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Reasons for Elective Surgery Cancellations in a Senegalese pediatric Surgery department

Open Journal of pediatrics 2024年第5期14卷 783-789页

作者： Cheikh Tidiane Mbaye Cheikh Diouf Florent Tshibwid A Zeng Faty Balla Lô Lissoune Cissé Doudou Gueye Ibrahima Bocar Wellé Souleymane Camara Papa Alassane Mbaye Oumar Ndour Gabriel Ngom department of pediatric Surgery Aristide Le Dantec University Teaching Hospital Universit Cheikh Anta Diop Dakar Senegal department of pediatric Surgery Ziguinchor Regional Hospital Center Universit Cheikh Anta Diop Ziguinchor Senegal department of pediatric Surgery El Hadj Ibrahima Niass Regional Hospital Center Kaolack Senegal department of pediatric Surgery Pikine National Hospital Center Dakar Senegal department of pediatric Surgery Albert Royer National Childrens Hospital Center Universit Cheikh Anta Diop Dakar Senegal Unit of pediatric Surgery Department of Pediatrics Dalal Jamm National Hospital Center Dakar Senegal

Introduction: Cancellation of elective surgery is common in developing countries. This decision is difficult to make as it generates economic and organizational consequences for the healthcare facility and an additional source of stress for patients and their caregivers. This study aimed to analyze the various aspects of this medical problem. Patients and Methods: We conducted a prospective and descriptive study over six months (from January 1st, 2017, to June 30th, 2017) at the pediatric surgery department of Aristide Le Dantec University Teaching Hospital in Senegal. Results: Ninety-one cases were collected. The cancellation rate was 20.8%. Infants were affected in 36.3% of cases. Among anesthesiologists, 83.5% were residents, and 16.5% were specialists. Cancellation in nephroblastoma children with an indication for extended nephrectomy represented 15.4% of cases. Concerning reasons for cancellation, comorbidities, dominated by respiratory infections, accounted for 28.5% of cases, patient absences for 24.2%, and issues related to the anesthesiologist for 17.6%. Cancellations were avoidable in 33% of cases. Patients were responsible for cancellation in 37.4% of cases, the healthcare system in 33%, and medical reasons in 29.7%. Conclusion: Our findings suggest that one-third of cancellations could have been avoided with improvements in the healthcare system. Actions should be taken to reduce the cancellation rate in our context.

关键词： Cancellation Elective Surgery pediatric Surgery LMICs Senegal

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Audits of Death in HIV-Infected Children and Adolescents Followed up in the pediatric department of the Regional Teaching Hospital of Borgou/Alibori from 2005 to 2020

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Open Journal of pediatrics 2024年第2期14卷 285-296页

作者： Alphonse Noudamadjo Mohamed Falilatou Agbeille Dénagan Kévin Amoussou Médétinmè Gérard Kpanidja Lahanatou Séidou Chantal Chabi Réckya Kilaya Julien Didier Adédémy Agossou Joseph Mother and Child department Faculty of Medicine University of Parakou Parakou Benin pediatric department Regional Teaching Hospital of Borgou/Alibori Parakou Benin

Introduction: Human immunodeficiency virus (HIV) is a major public health problem with high morbidity and mortality among children. The objective of this work was to audit the deaths of children and adolescents with HIV infection followed up in the pediatric department of the Regional Teaching Hospital of Borgou/Alibori (CHUDB/A) the from 2005 to 2020. Patients and Method: This was a retrospective and descriptive study conducted in the pediatric department of CHUD/B-A in Parakou. All children with HIV infection who died from January 1, 2005 to August 31, 2020 were included. Data collection was carried out in three stages: a phase of medical records processing, a phase of community survey and a phase of death audits. The variables studied were sociodemographic, clinical, biological, therapeutic and evolutionary. Results: Over the study period, the data of 464 infected children were recorded, including 92 deaths, representing a case fatality rate of 19.83%. Severe acute malnutrition (69.23%), gastro-intestinal tract infections (43.58%) and serious opportunistic pulmonary infections (24.36% pulmonary tuberculosis and 19.23% pneumocystis) were the main causes of death. The main dysfunctions found were: the delayed diagnosis of HIV infection (79.35%), the absence or delay in consultation when the child’s clinical condition deteriorates (32.61% and 47.83%), delayed initiation of antiretroviral treatment (42.39%) and non-adherence to treatment (38.04%). Non-adherence to treatment was predominant in adolescents (90.49%). Conclusion: Specific interventions for early detection, adequate nutritional care, psychosocial support for adolescents and mothers of children are necessary to reduce mortality due to HIV among children and adolescents.

