ABSTRACT
Background. Childhood tuberculosis (TB) has been neglected by TB programs in Sub-Saharan Africa. The aim of this study was to determine the incidence and predictors of poor outcome in children with TB in the North region of Cameroon. Methods.It was a retrospective cohort study based on hospital TB registers and treatment TB forms, in all of the 18 functional diagnosis and therapeutic centers (DTC) in the North region. All children aged 0-15years, on anti-TB treatment between 2010-2016 were enrolled. Logistic regression was used to find independent factors associated to poor outcome. Results. Of the 668 children included [321 (48.1%) boys], the median (25th-75thpercentile) age was 11(6-14) years, with 75.9% children aged >5 years. Pulmonary TB was the most common (62.9%) with 34.3% smear-negative pulmonary TB. Extrapulmonary TB (62.1%) was mostly found in children aged 0-5years. HIV/TB coinfection was 10.3%. Incidence (95%CI) of poor outcome was 4.0 %( 2.5-5.5%). Predictors [OR (95%CI)] of poor outcome were: HIV positivechildren [3.995(1.131-14.112), p=0.031], management in peripheral DTC [32.451(4.211-250.099), p=0.001], and transferred in patients from a peripheral zone toward a 3rdor 4thDTC category [4.602(1.092-19.386), p=0.037]. Conclusion.Incidence of poor outcome of childhood TB was quite low in the North region of Cameroon. HIV, peripheral TDC and transferred in patients were predictors of poor outcome. A better management of HIV, retraining DTC personnel and early reference from peripheral DTC would reduce poor outcome among childhood TB.
Subject(s)
Tuberculosis , Psychology, Child , Incidence , Neglected Diseases , Hospitals, Chronic DiseaseABSTRACT
Objective: This study explored the concept of home-based care for people living with full-blown AIDS and the impact of this on their children's psychological functioning. There were 30 children in the study whose parents had full-blown AIDS. The comparison group comprised 30 children. The parents of the children in the comparison group reported that they did not have full-blown AIDS and were not registered as AIDS patients with their community home-based care group. Method: The children's psychological functioning and performance on cognitive tasks were examined; using the Impact of Event Scale - Revised; the Secondary Traumatic Stress Scale (STSS); the Stress Symptoms Checklist; the Child Behaviour Checklist (CBCL); the British Ability Scales and Daniel and Diack's Graded Spelling Test. Result: The results of the study showed that children whose parents had full-blown AIDS showed mental distress and low cognitive performance on numerical and spelling skills. Conclusion: The findings of the study seem to suggest that although the home-based care concept is a noble and global idea; it should be accompanied by psychological support mechanisms to mitigate the effects of traumatic stress that normally follow exposure to a traumatic event. Suggestions for further research on the topic are discussed
Subject(s)
Acquired Immunodeficiency Syndrome , Home Care Services , Parents , Psychology, ChildABSTRACT
L'auteur rappelle d'abord la definition du premature et sa physiopathologie a partir desquelles il devient aise de comprendre certains etats morbides lies a la prematurite. De meme; il insiste particulierement sur deux faits a savoir le cerveau du premature qui constitue le carrefour et qui s'avere etre la grande victime de la plupart des affections en periode neonatale; que le constat de sequelles neuro-psychiques se fait souvent de maniere tardive. Enfin; l'auteur fait egalement ressortir chez le premature la correlation qui existe entre certaines pathologies (hypoglycemie; hemorragie cerebro-meningee; troubles metaboliques) et les sequelles neuropsychiques
Subject(s)
Infant , Neurologic Manifestations , Psychology, ChildABSTRACT
Les enfants de 4 a 12 ans de cette etude etaient bien informes de l'existence des cabinets dentaires. De plus; ils savaient qu'ils pouvaient recourir au dentiste en cas de douleur dentaire. Ils ont aime le dentiste et ont conclu qu'il etait utile. Il nous a donc paru interessant et possible; malgre le contexte socio-culturel particulier; d'agir aupres de cette population pour motiver les enfants aux soins et a la prevention par l'hygiene bucco-dentaire