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Infantile Spinal Muscular Atrophy at the Albert Royer National Children’s Hospital Center in Dakar

Open Journal of Pediatrics 2024年第3期14卷 514-521页

作者： Guillaye Diagne Khadim Bop Sofiatou Dieye Arame Faye Fatou Ly amadou lamine fall Pediatrics Ward of Pikine Hospital Pikine Senegal Pé diatrics Ward of Albert Royer National Hospital Dakar Senegal

Introduction: Infantile spinal muscular atrophy (ISA) is an autosomal recessive disease caused by primary degeneration of cells in the anterior horn of the spinal cord, leading to muscle weakness and hypotonia. Its incidence is estimated at 1 in 6000 births worldwide. In Africa, particularly in Senegal, there are few studies interested on this pathology. We therefore deemed this study necessary, which set itself the objective of describing the diagnostic, therapeutic and progressive aspects of infantile spinal muscular atrophy at the Albert Royer National Children’s Hospital Center in Dakar (CHNEAR). Methodology: We conducted a retrospective descriptive study over a period of two (2) years from December 2020 to December 2022. Included were all hospitalized patients in whom the diagnosis of spinal muscular atrophy was made with or without genetic confirmation. The data were collected on a pre-established form then entered and analyzed with the following software: Excel 2013 and R version 4.1.3. Results: During our study period, 2100 children were hospitalized, the annual incidence was 0.76%. The average age of our patients was 9 ± 9 months with a range of 3 months to 32 months and the median was 6.5 months. The sex ratio was 7. The notion of family consanguinity was found in 62.5% of cases and the notion of ISA in the family in 25% of cases. Hypotonia and respiratory distress were found at the forefront in equal proportions (50% of cases). Electromyogram (EMG) was performed in 3 patients (37.5%). Symptomatic medical treatment was administered in 100% of patients, 04 patients had benefited from respiratory physiotherapy, i.e. 50% of cases, and genetic counseling was carried out in one patient (12.5%). The evolution was immediately favorable in 2 patients or 25% of cases, unfavorable in 75% of cases with a death rate of 50% and the average age of death was 5.5 months ± 1 with extremes ranging from 3 to 7 months. Conclusion: The number of Infantile spinal muscular atrop

关键词： Spinal Muscular Atrophy Child Hypotonia Dakar

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Rheumatic Heart Disease in Children: Epidemiological Aspects. Diagnostic and Evolutive at the Dakar Chu

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Open Journal of Pediatrics 2023年第3期13卷 304-312页

作者： Guillaye Diagne Khadim Bop Sadio Konate Papa Souley Sow amadou lamine fall Albert Royer National Hospital Center Dakar Senegal

Rheumatic heart disease is the ultimate consequence of acute articular rheumatism. It remains a public health problem in developing countries. It is a pathology found in all countries of the world, with a clear predominance in developing countries. In Senegal, the hospital prevalence of rheumatic heart disease is 30.5%. Its seriousness lies in the risk of valvular sequel responsible for cardiac dysfunction that can lead to death. The objective of this study was to describe the epidemiological, diagnostic and evolutionary aspects of rheumatic heart disease at the Albert Royer National Hospital Center of child (CHNEAR). We had carried out a retrospective, descriptive and analytical study lasting 3 years from January 1, 2017 to December 31, 2019. All children aged 4 to 17 hospitalized at CHNEAR for rheumatic heart disease were included. The hospital prevalence was 0.8%. The average age was 10.9 years with a sex ratio of 0.875 in favor of girls. 85.47% of cases came from parents who had a low economic level of life. The history of repeated angina and acute articular rhumatism (AAR) was found respectively in 22.69 and 15.13% of cases. The clinical symptomatology was dominated by heart failure with 58.3% of cases, arthralgia in 7.5% of cases. The biological inflammatory syndrome was found in 86.1%. 73% of the patients had a positive antistreptolysin O antibody (ASLO). Cardiomegaly was found in 89.7%. Heart doppler ultrasound found polyvalvular involvement in more than half of the cases. Mitral insufficiency was the predominant valve disease in 98.20% of cases. The evolution was favorable in the majority of cases but 9.32% of deaths were observed.

