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Etiological Factors of Infective Endocarditis in Children Aged 1 Month to 15 Years Hospitalised in the Paediatric Department of CHU Gabriel Touréof Bamako (Mali)

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World Journal of Cardiovascular Surgery 2022年第2期12卷 13-20页

作者： Maiga Belco Sacko Karamoko Konaté Djéneba Diakité Abdoul Aziz Dembélé Adama Cissé Mohamed Elmouloud DansoKo Nassira Traoré Kalilou Togo Pierre Doumbia Abdou Karim Traoré Fousseini Diakité Fatoumata Léonie Sidibé Lalla Maiga Leila Ahmadou Ibrahim coulibaly oumar Diall Hawa Sylla Mariam Department of Pediatrics CHU Gabriel Touré Bamako Mali

Introduction: In emerging countries where studies are rarer, the epidemiological profile of infective endocarditis resembles that of developed countries at the beginning of the antibiotic era. There is little data available in Mali on this subject, motivating this study, the aim of which was to study the etiological factors of infective endocarditis in children aged between 1 month and 15 years hospitalised in the paediatric department of the CHU Gabriel Touré. Patients and Methods: We conducted a cross-sectional and descriptive study, which took place from August 2018 to August 2019 (13 months), in children aged between 1 month and 15 years hospitalised in the paediatric department of the Gabriel Touré University Hospital with an ultrasound- confirmed cardiac disease and a temperature above 38°C. Results: The hospitalization rate was 0.4%. The average age was 11 months, the sex ratio was 1.35. Respiratory distress (63.6%) and fever (30.3%) were the most common reasons for referral. Congenital heart disease (87.9%) and dyspnoea on feeding (24.2%) were the most common medical histories. IVC was the most frequent congenital heart disease (36.4%). The mean temperature was 39.1°C. Blood cultures were taken in 24 patients (72.7%) and were positive in 27.3%. Staphylococcus aureus was found in 55.6% of cases. Trans-thoracic ultrasound found vegetations in 03 cases. According to the modified DUKE criteria, the diagnosis of endocarditis was retained in 27.30%. The evolution was marked by a high case fatality rate (45.45%). Conclusion: Endocarditis is an uncommon disease in children with a pulmonary portal of entry and Staphylococcus aureus as the main germ. Its mortality remains high.

关键词： Infective Endocarditis Etiological Factors Pediatrics Bamako

Become Immediate of Newborns Operated in the Neonatology Department of the Hospital and University Center Gabriel Toure of Bamako (Mali)

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Open Journal of Pediatrics 2022年第1期12卷 12-18页

作者： oumar coulibaly Hawa Gouro Diall Pierre Togo Hawa Camara Fatoumata Léonie Françoise Diakité Lala Ndrayni Sidibé Leyla Maiga Ibrahima Ahamadou Abdoul Karim Doumbia Adama Dembelé Belco Maiga Karamoko Sacko Mohamed Elmouloud Cissé Djeneba Konaté Fousseyni Traoré Yacouba Aba coulibaly Issa Amadou Touré Hamadi Sissoko Mariam Maiga Alou Samake Bourama Kané Guédiouma Dembelé Abdoul Aziz Diakité Fatoumata Dicko Traoré Mariam Sylla Boubacar Togo Neonatology Department of the Gabriel Touré CHU Bamako Mali Pediatric Surgery Department of the Gabriel Touré CHU Bamako Mali Reference Health Center of the Municipality III Bamako Mali Reference Health Center of the Municipality VI Bamako Mali Mali Hospital Bamako Mali