关键词： HIV Death Children Adolescents Dysfunctions Benin

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Evaluation of Antibiotic Prescribing in the pediatric department of Gabriel TouréTeaching Hospital, Bamako, Mali

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Open Journal of pediatrics 2024年第3期14卷 645-656页

作者： Pierre Togo Hawa Konaré Mariam Maïga Karamoko Sacko Djénéba Konaté Abdoul Karim Doumbia Adama Dembélé Oumar Coulibaly Aminata Sangaré Mohamed Elmouloud Cissé Fousseyni Traoré Belco Maïga Ibrahim Ahamadou Aminata Doumbia Lala N’Drany Sidibé Amadou Touré Yacouba Aba Coulibaly Kalirou Traoré Tati Simaga Souleymane Sagara Leyla Bagna Maïga Bory Traoré Abdoul Aziz Diakité Fatoumata Dicko Mariam Sylla Sounkalo Dao Boubacar Togo Paediatric department Gabriel Tour&#233 Teaching Hospital Bamako Mali pediatric department Distric VI Reference Health Center Bamako Mali Infectious Diseases department Point G Teaching Hospital Bamako Mali

Objectives: The main objective was to evaluate antibiotic prescribing in the department of pediatrics at Gabriel Touré teaching hospital. Methods: This was a prospective descriptive study conducted from September 1 to November 31, 2018, in the department of pediatrics at Gabriel Touré teaching hospital. All children aged 0 to 15 years hospitalized for any pathology during the study period and having received at least one antibiotic had been included. Results: We collected 445 children’s records out of 1032 admissions during the study period, representing a hospital frequency of 43.1%. The sex ratio was 1.3%. The 2 - 5 age group accounted for 48.1%. Fever was the reason for consultation in 45.6% of cases. Patients’ general condition was altered in 60% of cases. The fathers were blue-collar workers in 65.4% and the mothers housewives in 85%, and had no education in 42.9% and 64.5% respectively. Hepatomegaly was present in 18.2%, splenomegaly in 9.6% and peripheral adenopathy in 3.1%. The site of infection was pulmonary in 37.6% and ENT in 9.2%. Bacterial infection was assumed on admission in 54% of cases, and meningitis in 57.7%. The discharge diagnosis was malaria in 54.6%, severe acute malnutrition in 18.6% and meningitis in 6.7%. The death rate was 3.8%. Neutrophilic leukocytosis was present in 47.3% of patients. CRP was positive in 85% of patients. Blood cultures taken in 27.6% of patients were positive in 5. CSF analysis in 30% of patients showed elevated leukocytes in 6.5%. No cultures were positive. Antibiotic prescription was justified by infectious hypotheses in 43.1% of patients. β-lactam antibiotics were prescribed in 98.6%. Antibiotic therapy was not adapted to national/international recommendations in 68.3% of cases, and was not justified in 16.3% of cases on D5 of hospitalization. Conclusion: Antibiotic use was justified in more than half of patients, but remained inadequate in almost two-thirds of cases, in line with national and international recommend

关键词： Antibiotic Prescription Hospitalization Child

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Urinary Tract Infection in pediatric Emergency department of Mohamed VI Hospital in Marrakech: Epidemiological Profile and Antibiotic Resistance

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Journal of Biosciences and Medicines 2024年第6期12卷 85-93页

作者： Radia Laanait Soufiane Elmoussaoui Widad Lahmini Mounir Bourrous pediatric Emergency department Mother and child hospital University Hospital Mohammed VI Marrakesh Morocco Laboratory Childhood Health and Development Faculty of Medicine and Pharmacy Cadi Ayyad University Marrakech Morocco Laboratory for Infectious Disease Control Faculty of Medicine and Pharmacy Cadi Ayad University Marrakech Morocco

