Profil épidémiologique des pathologies respiratoires chez l'enfant à l'Hôpital d'Enfants de Rabat, Maroc

Introduction: les pathologies respiratoires représentent un motif fréquent d'hospitalisation en pédiatrie. L'objectif de cette étude était d'évaluer le profil épidémiologique des pathologies respiratoires chez l'enfant à l'hôpital d'enfants de Rabat, Maroc.Méthodes: il s'agit d'une étude observationnelle transversale qui a concerné tous les cas d'enfants âgés de 3 mois à 15 ans hospitalisés pour une pathologie respiratoire au service de pneumoallergologie et infectiologie pédiatriques de l'hôpital d'enfants de Rabat sur une période d'une année, du 1 janvier 2014 au 31 décembre 2014.Résultats: sur 3537 patients hospitalisés, 2493 (70,5%) l'ont été pour une pathologie respiratoire. Les hospitalisations pour exacerbation d'asthme (p < 0,001), bronchiolite aigüe (p < 0,001) et dyspnée laryngée (p = 0,004) étaient plus fréquentes chez le garçon alors que les hospitalisations pour pneumopathie aigüe (p = 0,005), pour inhalation de corps étranger (p = 0,007) et pour coqueluche (p = 0,020) étaient plus fréquentes chez la fille. Les hospitalisations pour pneumopathie aigüe (p < 0,001), exacerbation de séquelles graves de virose (p < 0,001) et pour coqueluche (p < 0,001) étaient plus fréquentes chez le nourrisson. Les hospitalisations pour pneumopathie aigüe (p < 0,001) et pour coqueluche (p = 0,015) étaient plus fréquentes en période automnohivernale.Conclusion: les motifs d'hospitalisation étaient dominés par les exacerbations d'asthme et la bronchiolite aigüe, lesquelles étaient plus fréquentes chez le garçon. Les infections respiratoires, représentées par les pneumopathies aigües et la coqueluche, étaient plus fréquentes en période automnohivernale et touchaient plus le nourrisson

Clinical Presentation of Infants Hospitalised with Pertussis

Background. Despite the widespread use of pertussis vaccine; there has been a resurgence of pertussis cases in developed and developing countries. South Africa lacks data regarding clinical presentation and healthcare impact of pertussis.Objectives. To describe the clinical presentation and healthcare impact in hospitalised infants with confirmed pertussis.Methods. This was a retrospective cohort study; conducted in Bloemfontein between April 2008 and September 2012. Infants with laboratory-confirmed pertussis (group 1; N=102); were compared with infants with a negative pertussis result (group 2; N=104) and infants with a lower respiratory tract infection of unspecified aetiology (group 3; N=104). The following data were extracted from the clinical records: demographics; presenting symptoms; paediatric intensive care unit (PICU) admission; length of stay in the general ward and PICU; overall hospital stay and outcome.Results. There were no significant demographic differences between the groups. A larger percentage of infants in group 1 (n=41; 40%) required PICU admission compared with group 2 (n=37; 36%) and group 3 (n=20; 19%). The median PICU stay of group 1 was longer (11 days) compared with group 2 (6 days) and group 3 (5 days). The presence of cough and post-tussive vomiting was significantly higher in group 1 than groups 2 and 3. There was no significant difference in mortality between the groups. Conclusion. Pertussis results in significant morbidity in infants. Measures to identify and manage this vaccine-preventable disease should be considered at a national level

Pertussis An update for general practice

Although there has been a global decline in the incidence of pertussis in the past four decades; the incidence has increased in developed countries; particularly in preteens; adolescents and adults. These groups provide a major reservoir of the disease for vulnerable unimmunised or incompletely immunised infants. This trend has not yet been documented in South Africa. In young infants; the diagnosis is made on the basis of clinical features. Older age groups do not usually show the typical clinical picture; leading to misdiagnosis and underreporting. The culture of Bordetella pertussis from the posterior nasopharynx remains the gold standard for diagnosis but laboratory diagnosis is complex and unavailable in most settings. Erythromycin; instituted early in the course of illness; remains the treatment of choice although there is now good evidence for the use of other macrolides; particularly in the neonate. Immunisation of young infants remains the best preventative methodagainst the disease. Due to the re-emergence of the disease in older age groups; developed countries are recommending booster vaccines in adolescents

Some facts on child survival and some ways to achieve it

Provides the reader some information on diseases which are a major cause of death and suffering of children within the 0-4 age group