Pregnancy and cirrhosis: four cases at the Lome campus university teaching hospital (Togo).

To evaluate the hepatic and obstetric complications in pregnant women with cirrhosis. We report the cases of four pregnant women with cirrhosis treated in the gastroenterology and obstetrics-gynecology departments of the Lome Campus University Teaching Hospital between 2013 and 2015. The women's mean age was 32 years. Three were in the first trimester of pregnancy. Almost all had signs of advanced cirrhosis, including ascites (50%), lower-limb edema (75%), and jaundice (25%). All (100%) had liver failure and anemia. Cirrhosis was due to hepatitis virus B infection for 3 women. All had singleton pregnancies. Two mothers died; fetal outcome included one fetal loss and one stillbirth. This study shows the high risk associated with the combination of pregnancy and cirrhosis. Prognosis is poor for both mother and fetus.

[Upper arm circumference reference values for children aged 1 to 36 months in Lome (Togo)]. / Croissance du périmètre brachial chez l'enfant de un à 36 mois à Lomé (Togo).

BACKGROUND: Mid-upper-arm circumference (MUAC) is widely used as a nutritional status index for children. The aim of our study was to construct MUAC-for-age curves for well-fed 1-36-month-old children of a developing country and to compare them with the WHO reference charts based on samples of American children. POPULATION AND METHODS: Five thousand thirty-eight boys and 4,972 girls aged 1-36 months were recruited cross-sectionally from 1994 to 1997. Their MUAC were measured as recommended by the WHO. To develop the curves, estimations were first obtained for the mean and standard deviation (SD) of MUAC for each month of age using a 7-month segmental regression equation; the Count model and 2nd degree polynomial in age were then used to describe the mean and SD respectively. RESULTS: These curves showed important differences for age and sex and were lower than the reference curves, particularly for the older children. The mean curve was -0.44 to -0.75 SD for boys and 0 to -0.8 SD for girls, far from the WHO's reference. CONCLUSIONS: The authors proposed to take into account the WHO's nutritional recommendations and developing country features in the construction of the reference charts.

[Epidemiologic and etiologic features of urinary infections in children at the pediatrics service of the CHU-Campus de Lome (Togo)]. / Aspects épidémiologiques et étiologiques de l'infection urinaire de l'enfant dans le service de pédiatrie du CHU-Campus de Lomé (Togo).

From 1st January 1989 to 31th December 1997, 175 infants (108 females and 67 males) were hospitalised and treated at the pediatric service of CHU-Campus for urinary tract infection; this study follows the observation of the increasing of urinary tract infection in several centers of health in Togo; the aim of this study was to have a list the contributing factors, to understand the mechanism of such infection in order to reduce its frequency and the high percent of the mortality; the diagnosis of urinary tract infection was given by the result of the cytobacteriological exam of the urine which shows the pathological germ; others forms of the investigation, as abdominal echography were used also to look for the etiology of the urinary tract infection; but, the deficit of the of the medical imagery or the old material of the laboratories limited the searching of urinary tract infection etiology; cured infants were declared on the basis of absence of pathological germ in the result of the cytobacteriological exam control of the urine; the prevalence of the urinary tract infection was 8.29% with an incidence of 7.84% at the pediatric service of CHU-Campus; clinics symptoms were atypic and polymorphic; but the fever was the first clinical sign in the newly born and the urological signs were clear only from two to thirty months; 141 children (80.57%) were cured and 34 presented the complications with 3.43% of mortality; preventive measures on the urinary tract infection in infancy were proposed for the children parents and the practical physicians; these measures included information, education and communication (IEC) on the urinary tract infection, the symptomatology and the cytobacteriological exam of the urine.

[The use of Doppler echocardiography in the diagnosis of congenital heart disease in the Pediatric Department of CHU-Tokoin, at Lomé (Togo)]. / Apport de l'échocardiographie-Doppler dans le diagnostic des cardiopathies congénitales dans le service de pédiatrie du CHU-Tokoin, à Lomé (Togo).

Currently, echography coupled with Doppler is a primary technique in the diagnosis of congenital heart disease. Since September 1993, the pediatric ward of the Tokoin teaching hospital of Lome has been equipped with this technology. During the following 23 months, there were 299 examinations with Doppler-echocardiography among the consultations of 15,082 children. Eighty-two cases of congenital heart defects were detected in 73 children, aged between 3 days and 13 years, of whom 79.4% were between 7 days and 30 months old. In all cases, either pulsed or continuous Doppler-echocardiography was performed at the request of doctors treating symptoms suggestive of cardiac disease, such as heart murmur (67%) and cyanopathy (22%). The noncyanotic cardiopathies found were ventricular septal defects (24%), patent ductus arteriosus (21%), interatrial septal defects (18%) and atrioventricular canal defects (9%). The most frequent cyanotic cardiopathy detected was Fallot's tetralogy (19.5%). Thus, early diagnosis and management of congenital heart disease is facilitated by systematic examination of newborns and sustained collaboration between pediatricians, obstetricians and cardiologists.