Background: Urinary tract infection (UTI) is one of the most frequent bacterial infections in pediatrics. The aim of our work was to establish the epidemiological and bacteriological profile of UTIs in children and then to study the sensitivity of the bacterial strains isolated to antibiotics. Materials and methods: This is a retrospective descriptive study over 3 years (2019-2022), including all cytobacteriological examination of urine (CBEU), performed in children aged 3 months to 14 years, admitted and treated for UTI, in the pediatric emergency department of Mohamed VI University Hospital. Results: A total of 239 children were included in our study. The mean age was 26 months. The sex ratio was 1.08. Escherichia coli was the most isolated bacterial strain in 79% of samples. The tested strains showed a high level of sensitivity to susceptibility rate toward amikacin (91%) and ciprofloxacin (100%) and whereas the level of resistance was high to the most current recommended antibiotics, mainly beta-lactams. Management was based, in severe forms of pyelonephritis, dual antibiotic therapy based on Third-generation cephalosporins combined with gentamycin. Favorable outcome was noted in 94% of children. Conclusion: Awareness-raising on the proper use of antibiotics, issuing national recommendations for the treatment of urinary tract infections in order to standardize therapeutic regimens is strongly recommended. Effective control of these infections requires a global prevention strategy that implies close collaboration between epidemiologists, clinicians, bacteriologists, hygienists and the health care team.

关键词： Child Urinary Tract Infection Bacteria Antibiotics Resistances

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Cancellation Causes of Elective Surgical Procedures in a Major pediatric Surgery department

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Open Journal of pediatrics 2022年第1期12卷 131-136页

作者： Salsabil Mohamed Sabounji Mbaye Fall Cheikh Seye Mouhamadou Mansour Diene Gabriel Ngom pediatric Surgery department Albert Royer Children’s Hospital Dakar Senegal pediatric Surgery department Aristide Le Dantec Hospital Dakar Senegal pediatric Surgery department Heinrich Lubke Hospital Diourbel Senegal

Introduction: Cancellation of surgical operation is a surgical operation registered in the official schedule the day before or added to the list after and not carried out on the operating day. The purpose of this work was to determine the causes of cancellation of elective surgical operations in a major pediatric surgery department in Senegal. Patients and methods: It was a prospective and descriptive study of 278 patients scheduled during a period of 13 weeks. The study took place between April 3rd, 2017, and January 31st, 2018. Mean age was 2.9 years with extremes of 3 days and 15 years. The age group of 29 days to 30 months was the most represented (62.2%). Sex ratio was 1.41. Causes of cancellation were categorized into administrative and organizational causes, patient-related causes and staff-related causes. Results: Cancellation rate was 29.4%. Patient-related causes were most common (51.2%). Upper Respiratory tract infection (URTI) was commonest reason within this category (57.5%). Organizational causes (28.1%) came second and were mainly represented by the unavailability of the operating room (60.8%) related to breakdowns of anesthesia equipment. Finally, staff-related causes (20.7%) were due for most to the unavailability of the anesthesiologist (12 cases/17). Conclusion: Majority of causes that led to cancellation of elective surgical operations in our pediatric surgery department are related to intercurrent illnesses affecting the patient, in particular URTI.

关键词： Cancellation Elective Surgery URTI pediatric Surgery Surgical Procedures

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Pulmonary Complications in Children with Sickle Cell Disease Followed at the pediatric department of Gabriel Toure University Hospital

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Open Journal of pediatrics 2022年第1期12卷 89-99页

作者： Mohamed E. Cissé Abdoul A. Diakité Adama Dembélé Belco Maiga Pierre Togo Nicole A. Kpakoutou Oumar Coulibaly Karamoko Sacko Tiaria M. Sanogo Hawa Diall Fousseyni Traoré Abdoul K. Doumbia Djenèba Konaté Fatoumata L. Diakité Ibrahim Ahamadou Lalla N. Sidibé Amadou Touré Fatoumata Dicko-Traoré Boubacar Togo Mariam Sylla pediatric department of Gabriel Toure University Hospital Bamako Mali

