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Study of Cerebral Vascular Accidents in Children with Sickle Cell from 6 Months to 15 Years of Age at the Gabriel Toure University Hospital Center

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Open Journal of Pediatrics 2023年第6期13卷 852-861页

作者： Mohamed Elmouloud Cissé Abdoul Aziz Diakité Adama Dembélé Belco Maiga Moussa Diallo Abdoul Karim Doumbia Oumar coulibaly pierre Togo Hawa Gouro Diall Abdoulaye Barry Karamoko Sacko Amadou Touré Issa Sanou Fousseyny Traore Djeneba Konaté Kalirou Traoré Lala N’Drainy Sidibé Bory Traoré Ibrahim Ahamadou Yacouba Aba coulibaly Hawa Konaré Aminata Doumbia Department of Pediatrics Gabriel Toure University Hospital Bamako Mali

Sickle cell disease is a hereditary disease that remains a public health problem in Mali. Our objective was to study strokes in children with sickle cell disease aged from 6 months to 15 years in the pediatrics department of the Gabriel Toure university hospital center. This was a retrospective descriptive study from April 1, 2019 to March 31, 2021 and prospective from April 1, 2021 to April 30, 2022, i.e. 3 years, which took place in the Pediatrics department of the Gabriel Toure university hospital center. During this study, we identified 22 cases of stroke among 714 children with sickle cell disease. The frequency of stroke in this population is 3.08%. The age group from1 to 5 years was the most affected with 40.9%. The average age of the patients was 7 years with extremes ranging from 1 year to 15 years and a median of 5 years. The male gender was predominant with 54.5%, for a sex ratio of 1.2. Headaches were the most common neurological antecedents (63.5%). Half of the patients were diagnosed with sickle cell disease after the onset of the stroke. The installation of the deficit was progressive in 54.5% of cases. Consciousness disorders were the most frequent reason of consultation (27.2%), followed by convulsions (18.1%). The most common neurological signs were impaired consciousness and hemiparesis with 45.5% each. The stroke was ischemic in 100% of cases. There were 95.5% of SS forms and 4.5% of Sβ0thalassemia forms. Our patients had a hemoglobin level less than 7 g/dl in 57.1% of cases and between 7 and 9 g/dl in 42.8% of cases and hyperleukocytosis (leukocytes > 10,000/mm3) in 95.4% of cases. The Sylvian artery was the most affected (45.5%). The fatality rate was 22.7%.

关键词： Sickle Cell Anemia Vessels Brain Children

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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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Non-Chemotherapy Medullary Aplasia in the Pediatric Oncology Unit of the Gabriel Touré Teaching Hospital, Bamako

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Open Journal of Pediatrics 2023年第6期13卷 798-806页

作者： pierre Togo Ibrahim Ahamadou Tati Simaga Abdoul Karim Doumbia Fousseyni Traoré Oumar coulibaly Djénéba Konaté Salif Zigmé Adama Dembélé Mohamed Elmouloud Cissé Belco Maïga Karamoko Sacko Hawa Gouro Diall Boubacar Ali Touré Amadou Touré Yacouba Aba coulibaly Aminata Doumbia Hawa Konaré Kalirou Traoré Souleymane Sagara Abdoul Aziz Diakité Fatoumata Dicko Cheick Bougadari Traoré Boubacar Togo Department of Pediatrics Gabriel Touré Teaching Hospital Bamako Mali National Institute for Training in Health Sciences Bamako Mali Center for Research and Fight against Sickle Cell Disease Bamako Mali Pathological Anatomy Department Point G Teaching Hospital Bamako Mali

Objectives: The main objective was to study the epidemiological, diagnostic and therapeutic aspects of medullary aplasia (MA). Methods: This was a prospective and descriptive retro study conducted from January 1, 2008 to December 31, 2018 in the pediatric oncology unit of the pediatrics department of the Gabriel Touré teaching Hospital in Bamako. Results: We collected 29 children’s cases out of 1632 admissions during the study period, representing a frequency of 1.8% and an incidence of 2.6 cases per year. The sex ratio was 2.6. The 11 - 15 age group accounted for 45%, with an average age of 8.93 years. The majority of fathers (55.2%) and mothers (62.1%) had received no education;they were mainly farmers (62.1%) and housewives (86.2%). The average consultation time was 92.21 days. Anemia was the reason for consultation in 69% of cases. Pallor was present on admission in 96.5%;infectious syndrome accounted for 79.3%, anemic syndrome for 51.7% and hemorrhagic syndrome for 27.6%;the three syndromes were associated in 27.6%. Malaria was associated with bone marrow aplasia in 58.6%. Anemia was present in 93.1%, neutropenia in 65.5% and thrombocytopenia in 86.2%. All had received a labile blood product (LBP) transfusion, and 24 (83%) had received antibiotics. Patients were treated with corticosteroids (58.6%), androgens (20.7%) and immunosuppressants (20.7%). The death rate was 34.6%. At last count, 15 (83%) had discontinued treatment, 2 (11%) were undergoing treatment and 1 (6%) was in remission. Conclusion: Effective treatment of MA requires improved technical facilities and better economic conditions for parents.

