[Serological markers of viral hepatitis B and C in children with sickle cell disease monitored in the Pediatrics Department at the University Hospital of Bobo-Dioulasso (Burkina Faso)]. / Étude des marqueurs sérologiques des hépatites virales B et C chez les drépanocytaires suivis en pédiatrie au CHU de Bobo-Dioulasso (Burkina Faso).

Viral hepatitis B and C are universal public health problems. Burkina Faso is a high endemic area for hepatitis B. Patients with sickle cell disease are at risk. The aim of this study was to investigate and quantify the serological markers of viral hepatitis B and C among pediatric patients with sickle cell disease. This was a descriptive cross-sectional study, which took place from July to November 2014 at the Department of Pediatrics, University Hospital of Bobo- Dioulasso. The study included 44 SS and 26 SC sickle cell patients. General data (age, gender) and medical information (vaccinations, medical history including transfusion) were collected. Blood samples were taken for research and titration of serological markers of hepatitis viruses B and C with a commercial Elisa test on the ARCHITECT i1000® automat of Abbott Laboratories. The mean age of the patients was 7.98 years. Seventeen patients (13 SS and SC 4) had already been transfused at least once. The transfusion rate was significantly higher among the SS patients than among SC (29.5% and 15.3% respectively) patients. No patient with HBs Ag was been found. In two patients, the anti-HBc Ab was found alone. In 33% of cases, no markers of hepatitis B were found. Less than 20% of children fully vaccinated (N = 45) had a protective level of anti-HBs Ab (greater than 10 IU/l). The prevalence of anti-VHC Ab was 2.8%. No case of HBV-HCV co-infection was found. The prevention of infection is an important part of the management of sickle cell patients. Immunization against hepatitis B should be systematic. The results of this study assume that blood safety was good.

[Infective endocarditis in sub-Saharan african children, cross-sectional study about 19 cases in Ouagadougou at Burkina Faso]. / Les endocardites infectieuses chez l'enfant africain subsaharien, étude transversale à propos de 19 cas à Ouagadougou au Burkina Faso.

INTRODUCTION: Infective endocarditis is a transplant of a microorganism on a most often injured endocardium. It is rare in children. This work aimed to determine the frequency of endocarditis of the child, to describe clinical presentation, data from echocardiography, microbiological profile and clinical course. PATIENTS AND METHODS: From May 1 2010 to April 30 2011, we consecutively included children received for infective endocarditis in two medical centers in the city of Ouagadougou: Saint-Camille medical center and teaching hospital Yalgado-Ouedraogo. We investigated the functional and general signs and treatment already received. The physical examination looking for an infectious syndrome, pneumonia, heart failure and entrance doors. Blood cultures, blood count, creatinine, blood chemistry, HIV status, electrocardiogram, chest radiography and cardiac Doppler ultrasound were systematic. The diagnosis of the disease was based on Duke criteria. RESULTS: Nineteen endocarditis in children were reported, that is 1.7% of admissions. The average age was 4.7 ± 2.6 years (extremes: 1 and 14). The sex ratio was 1.7 for girls. The clinical presentation was a common infectious syndrome. Impaired general condition and congestive heart failure were present on admission in six cases, respectively. The front door was dental in nine cases (47.4%), skin in four cases (21%) and ENT in three cases (15.8%). A peripheral vein was implicated in one case. In the two other cases, no front door had been found. HIV serology was positive in four cases. As for the blood cultures, they were positive in 13 cases. The germs found were Streptococcus in 10 cases and staphylococcus in three cases. Echocardiography had revealed vegetations in 18 cases. These vegetations were localized on the mitral in nine cases. Multiple locations were found in four cases. Underlying heart disease was dominated by rheumatic valve disease (68.4%), healthy heart forms were found in two cases. Treatment consisted of antibiotics, antipyretic treatment and that of heart failure as appropriate. The evolution was marked by five deaths (26.3%) in an array of septic shock. Death was more important in congenital heart disease. CONCLUSION: Infective endocarditis of the child is common in our practice. The clinical syndrome is common infectious. Streptococcus and Staphylococcus are the two germs found. The main door is dental. Hence, dental care should be promoted for better prevention of infective endocarditis in our context.

[Acute renal failure and Plasmodium falciparum malaria: a case report]. / Insuffisance rénale aiguë et paludisme à Plasmodium falciparum : à propos d'un cas.

Malaria is an endemic disease caused by one of the several Plasmodium species. Severe malaria is mainly due to Plasmodium falciparum in highly endemic areas. Acute renal failure (ARF) is a criterion of malaria severity as defined by WHO. Often observed in adults, particularly in India and Southeast Asia, this complication remains a rare complication of malaria in children. We report a case of oliguric ARF that occurred in a 7-year-old girl a few days after the onset of fever. The vascular obstruction by parasitized erythrocytes often causing tubular necrosis is the primary mechanism of renal failure. As a possible diagnosis, hemolytic uremic syndrome, renal failure and quartan hemoglobinuric nephropathy are other possible causes of renal failure in malaria. Renal biopsy, which was not performed in our patient, would have been a great help, but was not available. The outcome was favorable with recovery of renal function after 3 weeks of diuretic therapy. This development is not always the rule and the prognosis depends on early diagnosis and treatment options.

Snakebite in Bobo-Dioulasso, Burkina Faso: illustration of realities and challenges for care based on a clinical case

We report herein the case of 19-year-old female farmer who suffered a double snakebite on the right foot. After an unsuccessful traditional treatment, she consulted a health center, 48 hours after the bite. Upon arrival at the hospital, she showed signs of severe damage, including hemorrhagic syndrome, extensive gangrene of the bitten limb and severe acute renal failure. Due to financial constraints, neither antivenom nor the scheduled amputation was performed. After 35 days of hospitalization, she returned home, against the advice of medical personnel. Our case summarizes the daily challenges of patients and practitioners that suffer snakebite envenomation in Bobo-Dioulasso, western Burkina Faso.(AU)