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Epidemiological and Clinical Aspects of Congenital Hydrocephalus in the Neonatal Department of Gabriel TouréTeaching Hospital Bamako Mali

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Open Journal of Pediatrics 2022年第1期12卷 1-11页

作者： Hawa G. Diall Oumar Coulibaly Youssouf Sogoba Hatouma Sylla Yacouba A. Coulibaly Fatoumata L. Diakité Lala N. Sidibé Ibrahima Ahamadou Leyla Maiga Abdoul K. doumbia Pierre Togo Adama Dembélé Mohamed E. Cissé Fousseini Traoré Belco Maiga Karamoko Sacko Djeneba Konaté Bourama Kané Oumou Koné Guedjouma Dembélé Abdoul A. Diakité Drissa Kanikomo Fatoumata D. Traoré mariam Sylla Boubacar Togo Department of Pediatrics CHU Gabriel Touré Bamako Mali Department of Neurosurgery CHU Gabriel Touré Bamako Mali Department of Pediatrics Hospital Mali Bamako Mali National Institute of Public Health Bamako Mali

Objective: The aim of our work was to access the epidemiological and clinical aspects of congenital hydrocephalus in the pediatrics department of Gabriel Touré teaching Hospital Bamako. Methods: We conducted a retro and prospective study that ran from January, 1st 2018 to July, 30, 2019. All newborns of 72 hours of life or less with hydrocephalus confirmed by sonography or CT scan were enrolled in this study. Results: During the study period, 5416 patients were hospitalized in the neonatology department. Among them, 39 patients (0.72%) presented congenital hydrocephalus and congenital infectious causes accounted for 25.6%. The sex ratio (M/F) was 1.78. Mothers were housewives and not educated in 79.5% and 64.1% respectively. The parents resided outside Bamako in 61.5% of cases. Prenatal consultations were conducted in 32 patients (82%). Consanguinity between the 2 parents was present in 38.5%. The antenatal diagnosis was made in 8 patients (20.5%). Vaginal delivery was the main mode of birth (67%). The average birth weight was 2930 g (1000 to 5400 g) and the average head circumference was 37.82 cm (26 - 55 cm). In 87.2% of cases, newborns were eutrophic. The main clinical signs were bulging anterior fontanel (46.2%), sunset gaze (20.5%), prominent forehead (48.7%), reduced face (20.5%), enlarged cranial sutures (43.6%), macrocrania (25.6%). Transfontanellar ultrasound and CT scan were performed in 51.3% and 48.7% of cases respectively. Associated malformations were spina bifida in 30.8% of cases followed by Dandy Walker malformation (5.1%), and omphalocele (2.5%). The neurological signs were diminished neonatal reflexes (51.3%), hypotonia (30.8%), motor deficit (38.4%), intracranial hypertension (25.6%), seizures 10.25% and psychomotor delay (43.6%). Surgery was performed in 8 neonates (20.5%). Ventriculo-peritoneal shunt (VPB) was the main treatment. Postoperative complications were infectious (37.5%) and mechanical complications (12.5%). The postoperative mortality rate was 12.5%.The overall mortality was 13 ca

关键词： Newborn Congenital Hydrocephalus Mortality Gabriel Toure

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Papilloma of the Tongue: About a Clinical Case at the Center Hospitalier Universitaire CHU Gabriel Toure in Bamako

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International Journal of Otolaryngology and Head & Neck Surgery 2021年第1期10卷 1-5页

作者： doumbia-Singare Kadidatou Sangaré mariam Kone Fatogoma Issa Guindo Boubacary Soumaoro Siaka Cisse Naoma Konate N’Faly Diarra Kassim Timbo Samba Karim Keita Mohamed Alhousseini AG Mohamed Department of ENT and Head and Neck Surgery Bamako Mali

