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Management of Severe Acute Malnutrition in a Senegalese Paediatric Hospital

Open Journal of Pediatrics 2021年第2期11卷 198-207页

作者： ndiogou seck Idrissa Basse Djibril Boiro Younoussa Keïta Lamine Thiam Aliou Abdoulaye Ndongo Ndéye Rama Diagne-Gueye Service de péDiatrie Centre Hospitalier Régional de Saint-Louis Saint-Louis Sénégal Hô pital pour Enfants de Diamniadio Bargny Sénégal Service de péDiatrie Centre Hospitalier Abass Ndao Dakar Sénégal Service de péDiatrie Hô pital Aristide Ledantec Dakar Sénégal Service de PéDiatrie H&ocirc pital de la Paix Boucoutte Ziguinchor Sénégal

Malnutrition is a global health problem. It is very common in developing countries where it contributes to an increase in morbidity and mortality, especially among children under five years of age. The main objective of this study was to describe the management of severe acute malnutrition (SAM) in children six months to five years of age hospitalized at Diamniadio Children’s Hospital (DCH). This was an epidemiological, retrospective, descriptive and cross-sectional study of children aged six to 59 months hospitalized at DCH for SAM. The study took place over a 12-month period (from January 1, 2018 to December 31, 2018). During the study period, 67 children were admitted for SAM, representing a hospital prevalence of 8.4%. The majority (88%) children were less than 24 months old. Reasons for consultations were dominated by diarrhea (57.5%) vomiting (38.8%). Complications related to SAM were mainly: anaemia (74.6%), infections (85%) and severe acute dehydration (40.3%). Factors associated with SAM were young age (infants under 24 months of age), poverty, the first four children of a sibling, poor behaviour of food diversification. The average length of hospitalization was 12 days. The nutritional recovery rate was 73.1% and lethality was 3%. Conclusion: The prevention of malnutrition must involve the fight against poverty, an optimal and well-diversified diet, monitoring the nutritional status of children up to five years of age.

关键词： Severe Acute Malnutrition Children Complications Risk Factors Lethality

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Assessment of Insulin Therapy in 281 Children and Adolescents with Type 1 Diabetes in Senegal

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Open Journal of Pediatrics 2022年第1期12卷 283-292页

作者： Djibril Boiro Amadou Sow Aliou Abdoulaye Ndongo Idrissa Basse Lamine Thiam ndiogou seck Cheha Fatoumia Babacar Niang Modou Guéye Maïmouna Ndour Mbaye Ousmane Ndiaye Abass Ndao Hospital Dakar Senegal Aristide Le Dantec Hospital Dakar Senegal Diamniadio Children’s Hospital Dakar Senegal Ziguinchor Peace Hospital Dakar Senegal Saint Louis Regional Hospital Dakar Senegal Albert Royer Children’s Hospital Dakar Senegal

Introduction: In Senegal, with the CDIC “Changing Diabetes In children” project, insulin has been made free. The objective of this study was to evaluate the accessibility and modalities of insulin therapy in the management of type 1 diabetes. Methodology: This was a retrospective study including patients followed for type 1 diabetes (T1DM) in hospital between April 2018 and December 2020. Results: 281 patients were included. The mean age was 14.22 years. The mean age at diagnosis was 11.28 years. Ketoacidosis was the main mode of discovery of diabetes at 51.6%. Premix and rapid insulins were most commonly used at 84.7% and 82.9% respectively, most often in combination. The most commonly used treatment regimen was three injections/day in 82.5% of cases. The average daily insulin dose was 0.62 IU/Kg/dr. Of the patients, 219 (78%) were self-monitoring of blood glucose. The average number of blood glucose checks was 1.78 per day. 76 patients (27%) went days without an insulin injection and up to 7 days in 51% of cases. The main reasons were forgetfulness, therapeutic errors and stock-outs. Hypoglycaemia was observed in 14.2%. The average glycated haemoglobin was 10%. Conclusion: Despite the efforts made, there are still challenges to improve access to insulin. The reinforcement of therapeutic education on insulin therapy is essential for a better quality of life of diabetic children and adolescents.