Objective: To study the pulmonary complications of major sickle cell syndromes in children aged 6 months to 15 years followed at the department of pediatrics of Gabriel Toure University Hospital. Materials and methods: This was a retrospective study from January 1st, 2017 to February 28, 2018 and a prospective study from March 1, 2018 to December 31, 2019, concerning sickle cell disease children followed at the Gabriel Touré University Hospital. All children with sickle cell disease confirmed by hemoglobin electrophoresis, aged 6 months to 15 years with a pulmonary complication and admitted to pediatrics were included. Were not included: 1) Infants and children with sickle cell disease not presenting a pulmonary complication coming only to their routine follow-up. 2) Sickle cell patients over 16 years of age and those whose parents do not consent. 3) Those who have not done electrophoresis. Results: During the study period, we were able to include 45 sickle cell children with a pulmonary complication. The frequency of pulmonary complications was 13.76%, involving homozygotes in 91.11% of cases. The age group 6 - 10 years predominated with 46.66% and the sex ratio was 0.45. Vaso-occlusive crisis was the most frequent reason for consultation with 35.56%. Respiratory distress (80%), fever (66.67%), crepitus rales (64.44%) and chest pain (60%) were the most frequent clinical signs. The main pulmonary complication was acute chest syndrome with 86.67%. Treatment was based on hydration (91.91%), analgesics (91.91%) and antibiotics (73.33%). Lethality was 4.44%. Conclusion: Pulmonary complications of sickle cell disease are serious and constitute the main cause of mortality in our context.

关键词： Sickle Cell Disease Children Lungs Complications

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The Scrotoschisis about a Case in the pediatric Surgery department of the Donka National Hospital

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Open Journal of pediatrics 2021年第2期11卷 238-242页

作者： Balla Keita Mamadou Alpha Touré Mamadou Madiou Barry Mohamed Lamine Sacko et Lamine Camara pediatric Surgery department of the Donka CHU National Hospital Conakry Guinea

Introduction: Scrotoschisis is a very rare congenital defect of the scrotum characterized by the exteriorization of one or two testes. We report a case of right scrotoschisis in a newborn as well as a review of the literature for an approach of probable etiology. Patient and Observation: A newborn baby of 8 hours of life, weighing 3200 g was referred to our department for a right scrotal defect with exteriorization of the testis associated with fluid swelling of the left bursa. The 18-year-old mother, primiparous and primigeste followed all the prenatal consultations with eutocic delivery. After clinical investigation the diagnosis of right scrotosisis and left hydrocele was retained. Surgical treatment was carried out by primary closure after orchidopexy and exploration of the contralateral bursa, the content of which was calcified meconium bathed in a yellowish liquid. The post-operative consequences were simple. Conclusion: Scrotoschisis is an extremely rare birth defect whose etiology is poorly understood. However, it could be the cause of meconium peritonitis secondary to a scarred fatal intestinal perforation.

关键词： Scrotoschisis Congenital Anomaly Etiology

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Epidemiological and Clinical Study of Cardiac Diseases in the pediatric department of the University Hospital Gabriel Touré(UH GT), Bamako (Mali)

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World Journal of Cardiovascular Diseases 2018年第7期8卷 328-336页

作者： Maiga Belco Ba Hamidou Oumar Sacko Karamoko Dembélé Adama Sanogo Nouhoum Cissé Mohamed Elmouloud Togo Pierre Diakité Abdoul Aziz Dicko-Traoré Fatoumata Sylla Mariam pediatric department UH GT Bamako Mali Cardiology UH GT Bamako Mali

Introduction: Children’s heart disease is a major public health problem in developing countries and especially in Mali. The purpose of our work was to determine frequency, different types of heart disease and their short term evolution in the pediatric department. Methods: We performed a retrospective study among children aged 0 to 15 years, hospitalized in the pediatric department from January to December 2015 and whose diagnosis was confirmed using trans-thoracic echocardiography. Results: We included 103 cases of heart disease out of a total of 8613 admissions in the pediatric department, giving an hospital prevalence of 1.2%. Mean age was 4.1 years (from 1 day to 15 years) and children under 5 years were the most affected with 73.80% of cases. Male predominance was noted (sex ratio = 1.2). Respiratory distress was the most common circumstance of discovery (93.20%). Cardiac murmur and tachycardia were the most common cardiac signs with respectively 88.35% and 83.50%. Congenital heart disease accounted for 70.87% and was dominated by ventricular septal defect (VSD) with 30.13%. Acquired heart disease (29.13% of the sample) was dominated by mitral regurgitation (MR) with 56.67%. Mortality rate was 31.9% for congenital heart disease and 11.1% for acquired heart disease. Conclusion: children’s heart disease is responsible for high mortality. Early detection improves the management of this pathology, which remains frequent.

