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Profile and Antibiotic Sensitivity of Acute Pyelonephritis in Children at Gabriel Toure Teaching Hospital, Bamako

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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发展中国家剖腹产指示常规报告的建议(英文)

发展中国家剖腹产指示常规报告的建议(英文)

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北京论坛（2007）文明的和谐与共同繁荣——人类文明的...

作者： C.Stanton C.Ronsmans P.Bailey J.Belizán P.Buekens C.T.cisse A.A.Creanga Luc de Bemis D.Dubourg E.M.Farrell S.A.Holtz T.Lippeveld A.Moran D.Shaw T.S.Thach J.Thomas L.L.Wright Johns Hopkins Bloomberg School of Public Health BaltimoreMaryland USA London School of Hygiene and Tropical Medicine LondonUK

Objective:This paper presents recommendations for routine reporting on indications for cesarean delivery in developing *** recommendations resulted from an international meeting of researchers and obstetricians held in February 2006 which was organized to promote the collection of comparable data to understand change in or composition of the cesarean rate in developing *** and Results:This paper presents data from selected countries categorizing cesareans by three classification *** group recommended a hierarchical categorization is hierarchical that prioritizes cesareans performed for absolute maternal *** among the remaining non-absolute indications are based on the primary indication for the procedure and include maternal and fetal indications,as well as psycho-social indications,required for higher cesarean rate settings. Conclusion:Advocacy within Ministries of Health and medical professional organizations is required to advance the routine monitoring of cesarean indications as researchers have not effectively communicated the effects on health and health care infrastructure of either excessive or inadequate use of cesarean.

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Non Hodgkin Lymphomas (NHL) in the Pediatric Oncology Unit of the Gabriel TouréTeaching Hospital, Bamako Mali

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Open Journal of Pediatrics 2019年第4期9卷 309-316页

作者： B.Togo P.Togo O.Kone F.Traore A.K.Doumbia A.Toure A.A.Diakite O.Coulibaly H.Diall1 B.Maiga K.Sacko A.Dembele Y.A.Coulibaly D.Konate M.E.cisse A.A.Ba F.L.Diakite L.N.Sidib A.Doumbia H.Konare L.B.Maiga C.B.Traore Department of Pediatrics Gabriel TouréTeaching HospitalBamakoMali National Institute of Research in Public health BamakoMali Pathology Service of Point G Teaching Hospital BamakoMali

Background :Non-Hodgkin lymphomas are the first childhood cancer in sub-Saharan Africa. Objective: The purpose of this study was to assess non-Hodgkin lymphomas cases in our setting. Methodology: A retrospective and descriptive study carried out in the pediatric oncology unit of the Gabriel Touré Teaching Hospital Bamako over 10 years from 1st January 2005 to 31th December 2015. Results: We exploited 274 (21.6%) cases of Non-Hodgkin Lymphoma out of 1295 cancer cases registered, the age group 6 - 10 years was the most represented (46.4%);the male sex was predominant with a sex-ratio of 1.8;digestive signs were the most common signs of discovery (44.2%) followed by maxillary swelling (42.7%);the majority of patients (52.9%) consulted between 1 and 3 months after the onset of signs;the malnutrition rate was 39.8%, of which 24.1% were severe cases and 15.7% were moderate rate. Abdominal localization was the most common (43.1%) followed by maxillofacial localization (33.9%). Almost all were Burkitt type cytology (92.7%), the majority (73.4%) were in Murphy stage III. Almost all (96%) had received chemotherapy and the modified LMB 01 protocol was widely used (62.4%). The majority of patients (85%) were chemosensitive at day 7 or after the third cyclophosphamide injection but at the end of induction only 31% were in complete remission. Gastrointestinal toxicity was the most common (37.13%) followed by hematologic toxicity 35.09 %;9.12 % of patients were lost of follow-up and 22.26% died. Tumor progression was the most common cause of death (60.66%) followed by infection (21.31%). Conclusion: In light of these findings, the late diagnosis and the poor management of NHL, as well as the limited ability to primarily treat metabolic complications, explain the high case-fatality rate, hence the important role of early diagnosis and treatment multidisciplinary.

