[Epidemiology of neonatal surgical emergencies in Ouagadougou]. / Épidémiologie des urgences chirurgicales néonatales à Ouagadougou.

OBJECTIVE: The purpose of this study was to determine the rate of neonatal surgery emergencies and to highlight the main causes and difficulties related to better handling of these emergencies. PATIENTS AND METHODS: We conducted a 1-year descriptive prospective study from September 2009 to September 2010 based on 102 cases collected. At admission, we studied the patients' age, the pathologies encountered, the related malformations, the terms for better management, and prognosis. FINDINGS: In 1 year, we registered 102 cases of neonatal surgical emergencies affecting the digestive tract (63.7%), the anterior side of the abdomen (24.5%), trauma (6.7%), and tumors (2%). Males comprised 60.8% of the cases. The sex-ratio was 1.55. The frequency of such cases was 3.94%. The average age of patients was 5 days with the 0- to 5-day-old age group presenting most frequently. The average hospitalization lasted 2.75 days and the admission method was the reference in 75.5%. Congenital pathology accounted for 95.5% of cases with anorectal malformations (ARM) (35; 95%) and omphaloceles (28.1%). Hirschsprung disease was the main cause of bowel obstruction other than ARM (50%). The average time to surgery was about 2.54 days. The overall mortality of neonatal surgical emergencies was 30.3% and postoperative mortality 32.35%. The late consultation, poverty, a shortage of qualified staff, prematurity, low birth weight, congenital disease, and related malformations were the leading factors of a poor prognosis. Acquisition of effective technical means, staff training, measures to combat poverty, and better prenatal care would improve the management of neonatal surgical emergencies. CONCLUSION: Neonatal surgical emergencies include conditions that require immediate and adequate support. The continuous training of healthcare workers at all levels in the detection of neonatal emergencies and equipping healthcare facilities are an absolute necessity to provide better management and reduce the mortality rate.

[Acute intestinal obstruction]. / Occlusion intestinale aiguë.

A 12-year-old boy is admitted for emergency surgery for acute abdominal syndrome. The intervention showed strangulation of the terminal ileum by the vermiform appendix. The pathology analysis showed bilharzial appendicitis by Schistosoma haematobium. The patient was treated with praziquantel. The literature is not plentiful on this subject. Because protozoiasis is endemic in this area, it should be looked for in all cases of appendicitis, as it requires medical treatment in addition to the appendectomy.

[Bessef Hogen's disease, or exostosis disease, with spinal cord compression: a case in the service of the Paediatric CHU Ouedraogo, Ouagadougou, BF]. / La Maladie de Bessef Hogen ou Maladie Exostosante Avec Compression Medullaire: A Propos d'un Cas Dans le Service de Pediatrie du chu Yalgado Ouedraogo, Ouagadougou, B.F.

CA, 14 old years, female, born last uterine siblings of 9 children, 4 died of various causes, was admitted in the pediatric service of CHU-YO for functional impairment of the lower limbs. Physical examination revealed swelling and deformation harsh, uneven surfaces, the circumferential upper and lower limbs and lumbar spine associated with spastic paraplegia. Sphincter disturbances accompany this clinical picture. The radiographic bone marrow hypertrophy individually with images of exostosis at the epiphyses. Multiple exostosis or BESSEF Hogen's disease is rare and has a reserve functional prognosis because of outcome of low spinal cord compression and vascular compression. We felt it appropriate to bring this case discovered during our clinical practice because of its rarity and the risk of malignant degeneration.

CA, âgée de 14 ans, de sexe féminin, dernière née d'une fratrie utérine de 9 enfants dont 4 sont décédés de causes diverses, est admise dans le service de pédiatrie du CHU-YO pour impotence fonctionnelle des membres inférieurs. L'examen physique révèle des déformations et des tuméfactions dures, à surfaces irrégulières, circonférentielles aux membres inférieurs et supérieurs et au rachis dorsolombaire associées à une paraplégie spasmodique. Des troubles sphinctériens accompagnent ce tableau clinique.La radiographie osseuse individualise une hypertrophie osseuse avec des images d'exostose au niveau des épiphyses.Affection rare, l'exostose ou maladie des exostoses multiples de BESSEF HOGEN a un pronostic fonctionnel réservé du fait des compressions médullaires basses et vasculaires. Nous avons jugé opportun de rapporter ce cas découvert lors de notre pratique clinique à cause de sa rareté et du risque de dégénérescence maligne.

[Comparison of Kinyoun, auramine O, and Ziehl-Neelsen staining for diagnosing tuberculosis at the National Tuberculosis Center in Burkina Faso]. / Comparaison des performances des colorations de Kinyoun et à l'auramine O, avec celle de Ziehl-Neelsen pour le diagnostic de la tuberculose au Centre national de lutte antituberculeuse du Burkina Faso.

CONTEXT: This study was conducted at the National Tuberculosis Center in Burkina Faso from October 2007 through May 2008. OBJECTIVE: Our objective was to compare the diagnostic performance of three staining methods: Kinyoun, auramine O, and Ziehl-Neelsen. METHODS: Ziehl-Neelsen staining served as the reference method to assess the diagnostic performance of Kinyoun and auramine O staining. In all, 616 sputum smears from 233 patients were read with each method to detect acid-fast bacilli. SPSS was used for data analysis. RESULTS: The results of auramine O staining showed positive diagnoses in 15.9% of the samples; sensitivity was 100%, specificity 95.6%, and the positive and negative predictive values 75.7% and 100% respectively. Kinyoun staining produced a positive diagnosis rate of 12%, sensitivity of 96.4%, specificity of 99.5%, and positive and negative predictive values of 96.4% and 99.5%. CONCLUSION: Our study indicates that auramine O staining had a better sensitivity for detecting acid-fast bacilli than Kinyoun staining. Accordingly, the use of auramine O staining should increase the detection rate for pulmonary tuberculosis in Burkina Faso.

Mycobacterium tuberculosis drug-resistance in previously treated patients in Ouagadougou, Burkina Faso.

BACKGROUND: Tuberculosis drug-resistance becomes common in sub-Saharan Africa; however, very few data are available in Burkina Faso. The aim of this study is to assess the acquired resistance of Mycobacterium tuberculosis complex strains identified in TB patients to four first-line drugs in Ouagadougou. METHODS: One hundred and ten (110) pulmonary tuberculosis patients with acid-fast bacilli-positive sputum and in situation of failure, relapse, or treatment abandonment were included in the study. Ninety six strains, including 92 (95.8%) M. tuberculosis and 4 (4.2%) M. africanum, were isolated from the sputum samples of these patients. Their drug susceptibility testing was performed using the proportion method. The first-line drugs tested were isoniazid (INH), streptomycin (STR), ethambutol (EMB), and rifampicin (RIF). RESULTS: The overall drug-resistance rate of M. tuberculosis was 67.4% (n=60), including 3.4% to one drug, 18% to two, 10.1% to three, and 35.9% to four drugs. The resistance to INH, RIF, EMB, and STR were 67.4%, 51.7%, 50.6%, and 44.9%, respectively. Two strains of M. africanum were resistant to all drugs. Forty-six (51.7%) strains were multidrug-resistant (resistant to at least INH and RIF). CONCLUSIONS: In previously treated patients, the level of resistance of M. tuberculosis complex to commonly used anti-tuberculosis drugs is very high in Ouagadougou. Our results showed that multidrug-resistant tuberculosis could be a public health problem in Burkina Faso.