Childhood cancer: epidemiology in the pediatric oncology department of a university hospital center in Abidjan, Ivory Coast.

Cancer is a major cause of morbidity and mortality in children under the age of 15 years worldwide. To contribute to better knowledge of childhood cancers in Africa. To determine the causes of pediatric cancers and compare them with the results of a previous study and with data available for sub-Saharan Africa. This observational, descriptive study of the data recorded from 2007 to 2015 in the pediatric oncology unit of the University Hospital Center of Treichville in Abidjan analyzes the general and the age- and sex-specific proportions of children under the age of 15 years with neoplasia according to the International Classification of Childhood Cancer, 3rd edition (ICCC.3). This study includes 863 new cases. The sex ratio (M/F) was 1.4, and the mean age 7 years (range: 3 months to 14 years 9 months). The neoplasia rate peaked in the group aged 5-9 years (38.6 %). The most common cancers were: lymphomas (44 %), retinoblastoma (11.7 %), renal tumors (10.1 %), leukemias (6.3 %), and soft tissue sarcomas (5, 9 %). Burkitt lymphoma (85.3 %) and nephroblastoma (90.8 %) were the dominant histological type of lymphoma and renal tumors. This study shows an increase in the annual number of new cases, and an epidemiology close to that reported in other centers in sub-Saharan Africa.

[Neonatal and child tetanus morbidity and mortality in the University hospitals of Abidjan, Côte d'Ivoire (2001-2010)]. / Morbidité et mortalité du tétanos des nouveau-nés et des enfants dans les Centres hospitaliers universitaires d'Abidjan, Côte d'Ivoire (2001-2010).

The lack of data on neonatal tetanus and children in university hospitals (UH) in Abidjan for over a decade has motivated the realization of this study. The objective of this study is to evaluate the morbidity and mortality related to neonatal tetanus (NT) and child tetanus (CT) in Abidjan University Hospital from 2001 to 2010. It is a retrospective study, multicenter analysis with records of newborns and children suffering from tetanus in the three UH of Abidjan. The collection and analysis of data were made by the SPHINX 4.5 and EPI.INFO 6.0 software. In ten years, 242 cases of tetanus (53 NT cases and 189 CT cases) were collected with a predominance of cases after the fifth year of life (59.5%). The incidence rate of NT was less than 1 case per 1,000 live births. All mothers of the newborns were inhabiting the city of Abidjan. Their median age was 19 years [16-32] and 64% were teenagers. Gateways were dominated by umbilical wounds (77.3%) in the NTand skin wounds (59%) in CT. The cure rate was 30.2% in the NT and 60% in the CT. Lethality was 60% for NT and 22% for CT with a positive correlation with young age (neonates: p = 4.10-7, age <5 years: p = 0.01), lack of intraspinal injection of tetanus serum (p = 8.10-6), the absence of conventional antibiotic therapy (p = 0.023), the existence of metabolic complications (p = 2.10-5), the score of ≥ 4 Dakar (p = 0.005). Tetanus remains a real morbidly cause among children in Abidjan University Hospital with high lethality. However, the incidence of NT seems consistent with the incidence threshold desired by WHO.

[Knowledge and practices of the mothers of children from 6 to 18 months relative to the conduct of weaning: cases from the general hospital of Marcory]. / Connaissances et pratiques des meres d'enfants de 6 a 18 mois relatives à la conduite du sevrage: cas de l' hôpital général de Marcory.

Weaning is a high-risk phase in the life of infants around the world, because poorly managed, it raises protein-energy malnutrition to levels causing crucial problems to the health of infants. AIMS: The purpose is to estimate the knowledge and the practices of the mothers regarding the conduct of food weaning of their children aged 6 to 18 months. MATERIALS AND METHODS: We conducted a descriptive cross-sectional survey at the general hospital of Marcory in Abidjan-CI on a sample of 100 mother-child pairs who came to consult. RESULTS: It emerges from this survey that.The mothers are young, with 94% younger than 35 years old. 88% of the mothers were of a low socioeconomic level. Dietary restrictions still remained a real obstacle to a better practice of weaning.The vast majority of the mothers (74%) ignore the notion of weaning and 40% of them had no information regarding this process. Food weaning was not conventional with an early weaning at 1 to 6 months in 38% of the cases and a late weaning (30%) after 13 months. CONCLUSION: It is necessary to set up a program focusing on the adequate conduct of weaning in infants to improve mothers' knowledge and the practices.

