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Epidemiological, Diagnostic, Therapeutic and Progressive Aspects of Arterial Hypertension in Children at the University Hospital Center of Bouaké (Côte d’Ivoire)

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Open Journal of Pediatrics 2024年第2期14卷 379-390页

作者： richard azagoh-kouadio Yao Kossonou Roland Yeboua Kouassi Christian Yao John Patrick Yenan Iburaima Alamun Akanji kouadio Vincent Assé Pediatric Department of Angré University Hospital Abidjan Ivory Coast Pediatric Department of Bouaké University Hospital Bouaké Ivory Coast

Introduction: Arterial hypertension (AH) in children is under-diagnosed and often has a poor prognosis. The aim of this study was to describe the epidemiological, diagnostic, therapeutic and evolutionary aspects of hypertension in children at the University Hospital of Bouaké, with a view to improving the prognosis. Methods: This was a cross-sectional, analytical study carried out in the paediatrics department of Bouaké University Hospital. It concerned the medical records of children aged 4 to 15 hospitalised from 1 January 2017 to 31 December 2020 for hypertension. Diagnosis was based on the simplified blood pressure guidelines of the Expert Consensus of the French Society of Hypertension. The variables studied were epidemiological, diagnostic, therapeutic and evolutionary. Quantitative variables were compared at the significance level p ≤ 0.05. Results: The hospital incidence of hypertension was 0.32% (69/21,642). The sex ratio was 0.72. 97.1% of the children were over five years of age. Oedema (49.3%) and breathing difficulties (20.2%) were the main reasons for consultation. Hypertension was classified as threatening (56.5%), confirmed (31.9%) and borderline (11.6%). The cause was renal in 66.7%, dominated by impure nephrotic syndrome (24.6%). Treatment for hypertension consisted mainly of a diuretic (79.7%) and a calcium channel blocker (47.8%). Outcome was favourable in 50.7% of cases. Mortality was 20.3%. No factor was significantly associated with death. Conclusion: Hypertension in children at Bouaké University Hospital is serious. The aetiology is mainly renal. Early diagnosis and management are key to improving prognosis.

关键词： Hypertension Children Renal Pathologies Prognosis Côte d’Ivoire

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Epidemiological, Diagnostic, Therapeutic, and Prognostic Profile of Non-Tuberculous Community-Acquired Purulent Pleurisy in Children at the Bouaké University Hospital Center, 2017-2021

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Advances in Infectious Diseases 2024年第1期14卷 220-232页

作者： Yapo Thomas Aba Christian Yao Pacôme Monemo richard azagoh-kouadio Iburaima Akandji Noelle Gonné Jean-Marie Karidioula Vincent Achi Vincent kouadio Asse Department of Infectious and Tropical Diseases University Hospital of Bouaké Bouaké Ivory Coast University Alassane Ouattara of Bouake Bouake Ivory Coast Department of Pediatrics University Hospital of Bouaké Bouaké Ivory Coast Department of Bacteriology & Virology University Hospital of Bouake Bouaké Ivory Coast Department of Pediatrics University Hospital of Angré Abidjan Ivory Coast Department of Pneumology University Hospital of Bouake Bouaké Ivory Coast

Introduction: In Côte d’Ivoire, there is a scarcity of data on children’s purulent pleurisies. Objective: This study aims to elucidate the epidemiological, diagnostic, therapeutic, and evolutionary facets of non-tuberculous purulent pleurisies in pediatric patients. Methods: A retrospective analysis was conducted using the medical records of children aged one month to fifteen years with purulent pleurisies at Bouaké University Hospital Center from January 2017 to December 2021. Results: The study identified 124 cases of purulent pleurisies, constituting 18% of lower respiratory tract infections and 0.8% of all hospitalizations. The majority of these cases (69%) were in children between 1 and 24 months of age. Prominent symptoms included dyspnea (85.5%), O2 saturation below 95% in room air (76.6%), respiratory distress (68.5%), cutaneous-mucosal pallor (63.7%), and fever (43.5%). Radiological findings predominantly showed right-sided pleurisy (62.1%). The pleurisy was often extensive (78.2%), accompanied by pneumothorax (37.1%), alveolo-interstitial opacities (8.1% of cases), and abscess formations (1.6%). Pleural fluid cultures were positive in 46.9% of cases, with Staphylococcus aureus (75%, methi-S) identified among 32 bacteria. Initial antibiotic treatment was empirical, favoring oxacillin (53.2%) or amoxicillin-clavulanic acid (53.2%) in dual (42%) or triple therapy (33%) with gentamicin (64.1%) and/or metronidazole (21.8%). Treatments also included pleural drainage (68.5%) or repeated evacuation punctures (33.1%), and blood transfusion (39%). The mortality rate was 18.8%. Conclusion: Non-tuberculous purulent pleurisy remains a significant concern in pediatric hospitalizations at the CHU of Bouaké, marked by high mortality rates.

