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Epidemiology of Renal Failure in Children at the Pediatric University Hospital Charles De-Gaulle of Ouagadougou (Burkina Faso)

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Open Journal of Pediatrics 2016年第1期6卷 141-148页

作者： Coulibaly Gérard Savadogo Hamidou Bakoné B. Evariste Karambiri Adama Roger kouéta fla Hien Kpienoba Manan Champion Gérard Lengani Adama Yé Diarra Department of Nephrology and Hemodialysis University Hospital Center Yalgado Ouedraogo Ouagadougou Burkina Faso Department of Medical Pediatrics Pediatrics University Hospital Center Charles De-Gaulle Ouagadougou Burkina Faso Pediatrics Nephrology Service Pediatrics Federation CHU Angers Cedex France

Objective: Renal failure (RF) is a serious condition that is still insufficiently evaluated in our context. We wanted to know its epidemiology at the Pediatrics University Hospital Center Charles De-Gaulle (PUHC-CDG) of Ouagadougou. Patients and Methods: We retrospectively studied all children aged from three to fifteen years old who were diagnosed with renal failure (RF) in the Department of Medical Pediatrics, from January 1, 2011 to December 31, 2013. RF was defined by a glomerular filtration rate (GFR) less than 80 mL/min/1.73m2, estimated by the formula of Pottel et al., which ignored the size that was rarely found in the medical records. The department constantly lacked pediatric blood pressure monitors or urinary strips. Results: In total, 119 cases of RF (3.3% of all admissions) were collected. They were about acute RFs (ARFs), chronic RFs (CRFs), and Unclassified RFs (URFs), respectively in 28.6%, 2.5% and 68.9% of cases. The overall average age of patients was 6.7 ± 3.4 years old. The average GFR was 35.2 ± 22.2 mL/min/1.73m2. The mechanism of ARF was presumed to be organic in 26 cases (76.5%). The most common presumed etiology was malaria (47.9%). Twelve patients (10.1%) died. Conclusion: RF was common at the PUHC-CDG but it was unclassified in over half of the cases. The diagnosis was based on the estimation of the GFR by Pottel et al.’s formula which was a good alternative to the Schwartz’s formula. The improvement of human and material resources would certainly help for a screening and characterization of RF at the PUHC-CDG.

关键词： Burkina Faso Epidemiology Glomerular Filtration Rate Pediatrics Renal Failure

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Neonatal Morbidity and Mortality at Hospital Saint Camille de Ouagadougou (HOSCO): A Study from 2017 to 2020

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Open Journal of Pediatrics 2024年第1期14卷 63-77页

作者： Nicaise Zagre Ines Kinda Abdoul Karim Ouattara Paul Ouedraogo Théodora Mahoukèdè Zohoncon Caroline Yonaba fla koueta Jacques Simpore Hô pital Saint Camille de Ouagadougou (HOSCO) Ouagadougou Burkina Faso Faculté des Sciences de la Santé Université Saint Thomas d’Aquin (USTA) Ouagadougou Burkina Faso Laboratoire de Biologie Moléculaire et de Génétique (LABIOGENE) Université Joseph KI-ZERBO Ouagadougou Burkina Faso Centre de Recherche Biomoléculaire Pietro Annigoni (CERBA) Ouagadougou Burkina Faso Faculté des Sciences de la Santé Université Joseph KI-ZERBO Ouagadougou Burkina Faso

