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Jaundice in the Newborn at the Teaching Hospital of Brazzaville

Open Journal of Pediatrics 2019年第2期9卷 111-118页

作者： Gaston Ekouya Bowassa Giresse Tsouassa Wa Ngono neli yvette ngakengni Engoba Moyen Koumou Onanga Steve Missambou Mandilou Georges Moyen Faculty of Health Sciences Marien NGOUABI University of Brazzaville Brazzaville Congo Department of Neonatology University Hospital of Brazzaville Brazzaville Congo Department of Biochimy University Hospital of Brazzaville Brazzaville Congo

Introduction: Jaundice is a major symptom during neonatal time. It is defined by a bilirubin ≥ 50 mg/l. Objectives: To determine the frequency of neonatal jaundice at the Brazzaville University Hospital, to determine the main etiologies, to evaluate the management, to specify the evolution. Patients and Method: It was a prospective and descriptive study that was conducted in the Neonatology Department and Biochemistry Laboratory of the University Hospital of Brazzaville, from 1st August 2015 to 31st July 2016. It included newborn children admitted into the neonatal unit for treatment of jaundice. The variables studied were epidemiological, clinical, etiological therapy and outcome. Results: The frequency of the neonatal jaundice is 7.2%. The hyperbilirubinemia as not conjugated was found in 99.1% of cases. The main causes are bacterial neonatal infection n = 102 (47.9%), the physiological icterus n = 46 (21.6%) and the ABO incompatibility n = 40 (18.8%). The treatment consists of the phototherapy in all cases. Each phototherapy session lasts 3 hours n = 99 (56.9%), 6 hours n = 58 (33.3%) and 12 hours n = 17 (9.8%). The average duration of the administering of the therapy is of 3 ± 2 days. Hyperbilirubinemia encephalopathy occurred in 62 (29.1%) cases, including 49 cases of kernicterus. The death occurred in 70 (32.9%) children. Conclusion: The importance and the gravity of the neonatal jaundice require primary preventive means based on proper care in pregnancy and the birth. While the secondary prevention includes high index of suspicion, comprehensive diagnostic equipment availability to prevent acute bilirubin encephalopathy.

关键词： Jaundice Neonatal Phototherapy Bilirubin Encephalopathy

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Associated Factors with Early Sexual Intercourse among In-School Adolescents in Brazzaville

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Open Journal of Pediatrics 2024年第5期14卷 898-907页

作者： Aymar Pierre Gildas Oko Dumez Ngoma Judicaël Kambourou Eryx Darius Mbou Essie neli yvette ngakengni Lynda Tchidjo Ngamo Georges Marius Moyen Faculty of Health Sciences Marien Ngouabi University of Brazzaville Brazzaville Congo Department of Pediatrics Teaching Hospital Center of Brazzaville Brazzaville Congo

Background: Early sexual intercourse (ESI) is a global public health problem. In Congo, associated factors with ESI have been under-studied. Objective: To analyse factors associated with early sexual intercourse among in-school adolescents in Brazzaville. Method: A cross-sectional analytic study with three-stage random sampling was carried out from March 2 to June 2, 2022 in Brazzaville secondary and high schools. Adolescents in the selected schools were interviewed about their sexual and social behaviour, and their family and school environment. Multivariate analysis using logistic regression was used to identify factors associated with ESI. The significance level of the p-value was set at 5% and the confidence interval at 95%. Results: Of a total of 1100 adolescents surveyed, 800 (72.7%) had ESI, 98% of them were female. The main reason for early initiation of sexual intercourse was curiosity (81.8%). Non-use of condoms and multiple sexual partnerships were noted respectively in 98.7% and 68.7% of adolescents who had experienced ESI. Female gender (p Conclusion: The prevalence of ESI is high, and the factors identified in this study may help to reduce it.

