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Acute Pneumonia Characteristics in Children under Five Years of Age in Bamako, Mali

Open Journal of Pediatrics 2019年第1期9卷 7-18页

作者： Fatoumata Dicko-Traoré abdoul Karim Doumbia Mariam Sylla Mariatou Traoré Djènèba Konaté Fatoumata Léonie diakité Karamoko Sacko Belco Maiga Hawa Diall Oumar Coulibaly Pierre Togo Fousseyni Traoré abdoul aziz diakité Yacouba Toloba Department of Pediatrics CHU Gabriel Touré Bamako Mali Faculty of Medicine and Odontostomatology Bamako Mali Department of Pneumology CHU Point G Bamako Mali

Pneumonia is the most common cause of mortality in child under five years of age. The objective of the study was to assess socio-demographic and clinical characteristics of children under 5 hospitalized for pneumonia. Material and method: We conducted a 6 months prospective study from June 1st, 2016 to December 31st, 2016 in the general pediatric service in the Pediatric Department of Gabriel Touré Teaching Hospital in Bamako, the capital city of Mali. Result: We have selected 63 cases of pneumonia according to our definition criteria, i.e. 2.2% of hospitalizations for children aged 1 to 59 months. The average age was 14 months. Infants under 2 years accounted for 82.53%. The sex ratio was 1.2. Seventy eight percent came from an unfavorable socio-economic background. The majority of mothers were uneducated (71.42%). Breastfeeding was exclusive up to 6 months in 50.79% of patients. Vaccination according to the national program was not up to date in 27% of patients. The average consultation time was 18 days. On admission, 81% of the patients had a fever, 93.64% had a tachypnea and 58.73% had crackling rales at pulmonary auscultation. Hypoxemia was present in 58.73%. Severe anemia was present in 79.36%. Radiologically, opacity was found in 42 patients (66.66%). The blood culture was positive in 8.3%. Beta-lactams were first-line prescribed in all patients. The case fatality rate was 9.52%. The factors associated with mortality were age less than 14 months (p = 0.08), adverse socio-economic conditions (p = 0.0003) and the presence of hypoxemia at the entrance (p = 0.01). Conclusion: Pneumonia remains major cause of morbidity and mortality in our context. Emphasis should be put on preventive measures.

关键词： Acute Pneumonia Children Mortality Mali

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Epidemiological Profile of Newborns Who Died during Their Hospitalization in the Neonatology Unit, Mali Hospital

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Open Journal of Pediatrics 2022年第2期12卷 424-432页

作者： Korotoumou Wéllé Diallo Bourama Kané Aboubacar Sangaré Kadidiatou Touré Fatoumata Léonie François diakité Mamadou Traoré Mohamed Maba Traoré Mamadou Berthé Mariam Maiga abdoul aziz diakité Fatoumata Dicko Traoré Department of Pediatrics Mali Hospital Bamako Mali Department of Pediatrics Gabriel Touré University Hospital Bamako Mali Reference Health Center of Commune V Bamako Mali Department of Medical Imaging Mali Hospital Bamako Mali National Institute of Public Health Bamako Mali Reference Health Center of Commune VI Bamako Mali

Introduction: Neonatal mortality is a serious problem, particularly in developing countries. Objective: To study the epidemiological and clinical profiles of newborns who died during their hospitalization in the neonatology unit of the hospital in Mali. Methodology: This was a prospective study over a 12-month period (January 1 to December 31, 2020) including all newborns aged 0 - 28 days who died during their hospitalization. Results: A total of 424 neonates were hospitalized in neonatology, 54 died, or 12.73%. Newborns aged 0 - 7 days at admission were the most represented at 79.63% and 94.4% were full-term babies. The male gender was dominant with a ratio of 1.17. The following characteristics were frequently observed in the mothers: not educated (46.3%), poor 75.9%, living in urban areas (68%), housewives 75.4%, and having had less than 4 antenatal care visits (53.7%). For babies, respiratory distress and hyperthermia were the most common reasons for hospitalization (37% and 22.2%, respectively), with 40% being resuscitated at birth. Infection and perinatal anoxia were the most frequent diagnoses, respectively 96.3% and 37%. The death occurred within the first three days of hospitalization in 60% of cases. Conclusion: In order to reduce the mortality rate in our facilities, monitoring of pregnancy and delivery, and correct management of newborns both at birth and in the pediatric wards are important.