关键词： Community-Acquired Purulent Pleurisies Children Mortality Bouaké

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Epidemiological, Clinical Progress Aspects of Congenital Heart Disease with Neonatal Revelation at the Mother-Child Hospital of Bingerville (HME) Concerning 98 Cases from January 2021 to December 2022 (Côte d’Ivoire)

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Open Journal of Pediatrics 2024年第1期14卷 89-100页

作者： Adja Evelyne Akaffou-Gbery richard azagoh-kouadio Anne-Lise Laetitia Mobio Jean-Jacques Yao Atteby Serenah Marie Janice N’vrah Anoh Kouassi Raoul Yao Department of Paediatrics and Neonatology H&#244pital Mère-Enfant de Bingerville (HME) Bingerville C&#244te d’Ivoire Department of Medical Pediatrics and Specialties CHU de Angré Abidjan C&#244te d’Ivoire

Introduction The distribution of congenital heart disease (CHD) in sub-Saharan Africa is highly imprecise and varies from one region to another due to the inequality of diagnostic facilities. The aim of this study was to determine the in-hospital prevalence of congenital heart disease in children at the Mother-Child hospital of Bingerville (HME) by specifying the diagnostic, therapeutic and evolutionary aspects. Materials and methods We conducted a retrospective, descriptive, cross-sectional study at HME of Bingerville from January 2021 to December 2022. All newborns with congenital heart disease confirmed by echocardiography were included in the study. Results Of 656 admissions to the neonatology department over the study period, congenital heart disease accounted for 14.9% (98/656) of cases. In our series, 76.7% were diagnosed before the 1st week of life, with a mean chronological age of 5.18 days and extremes of 0 and 46 days. There were as many male patients (50%) as female (50%), i.e. a sex ratio of 1. These newborns were premature in 60.2% of cases, with a mean and median gestational age of 34 weeks’ amenorrhea. Most were left-right shunts (90.8%). Persistent ductus arteriosus (PDA) (48.9%) predominated, followed by atrial septal defect (38.7%), ventricular septal defect (13.3%), common trunk artery (CTA) (3.1%) and open septal pulmonary atresia (OSPA) (1%) as the primary cyanogenic heart disease. Pulmonary arterial hypertension (PAH) (50%) was primary in 38.8% and secondary (61.2%). The mortality rate was 30.6%, and all CTA patients died (100%), with a significant statistical relationship (p = 0.027). Progression under treatment was marked by clinical stabilization (68/98) in 69.4% of cases. Conclusion: Congenital heart disease is relatively common at the Bingerville HME. Access to echocardiography should be facilitated in neonatology departments for rapid diagnosis and optimal management of congenital heart disease in newborns.

关键词： Newborn Congenital Heart Disease Côte d’Ivoire

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Growth Profile of 100 Breastfeeding Children with Early Introduction of Infant Formulas in Abidjan, Côte d’Ivoire

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Open Journal of Pediatrics 2017年第4期7卷 236-244页

作者： richard azagoh-kouadio kouadio Vincent Asse Jean-Jacques Yao Atteby Lassina Cisse Jacob Slanziahuelie Enoh Ehouman Mocket Adolphe Stéphane Koffi-Djadan Soumahoro Oulai Paediatric Ward of University and Teaching Hospital of Treichville Abidjan Cote d’Ivoire Paediatric Ward of University and Teaching Hospital of Bouake Bouaké Cote d’Ivoire University of Stellenbosch Cape Town South Africa

Objective: To describe the growth profile of breastfeeding babies following early introduction of infant formulas to improve the feeding pattern of the young infant. Methodology: This is a longitudinal descriptive study conducted in 2 medical clinics in Abidjan from 11-Jun-2013 to 15-Dec-2016 on 100 healthy newborn babies with the introduction of infant formulas before 6 months of life. The anthropometrics parameters were compared to those of WHO. Results: The exclusive breastfeeding rate was 5%. Ablactation occurred within 12 months in 95% of cases. All Infants have doubled and tripled their birth weight at 3 and 9 months respectively. The height and the head circumference at birth increased by 50% and 37% respectively at 12 months. Compared to WHO growth charts, the weight gain for the girls at 3 months was 12.4% higher and for the boys was 7.3% higher at 6 months. On the other hands, the statural gain at 12 months was 50% lower than the WHO standards while the head circumference was 37.8% and 45.5% higher than the WHO standards in boys and girls respectively. At 3 months, the prevalence of stunting was 26.1% for boys and 13.3% for girls. Lastly, at 12 months, the BMI showed 10% overweight and 19% obesity. Conclusion: Breastfeeding associated with an early introduction of infant formulas increases the risk of malnutrition of the young infant. We advise to avoid it and recommend an exclusive breastfeeding.

