ABSTRACT
INTRODUCTION. Les diarrhees aigues restent encore de nos jours un probleme d'actualite du fait de leur grande incidence et de leur consequence en termes de mortalite et morbidite. OBJECTIF. evaluer la prise en charge des enfants atteints de diarrhee avant leur hospitalisation.PATIENTS ET METHODES. Il s'agit d'une enquete retrospective et descriptive conduite a partir de dossiers d'enfants hospitalises pour diarrhee du 1er janvier au 31 decembre 2012; dans le service de pediatrie du Centre Hospitalier Universitaire de Libreville. Nous avons inclus les enfants de moins de 5 ans hospitalises pour diarrhee. Les donnees ont ete collectees a l'aide d'un questionnaire preetabli et analysees avec le logiciel epi info 3.5.4. RESULTATS. Sept cent quatorze enfants ont ete hospitalises pendant la periode dont 143 (20%) de moins de 5 ans pour diarrhee. Le sex ratio garcon/fille etait de 1;4. L'age moyen etait de 12;9 mois. Les enfants ages de 0 a 11 mois representaient 58;1% de l'effectif. Chez 66;1% des enfants; la diarrhee avait debute en moyenne 4;6 jours avant la date de la consultation. La deshydratation etait moderee chez 67 enfants (46;9%) et severe chez 20 (14%). L'alimentation habituelle de l'enfant etait reportee dans 34 dossiers; soit 23;8%. Une automedication avait ete conduite par les parents dans 88;8% des cas. Les sels de rehydratation orale avaient ete administres dans 5;6% des cas. CONCLUSION. La rehydratation orale n'est pas suffisamment utilisee par les familles dans la prise en charge de la diarrhee chez les enfants de moins de 5 ans. La mise en ouvre de la PCIME est une strategie qui pourrait ameliorer la prise en charge des maladies diarrheiques a domicile
Subject(s)
Child, Preschool , Diarrhea , Disease Management , InfantABSTRACT
Knowledge about transmission of sleeping sickness in a given focus is of a great importance since it governs the efficacy and the cost-effectiveness of control strategy. The Komo-Mondah focus is the most endemic sleeping sickness focus of Gabon. This focus has hardly been investigated and available publications are more than thirty years old. In order to update transmission features of sleeping sickness in that focus; we have conducted epidemiological and entomological surveys in March-April 2008. Methods: Epidemiological investigation relied on a case-control study using a quantitative and qualitative methodology (a structured questionnaire). Cases were affected people (parasitological positive) diagnosed by the national control program from 2004 to 2007; controls were those found disease-free after clinical examination and biological tests in the same period. They were asked to respond to a standard questionnaire concerning their activities after having signed a written consent. An unvaried analysis was first performed and then a multivariate analysis using the conditional logistic regression for matching method. Traps were then set out for four days in areas where people were working. Tsetse flies captured were identified and dissected; their density and human-fly contact points were determined. Results: A risk of infection was associated with fishing activities (Odds-ratio: 5.69; CI95: 3.38-9.57). Three species of Glossina were captured: Glossina palpalis palpalis; Glossina fuscipes fuscipes and G. Caliginea. Human-fly contact points were mainly landing stages. Conclusion: A combined strategy of case-detection and vector control targeted at landing stages should be efficient against the disease