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Severe Childhood Malaria in Two Health Districts of Cuvette-Congo

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Open Journal of Pediatrics 2022年第3期12卷 582-593页

作者： Moyen Engoba Prudencia Joachinelle Malouono Moukassa Géril Sekangue Obili Lynda Tchidjo Ngamo georges marius Moyen Jean-Louis Nkoua Faculty of Health Sciences University Marien Ngouabi Brazzaville Congo Department of Intensive Care Pediatrics University Hospital of Brazzaville Congo

Introduction: Malaria is a public health problem. Severe forms of malaria are linked to high mortality. Objective: To establish the cartography of severe malaria in two health districts in Cuvette-Congo. Methodology: An analytical and cross-sectional study was conducted from January to September 2019 in two health districts of Cuvette-Congo. Children aged three months to 17 years diagnosed with severe malaria were included. The epidemiological, clinical and paraclinical variables were analyzed. The statistical tests used were Pearson’s chi2 and the corrected Yates test. Results: Out of 806 children hospitalized, 277 had severe malaria (34.4%). There were 144 boys and 133 girls, an average of 60.9 months old. Anemia n = 247 (89.2%), repeated seizures n = 66 (23.8%), were the signs of severity observed. The clinical forms were isolated (n = 237) in 85.6% and associated (n = 40) in 14.4%, including 210 (88.6%) anemic form and 27 (11.4%) neurological form. The death occurred in seven cases (2.5%). The predictors of death were coma, jaundice, hypoglycemia, thrombocytopenia, hepatomegaly, undernutrition, dehydration and delayed consultation. Conclusion: The large number of cases of severe malaria in Cuvette, often in children under five years old, requires that the national program for control of malaria be strengthened by insisting on a wide distribution of long-lasting insecticide-treated mosquito nets.

关键词： Severe Malaria Child Cuvette-Congo

Morbidity and Mortality in Adolescents at the University Hospital of Brazzaville

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Open Journal of Pediatrics 2021年第2期11卷 243-253页

作者： Engoba Moyen Vérinal Ouemeyi-Enani Annie Rachelle Okoko Ben Borgea Nianga Verlem Bomelefa-Bomel georges marius Moyen Faculty of Health Sciences University Marien Ngouabi Brazzaville Congo Department of Intensive Care Pediatrics University Hospital of Brazzaville Brazzaville Congo Program and Project Coordination Unit Ministry of Health and Population Brazzaville Congo

Introduction: Adolescent morbidity and mortality is a health concern. Objective: To determine morbidity, identify the causes of morbi-mortality and the factors associated with adolescent mortality in Brazzaville. Patients and Methods: A retrospective, descriptive and analytical study was carried out at the Brazzaville Hospital and University Center between January 2015 and December 2016. Adolescents hospitalized in clinical services whose records were workable were included. The Epidemiological, clinical and evolutionary variables were analyzed. The statistical test used was the khi-two, the significance level set at 0.05. Results: In total, Out of 67,488 hospitalized patients, 2062 were adolescents: 3% including 891 (43.2%) boys and 1171 (56.8%) girls mean age 14.8 ± 2.92 years, seen in average 9.38 days after the onset of symptoms. Childbirth 415 (20.1%), malaria 309 cases (14.9%), major sickle cell crisis 223 (10.8%) and traumatic injuries 166 cases (8.05%) are the main causes of morbidity. One death was recorded in n = 193 (9.4%), of which n = 104 (5.0%) in the first 48. Tumors, malaria and status epilepticus are the lead

关键词： Adolescents Morbidity Mortality Brazzaville University Hospital

Impact of the Covid-19 Pandemic on Severe Childhood Malaria at the University Hospital of Brazzaville

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Open Journal of Pediatrics 2021年第2期11卷 301-312页

作者： Moyen Engoba Arquevia Nature Ofamalekou Gnakingue Ben Borgea Nianga Carel Ervane Goma Armel Landry Batchi-Bouyou Annie Rachelle Okoko georges marius Moyen Faculty of Health Sciences Marien Ngouabi University Brazzaville Congo Pediatric Intensive Care Service University Hospital of Brazzaville Brazzaville Congo Program and Project Coordination Unit Ministry of Health and Population Brazzaville Congo