关键词： Medullar Aplasia Children Bamako

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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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Epidemiological and Clinical Aspects of Abnormal Movements in Children from 2 Months to 15 Years in the Pediatric Department of Gabriel Toure University Hospital Centre of Bamako

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Open Journal of Pediatrics 2022年第1期12卷 170-178页

作者： Karamoko Sacko Djeneba Konaté Amadou Touré Belco Maiga Fousseyni Traoré Adama Dembelé pierre Togo Abdoul Karim Doumbia Andoule Guindo Rokia Togola Oumar coulibaly Diakite Fatoumata Léonie Francois Ibrahima Ahamadou Kalirou Traoré Abdoul Aziz Diakité Boubacar Togo Gabriel Toure University Hospital Centre Bamako Mali University Hospital Centre Point G Bamako Mali

Introduction: Abnormal or involuntary movements correspond to a disorder in the programming and/or execution of movement. They have two characteristics;they are hardly or not at all controlled by the will and occur in the absence of any paralysis. Objective: To determine the epidemiological, clinical and etiological characteristics of abnormal (involuntary) movements in children aged 2 months to 15 years. Patients and Methods: This was a prospective, descriptive study from January 2016 to December 2018 of children aged 2 months to 15 years seen in neuropediatric consultations for abnormal movements. Results: During the study period 1920 children were seen in neuropediatric consultations and 57 presented with abnormal movements, i.e. a frequency of 2.96%. Children aged between 6 and 60 months were the most affected (54.4%). The sex ratio was 1.53. Movement abnormality was the most common reason for consultation (45.7%), followed by apyretic convulsions (28%), and laxity (5.3%). The onset was progressive in 68.4% of children. The main types of abnormal movements were chorea (31.6%), dystonia (26.3%), myoclonus (17.5%), tremor in 10.5%. The causes were infectious (73.68%). Conclusion: Abnormal movements are rare in paediatric practice. They have multiple causes and their management is urgent in certain situations that can jeopardise the future of children.

关键词： Abnormal Movements Convulsions Children Bamako

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Comparison of Transrectal Prostate Digital and Ultrasound-Guided Core Biopsies in 400 Men in a Low-and-Middle Income Country

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Open Journal of Urology 2023年第10期13卷 418-432页

作者： Junior Barthelemy Mekeme Mekeme Oriol Landry Mbouche Figuim Bello Bright Che Awondo Aurele Achille Mbassi Cedrick Jean Fouda Tax Liendi Marcella Biyouma Guillaume Gayma Marcel Junior Yon Mekeme Junior Ngue Ngue Mabah Paul Adrien Atangana pierre Ongolo Zogo pierre Joseph Fouda Noel coulibaly Angwafo III Fru Maurice Aurelien Sosso Faculty of Medecine and Biomedical Sciences University of Yaounde I Yaounde Cameroon Department and Urology and Andrology Yaounde Central Hospital Yaounde Cameroon Higher Institute Medical Technology Yaounde Cameroun Anatomy and CytoPathology Laboratory “Centre Pasteur” Yaounde Cameroon Felix Houphouet Boigny University of Cocody Abidjan Ivory Coast

Background: The diagnosis of prostate cancer (PCa) relies on clinical assessment with digital rectal examination, serum PSA and histological examination. Limitations in our technical facilities, high financial cost of ultrasound-guided biopsy often prevent us from implementing the guidelines on the practice of prostate biopsy. Methods: We conducted a retrospective and cross-sectional descriptive study comparing digital-guided and ultrasound-guided transrectal prostate biopsy of 400 patients over a period of 12 years in the Yaounde Central Hospital. We reviewed files of patients who underwent digital and ultrasound guided biopsy procedures. Data was analyzed using EPI info 7.0. Parametric variables were reported as means and standard deviations and percentages and counts were used to report categorical variables. Results: Out of the 400 patients, 292 digital-guided transrectal biopsies (73%) and 108 ultrasound-guided transrectal biopsies (27%) were performed in patients who were suspected of having prostate cancer (PCa). Patients were aged between 39 to 90 years. Both procedures were effective in identifying prostate cancer. Gleason score between 2 to 10 detected prostate adenocarcinoma for 301 patients (75.2%). The complications included anal pain, rectal bleeding, hematuria and urinary tract infections, with an occurrence rate similar for both ultrasound-guided (2.25%) and digitally-guided techniques (2.5%). Seven patients (1.75%) required hospitalization for management of complications. The mortality rate was null. Conclusion: Both techniques are effective in detecting PCa with the similar complication rates. Digital-guided trans-rectal prostate biopsy still has its place in a resource-limited setting like ours.

