[Neonatal septicaemia: bacteriological aspects and outcome in the university hospital center of Lome]. / Septicémie néonatale: aspects bactériologiques et évolutifs au centre hospitalier universitaire de Lomé, Togo.

UNLABELLED: Despite the progress in neonatal intensive care and antibiotics, the neonatal septicaemia remains very frequent and lethal in tropical areas. OBJECTIVE: To study the bacteriology and outcome of the neonatal septicaemia through an analysis of 50 confirmed cases. METHODS: Every child aged of less than 29 days, suspected of infection and with at least one positive blood culture has been included. His perinatal antecedents, clinical features, bacteriological findings, treatments and clinical outcome have been collected. The patients have been divided into 3 groups in regard to the postnatal age at the first positive blood culture: before 48 hours, between 3 and 7 days and after 7 days of life. RESULTS: The neonatal septicaemia occurred in 50% of the cases before 48 hours, 24% from the 2nd to the 7th day and 26% from the 8th to the 28th day of life. Enterobacteriaceae (54%) with E. coli predominant (30%) and S. aureus (28%) were the most frequent germs and particularly during the first week of life: 20/27 and 11/14 respectively. The resistance to the association of ampicillin or amoxicillin and gentamicin was 70% for Enterobacteriaceae and 71% for Staphylococci. The lethality was 36% with an excess of lethality for S. aureus (43%). CONCLUSION: The high rates of frequency and lethality of the neonatal septicaemia in tropical areas require a perinatal care improvement to reduce its morbidity and mortality.

[Malaria following surgery in an endemic region]. / Le paludisme dans les suites des interventions chirurgicales en région endémique.

The frequency of malaria attacks after surgery was determined during a 3-month period in the surgical ward of Bobo-Dioulasso hospital (Burkina Faso). The survey was carried out during the period of highest malarial morbidity. All adolescents and adults admitted to the ward were included, except women undergoing Cesarian section and patients who died in the perisurgical period. Patients were questioned as to the use of antimalarial drugs during the days prior to admission, their occupation and their place of residence. Malarial parasites were tested for routinely on D0, D2 and D5, and every day in case of suspected malaria. Malaria attacks were diagnosed on the basis of clinical signs (fever, headache and tiredness), and microscopic identification of parasites. Only 6% of the patients developed malaria attacks during the 5 days after surgery, and all were due to Plasmodium falciparum. Parasite density at the time of the attacks was between 1,000 and 10,000 PRBC/mm3. These patients did not differ from the overall population in social or medical characteristics. This low incidence of postsurgical malaria attacks relative to other African countries may be due to the routine use of antimalarial drugs in case of attacks. The frequency of such attacks appears to be overestimated by physicians, and microscopic analysis is thus recommended to establish the diagnosis after surgery.