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epidemiological, clinical and Etiological Aspects of Non-Traumatic Comas in Children at the Pediatric Teaching Hospital in Bangui

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Open Journal of Pediatrics 2022年第3期12卷 489-506页

作者： Olivier Brice Bogning Mejiozem Moyen Engoba Evodie Pierrette Bogning Kakounguere Jean Chrysostome Gody Centre Hospitalier Universitaire Pédiatrique de Bangui Bangui Central African Republic Université Marien Ngouabi Brazzaville Republic of the Congo Faculté des Sciences de la Santé de l’Université de Bangui Bangui Central African Republic

Background: Non-traumatic coma is the most common pediatric medical emergency. Its clinical diagnosis is easy. The difficulty lies in finding the etiology. Objective: To determine the prevalence and clinical profiles of non-traumatic Coma at the Centre Hospitalier Universitaire Pédiatrique de Bangui (CHUPB). Methodology: This was a descriptive and analytical cross-sectional study conducted between January 1 and June 31, 2021, at CHUPB. Children aged 1 month to 15 years, admitted to the emergency room with a Glasgow score less than or equal to 8 without any traumatism were included. The variables studied were sociodemographic, clinical and paraclinical. Data were entered and analyzed using SPSS 20.0 statistical software. The statistical test used was Pearson’s chi2, any p-value Results: Of 8551 children hospitalized during the study period, 370 were hospitalized for non-traumatic coma: 4.32%. They were divided into 57.5% (n = 213) boys and 42.44% (n = 157) girls, giving a sex ratio of 1.35. Their mean age was 35.95 ± 27.21 months. Children aged 1 to 24 months represented 54.59% (n = 202) of cases. The mean time to the consultation was 2.91 days ± 1.8. Fever 86.48% (n = 320) and convulsions 80% (n = 296) were the main reasons for consultation. Coma stages II - III and IV represented 52.44% (n = 194), 42.97% (n = 159) and 4.59% (n = 17) respectively. Neuromalaria (29.72%;n = 110), meningitis-meningoencephalitis-encephalitis (30%;n = 111), sepsis (19.72%;n = 73) and acidosis Coma (5.40%;n = 20) were the main etiologies. Conclusion: Non-traumatic coma is common at CHUPB. Infections were the main etiology, particularly cerebral malaria. The reduction of its frequency requires, among others, the strengthening of the national monitoring malaria program. The strengthening of the technical platform for a good etiological diagnosis constitutes the other axis of prevention.

关键词： Non-Traumatic Coma Child epidemiological-clinical Etiological CHUPB

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Biermer’s Disease at the Donka National Hospital in Guinea—Epidemio-clinical, Therapeutic and Evolutionary Aspect in the Internal Medicine Department

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Open Journal of Internal Medicine 2023年第3期13卷 218-224页

作者： Thierno Amadou Wann Mamadou Sarifou Diallo Djenabou Diallo Kadiatou Diallo Mamadou Lamine Yaya Bah Mamadou Diakhaby Mohamed Cissoko Amadou Kaké Djibril Sylla Department of Internal Medicine Teaching Hospital of Conakry Conakry Guinea Department of Hepato-Gastroenterology University Hospital of Conakry Conakry Guinea

Introduction: Biermer’s disease is an autoimmune disease characterized by a lack of absorption of vitamin B12 in connection with the production of antibodies (A) destroying the intrinsic factor (IF) which allows the absorption of vitamin B12 (cobalamin). These clinical manifestations are polymorphic and severe in our context. The objective of this work is to identify the epidemiological-clinical, therapeutic and evolutionary characteristics of Biermer’s disease in Guinean population. Materials and methods: This was a retrospective of patient files followed for Biermer’s disease at the internal medicine department of Donka National Hospital from January 2012 to December 2021. Results: Eight patients were included including 5 women and 3 men. The average age of the patients was 48 years old. The diagnostic delay was 3.6 years on average. All our patients had bioclinical anemia (8 cases, i.e. 100%) followed by epigastralgia in 4 cases (50%), neurological damage such as sensitive polyneuropathy in 3 cases (37.5%). Four patients had acquired melanoderma (50%). Hypovitaminosis B12 was found in 4 patients. The myelogram performed in three patients (37.5%) found medullary megaloblastosis. One patient had Hashimoto’s disease associated with Biermer’s disease in endoscopy, (FOGD) found fundica trophy on macroscopy in 4 cases (50%). Treatment consisted of B12 vitamin therapy in all cases with a favorable clinical and biological outcome. Conclusion: Biermer’s disease remains common in Africa and is characterized at a younger age in addition to the severity of clinical and biological manifestations. The care consists of taking vitamin B12 which remains accessible in our context.

关键词： Biermer’s Disease Donka Aspects epidemiological-clinical Therapeutics

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