Neonatal surgical pathologies in developing countries are characterized by high mortality. The aim of this work was to describe the characteristics of the newborn and its surgical pathologies treated in the neonatal department of the Gabriel Touré University Hospital in Bamako (Mali). Patients and method: This is a retrospective study of 626 files of newborns hospitalized over a period of 3 years (January 2016 to December 2018) for a surgical pathology, whether operated on or not. We have studied the etiological, therapeutic and evolutionary aspects. Results: During the study period, we collected 626 patients who had surgical pathology, i.e. a frequency of 5.35%. The average therapeutic consultation time was 2 days with extremes (1 and 30 days). Pathologies of the abdominal wall and digestive tract represented 57.9% (n = 84) followed by pathologies of the spine 26.9% (n = 39). The mean treatment time was 4.5 days. Twenty-three point sixteen (23.16%) newborns could be operated on. The neonatal mortality rate was 12.4% (n = 18). Mortality was postoperative (100%) with a mean time to onset of 5 days. Abdominal wall pathologies were responsible for 8.7% (n = 13) of deaths. Conclusion: Surgical pathologies of the newborn are characterized by delayed treatment with high mortality. Improving their prognosis requires early diagnosis (prenatal diagnosis) and adequate management.

关键词： Newborn Surgical Pathologies Mortality

Epidemiological and Clinical Aspects of Congenital Hydrocephalus in the Neonatal Department of Gabriel TouréTeaching Hospital Bamako Mali

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Open Journal of Pediatrics 2022年第1期12卷 1-11页

作者： Hawa G. Diall oumar coulibaly Youssouf Sogoba Hatouma Sylla Yacouba A. coulibaly Fatoumata L. Diakité Lala N. Sidibé Ibrahima Ahamadou Leyla Maiga Abdoul K. Doumbia Pierre Togo Adama Dembélé Mohamed E. Cissé Fousseini Traoré Belco Maiga Karamoko Sacko Djeneba Konaté Bourama Kané Oumou Koné Guedjouma Dembélé Abdoul A. Diakité Drissa Kanikomo Fatoumata D. Traoré Mariam Sylla Boubacar Togo Department of Pediatrics CHU Gabriel Touré Bamako Mali Department of Neurosurgery CHU Gabriel Touré Bamako Mali Department of Pediatrics Hospital Mali Bamako Mali National Institute of Public Health Bamako Mali

Objective: The aim of our work was to access the epidemiological and clinical aspects of congenital hydrocephalus in the pediatrics department of Gabriel Touré teaching Hospital Bamako. Methods: We conducted a retro and prospective study that ran from January, 1st 2018 to July, 30, 2019. All newborns of 72 hours of life or less with hydrocephalus confirmed by sonography or CT scan were enrolled in this study. Results: During the study period, 5416 patients were hospitalized in the neonatology department. Among them, 39 patients (0.72%) presented congenital hydrocephalus and congenital infectious causes accounted for 25.6%. The sex ratio (M/F) was 1.78. Mothers were housewives and not educated in 79.5% and 64.1% respectively. The parents resided outside Bamako in 61.5% of cases. Prenatal consultations were conducted in 32 patients (82%). Consanguinity between the 2 parents was present in 38.5%. The antenatal diagnosis was made in 8 patients (20.5%). Vaginal delivery was the main mode of birth (67%). The average birth weight was 2930 g (1000 to 5400 g) and the average head circumference was 37.82 cm (26 - 55 cm). In 87.2% of cases, newborns were eutrophic. The main clinical signs were bulging anterior fontanel (46.2%), sunset gaze (20.5%), prominent forehead (48.7%), reduced face (20.5%), enlarged cranial sutures (43.6%), macrocrania (25.6%). Transfontanellar ultrasound and CT scan were performed in 51.3% and 48.7% of cases respectively. Associated malformations were spina bifida in 30.8% of cases followed by Dandy Walker malformation (5.1%), and omphalocele (2.5%). The neurological signs were diminished neonatal reflexes (51.3%), hypotonia (30.8%), motor deficit (38.4%), intracranial hypertension (25.6%), seizures 10.25% and psychomotor delay (43.6%). Surgery was performed in 8 neonates (20.5%). Ventriculo-peritoneal shunt (VPB) was the main treatment. Postoperative complications were infectious (37.5%) and mechanical complications (12.5%). The postoperative mortalit

