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Epidemiological, Clinical and Evolutionary Aspects of Human African Trypanosomiasis in Children in Nola

Open Journal of Pediatrics 2024年第2期14卷 344-358页

作者： Brice Olivier Bogning Mejiozem Gaspard Tékpa Synthia Ningatoloum Nazita Jocelyn Tony Nengom Danebera Lydie Verlaine carine judith kiteze nguinzanémou Rostand Juste Koyangboi Kombaya Iris Vanessa Gaspiet Sonny Jean Chrysostome Gody Complexe Hospitalier Pédiatrique de Bangui Bangui République Centrafricaine Service des Maladies Infectieuses H&#244pital de l’Amitié Bangui République Centrafricaine Faculté des Sciences de la Santé de l’Université de Bangui Bangui République Centrafricaine Centre Hospitalo Universitaire Communautaire de Bangui Bangui République Centrafricaine Faculté de Médecineet des Sciences Biomédicales Université de Yaoundé 1 Yaoundé Cameroun

Background: Human African trypanosomiasis (HAT) occurs in three historical foci in the Central African Republic. Objective: To describe the morbi-mortality of childhood HAT in rural Central African Republic with the aim of early management. Methods: Descriptive and analytic cross-sectional study conducted from January 1, 2017 to March 30, 2018 at Nola prefectural hospital. This study was included all children seen as outpatients and/or hospitalized in the pediatric wards, in whom the diagnosis of HAT was confirmed. Statistical analysis was performed using Epi-info software. Results: Forty children were included from Bilolo (60%), Nola (30%) and Salo (10%). The sex ratio was 0.66 with a median age of 8.65 ± 12.48 years. Fever (82.5%), nocturnal insomnia (75%), daytime somnolence (67.5%), headache (65%), polyarthralgia (62.5%), convulsions 52.5% (n = 21), tremor (27.5%), trypanidism (7.5%) and delirium (2.5%) were the main functional signs. Examination signs were adenopathy (52.5%), paresthesia (30%), decreased cutaneous-abdominal reflexes (25%) and osteoarticular reflexes (17.5%), hyperesthesia (20%), extrapyramidal hypertonia (15%) and depression (2.5%). The children were in the lymphatic-blood phase in 65% of cases, and meningoencephalitis in 35%. Pentamidine was administered in 65% of cases. Four children died and 6 had neurological sequelae. There was an association between age under 5, Bilolo’s focus, the children’s history and the severity of the disease. Age under 5, gender, household, children’s activity, history and occurrence of sequelae were also associated. Conclusion: HAT remains a permanent threat to Central African children. Any clinical presentation combining long-term infectious signs and unexplained neurological or neuropsychological disorders must be treated with caution.

关键词： Morbidity-Mortality Child HAT Nola CAR

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Epidemiological, Clinical, Bacteriological and Evolutionary Profiles of Bacterial Meningitis in Children in Bangui (CAR)

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Open Journal of Pediatrics 2023年第4期13卷 553-561页

作者： Synthia Ningatoloum Nazita Simplice Cyriaque Kango carine judith kiteze nguinzanémou Rostand Juste Koyangboi Kombaya Iris Vanessa Gaspiet Sonny Brice Olivier Bogning Mejiozem Franck Houndjahoue Jean Chrysostome Gody Centre Hospitalo Universitaire Communautaire de Bangui Bangui République Centrafricaine Faculté des Sciences de la Santé de l’Université de Bangui Bangui République Centrafricaine Complexe Hospitalo Universitaire Pédiatrique de Bangui Bangui République Centrafricaine

Background: Bacterial meningitis is a major public health problem worldwide due to its severity. It is a vaccine-preventable disease. Methodology: It was a retrospective descriptive study conducted at the Pediatric Teaching Hospital of Bangui from June 2019 to May 2021. Children aged 1 month to 15 years hospitalized for bacterial meningitis were included in the study. Data were entered and analyzed using Stata/IC version 16.1. Results: Of 2490 patients hospitalized during the study period, 122 (4.9%) had bacterial meningitis. The patients were male in 54.92% of cases with a sex ratio of 1.21. The mean age was 35.95 months ± 49.16. Most of the patients (84.42%) came directly from home. The average consultation delay was 3.4 days ± 2.6. The vaccination coverage was 56.55%. The CSF study isolated germs from 24 patients (19.67%), the main ones being S. pneumoniae (75%) and H. influenzae (16.67%). Ceftriaxone was prescribed alone or in combination in all cases as first-line treatment. The average duration of antibiotic therapy was 8.95 days. The mortality rate was 27.87% and 12.30 % of patients had sequelae. Conclusion: Bacterial meningitis is common in Bangui and still poses a public health problem despite the introduction of new vaccines in the EPI. Improving vaccination coverage and raising awareness for early consultation could improve the situation.

关键词： Bacterial Meningitis Child Bangui

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