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Audits of Death in HIV-Infected Children and Adolescents Followed up in the Pediatric Department of the Regional Teaching Hospital of Borgou/Alibori from 2005 to 2020

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Open Journal of Pediatrics 2024年第2期14卷 285-296页

作者： alphonse noudamadjo Mohamed Falilatou Agbeille Dénagan Kévin Amoussou Médétinmè Gérard Kpanidja Lahanatou Séidou Chantal Chabi Réckya Kilaya Julien Didier Adédémy Agossou Joseph Mother and Child Department Faculty of Medicine University of Parakou Parakou Benin Pediatric Department Regional Teaching Hospital of Borgou/Alibori Parakou Benin

Introduction: Human immunodeficiency virus (HIV) is a major public health problem with high morbidity and mortality among children. The objective of this work was to audit the deaths of children and adolescents with HIV infection followed up in the pediatric department of the Regional Teaching Hospital of Borgou/Alibori (CHUDB/A) the from 2005 to 2020. Patients and Method: This was a retrospective and descriptive study conducted in the pediatric department of CHUD/B-A in Parakou. All children with HIV infection who died from January 1, 2005 to August 31, 2020 were included. Data collection was carried out in three stages: a phase of medical records processing, a phase of community survey and a phase of death audits. The variables studied were sociodemographic, clinical, biological, therapeutic and evolutionary. Results: Over the study period, the data of 464 infected children were recorded, including 92 deaths, representing a case fatality rate of 19.83%. Severe acute malnutrition (69.23%), gastro-intestinal tract infections (43.58%) and serious opportunistic pulmonary infections (24.36% pulmonary tuberculosis and 19.23% pneumocystis) were the main causes of death. The main dysfunctions found were: the delayed diagnosis of HIV infection (79.35%), the absence or delay in consultation when the child’s clinical condition deteriorates (32.61% and 47.83%), delayed initiation of antiretroviral treatment (42.39%) and non-adherence to treatment (38.04%). Non-adherence to treatment was predominant in adolescents (90.49%). Conclusion: Specific interventions for early detection, adequate nutritional care, psychosocial support for adolescents and mothers of children are necessary to reduce mortality due to HIV among children and adolescents.

关键词： HIV Death Children Adolescents Dysfunctions Benin

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Children with Sickle Cell Disease in Northern Benin: Follow up of a Cohort at the Borgou/Alibori Branch of Integrated Medical Healthcare Center for Infants and Pregnant Women with Sickle Cell Disease from 2017 to 2022

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Open Journal of Pediatrics 2024年第3期14卷 445-458页

作者： Falilatou Agbeille Mohamed alphonse noudamadjo Médétinmè Gérard Kpanidja Yémalin Zinsou François Anikè Akinola Kpedio Clarisse Marie Chantal Bossa Julien Didier Adédémy Joseph Agossou Teaching and Research Unit Department of Mother and Child Faculty of Medicine University of Parakou Parakou Benin Integrated Healthcare Center for Infants and Pregnant Women with Sickle Cell Disease (CPMI-NFED) Branch of Borgou/Alibori Parakou Benin

Introduction: Sickle cell disease is a public health problem in sub-Saharan Africa. A national referral center for the management of infants and pregnant women with sickle cell disease (CPMI-NFED) was created three decades ago in Cotonou, in the south of Benin with two regional branches including that of Parakou in the North for better access of patients to specialized care. This work is a review of five years of activities in order to describe the epidemiological, clinical, hematological and evolutionary profiles of the children followed up in the said branch. Method: This was a descriptive and retrospective cross-sectional study on the medical records of children with sickle cell disease, followed up at the regional branch of CPMI-NFED in Borgou/Alibori from June 1, 2017 to May 31, 2022. The variables studied were epidemiological, clinical, biological and evolutionary. Results: A total of 101 children with sickle cell disease were included in the study, including 78 homozygous SS (77.2%) and 23 heterozygous SC (22.8%). Their mean age at inclusion was 51.2 ± 37.6 months [6 - 204]. The sex ratio was 1.4. Vaso-occlusive crises were the main diagnostic circumstances in 42.3% of homozygotes. More than half of the children (51.5%) had a regular follow-up. The average baseline level of hemoglobin (Hb) in homozygous children was 8.8 ± 1.4 g/dl [5.8 - 11.5];and the rate of Hb S varied between 61.9 and 94.7%. In heterozygous SC children, the mean baseline level of Hb was 10.7 ± 0.6 g/dl [9.7 - 11.5]. Acute complications observed during follow-up were dominated by pneumonia and vaso-occlusive crises in both phenotypes. The overall mortality was 3% and only affected homozygous patients. Conclusion: On average, three out of four children were homozygous in our cohort. The main acute complications were infectious and vaso-occlusive. The mortality only affected homozygous carriers. Specialized follow-up has contributed to improving the quality of life of children with sickle cel

