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Audits of death in HIV-Infected Children and adolescents Followed up in the Pediatric department of the Regional Teaching Hospital of Borgou/Alibori from 2005 to 2020

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Open Journal of Pediatrics 2024年第2期14卷 285-296页

作者： Alphonse Noudamadjo Mohamed Falilatou Agbeille dénagan Kévin Amoussou Médétinmè Gérard Kpanidja Lahanatou Séidou Chantal Chabi Réckya Kilaya julien didier adédémy Agossou Joseph Mother and Child department Faculty of Medicine University of Parakou Parakou Benin Pediatric department Regional Teaching Hospital of Borgou/Alibori Parakou Benin

Introduction: Human immunodeficiency virus (HIV) is a major public health problem with high morbidity and mortality among children. The objective of this work was to audit the deaths of children and adolescents with HIV infection followed up in the pediatric department of the Regional Teaching Hospital of Borgou/Alibori (CHUdB/A) the from 2005 to 2020. Patients and Method: This was a retrospective and descriptive study conducted in the pediatric department of CHUd/B-A in Parakou. All children with HIV infection who died from January 1, 2005 to August 31, 2020 were included. data collection was carried out in three stages: a phase of medical records processing, a phase of community survey and a phase of death audits. The variables studied were sociodemographic, clinical, biological, therapeutic and evolutionary. Results: Over the study period, the data of 464 infected children were recorded, including 92 deaths, representing a case fatality rate of 19.83%. Severe acute malnutrition (69.23%), gastro-intestinal tract infections (43.58%) and serious opportunistic pulmonary infections (24.36% pulmonary tuberculosis and 19.23% pneumocystis) were the main causes of death. The main dysfunctions found were: the delayed diagnosis of HIV infection (79.35%), the absence or delay in consultation when the child’s clinical condition deteriorates (32.61% and 47.83%), delayed initiation of antiretroviral treatment (42.39%) and non-adherence to treatment (38.04%). Non-adherence to treatment was predominant in adolescents (90.49%). Conclusion: Specific interventions for early detection, adequate nutritional care, psychosocial support for adolescents and mothers of children are necessary to reduce mortality due to HIV among children and adolescents.

关键词： HIV death Children adolescents dysfunctions Benin

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Children with Sickle Cell disease in Northern Benin: Follow up of a Cohort at the Borgou/Alibori Branch of Integrated Medical Healthcare Center for Infants and Pregnant Women with Sickle Cell disease from 2017 to 2022

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Open Journal of Pediatrics 2024年第3期14卷 445-458页

作者： Falilatou Agbeille Mohamed Alphonse Noudamadjo Médétinmè Gérard Kpanidja Yémalin Zinsou François Anikè Akinola Kpedio Clarisse Marie Chantal Bossa julien didier adédémy Joseph Agossou Teaching and Research Unit Department of Mother and Child Faculty of Medicine University of Parakou Parakou Benin Integrated Healthcare Center for Infants and Pregnant Women with Sickle Cell disease (CPMI-NFEd) Branch of Borgou/Alibori Parakou Benin

Introduction: Sickle cell disease is a public health problem in sub-Saharan Africa. A national referral center for the management of infants and pregnant women with sickle cell disease (CPMI-NFEd) was created three decades ago in Cotonou, in the south of Benin with two regional branches including that of Parakou in the North for better access of patients to specialized care. This work is a review of five years of activities in order to describe the epidemiological, clinical, hematological and evolutionary profiles of the children followed up in the said branch. Method: This was a descriptive and retrospective cross-sectional study on the medical records of children with sickle cell disease, followed up at the regional branch of CPMI-NFEd in Borgou/Alibori from June 1, 2017 to May 31, 2022. The variables studied were epidemiological, clinical, biological and evolutionary. Results: A total of 101 children with sickle cell disease were included in the study, including 78 homozygous SS (77.2%) and 23 heterozygous SC (22.8%). Their mean age at inclusion was 51.2 ± 37.6 months [6 - 204]. The sex ratio was 1.4. Vaso-occlusive crises were the main diagnostic circumstances in 42.3% of homozygotes. More than half of the children (51.5%) had a regular follow-up. The average baseline level of hemoglobin (Hb) in homozygous children was 8.8 ± 1.4 g/dl [5.8 - 11.5];and the rate of Hb S varied between 61.9 and 94.7%. In heterozygous SC children, the mean baseline level of Hb was 10.7 ± 0.6 g/dl [9.7 - 11.5]. Acute complications observed during follow-up were dominated by pneumonia and vaso-occlusive crises in both phenotypes. The overall mortality was 3% and only affected homozygous patients. Conclusion: On average, three out of four children were homozygous in our cohort. The main acute complications were infectious and vaso-occlusive. The mortality only affected homozygous carriers. Specialized follow-up has contributed to improving the quality of life of children with sickle cel

