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Outcome after Discharge from Hospital of Children with Complicated Severe Acute Malnutrition and Predictors Factors of Non-Response during Outpatient Treatment, in Senegal

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Open Journal of Pediatrics 2023年第4期13卷 473-483页

作者： Abou Ba aliou Thiongane Babacar Niang Younoussa Keïta Fatou Ly aliou abdoulaye ndongo Ousmane Ndiaye Pediatric Department of Dalal Jamm National Hospital Center Dakar Senegal Institute of Social Pediatrics of Cheikh Anta DIOP University Dakar Senegal Albert Royer Children’s National Hospital Center Dakar Senegal Abass Ndao Hospital Center Dakar Senegal Pikine National Hospital Center Dakar Senegal

Introduction: Malnutrition is a public health problem. It is responsible for high morbidity and mortality in children aged 6 - 59 months. The aim of this study was to determine the outcome of children with complicated severe acute malnutrition after hospital discharge. Methods: This is a descriptive and analytical cross-sectional study conducted from March 1 to November 31, 2021 at the Albert Royer Children’s Hospital. Children discharged from hospital for complicated severe acute malnutrition were included. Results: A total of 103 children were included. The mean age of children at hospitalization was 16.41 ± 10.11 months and mean duration of follow-up after hospital discharge was 29.63 ± 8.59 months. Three children (2.91%) died after hospital discharge. The mean z-score of the weight-for-current height was -1.34 ± 1.08. Almost a quarter (24.27%) of the children remain acute malnourished with 3.88% of severe acute malnutrition (SAM). The predictors’ factors associated with non-response were weaning before 2 years of age (ORaj: 12.21;95% CI [6.82 - 18.44];p = 0.04) and tuberculosis (ORaj: 21.06;95% CI [12.54 - 41.09];p = 0.03). Conclusion: The rate of recovery of nutritional status in children with complicated severe acute malnutrition is satisfactory. Ablactation before the age of two and the existence of tuberculosis are significantly associated with non-recovery of nutritional status.

关键词： Children Severe Acute Malnutrition Recovery Non-Response

Congenital Heart Disease in Rural Senegal: A Retrospective Study of 79 Patients

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Open Journal of Pediatrics 2023年第1期13卷 43-49页

作者： Babacar Niang Aminata Mbaye Djibril Boiro aliou abdoulaye ndongo Mame Diarra Thiam aliou Thiongane Modou Guéye Amadou Lamine Fall Ousmane Ndiaye Albert Royer Children’s Hospital Dakar Sénégal Abass Ndao Hospital Dakar Sénégal

Introduction: Congenital heart disease (CHD) is a malformation of the heart present at birth and resulting from a developmental defect during embryonic life. The aim was to assess CHD in rural areas. Methodology: This is a retrospective study conducted over a period of 2 years in rural Senegal. Results: During the study period, we collected 79 patients with CHD, representing a hospital prevalence of 2.6%. The mean age at diagnosis was 17.05 months and the sex ratio was 1.19. The mean birth weight was 2826 g. The main comorbidities were anaemia (54.43%) and respiratory infections 38 cases (48.10%). Respiratory distress was the most common sign with 98.73%. Radiological cardiomegaly was noted in 86.7%. The most frequent CHD were interventricular septal defect (IVD) 21.51% and atrial septal defect (ASD) 8.86%. No patient was able to receive surgical treatment. Seven children died (8.86%) and 21 children were lost to follow-up (26.58%). On Doppler echocardiography, 16.45% of the patients had pulmonary arterial hypertension (PAH). Conclusion: In light of this work, emphasis should be placed on the quality of antenatal consultations, the quality of management and the regular availability of echocardiography and a cardio-paediatrician in order to reduce morbidity and mortality.