关键词： Prostate Biopsy Digital Guided Ultrasound Guided Adenocarcinoma Gleason Score

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Epidemioclinical Profile and Immediate Outcome of Low Birth Weight at the Reference Health Center in Commune VI of the District of Bamako, Mali

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Open Journal of Pediatrics 2023年第2期13卷 235-243页

作者： Mariam Maiga Oumar coulibaly Mariam Traore Hibrahima Diallo Korotoumou W. Diallo Bourama Kane Alou Samake Mamadou Diallo Moussa Konate Mamadou Keita Mohamed Saydi Ag Med Elmehdi Elansari Diarra Sidy Moctar Mamadou Traore Djibril Kassogue Kadiatou Ba pierre Togo Pediatric Service of the Reference Health Center of the Commune VI Bamako Mali Pediatric Department of CHU Gabriel Touré Bamako Mali Mali Hospital Bamako Mali Pediatric Service of the Reference Health Center of the Commune V Bamako Mali Timbuktu Regional Hospital Bamako Mali Pediatric Service of the Reference Health Center of the Commune II Bamako Mali

Introduction: Low birth weight is responsible for 9.1 million child deaths each year worldwide. It is the leading cause of perinatal and infant mortality. The objective of this work was to determine the epidemio-clinical profile as well as the future of low birth weight at the Reference Health Center of commune VI in the district of Bamako, Mali. Methods: Our study was descriptive and prospective over a year from April 1, 2018 to March 31, 2019. Data were taken from hospital records and newborn referral/evacuation forms. Data processing was performed using Epi Info software version 3.5.4 and Word. Results: The frequency of low birth weight was 34.94%. Multiparity accounted for 47.84%, sex ratio was 0.93, maternal arterial hypertension was present in 41.66%, genitourinary infection was in 58.37% and delivery was by low way in 86.12%. The majority of newborns had a gestational age between 28SA-33SA (56.52%) and a weight between 1501-1999 grams (47.36%). Mortality accounted for 18.66%. Conclusion: Low birth weight is common in our settings with modifiable risk factors. Practitioners must play on them to minimize its importance.

关键词： Low Birth Weight Future Risk Factors Bamako Mali

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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 mortalit

关键词： Newborn Congenital Hydrocephalus Mortality Gabriel Toure

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Become Immediate of Newborns Operated in the Neonatology Department of the Hospital and University Center Gabriel Toure of Bamako (Mali)

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Open Journal of Pediatrics 2022年第1期12卷 12-18页

作者： Oumar coulibaly Hawa Gouro Diall pierre Togo Hawa Camara Fatoumata Léonie Françoise Diakité Lala Ndrayni Sidibé Leyla Maiga Ibrahima Ahamadou Abdoul Karim Doumbia Adama Dembelé Belco Maiga Karamoko Sacko Mohamed Elmouloud Cissé Djeneba Konaté Fousseyni Traoré Yacouba Aba coulibaly Issa Amadou Touré Hamadi Sissoko Mariam Maiga Alou Samake Bourama Kané Guédiouma Dembelé Abdoul Aziz Diakité Fatoumata Dicko Traoré Mariam Sylla Boubacar Togo Neonatology Department of the Gabriel Touré CHU Bamako Mali Pediatric Surgery Department of the Gabriel Touré CHU Bamako Mali Reference Health Center of the Municipality III Bamako Mali Reference Health Center of the Municipality VI Bamako Mali Mali Hospital Bamako Mali

Neonatal surgical pathologies in developing countries are characterized by high mortality. The aim of this work was to describe the characteristics of the newborn and its surgical pathologies treated in the neonatal department of the Gabriel Touré University Hospital in Bamako (Mali). Patients and method: This is a retrospective study of 626 files of newborns hospitalized over a period of 3 years (January 2016 to December 2018) for a surgical pathology, whether operated on or not. We have studied the etiological, therapeutic and evolutionary aspects. Results: During the study period, we collected 626 patients who had surgical pathology, i.e. a frequency of 5.35%. The average therapeutic consultation time was 2 days with extremes (1 and 30 days). Pathologies of the abdominal wall and digestive tract represented 57.9% (n = 84) followed by pathologies of the spine 26.9% (n = 39). The mean treatment time was 4.5 days. Twenty-three point sixteen (23.16%) newborns could be operated on. The neonatal mortality rate was 12.4% (n = 18). Mortality was postoperative (100%) with a mean time to onset of 5 days. Abdominal wall pathologies were responsible for 8.7% (n = 13) of deaths. Conclusion: Surgical pathologies of the newborn are characterized by delayed treatment with high mortality. Improving their prognosis requires early diagnosis (prenatal diagnosis) and adequate management.

关键词： Newborn Surgical Pathologies 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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