关键词： Sickle Cell Disease Children CPMI-NFED Parakou Benin

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Factors Associated with Low Use of Insecticide-Treated Nets among Children under 5 Years of Age in Fo-Boure (Benin) in 2019

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Open Journal of Pediatrics 2023年第5期13卷 619-625页

作者： alphonse noudamadjo Mèdétinmè Gérard Kpanidja Falilatou Agbeille Mohamed Zinsou Rodrigue Ahodègnon Julien Didier Adédémy Joseph Agossou Faculty of Medicine Mother and Child Department University of Parakou Parakou Benin National School of Higher Technicians in Public Health and Epidemiological Surveillance University of Parakou Parakou Benin

Despite the free distribution of insecticide impregnated nets, malaria is still the cause of many deaths, particularly among children under 5 years old, casting doubt on the real use of these mosquito nets by parents. The present work aimed to identify the factors associated with the low use of mosquito nets. This was a cross-sectional study with an analytical aim, carried out in the locality of Fô-Bouré (Sinendé) in 2019 among children under 5 years old and their parents. A cluster random sampling was carried out according to the WHO technique. The dependent variable was the low use of LLINs and the independent variables were: socio-demographic, economic, relative to parents’ knowledge of the causes and control methods of malaria. Results: The factors identified as associated with the low use of LLINs were: female sex (p = 0.0059), low level of education (p = 0.0001), free mode of acquisition (p = 0.0476), poor knowledge of control methods (p = 0.0389), type of house: mud or tent house (p = 0.0034), unsanitary immediate environment (p = 0.0002) and children’s evening dressing style (p = 0.0001). Conclusion: A global development policy, especially in terms of education, sanitation and housing improvement as recommended by the “Roll Back Malaria” initiative is necessary to improve the rate of insecticide impregnated nets use. .

关键词： Use LLIN Associated Factors Benin

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Early Morbidity and Mortality in Neonates of Mothers with Sickle Cell Disease at the Borgou/Alibori Center Departmental Teaching Hospital in Benin

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Open Journal of Pediatrics 2023年第3期13卷 437-449页

作者： alphonse noudamadjo Falilatou Agbeille Mohamed Médétinmè Kpanidja Gérard Mahublo Voduhe Justin Chogou Guedenon Romulus Julien Didier Adedemy Joseph Agossou Faculty of Medicine Mother and Child Department University of Parakou Parakou Benin National Training School for Senior Technicians in Public Health and Surveillance University of Parakou Parakou Benin

Introduction: Association of sickle cell disease and pregnancy is a risky situation for both the mother and neonate. Objective: To determine the early morbidity and mortality among neonates of mothers with sickle cell disease at Borgou/Alibori Center Departmental Teaching Hospital (CHUD B/A) in Benin. Patients and Methods: This was a descriptive and analytical observational study conducted at CHUD-B/A from January 1, 2015, to August 31, 2019. It included pregnant women with sickle cell disease who gave birth to a liveborn neonate at the term of at least 28 weeks of amenorrhea. Variables studied were sociodemographic, clinical, and evolutionary. Analysis of the factors associated with early death was also carried out with a significance threshold set at p Results: Out of a total of 119 pregnant women, 95 neonates were recorded. Main morbidities were: prematurity and intrauterine growth restriction (49.5%);respiratory distress (40%), bacterial infection (30.5%), and perinatal asphyxia (21.1%). Early mortality rate was 8.4%. In bivariate analysis, the factors associated with early death were: parity (p < 0.001), the severity of maternal anemia (p < 0.008), birth weight under 1500 g (p < 0.002), the birth term under 32 weeks of amenorrhea (p < 0.001), resuscitation for at least 5 minutes (p = 0.001). In multivariate analysis, resuscitation for at least 5 minutes (p = 0.007) was mainly associated with early death. Conclusion: One out of two neonates of mothers with sickle cell disease has a low birth weight. Early mortality is high due to perinatal asphyxia. Hence the multidisciplinary care of these mothers.

