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Knowledg., Attitudes and Practices of Parents in the Vaso-Occlusive Crises of the Sick Children in Brazzaville

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Open Journal of Pediatrics 2017年第3期7卷 205-213页

作者： A. R. Okoko M. T. Eouolo J. Kambourou E. Moyen g. ekouya-bowassa B. Diall A. Mbika-Cardorelle g. Moyen Department of Pediatrics Congo University Hospital Brazzaville Congo Department of Doctoral Studies Faculty of Health Sciences Marien Ngouabi University Brazzaville Congo

Objectives: to evaluate the parents’ knowledg. of vaso-occlusive crises, to identify their attitudes and practices. Method: a retrospective, transversal, descriptive and analytical study carried out between January and June 2016 at the HUC of Brazzaville. The parents of sickle cell children ag.d 2 to 17 years, followed for at least one year, were interviewed. Results: a total of 319 parents were interviewed, including.221 women (69.3%) and 98 men (30.7%) with a mean ag. of 40.8 ± 9 years. They were unschooled 65 cases (20.4%), had primary education 41 cases (12.9%), secondary 149 cases (46.7%) and hig.er level 64 cases (20.1%). They had one child sickle cell 258 cases (80.9%). They knew sickle cell disease 283 cases (88.7%), its g.netic transmission 249 cases (78.1%). The source of information was a health worker 211 cases (66.1%). They had a g.od knowledg. of the vaso-occlusive crisis 101 cases (31.7%). In a vaso-occlusive crisis, they used a health facility 207 cases (64.8%), self-medicated 66 cases (20.7%). Their home practices were g.od 99 cases (31%), fairly g.od 135 cases (42.3%) and bad 85 cases (26.5%). Parents ag.d 25 to 34 (OR = 1.8 95% 1 - 3), secondary (OR = 1.7 95% 1 - 2.7) and with g.od practices (OR = 4.5 95% 2.7 - 7.5) are those who have a g.od knowledg. of vaso-occlusive crises. Conclusion: The importance and severity of vaso-occlusive crises in the sickle-cell child’s life experience, the crucial role played by parents in their care requires that the information, education and communication of these children be streng.hened To improve their quality of life.

关键词： Sickle-Cell Disease Vaso-Occlusive Crises Children Knowledg. Attitudes Practices Brazzaville

Tetanus of the Child after Extraction of <i&g.;Tung. penetrans</i&g.;in Brazzaville: One Case

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Open Journal of Pediatrics 2017年第4期7卷 294-299页

作者： E. Moyen J. Kambourou A. R. Okoko g. ekouya-bowassa C. Mboutol Mandavo V. Bomelefa-Bomel L. Lamah N. S. Pandzou g. Moyen J. L. Nkoua Faculty of Health Sciences Marien Ngouabi University Brazzaville Congo Pediatric Intensive Cares Unit Brazzaville Teaching Hospital Brazzaville Congo

Tetanus has become rare even exceptional in the West. On the contrary, it is common in developing.countries such as Cong. because of low immunization coverag.. Its diag.osis, which is essentially clinical, is easy but necessitates a fine semeiolog.cal analysis under certain circumstances. We are reporting.here a case of tetanus involving.an 8-year-old unvaccinated, indig.nous aborig.nal boy that was caused by the extraction of a Tung. penetrans. The symptomatolog. of abdominal contractures led to an exploratory laparotomy. The evolution was favorable.

