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Evaluation of Antibiotic Prescribing in the Pediatric Department of gabriel TouréTeaching Hospital, Bamako, mali

Open Journal of Pediatrics 2024年第3期14卷 645-656页

作者： Pierre Togo Hawa Konaré ma.ia. maïga Karamoko Sacko Djénéba Konaté Abdoul Karim Doumbia Adama Dembélé Oumar Coulibaly Aminata Sangaré Mohamed Elmouloud Cissé Fousseyni Traoré Belco maïga Ibrahim Ahamadou Aminata Doumbia Lala N’Drany Sidibé Amadou Touré Yacouba Aba Coulibaly Kalirou Traoré Tati Simaga Souleymane Sagara Leyla Bagna maïga Bory Traoré Abdoul a.iz diakité Fatoumata Dicko ma.ia. Sylla Sounkalo Dao Boubacar Togo Paediatric Department Gabriel Tour&#233 Teaching Hospital Bamako Mali Pediatric Department Distric VI Reference Health Center Bamako Mali Infectious Diseases Department Point G Teaching Hospital Bamako Mali

Objectives: The main objective was to evaluate antibiotic prescribing in the Department of Pediatrics at gabriel Touré teaching hospital. Methods: This was a prospective descriptive study conducted from September 1 to November 31, 2018, in the Department of Pediatrics at gabriel Touré teaching hospital. All children aged 0 to 15 years hospita.ized for any pathology during the study period and having received at least one antibiotic had been included. Results: We collected 445 children’s records out of 1032 admissions during the study period, representing a hospital frequency of 43.1%. The sex ratio was 1.3%. The 2 - 5 age group accounted for 48.1%. Fever was the reason for consultation in 45.6% of cases. Patients’ general condition was altered in 60% of cases. The fathers were blue-collar workers in 65.4% and the mothers housewives in 85%, and had no education in 42.9% and 64.5% respectively. Hepatomegaly was present in 18.2%, splenomegaly in 9.6% and peripheral adenopathy in 3.1%. The site of infection was pulmonary in 37.6% and ENT in 9.2%. Bacterial infection was assumed on admission in 54% of cases, and meningitis in 57.7%. The discharge diagnosis was malaria in 54.6%, severe acute malnutrition in 18.6% and meningitis in 6.7%. The death rate was 3.8%. Neutrophilic leukocytosis was present in 47.3% of patients. CRP was positive in 85% of patients. Blood cultures taken in 27.6% of patients were positive in 5. CSF analysis in 30% of patients showed elevated leukocytes in 6.5%. No cultures were positive. Antibiotic prescription was justified by infectious hypotheses in 43.1% of patients. β-lactam antibiotics were prescribed in 98.6%. Antibiotic therapy was not adapted to national/international recommendations in 68.3% of cases, and was not justified in 16.3% of cases on D5 of hospita.ization. Conclusion: Antibiotic use was justified in more than half of patients, but remained inadequate in almost two-thirds of cases, in line with national and international recommend

关键词： Antibiotic Prescription Hospita.ization Child

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Evaluation of Antibiotic Prescribing in the Pediatric Department of gabriel Touré Teaching Hospital, Bamako, mali

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Open Journal of Pediatrics（儿科学期刊） 2024年第3期 645页

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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 a.iz diakité ma.ia. 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 hospita.ized 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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Risk Factor for malnutrition in Children Aged 6 to 59 Months Hospita.ized in a Pediatric Ward in the South of the Sahara

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Open Journal of Pediatrics 2021年第3期11卷 329-338页

作者： A. A. diakité A. Diall B. maïga A. Dembélé F. L. diakité B. Coulibaly L. N. Sidibé A. K. Doumbia O. Coulibaly P. Togo G. Dembélé A. Diall M. Sylla Department of Pediatrics Gabriel Touré University Hospital Bamako Mali

malnutrition is a major public health problem in mali, along with the country’s political and security instability. We initiated this work with the objective of determining the frequency as well as the risk factors favoring the occurrence of malnutrition in children aged 6 - 59 months hospitalized in the pediatrics department of the Gabriel Touré University Hospital in Bamako, country reference service to identify potential interventions to plan. A cross-sectional study was carried out over a period of 4 months. A bivariate logistic regression analysis allowed us to identify risk factors with degree of significance if p 0.05. During the study period, 2888 children were hospitalized, including 348 aged 6 to 59 months, or a frequency of 12.04%. One in two children was malnourished, i.e. a frequency of 50%. It more frequently

关键词： malnutrition Contributing Factors Pediatrics

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Synchronous Volvulus of the Sigmoid Colon and the Transverse Colon: A Case Report at gabriel Toure University Hospital in mali

