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Tuberculosis in Children: Epidemio-Clinical Aspects in the Paediatric department of the gabriel touréuniversity hospital Center

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Open Journal of pediatrics 2022年第2期12卷 376-388页

作者： Adama Dembélé Abdoul Aziz Diakité Mohamed Elmouloud Cissé Bassirou Diarra Belco Maïga Issa Sanou Pierre Togo Abdoul Karim Doumbia Oumar Coulibaly Karamoko Sacko Djéneba Konaté Hawa Diall Lala Ndrainy Sidibé Bréhima Dégoga Fatoumata Léonie Diakité Guédiouma Dembélé Fatoumata Dicko Mariam Sylla Boubacar Togo department of Paediatrics University Teaching Hospital of Gabriel Touré Bamako Mali university Clinical Research Center University of Sciences Techniques and Technologies of Bamako Bamako Mali department of pediatrics CHU Gabriel Touré Bamako Mali

Introduction: Globally, tuberculosis is the leading cause of death from a single infectious agent ahead of HIV/AIDS. Approximately 10 million people contracted TB in 2017, 10% of whom were children aged 0 - 15 years, or about 1 million with 250,000 deaths in 2016 (including children with HIV-associated TB). The signs of TB in children are not always specific and diagnosis remains difficult unlike in adults. According to a study conducted in 2011 in the paediatric department of the CHU-gabriel touré, only seventeen cases of all forms of tuberculosis were found, or approximately 0.2% of hospitalised children. The objective of our study was to investigate the epidemiological and clinical aspects of tuberculosis in children. Materials and Method: This was a prospective, cross-sectional and descriptive study that took place from 24 October 2017 to 23 October 2018, or 12 months in children aged 0-15 years. Data were collected from an individual medical record opened for each patient and an individual survey form established for each child. Results: During the study period, 40,434 children were consulted. Tuberculosis was suspected in 91 children, with a frequency of 0.22%. The age range of 1 to 4 years was 36.3% with a median age of 72 months. The sex ratio was 1.8. Chronic cough with 84.6% and malnutrition with 24.17% were the most frequent symptoms. Chest X-ray revealed bilateral pulmonary lesions in 52.7% and mediastinal adenopathy in 12.1%. TST was positive in 10.9% of patients, microscopy in 26.4%, Gene Xpert in 18.7%, and culture in 16.5%. The biological diagnosis of tuberculosis was retained in 48.4% of the patients, the pulmonary form represented 93.2%. The therapeutic regime (2RHZE/4RH) was used in 81.6% of cases and the evolution was favourable in 65.9% of patients. Conclusion: The diagnosis of tuberculosis in children remains difficult in our context. The clinical signs are not always specific, and further studies are needed to further elucidate this disease.

关键词： Child Clinic Epidemiology gabriel touré university hospital Center Tuberculosis

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Invasive <i>Haemophilus influenzae</i>Type b (Hib) Infections in Children in the Pediatric department of the university hospital gabriel touré(UH-GT)

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Open Journal of pediatrics 2021年第1期11卷 100-107页

作者： B. Maiga A. A. Diakité K. Sacko M. Sylla M. Maiga M. E. Cissé A. Dembélé F. Traoré D. Konaté F. L. Diakité L. Sidibé A. K. Doumbia O. Coulibaly P. Togo A. touré K. Traoré L. Maiga A. Ibrahim H. Diall A. Doumbia H. Konare S. Sagara M. Niakaté A. Cissouma Pediatric Departement University Hospital Gabriel Touré Bamako Mali

Introduction: According to Mali’s National Immunization Center, the Haemophilus influenzae b (Hib) vaccine coverage rate was 90% in 2015. Our work aimed to study invasive bacterial infections due to Haemophilus influenzae type b in children aged 0 - 15 years hospitalized in the pediatrics department of the UH-GT. Method: We carried out a retrospective descriptive study from January 2017 to December 2018 (i.e. 2 years) among children aged 0 - 15 years and hospitalized for Haemophilus influenzae type b infection confirmed by culture (blood culture, Cerebro-spinal Fluid, and pleural and skin fluid). Results:

关键词： Invasive Bacterial Infections Haemophilus influenzae b Children pediatrics

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Hypertension in Clinical Practice: Control Rate in Short Term and Associated Factors in the Cardiology department of the university hospital gabriel touré(UH-GT) in Bamako (Mali)