Introduction: Malaria management has been a source of concern for health systems since the advent of the Covid-19 pandemic. Objective: To assess the impact of the Covid-19 pandemic on severe childhood malaria in Brazzaville. Material and Method: A quasi-experimental intervention/non-intervention study was carried out between March and October 2020 in the pediatric departments of the Brazzaville University Hospital. Children aged three months to 15 years hospitalized were the target population. Two groups were formed: the “intervention” group, that of children hospitalized between March and October 2020 and the “control” group that of those hospitalized between January and August 2015. The study variables were epidemiological, clinical, biological and therapeutic. Chi-square and T-Student tests were used. The impact of the intervention was assessed by the absolute risk difference. Results: Of 1392 children hospitalized, 199 (14.6%) had severe malaria with an average age of 6.94 years. These were children under 5 years old n = 95 (47.7%) of low socioeconomic level n = 145 (72.9%) seen on average after 4.6 +/? 2.4 days. Repeated convuls

关键词： Impact Covid-19 Severe Malaria Children Brazzaville

Acute Renal Failure in Children at the University Hospital of Brazzaville

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Open Journal of Pediatrics 2019年第3期9卷 253-271页

作者： Engoba Moyen Verlem Bomelefa-Bomel Gaston Ekouya-Bowassa Tony Eyeni Sinomono Aymar Pierre Gildas Oko Bertrand Fikahem Ellenga Mbolla georges marius Moyen Intensive Care Pediatric Department University Hospital of Brazzaville Brazzaville Congo Neonatology Department University Hospital of Brazzaville Brazzaville Congo Nephrology Department University Hospital of Brazzaville Brazzaville Congo Cardiology Department University Hospital of Brazzaville Brazzaville Congo

Introduction: Acute renal failure (ARF) is a medical emergency that does not spare children. Its interest lies in the search for etiologies and management made difficult by the poor quality of hospital technical platform in Africa. Objectives: To improve the management of ARF in children, determine its prevalence, and identify the causes and factors associated with mortality. Patients and Methods: We reviewed the records of children from one month to 17 years hospitalized between January 2016 and December 2018 in every pediatric department at the University Hospital of Brazzaville and included those whose discharge diagnosis included the item “ARF”. Study variables were age, sex, source, (para)clinical signs, stage and type of ARF, etiology and evolutionary profile. Results: Included were 18952 hospitalized children out of whose 253 had ARF 1.3%. There were 145 (57.3%) boys and 108 (42.7%) girls with an average age of 71.5 months. The mean time to consultation was 8.1 days. ARF was at failure stage in 147 cases (58.1%). It was functional in 210 cases (83.0%), out of which 95.1% resulted from severe dehydration. No extra-renal treatment was performed. Lethality was 34.4%. Hypovolemic shock (56.3%), severe sepsis (18.4%) and severe malaria (14.9%) were the main causes. Young age, provenance of the child, severe dehydration, deep coma, oligoanuria, stage of failure, hyperkalemia, absence of an extra-renal purification center were factors associated with mortality (p Conclusion: The high prevalence of ARF and its lethality requires public health actions including proper management of dehydration and malaria but also the creation of an extra-renal purification center.

关键词： Acute Renal Failure Child Brazzaville

Excessive Alcohol Intake and Cigarette Smoking among Black Schoolchildren in a Central African City (Brazzaville, Congo)

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Open Journal of Pediatrics 2017年第1期7卷 18-25页

作者： Annie Rachel Okoko Gaston Ekouya Bowassa Bertrand Fikahem Ellenga Mbolla Moyen Engoba Paul Ossou-Nguiet Suzy-Gisèle Kimbally-Kaky georges marius Moyen Department of Doctoral Studies Faculty of Health Sciences Marien Ngouabi University of Brazzaville Brazzaville Congo

Objective: To determine the prevalence of excessive alcohol intake (EAI) and cigarette smoking (CS) in schoolchildren of Brazzaville. Methods: This cross sectional survey included a representative population of schoolchildren in Brazzaville (603 schoolchildren divided 325 girls and 278 boys). Results: The prevalence of EAI was 9% (n = 54). The mean age of EAI children was 16.2 ± 1.3 years (range: 13 - 18 years) vs 11.4 ± 3.4 years (range: 5 - 18 years) for no EAI children (p Conclusion: Low social level, siblings, addictions in parents were correlate addictions in schoolchildren. It is necessary to prevent the acute and futures complications of this addiction in our children.

关键词： Smoking Alcohol Child School Sub-Saharan Africa

Severe Hypoglycemia in Hospitalized Children with Diabetic Ketoacidosis in Brazzaville

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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

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

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