Congenital Malaria and Its Associated Factors at Issaka Gazobi Maternity of Niamey in Niger.

BACKGROUND: Congenital malaria is a serious and common infection in tropical Africa. It has multiple consequences on the newborn and the mother. OBJECTIVE: The objective of this study is to calculate the prevalence of congenital malaria, describe its clinical signs, and analyze its associated factors. Methodology. It is a cross-sectional and prospective study, conducted at Issaka Gazobi Maternity of Niamey, from June 1 to November 30, 2017. The diagnosis was made by microscopy of a thick and thin blood smear of mother, newborn, and umbilical cord. RESULTS: Two hundred and forty-nine (249) consecutive newborn/mother pairs were included. The prevalence of congenital malaria infection was 26.51% (66/249) with a parasite density of 101 P/µl (SD: 47.3; [80; 320]). The prevalence of congenital malaria disease was 14.06% (35/249) with a parasite density of 108 P/µl (SD: 32.6; [40; 200]. All patients were infected with Plasmodium falciparum. 43% (18/35) of neonates had hyperthermia and did not have a sucking reflex, 8.5% (3/35) were anaemic, 11.42% (4/35) had convulsed, 20% (7/35) had a coma, and 45.71% (16/35) had a low birth weight. No deaths were recorded, and only the nonuse of bed nets was significantly associated with congenital malaria (p = 0.04). CONCLUSION: In Niger, one out of four newborns is infected with Plasmodium. Infection can progress to congenital malaria disease. The use of mosquito nets and intermittent preventive treatment would reduce the incidence of congenital malaria.

[Prescription of antimalarial drugs in the pediatric ward of the National Hospital of Lamordé, in Niamey]. / Prescription d'antipaludiques dans le service de pédiatrie de l'Hôpital national de Lamordé, à Niamey.

In Niger, malaria is a major public health problem, due to the high number of deaths that are attributable to it and because of its heavy weight and socioeconomic status. The objective of this study was to contribute to the inventory of medical practices to rationalize the use of medicines and minimize the resistance phenomenon. This is a prospective study, which took place from May 1 to July 31, 2009, in the pediatric ward of the National Hospital of Lamordé. It concerned children aged from 0 to 14 years hospitalized and having received one or more antimalarial drugs during at least 24 h. During the 3 months of the study, 1,248 children had been admitted in the department. Among them, 881 children received antimalarial treatment, i.e., 70.5% with prescriptions. Malaria was confirmed by microscopy in 410 children, i.e., 46.5% of the sick children received antimalarial treatment. Prescription control was deemed noncompliant in 258 patients, i.e., 29.3% of the total. Treatments based on microscopic diagnosis are one of the strategies that will help to streamline the use of antimalarial drugs to improve their effectiveness and efficiency and also to reduce the risk of emergence of resistance.

[Mortal poisoning by bee stings in a child: Study of a case observed in the regional hospital of Maradi (Niger)]. / Envenimation mortelle par piqûres d'abeilles chez l'enfant : à propos d'un cas observé au centre hospitalier régional de Maradi (Niger).

We report a fatal case due to a massive attack by a swarm of bees in a nine-year-old child. The accident was fatal because of two aggravating factors: the cephalic location and the large number of stings (about 300). Complications were coagulopathy, anemia, hemorrhage, coma, and oligoanuria. Support was symptomatic at a facility second level. The outcome was fatal within 14 days. In view of the encountered difficulties, we recommend to build written protocols for the management of envenomation in any health training reference.

[Tuberculosis in children: 29 cases in two hospitals of Niamey and at the national tuberculosis center]. / La tuberculose chez l'enfant: a propos de 29 cas colliges dans deux hopitaux de Niamey et au centre national antituberculeux.

In 2013, the WHO considered that worldwide, the annual incidence of the tuberculosis is of 9 million cases, and prevalence at 14 million. The diagnosis of tuberculosis in children is difficult and can be at the origin of a delay of care and an under estimation of the amount of cases. The purpose of this study was to analyze the epidemiological and diagnostic aspects of tuberculosis in children. It was a multicenter study taking place from October 1st, 2009 until June 1st, 2011. The average age of children was of 4.6 years, with a sex-ratio of 1.43. 65, 52% of patients were inoculated with BCG; 86, 21% arose from family from a low socio-economic level; 55% suffered from malnutrition. Extrapulmonary effects are more frequent than pulmonary (62.07% versus 37.93%). IDR was positive in 85.71% of the children; the sedimentation speed was high in 88.89% of them. The HIV serology tests were administered to 27.59% of the children, all were seronegative. The fight against tuberculosis has to intensify, through the combination of several strategies, such as vaccination, active screening, the adequate care of the cases, improvement of socioeconomic conditions of the populations and research for a new more effective vaccine, news methods of diagnostic and antituberculosis drugs successful.

INTRODUCTION: En 2013, l'OMS a estimé qu'à travers le monde, l'incidence annuelle de la tuberculose était de 9 millions de cas, et la prévalence de 14 millions. Le diagnostic chez l'enfant est difficile et cela est à l'origine de retard de prise en charge et d'une sous estimation des cas. MÉTHODE: Cette étude a été réalisée dans le but d'analyser les aspects épidémiologiques et diagnostiques de la tuberculose chez l'enfant. Il s'agit d'une étude multicentrique prospective qui s'est déroulée d'octobre 2009 à juin 2011, à Niamey dans les deux hôpitaux nationaux et au Centre National Antituberculeux. RÉSULTATS: L'âge moyen des enfants était de 4,6 ans, et le sex-ratio était de 1,4. Soixante cinq virgule cinq pourcent des patients étaient vaccinés au BCG; 86, 2% étaient issus de famille à bas niveau socio-économique; 55% d'entre eux souffraient de malnutrition. Les atteintes extra-pulmonaires étaient plus fréquentes que les formes pulmonaires (62,1% versus 37,9%). L'IDR était positive chez 85,7% des enfants; la vitesse de sédimentation était élevée chez 88,9% d'entre eux. Le test sérologique pour le VIH a été fait chez 27,6% des enfants; tous étaient séronégatifs. CONCLUSION: La lutte contre la tuberculose doit s'intensifier, à travers la combinaison de plusieurs stratégies, telles que la vaccination, le dépistage actif, la prise en charge adéquate des cas, l'amélioration des conditions socio-économiques des populations et la recherche d'un nouveau vaccin, ainsi que de nouvelles méthodes de diagnostic.