关键词： Infant Exclusive Breastfeeding Infant Formulas Growth WHO Standards Cote d’Ivoire

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Medication Error (ME) in the Pediatrics Service of the University Teaching Hospital (CHU) of Bouaké(Côte d’Ivoire)

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Open Journal of Pediatrics 2018年第2期8卷 141-153页

作者： kouadio Vincent Asse Kossonou Roland Yeboua richard azagoh-kouadio Kouassi Christian Yao Koko Aude Aka-Tanoh Christelle Avi Mocket Adolphe Ehouman Kouie Jeannot Plo Paediatric Ward of University and Teaching Hospital of Bouake Bouaké Cote d’Ivoire Paediatric Ward of University and Teaching Hospital of Treichville Abidjan Cote d’Ivoire Olopam Pharma and Research & Development Abidjan Cote d’Ivoire

Introduction: Medication error (ME) is a common cause of childhood morbidity and mortality reported in developed countries. It has not yet been described in the pediatric services in Cote d’Ivoire. Objective: To evaluate ME in pediatrics for the improvement of professional practice. Materials and Methods: This was a cross-sectional, descriptive and analytical study conducted in the service of pediatrics at the University Teaching Hospital (CHU) of Bouaké from January 11 to February 25, 2016. It involved 204 children hospitalized and treated with drugs. The variables studied were the prescription, dispensing and administration of the drugs. Results: A total of 483 prescriptions notes were recorded for 733 therapeutic lines, i.e. 2.3 prescriptions notes and 3.6 lines per child. The overall prevalence of ME was 31% (prescription 83%, dispensing 0%, administration 11%). The prescription error concerned the illegible writing (20%), the omission of the stamp & signature (47%), the omission of the date (33%), weight (66%), age (25%) and name of the child (9%).The drug name and the dosage were incorrect in 99% and 1% respectively. Regarding the administration error, care was provided by a person without a nursing qualification in 65.5% of cases. On the patient’s care record, the care giver’s name was omitted in 100%, the child’s name in 57% and the date in 47%. The route of administration and the administered dose were each incorrect in 5%. The student nurses and assistant nurse caregivers committed more prescription errors than doctors and nurses and midwives (p= 0,000 X2 = 44.91). Administration error was not significantly related to the service, the socio-professional category, the gender and the age of the patient. Conclusion: EM is common in pediatrics at the University Teaching Hospital (CHU) of Bouaké. To prevent it, it is necessary to strengthen the staff’s capacity to prescribe and administer the drug in children.

关键词： Pediatrics Medication Error Hospitalization Ivory Coast

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Childhood Heart Disease in Côte d’Ivoire: Retrospective Multicentric Study about 228 Cases

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Open Journal of Pediatrics 2018年第4期8卷 375-388页

作者： richard azagoh-kouadio Kouakou Florent Diby kouadio Vincent Asse Loa Gnaba Koko Aude Aka-Tanoh Kossonou Roland Yeboua Kouassi Christian Yao Christelle Avi Soumahoro Oulai Paediatric Ward of University Teaching Hospital of Treichville Abidjan Cote d’Ivoire Department of Cardiovascular and Thoracic Diseases CHU de Bouaké Bouaké Cote d’Ivoire Paediatric Ward of University Teaching Hospital of Bouake Bouaké Cote d’Ivoire

Introduction: In Cote d’Ivoire, the paediatrician has to face a diagnosis and management problem in front of pediatric heart disease, with consequent a high lethality. Objective: To describe the epidemiological, diagnostic, therapeutic and progressive aspects of childhood cardiopathy for the improvement of prognosis and professional practice. Materials and methods: This was a multicenter retrospective and descriptive study conducted from January 2011 to March 2016 in two main hospitals universities, one located in Abidjan and the other in Bouaké. It concerned children aged 0 to 15 admitted for cardiac disease diagnosed on clinical and/or echocardiographic arguments. The variables studied were the epidemiological, diagnostic, therapeutic and evolutionary aspects. Results: A total of 49.760 admissions including 228 infantile heart disease cases (congenital 113, acquired 51, indeterminate 64) are overall prevalence of 4.6‰. They involved 106 boys and 122 girls. In 74.6% of cases, the age was between 0 and 2 years. Respiratory distress 73.7% was the main reason for consultation. The main congenital heart diseases (CHD) are ventricular septal defect (VSD) (31%), atrial septal defect (ASD) (20.4%), atrioventricular canal (AVSD) (12.4%) and tetralogy of Fallot (TOF) (11.5%). As for acquired forms (AHD), rheumatic mitral insufficiency (41.2%) and tuberculous pericarditis (15.7%) were the two main causes. Treatment progress is marked by stabilization (71.1%) and death (14%). Death was significantly associated with low socioeconomic status (p = 0.01) and with complication (p 0.001). Conclusion: Infantile heart diseases are relatively less frequent and serious in Cote d’Ivoire. To improve the prognosis, close collaboration between the pediatrician and the cardiologist is required for early diagnosis and management.