关键词： Newborn Death Hospital in Mali

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Hemorrhagic Stroke: About a Pediatric Case

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Open Journal of Pediatrics 2021年第4期11卷 804-809页

作者： abdoul Karim Doumbia Oumar Coulibaly Hawa Gouro Diall Guediouma Dembélé Agaly Hamadassaliha Fatou S. Mangara Pierre Togo Adama Dembélé Belco Maiga Karamoko Sacko abdoul aziz diakité Boubacar Togo Department of Pediatrics of the University Hospital Gabriel Touré Bamako Mali Department of Pediatrics Mali Hospital Bamako Mali Department of Neurosurgery of the University Hospital Gabriel Touré Bamako Mali

Stroke is a rare but serious condition with high mortality and morbidity. We report the case of a 10-year-old child with no known pathological history who was transferred to the pediatric department for hemorrhagic stroke. He had been hospitalized 6 days earlier in a peripheral center for a tonic-clonic seizure accompanied by loss of consciousness and fever. Clinical examination revealed meningeal syndrome, facial paralysis, right hemiparesis, ataxia with disturbed balance, aphasia, and a peripapillary hemorrhage on the fundus. A cerebral computed tomography (CT) scan showed a hemorrhagic stroke with ventricular flooding. A lumbar puncture was performed and a hematic cerebrospinal fluid (CSF) with 12 leukocytes and 8000 red blood cells was obtained. The evolution was marked by the extinction of the infectious and meningeal syndromes, the regression of the pyramidal syndrome and the persistence of the dysarthria justifying a neuropsychological and speech therapy follow-up. Several challenges (diagnostic, therapeutic) exist in the management of children with stroke. Prospective studies with a larger sample are needed to fill the observed gaps.

关键词： Hemorrhagic Stroke Pediatrics Intracerebral Hemorrhage Subarachnoid Hemorrhage Malaria Mali

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Compressif Giant Segmental Congenital Emphysema: Diagnosis and Traitment

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Surgical Science 2016年第4期7卷 195-198页

作者： Moussa abdoulaye Ouattara Seydou Togo abdoul aziz diakité Ibrahima Sankaré Bourama Kané Sekou Koumaré Mody abdoulaye Camara Zimogo Ziè Sanogo Sadio Yena Department of Thoracic Surgery Hospital of Mali Bamako Mali Department of Pediatric Gabriel Touré Teaching Hospital Bamako Mali Department of Surgery Point G Teaching Hospital Bamako Mali Department of Imagery Hospital of Mali Bamako Mali

The giant congenital lobar emphysema is a rare malformation infant pathology. The authors report a similar case which is distinguished by its segmental location even rare with its compressive character in which segmen... 详细信息

关键词： Emphysema Congenital Segmentectomy

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Kangaroo Mother Care and Neonatal Outcomes in the Pediatric Department of CHU Gabriel Toure

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Open Journal of Pediatrics 2022年第1期12卷 179-187页

作者： Fousseyni Traoré Hawa G. Diall Karamoko Sacko Belco Maiga Oumar Coulibaly Isabelle Traore Leyla Maiga Lala N. Sidibe Pierre Togo abdoul Karim Doumbia Djeneba Konaté Fatoumata Leonie diakité Ibrahima Ahamadou Adama Dembélé abdoul aziz diakité Fatoumata Dicko Traoré Mariam Sylla Boubacar Togo Department of Pediatrics CHU Gabriel Toure Bamako Mali Faculty of Medicine and Odontostomatology Bamako Mali