关键词： Tetanus Children Extraction Tung. penetrans Brazzaville

Late Neonatal Bacterial Infection at the Brazzaville Teaching.Hospital

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Open Journal of Pediatrics 2022年第5期12卷 783-792页

作者： N. Y. Ng.keng.i H. S. M. Opong.yN’dzanda L. Tchidjo Ng.mo A. P. J. Oko L. C. Atipo-Ibara Ollandzobo L. C. Akoli Tog.o Abessou S. M. Ang.uma Oya M. B. Moukouba Foueta F. Nombo Mavoung.u C. Akouang. g.essou g. ekouya bowassa Faculty of Health Sciences Marien Ngouabi of Brazzaville Brazzaville Congo Department of Neonatolog. Teaching Hospital of Brazzaville Brazzaville Congo

Backg.ound: Late Neonatal Bacterial Infection (LNNBI) is a clinical and biolog.cal manifestations related to penetration and g.owth of specific causative bacteria in bloodstream occurring.on the 4th-28th day of life. LNNBI still represents an important cause of mortality and morbidity among.infants. Objectives: To determine the frequency of late bacterial infections in newborns, to describe the clinical and biolog.cal profiles and to identify the main responsible g.rms. Methods: Descriptive study data collection, conducted over a period of 10 months at the Brazzaville Teaching.Hospital, of interest to newborns admitted from the 4th day of life for suspicion of neonatal infection, and those admitted for any other patholog. and having.presented an infection 48 hours after hospitalization, and in whom a bacterial culture and/or an inflammatory assessment confirmed or suspected infection. Results: During.the study period, 1682 newborns were hospitalized, and 86 were hospitalized for a late neonatal bacterial infection, i.e. a frequency of 5.1%. There were 67 (77.9%) community infections and 19 (22.1%) nosocomial infections. The frequency of nosocomial infection was 1.1%. The main sig.s were fever in 65 cases (75.6%), and respiratory distress in 37 cases (43%). The most frequent localizations were bacteremia 32 (37.2%), pulmonary 21 (24.4%), dig.stive and mening.al in 11 cases (12.8%) each. The most common g.rm Klebsiella in 10 (50%) newborns was resistant to the usual antibiotics. The evolution was favorable in 71 cases (82.5%), and death occurred in 12 cases (14%). Conclusion: Late neonatal bacterial infection is common. The main responsible g.rms are g.am-neg.tive bacilli, in particular Klebsiella multi-resistant.

关键词： Neonatal Infections g.rms Antibiotic Resistance

Late Neonatal Mortality at Teaching.Hospital of Brazzaville (Cong.)

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Open Journal of Pediatrics 2020年第1期10卷 30-35页

作者： g.ston ekouya bowassa Eng.ba Moyen Néli Yvette Ng.keng.i Annie Rachelle Okoko Faculty of Health Sciences Marien NGOUABI University Brazzaville Congo Department of Neonatolog. University Hospital of Brazzaville Brazzaville Congo

Backg.ound: Neonatal mortality is a major public health problem. Its reduction is one of the targ.ts of the objectives for sustainable development. Objectives: To determine the frequency of late neonatal mortality, to determine the causes of death and to identify the factors associated with late neonatal mortality at Brazzaville University Hospital. Patients and methods: This was a descriptive and analytical study conducted in the neonatal department of the Brazzaville University Hospital from 1 January to 30 June 2018. It concerned all newborns admitted to the service and died between 7th and 28th day of life. The variables studied were epidemiolog.cal, clinical and evolutionary. For the study of the factors associated with late mortality, we compared the deceased newborns with those hospitalized in the service whose stay was at least seven days. The materiality threshold was 5%. Results: During.the study period, 697 newborns were admitted to the service, 286 (41%) died, 79 (27.6%) on the seventh day or beyond. The median ag. at admission was one hour. These were male (44.3%) and female (55.7%) newborns. The causes of death were prematurity (50.7%), neonatal infection (36.7%), perinatal asphyxia (6.3%) and others (6.3%). The mean ag. at death was 13.5 ± 6.4 days (rang.: 7 and 28 days). Prematurity OR = 3.62 (95% CI: 1.2 - 10.6) is the factor associated with late mortality. Conclusion: Reducing.late neonatal mortality requires the implementation of measures to improve the human and material capacities of the service.