Introduction: Tongue papillomas are benign epithelial tumors of the tongue lining. It is a precancerous lesion of viral origin caused by the Human papilloma virus (HPV). Objective: To describe the clinical and histological manifestations of a particular type of oral papilloma. Observation: A young woman aged 28 years resident in Siguiri (Guinea), received in consultation for a painless mass on the tongue slow evolving for 6 months duration. There was no notion of mouth bleeding. She had no particular medical and surgical history and negative for retroviral test/HIV test. Examination of the oral cavity found a fungating mass in at Right or Left posterior third of the tongue, painful on contact, sessile and pedunculated and not bleeding on contact and of soft consistency. The excision of the tongue mass was performed under general anesthesia. Biopsy was taken and sent for HPE. The consequences were mild, allowing her to be released 3 days after surgery. Histological examination showed an acanthotic stratified para-keratinized squamous epithelium containing small parts of connective tissue and koilocytes containing connective tissue nuclei reminiscent of papilloma. There was no malignancy cell. Conclusion: The papilloma of the tongue is a benign proliferative lesion characterized by slow and painless growth. I would say early diagnosis and surgical excision should be done to avoid recurrence, contact bleeding and morbidity secondary to mass effect.

关键词： Papilloma Tongue Histology Excision HPV

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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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Early Management of Nephroblastoma: A Single-Center Study in a Sub-Saharan African Country

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Open Journal of Pediatrics 2021年第4期11卷 797-803页

作者： Abdoul Karim doumbia Pierre Togo mariam Maiga Mohamed Elmouloud Cissé Guédiouma Dembélé Oumar Coulibaly Karamoko Sacko Belco Maiga Djeneba Konaté Abdou Diarra Yakaria Coulibaly Fatoumata Léonie Diakité Abdoul Aziz Diakité Boubacar Togo Check Bougadary Traore Adama Bah Department of Pediatrics at CHU Gabriel Touré Bamako Mali Reference Health Center of the Municipality 6 Bamako Mali Pediatric Surgery Department of the Gabriel Touré CHU Bamako Mali Pathological Anatomy and Cytology Department of the “Point G” CHU Bamako Mali

Introduction: Nephroblastoma is the most common renal cancer in pediatrics. The aim of this study was to describe the epidemiological, clinical, histological characteristics and the immediate outcome of patients with nephroblastoma. Methodology: This was a cross-sectional study of 18 cases of unilateral nephroblastoma, carried out in the pediatric oncology unit (UOP) of the CHU Gabriel Touré from January 2015 to December 2016. Results: The mean age of the patients was 33 months old. The sex ratio was 0.63. The average consultation time was 3 months. A case of malformation syndrome (aniridia and mental retardation) had been observed. The main reason for consultation was abdominal mass (100%) associated with deterioration of general condition (44%), pain (44%) and fever (17%). Stage I accounted for 61% and stage II 39%. The postoperative histological classification made it possible to find the high-risk blastematous type (33%), the regressive type of intermediate risk (11%) and the stromal type of intermediate risk (45%). Toxicities (haematological and digestive) were minimal. The 3-year overall survival was 90%. Conclusion: This study is characterized by the predominance of stages I and II and the fairly large percentage of histology at intermediate risk. These results are above all the result of multidisciplinary collaboration.

关键词： Cancer Child Nephroblastoma Diagnosis Prognosis Mali

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Profile of Newborns Hospitalized for Maternal Fetal Infection and Having a Positive CRP in the Pediatric Department of the Gabriel TouréCHU in Bamako, Mali

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Open Journal of Pediatrics 2021年第4期11卷 684-693页

作者： Oumar Coulibaly Hawa Gouro Diall Guédiouma Dembélé Mamary Coulibaly Fatoumata Léonie Françoise Diakité Lala Ndrayni Sidibé Leyla Maiga Ibrahima Ahamadou Abdoul Karim doumbia Belco Maiga Adama Dembelé Pierre Togo Karamoko Sacko Mohamed Elmouloud Cissé Djeneba Konaté Fousseyni Traoré Aminata doumbia Yacouba Aba Coulibaly Amadou Touré Bourama Kané Issa Amadou Touré Abdoul Aziz Diakité Traoré Fatoumata Dicko Traoré mariam Sylla Boubacar Togo Department of Pediatrics CHU Gabriel Touré Bamako Mali Department of Pediatrics Mali Hospital Bamako Mali Department of Pediatric Surgery CHU Gabriel Touré Bamako Mali

