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Background: The childhood tuberculosis (TB) epidemic has been long neglected. Data on pediatric tuberculosis is needed to develop effective strategies against TB. Methods: We retrospectively reviewed 200 medical records from children aged 0-15 years who suffered from tuberculosis between 2011 and 2021 in Libreville, Gabon. We collected and analyzed socio-demographic data and clinical data. Results: 141 children files were selected (43 % girls and 57 % boys). The mean age of the patients was 9.2 years (CI: 8.5-10). Sixty per cent (60 %) of cases were from precarious housing areas, 35.34 % from mixed housing areas, and 4.51 % from residential. The cure rate was 75.24 %, 9.52 % relapsed, and 15.24 % died. Deaths were significantly higher in older children (Dunn's post-test p < 0.01). Children who recovered had higher haemoglobin and platelet counts than those who died (Dunn's test: haemoglobin p < 0.0001; thrombocytes p < 0.05). The haemoglobin threshold value of 5.5 g/dL identified children death with up to 80 % sensitivity and 86 % specificity. Thrombocytes count identified children's death with a sensitivity of 80 % and a specificity of 51 %. Conclusion: Precariousness is associated with childhood tuberculosis. The directly observed therapy (DOTS) in older children should be reinforced to limit tuberculosis-associated deaths. Haemoglobin concentration and platelet are vital prognosis markers in pediatric tuberculosis.
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Introduction.Kawasaki disease (KD) is an acute multi-systemic vasculitis of young children and infants. It is the first cause of acquired cardiac disease in children and remains poorly described in Gabon. We therefore wanted to describe the epidemiological and therapeutic aspects of this disease in two hospitals in Libreville. Patients and methods.We conducted a retrospective, descriptive study from 2014 to 2021 at the Akanda University Hospital and the El Rapha polyclinic in Libreville. All records of patients hospitalised in paediatrics for MK were included. Results.Thirty three cases of MK were retrieved, giving ahospital prevalence of0.6%. The mean age of patients was 20.4 months, the proportion of patients <18 months was 60.6% and the sex ratio was 1.7. The symptoms were observed mainly during the dry season (69.7%). Fever (100%), conjunctivitis (78.8%) and desquamation (72.7%) were the main reasons for consultation. In 24.2% of cases, a traditional medicine was administered. The average time between the onset of symptoms and hospitalization was 11 days. Once hospitalized, the diagnosis of MK was evoked within an average of 3 days. The typical form was observed in 57.6% of cases. In 100% of cases, the hemoglobin level was <12g/dl and the CRP was >15mg/l. Echocardiography was abnormal in 5 patients. Acetylsalicylic acid was the only treatment with a mean time to apyrexia of 3 days after administration. No deaths were recorded. Conclusion:the MK is relatively present in Libreville. It is important to mention it in the event of a fever of more than 5 days.
Subject(s)
Pharmacoepidemiology , Mucocutaneous Lymph Node Syndrome , Therapeutics , Disease , Hyperthermia, InducedABSTRACT
BACKGROUND: Nosocomial infection outbreaks in neonatal services are a serious healthcare concern in both developed and developing countries, but few studies have been conducted in sub-Saharan Africa. OBJECTIVE: This study explored the etiology of septicemia in neonates and associated patterns of antimicrobial susceptibility in Gabon. METHODS: We analyzed cultures from neonates' blood and swabs from medical personnel and equipment located in the neonatology service. RESULTS: Sixty-eight microorganisms were isolated from the medical personnel and equipment; 46 microorganisms were isolated from neonates' blood culture. Klebsiella pneumoniae spp pneumoniae was the most common bacteria found in both (30.6% and 26.9%, respectively). All Klebsiella pneumoniae spp pneumonia isolates were resistant to amoxicillin with clavulanic acid, gentamycin resistance ranged from 93% to 100%, and cephalosporin resistance ranged from 33.3% to 47%. CONCLUSIONS: Awareness of the etiology, prevalence, and outcome of nosocomial infection is the first and most important step to appropriate interventions.
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OBJECTIVE: Herd immunity is achieved when in a population, immune individuals are in a sufficiently large proportion. Neutralizing antibodies specific to SARS-CoV-2 that are produced following infection or vaccination are critical for controlling the spread of COVID-19. The objective of the present work was to investigate the rate of SARS-CoV-2 natural immunization in Gabonese. RESULTS: One thousand, four hundred and ninety two people were enrolled. The overall prevalence of anti-SARS-CoV-2 antibodies was 36.2%. Moreover, 76.4% of people who developed a humoral response to SARS-CoV-2 produced both anti-SARS-CoV-2 N-protein antibodies and anti-SARS-CoV-2 S-protein antibodies, which correspond to 27.7% of the total population. In infants (0-9 month), children (1-17 years) and adults, the prevalence of anti-SARS-CoV-2 antibodies was relatively the same, between 33 and 37% (any antibody types) and between 25 and 28.6% (neutralizing antibodies). In this African context, one-third (1/3) of the screened population was exposed to SARS-CoV-2 and three-quarter (3/4) of those exposed individuals developed neutralizing antibodies against SARS-CoV-2. This data suggest that herd immunity is not yet to be achieved in Gabon.