关键词： Sickle Cell disease Children CPMI-NFEd Parakou Benin

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Open Journal of Pediatrics（儿科学期刊） 2024年第3期 445页

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Audits of death in HIV-Infected Children and adolescents Followed up in the Pediatric department of the Regional Teaching Hospital of Borgou/Alibori from 2005 to 2020

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Open Journal of Pediatrics（儿科学期刊） 2024年第2期 285页

作者： Alphonse Noudamadjo Mohamed Falilatou Agbeille dénagan Kévin Amoussou MédétinmèGérardKpanidja Lahanatou Séidou Chantal Chabi Réckya Kilaya julien didier adédémy Agossou Joseph

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Neonatal Bacterial Infections in Parakou in 2013

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Open Journal of Pediatrics 2016年第1期6卷 100-108页

作者： Joseph Agossou Marcelline Hounnou-d’Almeida Alphonse Noudamadjo julien didier adédémy Wèrè Sylvestre Nékoua Blaise Ayivi Mother & Child department Faculty of Medicine University of Parakou and Borgou Regional University Teaching Hospital in Parakou Parakou Benin Mother & Child department Faculty of Health Sciences (University of Abomey-Calavi) and National University Teaching Hospital (CNHU-HKM) Cotonou Benin

Objective: Neonatal bacterial infections are a leading cause of mortality in developing countries, including Benin. This study aimed to investigate the epidemiological, clinical and bacteriological aspects of neonatal bacterial infections and their outcomes in the neonatal care unit of the Borgou Regional University Teaching Hospital (CHUd-Borgou). Study design: This manuscript described a cross-sectional study with prospective data collection and an analytical purpose that was performed over the course of 3 months. It was conducted in the neonatal care unit of CHUd-Borgou and focused on 203 newborns who were admitted for suspected bacterial infection. Results: Neonatal bacterial infections accounted for 63.75% of admissions. The sex ratio was 1:1. Prematurity was the main reason for admission (25.1%), and respiratory distress was the most common physical symptom (22.2%). From a bacteriological point of view, 14.7% of blood cultures were positive, and the main isolated pathogens were Escherichia coli (35.8%), Staphylococcus aureus (21.5%) and Klebsiella pneumoniae (14.3%). These pathogens were more sensitive to aminoglycosides than to other antibiotics. Lethality was 21.6%. Place of birth (p -3), age of the newborn at admission (p = 0.003) and maternal history of infectious diseases during pregnancy (p = 0.02) were factors associated with neonatal bacterial infections. Conclusion: This study identified the main pathogens responsible for neonatal bacterial infections and their level of sensitivity to antibiotics. It also determined the different factors associated with neonatal bacterial infections that should be considered in newborn care.

关键词： Infectious diseases Neonatology Parakou Benin

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Newborn Umbilical Cord Care in Parakou in 2013: Practices and Risks

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Open Journal of Pediatrics 2016年第1期6卷 124-135页

作者： Joseph Agossou Marcelline Hounnou-d’Almeïda julien didier adédémy Alphonse Noudamadjo doué Yasmine Gounou N’gobi Blaise Ayivi department of Mother and Child Faculty of Medicine University of Parakou Parakou Benin department of Mother and Child Faculty of Health Sciences University of Aboomey-Calavi Cotonou Benin

Objective: The objective was to study umbilical care practices and risks in Parakou (North Benin). Patients and method: It was a cross-sectional and descriptive study carried out within a community from June 1 to August 31, 2013. It focused on all the infants born at the maternity of Parakou Health Center and their mothers. Results: Two hundred and ten newborns were included i.e. 101 boys and 109 girls. In 80.9% of cases, inappropriate substances had been applied to umbilical cord. Umbilical cord care quality was adjudged as poor, acceptable and good in 58.6%, 31.9% and 9.5% of cases respectively. A bacterial umbilical infection had been noted in 59.5% of newborns. Only 4.8% had sterile umbilical wound. The commonest bacteria were: Staphylococcus aureus (58.1%), Staphylococcus saprophiticus (53.3%), Escherichia coli (44.8%) and Pseudomonas aeruginosa (14.3%). The factors associated with umbilical infection were: low educational status of mother (p = 0.026), low-income occupation of mother (p = 0.021), customary practices to accelerate umbilical cord fall off (p = 0.007), short time to cord falling off lower than 6 days (p = 0.015). Conclusion: Umbilical cord care involves high risk for bacterial infection in our context. Strong actions must be taken within the community in order to reduce that risk.

