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Severe Hypoglycemia in Hospitalized Children with Diabetic Ketoacidosis in Brazzaville

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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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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Blood Glucose Concentration Abnormalities in Children with Severe Malaria: Risk Factors and Outcome

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Open Journal of Pediatrics 2017年第4期7卷 222-235页

作者： Oko Aymar Pierre Gildas Ekouya Bowassa Gaston Lombet Laetitia Missambou Mandilou Steve vassili Kambourou Judicaël Poathy Jeysse Pierre Yoleine Pandzou Guembo Nelly Ndjobo Mamadou Ildevert Cyriaque Moyen Engombo Moyen Georges Marius Department of Pediatrics Teaching Hospital Center(THC)of BrazzavilleBrazzavilleCongo Faculty of Health Sciences Marien Ngouabi University of BrazzavilleBrazzavilleCongo

Background: The place of blood glucose abnormalities in severe malaria is poorly defined. The objective of the study was to determine the incidence of glycemic abnormalities and to identify the factors associated with their occurrence and death. Patients and Methods: A prospective study was conducted from January to October 2016 at the Teaching Hospital of Brazzaville. The blood glucose levels of all children hospitalized for severe malaria were measured for 3 days. The variables were compared in univariate and multivariate analysis. Results: A total of 158 children with an average age of 69.6 months ± 43.2 (ranges: 5 months and 15 years) were hospitalized for severe malaria. Moderate hyperglycemia was observed in 52.53% of children, severe hyperglycemia: 17.72%, moderate hypoglycemia: 15.19% and severe hypoglycemia: 2.53%. Children aged 5 years (p = 0.03), females (p = 0.03), with disease duration before admission ≥ 7 days (p = 0.03) and referred from private hospitals (p = 0.04) had an increased risk of hypoglycemia. Age > 5 years was associated with hyperglycemia (p = 0.0006). The presence of hypoglycemia (blood glucose ≤ 3.3 mmol/L) on admission was associated with the risk of death (OR = 9.59, p = 0.02), no death occurred in children with hyperglycemia (p = 0.4) on admission. Conclusion: The incidence of blood glucose abnormalities is high in severe malaria. Hyperglycemia is more common than hypoglycemia, but only hypoglycemia is associated with an increased risk of death.

关键词： Glucose Abnormalities Deaths Risk Factors Malaria Children

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Late Diagnosis of HIV Infection in Children: Prevalence and Outcome

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Open Journal of Pediatrics 2017年第4期7卷 331-344页

作者： Aymar Pierre Gildas Oko Antoinette Géraldine Olandzobo Gaston Ekouya-Bowassa Mamadou Ildevert Cyriaque Ndjobo Lucie Ollandzobo Nelly Pandzou-Guembo Letitia Lombet Jeysse Pierre Yoleine Poathy Steve vassili Missambou-Mandilou Aurore Mbika-Cardorelle Georges Marius Moyen Department of Pediatrics Teaching Hospital Center (THC) of Brazzaville Brazzaville Congo Faculty of Health Sciences Marien Ngouabi University of Brazzaville Brazzaville Congo Hospital Center of Loandjili Pointe-Noire Congo

Background: Late diagnosis of HIV infection is an important cause of death in children. Objectives: To determine the prevalence of late diagnosed HIV infection in children, describe the socio-demographic characteristics and to analyze outcome of these children. Methods: From January 2015 to October 2016, we carried out a prospective analytical study in the pediatric departments of University Teaching Hospital of the Brazzaville. Late diagnosed HIV children were selected for this work. Data analysis was performed in univariate and multivariate with Epi Info 7.2.1. Results: Of the 6058 hospitalized children, 103 (1.7%) were selected, 57.3% were boys;the median age was 21.9 months (IQR, 17.8 - 76.7 months). Children of low socio-economic status accounted for 68.0%, those motherless: 43.7%. None of the children were tested for HIV before hospitalization. Mothers had a low education level in 60.2% of cases and were unaware of prevention of mother-to-child transmission (PMTCT): 60.3%. Children mostly showed signs of stages 4 (49.5%), and 3 (31.1%) of HIV infection, immunodeficiency was severe for 68.0% of children. Children discharged from the hospital accounted for 62.1% of which 15.53% against medical advice. The case fatality rate was 37.9%. The risk factors for death in univariate analysis were: age < 12 months (OR = 8.66), maternal death (OR = 17.93), severe malnutrition (OR = 66.07), clinical stages 4 (OR = 66.07) and severe immunodeficiency (OR = 17.37). The main pathologies responsible for death were respiratory infections (38.5%) and diarrheal diseases (30.8%). Conclusion: Improvement of PMTCT program effectiveness, universal access to early detection and antiretroviral therapy for infants are needed to reduce the number of late diagnosed HIV-children and therefore HIV-related morbidity and mortality.