关键词： Rheumatic Heart Disease Child CHNEAR

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Pulmonary Arterial Hypertension in Congenital Heart Disease with Left-to-Right Shunt: According to a Retrospective Study at Albert Royer’s National Children’s Hospital Center

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Open Journal of Pediatrics 2023年第5期13卷 649-656页

作者： Aliou Mar Coundoul Khadim Bop Abdou Aziz Faye amadou lamine fall Idrissa Demba Ba Papa Mactar Faye Department of Cardiology Albert Royer’s National Children’s Hospital Dakar Senegal Pediatric Ward Abass Ndao Hospital Center Dakar Senegal

Pulmonary arterial hypertension PAH is a progressive disease characterized by an increase in pulmonary arterial pressure and resistance. It often complicates congenital heart disease with a left-to-right shunt. The objective of this study is to evaluate the evolutionary profile of the pulmonary pressures of children with congenital heart disease with left-to-right shunt and to identify the factors favoring an evolution towards PAH. This is a retrospective, descriptive and analytical study over a period of four years and six months (from January 1, 2016 to June 30, 2020) at the Center National d’Enfant Albert Royer in Dakar on a series of 87 cases. The hospital frequency was 3.98 per thousand, and the incidence of PAH was 9.44%. The sex ratio of 0.74. The average age was 44.76 months. The average time between the onset of symptoms and the diagnosis of heart disease is 78.81 days. Dyspnea was found in 70.11% of cases, the burst of pulmonary B2 was found in 55%. Global heart failure was noted in 39.08% of cases. Cardiomegaly was found in 89.66% and pulmonary hypervascularization was found in 57.72% of cases. CIV was present in 54.02% of cases, followed by PCA in 21.14% and CAVc in 18.39% of cases. furosemide was used in 97.70% of cases and Captopril in 74.71% of cases. Sildenafil was used in 10.34% of patients, and 12.64% of patients benefited from surgical management. Eisenmenger syndrome was found in 12.64% of patients. PAH in these heart diseases is a formidable and frequent complication, due to an increase in precapillary flow. The major improvement in mortality and morbidity is early surgical management, in the first months of life, to prevent pulmonary vascular disease.

关键词： PAH Left-to-Right Shunt Einsenmenger Syndrome

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Particularities of Tuberculosis in Children and Adolescents with Sickle Cell Disease in Senegal

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Open Journal of Pediatrics 2022年第1期12卷 59-66页

作者： Idrissa Demba Ba Indou Deme/Ly Yaye Joor Dieng Abou Ba Babacar Niang Aliou Abdoulaye Ndongo Papa Moctar Faye Guillaye Diagne amadou Sow Fatima Tall/fall amadou lamine fall Ousmane Ndiaye Hô pital d’enfants Albert-Royer de Fann-Dakar Université Cheikh Anta Diop de Dakar Fann Dakar Senegal

Introduction: Tuberculosis and sickle cell disease are one of the main global health priorities particularly in Africa. We aimed to determine the epidemiological, diagnostic and therapeutic aspects of tuberculosis in children and adolescents with sickle cell disease. Patients and methods: Patients aged 0 - 20 years with sickle cell anemia presented with tuberculosis at the Centre Hospitalier National d’Enfants Albert Royer (CHNEAR), Dakar, Senegal were included in the study. Medical history, risk factors, clinical, bacteriological, and outcome data was collected. Data was analyzed using the SPSS software, version 16. Results: A total of 25 cases of tuberculosis were documented from January 1st, 1991 to December 31st, 2019 (hospital prevalence: 0.97%). Mean age was 12.5 years. The sex ratio was 1.5 (15 girls and 10 boys). Pulmonary tuberculosis in 14 cases was the most frequent followed by lymph nodes in 7 cases involvement and Pott’s disease in 4 cases. In 5 patients Tb was multifocal. Mean duration of treatment was 8.27 months (6 to 12 months). Outcome was good on antituberculosis treatment. None patient died. Conclusion: Children and adolescents with sickle cell disease can be infected with Mycobacterium tuberculosis. Pulmonary tuberculosis, lymph nodes and bone involvement are the most frequent localizations. Outcome is good on antituberculosis treatment.