关键词： Early Morbidity Mortality Neonates Mothers Sickle Cell Disease Benin

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Prevalence of Undernutrition among Children Aged 6 - 59 Months in the Municipality of Toucountouna (Benin) in 2017

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Open Journal of Pediatrics 2023年第5期13卷 641-648页

作者： alphonse noudamadjo Falilatou Agbeille Mohamed Mèdétinmè Gérard Kpanidja Myriam Anita Dogo Gado Tchando Julien Didier Adédémy Joseph Agossou Faculty of Medicine Mother and Child Department University of Parakou Parakou Benin Saint Jean de Dieu District General Hospital of Tanguieta Tanguieta Benin National Training School of Higher Technicians in Public Health and Epidemiological Surveillance (ENATSE) University of Parakou Parakou Benin

Introduction: Undernutrition is a public health problem in the world and especially in developing countries. According to the demographic and health survey with multiple indicators of Benin IV (DHS-MICS-IV), the prevalence of acute undernutrition (AU), chronic undernutrition (CU) and that of underweight (UW) was 16%, 45% and 21%, respectively. The objective of this work was to determine the prevalence of undernutrition in children aged 6 to 59 months in the municipality of Toucountouna in 2017. Materials and Methods: This was a descriptive cross-sectional study with two-stage cluster random sampling, composed of 390 children aged 6 to 59 months, living in the municipality of Toucountouna for at least six months. The study variables were: socio-demographic, economic, behavioral, socio-sanitary and anthropometric. Data were entered and analyzed using Epi-info 7.2 software. Results: 203 out of 390 children included, were boys (sex ratio of 1.08). The mean age of the children was 28.70 ± 11.79 months. The prevalence of AU, CU and UW was 10.26%, 31.54% and 11.79%, respectively. Conclusion: The results of this study showed that efforts remain to be made in terms of undernutrition and other surveys could identify the determinants linked to this situation in the locality for the effective implementation of prevention.

关键词： Prevalence Undernutrition Children Benin

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Epidemiological, Clinical, Biological, Therapeutic Features and Outcome of Congenital Malaria at the Borgou Regional University Teaching Hospital (CHUD-B) in Benin in 2015

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Open Journal of Pediatrics 2017年第4期7卷 263-271页

作者： Godonou Gratien Sagbo alphonse noudamadjo Joseph Agossou Julien Didier Adedemy Awade Achille Obossou Djewessi Saturnin Lokossou Faculty of Health Sciences University of Abomey-Calavi Cotonou Benin Faculty of Medicine University of Parakou Parakou Benin

Background: The prevalence of congenital malaria is getting more and more significant in Sub-Saharan Africa where is a malaria-endemic area. This study aimed to identify the clinical and therapeutic features as well as the outcome of congenital malaria in CHUD-B in 2015. Method: It was a cohort and descriptive study with analytical purpose, carried out in the Mother and Child Department which includes the Gynecology & Obstetrics and Pediatric Unit of CHUD-B. The study target population consisted of all the infants born in the CHUD-B as well as their mothers. The main variable was the presence of congenital malaria. The independent variables were those related to clinical, therapeutic features and outcome. Results: In the study, among the 300 newborns registered, 57 carried congenital malaria i.e. a prevalence of 19%. 171 (57.0%) of them were males versus 129 (43.0%) females. Among the 281 mothers involved, 48 presented with malaria in pregnancy i.e. a prevalence of 17.0%. At the end of this research work, the factors associated with congenital malaria were fever in the 3rd quarter and malaria in pregnancy in the mother. Conclusion: Nearly one out of five infants born in the CHUD-B was carrier of congenital malaria and approximately one out six mothers presented with malaria detection during pregnancy. A method based on Polymerase Chain Reaction (PCR) should be implemented during the diagnosis in order to confirm malaria cases among both newborns and mothers.

