RESUMO
Acute respiratory infections remain the principal cause of morbidity and mortality in Moroccan children. Besides bacterial infections, respiratory syncytial virus (RSV) and human metapneumovirus (hMPV) are prominent among other viruses due to their high prevalence and association with severe clinical episodes. We aimed to describe and compare RSV- and hMPV-associated cases of WHO-defined severe pneumonia in a paediatric population admitted to Morocco's reference hospital. Children aged 2-59 months admitted to the Hôpital d'Enfants de Rabat, Morocco meeting WHO-defined severe pneumonia criteria were recruited during 14 months and thoroughly investigated to ascertain a definitive diagnosis. Viral prevalence of RSV, hMPV and other viruses causing respiratory symptoms was investigated in nasopharyngeal aspirate samples through the use of molecular methods. Of the 683 children recruited and included in the final analysis, 61/683 (8·9%) and 124/683 (18·2%) were infected with hMPV and RSV, respectively. Besides a borderline significant tendency for higher age in hMPV cases, patients infected with either of the viruses behaved similarly in terms of demographics, patient history, past morbidity and comorbidity, vaccination history, socioeconomic background and family environment. Clinical presentation on arrival was also similar for both viruses, but hMPV cases were associated with more severity than RSV cases, had a higher risk of intensive care need, and received antibiotic treatment more frequently. RSV and hMPV are common and potentially life-threatening causes of WHO-defined pneumonia in Moroccan children. Both viruses show indistinctive clinical symptomatology, but in Moroccan children, hMPV was associated with a more severe evolution.
Assuntos
DNA Viral/análise , Metapneumovirus/isolamento & purificação , Infecções por Paramyxoviridae/complicações , Pneumonia Viral/epidemiologia , Pneumonia Viral/virologia , Infecções por Vírus Respiratório Sincicial/complicações , Vírus Sincicial Respiratório Humano/isolamento & purificação , Pré-Escolar , Feminino , Humanos , Lactente , Masculino , Metapneumovirus/genética , Marrocos/epidemiologia , Nasofaringe/virologia , Infecções por Paramyxoviridae/tratamento farmacológico , Infecções por Paramyxoviridae/epidemiologia , Pneumonia Viral/tratamento farmacológico , Prevalência , Infecções por Vírus Respiratório Sincicial/tratamento farmacológico , Infecções por Vírus Respiratório Sincicial/epidemiologia , Vírus Sincicial Respiratório Humano/genética , Estações do Ano , Índice de Gravidade de Doença , Organização Mundial da SaúdeAssuntos
Alérgenos , Asma/imunologia , Poluição do Ar/efeitos adversos , Criança , Pré-Escolar , Feminino , Humanos , Lactente , Masculino , MarrocosRESUMO
Early congenital syphilis is still common in Morocco, where it causes a large number of stillbirths and neonatal deaths. Over the last 16 years, we managed 86 cases of congenital syphilis in infants aged one day to four months. Multiple organs were affected in half the patients. Skeletal lesions were found in 65% of patients, Wimberger's sign in nearly 20% (17/86), and pseudoparalysis in 23%. The significance of the skeletal lesions often seen in congenital syphilis in Morocco is emphasized.