关键词： Diabetes Children Insulin Therapy Senegal

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Epidemiology of Admissions in a Pediatric Emergency Department in Albert Royer Hospital Dakar

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Open Journal of Pediatrics 2022年第1期12卷 188-195页

作者： Aliou Thiongane Aliou Abdoulaye Ndongo Amadou Sow Younoussa Keita Djibril Boiro Yaye Joor Dieng Idrissa Basse ndiogou seck Lisimo Abwa Hilaire Papa Moctar Faye Amadou Lamine Fall Assane Sylla Saliou Diouf Ousmane Ndiaye Centre Hospitalier National d’Enfants Albert Royer Dakar Sénégal Service de pédiatrie Hô pital Le Dantec Dakar Sénégal Service de pédiatrie Hô pital Abass ndao Dakar Sénégal Centre Hospitalier National d’Enfants de Diamniadio Dakar Sénégal Service de pédiatrie Hô pital régional Saint Louis Sénégal Service de pédiatrie Hô pital Dalal Jamm Dakar Sénégal

Background: Pediatric emergencies are a public health priority in Senegal. The objective was to describe the epidemiology of admissions to the emergency department of the Albert Royer National Children’s Hospital in Dakar, Senegal. Methods: Prospective, descriptive and analytical study over a period of 4 months (January-April 2020). The study population was children admitted for vital distress. Results: A total of 300 children met the inclusion criteria and represented the study population (2.83%). The majority (70.67%) were younger than 60 months, compared with 2.00% of newborns. Boys represented 53.8%, sex ratio 1.16. A proportion of 35.1% was referred. More than half of our patients (55.88%) were managed within 30 minutes of arrival. Medicalized transport concerned 21.5% against 78.5% of nonmedicalized. Emergencies were dominated by respiratory distress (56.33%), dehydration (29%) and shock (13.33%). We recorded 16 deaths (5.3%). This mortality was significantly related to the low socio-economic level (p = 0.000), as well as the young age of the children (p = 0.01). Conclusion: Life-threatening emergencies are frequent and responsible for significant lethality. Health policy efforts are still needed to reduce this infant and child morbidity and mortality.

关键词： Children Emergencies Morbidity Mortality

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Descriptive and Analytical Study of Factors Associated with Mortality in Severe Malaria among Children in Dakar Emergency Departments from July to December 2022

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Open Journal of Pediatrics 2023年第6期13卷 866-878页

作者： Aliou Thiongane Abou Ba Fatou Ly Aliou A. Ndongo Djibril Boiro Younoussa Kéita Idrissa Basse Babacar Niang Indou Dême Ly Yaye Joor Dieng Djenaba Fafa Cissé ndiogou seck Lamine Thiam Papa Moctar Faye Amadou Lamine Fall Assane Sylla Ousmane Ndiaye Centre Hospitalier National d’Enfants Albert Royer Dakar Sénégal Service de pédiatrie Hô pital Dalal Jamm Dakar Sénégal Service de pédiatrie Hô pital Pikine Dakar Sénégal Service de pédiatrie Hô pital Abass Ndao Dakar Sénégal Centre Hospitalier National d’Enfants de Diamniadio Dakar Sénégal Service de pédiatrie Hô pital régional Saint Louis Sénégal Service de pédiatrie Hô pital de la paix de Ziguinchor Ziguinchor Sénégal

Background: Malaria is the most widespread parasitic disease and remains a public health priority worldwide. The severe form is fatal if not treated early and appropriately. The aim was to carry out a descriptive and analytical study of the factors associated with mortality during severe malaria in children attending emergency departments in Dakar, Senegal. Methods: This is a prospective, observational and analytical study conducted over a 6-month period (July 1 to December 31, 2022), focusing on children hospitalized for severe malaria according to WHO severity criteria. Results: A total of 403 patients were hospitalized, including 78 cases of severe malaria (19.35%). Males predominated (60.26%) (sex ratio 1.51). The average age was 6.56 years [8 months - 14 years], with the [5 - 10 years] age group the most represented (40.26%). The average consultation time was 5.33 days (1 - 19 days). The main reasons for consultation were fever (70.51%), vomiting (24.35%) and convulsions (14.10%). Biological signs of severity were severe anemia (17.95%), renal failure (6.4%) and hypoglycemia (3.85%). Thrombocytopenia was noted in 52.56% of patients, including 32.05% of severe cases (sis in 61.41% of cases. Hyponatremia was noted in 39.74% of cases and hyperkalemia in 2 patients. Artesunate was the main drug used (93.59% of cases). Mortality was estimated at 1.5%. Factors leading to death were coma (P < 0.01), respiratory distress (P Conclusion: Malaria is still a public health problem, with a high mortality rate in emergency departments. Reducing this mortality rate requires effective management of the factors associated with death.