Subject(s)
Antibodies, Viral/immunology , COVID-19/immunology , Coronavirus Nucleocapsid Proteins/immunology , Immunity, Herd , Spike Glycoprotein, Coronavirus/immunology , Adolescent , Adult , Aged , Antibodies, Neutralizing/immunology , Child , Child, Preschool , Female , Gabon/epidemiology , Humans , Infant , Infant, Newborn , Male , Middle Aged , Phosphoproteins/immunology , SARS-CoV-2/immunology , Young AdultABSTRACT
Pathogen sensing and recognition through pattern recognition receptors, and subsequent production of pro-inflammatory cytokines, is the cornerstone of the innate immune system. Despite the fact that HIV-exposed uninfected (HEU) infants are prone to serious bacterial infections, no study has focused on the functionality of their bacteria recognition system. This is the first study to investigate baseline levels of three critically important immune response molecules in this population: complement component (C)-3, toll-like receptor (TLR)-4, and C-reactive protein (CRP). We enrolled 16 HEU and 6 HIV-unexposed (HU) infants. TLR4 function was investigated by stimulating whole blood with increasing concentrations of TLR4-agonist ultrapure lipopolysaccharides. TLR4/TLR4-agonist dose response were assessed by measuring IL-6 secretion. Complement C3 and CRP were measured by photo spectrometry. Data showed no significant differences in baseline concentration of CRP between HEU and HU infants. Complement C3 was significantly higher in HEU infants than HU infants. TLR4 anergy was observed in 7 of 12 HEU infants, whereas the rest of HEU infants (n = 4) and the control HU infants tested (n = 3) showed responsive TLR4. None of the HEU infants investigated in this study had severe infections in the year after their birth. In conclusion, TLR4 anergy can occur in HEU infants without necessarily translating to increased vulnerability to infectious diseases.
Subject(s)
HIV Infections/immunology , Immune Tolerance/immunology , Pregnancy Complications, Infectious/immunology , Toll-Like Receptor 4/immunology , C-Reactive Protein/analysis , C-Reactive Protein/immunology , Complement C3/analysis , Complement C3/immunology , Female , Gabon , HIV Infections/drug therapy , HIV Infections/prevention & control , HIV-1 , Humans , Infant, Newborn , Interleukin-6/immunology , Lipopolysaccharides/immunology , Male , Pregnancy , Pregnancy Complications, Infectious/drug therapy , Prospective Studies , Toll-Like Receptor 4/bloodABSTRACT
Introduction : l'anémie néonatale est une pathologie fréquemment rencontrée dans les services de néonatologie. Sa prévalence est mal définie dans la littérature en général, et en Afrique en particulier. Objectif : étudier les caractéristiques épidémiologiques et thérapeutiques de l'anémie néonatale au Centre Hospitalo-Universitaire d'Angondjé. Patients et méthodes : il s'agit d'une étude rétrospective qui s'est déroulée au Centre Hospitalo-Universitaire d'Angondjé, sur une période de 4 ans allant de 2012 à 2016. Tous les dossiers de nouveau-nés hospitalisés pendant cette période et ayant présenté une anémie (taux d'hémoglobine Ë13g/dl) ont été inclus. Résultat : 105 cas d'anémie néonatale avait été enregistré parmi les 658 hospitalisations soit une prévalence de 16%. Les nouveau-nés prématurés représentaient 64%. A l'admission, 45,7% de nouveau-nés présentaient d'emblée une anémie avec un taux moyen d'hémoglobine de 10,8g/dl et 54,3% étaient non anémiés à l'admission avec une hémoglobine moyenne de 15,2g/dl±2,5. L'infection néonatale (56,3%), l'anoxie périnatale (8,5%), la prématurité, les prélèvements répétés représentent les facteurs de risque associés à la survenue de l'anémie. La transfusion de globules rouges était la base thérapeutique dans 69,1% de cas. Le taux de décès lié à l'anémie était de 9,6%. Conclusion : l'anémie chez le nouveau-né est un facteur de risque de mortalité néonatale en Afrique, et dans le monde. La régression de ce trouble passe par la prévention