Introduction: In Mali, prematurity is currently the leading cause of neonatal morbidity and mortality at the Gabriel Toure Hospital. Kangaroo Mother” care is an efficient and effective alternative care strategy for preterm and low birth weight babies. This study aimed to evaluate the epidemio-clinical and therapeutic profile of premature/hypotrophic newborns admitted to the “Kangaroo-mother” care unit. Material and method: It was a retrospective study from 01/01/2010 to 31/12/2012. Were included all stable preterm with gestational age between 28 - 37 weeks and hypotrophic newborns with a birth weight 10th percentile for gestational age. Results: One thousand and eighty-four patients (n = 1084) were included. The sex ratio was 1.2 (F = 592;M = 492). The mean birth weight was 1300 g (600 g - 2000 g). The mean gestational age was 32.69 (28 - 37). The mean age of the mothers was 24 years (13 - 45 years). Single pregnancies accounted for 85.1%. Discontinuation of care was 56%. Follow-up to 24 months was effective in 14% of patients. Sixteen percent of the patients died (n = 176). The mothers’ lack of schooling (p = 0.03) and birth weight < 1000 g (p = 0.003) were the major factors in the patients’ mortality. Conclusion: The kangaroo-mother care is an alternative means to improve the survival of preterm and low birth weight babies in Mali.

关键词： Newborns Kangaroo-Mother Care Mali

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The Bronchiolitis in Paediatric Emergencies at the University Teaching Hospital of Gabriel Touré

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Open Journal of Pediatrics 2022年第2期12卷 396-412页

作者： Adama Dembélé abdoul Karim Doumbia Belco Maïga Mohamed Elmouloud Cissé Younoussa Koné Pierre Togo Oumar Coulibaly Karamoko Sacko Djéneba Konaté Hawa Diall Lala Ndrainy Sidibé Koné Oumou Fatoumata Leonie diakité Fatoumata Dicko abdoul aziz diakité Mariam Sylla Boubacar Togo Department of Paediatrics University Teaching Hospital of Gabriel Touré Bamako Mali

Introduction: Bronchiolitis is a generally benign condition characterised by acute inflammation, oedema and necrosis of the epithelial cells lining the small airways, and increased mucus production. Symptoms usually begin with rhinitis and cough, which may progress to tachypnoea, wheezing, and rales. The most common etiology is a respiratory syncytial virus (RSV). Bronchiolitis occupies an important place among Acutes Respiratory Infections (ARI) and represented the fifth cause of hospitalisation in the paediatric emergency department of the Gabriel Touré University Hospital in 2008 with a frequency of 10% and a mortality rate of 3.2%. This shows that we are constantly confronted with the management of this pathology. The objective of our study was to study the epidemiological, clinical, and therapeutic aspects of bronchiolitis in the paediatric emergency room of the Gabriel Touré University Hospital. Materials and Method: This was a prospective cross-sectional and descriptive study from April 1, 2018, to March 31, 2020, i.e. 2 years in infants aged 1 to 23 months. Data were collected using an individual survey form by questioning parents and physically examining patients. Results: During the study period, we were able to collect 342 patients meeting our inclusion criteria out of 4207 hospitalized patients, or a frequency of 8.1%. The age range of 1 to 5 months represented 64.9%. The sex ratio was 1.2. The most common reason for consultation was respiratory discomfort (86.8%). Most patients (46%) were hospitalised during the period from September to November. In the majority of cases (74%), patients consulted within five days of the onset of symptoms. The physical examination was mainly dominated by signs of respiratory struggle, fever (51.8%), and sibilants (37%) on auscultation. Complications associated with bronchiolitis were mainly respiratory infections with 57.6% of cases. The main management steps were: nasopharyngeal decontamination (78.9%), oxygen therapy (

关键词： Bronchiolitis Epidemiology Clinic Pediatrics

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Early Management of Nephroblastoma: A Single-Center Study in a Sub-Saharan African Country

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Open Journal of Pediatrics 2021年第4期11卷 797-803页

作者： abdoul Karim Doumbia Pierre Togo Mariam Maiga Mohamed Elmouloud Cissé Guédiouma Dembélé Oumar Coulibaly Karamoko Sacko Belco Maiga Djeneba Konaté Abdou Diarra Yakaria Coulibaly Fatoumata Léonie diakité abdoul aziz diakité Boubacar Togo Check Bougadary Traore Adama Bah Department of Pediatrics at CHU Gabriel Touré Bamako Mali Reference Health Center of the Municipality 6 Bamako Mali Pediatric Surgery Department of the Gabriel Touré CHU Bamako Mali Pathological Anatomy and Cytology Department of the “Point G” CHU Bamako Mali