关键词： Umbilical Care Practices Risks Newborn Parakou Benin

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Factors Associated with Low Use of Insecticide-Treated Nets among Children under 5 Years of Age in Fo-Boure (Benin) in 2019

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Open Journal of Pediatrics 2023年第5期13卷 619-625页

作者： Alphonse Noudamadjo Mèdétinmè Gérard Kpanidja Falilatou Agbeille Mohamed Zinsou Rodrigue Ahodègnon julien didier adédémy Joseph Agossou Faculty of Medicine Mother and Child Department University of Parakou Parakou Benin National School of Higher Technicians in Public Health and Epidemiological Surveillance University of Parakou Parakou Benin

despite the free distribution of insecticide impregnated nets, malaria is still the cause of many deaths, particularly among children under 5 years old, casting doubt on the real use of these mosquito nets by parents. The present work aimed to identify the factors associated with the low use of mosquito nets. This was a cross-sectional study with an analytical aim, carried out in the locality of Fô-Bouré (Sinendé) in 2019 among children under 5 years old and their parents. A cluster random sampling was carried out according to the WHO technique. The dependent variable was the low use of LLINs and the independent variables were: socio-demographic, economic, relative to parents’ knowledge of the causes and control methods of malaria. Results: The factors identified as associated with the low use of LLINs were: female sex (p = 0.0059), low level of education (p = 0.0001), free mode of acquisition (p = 0.0476), poor knowledge of control methods (p = 0.0389), type of house: mud or tent house (p = 0.0034), unsanitary immediate environment (p = 0.0002) and children’s evening dressing style (p = 0.0001). Conclusion: A global development policy, especially in terms of education, sanitation and housing improvement as recommended by the “Roll Back Malaria” initiative is necessary to improve the rate of insecticide impregnated nets use. .

关键词： Use LLIN Associated Factors Benin

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Prevalence of Undernutrition among Children Aged 6 - 59 Months in the Municipality of Toucountouna (Benin) in 2017

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Open Journal of Pediatrics 2023年第5期13卷 641-648页

作者： Alphonse Noudamadjo Falilatou Agbeille Mohamed Mèdétinmè Gérard Kpanidja myriam Anita dogo Gado Tchando julien didier adédémy Joseph Agossou Faculty of Medicine Mother and Child Department University of Parakou Parakou Benin Saint Jean de dieu district General Hospital of Tanguieta Tanguieta Benin National Training School of Higher Technicians in Public Health and Epidemiological Surveillance (ENATSE) University of Parakou Parakou Benin

Introduction: Undernutrition is a public health problem in the world and especially in developing countries. According to the demographic and health survey with multiple indicators of Benin IV (dHS-MICS-IV), the prevalence of acute undernutrition (AU), chronic undernutrition (CU) and that of underweight (UW) was 16%, 45% and 21%, respectively. The objective of this work was to determine the prevalence of undernutrition in children aged 6 to 59 months in the municipality of Toucountouna in 2017. Materials and Methods: This was a descriptive cross-sectional study with two-stage cluster random sampling, composed of 390 children aged 6 to 59 months, living in the municipality of Toucountouna for at least six months. The study variables were: socio-demographic, economic, behavioral, socio-sanitary and anthropometric. data were entered and analyzed using Epi-info 7.2 software. Results: 203 out of 390 children included, were boys (sex ratio of 1.08). The mean age of the children was 28.70 ± 11.79 months. The prevalence of AU, CU and UW was 10.26%, 31.54% and 11.79%, respectively. Conclusion: The results of this study showed that efforts remain to be made in terms of undernutrition and other surveys could identify the determinants linked to this situation in the locality for the effective implementation of prevention.

关键词： Prevalence Undernutrition Children Benin

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Congenital Malaria in the Borgou/Alibori Regional University Teaching Hospital: myth or Reality?

