Algerian Registry for Inborn Errors of Immunity in Children: Report of 887 Children (1985-2021).

INTRODUCTION: Inborn errors of immunity (IEI) represent a heterogeneous large group of genetic disorders characterized by susceptibility of affected individuals to recurrent infections, autoimmune/inflammatory diseases, allergy, and malignancy. We aimed to report for the first time the Algerian registry for IEI in children. METHODS: We described the characteristics of IEI in Algerian children from the data collected in the Algerian registry for IEI between 1985 and 2021. RESULTS: Over a period of 37 years, we included 887 children (530 male, 59.6%) with a mean age at diagnosis of 3.23 years and a mean diagnosis delay of 2 years. The prevalence rate was estimated at 1.97/100,000 inhabitants or 5.91/100,000 children. The parental consanguinity was found in 52.6%. The most prevalent category was combined immunodeficiencies (CID) (35.5%), followed by predominantly antibody deficiencies (24.5%) and CID with syndromic features (18.3%). The most predominant diseases were severe CID (134 cases), MHC II deficiency (99 cases), agammaglobulinemia (82 cases), common variable immunodeficiency (78 cases), hyper IgE syndromes (61 patients), ataxia-telangiectasia (46 patients), Wiskott-Aldrich syndrome (40 patients) and chronic granulomatous disease (39 cases). The clinical presentation was dominated by lower respiratory tract infections (69%), failure to thrive (38.3%), and chronic diarrhea (35.2%). Genetic analysis was performed in 156 patients (17.6%). The global mortality rate was 28.4% mainly caused by CID. CONCLUSION: This is the first report of the Algerian registry for IEI in children. Data is globally similar to that of the Middle East and North African (MENA) registries with high consanguinity, predominance of CID, and significant mortality. This registry highlights the weak points that should be improved in order to provide better patient care.

Maternal mortality in Maghreb: problems and challenges of public health.

The epidemiology of Maternal Mortality (MM) associated with practical field specificities led, inter alia, to adopt consensus approaches developed by international community in order to control the situation (MM in 2015 of  303000 with 830 daily deaths by perinatal complications). Application degree of these approaches, while based on scientific evidence, remains country-dependent, with emerging problems within large geographical entities. This is the case of the Maghreb countries* that are facing concrete realities requiring better state commitment, allocation of resources and time, and improved accessibility to the continuum of care. Public health remains the leading discipline in maternal health offering expertise in analysis and intervention that will not be enough to implement effective programs, because it is essential to consider practical realities, often poorly known or ignored. The required efficiency needs a large, egalitarian and multi-disciplinary partnership with socio-anthropology, health economics, political science and political and community mobilization specialists. Strategies adopted by Maghreb countries* must be updated and adapted to national and then regional specificities by involving stakeholders in concerned sectors. In addition, to implant mechanisms ensuring best governance and actor's accountability, it is a priority to support quality assurance projects, institutionalize partnerships between different care levels and opt to accreditation of maternal health care structures and services. A depth reflection seam necessary for implementation of mobile health support schemes that provide maternal care with enhanced proximity and better adaptation to real needs of communities. * The article concerns exclusively the following 3 countries: Tunisia, Algeria and Morocco.

Barriers of influenza vaccination in health care personnel in France.

To identify barriers against influenza vaccination of health care personnel in Northern France, a cross-sectional study was conducted in health care facilities. A total of 3,213 questionnaires from 67 health care facilities were completed. In multivariate analysis using a logistic model, influenza vaccine coverage in health care personnel was significantly associated with level of knowledge about influenza disease and vaccine.

Prolongation of hospital stay and additional costs due to nosocomial bloodstream infection in an Algerian neonatal care unit.

BACKGROUND: Previous studies from developed countries reported that nosocomial bloodstream infection (BSI) in neonatal care units (NCUs) increases length of stay and costs. However, no such information is available for Algerian NCUs. OBJECTIVE: To evaluate the influence of BSI in neonates on additional charges and length of hospital stay. DESIGN: Prospective, nested case-control study. SETTING: The 47-bed NCU of the University Hospital of Blida, Algeria. PATIENTS AND METHODS: A total of 83 neonates with BSIs (case patients) and 166 neonates without BSIs (control patients), admitted to the NCU during the study period (April 2004 through December 2007), were matched for sex, birth weight, length of NCU stay, and year of hospital admission. Each patient's length of stay in the NCU was obtained prospectively on daily rounds. The estimated cost of each NCU-day was provided by the hospital's finance department. The cost of antibiotics prescribed was provided by the hospital's pharmacy department. RESULTS: The mean additional length of NCU stay for case patients, compared with control patients, was 9.2 days (24.3 vs 15.1 days). The mean additional cost of antibiotics was dollars 546. The mean cumulative additional cost was dollars 1,315. CONCLUSION: This study highlights the effect of BSI on extra costs for NCU patients, especially costs due to prolongation of hospital stay and increased antibiotic use, and suggests that NCUs in Algeria have a financial interest in reducing the rate of BSI.