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Causes of developmental delay in children of 5 to 72 months old at the child neurology unit of Yaounde Gynaeco-Obstetric and Paediatric Hospital (Cameroon)

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Open Journal of Pediatrics 2013年第3期3卷 279-285页

作者： Séraphin Nguefack Karen Kengne Kamga Boniface Moifo Andréas Chiabi Evelyn Mah elie mbonda Departement of Pediatric Neurology Yaounde Gynaeco-Obstetric and Pediatric Hospital Yaoundé Cameroon Faculty of Medicine and Biomedical Sciences University of Yaounde I Yaoundé Cameroon

Background: According to the World Health Organization, about 5% of children world-wide of 14-year-old and under have a moderate to severe developmental disability, and up to 15% of children under 5-year-old are developmentally delayed. Purpose: To determine the prevalence, socio-demographic profile, aetiologies, and the clinical presentation of developmental delay in children less than 6-year-old at the child neurology unit in a university-affiliated hospital in Yaounde. Materials and methods: It was a crosssectional descriptive study carried out in Yaounde Gynaeco-Obstetric and Paediatric Hospital (Cameroon) from August to December 2012. Children aged between 5 - 72 months with a developmental quotient less than 70 were enrolled. Developmental delay (DD) was diagnosed and classified using the Denver developmental screening test (DDST). Data concerning the child (age, gender, severity of DD), the mother (age, age at conception, educational level, marital status), history of pregnancy and delivery, perinatal and postnatal events, results of para-clinical explorations (EEG, CT-scan, genetic tests), the severity of DD and the probable or demonstrate cause of DD were recorded on a standardized questionnaire. The chisquare test was used to compare variables. Results: During the study period, 2171 children aged 5 - 72 months consulted the paediatric department of the hospital, 296 were examined at the child neurology unit of which 153 had a developmental quotient less than 70, giving a hospital prevalence of 7.0% and a prevalence of 51.7% at the child neurology unit. The mean age was 26.6 ± 18.0 months and there were 56% males. The main reason for consulting was tonus disorder (43.8%) and the developmental area of parental concern was the motor domain (90.2%). Regarding the clinical presentation, 75.2% of our population were children with cerebral palsy. DD was severe, mild, moderate and profound respectively in 14.2%, 13.5%, 12.2%, and 11.1%. Gross DD represented 90.2%

关键词： Developmental Delay Risk Factors Aetiologies Hypoxic-Ischemic Encephalopathy Children Cameroon

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Predictive Factors for Abnormal Brain CT-Scan in Childhood Epilepsy at Yaoundé(Cameroon)

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Open Journal of Medical Imaging 2014年第1期4卷 31-37页

作者： Boniface Moifo Séraphin Nguefack Jean Roger Moulion Tapouh Evelyn Mah elie mbonda Joseph Gonsu Fotsin Department of Pediatrics and Subspecialties Yaoundé Gynaeco-Obstetrical and Pediatric Hospital (YGOPH) Yaoundé Cameroon Faculty of Medicine and Biomedical Sciences The University of Yaoundé I Yaoundé Cameroon Department of Radiology and Medical Imaging Yaoundé Gynaeco-Obstetrical and Pediatric Hospital (YGOPH) Yaoundé Cameroon Faculty of Medicine and Biomedical Sciences The University of Yaoundé I Yaoundé Cameroon Faculty of Medicine and Biomedical Sciences The University of Yaoundé I Yaoundé Cameroon

