ABSTRACT
Digestive symptoms have been reported in an important proportion of children with COVID-19, and the clinical expression of critical patients with COVID-19 is thought to result from progressive increase of inflammation and an unusual trend of hypercoagulation. We report a newborn received with abdominal distension, green vomiting and imaging suggestive for enterocolitis. He had a close contact with COVID-19 and the PCR for SARS-CoV-2 came back positive. Despite the supportive measures, his condition deteriorated and a surgery was decided. The surgical exploration found an ischemic bowel. The therapeutic measures were ineffective as the child passed away a few hours after surgery despite the resuscitation treatment performed. The confirmed enterocolitis happening within the period of acute infection by SARS-CoV-2, the NEC was likely a manifestation of COVID-19.
Subject(s)
COVID-19 , Enterocolitis, Necrotizing , Enterocolitis , Infant, Newborn, Diseases , Male , Child , Infant, Newborn , Humans , Enterocolitis, Necrotizing/etiology , COVID-19/complications , SARS-CoV-2 , Enterocolitis/complicationsABSTRACT
Hydrocolpos and the hydrometrocolpos are anomalies resulting from vaginal and uterine retention and accumulation of cervicovaginal secretions caused by congenital malformation. It is a rare pathology affecting the female newborn and infant and much less often young girls. It appears clinically as an abdominal mass associated with absence or abnormality of the vaginal opening. The diagnosis is confirmed by abdominal echography and CT scan. Treatment varies from the simple X-shaped hymenotomy for the isolated imperforate hymen to major surgery for substantial retentions and complex urogenital abnormalities. The authors report two cases of hydrocolpos and hydrometrocolpos discovered in the neonatal period. These were two newborn babies resulting from poorly followed pregnancies at which the clinical examination noted in both cases a large abdominal mass. The physical examination, imagery and surgical exploration demonstrated the existence of enormous hydrocolpos with imperforate hymen in 1 case and hydrometrocolpos with distal vaginal atresia in the second case. The treatment consisted of draining the secretions for both patients, after an X-shaped hymenotomy for the first and after section anastomosis of the vaginal atresia for the second. Both cases progressed favorably.
Subject(s)
Hydrocolpos , Uterine Diseases , Body Fluids , Female , Humans , Hydrocolpos/diagnosis , Hydrocolpos/therapy , Infant, Newborn , Uterine Diseases/diagnosis , Uterine Diseases/therapyABSTRACT
Neisseria meningitidis is responsible for high levels of morbidity and mortality in the developing countries of the African meningitis belt. There are frequent meningococcal meningitis epidemics in this region affecting almost 1,000 people in every 100,000 (1%). Epidemics generally occur during the dry season but the interval between epidemics is variable (between 2 and 25 years). The reasons for these recurrent epidemics are unclear. There is a safe and effective polysaccharide vaccine against meningococci A and C. Unfortunately, the immunity it provides decreases with time, especially in young children (aged less than 5 years) and it is thus not included in the Expanded Program on Immunization (EPI). WHO recommends mass vaccination using a threshold approach. This control strategy is effective if vaccination begins very soon after the threshold is crossed. There was an outbreak of group A meningococcal meningitis in the Savanes region of northern Togo in December 1996. The national surveillance system put out an alert and control measures were implemented. These involved improvement of the surveillance system, and containment immunization in villages for early cases followed by a mass immunization campaign in the entire region, distribution of oily chloramphenicol and decentralized case management. The target population for mass vaccination included everyone older than 6 months of age living in the Savanes region. The aim was to vaccinate at least 80% of the target population. There were 2,992 cases of meningitis reported in the Savanes region between December 1996 and May 1997 (in a population of about 500,000). This gives a cumulative incidence rate of 581 per 100,000 population. The epidemic was bimodal, with the first peak in the number of cases occurring at the end of January and the second peak in March. There were 60,700 vaccinations in two of the four districts of the region in December and January, as part of the containment strategy and 346,469 vaccinations in the four districts of the region during February, as part of the mass vaccination campaign. By the end of the mass campaign, 67.3% of the target population in the region as a whole had been vaccinated, with 61% vaccinated in the Kpendjal district and 78% in the Oti district. There was an increase in the number of cases 2 weeks after the end of the mass vaccination campaign. This was attributed to the inadequate level of vaccination achieved. Only 52% of the urban population of Dapaong were vaccinated. The national surveillance system put out an alert early in the epidemic. The intervention was planned and adapted according to the progression of the epidemic, and national and international efforts were well coordinated. This emphasizes the importance of a rapid reaction from the surveillance system and of the choice of strategy for dealing with meningitis epidemics in sub-Sahelian Africa.
Subject(s)
Bacterial Vaccines , Disease Outbreaks , Meningitis, Meningococcal/epidemiology , Vaccination , Adolescent , Adult , Anti-Bacterial Agents/therapeutic use , Case Management , Child , Child, Preschool , Chloramphenicol/therapeutic use , Developing Countries , Disease Outbreaks/prevention & control , Health Planning , Humans , Immunization Programs , Immunization, Secondary , Incidence , Infant , Meningitis, Meningococcal/prevention & control , Middle Aged , Neisseria meningitidis/immunology , Population Surveillance , Seasons , Togo/epidemiology , Urban Health , World Health OrganizationABSTRACT
A sero-epidemiological survey to assess the frequency and the distribution of toxoplasmosis has been conducted in schools of Mauritania. The prevalence, although very low compared to European standards, varies in the different villages, higher values being related to the presence of Arab-Berber populations. The main determinants of this difference are probably the food habits. Prevalence increases and reaches a stable level during adolescence. No difference was shown between sexes. These results are discussed in the context of the geography of toxoplasmosis in West Africa.
Subject(s)
Toxoplasmosis/epidemiology , Adolescent , Adult , Child , Ethnicity , Female , Humans , Male , MauritaniaABSTRACT
In 1973, a sero-epidemiological survey was undertaken to investigate the prevalence of malaria along the Senegal river valley. More than 75 % of school children had antimalarial antibodies in their sera. This prevalence was independent of age and sex, and was found to be effectively high particularly in the regions of Gorgol and Guidimaka. These results may be considered exclusively as an indication to raise up, nevertheless, a general planning of malaria protection along the Senegal river.