Objective: Early bacterial neonatal infection (INBP) or maternofetal infection (early neonatal sepsis) remains a concern of the pediatrician due to diagnostic difficulties and its increased morbidity and mortality. No study has been done in Mali on the profile of newborns admitted for INBP with positive CRP, hence the initiation of this work with the aim of studying the epidemiological, biological and bacteriological profile of newborns with a bacterial maternal-fetal infection. Method: Longitudinal study descriptive (from 27 June to 3 September 2016) which concerned all newborns aged from 0 to 72 hours of life hospitalized for confirmed early bacterial neonatal infection with a positive C-reactive protein (CRP) in the neonatal department of the CHU Gabriel Touré. INBP was defined by the presence of maternal and neonatal infectious risk factors, positivity of CRP with a germ in the blood culture. Results: During the study period we included 244 newborns for probable maternofetal infection and who benefited from the CRP assay, 43 had a positive CRP, i.e. a frequency of 17.62%. The sex ratio was 2.30. The majority had a low birth weight ( g) in 69.8% of cases. Mothers were aged 18 to 35 in 93%. The majority were out of school (43.8%) and housewives in 74.4%. The main reason

关键词： Early Bacterial Neonatal Infection Clinical Profile Neonatal Mortality

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Profile and Antibiotic Sensitivity of Acute Pyelonephritis in Children at Gabriel Toure Teaching Hospital, Bamako

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Open Journal of Pediatrics 2020年第1期10卷 94-108页

作者： Djeneba Konate Lala N’Driany Sidibe Karamoko Sacko Bakary Kone Adama Kone Aminata doumbia Fatoumata Tiero Pierre Togo Fatouamata Leonie Diakite Abdoul Karim doumbia Belco Maiga Fousseyni Traore Aamadou Toure Hawa Diall Mohamed Elmouhouloud Cisse Adama Dembele Oumar Coulibaly Yacouba Aba Coulibaly H.Konare Isabelle Traore Guediouma Dembele Issiaka Kone Leyla Maiga Ibrahima Ahamadou Abdoul Aziz Diakite Boubacar Togo mariam Sylla Fatoumata Dicko-Traore Pediatric Department CHU Gabriel ToureBamakoMali Pediatric Unit Hospital Center Mother-ChildLuxembourgLuxembourg

Background: Very common symptom in children, fever, perhaps a warning sign of more or less severe pathology, rapidly progressive, including an invasive bacterial infection such as acute pyelonephritis (APN). The aim of this work was to study the bacteriological profile and antibiotic sensitivity of APN in children. Methods: A prospective study involving any infant or child aged 3 months to 15 years with an acute fever (≥38°C) in which a urine test strip was performed in the pediatric department of the teaching hospital Gabriel Toure between April 1st and May 15th, 2019 (45 days). Results: 124 children were included out of 244 febrile patients. Infants (3 - 23 months) predominated (52.8%) with a sex ratio of 2. Seventy-five percent of children came directly from home and 30.6% were on antibiotic prior to admission. The urine bag sample was taken in 55.6% and the urine was macroscopically cloudy in 32.3%. Stigmas of urinary tract infection at the urinary strip were present in 56.5%. Confirmation of acute pyelonephritis (APN) by CytoBacteriological Urine Examination (CBUE) was 29% with Escherichia coli (63.9%) or Enterococcus faecalis (30.5%). Sensitivity was excellent for ciprofloxacin and imipenem (100%). The overall resistance was greater for gentamicin, cotrimoxazole, ceftriaxone, cefotaxime and amoxicillin-clavulanic acid (Threshold: 17.9% - 95.6%). APN was associated with bacteremia in 2.8% with hospitalization for 45.2% and mortality of 11.1% (due to severe acute malnutrition, severe dehydration and multifocal infection). Conclusion: The APN, daily activity of pediatrician in Bamako, is observed in one third of febrile children associated with a major life-threatening condition of risk factors, then the likely antibiotherapy could be amikacin in our context.