Introduction: Nephroblastoma is the most common renal cancer in pediatrics. The aim of this study was to describe the epidemiological, clinical, histological characteristics and the immediate outcome of patients with nephroblastoma. Methodology: This was a cross-sectional study of 18 cases of unilateral nephroblastoma, carried out in the pediatric oncology unit (UOP) of the CHU Gabriel Touré from January 2015 to December 2016. Results: The mean age of the patients was 33 months old. The sex ratio was 0.63. The average consultation time was 3 months. A case of malformation syndrome (aniridia and mental retardation) had been observed. The main reason for consultation was abdominal mass (100%) associated with deterioration of general condition (44%), pain (44%) and fever (17%). Stage I accounted for 61% and stage II 39%. The postoperative histological classification made it possible to find the high-risk blastematous type (33%), the regressive type of intermediate risk (11%) and the stromal type of intermediate risk (45%). Toxicities (haematological and digestive) were minimal. The 3-year overall survival was 90%. Conclusion: This study is characterized by the predominance of stages I and II and the fairly large percentage of histology at intermediate risk. These results are above all the result of multidisciplinary collaboration.

关键词： Cancer Child Nephroblastoma Diagnosis Prognosis Mali

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Epidemiological and Clinical Aspects of Abnormal Movements in Children from 2 Months to 15 Years in the Pediatric Department of Gabriel Toure University Hospital Centre of Bamako

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Open Journal of Pediatrics 2022年第1期12卷 170-178页

作者： Karamoko Sacko Djeneba Konaté Amadou Touré Belco Maiga Fousseyni Traoré Adama Dembelé Pierre Togo abdoul Karim Doumbia Andoule Guindo Rokia Togola Oumar Coulibaly diakite Fatoumata Léonie Francois Ibrahima Ahamadou Kalirou Traoré abdoul aziz diakité Boubacar Togo Gabriel Toure University Hospital Centre Bamako Mali University Hospital Centre Point G Bamako Mali

Introduction: Abnormal or involuntary movements correspond to a disorder in the programming and/or execution of movement. They have two characteristics;they are hardly or not at all controlled by the will and occur in the absence of any paralysis. Objective: To determine the epidemiological, clinical and etiological characteristics of abnormal (involuntary) movements in children aged 2 months to 15 years. Patients and Methods: This was a prospective, descriptive study from January 2016 to December 2018 of children aged 2 months to 15 years seen in neuropediatric consultations for abnormal movements. Results: During the study period 1920 children were seen in neuropediatric consultations and 57 presented with abnormal movements, i.e. a frequency of 2.96%. Children aged between 6 and 60 months were the most affected (54.4%). The sex ratio was 1.53. Movement abnormality was the most common reason for consultation (45.7%), followed by apyretic convulsions (28%), and laxity (5.3%). The onset was progressive in 68.4% of children. The main types of abnormal movements were chorea (31.6%), dystonia (26.3%), myoclonus (17.5%), tremor in 10.5%. The causes were infectious (73.68%). Conclusion: Abnormal movements are rare in paediatric practice. They have multiple causes and their management is urgent in certain situations that can jeopardise the future of children.

关键词： Abnormal Movements Convulsions Children Bamako

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Seizures in Children under Five in a Pediatric Ward: Prevalence, Associated Factors and Outcomes

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Open Journal of Pediatrics 2021年第4期11卷 627-635页

作者： abdoul Karim Doumbia Oumou Koné Guédiouma Dembélé Adama Dembelé Oumar Coulibaly Hawa Gouro Diall Karamoko Sacko Amadou Touré Pierre Togo abdoul aziz diakité Mohamed Elmouloud Cissé Belco Maiga Djeneba Konaté Fatoumata Léonie diakité Lala N’drainy Sidibe Fousseyni Traoré Adama Bah Djibril Kassogue Boubacar Togo Madou Traoré Department of Pediatrics at CHU Gabriel Touré Bamako Mali National Institute of Public Health Bamako Mali Mohammed VI Perinatal Clinic Bamako Mali