Purpose: Despite irradiation, CT-scan remains an important diagnostic tool in epilepsy in poor countries where MRI is neither available nor affordable. But many causes of epilepsy are not accessible to CT-scan and this technique remains expensive for many poor families in countries with limited resources. The aim of this study was to determine clinical or electroencephalogram variables which could predict brain CT-scan abnormalities in childhood epilepsy. Methods: It was a cross-sectional study including 151 epileptic children who underwent head CT-scan from October 2011 to march 2012, in one university-affiliated hospital in Cameroon (YGOPH). The data collected were clinical, type of seizure, Electroencephalogram and head CT-scans results. Independent predictive factors for CT abnormalities were sought by logistic regression. A p value : Of the 151 children, 54.3% (82/151) were boys (sex ratio: 1.18 M/1F). The median age was 54 months [2 - 190 months];74.8% of children were more than 2 years old but at the onset of epilepsy they were 2 years old or less. Birth asphyxia, mental retardation and neurologic deficit were respectively associated in 62.4%, 54.3% and 51.7% of cases. Eighty-five had focal epilepsy (56.3%), 61.6% had abnormal head CT-scan, 68.9% had abnormal EEG, with no significant gender difference. The factors most significantly associated with abnormal head CT-scan were: child age ≤ 2 years, maternal hypertension/eclampsy, cerebral palsy, and child microcephaly, with 89% to 92% abnormal CT. The two independent predictors of abnormal CT were patients’ age ≤ 2 years and microcephaly. The two main CT-scan lesions were cerebral atrophy (28.5%) and brain infarct (16.6%). None of these abnormalities was correlated to any type of epilepsy. Conclusion: Almost two-thirds of head CT-scan performed in epileptic children are abnormal in our setting. Patients of 2 years old or less and those with microcephaly are very likely to have brain anomalies on CT-scan. The mo

关键词： Epilepsy Childhood Electroencephalogram CT-Scan Predicting Factor Microcephaly Cameroon

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Clinical, aetiological and evolutive aspects of West syndrome in Yaoundé(Cameroon)

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Open Journal of Pediatrics 2013年第4期3卷 306-310页

作者： Séraphin Nguefack Boniface Moifo Andréas Chiabi Antoine Ledoux Defo Evelyn Mah Florence Fru Paul Cédric mbonda Pierre Fernand Tchokoteu elie mbonda Departement of Pediatric Neurology Yaounde Gynaeco-Obstetric and Pediatric Hospital Yaoundé Cameroon Faculty of Medicine and Biomedical Sciences The University of Yaounde I Yaoundé Cameroon

Background: West syndrome (WS) is an epileptic syndrome of the infant occurring between the 3rd and 12th months of life and characterized by the triad: infantile spasms in flexion, extension or mixed;global developmental delay;and hypsarrythmia on the electroencephalogram (EEG). Its incidence varies between 2.9 and 4.5 per 10,000 live births. West syndrome is caused by a brain dysfunction whose origins can be prenatal, neonatal and postnatal. Sometimes the aetiology is genetic or unknown. Purpose: To determine the main clinical, aetiological and major evolutive aspects of West syndrome in child neurology unit in a university-affiliated hospital in Yaoundé. Materials and Methods: It was a retrospective descriptive study conducted from September 2011 to January 2012 inthe child neurology unit of the Yaoundé gynaeco-obstetric and paediatric hospital. The medical records of 68 children followed for West syndrome (WS) in the service during the period from February 2008 to January 2012 (48 months) were used. All infants of 1- to 16-month-old with the diagnosis of WS were included. The diagnosis of WS was based on clinical evidence of spasm in flexion and/or in extension with global development delay, and EEG evidence of hypsarythmia or focal/multifocal epileptic abnormalities when hypsarythmia is absent. For each included infant, relevant medical history and complete physical examination were performed. The following data were collected and reported on a standardized questionnaire: prenatal, perinatal and postnatal past histories, age at onset of spasms, age at diagnosis, semiology of spasms, psychomotor development, the EEG and CT aspects and the evolutive modes of WS under treatment. Psychomotor development was assessed using theDenverdevelopmental screening test (DDST) which assesses the mental age compared to chronological age. Results: The age of onset of spasms varied between 1 and 16 months with a mean of 4.69 (±1.98) months. Males were highly represented with a se

关键词： West Syndrome Epilepsy Aetiology Evolution Cameroon

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Prevalence and CT-Scan Presentations of Brain Malformations in Children at a University-Affiliated Mother and Child Hospital (Cameroon)

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Open Journal of Medical Imaging 2017年第4期7卷 220-228页

作者： Boniface Moifo Rosine Azegha Jiotsa Seraphin Nguefack Sandra Tatah Evelyne Mah Félicité Dongmo Nguefack elie mbonda Faculty of Medicine and Biomedical Sciences The University of Yaounde 1 Yaounde Cameroon Radiology Department Yaounde Gynaeco-Obstetric and Pediatric Hospital Yaounde Cameroon Department of Pediatrics and Pediatric Sub-Specialties Yaounde Gynaeco-Obstetrics and Pediatric Hospital Yaounde Cameroon

