RESUMO
INTRODUCTION: In Congo, data on diabetic ketoacidosis (DKA) in children are old and rare. This study aims to describe the sociodemographic features of DKA and to identify risk factors for mortality. PATIENTS AND METHODS: We conducted an analytical study on DKA in childred at the University Hospital in Brazzaville over the period from January 2013 to June 2016. We examined the socio-demographic, clinical, paraclinical and evolutionary variables. Chi-Square Test, Fisher's exact test and odds ratio were used in the univariate analysis process and logistic regression model in the multivariate analysis. RESULTS: Out of 172 children hospitalized with diabetes 55 (31%) were hospitalized with ketoacidosis. They were girls (33; 60%) with an average age of 11.1± 4.9 years (ranging from 1 months to 17 years), 61.8% of parents came from low socioeconomic status. Ketoacidosis was the revealing symptom in 67.2 % of cases. The diagnosis made before hospitalization was wrong (50%). The triggering factor was often an infection (52.7%). Mortality rate was 12.7%. The risk factors for mortality in the univariate analysis were: age < 5 years (p=0,000006), average consultation time higher than 7 days (p= 0.001), severe dehydration (p = 0.0006), hemodynamic disorders (p= 0.0006), severe undernutrition (p= 0.02), Glasgow Coma Scale < 9 (p= 0.007) and diarrhea (p= 0.001). CONCLUSION: The importance and the seriousness of ketoacidosis impose preventive measures based on awareness, information and education campaigns as well as on the management of risk factors for mortality.
Assuntos
Diabetes Mellitus/epidemiologia , Cetoacidose Diabética/epidemiologia , Hospitalização/estatística & dados numéricos , Adolescente , Criança , Pré-Escolar , Congo/epidemiologia , Cetoacidose Diabética/diagnóstico , Cetoacidose Diabética/mortalidade , Feminino , Escala de Coma de Glasgow , Hospitais Universitários , Humanos , Lactente , Modelos Logísticos , Masculino , Análise Multivariada , Pais , Prognóstico , Fatores de Risco , Fatores SocioeconômicosRESUMO
Background. Lack of medical coverage in Africa leads to inappropriate care that has an impact on the mortality rate. In this study, we aimed to evaluate the cost of severe acute sickle-cell related complications in Brazzaville. Methods. A retrospective study was conducted in 2014 in the Paediatric Intensive Care Unit. It concerned 94 homozygote sickle-cell children that developed severe acute sickle-cell disease related complications (average age 69 months). For each patient, we calculated the cost of care complication. Results. The household income was estimated as low (
