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Epidemiological Profile of Newborns Who Died during Their Hospitalization in the Neonatology Unit, Mali Hospital

Open Journal of Pediatrics 2022年第2期12卷 424-432页

作者： Korotoumou Wéllé Diallo Bourama Kané Aboubacar Sangaré Kadidiatou Touré fatoumata Léonie François Diakité Mamadou Traoré Mohamed Maba Traoré Mamadou Berthé Mariam Maiga Abdoul Aziz Diakité fatoumata dicko Traoré Department of Pediatrics Mali Hospital Bamako Mali Department of Pediatrics Gabriel Touré University Hospital Bamako Mali Reference Health Center of Commune V Bamako Mali Department of Medical Imaging Mali Hospital Bamako Mali National Institute of Public Health Bamako Mali Reference Health Center of Commune VI Bamako Mali

Introduction: Neonatal mortality is a serious problem, particularly in developing countries. Objective: To study the epidemiological and clinical profiles of newborns who died during their hospitalization in the neonatology unit of the hospital in Mali. Methodology: This was a prospective study over a 12-month period (January 1 to December 31, 2020) including all newborns aged 0 - 28 days who died during their hospitalization. Results: A total of 424 neonates were hospitalized in neonatology, 54 died, or 12.73%. Newborns aged 0 - 7 days at admission were the most represented at 79.63% and 94.4% were full-term babies. The male gender was dominant with a ratio of 1.17. The following characteristics were frequently observed in the mothers: not educated (46.3%), poor 75.9%, living in urban areas (68%), housewives 75.4%, and having had less than 4 antenatal care visits (53.7%). For babies, respiratory distress and hyperthermia were the most common reasons for hospitalization (37% and 22.2%, respectively), with 40% being resuscitated at birth. Infection and perinatal anoxia were the most frequent diagnoses, respectively 96.3% and 37%. The death occurred within the first three days of hospitalization in 60% of cases. Conclusion: In order to reduce the mortality rate in our facilities, monitoring of pregnancy and delivery, and correct management of newborns both at birth and in the pediatric wards are important.

关键词： Newborn Death Hospital in Mali

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Acute Pneumonia Characteristics in Children under Five Years of Age in Bamako, Mali

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Open Journal of Pediatrics 2019年第1期9卷 7-18页

作者： fatoumata dicko-Traoré Abdoul Karim Doumbia Mariam Sylla Mariatou Traoré Djènèba Konaté fatoumata Léonie Diakité Karamoko Sacko Belco Maiga Hawa Diall Oumar Coulibaly Pierre Togo Fousseyni Traoré Abdoul Aziz Diakité Yacouba Toloba Department of Pediatrics CHU Gabriel Touré Bamako Mali Faculty of Medicine and Odontostomatology Bamako Mali Department of Pneumology CHU Point G Bamako Mali

Pneumonia is the most common cause of mortality in child under five years of age. The objective of the study was to assess socio-demographic and clinical characteristics of children under 5 hospitalized for pneumonia. Material and method: We conducted a 6 months prospective study from June 1st, 2016 to December 31st, 2016 in the general pediatric service in the Pediatric Department of Gabriel Touré Teaching Hospital in Bamako, the capital city of Mali. Result: We have selected 63 cases of pneumonia according to our definition criteria, i.e. 2.2% of hospitalizations for children aged 1 to 59 months. The average age was 14 months. Infants under 2 years accounted for 82.53%. The sex ratio was 1.2. Seventy eight percent came from an unfavorable socio-economic background. The majority of mothers were uneducated (71.42%). Breastfeeding was exclusive up to 6 months in 50.79% of patients. Vaccination according to the national program was not up to date in 27% of patients. The average consultation time was 18 days. On admission, 81% of the patients had a fever, 93.64% had a tachypnea and 58.73% had crackling rales at pulmonary auscultation. Hypoxemia was present in 58.73%. Severe anemia was present in 79.36%. Radiologically, opacity was found in 42 patients (66.66%). The blood culture was positive in 8.3%. Beta-lactams were first-line prescribed in all patients. The case fatality rate was 9.52%. The factors associated with mortality were age less than 14 months (p = 0.08), adverse socio-economic conditions (p = 0.0003) and the presence of hypoxemia at the entrance (p = 0.01). Conclusion: Pneumonia remains major cause of morbidity and mortality in our context. Emphasis should be put on preventive measures.