关键词： Newborn Congenital Hydrocephalus Mortality Gabriel Toure

Profile and Antibiotic Sensitivity of Acute Pyelonephritis in Children at Gabriel Toure Teaching Hospital, Bamako

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Open Journal of Pediatrics 2020年第1期10卷 94-108页

作者： Djeneba Konate Lala N’Driany Sidibe Karamoko Sacko Bakary Kone Adama Kone Aminata Doumbia Fatoumata Tiero Pierre Togo Fatouamata Leonie Diakite Abdoul Karim Doumbia Belco Maiga Fousseyni Traore Aamadou Toure Hawa Diall Mohamed Elmouhouloud Cisse Adama Dembele oumar coulibaly Yacouba Aba coulibaly H.Konare Isabelle Traore Guediouma Dembele Issiaka Kone Leyla Maiga Ibrahima Ahamadou Abdoul Aziz Diakite Boubacar Togo Mariam Sylla Fatoumata Dicko-Traore Pediatric Department CHU Gabriel ToureBamakoMali Pediatric Unit Hospital Center Mother-ChildLuxembourgLuxembourg

Background: Very common symptom in children, fever, perhaps a warning sign of more or less severe pathology, rapidly progressive, including an invasive bacterial infection such as acute pyelonephritis (APN). The aim of this work was to study the bacteriological profile and antibiotic sensitivity of APN in children. Methods: A prospective study involving any infant or child aged 3 months to 15 years with an acute fever (≥38°C) in which a urine test strip was performed in the pediatric department of the teaching hospital Gabriel Toure between April 1st and May 15th, 2019 (45 days). Results: 124 children were included out of 244 febrile patients. Infants (3 - 23 months) predominated (52.8%) with a sex ratio of 2. Seventy-five percent of children came directly from home and 30.6% were on antibiotic prior to admission. The urine bag sample was taken in 55.6% and the urine was macroscopically cloudy in 32.3%. Stigmas of urinary tract infection at the urinary strip were present in 56.5%. Confirmation of acute pyelonephritis (APN) by CytoBacteriological Urine Examination (CBUE) was 29% with Escherichia coli (63.9%) or Enterococcus faecalis (30.5%). Sensitivity was excellent for ciprofloxacin and imipenem (100%). The overall resistance was greater for gentamicin, cotrimoxazole, ceftriaxone, cefotaxime and amoxicillin-clavulanic acid (Threshold: 17.9% - 95.6%). APN was associated with bacteremia in 2.8% with hospitalization for 45.2% and mortality of 11.1% (due to severe acute malnutrition, severe dehydration and multifocal infection). Conclusion: The APN, daily activity of pediatrician in Bamako, is observed in one third of febrile children associated with a major life-threatening condition of risk factors, then the likely antibiotherapy could be amikacin in our context.

关键词： APN Fever Child Bamako

Study of the Management of Children with Major Sickle Cell Disease in Pediatric Emergencies at the Gabriel Toure University Hospital

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Open Journal of Pediatrics 2023年第2期13卷 244-252页

作者： Mohamed Elmouloud Cissé Abdoul Aziz Diakité Adama Dembélé Belco Maiga Fatoumata Nampomo Diarra oumar coulibaly Hawa Diall Pierre Togo Abdoul Karim Doumbia Abdoulaye Barry Karamoko Sacko Fousseyny Traore Djeneba Konaté Kalirou Traoré Lala N’Drainy Sidibé Ibrahim Ahamadou Amadou Touré Fatoumata Dicko Boubacar Togo Mariam Sylla Department of Pediatrics Gabriel Toure University Hospital Bamako Mali

