The efficient management of pediatric malaria requires its rapid and accurate diagnosis. To fulfill this requirement, rapid diagnostic tests have been developed, but their evaluation before commercialization is never exhaustive. The aim of this study was to evaluate the performance of a rapid diagnostic test (SD Bioline Malaria Antigen P.f/Pan) to diagnose malaria in children. Materials and Methods: Testing was conducted on children aged between 6 months and 15 years who were examined at the CME-FCB as a result of fever. Enrollment took place from April to October 2014. All children presenting with fever were sampled (3ml of blood). These blood samples were tested for malaria using microscopy on a thick blood smear and by a rapid diagnostic test (RDT) SD Bioline Malariae Antigen P.f/Pan. Results: A total of 249 children were enrolled in this study. Malaria presence as determined by microscopy and by RDT was 30.9% and 58.2% respectively. The sensitivity, specificity, positive and negative predictive values compared to microscopy were: 75; 48.8; 39, and 81.6%. With these performances, the malaria SD Bioline rapid test presents lower values compared to WHO recommendations for rapid tests (sensitivity > 95%) in children. Conclusion: SD Bioline Malaria Antigen P.f/Pan test should only be used in peripheral health structures that lack resources, and should be aided by clinical diagnosis

Prevalence and risk factors to HIV-infection amongst health care workers within public and private health facilities in Cameroon.

Introduction: This study aimed at assessing the prevalence of Human Immunodeficiency Virus (HIV) among health care workers (HCWs) and to evaluate some risks factors for HCWs. Methods: We conducted a cross sectional study amongst HCWs in public and private healthcare facilities within seven regions amongst the 10 found in Cameroon. We collected data from 446 HCWs within 150 healthcare facilities. We used questionnaires for interviews and biological sampling for HIV test. Results: HIV prevalence was 2.61% (95% CI: 1.32% - 4.61%) regardless of gender and age. HCWs in private health facilities were more infected compared to those in public health facilities 5.00% vs 1.40% (p = 0.028); OR = 3.7 (95% CI: 1.01-12.90). HCWs who had never screened for HIV had a high risk of being infected OR = 7.05 (95% CI: 2.05-24.47). 44.62% of HCWs reported to have been victim of an Accidental Exposure to Blood (AEB). Amongst them, 45.80% in public HF versus 32.1% in private HF reported to have received an HIV screening and Post Exposure Prophylaxis following this incident. 4.20% of HCW victim of AEB were HIV positive, and 36.40% of HCWs had appropriate capacity training for HIV patient care. Conclusion: Though the HIV prevalence in HCWs is lower than in the general population 2.61% vs 4.3%, there is a high risk of infection as we observed a relatively high percentage of AEB amongst HCWs with an HIV prevalence of 4.20%. There is thus, a need in strengthening the capacity and provide psychosocial support to HCWs

INFECTION NEONATALE A STREPTOCOQUE B A L'HOPITAL EDOUARD-HERRIOT DE LYON (ETUDE PROSPECTIVE DE 1997 A 1999)

LYON1-BU Santé (693882101) / SudocPARIS-BIUM (751062103) / SudocSudocFranceF

Knowledge, attitudes and practices of health personnel of maternities in the prevention of mother-to-child transmission of HIV in a sub-Saharan African region with high transmission rate: some solutions proposed

Abstract Background High mother-to-child (MTC) transmission rate of HIV might contribute to the increased pandemic rate. The aim of this study was to identify the knowledge, attitude and practices of health personnel working in maternities in the prevention of MTC transmission of HIV. Methods This cross-sectional descriptive study was carried out from 20th February to 30th April, 2017. All health personnel working in the maternity wards were included in this study. The variables recorded included their age, grade, experience (number of year of practice), gender, educational level, health structure and the training in prevention of MTC transmission of HIV. Analyses were done using SPSS 21.0. The Pearson Chi-square test or Fisher’s exact test and logistic regression were used for comparison. The level of significance was P < 0.05. Results A total of 140 health personnel were recruited. Knowledge was insufficient amongst 73 of them (52.1%). The factors significantly associated with sufficient knowledge were midwifery qualification (aOR 9.01, 95% CI 1.82–48.60) and training in prevention of MTC transmission of HIV (aOR 2.23, 95% CI 1.02–4.81). Regarding attitudes, it was negative in 85 practitioners (60.7%). Only those aged ≥33 years were significantly associated with a positive attitude (aOR 2.34, 95% CI 1.14–4.23). As concerns practices, only 32 practitioners (22.9%) had good practices. Only midwives were associated with good practices (aOR 3.23, 95% CI 1.21–9.95). Conclusion Insufficient knowledge, attitude and practices in the prevention of MTC transmission of HIV were observed among the majority of health personnel in the region. This lack of knowledge in prevention can therefore contribute to the rise of the mother-to-child transmission rate of HIV. To reduce this rate, more health personnel should be trained, especially midwives, in the prevention of MTC transmission of HIV. Moreover, deliveries of all women living with HIV should be conducted or at least supervised by trained midwives, especially those of at least 33 years of age

