[Thoracopagus conjoined twins: case study conducted in Libreville and literature review]. / Jumeaux conjoints thoracopages: à propos d'un cas à Libreville et revue de la littérature.

Conjoined twins are a rare form of monozygotic and monoamniotic twins. Fetal prognosis is very poor and, if the diagnosis is made early, it most often requires therapeutic abortion. We here report a case of three-hour old thoracopagus conjoined twins who were born vaginally, at term, at 40 weeks + 3 days. They were born to non-consanguineous parents, without any significant pathological history. Their mother was young and primiparous. She received 5 antenatal visits and 3 obstetric ultrasounds were performed by an inexperienced physician. The diagnosis of thoracopages twins was suspected based on clinical examination and computerized tomography (CT) results. This test showed cardiovascular abnormalities incompatible with life. The twins died after 23 hours of age due to acute respiratory distress. Conjoined twins are a rare congenital abnormality. Early diagnosis based on ultrasound would help to determine common anatomical structures, investigate associated congenital abnormalities, schedule delivery in a suitable structure and multidisciplinary neonatal management.

[Assessment of vaccination status and booster vaccinations in adolescents attending school in Libreville, Gabon]. / Evaluation du statut vaccinal et des rappels vaccinaux chez les adolescents scolarisés à Libreville, au Gabon.

INTRODUCTION: Vaccination is targeted to selected adolescents and their vaccination status is little known. The purpose of this study is to assess the vaccination status and to identify factors associated with vaccination compliance in adolescents attending school in Libreville. METHODS: A cross sectional observational descriptive survey was conducted among students attending grades 6 at the Leon Mba high school in Libreville. RESULTS: In total, 304 students were included in the study. The average age of students was 11.60±1.20 years and sex ratio was 0.6. Two hundred and sixty-six children (87.5%) lived with their parent (father and/or mother). The average number of children per family was 4. Immunization coverage rate was 78.3%. The number of children per family was not associated with vaccine coverage of Expanded Program on Immunization (EPI) vaccines (p=0.088) while children living with at least one of their parents had a better immunization coverage for EPI vaccines (p=0.025) and vaccines outside EPI (p=0.035) respectively. Factors reported by parents to explain reasons for non-vaccination were the lack of information (30.59%), forgetfulness (24.67%) and the lack of financial resources (12.82%). CONCLUSION: Vaccination coverage for adolescents attending school in Libreville appears to be relatively close to the goals of EPI, but it is still associated with family situation. Other awareness campaigns would be useful to improve vaccination coverage in Gabon.