ABSTRACT
In this case report, the authors studied the difficulties to set up the diagnosis of hysteria in the Briquet's Syndrome. The description presented here is about an eleven years old girl patient without any particular family background and who, after her tonsils have been out against her will, presented a hysteria in the form of Briquet's Syndrome. All the explorations showed no abnormalities. It is the questioning, and the analysis of facts from informations by the patient and her family which allowed to conclude the diagnosis of hysteria. She received a chemotherapy, associated with a psychotherapy and a family guidance. The course was favourable after two months. The authors compare these findings with some data of the literature and underline the diagnostic and therapeutic difficulties they faced. How physicians should approach such form of hysteria to set up the diagnosis is to proceed by elimination because the disease can simulate all sorts of medical or psychiatrical affections.
Subject(s)
Somatoform Disorders/diagnosis , Child , Female , Histrionic Personality Disorder/diagnosis , HumansABSTRACT
Data concerning Cryptosporidium parvum infection in Black Africa are highly fragmentary. A 12-month study was carried out on 1392 stool specimens from children under 36 months of age with (n = 756) or without diarrhea (n = 629) in the Pediatric Department of Bobo Dioulasso Hospital in Burkina Faso. In 558 children HIV blood tests were also performed. The phenicated fuchsin technique was used to identify Cryptosporidia oocysts. Results were positive in 72 of the 1392 stool specimens tested (5.2%) and in 59 of the 756 stool samples from children with diarrhea (7.8%). Oocysts were not detected in any child under the age of 6 months and the highest incidence of infection was between 6 and 23 months. Detection of oocysts during this year long study was significantly higher from April to June, which corresponds to the beginning of the rainy season in Burkina Faso. Occurrence of diarrhea was not significantly correlated with parasite density. Presence of oocysts was correlated with malnutrition (p < 0.01) and rotavirus infection (p < 0.05). Of the 558 children who underwent HIV testing, only one was positive. In contrast the incidence of HIV infections in the overall population tested was 7%. This study indicates that cryptosporidiasis is a major factor in development of diarrhea and dehydration in the pediatric hospital setting of Burkina Faso. Two other notable findings are that occurrence of cryptosporidiosis is closely linked to hygiene in the population but is not significantly correlated with HIV infection in the pediatric setting in Africa.
Subject(s)
Cryptosporidiosis/epidemiology , Animals , Burkina Faso/epidemiology , Child, Preschool , Cryptosporidiosis/complications , Cryptosporidiosis/diagnosis , Cryptosporidium parvum/isolation & purification , Diarrhea/parasitology , Feces/parasitology , HIV Infections/complications , Hospitals, Pediatric/statistics & numerical data , Humans , Infant , Infant, Newborn , Parasite Egg Count/methodsABSTRACT
BACKGROUND: Acute lower respiratory tract infections are the primary cause of morbidity in developing countries. POPULATION AND METHODS: Six hundred and sixty seven children (379 boys, 288 girls, aged 0-30 months) admitted for lower respiratory tract infections from January 1990 to March 1991 were included in the study. Immediate medical history was collected from the mother. The weight, height, temperature and clinical manifestations, plus the results of chest X-rays, parasitologic and bacteriological examination of stools, and blood smear for malaria were recorded for each patient. Sero-immunologic study for HIV infection of 473 of the patients aged 12-36 months and their mothers also took part in a sero-immunological study for HIV infection. RESULTS: Lower respiratory tract infections were the second major cause of admission (16.8%) after malaria (28.7%). Infections peaked between 6 and 11 months of age (29.5%). The main diseases were pneumonia and bronchial pneumonia (54%) followed by bronchiolitis (21.7%). Almost half the patients were admitted during the hot, dry season. Two hundred and eighty seven patients (43.4%) were referred only after they had been suffering from the disease for 3 to 9 days, partly explaining the high level of mortality. One hundred and twenty one patients (20.9%) died; the main cause of death was staphylococcal pneumonia (57.9%), followed by pneumonia and bronchial pneumonia (29.3%). Some criteria for severity could be identified, based on pulmonary signs and symptoms and associated manifestations (dehydration, malnutrition, convulsions, anemia). Twenty two patients were positive for HIV-1 infection. CONCLUSIONS: This study confirms that acute lower respiratory tract infections remain a public health problem. Early diagnosis and treatment are necessary to reduce mortality.
Subject(s)
Hospitals, Pediatric/statistics & numerical data , Respiratory Tract Infections/epidemiology , Acquired Immunodeficiency Syndrome/epidemiology , Acute Disease , Burkina Faso/epidemiology , Child, Preschool , Female , HIV-1 , Humans , Infant , Infant, Newborn , Male , Prospective Studies , Respiratory Tract Infections/mortalityABSTRACT
The level of diarrheic diseases among children in Burkina Faso is very high. The identification of aetiologic agents of diarrhoea in hospitalized children (0-36 months) is one of the objectives of the study. All children less than 37 months old admitted to the Pediatric Unit of the National Hospital Souro Sanou of Bobo-Dioulasso between January 1990 and March 1991, were investigated by a standardized clinical examination, and in addition, we do an analysis of a rectal swab at admission and a stool to identify aetiologic enteric agents. As a conclusion to the study: an agent was isolated in 56% of the children with diarrhoea, and in 40% of the children without diarrhoea; some germs (such Salmonella, Shigella, Entamoeba) are found in children both with and without diarrhoea; also, the total of these examinations comes to 20 US $ per episode, or 100 US $ per children/year in Burkina Faso where the number of bouts reaches 5 times per year per infant who is less than 5 years old. Stool samples are not beneficial for children with diarrhoea, neither for the diagnosis nor for the treatment. There fore these types of routine exams should not be used in Sub-Saharan Africa.
Subject(s)
Diarrhea/etiology , Feces , Burkina Faso , Child, Preschool , Diarrhea/microbiology , Diarrhea/parasitology , Feces/microbiology , Feces/parasitology , Female , Humans , Infant , MaleABSTRACT
En Afrique au Sud du Sahara; les services de sante souffrent d'une baisse constante des budgets alloues. Les ministres de la sante de la region africaine ont adopte en 1987; sous l'egide de l'OMS; une strategie de recouvrement des couts au niveau du district sanitaire; appelee initiative de Bamako. Le probleme du financement des prestations au niveau des hopitaux reste a resoudre. Une experience de recouvrement des couts medicamenteux est menee dans le service de pediatrie du Centre Hospitalier National Souro Sanou de Bobo-Dioulasso (Burkina-Faso) depuis novembre 1989; a partir d'un stock de medicaments fournis par l'UNICEF