Additional file 3: of Knowledge, attitudes and practices of health personnel of maternities in the prevention of mother-to-child transmission of HIV in a sub-Saharan African region with high transmission rate: some solutions proposed

Table S3. Practice distribution according to grade of participants. Contains details of answers assessing practice according to grade of participants as well as the statistical analysis. (DOC 56 kb

Déterminants de la durée prolongée d’hospitalisation chez les nourrissons âges de 1 à 24 mois admis pour bronchiolite aiguë dans trois hôpitaux de Yaoundé

English Title: Determinants of prolonged hospitalization in infants aged 1 to 24 months admitted for acute bronchiolitis in three Yaounde hospitals. Introduction : La bronchiolite aiguë est une bronchopathie obstructive virale des voies aériennes inférieures. Généralement&nbsp; secondaire au virus respiratoire syncitial, elle est l’infection respiratoire basse la plus fréquente avant l’âge de 2 ans. Bien que peu létale, environ un quart des patients hospitalisés souffrant de bronchiolite sont souvent sujets à une durée prolongée d’hospitalisation.Objectif : Identifier les déterminants de la durée prolongée d’hospitalisation chez les nourrissons admis pour bronchiolite aiguë dans 3 hôpitaux de Yaoundé.Méthodes : Une étude transversale analytique a été réalisée sur une période de 4 mois, dans trois formations sanitaires de la ville de Yaoundé. Les nourrissons âgés de 1 à 24 mois chez qui le diagnostic de bronchiolite aigue a été posé dans chacune des 3 formations sanitaires retenues pour l’étude étaient éligibles. Tous les nourrissons pour lesquels le consentement éclairé parental n’a pas été obtenu, ainsi que ceux sortis de l’hôpital contre avis médical ont été exclus. Les variables sociodémographiques, cliniques,&nbsp; thérapeutiques, évolutives ainsi que les antécédents ont été recueillies. L’analyse des données s’est faite grâce au logiciel SPSS. Notre principal critère de jugement était la durée prolongée d’hospitalisation, définie par une d’hospitalisation supérieure à 4 jours. Le seuil de significativité a été fixé à 5%.Résultats : La durée moyenne d’hospitalisation était de 4,86 (±2,30) jours. L’âge inférieur ou égal à 6 mois [OR ajusté :8,58(2,43-12,21), p=0,024], l’antécédent de prématurité [OR ajusté :9,99(4,78-21,42), p=0,023] et la détresse respiratoire modérée à sévère [OR ajusté :12,89(5,89-26,01), p=0,017] étaient des facteurs indépendants significativement associés à la durée prolongée d’hospitalisation.Conclusion : La bronchiolite aigue du nourrisson est un réel problème de santé publique. Elle engendre des urgences pédiatriques et des hospitalisations prolongées induisant des dépenses financières importantes pour les familles et la société. Ainsi, nous&nbsp; recommandons la prise en compte des déterminants identifiés lors de la planification des politiques de santé publique visant à réduire la durée du séjour à l'hôpital chez les nourrissons atteints de bronchiolite aigue. Mots clés : Déterminants, Durée prolongée d’hospitalisation, Nourrisson, Bronchiolite aigue, Yaoundé, Cameroun

Long Standing Esophageal Perforation due to Foreign Body Impaction in Children: A Therapeutic Challenge in a Resource Limited Setting

Late presentation of foreign body impaction in the esophagus, complicated by perforation in children, has rarely been reported in the literature. Esophageal surgery is very difficult and challenging in Cameroon (a resource limited setting). We are reporting herein 2 cases of esophageal perforation in children seen very late (12 days and 40 days) after foreign body impaction, complicated with severe sepsis, who were successfully operated upon with very good results