关键词： Cardiac Disease Congenital Acquired pediatric Bamako

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Psychological Experience of Mothers of Children with Sickle Cell Disease Followed at the pediatric department of Bouaké University Teaching Hospital

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Open Journal of pediatrics 2024年第1期14卷 149-163页

作者： Akanji Iburaima Alamun Aka-Tanoh Koko Aude Hélène Yao Kouassi Christian Adou Leioh Romeo Sahi Gnantin Josette Landryse Amani Ehi Alexise Eleonore Boune Aboulaye Asse Kouadio Vincent Paediatrics department Bouaké University Teaching Hospital Bouaké C&#244te d’Ivoire

Introduction: Sickle cell disease has physical and emotional repercussions on the child and his family. The aim of this study was to describe the psychosocial experiences of mothers of children with sickle cell disease in order to improve the overall care of the child. Methods: This was a descriptive cross-sectional study carried out in the pediatrics department of Bouaké University Teaching Hospital from June to September 2023. It focused on mothers of major sickle-cell-affected children followed up in the pediatrics department of the Bouaké University Teaching Hospital. The variables studied were sociodemographic, psychological, social and economic. Results: Of the 40 mothers surveyed, 15% were not in school and 32.5% were unemployed. For them, sickle cell disease was of natural (genetic) origin in 90% and supernatural in 10%. They stated that the child had an average age of 36 months (extremes 7 and 108 months) when the disease was discovered. And 52% of them were satisfied with the way the disease was clearly and completely announced. Following the announcement, the questioned mothers said they had felt shock (35%), sadness (31.7%), guilt (23.3%) and discouragement (10%). Anxiety and depression were experienced by 77.5% and 22.5% respectively. In 60% of cases, they stated that the disease was incurable, and the outcome was fatal in 2.5% of cases. The child’s illness was a source of problems in the home in 25% of cases, represented by arguments in 92% and divorce in 8%. In 97.5% of cases, the mother told her family and friends about the child’s illness. In 90% of cases, the mother and child benefited from psychological support from family and friends. Conclusion: Sickle cell disease is a serious illness with a psychological and social impact on mothers. We recommend psychological support for mothers from the moment of diagnosis and throughout follow-up.

关键词： Psychosocial Experience Sickle Cell Disease Côte d’Ivoire

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Profile of Newborns Hospitalized for Maternal Fetal Infection and Having a Positive CRP in the pediatric department of the Gabriel TouréCHU in Bamako, Mali

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Open Journal of pediatrics 2021年第4期11卷 684-693页

作者： Oumar Coulibaly Hawa Gouro Diall Guédiouma Dembélé Mamary Coulibaly Fatoumata Léonie Françoise Diakité Lala Ndrayni Sidibé Leyla Maiga Ibrahima Ahamadou Abdoul Karim Doumbia Belco Maiga Adama Dembelé Pierre Togo Karamoko Sacko Mohamed Elmouloud Cissé Djeneba Konaté Fousseyni Traoré Aminata Doumbia Yacouba Aba Coulibaly Amadou Touré Bourama Kané Issa Amadou Touré Abdoul Aziz Diakité Traoré Fatoumata Dicko Traoré Mariam Sylla Boubacar Togo department of pediatrics CHU Gabriel Touré Bamako Mali department of pediatrics Mali Hospital Bamako Mali department of pediatric Surgery CHU Gabriel Touré Bamako Mali

Objective: Early bacterial neonatal infection (INBP) or maternofetal infection (early neonatal sepsis) remains a concern of the pediatrician due to diagnostic difficulties and its increased morbidity and mortality. No study has been done in Mali on the profile of newborns admitted for INBP with positive CRP, hence the initiation of this work with the aim of studying the epidemiological, biological and bacteriological profile of newborns with a bacterial maternal-fetal infection. Method: Longitudinal study descriptive (from 27 June to 3 September 2016) which concerned all newborns aged from 0 to 72 hours of life hospitalized for confirmed early bacterial neonatal infection with a positive C-reactive protein (CRP) in the neonatal department of the CHU Gabriel Touré. INBP was defined by the presence of maternal and neonatal infectious risk factors, positivity of CRP with a germ in the blood culture. Results: During the study period we included 244 newborns for probable maternofetal infection and who benefited from the CRP assay, 43 had a positive CRP, i.e. a frequency of 17.62%. The sex ratio was 2.30. The majority had a low birth weight ( g) in 69.8% of cases. Mothers were aged 18 to 35 in 93%. The majority were out of school

关键词： Early Bacterial Neonatal Infection Clinical Profile Neonatal Mortality

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