关键词： APN Fever Child Bamako

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Pulmonary Embolism: Epidemiological, Clinical, Therapeutic and Evolution Aspects in the Medicine Department of Hospital of Mali Bamako

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World Journal of Cardiovascular Diseases 2021年第4期11卷 242-248页

作者： Massama Konaté mariam Sako Boubacar Sonfo Samba Sidibé Souleymane Mariko Djeneba Sylla Sow Coumba Adjaratou Thiam Djenebou Traoré Hamidou Oumar Ba Asmaou Keita Maiga Ibrahima Sangare Mamadou Toure Souleymane Coulibaly Nouhoum Diallo Bah Traoré Modibo Mariko Nouhoum Ouologuem Amadou Koné Youssouf Camara Yacouba Lazare Diallo Nanko doumbia Mahamadoun Coulibaly Ichaka Menta Faculty of Medicine and Dentistry (FMOS) of the University of Sciences Technique and Technology of Bamako (USTTB) Bamako Mali Medicine Department Hospital of Mali Bamako Mali Cardiology department CHU Point G Bamako Mali Cardiology Department Hospital of Kati Kati Mali Medicine Department Hospital of Tombouctou Tombouctou Mali Internal Medicine Department CHU Point G Bamako Mali Cardiology Department CHU Gabriel Toure Bamako Mali Cardiology Department CHU Mère Enfant Bamako Mali

Background: Pulmonary embolism (PE) is a severe form of venous thromboembolic disease. In Africa, prevalence of PE in hospitalized medical patients varies among studies. Objective: Aim of this work was to study the epidemiological, clinical, therapeutic and evolution aspects of PE in the medicine department of Mali’s Hospital Bamako-Mali. Methodology: This was a retrospective cross-sectional study carried out from January 01, 2017 to December 31, 2020 in the medicine department of Mali’s hospital Bamako, including all inpatients admitted for PE during the study period. Results: Of 1814 hospitalized patients, 54 patients had pulmonary embolism. Hospital frequency of pulmonary embolism was 2.97%. Predominance was female and sex-ratio M/F was 0.38. Mean age in our series was 54.24 ±1.19 years. Predisposing factors to pulmonary embolism were dominated by obesity 37%, high blood pressure 35.2% and history of cardiovascular disease 20.4%. Dominant signs were dyspnoea and chest pain in 83.3% and 70.4% of cases respectively. Probability of pulmonary embolism was high in 40.7% according to Wells score. Patients with right heart failure were 22.2%. EKG showed sinus tachycardia70.4% and S1Q3 aspect 7.4%. Heart right chambers were dilated at transthoracic echography 42.6%. Obstruction was bilateral at chest angio CT for 51.9% and proximal for 42.6%. Deep venous thrombosis was associated at EP in 16.6%. Treatment was low weight molecular heparin followed by vitamin K antagonist or direct oral anticoagulant. One patient was successfully treated by thrombolysis. Hospital mortality was 16.7%. Conclusion: PE is a serious disease probably underdiagnosed. It is responsible of important mortality.