Introduction: Neonatal pathology remains a real public health problem in developing countries. In Burkina Faso, this mortality has declined over the last ten years but remains below compared to the Sustainable Development Goals, which is 12 per 1000 living births at most by 2030. This study aims to identify specific causes of neonatal morbidity and mortality and will contribute to the implementation of preventive and curative measures aimed at reducing neonatal mortality at HOSCO. Method: This was a retrospective study using the records and database of newborns hospitalized from January 1srt, 2017 to December 31srt, 2020. Using logistic regression, the factors associated with mortality were determined. Results: During the study period, 3020 newborns were hospitalized. Most newborns (83.71%) were referred by a peripheral health facility. The average age at admission was 0.3 days ± 0.9 and the sex ratio was 1.2. Prematurity was the leading cause of hospitalization (61.13%) followed by neonatal infection (38.34%) and neonatal suffering (23.88%). The mortality rate was 40.6% with 82.71% cases of death in the early neonatal period. The main causes of death were low birth weight (47.39%), respiratory distress (18.76%), neonatal suffering (17.37%) and neonatal infection (13.87%). Home delivery, gestational age 36 weeks, number of PNC 4, concept of resuscitation, Apgar at the 5th minute 7, birth weight 2000 g and >4000 g, respiratory distress, hypothermia, neurological disorders were factors associated with deaths. Conclusion: Neonatal mortality is influenced by both maternal and fetal factors and many of them are preventable.

关键词： Morbidity Mortality Newborns Neonatology HOSCO

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Analysis of Factors Associated with the Abandonment of Nutritional Recovery among Parents of Severely Malnourished Children Aged 6 to 59 Months in the Health District of Titao, Burkina Faso

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Open Journal of Nursing 2024年第9期14卷 477-490页

作者： Aminata Gansore Patrice Ngangue Birama Apho Ly Ludovic K. N’Tcha Douglas Mbang Massom Gbètogo Maxime Kiki Josiane Seu Nestor Bationo Noufou Gustave Nana fla koueta Institute for Interdisciplinary Training and Research in Health and Education Sciences Ouagadougou Burkina Faso Faculty of Nursing Laval University Quebec Canada Faculty of Medicine and Odonto Stomatology University of Sciences Techniques and Technology of Bamako Bamako Mali Centre de Recherche Entomologique de Cotonou Cotonou Benin Faculty of Medicine and Pharmaceutical Sciences University of Douala Douala Cameroon Centre for Interdisciplinary Research in Rehabilittaion and Social Integration (CIRRIS) Laval University Quebec Canada Faculty of Health Sciences Joseph Ki-Zerbo University Ouagadougou Burkina Faso

Introduction: In Burkina Faso, undernutrition is a public health problem associated with more than 40% of infant and child mortality. Undernutrition management is complex, and there is often a risk of treatment abandonment. Studies on this topic have not explored the influence of environmental and therapeutic factors on parental compliance. This study proposes an analysis of factors influencing the abandonment of nutritional recovery by parents of malnourished children aged 6 to 59 months in ambulatory care. Methods: This was a descriptive and exploratory qualitative study. Data collection took place in February 2020. Data were collected from seventeen (17) participants via in-depth interviews (IDI) and direct observation. The IDIs were transcribed verbatim and thematically analyzed using Nvivo software. Results: The results revealed that factors related to the physical environment, such as geographical inaccessibility, pastoral occupation, displacement at auriferous sites, and insecurity, are important causes of nutritional recovery abandonment. They also prove that factors related to the social environment, such as lack of family and social support, feelings of shame, stigmatization, occupation of the mother, and social events, lead to this abandonment. In addition, therapeutic factors such as interruptions of supplies of Ready to Use Therapeutic Food (RUTF), feeling of improvement or worsening of the state of health, recourse to traditional medicine, and ignorance of undernutrition are also associated with this issue. Conclusion: This study highlighted barriers to the abandonment of nutritional recovery among parents of severely malnourished children aged 6 to 59 months in the health district of Titao, Burkina Faso. It is more important to consider these different factors when evaluating care protocols so that policies to reduce child undernutrition can considerably impact the targets.