关键词： Childhood Lymphomas Gabriel TOURE Teaching Hospital Mali

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Epidemio-Clinical Characteristics of Perinatal Anoxia and Immediate Outcome of Patients at Hospital Teaching Gabriel Toure of Bamako

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Open Journal of Pediatrics 2019年第4期9卷 326-336页

作者： L.N.Sidibe H.Diall1,D.Konate O.Coulibaly F.L.Diakite K.Sacko F.Traore O.H.Diallo L.Maiga I.Ahamadou I.Traore I.Kone1,B.Maiga P.Togo A.K.Doumbia A.Toure E.M.cisse A.Dembele Y.A.Coulibaly A.Doumbie A.Konare1,A.A.Diakite B.Togo M.Sylla F.DickoTraore Department of Pediatrics CHU Gabriel ToureBamakoMali Faculty of Medicine and Odonto-Stomatology of Mali BamakoMali

Introduction: Neonatal asphyxia (NA) is one of the most likely causes of neuro-developmental abnormalities in children. In Mali it is responsible for half of the early deaths and the third of neonatal mortality. Updated data would help understand and improve intervention strategies to reduce mortality. Objective: It is the study of epidemiological and clinical characteristics, the immediate outcome and the factors associated with newborn (NB) mortality with NA. Material and Methods: This was a prospective cross-sectional study from June 27th to September 3rd 2016 about the NBs admitted for NA in the Hospital Teaching Gabriel Touré of Bamako. The clinical and biological data including the prognosis were collected from the health records of women, the liaison sheets and the medical file. The analysis was done using the software Epi info version 3.5.1. Results: 76 NBs were included which represented 23.45% of hospitalizations. The majority (89.5%, n = 68) were admitted to less than 24 hours of life for NA grade III according to the Sarnat classification (43.4%, n = 33). The average age of mothers was 24.17 ± 5.5 years. Almost half (41.3%, n = 31) were primigravida. The most common obstetrical event was dystocia (64.5%, n = 49). The prognosis was poor in grade III anoxia in our patients (56%) of deaths. Conclusion: The périnatal anoxia (PA) is a major health issue in Mali because of its frequency and severity. Monitoring of pregnancies, delivery assisted by skillful and qualified personnel, mastery of neonatal resuscitation techniques are good means of prevention.

关键词： Anoxia Newborn Epidemiology Clinical Outcome

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Scleroderma and HIV Infection: A Case Report with Literature Review

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Open Journal of Internal Medicine 2018年第4期8卷 255-260页

作者： I. A. Dembélé N. R. Nyanke D. Traore A. K. Souckho D. Sy M. Cissoko A. Sanogo B. B. Sangaré O. A. cisse K. Dao K. T. Tighankpa M. Malle M. Togo A. Keita A. Traore M. Saliou Y. Fofana D. Sangaré N. Tolo N. Doumbia A. Doumbia B. B. Berthé B. D. Camara S. A. Coulibaly N. Sawadogo M. Dembélé A. K. Traore H. A. Traore Internal Medicine Department Point G Teaching Hospital Bamako Mali Department of Internal Medicine Kaya Regional Hospital Kaya Burkina Faso

Introduction: Acquired immunodeficiency syndrome (AIDS) linked to HIV infection is accompanied by auto-immune phenomena. Autoimmune diseases can develop in people living with HIV, most in a context of good immunological control (vasculitis, anti-phospholipid syndrome). Since the advent of antiretroviral therapy, an increasing number of autoimmune connective tissue diseases such as systemic lupus erythematosus, dermatomyositis, and syndromes of Sj?gren and scleroderma have been reported. Purpose: To describe this association’s not very common scleroderma and HIV infection. Observation: We report the case of a 56-year-old lady admitted into the service for functional impotence that would have been evolving for a week. Prior to her hospitalization, she presented edemas of the lower limbs associated with anesthesia of the lower limbs for 5 months. The painting is accompanied by a productive cough and an intermittent fever. At the physical examination a weight loss (BMI = 13.74 Kg/m2), fever (38.7°C): Oral candidiasis, lower lip ulceration, perlicking, undernutrition folds, sclerodactyly and homogeneous hepatomegaly was noted. The diagnosis of immunosuppression to HIV Stage 3 with TB co-morbidity and positive hepatitis B Serology was retained while diffuse Scleroderma was selected from the ACR/EULAR criteria of 2012 with a score of 10 (sclerodactyly = 4 point;Raynaud’s phenomenon = 3 point and Ac Anti Scl 70 positive = 3 point). Conclusion: These associations of chronic pathology must be described to improve the future treatment of our patients.

关键词： Scleroderma HIV Internal Medicine

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