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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

Patterns of Acute Kidney Injury in a Medical Emergency Department in Sub-Saharan Africa

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Open Journal of Nephrology 2022年第3期12卷 267-275页

作者： Weu Mélanie Tia Mélanie Anastasie Wognin Christ Zahe Reine Marie Koffi Nathanael Mey Kehi Jonathan Kpan Abdul Yannick Gonan Ouattara Bourhaima Department of Internal Medicine University Teaching Hospital of Bouaké University Alassane Ouattara of C&ocirc te d’Ivoire Bouaké C&ocirc te d’Ivoire

Background: Acute kidney injury (AKI) is a common in community and a serious outcome in hospital setting. Despite the progress of dialytic and non-dialytic therapeutic means, its mortality remains high. Our objective was to contribute to a better knowledge of how AKI managed in an emergency medical ward in an African country located in the southern part of the Sahara. Patients and Methods: We conducted a retrospective study from January 1 to December 31, 2019, conducted at the emergency department of the university teaching hospital of bouake, on cases of AKI. Results: During the study period, we collected 221 cases of AKI out of a total of 1778 files giving a prevalence of 12.4%. The mean age was 54 ± 19 years. A male predominance with a sex ratio of 1.4 was observed. The main past histories were hypertension in 40.4%, cardiac disease in 16.9%, and diabetes in 14.3%. The patients in were classified in 63.8% of cases as stage I, in 22.1% as stage II and in 14.1% as stage III according to the AKIN criteria. AKI was functional in 93.2% of cases. Hemodialysis was indicated in 15 (6.8%) patients, but only 3 (1.4%) underwent it. The mortality rate was 45.2%. Factors associated with mortality were: creatinine level greater than or equal to 30 mg/l, sepsis and impaired vigilance. Conclusion: Acute renal failure was frequent in subjects under 60 years old. Its mechanism of occurrence is functional and therefore it can be prevented by vascular filling. The majority of patients were seen at AKIN Stage I. The outcome was favorable in more than one third of the cases and the mortality rate remains high.

关键词： AKI African Setting High Mortality

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

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

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

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

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