关键词： Nutritional Recovery Severe Acute Malnutrition Environmental Factors Therapeutic Factors Abandonment Burkina Faso

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Impact of HIV/AIDS on mortality and nutritional recovery among hospitalized severely malnourished children before starting antiretroviral treatment

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Open Journal of Pediatrics 2013年第4期3卷 340-345页

作者： Léon G. Blaise Savadogo Philippe Donnen fla kouéta Eléonore Kafando Philippe Hennart Michèle Dramaix CR2-Epidemiology-Biostatistics-Clinical Research School of Public Health Université Libre de Bruxelles (ULB) Brussels Belgium Department of Epidemiology and Public Health Child and Mother Health Nutrition and Survival Unit Institut Supérieur des Sciences de la Santé (IN.S.SA) Bobo Dioulasso University Bobo-Dioulasso Burkina Faso Ouagadougou Pediatric Hospital and University of Ouagadougou Ouagadougou Burkina Faso

In low income countries, severe acute malnutrition remains a major problem for HIV-infected children and an important risk factor for mortality. This study aims to analyze HIV impact on mortality rate and nutritional recovery among severely malnourished HIV/AIDS uninfected and infected children. This was a retrospective cohort study conducted from data of 521 hospitalized severely malnourished children. We used Pearson’s Chi square test to compare proportions;and Student’s independent t-test to compare means;general linear model to analyze repeated measurements. We used mortality relative risk with confidence interval (CI 95%), Kaplan-Meir survival curves and Cox proportional hazard models to analyze the HIV impact on mortality rate. Case fatality rate differed significantly from SAM HIV uninfected (10.7%) and HIV infected children (39.7%), p tality relative risk was 3.71, 95% IC [2.51 - 5.47] for HIV infected children. Kaplan-Meir survival curves differed significantly between the two groups, (p Log Rank tality relative risk of HIV infected children was 4.27, CI: 2.55 - 7.15, p tality relative risk was 3.71 times higher for HIV infected children. Multiples infections and metabolic complications have synergism on death occurrence in sever acute malnutrition;when associated to HIV infection, case fatality rate increases many times. Weight gain and anthropometrics index evolution were very slow for SAM HIV infected children, and specific diet may be needed for more nutritional recovery. Effective interventions, updated and adapting to local country context, to improve survival of severely malnourished HIV/AIDS infected children in HIV and SAM prevalent se

关键词： Mortality Severely Malnourished HIV/AIDS Children

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Impact of multivitamin and mineral supplements on mortality and nutritional status of hospitalized severely malnourished HIV/AIDS infected children

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Open Journal of Epidemiology 2013年第4期3卷 213-219页

作者： Léon G. Blaise Savadogo Philippe Donnen fla kouéta Eléonore Kafando Philippe Hennart Michèle Dramaix CR2-Epidemiology-Biostatistics-Clinical Research School of Public Health Université Libre de Bruxelles Bruxelles Belgique Department of Epidemiology and Public Health Child and Mother Health Nutrition and Survival Unit Institut Supérieur des Sci- ences de la Santé Bobo Dioulasso Burkina Faso Pediatric Hospital and University Ouagadougou Burkina Faso

Micronutrient deficiencies, in HIV/AIDS infected children, are common and associated with disease progression and increased mortality. There is no evidence to support specific recommendation for in-patient treatment of severely malnourished HIV/AID infected children. We analyzed the impact of daily oral multivitamin and mineral supplementation on nutritional status and on mortality rate, of severely malnourished HIV/AIDS infected infants, hospitalized in a feeding therapeutic center. Children were randomized at admission in one of the two treatment groups: WHO standard group or additional dose group. The trial has been approved by the national health research ethics committee. Case fatality rate was high in each group. There was no difference in mortality rate between WHO standard group (mortality rate = 16.9%) and “additional dose” group (mortality rate = 17.6%). Kaplan Meir survival curves did not differ between the two groups, (p Log Rank = 0.87). During the inpatient follow-up, the median weight gain (g/kg/d) was low in groups and did not differ between WHO standard group (8.88g/kg/d Min = 4.70, Max = 17.23) and “additional dose” group (10.50g/kg/d, Min = 3.29 Max = 17.81) (Wilcoxon test p-value = 0.10). From admission to discharge, anthropometric Z-scores means evolution did not differ between the two groups: WHZ (p = 0.74), WAZ (p = 0.79) and MUAC (p = 0.73). In this randomized trial among severely malnourished HIV/AIDS infected children, we found no evidence that the provision of daily additional micro-nutrient dose during inpatient treatment, compared to WHO standard, improves nutritional status or reduces case fatality rate. Rigorous malnutrition inpatient treatments, including effective HIV/AIDS management, improve nutritional status of severely mal-nourished HIV infected children.