关键词： Heart Disease Congenital Children Senegal

Management of Severe Acute Malnutrition in a Senegalese Paediatric Hospital

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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

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

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

Particularities of Tuberculosis in Children and Adolescents with Sickle Cell Disease in Senegal

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Open Journal of Pediatrics 2022年第1期12卷 59-66页

作者： Idrissa Demba Ba Indou Deme/Ly Yaye Joor Dieng Abou Ba Babacar Niang aliou abdoulaye ndongo Papa Moctar Faye Guillaye Diagne Amadou Sow Fatima Tall/Fall Amadou Lamine Fall Ousmane Ndiaye Hô pital d’enfants Albert-Royer de Fann-Dakar Université Cheikh Anta Diop de Dakar Fann Dakar Senegal

Introduction: Tuberculosis and sickle cell disease are one of the main global health priorities particularly in Africa. We aimed to determine the epidemiological, diagnostic and therapeutic aspects of tuberculosis in children and adolescents with sickle cell disease. Patients and methods: Patients aged 0 - 20 years with sickle cell anemia presented with tuberculosis at the Centre Hospitalier National d’Enfants Albert Royer (CHNEAR), Dakar, Senegal were included in the study. Medical history, risk factors, clinical, bacteriological, and outcome data was collected. Data was analyzed using the SPSS software, version 16. Results: A total of 25 cases of tuberculosis were documented from January 1st, 1991 to December 31st, 2019 (hospital prevalence: 0.97%). Mean age was 12.5 years. The sex ratio was 1.5 (15 girls and 10 boys). Pulmonary tuberculosis in 14 cases was the most frequent followed by lymph nodes in 7 cases involvement and Pott’s disease in 4 cases. In 5 patients Tb was multifocal. Mean duration of treatment was 8.27 months (6 to 12 months). Outcome was good on antituberculosis treatment. None patient died. Conclusion: Children and adolescents with sickle cell disease can be infected with Mycobacterium tuberculosis. Pulmonary tuberculosis, lymph nodes and bone involvement are the most frequent localizations. Outcome is good on antituberculosis treatment.

关键词： Tuberculosis Sickle Cell Disease Children Adolescent Senegal

Evolutionary Profile of Graves’ Disease in Children at Albert Royer National Children Hospital in Dakar

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Open Journal of Pediatrics 2019年第2期9卷 119-125页

作者： Babacar Niang Lamine Thiam Fatou Ly Indou Dème Ly Djibril Boiro Amadou Sow aliou Thiongane aliou abdoulaye ndongo Aminata Mbaye Younoussa Keita Abou Ba Idrissa Demba Ba Yaay Joor Dieng Dienaba Fafa Cissé Papa Matar Faye Amadou Lamine Fall Ousmane Ndiaye Albert Royer National Children Hospital Center Dakar Senegal La Paix Hospital Ziguinchor Senegal Pediatric Ward University Hospital Center of Pikine Dakar Senegal Pediatric Ward University Hospital Center of Abass Ndao Dakar Senegal Pediatric Ward University Hospital Center of Aristide Le Dantec Dakar Senegal

Graves’ disease is the most common cause of hyperthyroidism. Adequate management is an area of controversy, especially when it comes to children. The objective of our study was to assess the outcome of Graves’ disease treatment in Albert Royer Children Hospital of Dakar. This was a retrospective study conducted from 2001 to 2015, and which involved all children between 0 to 15 years of age who were being monitored in the Albert Royer National Children Hospital. The evolutionary modalities were: stability, remission, failure, relapse, lost to follow-up and death. The data were analyzed with SPSS software version 20.0. For the comparisons, the KHI 2 or Fisher test was used with a significance threshold (p < 0.05). During the study period, 88 children were enrolled. The average age was 8.6 years [ranging from 8 months to 15 years]. The consultation delay was 11.36 months. In our study, 61.4% of the patients were regular in the follow-up, the observance was good in 40.9% of the cases and 19 patients (21.6%) were lost to follow-up. Clinical courses of 69 children after treatment with Carbimazole for 37 months were promising in 21 cases (30.43%), with 17 cases of remission (24.63%) and 4 cases of stability (5.8%). Age older than 10, the initial ATD dose greater than 1 mg/kg/day and the initial free T4 lower than 50 pmol/l were significantly associated with remission with a p value of 0.01;0.024 and 0.004.