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World Journal of Cardiovascular Diseases 2018年第6期8卷 288-297页

作者： Hamidou Oumar Ba Ichaka Menta Ibrahima Sangare Youssouf Camara Noumou Sidibe Souleymane Coulibaly Djénébou Traoré Réné Dakouo Samba Samaké Aladji Traoré Samba Sidibé Mamadou Cissouma Cheick Hamala Fofana Lamine Sidibe Kassoum Mamourou Sanogo university hospital gabriel touré Bamako Mali university hospital Kati Kati Mali university hospital Point G Bamako Mali university hospital of Mali Bamako Mali

Introduction: Hypertension (HTN) is for many decades a worldwide major risk factor for cardiovascular ***, hypertension control rates are globally low in the world. Studies on observance have been published in Mali but there is to our knowledge no published data about HTN control rate. We therefore conducted this study to assess the control rate in short term after 3 months management and to look for factors associated with HTN control. Materials and Methods: This study designed as prospective was conducted in the cardiology department of the university hospital gabriel touré (UH-GT) from March 24 to September 24, 2017. All outpatients aged 18 years and more who came for visit and with hypertension as diagnose were involved. All patients have consented to participate in the study. Sociodemographic and data on physical examination including measures for BP, height, weight, waist circumference (WC) and direct costs as reported by the patients were recorded. Patients were asked about medication discontinuation and if yes why and then they were informed about the need to take regularly medication. The concept of chronic disease was explained to them. A formulary served to collect data that were inserted into a Microsoft Access database and analyzed using SPSS version 18. After describing of sociodemographics and continuous variables, crosstabs and finally a logistic regression was performed to look for blood pressure control predictors. Results: There was no statistical difference in sociodemographics between older and newly diagnosed patients. At 3 months globally 40.90% (31.1 for old Patients and 09.8% for newPatients) of the sample were controlled (Figure 1). For old patients, hypertension control rate at inclusion was 12.78% and reached 49.44% at 3 months (Figure 2). After logistic regression only HTN duration was significant predictor with Odd-ratio of 0.365 [0.213 - 0.624] 95% CI and p-value patients as reference). During the study period therapeutic r

关键词： Hypertension Control Rate Old Patient New Patient Medication Bamako Outpatient

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Risk Factor for Malnutrition in Children Aged 6 to 59 Months hospitalized in a Pediatric Ward in the South of the Sahara

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Open Journal of pediatrics 2021年第3期11卷 329-338页

作者： A. A. Diakité A. Diall B. Maïga A. Dembélé F. L. Diakité B. Coulibaly L. N. Sidibé A. K. Doumbia O. Coulibaly P. Togo G. Dembélé A. Diall M. Sylla department of pediatrics Gabriel Touré University Hospital Bamako Mali

Malnutrition is a major public health problem in Mali, along with the country’s political and security instability. We initiated this work with the objective of determining the frequency as well as the risk factors favoring the occurrence of malnutrition in children aged 6 - 59 months hospitalized in the pediatrics department of the Gabriel Touré University Hospital in Bamako, country reference service to identify potential interventions to plan. A cross-sectional study was carried out over a period of 4 months. A bivariate logistic regression analysis allowed us to identify risk factors with degree of significance if p 0.05. During the study period, 2888 children were hospitalized, including 348 aged 6 to 59 months, or a frequency of 12.04%. One in two children was malnourished, i.e. a frequency of 50%. It more frequently

关键词： Malnutrition Contributing Factors pediatrics

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Hemorrhagic Stroke: About a Pediatric Case

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Open Journal of pediatrics 2021年第4期11卷 804-809页

作者： Abdoul Karim Doumbia Oumar Coulibaly Hawa Gouro Diall Guediouma Dembélé Agaly Hamadassaliha Fatou S. Mangara Pierre Togo Adama Dembélé Belco Maiga Karamoko Sacko Abdoul Aziz Diakité Boubacar Togo department of pediatrics of the university hospital gabriel touré Bamako Mali department of pediatrics Mali Hospital Bamako Mali department of Neurosurgery of the university hospital gabriel touré Bamako Mali