Objective: To study the epidemiological, clinical and therapeutic aspects of sickle cell disease in children admitted to the pediatric emergency department of the Gabriel Toure University Hospital. Materials and methods: This was a prospective study over 12 months in sickle cell children aged 6 months to 15 years. Results: The frequency of sickle cell disease was 4.67% with 71.1% of SS form. The age range of 60 - 120 months predominated with 43.4% and the sex ratio 1.4. Vaso-occlusive crises (VOC) were the most frequent reason for consultation (50.6%) and osteoarticular pain was the main symptom followed by fever and pallor with respectively 67.5%, 60.2%, 39.8%. The pain subsided in less than 72 hours in 39.8% and hyper hydration was performed in 85.1% of patients. Analgesic treatment was given in 90.4%, antibiotic therapy in 51.8% and phenotyped red blood cells transfusion was performed in 36.1%. The average duration of treatment was 10 days. Conclusion: Vaso-occlusive crisis remains the main reason for consultation in sickle cell disease children at Gabriel Toure University Hospital. The management consisted, in addition to the correction of the triggering factors, of hyper hydration and the administration of analgesics and blood products.

关键词： Sickle Cell Disease Pediatrics Emergencies

Knowledge of Health Professionals on Essential Newborn Care in Bamako, Mali

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Open Journal of Pediatrics 2018年第4期8卷 311-323页

作者： Fatoumata Dicko Traore Mariam Sylla Hawa Diall Mamadou Traore Pierre Togo Mariam Maiga Nouhoum Lalama Traore Leyla Maiga Kalirou Traore Marikomosse Sacko Souleymane Sagara Hamadou Ibrahim Oumou Maiga Diakaridia Mariko Saoudatou Tall oumar coulibaly Issiaka Kone Modibo Soumare Kadiatou Ba Youssouf Traore Niani Mounkoro Toumani Sidibe Department of Pediatrics CHU Gabriel ToureBamakoMali Reference Health Center of Commune V BamakoMali Reference Health Center of Commune VI BamakoMali Reference Health Center of Commune IV BamakoMali Reference Health Center of Commune III BamakoMali Reference Health Center of Commune I BamakoMali Reference Health Center of Commune II BamakoMali Department of Gynecology and Obstetrics CHU Gabriel ToureBamakoMali

Despite existing policies on training health professionnels in essential newborn care (ENC), neonatal mortality still remains high in Mali. Our work aimed to assess the level of knowledge of health staff about ENC. Material and methods: From March 20th to April 20th, 2016, we interviewed newborn care providers at the six reference health centers and the Gabriel Touré University Hospital Center in Bamako. Results: In total, we interviewed 407 newborn care providers with a sex ratio of 0.52. Interviewees had over five years work experience in 62.1%. They considered a low Apgar score as an indication for neonatal resuscitation in 89%, regardless of profile (p = 0.1583). They knew the good aspiration technique in 54%, with nurses and midwives more knowledgeable (p ) of the reference health centers (p = 0.0000). The interviewees knew the indication and rate of ventilation in 30.2% and 16.0%, respectively. About one third (34%) thought oxygen administration should be systematic during ventilation. The knowledge level on ventilation was the lowest in the group of general practitioners (p = 0.0063 for oxygen indication and p for the technique). Knowledge level for other ENC components (temperature maintenance, eyes care, breastfeeding) were higher. The knowledge of the delay of the breasting did not correlated with either the profile (p = 0.0857) or the place of practice. The knowledge of the first bath was dependent on both the professional profile (p = 0.0002) and the reference level (p = 0.0238). Conclusion: The level of knowledge of health professionnels on ENC should be improved. This will involve the integration of ENC in initial training curricula along with an appropriate continuing training policy thereafter.

关键词： Essential Care Newborn Knowledge Bamako

Evaluation of Antibiotic Prescribing in the Pediatric Department of Gabriel TouréTeaching Hospital, Bamako, Mali

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

作者： Pierre Togo Hawa Konaré Mariam Maïga Karamoko Sacko Djénéba Konaté Abdoul Karim Doumbia Adama Dembélé oumar coulibaly Aminata Sangaré Mohamed Elmouloud Cissé Fousseyni Traoré Belco Maïga Ibrahim Ahamadou Aminata Doumbia Lala N’Drany Sidibé Amadou Touré Yacouba Aba coulibaly Kalirou Traoré Tati Simaga Souleymane Sagara Leyla Bagna Maïga 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

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

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