Pathologies ORL de l'enfant: aspects épidémio-cliniques et prévention primaire / Children ent pathologies: epidemio-clinical profiles and primary prevention

Introduction : les pathologies ORL de l'enfant sont multiples et diversifiées. Le cout élevé de leur prise en charge ainsi que l'accessibilité limitée aux soins démontrent la nécessité de renforcer la prévention. Le but de travail était de recenser les aspects épidémio-cliniques des affections ORL de l'enfant et d'en analyser les mesures de prévention primaire. Méthode : l'étude s'est déroulée dans le service d'ORL-CCF du CNHU de Cotonou. Elle a été descriptive avec un recrutement prospectif du 1er Janvier au 30 Juin 2018. Ont été inclus les enfants de 0 à 18 ans reçus en consultation ORL. Les données cliniques ont été analysées. Résultats : les enfants ont représenté 25,79 % des consultants (311 enfants sur 1206 patients). L'âge moyen était de 7,20 ± 5,36 ans et 164 parmi eux (52,73 %) étaient de sexe masculin. Les pathologies observées étaient : infectieuses/inflammatoires 181 cas (58,20 %), traumatiques 56 cas (18 %), fonctionnelles 26 cas (8,36 %), tumorales 20 cas (6,43 %), malformatives 17 cas (5,47 %) et vasculaires 11 cas (3,54 %). Les dix principales pathologies ORL infantiles étaient : otites moyennes aiguës 60 cas (19,29 %), corps étrangers ORL 47 cas (15,11 %), hypertrophies amygdaliennes 36 cas (11,58 %), rhinopharyngites 21 cas (06,75 %), amygdalites 19 cas (6,11 %), hypoacousies isolées 18 cas (5,79 %), rhinites 17 cas (5,47 %), freins de langue 9 cas (2,89 %), adénopathies cervicales 7 cas (2,25 %) et otite externe 5 cas (1,61 %). Conclusion : Les pathologies ORL de l'enfant sont fréquentes en consultation. Elles sont dominées par les infections et les traumatismes. Le suivi rigoureux du calendrier vaccinal et les sensibilisations sur les règles d'hygiène de vie des enfants pourraient contribuer à la réduction de leurs incidences

ENT pathologies in children are multiple and diverse. The high cost of their care and the limited accessibility to care demonstrate the need to strengthen prevention. The aim of the work was to identify the epidemiological and clinical aspects of ENT disorders in children and to analyze their primary prevention measures. Method: The study was conducted in the Department of Ear-Nose-Throat Head and Neck Surgery (ENT HNS-CFS) of the National University Hospital Center of Cotonou. It was a descriptive study realized through a prospective enrollment. We included in this study, children aged from 0 to 18 years that were received in the ENT's consultation during the period from January 1st to June 30th, 2018. Socio-demographic and clinical data were analyzed. Results: Children represented 25.79% of the consultants (311 children among 1206 patients). The mean age was 7.20 ± 5.36 years and 164 among them (52.73%) were male. The pathologies identified were: the infectious / inflammatory pathologies with 181 cases (58.20%), the traumatic ones with 56 cases (18%), functional with 26 cases (8.36%), tumoral with 20 cases (6,43%), malformations with 17 cases (5.47%), and vascular pathologies with 11 cases (3.54%). The ten most common childhood ENT diseases were: acute otitis media with 60 cases (19.29%), ENT foreign bodies with 47 cases (15.11%), tonsil hypertrophies with 36 cases (11.58%), Rhinopharyngitis with 21 cases (06.75%), tonsillitis with 19 cases (6.11%), isolated hearing loss with 18 cases (5.79%), rhinitis with 17 cases (5.47%), tongue brakes with 9 cases (2.89%), cervical lymphadenopathies with 7 cases (2.25%) and external otitis with 5 cases (1.61%). Conclusion: The ENT pathologies of the child are frequent in consultation. They are dominated by infections and trauma. Rigorous monitoring of the immunization schedule and raising awareness of healthy lifestyle rules for children could help reduce their impacT

[A randomized clinical trial comparing the effectiveness and tolerability of artemisinine-naphthoquine (Arco®) and artemether-lumefantrine (Coartem®) in the treatment of uncomplicated malaria in Benin]. / Essai clinique randomisé comparant l'efficacité et la tolérance de la combinaison artémisinine-naphthoquine (Arco®) et artéméther-luméfantrine (Coartem®) dans le traitement du paludisme simple au Bénin.