Le sevrage constitue une phase à haut risque dans la vie des nourrissons dans le monde , car mal conduit, le sevrage hisse la malnutrition protéino énergétique au rang des problèmes cruciaux de santé chez les nourrissons. OBJECTIF: Le but est d'évaluer les connaissances et les pratiques des mères concernant la conduite du sevrage alimentaire de leurs enfants âgés de 6 à 18 mois. MATERIEL: Nous avons réalisé une enquête transversale descriptive à l'hôpital général de Marcory à Abidjan-CI sur un échantillon de 100 couples mères enfants venus consulter. RESULTATS: Il ressort de cette enquête que.Les mères sont jeunes puisque 94% des mères avaient moins de 35 ans.88% des mères étaient d'un niveau socio économique bas. Les interdits alimentaires restaient encore un réel obstacle à une meilleure pratique du sevrage.La grande majorité des mamans (74%) méconnaissent la notion de sevrage et 40 % d'entre elles ne disposaient d'aucune information. Le sevrage alimentaire n'était pas conventionnel avec un sevrage précoce d'1 à 6 mois dans 38% des cas et un sevrage tardif (30%) au delà de 13 mois. CONCLUSION: Il faut mettre en place un programme axé sur la conduite adéquate du sevrage des nourrissons pour améliorer les connaissances et pratiques des mères.

[The psychological experience of the mothers whose babies were born deformed in the neonatological ward of the academic hospital center of Treichville (Côte-d'Ivoire)]. / Vécu psychologique des mères de nouveau-nés malformés dans le centre hospitalier et universitaire de Treichville (Côte-d'Ivoire).

OBJECTIVE: When a baby is born deformed, his birth breaks up plans his family has made for his life as well as for the family itself. So, our objective was to describe the experience undergone by the mothers who gave birth to babies with serious deformities. METHOD: A prospective and descriptive study was carried out during 12 months about 35 mothers whose babies were born seriously deformed. The data were collected from newborn's medical file and from a well-conducted interview with volunteered mothers. RESULTS: The incidence of the major deformities was 1.4% and the antenatal diagnosis was carried out on only 6 cases. The announcement of deformities in the 30 cases discovered at birth by the clinical staff brought about a shock among mothers. In fact, 28 mothers were disappointed, while 23 experienced fear and 10 others felt guilty. Six mothers thought in terms of aborting, followed by 25 mothers who without any psychological aid felt lonely. Furthermore, 30 mothers suffered from a lack of communication with nurses and with medical staff concerning deformities. The anxiety of mothers was linked, respectively to fear of their husband (33 cases), to the social environment (35 cases) and to the health care (10 cases). CONCLUSION: Mothers facing congenital deformity experienced painful and violent emotional distress. Therefore, the emphasis must be put on the improvement of the neonatal diagnosis and of relationship between physicians and parents in order to achieve a close support toward mothers.

Vecu psychologique des parents accompagneurs d'enfant hospitalises en oncologie pediatrique

La survenue d'un cancer chez un enfant entraine de nombreux bouleversements de la structure familiale. Il nous a paru important d'etudier les contours psychologiques de cette situation en milieu hospitalier a Abidjan. L'etude a ete retrospective; descriptive; sur une periode de douze mois. Elle a concerne 30 accompagnateurs majeurs d'enfants hospitalises dans l'unite d'oncologie du service de pediatrie du CHU de Treichville. Les donnees ont ete recueillies a partir des entretiens isoles ou en groupe avec des accompagnateurs et du dossier medical de l'enfant. 33;4 pour cent des parents accompagnateurs ont attribue l'origine de la maladie a un mauvais sort ou a une malediction; pour 66;6 pour cent il s'etait agi d'une maladie comme une autre. Notre objectif a ete de decrire les aspects psychologiques engendres par ce vecu hospitalier afin d'aider a l'amelioration de l'atmosphere autour de l'enfant lors de sa prise en charge

[Sensitivity to penicillin G of isolates of pneumococci meningitis and therapeutic implication in CHU of Treichville, Abidjan]. / Sensibilité à la pénicilline G des pneumocoques isolés des méningites et implication thérapeutique au CHU de Treichville - Abidjan.