关键词： Child Congenital Heart Disease Acquired Heart Disease Ivory Coast

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Ascites of Great Abundance Revealing a Nephrotic Congenital Syndrome at the University Teaching Hospital of Bouaké: About a Case

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Open Journal of Pediatrics 2018年第1期8卷 19-24页

作者： kouadio Vincent Asse Kouassi Christian Yao richard azagoh-kouadio Serge Gohi Bi Irie Kossonou Roland Yeboua John Patrick Yenan Koko Aude Aka-Tanoh Christelle Avi Paediatric Ward of University and Teaching Hospital of Bouake Bouaké Cote d’Ivoire Paediatric Ward of University and Teaching Hospital of Treichville Abidjan Cote d’Ivoire Polyvalent Reanimation Ward of University and Teaching Hospital of Bouaké Bouaké Cote d’Ivoire

Congenital nephrotic syndrome (CNS) is defined as the presence of proteinuria > 50 mg/kg/24h associated with a protein concentration g/L or albuminemia 30 g/L in an infant less than 3 months old. The CNS is rare, of various clinical forms dominated by the Finnish type caused by a mutation of the NPHS1 gene located on chromosome 19. The edematous syndrome is the most common mode of discovery. We report a case discovered in an infant of 50 days admitted for ascites of great abundance. The aim of this study was to describe the main epidemiological, diagnostic, therapeutic and evolutionary aspects of this syndrome. Improving the prognosis of this condition requires advocacy with the political authorities of Cote d’Ivoire to provide Teaching Hospital for the resources needed to perform kidney transplantation.

关键词： Ascites Congenital Nephrotic Syndrome Finnish Type Renal Transplantation Cote d’Ivoire

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Etiological and Evolutionary Profile of the Child’s Pericarditis in Tropical Environments

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Open Journal of Pediatrics 2017年第3期7卷 164-177页

作者： richard azagoh-kouadio Jacob Slanziahuelie Enoh Jean-Jacques Yao Atteby Line Guei Couitchere Lassina Cisse Yves N’da Kouakou N’goran kouadio Euloge Kramoh Oulai Soumahoro Paediatric Ward of University and Teaching Hospital of Treichville AbidjanCote d’Ivoire Institute of Cardiology of Abidjan(ICA) AbidjanCote d’Ivoire

Background: Liquid pericarditis is a frequent cause of hospitalization in developing countries. Objective: of this study was to describe the etiological and evolutionary aspects of fluid pericarditis in pediatric cardiology at ICA. Methods: This was a retrospective study of 42 cases of fluid pericarditis diagnosed among 202 children hospitalized over a five-year period (1st January 2009 to 31st December 2014). All patients with pericardial effusion were included in the study. Results: Prevalence was estimated at 20.8% of hospitalizations, sex ratio was 1.1 with a female predominance (52%) and the mean age at 9.2 years (11 days to 15 years). The etiologic varieties identified were: tuberculosis 22 cases, 52%, rheumatic pericarditis 6 cases or 14.3%, chronic parietal endocarditis 5 cases (11.9%), bacterial pericarditis with trivial germ 3 cases (7.1% 3 cases (7.1%), post-surgery syndrome 2 cases (4.8%), umbilical post-catheterization 1 case (2.4%). HIV serology was positive in 11.9% of cases. The progression was favorable in 55% of the cases with 10% of deaths. Conclusion: Fluid pericarditis in children is a severe condition that is clearly on the rise today, especially in immunocompromised patients. Optimal management of fluid pericarditis in children is the best guarantee to avoid short-term tamponade and in the medium term constriction.