Background: Brain malformations (BMs) are congenital abnormalities of the shape or structure of the brain, with corpus callosum agenesis known as the most frequent. Diagnosis of most BMs can be prenatal with ultrasound and fetal magnetic resonance imaging (MRI);post-natal diagnosis is based on transfontanellar ultrasound, CT-scan, and head MRI which is the imaging gold standard technique. MRI has been recently introduced and the CT-scan was previously the reference technique for the diagnosis of BMs in our context. Almost no publication has been made in sub-Saharan Africa on the clinical and CT scan characteristics of Brain malformations in children. Objective: The aim of this study was, in the absence of MRI, to describe the clinical and CT-scan presentations of brain malformations in children at the Yaounde Gynaeco-Obstetric and Pediatric Hospital (YGOPH). Patients and method: This was a cross-sectional descriptive study conducted from February to May 2016 at the YGOPH, including all children of 15-year-old and less with BM diagnosed on CT-scan at YGOPH between April 2006 and March 2016. The studied variables were clinical (age at diagnosis, sex, clinical manifestations) and CT findings (type of cerebral malformation). The data was analyzed using the SPSS 20.0 software with the estimation of hospital prevalence of BMs, frequencies and associations. The chi-square test was used to seek for an association between variables. The threshold of significance was p Results: The prevalence of BMs was 0.52%, with 29 cases of BMs identified out of 5590 patients followed up at the pediatric neurology outpatient unit over a period of 10 years. The mean age at diagnosis was 37.2 months (3.1 years) and the most represented age groups were 0 - 1 year (37.9%) and 1 - 5 years (37.9%). The sex ratio was 0.81 (55.2% girls). The clinical presentation was represented by neurological signs (93.1%) with convulsions (65.5%) and psychomotor retardation (58.8%) associated with skin lesions

关键词： Cerebral Malformations Psychomotor Retardation Convulsions Tuberous Sclerosis Complex Corpus Callosum Agenesis Cerebral CT Scan Sub-Saharan Africa

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Etiologies and Outcome of Children with Purulent Meningitis at the Yaounde Gyneco-Obstetric and Pediatric Hospital (Cameroon)

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Open Journal of Pediatrics 2014年第4期4卷 269-275页

作者： Seraphin Nguefack Andreas Chiabi Jacob Enoh El Hadji Djouberou Evelyn Mah Karen Kengne Kamga Sandra Tatah elie mbonda Departement of Pediatric Neurology Yaounde Gynaeco-Obstetric and Pediatric HospitalYaoundeCameroon Faculty of Medicine and Biomedical Sciences University of Yaounde IYaoundeCameroon Departement of Pediatric University of Cocody-AbidjanAbidjanCote d’Ivoire

Background: Bacterial meningitis is one of the most severe infections in infants and children. It is associated with high mortality and neurological sequelae. In order to improve the prognosis of infants and children with purulent meningitis, we decided to conduct this study whose main objective was to identify the main pathogens responsible and describe the outcome in infants and children aged 2 months to 15 years admitted for purulent meningitis at the Yaounde Gyneco-Obstetric and Pediatric Hospital (YGOPH). Method: This was a cross-sectional study with retrospective data collection and consecutive sampling. Our study was conducted from 1 January 2009 to 31 December 2013. The patients included in the study were infants and children aged from 2 months to 15 years who were admitted for bacterial meningitis at the YGOPH, confirmed by bacteriological examination of cerebrospinal fluid (CSF) with identification of the pathogen by culture or soluble antigen. The data was analyzed using SPSS Version 18.0 and Excel 2007. The Chi-square test was used to determine the association of various variables. The significance threshold was set as P 0.05. Results: We selected 171 cases of purulent meningitis who represented 1.54% of admitted patients. The sex ratio was 1.2. We noted that 45% of our patients were aged 2 months to 1 year. The main presenting complaints were fever (98.8%), seizures (44.4%) and vomiting (28.7%). Haemophilus influenzae was found in 67 children (39.2%), followed by Streptococcus pneumoniae in 54 children (31.6%) and Neisseria meningitidis in 17 children (9.9%). Acute complications (status epilepticus, coma) were seen in 33% of patients. The statistically significant (P 0.05) factors for poor prognosis were aged from 2 months to 1 year (P = 0.0004), coma (P = 0.32), intracranial hypertension (P = 0.0001), the pathogen (P = 0.0032Pneumococcus), a delay of more than three days between the onset of the disease and the treatment (P = 0.0134) and brain abscess

关键词： Bacterial Meningitis Etiologies Outcome Children Cameroon

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The Empiric Use of Palm Kernel Oil in Neonatal Skin Care:Justifiable or Not?

