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Evaluation of Antibiotic Prescribing in the Pediatric Department of gabriel TouréTeaching Hospital, Bamako, mali

Open Journal of Pediatrics 2024年第3期14卷 645-656页

作者： Pierre Togo Hawa Konaré mariam ma.ga Karamoko Sacko Djénéba Konaté Abdoul Karim Doumbia Adama Dembélé Oumar Coulibaly Aminata Sangaré Mohamed Elmouloud Cissé Fousseyni Traoré belco ma.ga Ibrahim Ahamadou Aminata Doumbia Lala N’Drany Sidibé Amadou Touré Yacouba Aba Coulibaly Kalirou Traoré Tati Simaga Souleymane Sagara Leyla Bagna ma.ga Bory Traoré Abdoul Aziz Diakité Fatoumata Dicko mariam Sylla Sounkalo Dao Boubacar Togo Paediatric Department Gabriel Tour&#233 Teaching Hospital Bamako Mali Pediatric Department Distric VI Reference Health Center Bamako Mali Infectious Diseases Department Point G Teaching Hospital Bamako Mali

Objectives: The main objective was to evaluate antibiotic prescribing in the Department of Pediatrics at gabriel Touré teaching hospital. Methods: This was a prospective descriptive study conducted from September 1 to November 31, 2018, in the Department of Pediatrics at gabriel Touré teaching hospital. All children aged 0 to 15 years hospitalized for any pathology during the study period and having received at least one antibiotic had been included. Results: We collected 445 children’s records out of 1032 admissions during the study period, representing a hospital frequency of 43.1%. The sex ratio was 1.3%. The 2 - 5 age group accounted for 48.1%. Fever was the reason for consultation in 45.6% of cases. Patients’ general condition was altered in 60% of cases. The fathers were blue-collar workers in 65.4% and the mothers housewives in 85%, and had no education in 42.9% and 64.5% respectively. Hepatomegaly was present in 18.2%, splenomegaly in 9.6% and peripheral adenopathy in 3.1%. The site of infection was pulmonary in 37.6% and ENT in 9.2%. Bacterial infection was assumed on admission in 54% of cases, and meningitis in 57.7%. The discharge diagnosis was malaria in 54.6%, severe acute malnutrition in 18.6% and meningitis in 6.7%. The death rate was 3.8%. Neutrophilic leukocytosis was present in 47.3% of patients. CRP was positive in 85% of patients. Blood cultures taken in 27.6% of patients were positive in 5. CSF analysis in 30% of patients showed elevated leukocytes in 6.5%. No cultures were positive. Antibiotic prescription was justified by infectious hypotheses in 43.1% of patients. β-lactam antibiotics were prescribed in 98.6%. Antibiotic therapy was not adapted to national/international recommendations in 68.3% of cases, and was not justified in 16.3% of cases on D5 of hospitalization. Conclusion: Antibiotic use was justified in more than half of patients, but remained inadequate in almost two-thirds of cases, in line with national and international recommend

关键词： Antibiotic Prescription Hospitalization Child

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Factors Associated with Mortality in Children Aged 1 Month to 15 Years Hospitalized in the Pediatric Ward of the Kalaban-Coro Reference Health Center: Cross-Sectional Study

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Open Journal of Pediatrics 2024年第5期14卷 800-813页

作者： Abdoul Salam Diarra Mohamed Diarra Dramane Touré Tawfiq Abu Beyadari Balilé Harber maimouna Kanté Issa Guindo belco ma.ga Karamoko Sacko Kalirou Traoré Fatoumata Dicko mamadou Togo Kalba Pélieba mariam Sylla mamadou Samaké Hamadoun Sangho National Center for Scientific and Technological Research Bamako Mali Department of Pediatric Health Referral Center of Kalaban Coro Koulikoro Mali Pediatric Department of the Mopti Referral Health Center Mopti Mali Private Practice for Family and Emergency Medicine Casablanca Morocco Paediatric Ward of Nianankoro Fomba Hospital Segou Mali Paediatric Ward Referral Health Center of Common V Bamako Mali Administration Department Health Referral Center of Kalaban Coro Koulikoro Mali Department of Paediatrics Gabriel Toure University Hospital Bamako Mali Department of Internal Medicine CHU Gabriel Tour Bamako Mali Service dHpato-gastro-Entrologie Gabriel Toure University Hospital Bamako Mali Department of Public Health Faculty of Medicine and Odontostomatology University of Sciences Techniques and Technologies of Bamako Bamako Mali