关键词： Late Diagnosis HIV Infection Prevalence Mortality Child Brazzaville

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Biological Markers of Undernutrition and Risk of Complications in Children Hospitalized at the Teaching Hospital of Brazzaville

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Journal of Biosciences and Medicines 2022年第2期10卷 1-9页

作者： Christel Mikolélé-Bilombo Lucie Charlotte Atipo-Ibara Ollandzobo Steve vassili Missambou Mandilou Thibaut Ocko Gokaba Lethso Clausina Mikolélé-Bilomb Ahoui Josué Simo Louokdom Martial Landry Miguel Etienne Mokondjimobe Donatien Moukassa Jean Robert Mabiala-Babela Ange Antoine Abena Jean-Rosaire Ibara Faculty of Health Sciences Marien Ngouabi University Brazzaville Congo Department of Pediatrics Teaching Hospital of Brazzaville Brazzaville Congo Department of Gastroenterology and Hepatology Teaching Hospital of Brazzaville Brazzaville Congo Cameroon Mountain University Douala Cameroon Denis Sassou Nguesso University Brazzaville Congo

Introduction: Undernutrition is a condition frequently encountered in pediatrics. It leads to an increased morbidity and mortality regardless of the underlying condition or other risk factors such as age. In countries with limited resources such as ours, the diagnosis of undernutrition is often limited to the clinical presentation, and the contribution of biology is not often taken into account. Objectives: To establish the relationship between anthropometric parameters and biological markers in the diagnosis and classification of undernutrition and to assess the risk of infectious complications during undernutrition in children. Materials and Methods: A cross-sectional study conducted in Brazzaville among undernourished children aged 1 - 59 months between October 2018 and April 2019. Clinical diagnosis was based on WHO growth charts. The CRP, orosomucoid, albumin and transthyretin were obtained using the Cobas c311 analyzer, which enabled the calculation of Prognostic Inflammatory and Nutritional Index (PINI). The comparison of the means of the biological markers used the Student’s t-test, the risk of infectious complications the chi-square. The correlation of the diagnostic value of Z-score weight/height and PINI was also investigated. The significance level was set at 0.05. Results: Of the 95 children enrolled 63 (66.3%) were clinically severely malnourished, including 26 acute (41.3%) and 37 chronic (58.7%). The PINI revealed severe undernutrition in 85 children (89.4%) including 50 acute (58.8%) and 35 chronic (41.2%). CRP and orosomucoid were statistically higher in severe acute undernutrition (p Conclusion: Anthropometric parameters have a front-line advantage for assessing and classifying undernutrition. However, biological markers of undernutrition with PINI should be systematized in the diagnosis and management of undernutrition.

关键词： Undernutrition Nutritional Marker Inflammatory Marker PINI Child Congo

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Sexual Behaviour of Congolese Teenagers

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Open Journal of Pediatrics（儿科学期刊） 2021年第4期

作者： Lucie Charlotte Ollandzobo Ikobo Steve vassili Missambou Mandilou Messie Josias Matsielo Lynda Tchidjo Ngamo Evrard Romaric Nika Jean Robert Mabiala Babela

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Iron Metabolism Abnormalities in Children with Homozygous Sickle Cell Disease in Brazzaville

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Open Journal of Pediatrics（儿科学期刊） 2023年第3期

作者： Lucie Charlotte Ollandzobo Ikobo Hardy Maryse Ibovi Gataud Steve vassili Missambou Mandilou Olivia Firmine Galiba Atipo-Tsiba Rolf Iwandza Jean Robert Mabiala Babela

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