关键词： Acute Pneumonia Children Mortality Mali

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The Effect of Human Immunodeficiency Virus-1 Infection on Low Birth Weight, Mother to Child HIV Transmission and Infants’ Death in African Area

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Open Journal of Obstetrics and Gynecology 2019年第2期9卷 158-169页

作者： Traoré Youssouf Téguété Ibrahima dicko fatoumata Traoré Bocoum Amadou Fané Seydou Traoré Tidiani Traoré Mamadou Salia Dao Seydou Touré Moustapha Varol Nesrin Dolo Amadou Department of Gynaecology and Obstétrics Gabriel TOURE Teaching Hospital Bamako Mali Department of Pediatics Gabriel TOURE Teaching Hospital Bamako Mali Department of Gynaecology and Obstétrics Regional Hospital of Segou Bamako Mali Department of Gynaecology and Obstétrics Point G Teaching Hospital Bamako Mali Motherhood Unit of “Csref Commune II” Bamako Mali Department of Gynaecology and Obstétrics “Hopital du Mali” Teaching Hospital Bamako Mali Sydney Gynaecology & Endometriosis Centre Sydney Medical School The University of Sydney Sydney Australia

Background: It is yet a controversy subject whether low birth weight and infant death are associated to human immunodeficiency virus-1 infection. Objective: To appreciate association between low birth weights, mother to child HIV transmission and infant mortality in HIV-1 infected pregnant women delivering between 2011 and 2016. Materials: We conducted 6 years cohort study in urban Mali. Outcome included preterm delivery, small for gestational age, infant survival status and HIV transmission. Comparison concerned women clinical WHO stage, mother viro-immunological status, and newborn anthropometric parameters. Results: HIV-1 infected women who delivered low birth weight newborn were 20.9% (111/531) versus 16.5% (1910/11.546) in HIV negative patients (p = 0.016). CD4 T cell counts low than 350 T cells count were strongly associated to LBW (p = 0.000;RR = 3.03;95% CI [1.89 - 3.16]). There is no significant association between ART that was initiated during pregnancy (p = 0.061, RR = 0.02;CI 95% (1.02 - 1.99)) or during delivery (p = 0.571;RR = 1.01;CI 95% (0.10 - 3.02)) and LBW delivery. In multivariate analysis ART regimens containing protease inhibitor (PI) were lone regimens associated with LBW ((p = 0.030;RR = 1.001;95% confidence interval [1.28 - 3.80]). Very low birth weight was statistically associated to women HIV infection (adjusted relative risk, 2.02;p = 0.000;95% confidence interval (2.17 - 4.10)). There is no significant difference between mother to child HIV transmission rate in the two HIV-infected pregnant women (10 infected children in group 2: MTCT rate 4.5%) and 3 infected children in group 1 (MTCT rate: 2.7%) (p = 0.56;RR, 0.59;CI 95% (0.18 - 4.39)). In multivariate analysis, LBW was associated with infant death (p = 0.001;RR = 2.04;CI 95% [1.04 - 5.05]). The median weight of infant at the moment of death in group 1 was 851 g (IQR: 520 - 1833 g). Significant relationship was found between infant death among LBW newborn with mother WHO stage 2 (p = 0

关键词： Low Birth Weight Human Immunodeficiency Virus Infection Mother to Child Transmission Newborn Death Mali

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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 Maïga 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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Clinical and Epidemiological Aspects of Severe Acute Malnourished Children from 6 to 59 Months Hospitalized in a Secondary Hospital in Mali

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Open Journal of Pediatrics 2023年第1期13卷 97-103页