关键词： Congenital Malaria Outcome Benin

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Frequency and Sociodemographic Factors Associated with Congenital Malaria at the Borgou Regional University Teaching Hospital (CHUD-B) in Benin in 2015

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Open Journal of Pediatrics 2017年第4期7卷 215-221页

作者： noudamadjo alphonse Sagbo G. Gratien Adededmy J. Didier Agossou Joseph Obossou A. Achille Lokossou D. Saturnin Faculty of Medicine University of Parakou Parakou Benin Faculty of Health Sciences of Cotonou University of Abomey-Calavi Cotonou Benin

Background: Every minute a child dies from malaria in Sub-Saharan Africa. Despite this high infant and child mortality associated with malaria, congenital malaria is still not adequately understood as regarding its frequency, severity and management. The objective of this research work was to determine the frequency and identify the socio-demographic factors associated with the onset of congenital malaria at the gynecological and pediatric units of the Borgou Regional Teaching Hospital (CHUD-B) in Benin in 2015. Methods: This study was a cross-sectional survey with analytical purpose, based on exhaustive census performed from April to July 2015 on newborns delivered at CHUD-B and their mothers. The dependent variable was the presence of congenital malaria and the independent variables were socio-demographic characteristics. The data were processed and analyzed using Epi Info software version 7.0 with a significant threshold of 0.05. Findings: The frequency of congenital malaria in newborns was 19%. No sociodemographic factor was associated with congenital malaria. Conclusion: Nearly one in five newborns delivered at CHUD-B had congenital malaria. Due to malaria’s contribution to perinatal morbidity and mortality and subsequent receptivity of child victims to malaria, a longer study covering a whole year and focused on the determinants of congenital malaria should be carried out.

关键词： Congenital Malaria Socio-Demographic Factors Benin

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Neonatal Bacterial Infections in Parakou in 2013

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Open Journal of Pediatrics 2016年第1期6卷 100-108页

作者： Joseph Agossou Marcelline Hounnou-d’Almeida alphonse noudamadjo Julien Didier Adédémy Wèrè Sylvestre Nékoua Blaise Ayivi Mother & Child Department Faculty of Medicine University of Parakou and Borgou Regional University Teaching Hospital in Parakou Parakou Benin Mother & Child Department Faculty of Health Sciences (University of Abomey-Calavi) and National University Teaching Hospital (CNHU-HKM) Cotonou Benin

Objective: Neonatal bacterial infections are a leading cause of mortality in developing countries, including Benin. This study aimed to investigate the epidemiological, clinical and bacteriological aspects of neonatal bacterial infections and their outcomes in the neonatal care unit of the Borgou Regional University Teaching Hospital (CHUD-Borgou). Study design: This manuscript described a cross-sectional study with prospective data collection and an analytical purpose that was performed over the course of 3 months. It was conducted in the neonatal care unit of CHUD-Borgou and focused on 203 newborns who were admitted for suspected bacterial infection. Results: Neonatal bacterial infections accounted for 63.75% of admissions. The sex ratio was 1:1. Prematurity was the main reason for admission (25.1%), and respiratory distress was the most common physical symptom (22.2%). From a bacteriological point of view, 14.7% of blood cultures were positive, and the main isolated pathogens were Escherichia coli (35.8%), Staphylococcus aureus (21.5%) and Klebsiella pneumoniae (14.3%). These pathogens were more sensitive to aminoglycosides than to other antibiotics. Lethality was 21.6%. Place of birth (p -3), age of the newborn at admission (p = 0.003) and maternal history of infectious diseases during pregnancy (p = 0.02) were factors associated with neonatal bacterial infections. Conclusion: This study identified the main pathogens responsible for neonatal bacterial infections and their level of sensitivity to antibiotics. It also determined the different factors associated with neonatal bacterial infections that should be considered in newborn care.