关键词： Multivitamin Mortality Nutritional Status Malnourished HIV Children

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The Destombes-Rosai-Dorfman Disease or Sinus Histiocytosis with Massive Lymphadenopathy: A Rare Case Described in the Paediatrics Department of Yalgado Ouedraogo University Hospital

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Open Journal of Pediatrics 2017年第4期7卷 345-352页

作者： Chantal Zoungrana-Ouattara Flore Ouédraogo Laure Toguyéni Angèle Kalmogho Caroline Yonaba Chantal Gabrielle Bouda Rolande Kaboré fla kouéta Département de pédiatrie du CHU Yalgado Ouédraogo de Ouagadougou Ouagadougou Burkina Faso Unité de Formation et de Recherche en Sciences de la Santé (UFR/SDS) Université de Ouagadougou Ouagadougou Burkina Faso Service de pédiatrie médicale du CHU Charles de Gaulle de Ouagadougou Ouagadougou Burkina Faso

Destombes-Rosai-Dorfman’ disease (DRD) is an inflammatory non-langerhansian histiocytosis with adenomegaly. It is a rare histiocytic disorder worldwide, less than 1000 reported cases. It is of unknown etiology and is characterized in its classical form by multiple adenomegalia, especially localized at cervical area, but also at mediastinal, axillary and inguinal areas. It is a benign condition, even if it is deforming, with spontaneously resolving evolution. We report a case of DRD disease in a 13-year-old girl, hospitalized in the Department of Pediatrics of the Yalgado Ouédraogo University Hospital Center in Ouagadougou, in March 2015. She was admitted for a voluminous bilateral painless cervical swelling, with no sign of local compression, having been operating for about a year. Biological tests showed signs of chronic inflammation;the imagery specified the benign character of these formations: adenomegalia. Confirmation of the diagnosis was made by pathological examination, describing the aspect of emperipolesis to histology and, immunohistochemistry, polytypic plasmacytosis and PS100 positive/CD1a histiocytosis negative. The treatment could not be properly carried out, in view of the early discharge, against medical advice from the patient. The evolution would have been marked, according to the parents, by a slight involution of swelling.

关键词： Destombes-Rosai-Dorfman Disease Emperipolesis Immunohistochemistry Yalgado Ouedraogo University Hospital

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Free amino acid content in trunk,branches and branchlets of Araucaria angustifolia(Araucariaceae)

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Journal of Forestry Research 2018年第6期29卷 1489-1496页

作者： Crizane Hackbarth Patricia Soffiatti fla′vio Zanette Eny Iochevet Segal Floh Amanda Ferreira Macedo Henrique Aparecido Laureano Departamento de Fitotecnia e Fitossanitarismo Federal University of Parana(UFPR)Rua dos Funcionarios1540JuveveCuritibaPR 81531-990Brazil Departamento de Botanica Federal University of Parana(UFPR)Av.Cel.Francisco H.dos Santos100Jardim das AmericasCuritibaPR 81531-980Brazil Instituto de Biociencias University of Sao PauloRua do Matao277Sao PauloSP 05508-090Brazil Departamento de Estatstica Federal University of Parana(UFPR)Av.Cel.Francisco H.dos Santos100Jardim das AmericasCuritibaPR 81531-980Brazil