作者： Mariam Maiga Hibrahima Diallo Tati Simaga Mariam Traore Alou Samake Mamadou Diallo Moussa Konate Mamadou Keita Mamadou Traore Djibril Kassogue Oumou Kone fatoumata dicko Hawa G Diall Department of Pediatrics Reference Health Center of Commune VI Bamako MALI Department of Pediatrics CHU Gabriel TOURE Bamako MALI Department of Pediatrics Reference Health Center of Commune V Bamako MALI Timbuktu Regional Hospital Tombouctou MALI National Institute of Public Health Bamako MALI National Institute for Health Science Training Bamako MALI

Introduction: Malnutrition acts on the immune system and thus increases susceptibility to infections. Infections can weaken the body and cause malnutrition, so we speak of a vicious circle between malnutrition and infection. Objective: To study the clinical and epidemiological aspects of severe acute malnutrition in children aged 6 to 59 months. Methodology: This was a prospective and descriptive study extending from July 1, 2018 to June 30, 2019. All severely acute malnourished children aged 6 to 59 months were hospitalized at URENI whose parents or careers accepted their participation in the study. Results: Severe acute malnutrition was diagnosed in 398 of the 671 hospitalized children, i.e. 59.3%. The median age was 15.33 months (2 months - 59 months). The sex ratio was 1.03 (M = 50.8 F = 49.2). Eighty-seven percent of mothers were housewives. Parents were uneducated in 49.3% for mothers and 51.8% for fathers. Marasmus represented 93.5% of cases, children diagnosed with HIV+ represented 6.3% with exclusively HIV1 (100%). Pneumopathy was most frequently associated pathology with 33.4%. The duration of hospitalization was less than 7 days in 67.6% of cases and 93.3% of children had been successfully treated. The mortality rate was 4%. Conclusion: Malnutrition still remains a public health problem affecting mainly children aged 13 to 24 months, mainly from low-income families.

关键词： Severe Acute Malnutrition Children Hospitalized Mali

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Kangaroo Mother Care and Neonatal Outcomes in the Pediatric Department of CHU Gabriel Toure

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Open Journal of Pediatrics 2022年第1期12卷 179-187页

作者： Fousseyni Traoré Hawa G. Diall Karamoko Sacko Belco Maiga Oumar Coulibaly Isabelle Traore Leyla Maiga Lala N. Sidibe Pierre Togo Abdoul Karim Doumbia Djeneba Konaté fatoumata Leonie Diakité Ibrahima Ahamadou Adama Dembélé Abdoul Aziz Diakité fatoumata dicko Traoré Mariam Sylla Boubacar Togo Department of Pediatrics CHU Gabriel Toure Bamako Mali Faculty of Medicine and Odontostomatology Bamako Mali

Introduction: In Mali, prematurity is currently the leading cause of neonatal morbidity and mortality at the Gabriel Toure Hospital. Kangaroo Mother” care is an efficient and effective alternative care strategy for preterm and low birth weight babies. This study aimed to evaluate the epidemio-clinical and therapeutic profile of premature/hypotrophic newborns admitted to the “Kangaroo-mother” care unit. Material and method: It was a retrospective study from 01/01/2010 to 31/12/2012. Were included all stable preterm with gestational age between 28 - 37 weeks and hypotrophic newborns with a birth weight 10th percentile for gestational age. Results: One thousand and eighty-four patients (n = 1084) were included. The sex ratio was 1.2 (F = 592;M = 492). The mean birth weight was 1300 g (600 g - 2000 g). The mean gestational age was 32.69 (28 - 37). The mean age of the mothers was 24 years (13 - 45 years). Single pregnancies accounted for 85.1%. Discontinuation of care was 56%. Follow-up to 24 months was effective in 14% of patients. Sixteen percent of the patients died (n = 176). The mothers’ lack of schooling (p = 0.03) and birth weight < 1000 g (p = 0.003) were the major factors in the patients’ mortality. Conclusion: The kangaroo-mother care is an alternative means to improve the survival of preterm and low birth weight babies in Mali.