Introduction: Infant and child mortality is a worldwide concern, but developing countries such as mali are more affected. The aim of this study was to investigate morbidity and factors associated with mortality in children aged 1 month to 15 years. Methodology: This was a cross-sectional study which took place from January 1 to December 31, 2020 covering children aged 1 month to 15 years hospitalized at the Kalaban-Coro CSRéf. Data were entered into Excel and analyzed using SPSS version 20 software. Results: Five hundred children aged 1 months to 15 years were included. The age range 1 to 5 years (53.6%) and male sex (58.2%) were the most represented. malaria (72.2%), acute respiratory infections (6.2%) and diarrhea/dehydration (3%) were the main morbidities. Mortality was estimated at 10.6%, and the two main causes of death were malaria (56.6%) and acute respiratory infections (7.54%). Univariate analysis revealed a statistically significant association between the dependent variable (death) and age (p Conclusion: This study confirms the high rate of infant and child morbidity and mortality in our health facilities. Strengthening human resources and intensifying behavior-change communication can help reverse the trend.

关键词： Children Aged 1 Months to 15 Years Morbidity Factors Associated with Mortality Morbidity

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Evaluation of Antibiotic Prescribing in the Pediatric Department of gabriel Touré Teaching Hospital, Bamako, mali

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Open Journal of Pediatrics（儿科学期刊） 2024年第3期 645页

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management of Acute Myeloblastic Leukaemia (AML) Treated with Intensive Chemotherapy: Experience in a Single Centre

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Open Journal of Pediatrics 2024年第2期14卷 401-411页

作者： Abdoul Karim Doumbia Hawa Konaré Tati Simaga Pierre Togo Oumoulkairi Nana Kouma Hawa Gouro Diall Oumar Coulibaly Adama Dembélé Mohamed Elmouloud Cissé Karamoko Sacko belco ma.ga Aminata Doumbia Kalirou Traoré Ibrahima Cissé Boury Traoré Abdoul Aziz Diakité Fousseyni Traoré Boubacar Togo Department of Pediatrics University Hospital Gabriel Touré Bamako Mali

Introduction: Acute myeloblastic leukaemia (AML) is a haematological malignancy with a poor prognosis, despite significant therapeutic progress. This study presents the results of AML management in mali according to GFAOP recommendations. Methodology: This was a retrospective, cross-sectional study. It included patients aged 0 - 15 years treated in the paediatric oncology unit for AML and followed up between January 2016 and December 2020. Results: During the study period, 85 cases of acute leukaemia were diagnosed in the paediatric oncology unit (including 51 cases of ALL), of which 34 cases of AML were included in this study. The majority were boys (59%). The mean age was 8 years, with extremes of 18 months and 15 years. The mean time to diagnosis was 68 days. In 79% of cases, patients were referred by 1st or 2nd level hospitals. Anaemia was observed in 91% of cases, an infectious syndrome in 68%, haemorrhage in 56% and a tumour syndrome in 85%. The haemogram showed hyperleukocytosis in 15% of cases, thrombocytosis in 22% and severe anaemia in 73%. Death occurred in 85% of cases, most often in the context of sepsis or haemorrhage. Conclusion: AML is probably underestimated in mali and diagnosis delayed, which may be explained by patient-related factors (lack of knowledge, financial constraints) and a cumbersome referral system. These results suggest the need to implement an appropriate diagnostic and therapeutic strategy, with strong involvement of the political authorities.

关键词： Acute Myeloblastic Leukaemia Children mali

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Fournier’s gangrene in a Child Hospitalised in the Paediatric Emergency Department of the gabriel Touré Teaching Hospital

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Open Journal of Pediatrics 2023年第2期13卷 214-219页

作者： Dembélé Adama Cissé Mohamed Elmouloud Togo Pierre Tall Koureissi ma.ga belco Keïta Djeneba Doumbia Abdoul Karim Coulibaly Oumar Issa Amadou Ahamadou Ibrahim Coulibaly Bakary Traoré Kalirou Togo Boubacar Department of Paediatrics Gabriel Touré Teaching Hospital Bamako Mali Bamako Dermatological Hospital Bamako Mali Department of Paediatric Surgery Bamako Mali

Fournier’s gangrene is a form of necrotizing fasciitis that has multiple causes and is relatively uncommon in children. We report a case of Fournier’s gangrene of infectious origin in a 12-month-old infant following... 详细信息

关键词： Pediatrics Infant Fournier’s gangrene Insect Bite

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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 ma.ga 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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management of Acute Myeloblastic Leukaemia (AML) Treated with Intensive Chemotherapy: Experience in a Single Centre

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Open Journal of Pediatrics（儿科学期刊） 2024年第2期 401页

作者： Abdoul Karim Doumbia Hawa Konaré Tati Simaga Pierre Togo Oumoulkairi Nana Kouma Hawa Gouro Diall Oumar Coulibaly AdamaDembélé Mohamed Elmouloud Cissé Karamoko Sacko belco ma.ga Aminata Doumbia Kalirou Traoré Ibrahima Cissé Boury Traoré Abdoul Aziz Diakité Fousseyni Traoré Boubacar Togo