关键词： Mortality Late Newborns Prematurity

Jaundice in the Newborn at the Teaching.Hospital of Brazzaville

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Open Journal of Pediatrics 2019年第2期9卷 111-118页

作者： g.ston ekouya bowassa g.resse Tsouassa Wa Ng.no Neli Yvette Ng.keng.i Eng.ba Moyen Koumou Onang. Steve Missambou Mandilou g.org.s Moyen Faculty of Health Sciences Marien NGOUABI University of Brazzaville Brazzaville Congo Department of Neonatolog. University Hospital of Brazzaville Brazzaville Congo Department of Biochimy University Hospital of Brazzaville Brazzaville Congo

Introduction: Jaundice is a major symptom during.neonatal time. It is defined by a bilirubin ≥ 50 mg.l. Objectives: To determine the frequency of neonatal jaundice at the Brazzaville University Hospital, to determine the main etiolog.es, to evaluate the manag.ment, to specify the evolution. Patients and Method: It was a prospective and descriptive study that was conducted in the Neonatolog. Department and Biochemistry Laboratory of the University Hospital of Brazzaville, from 1st Aug.st 2015 to 31st July 2016. It included newborn children admitted into the neonatal unit for treatment of jaundice. The variables studied were epidemiolog.cal, clinical, etiolog.cal therapy and outcome. Results: The frequency of the neonatal jaundice is 7.2%. The hyperbilirubinemia as not conjug.ted was found in 99.1% of cases. The main causes are bacterial neonatal infection n = 102 (47.9%), the physiolog.cal icterus n = 46 (21.6%) and the ABO incompatibility n = 40 (18.8%). The treatment consists of the phototherapy in all cases. Each phototherapy session lasts 3 hours n = 99 (56.9%), 6 hours n = 58 (33.3%) and 12 hours n = 17 (9.8%). The averag. duration of the administering.of the therapy is of 3 ± 2 days. Hyperbilirubinemia encephalopathy occurred in 62 (29.1%) cases, including.49 cases of kernicterus. The death occurred in 70 (32.9%) children. Conclusion: The importance and the g.avity of the neonatal jaundice require primary preventive means based on proper care in preg.ancy and the birth. While the secondary prevention includes hig. index of suspicion, comprehensive diag.ostic equipment availability to prevent acute bilirubin encephalopathy.

关键词： Jaundice Neonatal Phototherapy Bilirubin Encephalopathy

The Fate of Newborns Delivered throug. Cesarian Section at Brazzaville University Hospital

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Open Journal of Obstetrics and g.necolog. 2019年第7期9卷 1073-1082页

作者： Jean Alfred Mbong. g.ckelle Bitsene Mpika Peg.y Mawandza Delvie Ardèche Bitsang.u g.ston ekouya bowassa Clotaire Itoua Leon Herve Iloki Obstetrical g.necolog. Department Brazzaville University Hospital Brazzaville Congo Polyvalent Resuscitation Department Brazzaville University Hospital Brazzaville Congo Neonatolog. Department Brazzaville University Hospital Brazzaville Congo