Introduction: convulsion is a frequent cause of neurological and cognitive sequelae and then of epilepsy. The objective of this work was to describe the socio-demographic, clinical, therapeutic, and evolutionary aspects. Methodology: This was a descriptive retrospective study carried out in the general pediatrics department of CHU-Gabriel Touré. It took place over a period of 02 years from January 2017 to December 2018. We included all children aged 1 to 59 months hospitalized in the ward for convulsion. Results: During the study period, 2653 children aged 2 months to 59 months were hospitalized in the general pediatric ward. We included 288 medical records of children who presented with a seizure on admission. Convulsions represented 11% of pediatric hospitalizations from 1 month to 59 months. The average age was 29 months. Fever was present in 86% of patients. The cerebrospinal fluid (CSF) test was positive in 38 patients. Hypoglycemia was present in 14 patients. Serum calcium was low in 3 patients. The most implicated etiologies were malaria 70%, meningitis 20%, and dehydration 13%. Management consisted of airway clearance, oxygen therapy as needed, and administration of diazepam (54%). Antibiotics were prescribed in 77% of cases and antimalarials in 70%. The average length of hospital stay was 8 days with extremes of 1 and 30 days. The outcome was favorable in 95% of cases. Sequelae were observed in 5% of cases and one case of death was observed. Conclusion: Acute convulsions are one of the most common causes of hospitalization in children under 5 years old. The causes were dominated by infectious diseases (mal

关键词： Convulsions Child Infant Prognosis Sub-Saharan Africa

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Tuberculosis in Children: Epidemio-Clinical Aspects in the Paediatric Department of the Gabriel TouréUniversity Hospital Center

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Open Journal of Pediatrics 2022年第2期12卷 376-388页

作者： Adama Dembélé abdoul aziz diakité Mohamed Elmouloud Cissé Bassirou Diarra Belco Maïga Issa Sanou Pierre Togo abdoul Karim Doumbia Oumar Coulibaly Karamoko Sacko Djéneba Konaté Hawa Diall Lala Ndrainy Sidibé Bréhima Dégoga Fatoumata Léonie diakité Guédiouma Dembélé Fatoumata Dicko Mariam Sylla Boubacar Togo Department of Paediatrics University Teaching Hospital of Gabriel Touré Bamako Mali University Clinical Research Center University of Sciences Techniques and Technologies of Bamako Bamako Mali Department of Pediatrics CHU Gabriel Touré Bamako Mali

Introduction: Globally, tuberculosis is the leading cause of death from a single infectious agent ahead of HIV/AIDS. Approximately 10 million people contracted TB in 2017, 10% of whom were children aged 0 - 15 years, or about 1 million with 250,000 deaths in 2016 (including children with HIV-associated TB). The signs of TB in children are not always specific and diagnosis remains difficult unlike in adults. According to a study conducted in 2011 in the paediatric department of the CHU-Gabriel Touré, only seventeen cases of all forms of tuberculosis were found, or approximately 0.2% of hospitalised children. The objective of our study was to investigate the epidemiological and clinical aspects of tuberculosis in children. Materials and Method: This was a prospective, cross-sectional and descriptive study that took place from 24 October 2017 to 23 October 2018, or 12 months in children aged 0-15 years. Data were collected from an individual medical record opened for each patient and an individual survey form established for each child. Results: During the study period, 40,434 children were consulted. Tuberculosis was suspected in 91 children, with a frequency of 0.22%. The age range of 1 to 4 years was 36.3% with a median age of 72 months. The sex ratio was 1.8. Chronic cough with 84.6% and malnutrition with 24.17% were the most frequent symptoms. Chest X-ray revealed bilateral pulmonary lesions in 52.7% and mediastinal adenopathy in 12.1%. TST was positive in 10.9% of patients, microscopy in 26.4%, Gene Xpert in 18.7%, and culture in 16.5%. The biological diagnosis of tuberculosis was retained in 48.4% of the patients, the pulmonary form represented 93.2%. The therapeutic regime (2RHZE/4RH) was used in 81.6% of cases and the evolution was favourable in 65.9% of patients. Conclusion: The diagnosis of tuberculosis in children remains difficult in our context. The clinical signs are not always specific, and further studies are needed to further elucidate this disease.

关键词： Child Clinic Epidemiology Gabriel Touré University Hospital Center Tuberculosis

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