The Ministry of Health recommended in Benin, since 2004, artemisinin-based combination, artemether-lumtefantrine (Coartem®), therapy for the treatment of uncomplicated malaria. To resolve the difficulties related to observance, we are interested in a new combination, artemisinin-naphthoquine (Arco®). A study was conducted to assess and compare the efficacy and tolerability of the fixed combination artemisinin (125 mg)-naphthoquine (50 mg), a single-dose drug, administered one day versus artemether (20 mg)-lumefantrine (120 mg).The clinical assessment was a single-blinded, two-arm, randomized trial comparing Arco® combination as a single-dose regimen and three-day regimen of Coartem® for the treatment of uncomplicated falciparum malaria, from july to october 2008 and may to september 2009, with 28 days of follow-up in children. PCR genotyping was used to classify re-infection or recrudescence. The primary outcome measures for efficacy were cure rates on days 3, 7, 14, 21 and 28. Secondary outcomes included parasite clearance time and fever clearance time. The main outcome measures for safety were incidences of post-treatment clinical and laboratory adverse events. A total of 174 patients (84 in Arco® group and 90 in Coartem® group) were evaluated for clinical and parasitological outcomes. The cure rate was 98.8% for Arco® and 100% for Coartem® on day 28, with no statistically significant difference. Fever clearance was obtained within 24 hours in both groups. The parasite clearance is obtained at 48 hours in Arco® group and at 60 hours in Coartem® group. Both treatments were well tolerated without major side effects. This study therefore concluded that the combination of artemisinin-naphthoquine is as effective and well tolerated as the combination artemether-lumefantrine in the treatment of uncomplicated malaria in Benin children. This medication administered in single dose is therapy of choice to reduce compliance problems during malaria treatment and also to facilitate community-based care of malaria.

An intraspecific genetic map of velvetbean (Mucuna sp.) based on AFLP markers.

Velvetbean ( Mucuna sp., n=11), a self-pollinated species, is an important legume used in tropical agricultural systems in rotation with other crops for nematode management and/or soil improvement. A genetic map of velvetbean was constructed in order to identify potential molecular markers linked to important morphological and agronomic traits that would be particularly useful for developing and improving the species. Traits such as seed coat color, pod color, and pod pubescence were among the main parameters observed in a process of genetic diversity estimation. Two slightly divergent velvetbean accessions, PI364362 and 'Edgar Farm White', a land race from Alabama, were used to make an intraspecific F(1) hybrid. Amplified fragment length polymorphism analysis (AFLP) detected an average of six polymorphic fragments per primer pair between the two parents. As expected for dominant markers, the sum of all AFLP bands from both parents was generally observed to be present in the AFLP profiles of the F(1) progeny, indicating full penetrance and the dominant nature of AFLP markers. An F(2) population was generated by self-pollinating a single F(1) plant. Using 37 AFLP primer pairs, we detected 233 polymorphic markers of which 164 (70.4%) segregated in 3:1 Mendelian ratios, while the remaining 69 (29.6%) both segregated and were scorable. The genetic linkage map constructed from this population comprised 166 markers, including two morphological traits (pod color and pod pubescence). Twenty linkage groups were found with an average distance between markers of 34.4 cM, covering a total of 687.9 cM. The linkage groups contained from 2 to 12 loci each and the distance between two consecutive loci ranged from 0 to 21.8 cM. The newly designated morphological traits pod color ( pdc) and pod pubescence ( pdp) co-segregated with each other at a distance of 4.2 cM. Two DNA markers designated ACGCAG2 and ACTCTG1 were located in the same group as pdc and pdp. The AFLP linkage map provides opportunities for use in marker-assisted selection and in the detection of loci controlling morphologically important traits.