关键词： Associated Factors Early Sex Adolescents Brazzaville

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Severe Hypoglycemia in Hospitalized Children with Diabetic Ketoacidosis in Brazzaville

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Open Journal of Pediatrics 2020年第1期10卷 236-245页

作者： Aymar Pierre Gildas Oko Judicael Kambourou Engoba Moyen Laetitia Lombet neli yvette ngakengni Steve Vassili Missambou Mandilou Aurore Mbika Cardorelle Georges Marius Moyen Faculty of Health Sciences Marien Ngouabi University of Brazzaville Brazzaville Congo

Background: Severe hypoglycemia is a lifethreatening iatrogenic complication in the management of diabetic ketoacidosis, however, few studies have described how often this complication occurs. Objective: To identify the risk factors for severe hypoglycemia in children treated for diabetic ketoacidosis and to describe the sociodemographic, clinical characteristics and outcome of these children. Methods: From January 2013 to December 2017, 69 children admitted to pediatric intensive care unit with a diagnosis of diabetic ketoacidosis were enrolled in a retrospective and prospective study. Data of children with and without severe hypoglycemia were compared. Data were analyzed using Epi Info 7.***.5.0. Results: Out of 69 children enrolled, 10 (14.5%) had severe hypoglycemia (girls: 60%, median age 144 months (interquartile range, 108?-?168 months)). Episodes of severe hypoglycemia occurred during the first 48 hours of hospitalization in 8 (80%) children and during the late night shift in 6 (60%) children. Causes of severe hypoglycemia were: excessive insulin dose (60%), inappropriate infusion solution (70%), failure to properly monitor blood glucose levels (40%). Severe hypoglycemia risk factors were: age p?= 0.00004;OR = 42.0 [95% CI: 6.3?-?279]) and severe malnutrition (p?= 0.002;OR?=?10.9 [95% CI: 2.4 -?48.6]). Of 8 (11.6%) children died, 4 had severe hypoglycemia (p?= 0.01;OR = 8.8 [95% CI, 1.7 -?44.8]). Conclusion: The importance and severity of severe hypoglycemia require preventive measures to control risk factors.

关键词： Severe Hypoglycemia Diabetic Ketoacidosis Risk Factors Brazzaville

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Placentas and Newborns of Patients Suffering from High Blood Pressure in University Hospital of Brazzaville

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Open Journal of Obstetrics and Gynecology 2019年第5期9卷 649-655页

作者： Cautaire Itoua Jules Cesar Mokoko neli yvette ngakengni Mpianuelly Samantha Bialay Potokoue Levy Max Emmery Eouani Abdel Salam Bachir Jean Felix Peko Leon Herve Iloki Gynecology and Obstetric Department University Hospital of Brazzaville Brazzaville Congo Neonatology Department University Hospital of Brazzaville Brazzaville Congo Gynecology and Obstetrics Department Hopital général de Loandjili Pointe Noire Congo Anatomy and Pathology Department University Hospital of Brazzaville Brazzaville Congo

Objective: To analyze placentas and newborns of patients with high blood pressure (HBP). Materials and Methods: Case-control study conducted from 1 January to 31 October 2017 in University Hospital of Brazzaville (birth room, anatomy and pathology laboratory) and Faculty of Health Sciences of Brazzaville (laboratory of anatomy and organogenesis). It concerned 40 placentas freshly delivered and newborns of patients with HBP compared to 40 placentas and newborns of patients without HBP. The variables analyzed were related to mothers, placentas and the newborns. Results: The patients were similar in age (26.9 ± 1.2 years VS 26.5 ± 1.1 years, p = 0.17) and parity (1.26 ± 0.7 VS 1.61 ± 0.3, p = 0.26). The type of hypertension in the cases was dominated by pre-eclampsia (68%). A significant reduction in placental measurements was more observed in case of HBP: weight (431 ± 37 g VS 503 ± 26 g, p < 0.05), diameter (17.40 ± 1.2 cm VS 19.25 ± 1 cm, p < 0.05), and area (239.82 ± 15.7 cm2 VS 292.1 ± 22.2 cm2, p < 0.05). The macroscopic lesions were calcifications (75% VS 43.8%, p < 0.05) and the retro placental hematoma cup (18.8%) among the cases. Microscopic lesions were more observed in hypertensives: infarction (68.8% VS 18.8%, p = 0.004) and endarteritis (93.8% VS 12.5%, p < 0.05). The characteristics of newborns were significantly different between the two populations: prematurity (34.3% VS 9.3%, p < 0.05), mean weight (2577 ± 102 g VS 3060 ± 109 g, p < 0.05), the average APGAR score (6.7 ± 1.6 VS 7.8 ± 0.9, p 0.05). Conclusion: High blood pressure affects the placenta and the newborn. The placenta deserves to be systematically examined.