Araucaria angustifolia(Bertol.) O. Kuntze exhibits dimorphism in its stem structure, where the trunk is orthotropic and branches and branchlets(primary and secondary branches) are plagiotropic. These stems exhibit different behavior when used for vegetative propagation,and only segments of trunk can form a complete plant. The physiological and biochemical mechanisms that characterize these stems are still little known. The aim of this study was to describe the free amino acid profiles in trunks,branches, and branchlets of A. angustifolia. Segments of 5 cm in length were excised from young individuals below the stem apex. The needles were removed and samples were frozen and lyophilized. The determinations were made by high-performance liquid chromatography, and the results were expressed as lg/g fresh weight(FW). The trunks and branches had the highest content of total amino acids, which were 112.23 ± 20.57 lg/g FW and 111.97 ± 27.78 lg/g FW, respectively. The amino acids—glutamine, aspartate and c-aminobutyric acid and tyrosine—were noticeably higher in the three types of *** the trunk, a higher amount of asparagine and tryptophan,was also detected. Glutamic acid and glutamine were found in higher quantities in the branches. The branchlets had very low total amino acid content (30.79 ± 4.19 lg/g FW), wherein asparagine is the only amino acid not detected. Thus, it was observed that the profile of the free amino acid differs among trunks, branches, and branchlets in A. angustifolia, indicating that they perform different functions.

关键词： Brazilian pine Physiological mechanisms Stem’s dimorphism Free amino acids

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Verbal Autopsy of Stillbirths and Neonatal Deaths in a Rural Area of Burkina Faso

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Open Journal of Pediatrics 2015年第2期5卷 164-170页

作者： fla koueta Kisito Nagalo Leatitia Ouedraogo Francois Housseini tall Diarra Ye The Burkinabe Pediatrics Society OuagadougouBurkina Faso Training and Research Unit of Health Sciences University of OuagadougouOuagadougouBurkina Faso Service of Medical Pediatrics Charles De Gaulle Pediatric University Teaching HospitalOuagadougouBurkina Faso Service of Pediatrics Clinique El Fateh-SukaOuagadougouBurkina Faso

Introduction: In developing countries, many neonatal deaths still occur at home and the causes of these deaths are not ascertained. Objective: To identify the causes of stillbirths and neonatal deaths that occur at home and the factors that have contributed to these deaths. Materials and Method: We have used the method of verbal autopsy to investigate the stillbirths and neonatal deaths in nine villages in the health area of Namsiguia, health district of Ouahigouya, Burkina Faso, during the period January 1, 2007 to December 8, 2012. Results: Over these six years, we have recorded 19 stillbirths and 36 neonatal deaths among 1507 live births, demonstrating a neonatal mortality rate of 28.8 per1000 and a rate of stillbirths of 12.6 per 1000. The average age of newborns at death was 5.6 days and the sex-ratio was 1.6. The major cause of stillbirths was antenatal hypoxia and birth asphyxia (42.1%). The direct causes of neonatal deaths were neonatal sepsis (41.7%), preterm birth (19.4%) and hypoxia and birth asphyxia (11.1%). There were 42.1% deliveries and 58.3% neonatal deaths, which occurred at home. We have noted 89.5% fresh stillbirths. Death occurred more often during the early neonatal period (55.5%). Factors significantly associated with neonatal death were, lack of school education of mothers (OR = 4), precocious marriage of the mother (OR = 8), poor follow-up of pregnancies (OR = 3), birth at home (OR = 4), low socioeconomic level (OR = 6), and low geographical access to the health facility (OR = 4). Conclusions: Strengthening of the health infrastructure and improving their accessibility, reinforcement of the staff for high quality care, and communication for a change in behavior in rural communities, will contribute toward reducing neonatal mortality in the area of health of Namsiguia.

关键词： Verbal Autopsy Neonatal Deaths Stillbirths Cause of Death

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Acute Malnutrition and Infection with the Human Immuno-Deficiency Virus (HIV) in Children Followed up at the Pediatrics University Hospital Charles de Gaulle: Evolution of Anthropometric Parameters on Antiretroviral Treatment

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Open Journal of Pediatrics 2016年第1期6卷 34-41页

作者： Aïssata Kaboré Sylvie Armelle P. Ouédraogo Lassina Dao fla koueta Diarra Yé Service de Pédiatrie Médicale Centre Hospitalier Universitaire Pédiatrique Charles De Gaulle de Ouagadougou Ouagadougou Burkina Faso