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Blood Count Characteristics of Children Hospitalized in General Pediatrics at the gabriel Touré Teaching Hospital

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Open Journal of Pediatrics 2023年第4期13卷 543-552页

作者： Pierre Togo Abdoul Karim Doumbia Oumar Coulibaly Abdoul Aziz Diakité Moussa Tembély Adama Dembélé Hawa Gouro Diall Mohamed Elmouloud Cissé Fousseyni Traoré belco ma.ga Karamoko Sacko Djénéba Konaté Ibrahim Ahamadou Fatoumata Léonie Diakité Lala N’Drainy Sidibé Guédiouma Dembélé Oumou Koné Amadou Touré Yacouba Aba Coulibaly Leyla Bagna ma.ga Aminata Doumbia Hawa Konaré Kalirou Traoré Souleymane Sagara Tati Simaga Fatoumata Dicko mariam Sylla Boubacar Togo Department of Pediatrics Gabriel Touré Teaching Hospital Bamako Mali National Institute for Health Science Training Bamako Mali Pediatrics Department Mohamed V Perinatal Clinic Bamako Mali Pediatrics Department DSSA Bamako Mali National Institute of Public Health “NIPH” Bamako Mali

Objective: The main objective was to study the disturbances of the Blood Count of children hospitalized in the general pediatric of the gabriel Touré teaching hospital. Methods: This was a prospective and descriptive study conducted from September 1 to November 30, 2018 in the general pediatrics department of the gabriel Touré teaching hospital in Bamako. Data were collected on patient records using a survey sheet. Results: We collected 512 files of children out of 1030 admissions during the study period;the rate of completion of the blood count is 50%. The male sex was predominant with a sex ratio of 1.3. The majority of patients were under 5 years old (58%). The majority of fathers (56%) and mothers (64%) of children had no education;they are mainly farmers (61%) and housewives (88%). Pallor was the reason for consultation in 29% of patients and present in 60%. On blood count, anemia was present in 92% of patients, half of whom (50%) had severe anemia with a hemoglobin level below 7 g/dL. The anemia was mainly microcytic (72%) and hypochromic (66%). Hyperleukocytosis (62%), eosinophilia (68%) and basophilia (58%) were the abnormalities observed in the white line. Thrombocytopenia accounted for 40%. Severe malaria (53%) was the main discharge diagnosis and almost all patients (99%) were alive at discharge. Conclusion: The characteristics of anemia require a study of the complete blood count in healthy children with dosage of serum iron and ferritin for a better understanding of the phenomenon.

关键词： Characteristic Blood Count Child

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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 ma.ga 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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Congenital Heart Disease in Newborns: Epidemiological and Clinical Particularities in a Neonatology Department in mali

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Open Journal of Pediatrics 2022年第5期12卷 857-866页

作者： Abdoul Karim Doumbia Oumou Koné Adama Dembélé Noumou Sidibé Noel Banou Hawa Gouro Diall Pierre Togo Oumar Coulibaly Karamoko Sacko Djéneba Konaté Tati Simaga Lala Ndrainy Sidibé Fatoumata Léonie Diakité Boubacar Diarra Guédiouma Dembélé belco ma.ga Mohamed Elmouloud Cissé Hawa Konaré Aminata Doumbia Ibrahim Ahamadou Abdoul Aziz Diakité Fatoumata Dicko Traoré Boubacar Togo Department of the CHU gabriel Touré Bamako Mali

Introduction: Congenital heart disease is an important cause of mortality, chronic morbidity, and disability in children in poor countries. The objective of this study was to highlight the diversity of congenital heart defects in the neonatology department. Methodology: This work had taken place in a neonatology service over a period of six months from January 2019 to June 2019. It was a prospective descriptive study with information collected from the medical records of newborns with congenital heart disease. Results: Of 1478 neonates hospitalized during the study period, 41 had congenital heart disease, for a hospitalization rate of 2.77%. CHD accounted for 2.77% of neonatal hospitalizations. The sex ratio was 1.73 (26 boys/15 girls). Consanguinity was found in 19% of cases. The average time to consultation was 11 days. The main clinical signs were heart murmur (58%), respiratory distress (56%) and extracardiac malformations (54%). The main cardiac malformations found were atrial septal defect (46%), patent ductus arteriosus (44%), ventricular septal defect (17%), complete atrioventricular canal (15%), and transposition of the great vessels (5%). The case fatality rate was 29%. Conclusion: Delayed diagnosis, generally related to the long delay in consultation, and lack of surgical management partly explain this high case fatality.

关键词： Congenital Heart Disease Neonates management

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