关键词： Newborns Kangaroo-Mother Care Mali

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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

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Epidemiological and Clinical Profile and Immediate Outcome of Neonates Transferred from the Maternity Unit to the Neonatology Unit of the CSREF in Commune V of Bamako District, Mali

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Open Journal of Pediatrics 2024年第3期14卷 547-557页

作者： Maimouna Kante Ya Traoré Balilé Harber Beydari Mamadou Traoré Issiaka Koné Diéneba Sacko Maimouna Haidara Korotoumou Bamba Assitan Farota Abdoulaye Kassogué Mohamed Diarra Dramane Touré Abdoul Salam Diarra Leyla Maïga dicko fatoumata Paediatric Ward CSR&#233f CV Bamako Mali Paediatric Ward of Nianankoro Fomba Hospital S&#233gou Mali Paediatric Ward of Kalaban CoroCSREF Bamako Mali Pediatric Department of the Mopti Reference Health Center Mopti Mali National Centre for Scientific and Technological Research Bamako Mali Paediatrics Department Mohamed VI Perinatal Clinic Bamako Mali Department of Paediatrics Gabriel Tour&#233 University Hospital Bamako Mali

Introduction: Neonatal mortality remains a major public health concern. According to the World Health Organisation (WHO), the number of newborns dying each year has fallen from 5 million in 1990 to 2.4 million in 2019. The aim of our study was to describe the main morbid conditions and their lethality in newborns admitted to the paediatric ward of the CSREF in Commune V. Methodology: We conducted a 12-month prospective descriptive and analytical study from August 2020 to July 2021. Results: During the 12 months of the study, out of 2654 neonates admitted to hospital, 216 met our inclusion criteria, i.e. 8%. Newborns admitted in the first few hours of life represented 99.54% of cases. Full-term newborns accounted for 65.74% of the total. Forty-eight percent of newborns had hypothermia on admission. The most common diagnosis was asphyxia in 55.56% of cases, followed by neonatal infection in 27.78% and prematurity in 10.65%. Death was recorded in 22.2% of cases. Asphyxia was the main cause of neonatal death, followed by prematurity in our context. Conclusion: Improving the prognosis of newborn babies will require a thorough understanding of neonatal pathologies and the implementation of a pre- and perinatal prevention policy.

关键词： Newborns Morbidity Mortality

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Systemic Lupus Erythematosus Complicated by Pericarditis: A Case Report from the Guindo Clinic in Bamako, Mali

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Open Journal of Pediatrics 2023年第1期13卷 16-20页

作者： Kalirou Traoré Karamoko Sacko Souleymane Mariko Belco Maiga Hawa Konaré Adama Dembélé Mohamed Cissé Fousseyni Traoré Ibrahim Dollo fatoumata Traore Arouna Ouattara Aminata Doumbia Mamadou Traore Djeneba Konate Pierre Togo Abdoul Karim Doumbia Gassama Diaby Abdoul Aziz Diakité Ali Guindo fatoumata dicko Mariam Sylla Boubacar Togo Department of Pediatrics Gabriel TOURE University Hospital Bamoko Mali Guindo Clinic of Bamako Bamoko Mali Mopti Hospital Mopti Mali Reference Health Center of Commune V Bamoko Mali Bamako Dermatology Hospital Bamoko Mali

Juvenile systemic lupus erythematosus is a rare entity, affecting children under 16 years of age. Girls are more often affected than boys and the female predominance increases significantly with age. The initial manifestations are highly variable with an insidious and progressive onset. Non-specific symptoms include fever, anorexia, weight loss and asthenia. Pericarditis is the most common cardiac manifestation in systemic lupus erythematosus (SLE), occurring in 10% to 40% of cases. The biological elements of the diagnosis and follow-up of pediatric SLE are identical to those of adults and are based on regular measurement of complement, native anti-DNA antibodies, and inflammatory findings. Treatment is essentially based on corticosteroid therapy.

关键词： Lupus Child Pericarditis Clinic Guindo Bamako Mali

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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 Maiga 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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