Trends in childhood mortality in Kenya: the urban advantage has seemingly been wiped out.

BACKGROUND: We describe trends in childhood mortality in Kenya, paying attention to the urban-rural and intra-urban differentials. METHODS: We use data from the Kenya Demographic and Health Surveys (KDHS) collected between 1993 and 2008 and the Nairobi Urban Health and Demographic Surveillance System (NUHDSS) collected in two Nairobi slums between 2003 and 2010, to estimate infant mortality rate (IMR), child mortality rate (CMR) and under-five mortality rate (U5MR). RESULTS: Between 1993 and 2008, there was a downward trend in IMR, CMR and U5MR in both rural and urban areas. The decline was more rapid and statistically significant in rural areas but not in urban areas, hence the gap in urban-rural differentials narrowed over time. There was also a downward trend in childhood mortality in the slums between 2003 and 2010 from 83 to 57 for IMR, 33 to 24 for CMR, and 113 to 79 for U5MR, although the rates remained higher compared to those for rural and non-slum urban areas in Kenya. CONCLUSIONS: The narrowing gap between urban and rural areas may be attributed to the deplorable living conditions in urban slums. To reduce childhood mortality, extra emphasis is needed on the urban slums.

[Recurrent maxillo-mandibular odontogenic keratocysts: prevention and treatment]. / Kératokystes odontogéniques maxillo-mandibulaires récidivants: prévention et traitement.

Keratocyst is an odontogenic cyst with an aggressive clinical behavior and a high recurrence rate. Our work describes a 62 year-old patient with Gorlin's syndrome presenting advanced recurrent maxillo-mandibular keratocysts. He already had multiple resections of these lesions. Early diagnosis and treatment of keratocysts is crucial to reduce the extension of the cysts and minimize their malignant transformation especially when they are part of a Gorlin's syndrome.

[Anhidrotic ectodermal dysplasia. Rehabilitation]. / Dysplasie ectodermique anhidrotique. Réhabilitation.

INTRODUCTION: Anhidrotic ectodermal dysplasia (EAD) is an inherited syndrome with an incidence of one per 100,000 live births and is characterized by hypotrichosis, anhidrosis or hypohidrosis, and oligodontia. Various treatment options for the dental rehabilitation of children presenting with this disease have been published. There is however no consensus on what age implants should be placed. Our purpose was to describe the disease and rehabilitation with early implants through two case reports. OBSERVATION: Our two patients, a brother and sister, aged 14 and 15 years respectively, presented with EAD, maxillary hypodontia, and mandibular anodontia. They benefited from an orthodontic surgical treatment followed by prosthetic treatment. We designed a removable prosthesis on mandibular implants for the boy when he was 14, which was later replaced by a fixed prosthesis on implants. We shifted the lateral maxillary incisors orthodontically to a canine position, then performed autologous bone grafting for the placement of six implants. The same bone graft technique was used for the sister to insert four maxillary implants. The follow-up after implant placement was 7 and 4years, respectively. On the latest follow-up, the results were stable, functional, and esthetic. DISCUSSION: Dental implants are a reliable oral rehabilitation treatment for children presenting with ectodermal dysplasia.