[Psychosocial issues of mothers whose children have sickle cell disease]. / Vécu psychosocial des mères d'enfants drépanocytaires.

OBJECTIVES: To study and describe the psychological responses (depression and anxiety), the coping strategies, and the impact of sickle cell disease on the quality of life (QOL) of mothers. PATIENTS AND METHODS: A cross-sectional study of mothers with affected children was conducted at the university hospital center of Brazzaville, between February and April 2014. Hamilton and Beck scales, the Brief-COPE, and the Short Form Health Survey were used to assess anxiety, depression, coping strategies, and QOL, respectively. RESULTS: In all, 104 mothers of children with sickle cell disease were surveyed. Of the subjects, 73 (70.2%) had depression and 85 (81.7%) anxiety, while 19 (18.3%) mothers were neither anxious nor depressed. The study shows that depression occurred more often among mothers whose children presented with at least three vaso-occlusive crises (CVO) requiring hospitalization per year (OR=5.1; range=1.8-13.9), at least one blood transfusion (OR=6; range=2.3-15.5), and those whose disease had been known for at least 5 years (OR=3; range=1.2-7.2). On the contrary, maternal anxiety was influenced only by the number of transfusions and CVO requiring hospitalization. The main coping strategy was religious coping (65.4%) followed by acceptance (60%). The QOL of mothers with affected children was impaired in 56.7% of cases. Altered QOL was related to the number of hospitalized CVO per year, i.e., equal to or greater than 3 (OR=6.5; range=2.1-19.6 [P<0.01]), and the number of blood transfusions equal to or greater than 1 (OR=2.9; range=1.2-7.3 [P<0.025]). CONCLUSION: Sickle cell disease is a heavy burden for mothers caring for these children. Mental health disorders are present at the time of diagnosis and in everyday life.

[Epidemiology and outcome of Congolese children who had surgery for heart defects]. / Épidémiologie et devenir des enfants congolais opérés pour cardiopathies congénitales.

AIMS: to determine the principal heart defects for which children underwent surgery and to determine the survival rate. PATIENT AND METHODS: this retrospective cohort study involves Congolese babies treated surgically from September 1989 to September 2010 in France for congenital heart defects (through "Mécénat chirurgie cardiaque" and "Chaîne de l'espoir"). It includes only 110 of the 182 recorded patients during the study period. RESULTS: The sex ratio for the 110 subjects included in the analysis was 1. Their mean age at surgery was 77.4 ± 57.6 months old (range: 8 to 204 months). The main congenital heart defects for which surgery was performed were ventricular septal defect (21.9%), tetralogy of Fallot either isolated (22.8%) or associated with patent foramen ovale (1.8%) or coronary anomalies (1.8%), atrial septal defect associated with other malformations (8.2%), pulmonary atresia with ventricular septal defect (5.5%), aortic stenosis (3.7%), atrioventricular septal defect (0.9%), and Laubry-Pezzi syndrome (0.9%). The median length of follow-up was 42.4 ± 35.6 months (range, 3-240 months). Patients' mean age at the study's end was 121.1 ± 86.3 months (range 20-372 months). The 5-year survival rate was 90% and the 20-year survival, 83.3%. CONCLUSION: Heart surgery for congenital heart defects has improved survival.