关键词： Tuberculosis Sickle Cell Disease Children Adolescent Senegal

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Congenital Heart Disease in Rural Senegal: A Retrospective Study of 79 Patients

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Open Journal of Pediatrics 2023年第1期13卷 43-49页

作者： Babacar Niang Aminata Mbaye Djibril Boiro Aliou Abdoulaye Ndongo Mame Diarra Thiam Aliou Thiongane Modou Guéye amadou lamine fall Ousmane Ndiaye Albert Royer Children’s Hospital Dakar Sénégal Abass Ndao Hospital Dakar Sénégal

Introduction: Congenital heart disease (CHD) is a malformation of the heart present at birth and resulting from a developmental defect during embryonic life. The aim was to assess CHD in rural areas. Methodology: This is a retrospective study conducted over a period of 2 years in rural Senegal. Results: During the study period, we collected 79 patients with CHD, representing a hospital prevalence of 2.6%. The mean age at diagnosis was 17.05 months and the sex ratio was 1.19. The mean birth weight was 2826 g. The main comorbidities were anaemia (54.43%) and respiratory infections 38 cases (48.10%). Respiratory distress was the most common sign with 98.73%. Radiological cardiomegaly was noted in 86.7%. The most frequent CHD were interventricular septal defect (IVD) 21.51% and atrial septal defect (ASD) 8.86%. No patient was able to receive surgical treatment. Seven children died (8.86%) and 21 children were lost to follow-up (26.58%). On Doppler echocardiography, 16.45% of the patients had pulmonary arterial hypertension (PAH). Conclusion: In light of this work, emphasis should be placed on the quality of antenatal consultations, the quality of management and the regular availability of echocardiography and a cardio-paediatrician in order to reduce morbidity and mortality.

关键词： Heart Disease Congenital Children Senegal

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Cardiac Echography in Pediatrics at the Regional Hospital of Diourbel: Indication and Result

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World Journal of Cardiovascular Diseases 2023年第9期13卷 556-564页

作者： Aliou Mar Coundoul Abdou Aziz Faye Khadim Bop amadou lamine fall Papa Moctar Faye Ndeye Fatou Boye Ndeye Tenning Faye Ousmane Ndiaye Pediatric Service Cheikh Ahmadoul Khadim National Hospital Center of Touba Diourbel Diourbel Senegal Albert Royer National Hospital Center Dakar Senegal Henrich Lû ckbe Center Diourbel Senegal

Childhood heart disease is a real public health problem. In our contexts, care remains a major challenge. Doppler echocardiography remains the essential examination for diagnosis. The objective of our study was to describe the different clinical indications for cardiac ultrasound in children and the main pediatric heart diseases at the Diourbel Heinrich Lübke Regional Hospital. This was a descriptive and analytical retrospective study spanning from 2020 to 2022;covering a series of 140 cases. The study was carried out using patient clinical observation sheets and consultation sheets. We identified 140 ultrasounds. The average age of patients was 35.96 months with extremes of 0.03 months and 192 months. The female sex was predominant, with an M/F sex ratio of 0.72. Ultrasound was systematically requested in 67.14% of the study population. The indications found were mainly: heart murmur, polymalformative syndrome, respiratory failure, bronchiolitis, cardiomegaly, suspicion of heart disease, cardiomegaly, pre-therapeutic and pre-operative assessment. A total of 71 cardiac abnormalities were found in 65 patients, i.e. a prevalence of 46.42%. Congenital heart disease was more frequent (found in 49 patients, a prevalence of 35%) and was dominated by the CIA. There was a female predominance in almost all heart diseases except in the case of endocarditis where codominance is found. Our study has made it possible, through echocardiography, to evaluate the indications for echocardiography in children, to determine the prevalence of heart disease in children and also to assess the relevance of requests for echocardiography.