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Surgical Science 2021年第9期12卷 313-318页

作者： Traoré Amadou Konaté ma.ia.sa Diarra Abdoulaye Tounkara Idrissa Saye Zakari Doumbia Arouna Bah Amadou Sidibé Boubacar Yoro maïga Amadou Koné Tani Thiam Souleymane Karembé Boubacar Kelly Bouréima Traoré Kadia Kéita Koniba Bouaré Yacouba Koné Assitan diakité Ibrahim diakité Ibrahim Dembélé Bakary Tientigui Traoré Alhassane Togo Adégné General Surgery Department Gabriel Touré University Hospital Bamako Mali Surgery Department Kati University Hospital Kati Mali Reference Health Center of Commune III Bamako Mali

Synchronous transverse and sigmoid colon volvulus are very rare. We report the case of a 23-year-old man who underwent emergency surgery for sigmoid colon volvulus. An intraoperative finding of transverse colon volvulus associated with sigmoid colon volvulus was made. Left and transverse colectomy was performed followed by colorectal anastomosis. The postoperative period was uneventful. Synchronous volvulus of the transverse and sigmoid colon is a surgical emergency. The clinical signs are not specific and the discovery is often intraoperative. It is necessary to know how to evoke the diagnosis in a case of sigmoid colon volvulus, to avoid inadequate management with dramatic consequences.

关键词： Volvulus Synchronous Colon Sigmoid Transverse Surgery mali

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Blood Count Characteristics of Children Hospita.ized in General Pediatrics at the gabriel Touré Teaching Hospital

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Open Journal of Pediatrics 2023年第4期13卷 543-552页

作者： Pierre Togo Abdoul Karim Doumbia Oumar Coulibaly Abdoul a.iz diakité Moussa Tembély Adama Dembélé Hawa Gouro Diall Mohamed Elmouloud Cissé Fousseyni Traoré Belco maïga Karamoko Sacko Djénéba Konaté Ibrahim Ahamadou Fatoumata Léonie diakité Lala N’Drainy Sidibé Guédiouma Dembélé Oumou Koné Amadou Touré Yacouba Aba Coulibaly Leyla Bagna maïga Aminata Doumbia Hawa Konaré Kalirou Traoré Souleymane Sagara Tati Simaga Fatoumata Dicko ma.ia. Sylla Boubacar Togo Department of Pediatrics Gabriel Touré Teaching Hospital Bamako Mali National Institute for Health Science Training Bamako Mali Pediatrics Department Mohamed V Perinatal Clinic Bamako Mali Pediatrics Department DSSA Bamako Mali National Institute of Public Health “NIPH” Bamako Mali

Objective: The main objective was to study the disturbances of the Blood Count of children hospita.ized in the general pediatric of the gabriel Touré teaching hospital. Methods: This was a prospective and descriptive study conducted from September 1 to November 30, 2018 in the general pediatrics department of the gabriel Touré teaching hospital in Bamako. Data were collected on patient records using a survey sheet. Results: We collected 512 files of children out of 1030 admissions during the study period;the rate of completion of the blood count is 50%. The male sex was predominant with a sex ratio of 1.3. The majority of patients were under 5 years old (58%). The majority of fathers (56%) and mothers (64%) of children had no education;they are mainly farmers (61%) and housewives (88%). Pallor was the reason for consultation in 29% of patients and present in 60%. On blood count, anemia was present in 92% of patients, half of whom (50%) had severe anemia with a hemoglobin level below 7 g/dL. The anemia was mainly microcytic (72%) and hypochromic (66%). Hyperleukocytosis (62%), eosinophilia (68%) and basophilia (58%) were the abnormalities observed in the white line. Thrombocytopenia accounted for 40%. Severe malaria (53%) was the main discharge diagnosis and almost all patients (99%) were alive at discharge. Conclusion: The characteristics of anemia require a study of the complete blood count in healthy children with dosage of serum iron and ferritin for a better understanding of the phenomenon.