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Open Journal of Pediatrics 2019年第3期9卷 183-191页

作者： Joseph Agossou Falilatou Agbeille Mohamed Mèdétinmè Gérard Kpanidja Alphonse Noudamadjo julien didier adédémy Zinsou Rodrigue Ahodègnon department of Mother & Child Faculty of Medicine University of Parakou Parakou Benin Pediatric Unit of the Borgou/Alibori Regional University Teaching Hospital Parakou Benin

Introduction: The occurrence of malaria is classically described as uncommon or exceptional in the neonatal period. This work aims to describe the epidemiological, diagnostic, therapeutic, clinical features and outcomes of congenital malaria in the Borgou/Alibori Regional University Teaching Hospital (CHUd B/A) located in Parakou. Patients and Methods: This research is a cross-sectional and descriptive study that was conducted in the neonatal intensive care unit of the CHUd B/A from January to december 2017. It included and involved all newborns less than eight (08) days old with positive thick smears. Comorbidities were taken into account to establish the diagnosis of congenital malaria with accuracy. Findings: A total of 170 newborns out of 892 newborns admitted tested positive with Plasmodium falciparum thick smears, i.e., a hospital-based frequency of 19%. The sex ratio was 1.1. The mean age was 22.44 ± 2.72 hours. There was malaria-bacterial infection comorbidity in 39.3% of cases. Among the 91 cases of thick smears testing positive without stigma of bacterial infection, G6Pd deficiency and fetal-maternal Rhesus incompatibility, the main reasons for admission were prematurity (51.6%), low birth weight (44%), neonatal distress (31.8%) and respiratory distress (15.3%). In addition, the main signs found during the physical examination were neurological disorders or impairments (43.9%), respiratory distress (30%), hyperthermia (12.1%) and jaundice (4.4%). The mean or median parasitemia was 490 parasites/μl, with extremes ranging from 100 to 6500 parasites/μl. Treatment was based on artemisinin derivatives. The patient condition improved in 88.7% of cases. Overall mortality was estimated at 11.9%, and the specific mortality was 13.2%. Conclusion: Congenital malaria is a reality that actually prevails in the CHUdB/A. It has become vital and urgent to explore innovative, effective and efficient strategies to ensure its management and prevention. A study using PCR as t

关键词： Congenital Malaria Prevention Benin

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Frequency of Hypovitaminosis d in 6 - 59 Month Children with Severe Malaria in the Pediatrics Unit of the Teaching Hospital of Parakou (CHUd/BA) in Benin in 2016

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Open Journal of Pediatrics 2018年第1期8卷 66-73页

作者： Alphonse Noudamadjo julien didier adédémy Joseph Agossou Gratien Godonou Sagbo Falilatou Agbeille Gérard Kpanidja Jacques Assoklé Simon Akpona Faculty of Medicine University of Parakou CHUD/BA Parakou Benin Faculty of Health Sciences of Cotonou Cotonou Benin

Introduction: Vitamin d’s action outside of bone, especially on immunity, is widely reported in the international scientific literature over the last years. Objective: Calculate the frequency of hypovitaminosis d in children aged 6 to 59 months suffering from severe malaria in the CHUd-P pediatric unit in 2016. Setting and Methods: This research work is a cross-sectional study with descriptive and analytical purposes. data gathering was prospective. The study involved children aged 6 to 59 months hospitalized for severe malaria in the CHUd-P pediatric unit. The said children were HIV-uninfected, eutrophic and had not received vitamin d supplementation during the last 6 months. Vitamin d dose was measured using the High Performance Liquid Chromatography (HPLC) technique. Results: A total of 80 subjects were involved in the survey. Mean age was 26.08 months, sex ratio was 0.8 and average weight was 10.80 kg. Hypovitaminosis d frequency was 83.8% (67 cases out of 80 children investigated during the survey) with an average plasma concentration of vitamin d estimated at 21.57 ng/ml ± 7.34 with two extremes (11.24 - 42.32) ng/ml. The minimum parasitaemia was 202 P/μl and the maximum was 580,000 P/μl. Conclusion: Hypovitaminosis d is common in children suffering from severe malaria;this result suggests conducting a large-scale community-based study to decide on vitamin d inclusion in national supplementation policies and severe malaria management.

关键词： Hypovitaminosis d Severe Malaria Children Benin

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