Stroke is a rare but serious condition with high mortality and morbidity. We report the case of a 10-year-old child with no known pathological history who was transferred to the pediatric department for hemorrhagic stroke. He had been hospitalized 6 days earlier in a peripheral center for a tonic-clonic seizure accompanied by loss of consciousness and fever. Clinical examination revealed meningeal syndrome, facial paralysis, right hemiparesis, ataxia with disturbed balance, aphasia, and a peripapillary hemorrhage on the fundus. A cerebral computed tomography (CT) scan showed a hemorrhagic stroke with ventricular flooding. A lumbar puncture was performed and a hematic cerebrospinal fluid (CSF) with 12 leukocytes and 8000 red blood cells was obtained. The evolution was marked by the extinction of the infectious and meningeal syndromes, the regression of the pyramidal syndrome and the persistence of the dysarthria justifying a neuropsychological and speech therapy follow-up. Several challenges (diagnostic, therapeutic) exist in the management of children with stroke. Prospective studies with a larger sample are needed to fill the observed gaps.

关键词： Hemorrhagic Stroke pediatrics Intracerebral Hemorrhage Subarachnoid Hemorrhage Malaria Mali

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Management of Acute Myeloblastic Leukaemia (AML) Treated with Intensive Chemotherapy: Experience in a Single Centre

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Open Journal of pediatrics 2024年第2期14卷 401-411页

作者： Abdoul Karim Doumbia Hawa Konaré Tati Simaga Pierre Togo Oumoulkairi Nana Kouma Hawa Gouro Diall Oumar Coulibaly Adama Dembélé Mohamed Elmouloud Cissé Karamoko Sacko Belco Maiga Aminata Doumbia Kalirou Traoré Ibrahima Cissé Boury Traoré Abdoul Aziz Diakité Fousseyni Traoré Boubacar Togo department of pediatrics University Hospital Gabriel Touré Bamako Mali

Introduction: Acute myeloblastic leukaemia (AML) is a haematological malignancy with a poor prognosis, despite significant therapeutic progress. This study presents the results of AML management in Mali according to GFAOP recommendations. Methodology: This was a retrospective, cross-sectional study. It included patients aged 0 - 15 years treated in the paediatric oncology unit for AML and followed up between January 2016 and December 2020. Results: During the study period, 85 cases of acute leukaemia were diagnosed in the paediatric oncology unit (including 51 cases of ALL), of which 34 cases of AML were included in this study. The majority were boys (59%). The mean age was 8 years, with extremes of 18 months and 15 years. The mean time to diagnosis was 68 days. In 79% of cases, patients were referred by 1st or 2nd level hospitals. Anaemia was observed in 91% of cases, an infectious syndrome in 68%, haemorrhage in 56% and a tumour syndrome in 85%. The haemogram showed hyperleukocytosis in 15% of cases, thrombocytosis in 22% and severe anaemia in 73%. Death occurred in 85% of cases, most often in the context of sepsis or haemorrhage. Conclusion: AML is probably underestimated in Mali and diagnosis delayed, which may be explained by patient-related factors (lack of knowledge, financial constraints) and a cumbersome referral system. These results suggest the need to implement an appropriate diagnostic and therapeutic strategy, with strong involvement of the political authorities.

关键词： Acute Myeloblastic Leukaemia Children Mali

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Evaluation of the Practice of Immediate Care for Newborns in the Obstetric Gynecology department of the gabriel touré university hospital of Bamako, Mali

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Open Journal of pediatrics 2024年第6期14卷 1139-1147页

作者： Guediouma Dembélé Leyla B. Maiga Fatoumata Léonie F. Diakité Fatou Diakité Mariam Kané Niomo Kountao Mady Niakaté Tiaria Sanogo Marianne Djouell Nouhoum L. Traoré Hawa Diall Lala N. Sidibé Djeneba Konaté Belco Maiga Karamoko Sacko Abdoul K. Doumbia Pierre Togo Adama Dembélé Souleymane Sagara Abdoul A. Diakité Fatoumata Dicko Central Directorate of the Army Health Service Kati Mali Perinatal Clinic Mohammed VI Bamako Mali department of pediatrics of the university hospital Center gabriel tour Bamako Mali Reference Health Center of the District IV Bamako Mali