关键词： Characteristic Blood Count Child

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Tuberculosis in Children: Epidemio-Clinical Aspects in the Paediatric Department of the gabriel TouréUniversity Hospital Center

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Open Journal of Pediatrics 2022年第2期12卷 376-388页

作者： Adama Dembélé Abdoul a.iz diakité Mohamed Elmouloud Cissé Bassirou Diarra Belco maïga Issa Sanou Pierre Togo Abdoul Karim Doumbia Oumar Coulibaly Karamoko Sacko Djéneba Konaté Hawa Diall Lala Ndrainy Sidibé Bréhima Dégoga Fatoumata Léonie diakité Guédiouma Dembélé Fatoumata Dicko ma.ia. Sylla Boubacar Togo Department of Paediatrics University Teaching Hospital of Gabriel Touré Bamako Mali University Clinical Research Center University of Sciences Techniques and Technologies of Bamako Bamako Mali Department of Pediatrics CHU Gabriel Touré Bamako Mali

Introduction: Globally, tuberculosis is the leading cause of death from a single infectious agent ahead of HIV/AIDS. Approximately 10 million people contracted TB in 2017, 10% of whom were children aged 0 - 15 years, or about 1 million with 250,000 deaths in 2016 (including children with HIV-associated TB). The signs of TB in children are not always specific and diagnosis remains difficult unlike in adults. According to a study conducted in 2011 in the paediatric department of the CHU-gabriel Touré, only seventeen cases of all forms of tuberculosis were found, or approximately 0.2% of hospitalised children. The objective of our study was to investigate the epidemiological and clinical aspects of tuberculosis in children. materials and Method: This was a prospective, cross-sectional and descriptive study that took place from 24 October 2017 to 23 October 2018, or 12 months in children aged 0-15 years. Data were collected from an individual medical record opened for each patient and an individual survey form established for each child. Results: During the study period, 40,434 children were consulted. Tuberculosis was suspected in 91 children, with a frequency of 0.22%. The age range of 1 to 4 years was 36.3% with a median age of 72 months. The sex ratio was 1.8. Chronic cough with 84.6% and malnutrition with 24.17% were the most frequent symptoms. Chest X-ray revealed bilateral pulmonary lesions in 52.7% and mediastinal adenopathy in 12.1%. TST was positive in 10.9% of patients, microscopy in 26.4%, Gene Xpert in 18.7%, and culture in 16.5%. The biological diagnosis of tuberculosis was retained in 48.4% of the patients, the pulmonary form represented 93.2%. The therapeutic regime (2RHZE/4RH) was used in 81.6% of cases and the evolution was favourable in 65.9% of patients. Conclusion: The diagnosis of tuberculosis in children remains difficult in our context. The clinical signs are not always specific, and further studies are needed to further elucidate this disease.

关键词： Child Clinic Epidemiology gabriel Touré University Hospital Center Tuberculosis

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Clinical, Aetiological and Evolutionary Aspects of Respiratory Distress in Term Neonates: A Single-Centre Cross-Sectional Study

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Open Journal of Pediatrics 2023年第6期13卷 821-830页

作者： Abdoul Karim Doumbia Doumbia Aminata Coulibaly Oumar Pierre Togo Adama Dembélé Abdoul a.iz diakité Mohamed Elmouloud Cissé Hawa Diall Belco maïga Aminata Coulibaly ma.ia. Kané Tati Simaga Karamoko Sacko Yacouba Aba Coulibaly Djéneba Konaté Ibrahima Ahamadou Hawa Konaré Lala Ndrainy Sidibé Kalirou Traoré Fatoumata Léonie diakité Guédiouma Dembélé Fatoumata Dicko Fousseyni Traoré Boubacar Togo Department of the CHU gabriel Touré Bamako Mali

Introduction: Respiratory distress is a frequent cause of morbidity and mortality in neonates. The aim of this study was to assess its frequency and describe its clinical and evolutionary characteristics in the neonatology department of the gabriel Touré University Hospital in Bamako. Methodology: This was a prospective cross-sectional study conducted from 1 January 2021 to 30 June 2021. All term neonates aged 0 to 28 days hospitalised with signs of respiratory distress (tachypnoea, nasal flaring, expiratory whining, intercostal and subcostal indrawing, xiphoid funneling and cyanosis) were included. The sociodemographic and clinical variables of the newborns and their mothers were analysed using SPSS.20 software. Results: During the study period, 1272 newborns were admitted to hospital, including 705 born at term, of whom 188 were included in the study. The mothers’ ages ranged from 14 to 45 years, with an average of 24 years. The pregnancy was not followed up in 15% of cases. Newborns were resuscitated at birth in 51% of cases. The main clinical signs observed were hypoxia, neurological disorders and fever. Perinatal asphyxia (55%), neonatal infections (34%) and congenital malformations (6%) were the main causes of respiratory distress. Mortality was estimated at 37%. Conclusion: Neonatal respiratory distress is a major cause of death. Most causes can be avoided if pregnancy and delivery are properly managed.