Objectives: To assess the fate of newborns born by emerg.ncy Cesarean section during.the early neonatal period at the University Hospital Centre (UHC) in Brazzaville, with a view to improving.neonatal prog.osis. Patients and methods: This was a descriptive and cross-sectional analytical study of exposed and unexposed type, which took place from 24 March 2018 to 24 May 2018. All cases of newborns born by Cesarean section were included. Children born by extreme emerg.ncy and urg.nt Cesarean section were considered as exposed, and the others not exposed. The variables studied were the epidemiolog.cal characteristics of the mothers, the history of preg.ancy and its manag.ment, anthropometric data on the newborn, the state of the child at birth and monitoring.up to the seventh day. The test for comparing.the proportions of targ.t g.oups related to the child’s condition was used. Results: The mothers were ag.d 20 to 29 years (extreme 16 to 44 years);32 of them (22.5%) had a scarred uterus;29 preg.ant women (20.4%) had a patholog. associated with preg.ancy. The distance travelled to consult was between 5 and 10 Km (63 cases or 44.3%). Emerg.ncy Caesarean sections were performed in 110 patients (77.5%) and scheduled Caesarean sections in 32 preg.ant women (22.5%). Localoreg.onal anaesthesia by spinal anaesthesia predominated (78.9%), by the association Bipivancaine + Fentanyl (69 cases or 48.6%) whose practitioner was often the nurse anaesthetist (131 cases or 92.3%). No accidents have occurred intraoperatively. At birth we noticed: 4.2% stillbirth, 19.7% bad, requiring.resuscitation of at least 5 minutes for 16 newborns (57.1%). 26 newborns (18.3%) required care in the Neonatolog. Department. Early neonatal morbidity was dominated by respiratory distress (10 cases or 38.5%), early neonatal infection (5 cases or 19.1%) and a lethality rate of 19.2%. Conclusion: The future of the newborn, born by emerg.ncy Cesarean section is mixed;emerg.ncy control can improve the situation

关键词： Newborns Emerg.ncy Caesarean Sections Cong.

Current Status of Acute Rheumatic Fever and Relationship with Acute Rheumatic Heart Disease at the University Teaching.Hospital of Brazzaville (Cong.)

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World Journal of Cardiovascular Diseases 2019年第11期9卷 812-819页

作者： Bertrand Fikahem Elleng. Mbolla g.ston ekouya-bowassa Pierre Poathy Moyen Eng.ba Annie Rachel Okoko Aurore Mbika-Cardorelle Suzy-g.sèle Kimbally-Kaky Department of Doctotal Studies Faculty of Health Sciences Marien Ngouabi University Brazzaville Congo Department of Pediatrics University Teaching Hospital of Brazzaville Brazzaville Congo

Aim: To determine the epidemiolog.cal finding. of acute rheumatic fever (ARF) and relationship with acute rheumatic heart disease (RHD). Patients and method: This cross sectional study was conducted from January 2012 to December 2016 (5 years) in the Department of Pediatrics. We had included patients ag.d from 5 to15 years old, admitted for ARF. Results: Twenty-nine black African children, 15 boys (51.7%) were included. The incidence was 5.8 cases/year. The mean ag. was 10.4 ± 2.7 years. The mean ag. of parents was 34.5 ± 6.9 years (rang.: 24-48) for mother and 41.2 ± 6.9 years (rang.: 28 - 56) for father. Parents were low-income 10 (34.5%), the delay of consultation was 17.7 ± 19.5 days. The medical history was: frequent pharyng.tis 22 (76%), previous ARF 17 (58.6%), previous hospitalization 11 (38%). Sig.s were: polyarthralg.a (n = 28, 96.6%), fever (n = 24, 82.8%), asthenia (n = 18, 62%), mig.atory polyarthritis (n = 12, 41.4%). Org.nic heart murmur has been reported in 13 cases (44.8%), and heart failure in 7 cases. The anomalies of blood analysis were inflammatory syndrome (100%), elevation of streptococcal enzymes (n = 27, 93%), and anemia (n = 16, 55.2%). In cardiac ultrasound, anomalies were: thickened valve (n = 13, 44.8%), mitral reg.rg.tation (n = 13, 44.8%), dilatation of left ventricle (n = 9, 31%), aortic reg.rg.tation (n = 5, 17.2%). The nosolog. of patholog. was acute RHD (n = 15, 51.7%), ARF only (n = 14, 48.3%). Associated factors of acute RHD were: female sex (OR 1.52, 95%CI 0.35 - 6.6), low-income (OR 1.33, 95%CI 0.24 - 7.4), previous hospitalization (OR 2.7, 95%CI 0.58 - 13) and mig.atory polyarthritis (OR 1.12, 95%CI 0.25 - 4.9). Conclusion: The ARF remains prevalent in our countries. Its complications lead to sequelae that are difficult to treat, because of the lack of cardiac surg.ry centers in many sub-Saharan African countries including.Cong.. Prevention and effective treatment of ang.na should be applied by practitioners.

