[Child tuberculosis at the teaching hospital of Brazzaville from 1995 to 2003]. / La tuberculose chez l'enfant au CHU de Brazzaville de 1995 à 2003.

In the paediatric service of the teaching hospital of Brazzaville, 582 files of children hospitalized were studied from January 1995 to December 2003. To determine tuberculosis frequency among sickle cell children and estimate the clinical and paraclinical aspects, a case-control study of tubercular patients with HIV negative serology was carried out by comparing at the same time a cohort of 75 sickle cell patients versus 125 patients without sickle cell disease. The results of these studies are as follows. The main assessment is the high frequency of tuberculosis. In 1995 the tuberculosis rate reaches 8%, in 2003 it was up to 13.6%, and 20.6% in 2000 due to the serious consequences of the recurrent wars between 1993 and 1999. Another cause of that high frequency is the rate of HIV/aids patients with a frequency of 2.5% of hospitalization ranging from 1.6 to 3.2%, among them 35% of the tubercular patients were seropositive. The tuberculosis prevalence was 7.4% among sickle cell patients versus 14.2% among control patients. Infection was more often identified in control patients (51.2%) than in sickle cell patients (24%). 68% of the parents were really poor and 18.5% of the children were evicted from their home by war. The pulmonary localizations were prevailing in groups of patients with sickle cell disease as well as in group of control patients. Pleuritis was observed in 8% of the patients with sickle cell disease versus 16.8% for control patients (P = 0.02). No patient with sickle cell disease had a miliary. Anergia to tuberculin test was reported in 35.8% sickle cell patients versus 10.4% for the control patients (P = 0.001). Tuberculosis prevalence is higher among control patients than in sickle cell patients. The high proportion of clinical and paraclinical data of tuberculosis did not significantly differ from the two groups. Evolution was good for 98% of the patients, 1.4% of them died; 74% of deceased patients were affected by HIV/aids.

[Tuberculosis and HIV/AIDS co-infection in children: experience carried out in paediatric service of the teaching hospital of Brazzaville, Republic of Congo (1995-2004)]. / Tuberculose et infection dues au VIH/sida chez l'enfant: expérience du service de pédiatrie du CHU de Brazzaville, Congo (1995-2004).

Epidemiologic, clinical and paraclinical data of 126 children with tuberculosis whose HIV status was known, have been compared. Among them, 65% were HIV positive, the co-infection tuberculosis HIV/AIDS was observed in all social categories. The source of contamination was discovered for 72% of the patients. The mother was involved in 47.5% of cases. The main reasons of consultation were a long standing fever a chronic cough and a weight loss. Diarrhea was mainly observed in positive HIV patients (p = 0.00). The general condition was influenced by a weight loss which was more important in positive patients with a IMC lower than 10 in 12.8% of cases. There was no significant difference between all clinical forms. Digital hippocratism, chronic otitis and parotiditis were only observed in positive HIV patients with skin illness ten times more frequent (p = 0.00). Anergia to tuberculin tests (78.4%) and a sedimentation speed up to 100 mm at the first hour were observed in more than 60% of the positive HIV patients (p = 0.001). Evolution was favorable under treatment for 84% of positive HIV patients with an increasing weight becoming weaker after one month of treatment. All deaths happened among that population.

[Ovarian torsion revealing an ovarian cavernous hemangioma in a child]. / Torsion de tumeur kystique de l'ovaire chez une adolescente, révélatrice d'un hémangiome caverneux.

The authors report one case of cavernous hemangioma of the left ovary, which was revealed by ovarian torsion. Such benign tumors of the blood vessels are rare in ovaries during childhood. This hemangioma was observed in a 13-year-old patient, who presented with abdominal and pelvic pain and vomiting. The pelvic mass was noted and sonography revealed a cystic tumor. An annexectomia was realized. Histology showed narcotized ovary cells, with an increased number of vascular channels composed of thin walled vessels, whose wall consisted of an endothelium. This aspect evoked a cavernous hemangioma of the ovary.