关键词： Respiratory Distress Neonate Asphyxia

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Congenital Heart Disease in Newborns: Epidemiological and Clinical Particularities in a Neonatology Department in mali

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Open Journal of Pediatrics 2022年第5期12卷 857-866页

作者： Abdoul Karim Doumbia Oumou Koné Adama Dembélé Noumou Sidibé Noel Banou Hawa Gouro Diall Pierre Togo Oumar Coulibaly Karamoko Sacko Djéneba Konaté Tati Simaga Lala Ndrainy Sidibé Fatoumata Léonie diakité Boubacar Diarra Guédiouma Dembélé Belco maïga Mohamed Elmouloud Cissé Hawa Konaré Aminata Doumbia Ibrahim Ahamadou Abdoul a.iz diakité Fatoumata Dicko Traoré Boubacar Togo Department of the CHU gabriel Touré Bamako Mali

Introduction: Congenital heart disease is an important cause of mortality, chronic morbidity, and disability in children in poor countries. The objective of this study was to highlight the diversity of congenital heart defects in the neonatology department. Methodology: This work had taken place in a neonatology service over a period of six months from January 2019 to June 2019. It was a prospective descriptive study with information collected from the medical records of newborns with congenital heart disease. Results: Of 1478 neonates hospita.ized during the study period, 41 had congenital heart disease, for a hospita.ization rate of 2.77%. CHD accounted for 2.77% of neonatal hospita.izations. The sex ratio was 1.73 (26 boys/15 girls). Consanguinity was found in 19% of cases. The average time to consultation was 11 days. The main clinical signs were heart murmur (58%), respiratory distress (56%) and extracardiac malformations (54%). The main cardiac malformations found were atrial septal defect (46%), patent ductus arteriosus (44%), ventricular septal defect (17%), complete atrioventricular canal (15%), and transposition of the great vessels (5%). The case fatality rate was 29%. Conclusion: Delayed diagnosis, generally related to the long delay in consultation, and lack of surgical management partly explain this high case fatality.

关键词： Congenital Heart Disease Neonates management

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Traumatic Diaphragmatic Injury at gabriel Toure University Hospital, mali

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Surgical Science 2022年第3期13卷 110-118页

作者： Amadou Traoré ma.ia.sa Konaté Abdoulaye Diarra Idrissa Tounkara Mohamed Traoré Arouna Doumbia Amadou Bah Boubacar Yoro Sidibé Amadou maïga Tani Koné Boubacar Karembé Zakari Saye Koniba Kéita Yacouba Bouaré Assitan Koné Ibrahim diakité Lassana Kanté Bakary Tientigui Dembélé Alhassane Traoré Adégné Togo General Surgery Department of gabriel Touré University Hospital Bamako Mali Surgery Department of Kati University Hospital Kati Mali Reference Health Center of Commune II Bamako Mali Reference Health Center of Commune III Bamako Mali

Traumatic diaphragmatic injury (TDI) is rare and is most often the result of a traffic road accident (TRA) or an assault. We initiated this study with the aims of determining the epidemiological, clinical and therapeutic aspects of TDI at gabriel Toure University Hospital. This was a retrospective study from January 1999 to June 2021 that included all patients who presented a diaphragmatic injury consecutive to abdominal and/or thoracic trauma. In 22 years and 6 months, 46 cases of TDI were collected. They represented 0.17% of hospita.izations, 0.26% of surgical emergencies and 5.5% of thoraco-abdominal traumas. The average age was 31.69 years with a sex ratio of 3.2. Criminal stabbings accounted for 56.5% and TRA for 19.6%. Penetrating injuries accounted for 78.3% of cases. The parietal lesion was thoracic in 21 cases (45.7%), abdominal in 19 cases (41.3%) and thoraco-abdominal in 6 cases (13%). The chest X-ray, performed in 15 patients, showed an intrathoracic gas bubble (4 cases) and hemothorax (6 cases). Diagnosis of diaphragmatic lesion was preoperative in 21.7% (10 cases). The diaphragmatic breach was on the left side in 65.2% (30 cases) and the average size was 3.17 cm. Laparotomy was performed in 89.1%, thoracotomy in 4.4% and thoraco-laparotomy in 6.5% of cases. The surgical procedure consisted of reduction of the herniated viscera in 15.2% (7 cases) and closure of the diaphragmatic breach with non-absorbable sutures in 82.6% (36 cases). Chest tube drainage was performed in 73.9%. The average length of hospital stay was 9.8 days. Mortality was 13.04%. Conclusion: Traumatic diaphragmatic injury is rare but its frequency is increasing in our country. It most often affects the young man victim of assault or TRA. This type of trauma is rarely isolated;you have to think about it in case of any thoraco-abdominal trauma. The treatment is surgical. The prognosis depends on the severity of the associated lesions.

关键词： Diaphragmatic Injury Trauma Surgery gabriel Toure

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