关键词： Echocardiography Pediatrics Indications Diourbel

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Epidemiology of Admissions in a Pediatric Emergency Department in Albert Royer Hospital Dakar

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Open Journal of Pediatrics 2022年第1期12卷 188-195页

作者： Aliou Thiongane Aliou Abdoulaye Ndongo amadou Sow Younoussa Keita Djibril Boiro Yaye Joor Dieng Idrissa Basse Ndiogou Seck Lisimo Abwa Hilaire Papa Moctar Faye amadou lamine fall Assane Sylla Saliou Diouf Ousmane Ndiaye Centre Hospitalier National d’Enfants Albert Royer Dakar Sénégal Service de pédiatrie Hô pital Le Dantec Dakar Sénégal Service de pédiatrie Hô pital Abass ndao Dakar Sénégal Centre Hospitalier National d’Enfants de Diamniadio Dakar Sénégal Service de pédiatrie Hô pital régional Saint Louis Sénégal Service de pédiatrie Hô pital Dalal Jamm Dakar Sénégal

Background: Pediatric emergencies are a public health priority in Senegal. The objective was to describe the epidemiology of admissions to the emergency department of the Albert Royer National Children’s Hospital in Dakar, Senegal. Methods: Prospective, descriptive and analytical study over a period of 4 months (January-April 2020). The study population was children admitted for vital distress. Results: A total of 300 children met the inclusion criteria and represented the study population (2.83%). The majority (70.67%) were younger than 60 months, compared with 2.00% of newborns. Boys represented 53.8%, sex ratio 1.16. A proportion of 35.1% was referred. More than half of our patients (55.88%) were managed within 30 minutes of arrival. Medicalized transport concerned 21.5% against 78.5% of nonmedicalized. Emergencies were dominated by respiratory distress (56.33%), dehydration (29%) and shock (13.33%). We recorded 16 deaths (5.3%). This mortality was significantly related to the low socio-economic level (p = 0.000), as well as the young age of the children (p = 0.01). Conclusion: Life-threatening emergencies are frequent and responsible for significant lethality. Health policy efforts are still needed to reduce this infant and child morbidity and mortality.

关键词： Children Emergencies Morbidity Mortality

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Ischemic Stroke Complicating Neuromeningeal and Pulmonary Tuberculosis in Children: About a Case in Senegal

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Open Journal of Pediatrics 2023年第1期13卷 92-96页

作者： Papa Souleye Sow Khadim Bop Khalifa Ababacar Mbaye Guillaye Diagne Pape Malick Dibor Diouf Idrissa Demba Ba Papa Moctar Faye amadou lamine fall Ousmane Ndiaye National Hospital Center of Children Albert Royer Dakar Sénégal National Hospital Center of Fann Dakar Sénégal

Tuberculosis is a major public health problem, especially in developing countries. Neuro-meningeal involvement is rare but represents one of the most severe forms with high morbidity and mortality. We report the case of an ischemic stroke complicating neuromeningeal and pulmonary tuberculosis in a four-month-old infant at the National Hospital Center of children Albert Royer (Senegal). The case was a four-month-old, male infant with no history. His vaccination was up to date according to Senegal’s expanded vaccination program. There was no notion of tuberculosis contagion. He was seen for a prolonged fever for more than a month and chronic cough. He had moderate malnutrition. Neurological examination revealed coma, meningeal syndrome, generalized tonic convulsions and hypertonia. The pupils were in bilateral miosis. Osteotendinous reflexes were abolished with a bilateral Babinski sign. He also had severe respiratory distress, bilateral pulmonary condensation syndrome. Brain computed tomography was in favor of an ischemic stroke. The test GeneXpert MTB/RIF was positive on cerebrospinal fluid and gastric tubing fluid. The curative treatment was based on a quadruple therapy based on rifampicin, isoniazid, pirazinamide and ethambutol. The evolution was unfavorable with the death of the patient.

关键词： Tuberculosis Meningitis Child Senegal

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Malaria Characteristics in Children with Sickle Cell Disease

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Open Journal of Pediatrics 2022年第1期12卷 125-130页

作者： Indou Deme/Ly Cheikh Binetou fall Awa Kane Ibrahima Diop Aminata Mbaye Yaaye Joor Dieng Denika Estelle Liapoui Idrissa Demba Ba Abou Ba Aliou Thiongane Papa Moctar Faye amadou lamine fall Ibrahima Diagne Ousmane Ndiaye Cheikh Anta Diop University Dakar Senegal Gaston Berger University Saint-Louis Senegal