Burkina Faso, a country with very scarce resources, undertook to fight against HIV infection. In 2013, according to UNAIDS, 110,000 persons were living in this country with HIV infection. 18,000 children among these persons were under 15. We conducted a retrospective study from January 2003 to December 2012 at the Pediatrics University Hospital Charles De Gaulle, Ouagadougou (CHUP CDG), Burkina Faso. The study aimed at assessing the children’s ponderal growth when under antiretroviral treatment. The children who were under 15 and who had been on antiretroviral treatment for at least 5 years were included in the study. Acute malnutrition concerned children whose height/weight ratio (H/W) was lower at -2 width type (or Z score) of the median of reference regarding age according to WHO. Two categories of malnutrition were outstanding in our study: moderate acute malnutrition, (-3 Z-score ≤ H/W -2 Z-score) and severe acute malnutrition (W/H -3 Z-score). The clinical and paraclinical data recorded during previous consultations were extracted from the ESOPE (Monitoring and follow-up of patients) data basis and exported to the ENA software and SPSS for their analysis. In total, 210 out of 529 children’s cases were considered. These children’s average age was 6.9 years. There were 55.7% of male and 44.3% of female children. HIV1 was found in 97.6% of the children against 2.4% for HIV2. In a 5 year follow-up, 46 among the children, namely 20.4% were on a second line protocol of antiretroviral treatment and 164 among them were still on a first line protocol of antiretroviral treatment. When they were admitted at hospital, 38% of the children showed characteristics of acute malnutrition. 17.8% of these children presented characteristics of severe form of acute malnutrition. During this 5-year follow-up, the average of the W/H index of the children gradually rised from -1.62 Z-score when being admitted to -0.18 Z-score at after a 60-month antiretroviral treatment. Our study sho

关键词： Acute Malnutrition HIV-Infected Children Antiretroviral Treatment Burkina Faso

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Lipodystrophy among Children Infected with Human Immunodeficiency Virus and on Antiretroviral Treatment in Ouagadougou

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Open Journal of Pediatrics 2015年第3期5卷 199-206页

作者： Caroline Yonaba Aissata Ouedraogo Sylvie Armelle Pingwende Ouedraogo Bourama Ouattara Angel Kalmogho fla koueta Diarra Ye Ludovic Kam Department of Pediatric Yalgado Ouedraogo University Teaching HospitalOuagadougouBurkina Faso Department of Pediatric Charles de Gaulle Pediatric University Teaching HospitalOuagadougouBurkina Faso

Management of Human Immunodeficiency Virus infection remains a major challenge in many sub-Saharan African countries. Antiretroviral drugs which have reduced significantly the mortality rate of this pandemic disease are a source of side effects. Among these side effects, adult lipodystrophy has already been described by several authors. The aim of this study is to determine the prevalence of lipodystrophy and associate factors in children on antiretroviral therapy, managed at Charles De Gaulle Children University Hospital and Yalgado Ouedrago University Hospital in Ouagadougou, Burkina Faso. This is a cross-sectional study conducted from June 2013 to January 2014. We included children aged 2 to 15 years who had been on antiretroviral treatment for at least six months with no severe acute malnutrition (wasting). Lipodystrophy was diagnosed clinically after assessment of morphological changes. Overall, 323 children complying with the inclusion criteria were examined. The average duration of antiretroviral therapy was 5.3 years. Forty five children had lipodystrophy, i.e. 13.9% prevalence rate. One hundred and twenty seven different lipodystrophic lesions were noted, hence 82.7% lipoatrophy and 17.3% lipohypertrophy. The most common presentations were: face (32%), lower limbs (26%) and upper limbs (15.7%). Factors associated with lipoatrophy were: age above 10 years (P = 0.004);male gender (P = 0.0004);antiretroviral treatment duration of more than 60 months (P tavudine (P = 0.01). Our study showed that lipodystrophy is not exceptional in children on antiretroviral therapy in Ouagadougou. However, more researches on lipid profiles of these children are necessary to prevent other common complications related to fat accumulation.

关键词： HIV Children Lipodystrophy Burkina-Faso

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