[Intestinal parasitosis in children less than five years of age in Niamey, Niger]. / Les parasitoses intestinales chez les enfants de moins de cinq ans a Niamey au Niger.

According to the WHO, in 2002, 3.5 billion of people worldwide were infected with intestinal parasites. Every year, roundworms, hookworms and amoebae are the cause of 195,000 deaths around the world. Despite this high prevalence, these infections are said to be neglected and attract little interest. And yet, they are sometimes very grave especially when contracted by children where they can lead to malnutrition. This prospective study aims to clarify the overall prevalence of intestinal parasites in children. METHODS: The study took place in the pediatric service of the Lamorde national Hospital and the two pediatric services of the Niamey national hospital. This descriptive and analytical study, took place from April to June 2011. Included were children aged 1 month to 59 months, having had a stool examination. RESULTS: The search for parasites was positive in 66 children (33%). The prevalence is statistically higher (p = 0.02) among children 25-59 months (43.84%) than among those whose age is between 1-24 months (26.77%). Male children were more infected than female with respectively 38.7% and 28.04% infection rates. CONCLUSION: Intestinal parasites are frequent in Niamey, despite numerous deworming campaigns. There's been more parasitic protozoa caused by a proportion of 81, 81%, against a proportion of 18, 18 % for metazoans. Conducting a study on the national scale is necessary to understand the general prevalence of intestinal parasites. This would enable a more adapted strategy to the fight against these illnesses.

INTRODUCTION: Selon l'OMS, en 2002, on a évalué à 3,5 milliards le nombre de sujets infectés par des parasites digestifs, à travers le monde. Chaque année, les ascaris, les ankylostomes et les amibes occasionneraient 195000 décès dans le monde. Malgré cette forte prévalence, ces maladies dites négligées, suscitent peu d'intérêt. Et pourtant, elles sont parfois graves surtout chez l'enfant où elles peuvent entraîner la malnutrition. Cette étude vise à évaluer la prévalence globale des parasitoses intestinales chez les enfants. MÉTHODE: L'étude s'est déroulée dans le service de pédiatrie de l'Hôpital National Lamordé et les deux services de pédiatrie de l'Hôpital National Niamey. C'est une étude descriptive visée analytique, qui a été réalisée d'avril à juin 2011. Ont été inclus dans l'étude tous les enfants âgés de 1 à 59 mois, ayant bénéficié d'un examen coprologique. RÉSULTATS: La recherche des parasites était positive chez 66 enfants (33%). La prévalence était statistiquement plus élevée (p=0,02) chez les enfants âgés de 25 à 59 mois (43,8%), que chez ceux dont l'âge est compris entre 1 et 24mois (26,8%). Les protozoaires étaient les parasites les plus fréquents (81,8%) et les métazoaires représentaient 18,2%. CONCLUSION: Les parasitoses intestinales sont fréquentes au Niamey, malgré les campagnes de déparasitage. La réalisation d'une étude national, nous parait nécessaire afin de connaitre la prévalence générale des parasitoses intestinales. Cela permettra d'adapter les stratégies de lutte contre ces maladies.

[Abruptio placentae. Management in a reference Nigerien maternity. Prospective study about 118 cases during one year]. / Hématome rétroplacentaire. Prise en charge dans une maternité de référence du Niger. Etude prospective à propos de 118 cas sur un an.

OBJECTIVE: Placental abruption is a syndrome, which occurs in the third trimester of the pregnancy or during labour. It is the main cause of pregnancy last term bleeding and is also responsible for a high stillbirth rate. The objective is to describe the epidemiological, clinical, paraclinical and therapeutic characteristics in order to decrease the fetal and maternal mortality and morbidity. PATIENTS AND METHODS: It is a prospective and descriptive study in continuous series, over a twelve-month period, from 1st January 2003 to 31st December 2003, at Issaka Gazobi maternity of Niamey, Niger. RESULTS: During the study period, 3255 deliveries have been done. One hundred and eighteen placental abruptions have been observed, which corresponds to a frequency of 3.6% with the highest rate during raining season. The average age and parity were: 31 years and 5th with a predominance of grand multiparous (38.2%). The majority of the patients were in-utero transfers (83,1%) and had done at least 10 km before arriving. One hundred and eleven patients had a caesarean section (94,1%) and 7 delivered through the vaginal route (5.9%). The fetal prognosis was characterized by a high stillbirth rate of 71.3% (87/122), fetal hypotrophy (64.8%) and prematurity (23.8%). The main cause of maternal morbidity was anaemia (76.3%) and Disseminated Intravascular Coagulation (5.9%). Further, 81 patients have been transfused (68.7%). The maternal mortality was 5.1% (6/118). DISCUSSION AND CONCLUSION: Placental abruption, a medical and obstetrical emergency, is a serious obstetric condition, especially in our country. Physicians must be aware that patients with high blood pressure, preeclampsia, eclampsia, particularly in case of multiparity are at increased risk of placental abruption. Early diagnosis, prenatal follow-up and caesarean section improve the maternal and fetal prognosis.