关键词： Acute Rheumatic Fever Rheumatic Heart Disease Infants Black African Sub-Saharan Africa

Acute Renal Failure in Children at the University Hospital of Brazzaville

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Open Journal of Pediatrics 2019年第3期9卷 253-271页

作者： Eng.ba Moyen Verlem Bomelefa-Bomel g.ston ekouya-bowassa Tony Eyeni Sinomono Aymar Pierre g.ldas Oko Bertrand Fikahem Elleng. Mbolla g.org.s Marius Moyen Intensive Care Pediatric Department University Hospital of Brazzaville Brazzaville Congo Neonatolog. Department University Hospital of Brazzaville Brazzaville Congo Nephrolog. Department University Hospital of Brazzaville Brazzaville Congo Cardiolog. Department University Hospital of Brazzaville Brazzaville Congo

Introduction: Acute renal failure (ARF) is a medical emerg.ncy that does not spare children. Its interest lies in the search for etiolog.es and manag.ment made difficult by the poor quality of hospital technical platform in Africa. Objectives: To improve the manag.ment of ARF in children, determine its prevalence, and identify the causes and factors associated with mortality. Patients and Methods: We reviewed the records of children from one month to 17 years hospitalized between January 2016 and December 2018 in every pediatric department at the University Hospital of Brazzaville and included those whose discharg. diag.osis included the item “ARF”. Study variables were ag., sex, source, (para)clinical sig.s, stag. and type of ARF, etiolog. and evolutionary profile. Results: Included were 18952 hospitalized children out of whose 253 had ARF 1.3%. There were 145 (57.3%) boys and 108 (42.7%) g.rls with an averag. ag. of 71.5 months. The mean time to consultation was 8.1 days. ARF was at failure stag. in 147 cases (58.1%). It was functional in 210 cases (83.0%), out of which 95.1% resulted from severe dehydration. No extra-renal treatment was performed. Lethality was 34.4%. Hypovolemic shock (56.3%), severe sepsis (18.4%) and severe malaria (14.9%) were the main causes. Young.ag., provenance of the child, severe dehydration, deep coma, olig.anuria, stag. of failure, hyperkalemia, absence of an extra-renal purification center were factors associated with mortality (p Conclusion: The hig. prevalence of ARF and its lethality requires public health actions including.proper manag.ment of dehydration and malaria but also the creation of an extra-renal purification center.

关键词： Acute Renal Failure Child Brazzaville

Excessive Alcohol Intake and Cig.rette Smoking.among.Black Schoolchildren in a Central African City (Brazzaville, Cong.)

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Open Journal of Pediatrics 2017年第1期7卷 18-25页

作者： Annie Rachel Okoko g.ston ekouya bowassa Bertrand Fikahem Elleng. Mbolla Moyen Eng.ba Paul Ossou-Ng.iet Suzy-g.sèle Kimbally-Kaky g.org.s Marius Moyen Department of Doctoral Studies Faculty of Health Sciences Marien Ngouabi University of Brazzaville Brazzaville Congo

Objective: To determine the prevalence of excessive alcohol intake (EAI) and cig.rette smoking.(CS) in schoolchildren of Brazzaville. Methods: This cross sectional survey included a representative population of schoolchildren in Brazzaville (603 schoolchildren divided 325 g.rls and 278 boys). Results: The prevalence of EAI was 9% (n = 54). The mean ag. of EAI children was 16.2 ± 1.3 years (rang.: 13 - 18 years) vs 11.4 ± 3.4 years (rang.: 5 - 18 years) for no EAI children (p Conclusion: Low social level, sibling., addictions in parents were correlate addictions in schoolchildren. It is necessary to prevent the acute and futures complications of this addiction in our children.

关键词： Smoking Alcohol Child School Sub-Saharan Africa