Background: The relationship between sickle cell disease and malaria is the subject of much controversy. However, there is a lack of data in our services. Our objective was to study the epidemiological, diagnostic and evolutionary characteristics of malaria in children with sickle cell disease followed in a specialized setting. Patients and Methods: We conducted a retrospective, descriptive, and analytical study of children with sickle cell disease (SCD) who presented with malaria and were followed at the Ambulatory Care Unit for Sickle Cell Children and Adolescents (USAD) at the Albert Royer National Children’s Hospital in Dakar, from January 1st, 2017, to December 31th, 2019. We included all the followed pediatric patients, less than 16 years, with sickle cell disease who presented at least one episode of malaria, confirmed by a positive thick drop, during this 3 years. We did not include patients with incomplete records or those older than 16 years. The clinical and biological signs, the follow up was collected and analyzed with Excel package 2019. Results: Of 3773 patients followed for sickle cell disease, 21 had presented malaria. The frequency was 0.5% or 7 cases/year. However, we exploited the data of 14 of them. The sex ratio was 6 boys for a girl and the mean age at admission was 7.3 years. The highest number of malaria cases was observed in 2018 and the peak frequency was observed in November with 8 cases (57.1%). Fever was the most frequent symptom, observed in 10 patients (71.4%). All patients were SS homozygous, with a mean baseline hemoglobin level of 7.5g/dl. All patients had a positive thick blood smear and Plasmodium falciparum was the only species found in the blood smear, with a mean parasite density of 1693 parasites/ml of blood. All patients had anemia, with a mean hemoglobin level of 7.74 g/dl. Twelve patients (85.7%) were hospitalized and had all received injectable artesunate followed by oral Artemisinin Combination Ther

关键词： Malaria Sickle Cell Disease Children

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Descriptive and Analytical Study of Factors Associated with Mortality in Severe Malaria among Children in Dakar Emergency Departments from July to December 2022

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Open Journal of Pediatrics 2023年第6期13卷 866-878页

作者： Aliou Thiongane Abou Ba Fatou Ly Aliou A. Ndongo Djibril Boiro Younoussa Kéita Idrissa Basse Babacar Niang Indou Dême Ly Yaye Joor Dieng Djenaba Fafa Cissé Ndiogou Seck lamine Thiam Papa Moctar Faye amadou lamine fall Assane Sylla Ousmane Ndiaye Centre Hospitalier National d’Enfants Albert Royer Dakar Sénégal Service de pédiatrie Hô pital Dalal Jamm Dakar Sénégal Service de pédiatrie Hô pital Pikine Dakar Sénégal Service de pédiatrie Hô pital Abass Ndao Dakar Sénégal Centre Hospitalier National d’Enfants de Diamniadio Dakar Sénégal Service de pédiatrie Hô pital régional Saint Louis Sénégal Service de pédiatrie Hô pital de la paix de Ziguinchor Ziguinchor Sénégal

Background: Malaria is the most widespread parasitic disease and remains a public health priority worldwide. The severe form is fatal if not treated early and appropriately. The aim was to carry out a descriptive and analytical study of the factors associated with mortality during severe malaria in children attending emergency departments in Dakar, Senegal. Methods: This is a prospective, observational and analytical study conducted over a 6-month period (July 1 to December 31, 2022), focusing on children hospitalized for severe malaria according to WHO severity criteria. Results: A total of 403 patients were hospitalized, including 78 cases of severe malaria (19.35%). Males predominated (60.26%) (sex ratio 1.51). The average age was 6.56 years [8 months - 14 years], with the [5 - 10 years] age group the most represented (40.26%). The average consultation time was 5.33 days (1 - 19 days). The main reasons for consultation were fever (70.51%), vomiting (24.35%) and convulsions (14.10%). Biological signs of severity were severe anemia (17.95%), renal failure (6.4%) and hypoglycemia (3.85%). Thrombocytopenia was noted in 52.56% of patients, including 32.05% of severe cases (sis in 61.41% of cases. Hyponatremia was noted in 39.74% of cases and hyperkalemia in 2 patients. Artesunate was the main drug used (93.59% of cases). Mortality was estimated at 1.5%. Factors leading to death were coma (P < 0.01), respiratory distress (P Conclusion: Malaria is still a public health problem, with a high mortality rate in emergency departments. Reducing this mortality rate requires effective management of the factors associated with death.

关键词： Children Malaria Death Factors

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