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Chinese Journal of Integrative Medicine 2011年第12期17卷 950-954页

作者： Andreas Chiabi Maguerite Hortence Kenmogne Seraphin Nguefack Bolaji Obadeyi Evelyne Mah Franck Zeh Meka Pierre-Fernand Tchokoteu elie mbonda Tetanye Ekoe Yaounde Gynaeco-Obstetric and Pediatric Hospital P.O.Box 4362Yaounder Faculty of Medicine and Biomedical Sciences University of Yaounde IP.O.Box 1364YaounderCameroon Department of Organic Chemistry Faculty of ScienceUniversity of Yaounde IP.O.Box 812YaounderCameroon Faculty of Medicine and Biomedical Sciences University of Yaounde 1P.O.Box 1364YaounderCameroon Health Logics P.O.Box 13777Ikeia LagosNigeria Yaounde Gynaeco-Obstetric and Pediatric Hospital Faculty of Medicine and Biomedical Sciences University of Yaounde IP.O.Box 1364Yaounder Cameroon

Palm kernel oil is a vegetable oil derived from Elaeis guineensis and widely used in neonatal settings for skin care. It is a good emollient with a beneficial effect in moisturizing the skin and preventing transdermal heat and water loss. However, it＇s putative roles in the prevention or treatment of fatty acid deficiency is still controversial. So is its function in the improvement of neurological development from its long- chain polyunsaturated fatty acids？ We set out in this review to verify whether its empiric use in this context has any scientific justification and is recommendable. Although there is evidence that it has emollient and moisturizing properties necessary for softening the skin and restoring elasticity, controversy subsists on its other nutritional and neurodevelopmental properties.

关键词： palm kernel oil neonate skin care

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Neurodevelopmental Problems in Children at 9 Months of Age Associated with Neonatal Hypoxic-Ischemic Encephalopathy

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Open Journal of Pediatrics 2017年第2期7卷 98-108页

作者： Evelyn Mungyeh Mah Seraphin Nguefack Hélène Kamo Selangai Andréas Chiabi Mbassi Awa Félicité Dongmo Mazou Ngou Temgoua elie mbonda Affiliation Department of Pediatrics Gyneco-Obstetric and Pediatric Hospital of Yaoundé Yaoundé Cameroon Faculty of Medicine and Biomedical Sciences University of Yaoundé I Yaoundé Cameroon Mother and Child Center of the Chantal Biya Foundation Yaoundé Cameroon

Introduction: Neonatal asphyxia is a major cause of infant morbidity in Cameroon. The aim of this study was to describe the short-term neurological outcome of children following neonatal Hypoxic-ischemic encephalopathy (HIE). Methodology: We conducted a retrospective cohort study from May 2010 to September 2013. We included 39 exposed cases against 78 non-exposed cases followed-up for at least 9 months. The variables studied were: age, sex, head circumference, neurological sequelae, postural anomalies and motor skills and developmental age/quotient. The data collected were analyzed using Epi info software version 3.5.3. The Fisher Exact Test was used to compare the variables with a significance threshold defined for p Results: We recruited 39 cases for 78 controls. The majority (74.40%) of cases were classified as HIE Sarnat 3 and 25.60% Sarnat 2. Most of the children were aged 12 - 36 months with a mean age of 18 months. The male sex was predominant with a sex ratio of 1.2;and 61.50% of children with HIE had head circumference Conclusion: The frequency of neurological sequelae following HIE was high in our series. Efforts should be made to prevent perinatal asphyxia and to ensure the availability of material and staff trained to help babies’ breath in all the delivery rooms in our maternities.

关键词： Hypoxic-Ischemic Encephalopathy Cerebral Palsy Mental Retardation Cameroon

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