关键词： Infectious Diseases Neonatology Parakou Benin

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Newborn Umbilical Cord Care in Parakou in 2013: Practices and Risks

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Open Journal of Pediatrics 2016年第1期6卷 124-135页

作者： Joseph Agossou Marcelline Hounnou-d’Almeïda Julien Didier Adédémy alphonse noudamadjo Doué Yasmine Gounou N’gobi Blaise Ayivi Department of Mother and Child Faculty of Medicine University of Parakou Parakou Benin Department of Mother and Child Faculty of Health Sciences University of Aboomey-Calavi Cotonou Benin

Objective: The objective was to study umbilical care practices and risks in Parakou (North Benin). Patients and method: It was a cross-sectional and descriptive study carried out within a community from June 1 to August 31, 2013. It focused on all the infants born at the maternity of Parakou Health Center and their mothers. Results: Two hundred and ten newborns were included i.e. 101 boys and 109 girls. In 80.9% of cases, inappropriate substances had been applied to umbilical cord. Umbilical cord care quality was adjudged as poor, acceptable and good in 58.6%, 31.9% and 9.5% of cases respectively. A bacterial umbilical infection had been noted in 59.5% of newborns. Only 4.8% had sterile umbilical wound. The commonest bacteria were: Staphylococcus aureus (58.1%), Staphylococcus saprophiticus (53.3%), Escherichia coli (44.8%) and Pseudomonas aeruginosa (14.3%). The factors associated with umbilical infection were: low educational status of mother (p = 0.026), low-income occupation of mother (p = 0.021), customary practices to accelerate umbilical cord fall off (p = 0.007), short time to cord falling off lower than 6 days (p = 0.015). Conclusion: Umbilical cord care involves high risk for bacterial infection in our context. Strong actions must be taken within the community in order to reduce that risk.

关键词： Umbilical Care Practices Risks Newborn Parakou Benin

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The Determinants of Fatal Outcomes during Severe Malaria in Children at the HKM University Teaching Hospital of Cotonou-Benin

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Open Journal of Pediatrics 2017年第4期7卷 245-253页

作者： Godonou Gratien Sagbo Florence Alihonou Marouf Jules Alao Yevedo Tohodjede Lutecia Zohoun Gilles Bognon Joseph Agossou alphonse noudamadjo Aida Orou-Guidou Pediatric Unit CNHU-HKMCotonouBenin Lagoon Mother and Child Hospital CotonouBenin Hospital of Porto-Novo Porto-NovoBenin Pediatric Unit CHU-BorgouParakouBenin

Introduction: Malaria particularly affects children in sub-Saharan African countries. This study aimed to investigate the factors associated with death in cases of severe childhood malaria to better understand the determinants of death in these children. Patients and Methods: This cohort, descriptive and analytical study was conducted from April 1 to August 15, 2015, at the CNHU-HKM pediatric clinic in Cotonou. Recruitment was exhaustive for all patients under 15 years of age who were admitted for severe malaria, as confirmed by thick smear microscopy. Results: Among the 1774 admitted patients, 449 had severe malaria caused by Plasmodium falciparum (i.e., a hospital frequency of 25.31%). The age group most affected consisted of children younger than 60 months of age (73%);female predominance was noted. The lethality rate of malaria was 13.1% (n = 59). The factors associated with death were coma (p = 0.032), poor convulsive status epilepticus (p = 0.08) and bacterial co-infection by gram negative bacteria (p = 0.021) with respectively correlations coefficient of 0.003, 3.940 and 2.424. Conclusion: Reduction of the malaria mortality rates in Benin hospitals will depend on appropriate management of poor prognostic factors, such as coma, bacterial co-infection and convulsive illness.

关键词： Children Severe Malaria Lethality Neurological Disorders Bacterial Infection

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