关键词： Pulmonary Embolism Epidemiology Mali’s Hospital

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Post-Infectious Acute Glomerulonephritis in Child: Epidemiological, Clinical and Evolutionary Aspects in Gabriel TouréTeaching Hospital in Mali

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Open Journal of Pediatrics 2018年第4期8卷 366-374页

作者： mariam Sylla Fatoumata Dicko-Traoré Abdoul Karim doumbia Aminata Coulibaly Abdoul Aziz Diakité Modibo Sangaré Pierre Togo Fousseyni Traoré Amadou Touré Djènèba Konaté Karamoko Sacko Belco Maiga Fatoumata Léonie Diakité Lala N’Drainy Sidibé Mohamed Elmouloud Cissé Adama Dembélé Hawa Diall Oumar Coulibaly Ibrahim Hamadou Leyla Maiga Issiaka Koné Boubacar Togo Toumani Sidibé Department of Pediatrics CHU Gabriel Touré Bamako Mali Faculty of Medecine and Odontostomatology Bamako Mali

Introduction: Acute post-infectious glomerulonephritis (APIGN) can be serious due to its complications that still occur in our countries. In this work, we aimed to study the epidemiological, clinical, biological and evolutionary aspects of APIGN. Patients and methods: We conducted a retrospective, descriptive study from January 1st, 2015 to December 31st, 2017 in the pediatric ward of the Gabriel Touré Teaching Hospital in Bamako. All children hospitalized for APIGN were included. Results: In two years, we included 10 children aged 7 years old on average;all from low socioeconomic backgrounds. The sex ratio was 1.5. On average, the children spent 15.8 days before our consultation. Edema was the main reason for consultation. We found a history of infection and high blood pressure in 30% each, and renal failure in 10% of the children. Hematuria and proteinuria were detected in 100% and 90%, respectively. Hypocomplementemia was observed in 66.6%. One third of the children had a positive antistreptolysin O. The average duration of hospital stay was 11.2 days. The evolution was favorable in 90%. Kidney failure was the leading cause of death. Conclusion: Acute post-infectious glomerulonephritis is still a reality in our context. Emphasis should be put on its prevention by improving the hygienic conditions, detection and the management of infections.

关键词： Glomerulonephritis Infection Pediatrics Mali

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Neonatal References: Epidemiology and Prognosis in a Malian Context

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Open Journal of Pediatrics 2021年第3期11卷 479-489页

作者： Fatoumata L. F. Diakité Djénèba Konaté Nouhoum L. Traoré Noel Banou Lala N. Sidibé Oumar Coulibaly Belco Maiga Karamoko Sacko Fousseyni Traoré Abdoul K. doumbia Hawa G. Diall Leila Maiga Ibrahim Ahamadou Alou Traoré Adama Koné Guediouma Dembélé Djita Ba-Sidibé Pierre Togo Adama Dembélé El Mouloud Cissé Abdoul A. Diakité Boubacar Togo mariam Sylla Fatoumata Dicko-Traoré Department of Pediatrics of the University Hospital Gabriel Toure Bamako Mali Reference Health Center of Commune IV Bamako Mali Pediatrician Doctor Practicing in Private Bamako Mali Hospital Mother-Child “Luxembourg” Bamako Mali Mali Hospital Bamako Mali Reference Health Center of Commune III Bamako Mali

Neonatal mortality remains a public health problem in Mali. The neonatal referral is a systemic factor determining the neonatal prognosis. This work was initiated to determine the frequency of neonatal referrals and to determine their prognosis. Patients and Methods: A cross-sectional study was carried out from November 1, 2019 to January 31, 2020 in the neonatology service of the pediatrics department of the Gabriel Toure University Hospital in Bamako. All newborns referred by another health structure in the country were included in this stud. All newborns referred by another health structure in the country were included in this study. To determine the risk factors related to the neonatal referral, we performed univariate and multivariate analyzes to determine the odds ratios and fitted with a significant p probability if p 0.05 and the 95% confidence interval. Results: The frequency of referrals was 54.3%. Newborns came from basic structures in 19.3% of cases, from tertiary structures in 6.7%. The main reason for transfer was prematurity (40.2%) followed by perinatal anoxia (15.3%), malformations (15.3%), respiratory distress (15.2%) and infection neonatal (9.1%). The ambulance was the primary means of transfer in 71.3%. <

关键词： Neonatal References Epidemiology Prognosis Malian Context

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