关键词： Pericarditis Etiology Evolution Children Tropical Diseases

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Violence on Health Professionals: Experience of the Obstetrics &Gynecology and Pediatrics Departments at the University Teaching Hospital of Bouake;, Cote d’Ivoire

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Open Journal of Pediatrics 2018年第1期8卷 8-18页

作者： kouadio Vincent Asse richard azagoh-kouadio Kouassi Christian Yao Koko Aude Aka-Tanoh Christelle Avi Kossonou Roland Yeboua John Patrick Yenan Mocket Adolphe Ehouman Yacouba Doumbia Kouie Jeannot Plo Paediatric Ward of University and Teaching Hospital of Bouake BouakeCote d’Ivoire Paediatric Ward of University and Teaching Hospital of Treichville AbidjanCote d’Ivoire Olopam Pharma and Research&Development AbidjanCote d’Ivoire Obstetrics and Gynecoology Ward of University and Teaching Hospital of Bouake BouakeCote d’Ivoire

Introduction: Violence in hospital is a major Public Health issue. In Cote d’Ivoire, acts of violence against health professionals exist and may sometimes take a dramatic turn. Objective: To research the causes of this violence for the purpose to prevent them. Materials and Methods: This is a cross-sectional, descriptive study conducted in the Obstetrics & Gynecology and Pediatrics departments at the University Teaching Hospital of Bouaké from 26 January 2016 to 24 February 2016. It included 129 health workers who gave their consent. The data collection was done through individual interviews followed by a focus group according to the socio-professional category. Results: Out of 129 health professionals included, 100 were a victim of violence i.e. a frequency of 77.5%. Most of the violence occurred during “on-call hours” (55.8%) in the emergency units (34.8%). The violence was verbal (52.5%), physical (28.6%), moral and psychological (11.6%), theft (7.3%). The aggression was mainly related to patient’s care (32.1%), visiting hours (26%) and the low level of understanding of the person (16.5%). The victim’s immediate feelings were dominated by frustration (26.7%), discouragement (21.3%) and insecurity (18.3%). The victims received a medical assistance in 9% of cases. To prevent this violence, the staff mainly offered to raise awareness about violence (27.6%) and the respect for hospital staff (25%). Conclusion: Violence against health professionals is common and has negative impacts on staff and hospital activity. Its prevention requires a holistic approach centered on awareness. Keywords: Violence, Hospital, Pediatrics, Staff, Cote d’Ivoire.

关键词： Violence Hospital Pediatrics Staff Cote d’Ivoire

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Knowledge and Practices of Neonatal Resuscitation by Health Providers in Côte d’Ivoire

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Open Journal of Pediatrics 2017年第3期7卷 149-155页

作者： Cisse Lassina Joseph Gnegneri Ouattara kouadio Vincent Asse Line Couitchere Jacob Enoh kouadio richard azagoh Jean-Jacques Attebi Soumahoho Oulai Paediatric Ward of University and Teaching Hospital of Treichville Abidjan C&ocirc te d’Ivoire Paediatric Ward of University and Teaching Hospital of Bouake Bouake C&ocirc te d’Ivoire

Cote d’Ivoire ranks third among African countries with the highest neonatal mortality rate (38‰). Perinatal asphyxia is one of the major causes of neonatal mortality. In its severe form, it imposes an efficient neonatal resuscitation in the birth room. This can only be done when the proven competence of the staff in charge of the newborn and the availability of the appropriate equipment are met. What is the situation in the birth facilities of these two challenges for the response to the high rate of neonatal mortality in Cote d’Ivoire? Method: It is a cross-sectional study, which took place from March 28 to July 28, 2016, in three health districts of Cote d’Ivoire (Bouaké, Gagnoa, Yopougon). Public health structures offering delivery activities were selected. Based on a fact sheet, the practitioners present have been interviewed and a direct observation of the organization and equipment set up to perform neonatal resuscitation in the birth room has been done. In addition, an observation grid made it possible to evaluate the practical skills of providers in neonatal resuscitation on a newborn mannequin. The data were entered using the Epi-Info 7 software. Based on the data collected, we determined the numbers and frequencies of the responses of the target agents of the survey. Results: The membership structures included 46 first contact health facilities (FCHFs) and 4 reference hospitals (HRs). The heating system, mucus suction, oxygen, timers and self-inflating balloons were available in HR and in six, eight, four, 34 and 10 FCHFs respectively. The 253 midwives surveyed came from Bouaké (86), Gagnoa (62) and Yopougon (105). They had a seniority of at least eight years. Their knowledge for newborns’ care was acquired in initial training (75% of cases). They knew the golden minute in 95.6% of the cases. Inadequacies in the recognition of risk situations, useful equipment and in the execution of neonatal resuscitation steps were noted. Conclusion: The survival of the

关键词： Knowledge Midwives Neonatal Resuscitation Practice

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