关键词： Graves’ Disease Child Antithyroid Drug Remission Senegal

Review of 6 Years of Middle Ear Surgery in the ENT-Laryngology Department of the Donka National Hospital and a Literature Review

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Surgical Science 2024年第8期15卷 471-479页

作者： Mamadou aliou Diallo Ibrahima Diallo Mamadou Mouctar Ramata Diallo Sayon Kourouma Alsény Camara Alsény Cissé abdoulaye Bayo Barry Alpha Oumar Sory Sacko abdoulaye Keita Service dORL Hpital National Donka Conakry Guinea Service dORL Hpital Rgional de Mamou Mamou Guinea Service dORL Hpital Rgional de Lab Lab Guinea

Introduction: Middle ear surgery is increasingly performed in our department. Our goal was to take stock of this activity in the ENT department of the Donka National Hospital. Equipment and Methods: It was a descriptive and retrospective study;it involved 71 patients’ records operated from January 1, 2018 to December 31, 2023. We included the files of patients who had a middle ear surgery including the post-operative report and follow-up. Incomplete or illegible records were excluded. The parameters studied were epidemiological, otoscopic, tomodensitometric, surgical indications, surgical techniques and results. Results: We recorded 71 middle ear surgeries out of 548 ENT surgeries, the prevalence was 12.96%. The average age was 23 years (type-deviation = 17, 29 years) with extremes of 3 to 75 years. According to the preoperative audiometry, the deafness was medium (48.8%), mild (36.9%) and severe (14.3%). The operative indications were among others: perforation of the tympanic sequellar (52.5%), chronic otomastoiditis (23.8%), cholesteatoma (15%) and seromuqueous otitis (8.7%). We performed 70 tympanoplasties (90.9%), 50 mastoidectomies (64.9%) and 7 trans-tympanic aerators (9.1%). One month after surgery, the neotympanum was constituted in 86%, and the hearing gain was between 11 and 15 dB in 18.3% of cases. Conclusion: Middle ear surgery was infrequent. Young subjects are the most concerned. Tympanoplasty and mastoidectomy are the main surgical techniques. The anatomical and functional results are appreciable.

关键词： Surgery Ear Tympanoplasty Mastoïdectomie

Otorhinolaryngological (ORL) and Cervicofacial Injuries Resulting from Road Accidents within the Otorhinolaryngology (ORL) Department of the Regional Hospital of Mamou

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International Journal of Otolaryngology and Head & Neck Surgery 2024年第1期13卷 16-28页

作者： Mamadou Mouctar Ramata Diallo Ibrahima Diallo Alsény Camara Mamadou aliou Diallo Raphan Madi Kaba Keita abdoulaye Sow Alsény Cisse Sory Sacko Mamadou Gouraissiou Diallo abdoulaye Keita Alpha Oumar Diallo Ear Nose and Throat (ENT) Department Regional Hospital Mamou Mamou Guinea Ear Nose and Throat (ENT) Department National Hospital Donka Conakry Guinea Ear Nose and Throat (ENT) Department Regional Hospital N’zérékoré N’zérékoré Guinea Ear Nose and Throat (ENT) Department Regional Hospital Labé Labé Guinea Ear Nose and Throat (ENT) Department National Hospital Ignace Deen Conakry Guinea

Introduction: Otorhinolaryngological (ORL) and cervicofacial traumas encompass injuries affecting the neck, face, and ORL region, resulting from external influence. The objective of this study was to conduct an epidemiological and clinical analysis of ORL and cervicofacial injuries observed in victims of road accidents treated at the Otorhinolaryngology (ORL) department of the Regional Hospital of Mamou. Materials and Methods: This prospective and descriptive study was conducted over a period of 12 months, from January 1st to December 31st, 2021, within the Otorhinolaryngology (ORL) department of the Regional Hospital of Mamou. It included patients hospitalized for ORL and/or cervicofacial traumas resulting from road accidents during the study period. Results: A total of 348 cases were included, representing 36.22% of all traumas related to road accidents (AVP) within the Regional Hospital of Mamou. The average age of the patients was 26.44 years, with a sex ratio of 3.83, favoring males. The dominant socio-professional category was students, encompassing 32.47% of cases. Road accidents were mainly associated with motorcycle use (31.32% motorcycle-to-motorcycle, 24.43% motorcycle skidding, 13.51% motorcycle-pedestrian). Facial region injuries were the most common, accounting for 69.03% of cases, followed by rhinological injuries (17.28%) and otological injuries (13.69%). Associated injuries were predominantly closed head traumas (52.55%) and lower limb fractures (20.41%). Imaging was underutilized. Regarding surgical interventions, reconstructive surgery was the most predominant, accounting for 52.51% of cases, with a management timeframe of 30 minutes to 12 hours for 99.72% of patients. Conclusion: Road traffic accidents remain a serious public health issue, primarily affecting young males. Emphasis should be placed on road safety measures to reduce the frequency of these accidents.

关键词： ENT Injuries Road Accidents Regional Hospital of Mamou