The care provided in the neonatal period by caregivers in health facilities and by parents in the community is essential for the survival of the newborn. Our work aimed to assess the practice of essential care for newborns at the maternity hospital during the first six hours of life. Methodology: It was a cross-sectional study, which took place over a period of six months and fifteen days (from April 27 to November 12, 2020). We evaluated the practice of immediate care given to newborns over 32 weeks of amenorrhea by the health personnel involved against the recommendations of the World Health Organization (WHO) on essential newborn care (ENC). Results: Our study involved 422 live newborns, which represented 22% of all live births. The sex ratio was 1.2. The gestational age of newborns was 37 to 41Week of Amenorrhea (WA) in 69.2%. The majority of births were performed by doctors specializing in gynecology and obstetrics, or 66.4% of cases. Midwives provided care in 51.7% of cases. Out of 422 newborns, 408 were immediately dried, 96.7% of the time. Less than half (44.1% of newborns) had benefited from the late cord clamping. Eye care was administered to the vast majority of newborns (94.3% of cases). The breastfeeding technique was verified in only 2.8% of cases. Only 1.7% (7 newborns) were monitored during the first six hours of immediate postpartum. In the immediate post-partum period, 18 newborns had problems that required treatment. NNS were correctly administered in 39 newborns (9.2%). Conclusion: Our study shows inadequacies in the practice of essential care for newborns within our maternity. Thus, many newborns can be saved through the practice of essential newborn care (NHS) at different levels of the health pyramid.

关键词： Evaluation Immediate Care Newborn Bamako Mali

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Complications of Sinusitis: About 9 Cases in the Ear Nose &Throat (ENT) department of the university hospital gabriel touréin Bamako

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Surgical Science 2016年第1期7卷 27-33页

作者： Kadidiatou Doumbia-Singare Abdoul Aziz Diakite Sidiki N’Dao Samba Karim Timbo Youssouf Sogoba Drissa Kanikomo Boubacary Guindo Siaka Soumaoro Lamine Traore Fatogoma Kone Fatou Sylla Mohamed Keita Alhousseini Ag Mohamed ENT department and Neck Surgery of the university hospital gabriel toure Bamako Mali Neurosurgery department of the university hospital gabriel toure Bamako Mali Pediatric department of the university hospital gabriel toure Bamako Mali African Institute of Tropical Ophthalmology Bamako Mali

Objective: This study aims to analyze clinical, paraclinical and therapeutic aspects of sinusitis complications in the Otorhinolaryngology department at the teaching hospital of gabriel toure in Bamako. Materials and methods: This descriptive and longitudinal study was conducted on 12 months from March 2012 to February 2013 in 9 cases of sinusitis complications in the department of Otorhinolaryngology at the university hospital gabriel toure in Bamako. Results: The average age of patients was 22.7 years;a median of 19 years within 6 men and 3 women with almost 12.9 days of care seeking duration. The factors of risky were the use of nonsteroid anti-inflammatory drugs NSAID (4 cases), maxillofacial trauma (1 case) and HIV (1 case). Facial pain was the major symptom, such as frontal oedema, rhinorrhea with pus shedding and nasal obstruction. Computer tomography was used for complications specification. Frontal sinusitis was the most encountered with subperiosteal abscess (44.4%). Streptococcus pneumoniae was identified in 3 cases. Medical treatment associated to surgery was conducted on 7 patients. Two cases of death have been registered. Conclusion: The complicated sinusitis is an emergency and dangerous disease requiring specific care by a multidisciplinary staff. Much of complications are commonly encountered despite the antibiotic era.

关键词： Sinusitis Complications Diagnosis Treatment Surgery

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Enteropathica Acrodermatitis Complicated by Necrotising Fasciitis in an Infant Admitted to the Paediatric Emergency department of the gabriel touré university hospital

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Open Journal of pediatrics 2023年第6期13卷 831-837页

作者： Aichata Keita Bory Traoré Adama Dembélé Rokiatou Diarra Mariam Diarra Elmouloud M. Cissé Mariam Kané Bakary Coulibaly Hawa Konaré Reference Health Center of the Commune VI Bamako Mali department of Paediatrics CHU gabriel touré Bamako Mali Bamako Dermatology hospital Bamako Mali

Acrodermatitis enteropathica is a rare autosomal recessive genetic disorder characterised by periorificial dermatitis, alopecia and diarrhoea. It is caused by a mutation in the gene that codes for a membrane protein that binds zinc. We report a case in a 7-month-old girl, admitted with altered general condition and scaly, pustular erythematous lesions, initially located in the occipital and cervical regions, and secondarily inguinal and on the knees. Management and outcome in this patient? Genetic assay was not available to confirm this rare genetic disease. A delay in establishing the diagnosis and a disastrous outcome did not save the patient despite the administration of zinc.

关键词： Enteropathica Acrodermatitis Necrotizing Fasciitis Infant

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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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