[Blood biomarkers of early diagnosis for neonatal bacterial infections: back from Senegal cohort]. / Biomarqueurs sanguins du diagnostic précoce des infections néonatales bactériennes : retour d'expérience d'une cohorte sénégalaise.

In Senegal, reducing neonatal mortality remains a challenge. The management of neonatal infections remains problematic and presents a strong clinical focus. Indeed, like all developing countries, the difficulty of acquiring state-of-the-art infrastructure and the financial cost impact on the routine use of biomarkers. It is in this context that we conducted this study to identify the best biological strategy for making a reliable diagnosis. Ninety-nine newborns were recruited at the pediatric service of the Diamniadio Children's Hospital (Senegal). CRP was assayed by latex immuno-agglutination method, IL-6 and IL-8 using Luminex® technology, PCT by chemiluminescence, orosomucoid by immunoturbidimetry and SAA by ELISA technique. 20 newborns had probable infection and six established infection. Deaths and complications were significantly greater in these groups. With an optimal decision threshold of 16.3 mg/L, CRP performed better (compared to the other tested blood biomarkers) with AUC, sensitivity and specificity of 94%, 88% and 99%, respectively. With the performance obtained from CRP in the diagnosis of neonatal bacterial infections, the installation of panels with other biomarkers with advanced and expensive technology is not necessary. Thus, optimal care and within a reasonable timeframe can be done in our health facilities, with this accessible marker that is CRP.

Observed and Modeled Seasonal Air Quality and Respiratory Health in Senegal During 2015 and 2016.

In this work, we use existing particulate matter (PM) data from Dakar, Senegal, satellite aerosol optical depth (AOD) and the Weather Research and Forecasting (WRF) model to evaluate the role of dust transport from the Sahara and PM concentrations and exposure into other administrative districts of Senegal during 2015 and 2016. We also use data from the Ministry of Health to examine spatial and temporal patterns of acute respiratory infections, asthma, bronchitis, and tuberculosis across Senegal with an emphasis on Northern Hemisphere winter December-February, when air quality is poor, and June-August when there is an improvement in air quality. Measurements in Dakar, Senegal, suggest hazardous PM10 concentrations associated with Saharan dust storms but lower PM10 concentrations during the summer. The WRF dust simulations show a similar temporal pattern to the observations in Dakar, Senegal, with notable biases. However, the WRF model suggests that the highest dust concentrations are found across the northern half of Senegal during the winter season where there are no currently PM measurements. Health data during 2015-2016 show the highest prevalence of asthma and bronchitis in Dakar, Senegal, suggesting that other sources of air pollution are important. Acute respiratory infection is prevalent throughout the country with the high prevalence found in rural zones, for children between 12 and 59 months. All measures including real-time monitoring, air quality forecast, and communication should be used to protect the public from potentially hazardous environmental conditions during the winter season.

[Heart failure with normal heart revealing complex arteriovenous malformation of the lower limb in a child: case study and literature review]. / Insuffisance cardiaque sur cœur normal révélant une malformation artériole-veineuse complexe du membre inferieur chez un enfant: à propos d'une observation et revue de la littérature.

Arteriovenous malformations (AVM) are congenital high-flow vascular defects. They are very rare in children. Diagnosis and treatment are often delayed due to their atypical place of occurrence and to their variable clinical manifestations. We report the case of a child treated at the National Centre Hospitalier Albert Royer Children, Dakar. A boy aged 9 years was referred from a health facility in rural areas for the treatment of heart failure. Admission clinical examination showed impaired general condition, global heart failure syndrome and voluminous right warm inguinocrural mass extended to the right abdominal wall (iliac fossa and right flank), with poorly defined limits. Auscultation of this mass showed a thrill and diffuse murmur. Cardiac ultrasound showed severe pulmonary arterial hypertension (PAH) with extensive impairement of the heart cavities, without cardiac structural involvement. The diagnosis of AVM was confirmed by doppler ultrasound of the mass complemented by angiography scan. They showed multiple arteriovenous fistulas within the mass. The diagnosis of complex stage IV AVM (according to Schöbinger classification) of the root of the right thigh was retained. Clinical treatment of heart failure was based on furosemide, spironolactone and captopril to obtain hemodynamic stabilization before possible surgical procedure. Arteriovenous malformations of the limbs, in particular of the proximal end of the lower limb in children are still largely unknown, hence frequent diagnostic errors and delays. Their evolution is unpredictable requiring early diagnosis and careful monitoring involving multidisciplinary interaction between pediatrics, surgeons and radiologists.