关键词： High Blood Pressure Placenta Newborn Brazzaville Congo

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Proteinuria in Children Living with HIV on Highly Active Antiretroviral Therapy (Haart)

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Open Journal of Pediatrics 2020年第2期10卷 255-262页

作者： Lucie Charlotte Ollandzobo Ikobo Roland Bienvenu Ossibi Ibara neli yvette ngakengni Laren Babomi Gaston Ekouya Bowassa Linda Tchidjo Ngamo Steve Vassili Missambou Mandilou Sabrina Nadia Bouithy Evrard Romaric Nika Jean Robert Mabiala Babela Faculty of Health Sciences Marien Ngouabi University of Brazzaville Brazzaville Republic of Congo Pediatric Services Brazzaville University Hospital Brazzaville Republic of Congo Infectious Diseases Service Brazzaville University Hospital Brazzaville Republic of Congo Department of Neonatology Brazzaville University Hospital Brazzaville Republic of Congo Department of Internal Medicine and Cardiology Talangai Hospital Brazzaville Republic of Congo

Objective: To determine the prevalence of proteinuria in children living with HIV (CLHIV) and identify associated factors. Patients and methods: This was a cross-sectional, descriptive and analytical study carried out from April to August 2017 in the HIV care centres in Brazzaville and Pointe-Noire. The study included CLHIV with dipstick urinalysis test “Combur10 Test® M”. Results: Thirty seven CLHIV on HAART presented a proteinuria, 21.8%. Children were male gender in 21 cases (56.8%) and female gender in 16 cases (43.2%). Mean age was 10.9 ± 3.9 years. The children were infected with type 1 virus in 35 cases (94.6%), vertical transmission in all the cases (100%). Children were living with HIV for about 2 to 4 years of average n = 18 (48.6%) and they were WHO clinical stage 2 in 18 cases (48.6%). 13 children (35%) had CD4 level 3. All CLHIV (100%) were on HAART thus 20 (37.7%) on the combination of zidovudine (AZT), lamivudine (3TC) and nevirapine (NVP). This combination AZT, 3TC, NVP was a protective factor regarding the occurrence of proteinuria (OR: 0.43;IC (95%). Conclusion: Proteinuria

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Rare Neonatal Digestive Surgical Emergencies at the Brazzaville University Hospital Center

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Open Journal of Pediatrics 2020年第3期10卷 463-473页

作者： Lucienne Irène Patricia Ondima Caryne Mboutol-Mandavo Moïse Service Yanguedet Didace Massamba Miabaou Jean-Claude Mieret Cardinale Princilia Okiemy Niendet Gracia Christelle Ossete Peggy Dahlia Gallou Mawandza neli yvette ngakengni Gaston Ekouya Bowassa Department of Pediatric Surgery University Hospital Center Brazzaville Republic of Congo Department of Visceral Surgery University Hospital Center Brazzaville Republic of Congo Department of Intensive care and Anesthesia University Hospital Center Brazzaville Republic of Congo Department of Neonatology University Hospital Center Brazzaville Republic of Congo

The purpose of our study was to evaluate the morbidity-morality of rare neonatal digestive emergencies in order to improve their management. Observations: 7 newborns ranging in age from 6 hours to 3 weeks were treated for rare digestive pathologies between January 2013 and July 2017 (a period of 3 years and 6 months) in the Department of Pediatric surgery of Brazzaville University Center, Congo. Males were predominant (5 versus 2 females). Pathologies listed were: 1 antenatal volvulus of the small intestine, 1 annular pancreas and 5 gastric perforations. The average time of care in the operating room was 12 hours. The newborns were hospitalized in the pediatric surgery department in 28.6% of cases (n = 2), and 71.4% (n = 5) in the neonatology department. The antenatal volvulus of the intestine and annulus pancreas were integrated into a nosologic entity named neonatal occlusion (NNO). The postoperative outcomes were simple for 4 patients (57.14%) while 3 patients died immediately after surgery (42.86%). Conclusion:

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Split Hand/Foot Malformation about Two Family Cases

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Open Journal of Pediatrics 2023年第1期13卷 63-68页

作者： neli yvette ngakengni Bredel Djeri Djor Mabika Gauthier J. Buambo Irene L. P. Ondima Lucie C. Ollandzobo Atipo-Ibara Lynda Gamo Tchidjo Landes C. Togho Abessou Samia M. Oya Angouma Benedicte M. Foueta Moukouba Flora Nombo Mavoungou Corinne Akouango Gnessou Nuptia C. Obengui Dhalia Y. Ngonya Mbongo Rachelle Dusabimana Bowassa Ekouya Gaston Aurore Mbika Cardorelle Faculty of Health Sciences Marien Ngouabi University of Brazzaville (Congo) Brazzaville Congo Neonatology Department University Hospital of Brazzaville (Congo) Brazzaville Congo Stomatology Department University Hospital of Brazzaville (Congo) Brazzaville Congo Obstetrics and Gynecology Department University Hospital of Brazzaville (Congo) Brazzaville Congo Surgery Pediatric Department University Hospital of Brazzaville (Congo) Brazzaville Congo Pediatric Departments University Ce Hospital of Brazzaville (Congo) Brazzaville Congo

Split hand/foot malformation (SHFM), formerly known as ectrodactyly is a rare congénital anomaly, its incidence varies from 1/8.500 to 1/25.000 live birth. It mainly affects the development of the limbs, its clinical variability is standard, can present as an isolated feature or as a syndrome associated with other congenital anomalies. Our objective was to present the two cases of SHFM, and to review the literature on the clinical aspects and discuss a probable origin. The father went to school and is a driver because the malformations concerned only the fingers, were less severe, and did not prevent the realization of certain simple gestures of the daily life. On the other hand, the malformations of the fingers of the newborn were severe and the absence of the thumbs compromised the later prehension function. Also the association of a microglossia and a cleft palate contributed to a weight loss that justified hospitalization. The clinical presentation of split hands and feet is variable and the prognosis depends on the type of anomaly. Familial cases suggest a probable genetic origin. Genetic testing is necessary to establish genetic counseling.

关键词： Split Hand/Foot Malformation Isolated Form Syndromique Form Family

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Late Neonatal Mortality at Teaching Hospital of Brazzaville (Congo)

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Open Journal of Pediatrics 2020年第1期10卷 30-35页

作者： Gaston Ekouya Bowassa Engoba Moyen Néli yvette ngakengni Annie Rachelle Okoko Faculty of Health Sciences Marien NGOUABI University Brazzaville Congo Department of Neonatology University Hospital of Brazzaville Brazzaville Congo

Background: Neonatal mortality is a major public health problem. Its reduction is one of the targets of the objectives for sustainable development. Objectives: To determine the frequency of late neonatal mortality, to determine the causes of death and to identify the factors associated with late neonatal mortality at Brazzaville University Hospital. Patients and methods: This was a descriptive and analytical study conducted in the neonatal department of the Brazzaville University Hospital from 1 January to 30 June 2018. It concerned all newborns admitted to the service and died between 7th and 28th day of life. The variables studied were epidemiological, clinical and evolutionary. For the study of the factors associated with late mortality, we compared the deceased newborns with those hospitalized in the service whose stay was at least seven days. The materiality threshold was 5%. Results: During the study period, 697 newborns were admitted to the service, 286 (41%) died, 79 (27.6%) on the seventh day or beyond. The median age at admission was one hour. These were male (44.3%) and female (55.7%) newborns. The causes of death were prematurity (50.7%), neonatal infection (36.7%), perinatal asphyxia (6.3%) and others (6.3%). The mean age at death was 13.5 ± 6.4 days (range: 7 and 28 days). Prematurity OR = 3.62 (95% CI: 1.2 - 10.6) is the factor associated with late mortality. Conclusion: Reducing late neonatal mortality requires the implementation of measures to improve the human and material capacities of the service.

关键词： Mortality Late Newborns Prematurity

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