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Pediatric Hypertension in Two University Hospitals in Cotonou, Benin: Presentation, Etiology, Management and Outcome

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Open Journal of Pediatrics 2018年第1期8卷 74-85页

作者： Francis Lalya didier adedemy Yevedo Tohodjede Marcelline d’Almeida Linda Ayedadjou Maroufou Jules Alao Pediatrics Unit Centre National Hospitalier Universitaire Hubert K. Maga (CNHU-HKM) Cotonou Benin Pediatrics Unit Centre Hospitalier Universitaire Départemental Borgou-Alibori Parakou Benin Pediatrics Unit Centre Hospitalier Universitaire de la Mère et de l’Enfant Lagune (CHU-MEL) Cotonou Benin

Background: Hypertension (HPT) is a major public health problem. Many studies have attempted to investigate HPT in school children. Few, however, have targeted hospital HPT. We conducted this study to describe the epidemiologic characteristics, etiologies, management, and outcome of hospital HPT in our setting. Methods: This was a prospective and descriptive study carried out from March 01 through June 30, 2017 in the pediatric departments of two university hospitals: Centre National Hospitalier Universitaire Hubert K. Maga and Centre Hospitalier Universitaire de la Mère et de L’Enfant Lagune of Cotonou, Benin. Every consecutive patient aged 3 to 18 years who was admitted to the two hospitals for any reason had his (her) BP measured. Every patient with HPT was reviewed for demographics, history and clinical examination, and laboratory investigations as appropriate. Management was done accordingly. Outcome was also recorded. Results: The hospital frequency of HPT was 1.98% (31 cases/1565 admissions). The male/female ratio was 1.06 (16 males, 15 females). Mean age was 8.5 years ± 4.39 (range, 3 to 16 years). 74.19% patients had Body mass index within -2SD and +2SD. Only one patient had BMI above +3SD. The main etiologies found were renal: acute tubular necrosis (45.16%), acute glomerulonephritis (16.13%), and acute pyelonephritis (12.90%). Diuretics (64.5%), were the main antihypertensive drugs used. A single drug therapy was used in 35.4%, a two-drug therapy in 32.2% and a three-drug therapy in 9.6% of cases. Length of hospital stay was more than one week in 70.97% of cases. Hospital death rate for HPT was 19.35%. The outcome was not known in one patient due to exit from hospital against medical advice. All the other patients fully recovered at one month post-discharge follow-up. Conclusion: HPT presents as a symptomatic disease in our hospitals;it has a renal etiology in most cases and has significant death rate despite treatment. Advocacy with health authorities mu

关键词： Hypertension Hospital 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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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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Risk Factors for Acute Otitis Media in Children Aged 0 to 5 Years in Parakou

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International Journal of Otolaryngology and Head & Neck Surgery 2016年第2期5卷 73-78页

作者： Spero H. Raoul Hounkpatin Julien didier adedemy Marius C. Flatin Senami Florine E. Awassi Sonia Lawson Afouda François Avakoudjo Wassi Adjbabi Sogbadji J. Vodouhè Faculty of Medicine University of Parakou Parakou Benin Faculy of Health Sciences University of Abomey-Calavi Cotonou Benin

Introduction: Acute otitis media (AOM) is one of the most common ENT childhood diseases. Objective: To identify risk factors for AOM in children aged 0 to 5 years. Methods: This research work was a cross-sectional, descriptive and analytical study. It focused on 2040 children aged 0 to 5 years from both sexes, who were healthy or sick, and living in the Local government of Parakou for at least one year. Those children were randomly selected in all three districts of Parakou. Results: Frequency of AOM was 2.8% and their prevalence was estimated at 16.3%. The identified risk factors were persistent or chronic cases of rhinitis, exposure to charcoal and wood smoke, low socioeconomic status, personal history of AOM, AOM history among the siblings, and children’s poor nutritional status. No relationship could be established between AOM occurrence and factors like sex, passive smoking, attendance of a day-care centre or stay in nursery, prematurity, exclusive breastfeeding and large number of siblings. Conclusion: The identification of those risk factors will help put in place appropriate measures to reduce AOM prevalence in Parakou.

关键词： Acute Otitis Media Prevalence Risk Factors Children

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Sonographic Measurement of Optic Nerve Sheath Diameter: A Prognostic Tool for Childhood Cerebral Malaria?

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Open Journal of Radiology 2019年第1期9卷 69-81页

作者： Kofi-Mensa Savi de Tové Yolande Savi de Tové-Sissinto didier Julien adedemy Djivèdé Akanni Miralda Kiki Patricia Yèkpè-Ahouansou Olivier Biaou Vicentia Boco Achille Massougbodji Medical Imaging Department Faculty of Medicine University of Parakou Parakou Republic of Benin Parasitology Department Faculty of Health Sciences University of Abomey Calavi Cotonou Republic of Benin Pediatrics Department Faculty of Medicine University of Parakou Parakou Republic of Benin Medical Imaging Department Faculty of Health Sciences University of AbomeyCalavi Cotonou Republic of Benin

Background: Childhood cerebral malaria is one of the most frequent complications of malaria, with high morbidity and mortality. Raised Intracranial Pressure (ICP) is currently recognized as a fundamental element of the severity of that disease. This study aims to look into the prognostic role of the sonographic measurement of optic nerve sheath diameter (ONSD) in the context of that disease. Methods: This study was conducted in the pediatric and imaging departments of the University Hospital Center of Parakou in Republic of Benin in West Africa. This was a descriptive cross-sectional study with a prospective data collection conducted over a period of 6 months, from March 1st to August 31st, 2014. There were two groups of children with severe malaria and conscious impairment: one with unrousable coma or Cerebral Malaria (Group 1) and the other without unrousable coma (Group 2), benefitting from ONSD sonographic measurement. ONSD was measured 3 mm behind the papilla. Correlation between depth of coma, outcome and ONSD measure on ultrasound was investigated. Results: Group 1 consisted of 37 children and Group 2 of 50 children, i.e. a sample of 87 children. The mean age was 27.21 ± 20.11 months and sex ratio (Male/Female) estimated at 0.89. The average ONSD of the sample was 4.39 ± 0.94 mm with a significant difference (p = 0.0001) between Group 1 (5.09 ± 1.09 mm) and Group 2 (3.87 ± 0.17 mm). Raised ICP prevalence was 48.28% with a significant difference between Group 1 (83.78%) and Group 2 (22%) with p Conclusion: Sonographic measurement of ONSD could be a leading prognostic tool in childhood cerebral malaria management.

关键词： Cerebral Malaria Ultrasound Optic Nerve Sheath Diameter Prognosis Correlation

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