To determine the frequency of pneumococci meningitis with reduced sensitivity to penicillin G isolated from cerebrospinal fluid, 539 strains were studied between 1996 to 2000. All strains were analysed with oxacilline containing 5 mcg / standard antibiogram for determination of minimal inhibitory concentration (MIC) for penicillin G by E-test. Our results do not show any significant variation from 1996 to 2000. Generally as regard the penicillin G sensitivity we observed that strains were classified as: sensitive strains (CMI < or = 0.06 mg/l): 22.5%, less sensitive strains (0.6 mg/l < CMI < or = 2 mg/l): 58.2%, resistance (CMI > 2 mg/l): 19.2%. The pneumococci rate with reduced sensitivity observed in our study is high and should be taken into consideration in the therapeutic choices.

[Bacterial pneumopathies of the newborn: diagnostic and therapeutic aspects]. / Pneumopathies bactériennes du nouveau-né: aspects diagnostiques et thérapeutiques.

OBJECTIVES: To describe the diagnosis and therapeutic management of bacterial pneumopathies in a neonatology unit located in a tropical area. METHODS: Transverse and prospective survey over an 18-month period. The diagnosis was based on the comparison of anamnestic features with clinical, biological and radiological features. A research was made in order to determine the causal agent in the blood, in cerebrospinal fluid, in urines, in pleural liquid and skin lesions. A treatment by two antibiotics was administered through parenteral route. RESULTS: Risk factors were found in 61 selected patients. Polypnea was associated with signs of respiratory distress in 53 patients. Blood abnormalities were present in 47, 5% of the cases. All the patients showed a positive C reactive protein and abnormal X-rays. The diagnosis was confirmed bacteriologically in 32, 8% of the cases. The association of a third-generation cephalosporin with an aminoside was prescribed in 44 cases. The initial antibiotic therapy was not relevant in 19, 7% of the cases. The lethality rate was 24, 6%. The scarcity of bacteriological confirmation led us to consider the combination of radiological abnormalities with respiratory distress as significant symptoms of bacterial pneumopathy. Biological and anamnestic features were considered as extra elements. CONCLUSION: The severity of clinical features, the nature of germs and their sensitivity to antibiotics in our local environment led us to recommend a large prescription of third-generation cephalosporins combined to aminoglycosides.

Les meningites purulentes de l'enfant a Abidjan (A propos de 521 cas)

Les auteurs rendent compte de 521 cas de meningites purulentes observees sur une periode de 5 ans de 1985 a 1989 en milieu hospitalier

[Etiology of splenomegaly in children in the tropics. 178 cases reviewed at the university hospital center of Abidjan-Cocody (Ivory Coast)]. / Etiologie des splénomégalies de l'enfant en milieu tropical. A propos de 178 cas colligés au CHU d'Abidjan-Cocody (Côte d'Ivoire).

Discovery of an enlarged spleen in a child requires steps to identify the etiology. One hundred and seventy-eight patients seen over a four-year period (1985-1988) at the Cocody Teaching Hospital were reviewed. The incidence of splenic enlargement among pediatric inpatients was 1.6%. Males (n = 106) were more often affected than females (n = 72). Slightly over half the children (54.49%) were 0 to 5 years of age. The main clinical presenting features were fever (90%), anemia (72%), a decline in general health (36.50%), enlargement of the liver (33.50%), jaundice (26.50%), and enlarged lymph nodes (7%). Type II of Hackett's classification accounted for most cases (61.80%), followed by Type III (14%). Main etiologies included malaria (53%), salmonella infections (15%), sickle cell anemia (14%), schistosomiasis (9%), AIDS (3%), and thalassemia (2%). Malignancies (leukemia, lymphoma) were relatively infrequent. More than one etiology was found in 13 cases. The distribution of etiologies by age group was determined and a strategy for investigating children with splenic enlargement in tropical countries was developed.