关键词： Children Malaria Death Factors

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Early Prosthetic Valve Endocarditis with Mycobacterium Tuberculosis after Mitral Valve Replacement: A Case Report

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World Journal of Cardiovascular Surgery 2024年第3期14卷 33-40页

作者： Papa Amath Diagne Mory Camara Papa Ousmane Ba Momar Sokhna Diop Moussa Samba Abdou Lahad Mbengue Jean Claude ndiogou Dione Myriam Bizrane Marième Soda Mbaye Moussa seck Diop Toudiani Malam Kaka Papa Salmane Ba Papa Adama Dieng Amadou Gabriel Ciss Assane Ndiaye Cardiovascular and Thoracic Surgery Department FANN National University Hospital Dakar Senegal

Background: Tuberculous endocarditis is a rare but serious complication of heart valve replacement surgery. We report the case of a 24-year-old patient, who presented with tuberculous endocarditis after mechanical mitral valve replacement, with a favorable clinical course following anti-tuberculosis treatment. Case Presentation: We report a 24-year-old male patient, admitted to the cardiac surgery department of the Fann Hospital (Dakar, Senegal), for the management of severe mixed (rheumatic and endocarditic) mitral insufficiency with associated tricuspid insufficiency. He had a history of recurrent angina and polyarthralgia in childhood, was hospitalized several times for refractory global cardiac decompensation, and for a suspected infective endocarditis a month before his admission. On admission, the clinical examination revealed signs suggestive of mitral and tricuspid insufficiency. Transthoracic echocardiography revealed severe post-endocarditic mitral insufficiency with A3 amputation, highly mobile 15 mm vegetations on the free edge of the large valve, moderate tricuspid insufficiency, and severe pulmonary artery hypertension. Mechanical mitral valve replacement and tricuspid valve annuloplasty using autologous pericardial strip were performed via median sternotomy. After ten days, the patient presented with global cardiac decompensation associated with a clinico-biological infectious syndrome, and tans-oesophageal echography revealed an abscess at the sinotubular junction, communicating with the aorta. A thoraco-abdomino-pelvic CT scan was done, which revealed a bilateral alveolar-interstitial syndrome with mediastinal lymphadenopathy. Anti-tuberculosis treatment with RHZE was initiated for 06 months. The clinical course was favorable. Conclusion: Tuberculous endocarditis in prostheses is a serious complication of heart valve replacement surgery, which may evolve favorably under medical treatment.

关键词： Tuberculous Endocarditis Prosthetic Valve Endocarditis Mycobacterium Tuberculosis

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Results of the First 10 Cases of Coronary Bypass Surgery in Senegal

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World Journal of Cardiovascular Surgery 2024年第4期14卷 45-60页

作者： Papa Amath Diagne Jean Claude ndiogou Dione Papa Ousmane Ba Momar Sokhna Diop El Hadji Boubacar Ba Momar Dioum Marième Soda Mbaye Moussa seck Diop Mory Camara Abdou Lahad Mbengue Abdou Aziz Thiaw Abdoul Khoudoss Diallo Moussa Mareme Samba Dialtabé Ibrahima Guéssé Ba Anta Mbaye Sall Papa Salmaneba Amadou Gabriel Ciss Department of Cardiovascular and Thoracic Surgery FANN National University Hospital Dakar Senegal

This is a review of the first 10 coronary artery bypass surgeries performed by the local team. The mean age was 62 years old [45 - 74]. The patients were predominantly male, with a M/F ratio of 4:1. Cardiovascular risk factors were mainly myocardial infarction (MI) (60%), hypertension (50%), obesity (40%) and diabetes (30%), with at least two risk factors per patient. Angina was the main symptom (80%). The average time from presentation to surgery was 8 months. The mean Euroscore 2 was 2.92 ± 1.65 [1.33 - 6.60]. Coronary angiography revealed an average of 2 lesions per patient, with 3-vessel involvement in 70% of cases: the Interventricular artery (IVA) (100%), the right coronary artery (90%) and the circumflex artery (70%). On echocardiography, the mean Left ventricular ejection fraction (LVEF) was 59% [33% - 76%]. All patients underwent median sternotomy with bypass grafting. The average duration of the cardiopulmonary bypass was 150 min [46 - 275 min];that of aortic clamping, 120 min [43 - 232 min]. The grafts used were internal thoracic artery (ITA) in 100% of cases (80% on the left and 20% on the right), and the great saphenous vein (GSV) in 60% of cases (50% on the left and 10 on the right). Double bypass was performed in 60% of cases, single bypass in 30% and triple bypass in 10%. The bypasses were performed on the IVA (100%), the middle lateral of the circumflex (30%) and the bisector (20%). The average time to extubation was 11 hours and the length of stay in the intensive care unit was 7 days [03 - 17 days]. One patient had a reoperation on Day 0 post-op. The average hospital stay was 13 days [06 - 27 days]. Complications occurred in nine of the patients (90%), with a predominance of infectious and neurological complications. Overall operative mortality was 3%, all in intensive care.

关键词： Coronary Bypass Surgery Coronary Lesions Cardiac Surgery Senegal

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