Profil lipidique associé à l'obésité chez les adolescents à Brazzaville, Congo / Lipid profile among obese adolescents in Brazzaville, Congo

Contexte & objectif. Les modifications lipidiques chez les enfants obèses en Afrique noire sont peu documentées. Les objectifs de la présente étude étaient de déterminer chez les adolescents obèses le profil lipidique, et analyser les associations entre quelques paramètres anthropométriques et lipidiques. Méthodes. L'étude transversale a été réalisée à Brazzaville auprès de 82 adolescents âgés de 11 à 18 ans, répartis en 45 sujets obèses, 17 en état de surpoids et 20 poids normal. Des mesures de la taille, du poids, du tour de taille, des plis cutanés sous-scapulaire et tricipital ont été effectuées. Des prélèvements sanguins ont permis de déterminer les concentrations en cholestérol total, cholestérol-LDL, cholestérol-HDL et triglycérides. Résultats. Les concentrations lipidiques notées chez les adolescents obèses étaient significativement supérieures à celles des sujets de poids normal : cholestérol total, 1,70 vs 1,59g/L ; cholestérol-LDL, 1,03 vs 0,88g/L ; triglycérides, 1,18 vs 0,86. Par contre, celles du cholestérol-HDL étaient significativement inférieures : 0,42 vs 0,51g/L. Une corrélation positive a été retrouvée entre le rapport tour de taille/taille et le cholestérol-HDL (r=0,75 ; p=0,031). Conclusion. Nos résultats soulignent la nécessité de renforcer la prise en charge des enfants obèses afin de prévenir les facteurs de risque potentiels des maladies cardiovasculaires à l'âge adulte

Psychosocial functioning and health related quality of life in children, adolescents and young adults with type 1 diabetes mellitus in Congo.

OBJECTIVES: To describe the psychosocial functioning and assess the quality of life of children, adolescents and young adults with T1DM; and to identify the risk factors associated with the psychosocial experience and quality of life of these patients. MATERIAL AND METHODS: A cross-sectional, descriptive study of children, adolescents and young adults with type 1 diabetes. Symptoms of anxiety and depression, and the quality of life were assessed using the Beck's Anxiety and Depression Scales and the pedsQL diabetes module score respectively. RESULTS: A total of 74 patients were recruited. The mean age was 18 ± 4.1 years. Minimal symptoms of anxiety were noted in 51 (69%) patients, 23 (31%) had non-minimal symptoms of anxiety (mild:14, moderate: 5, severe: 4). Symptoms of depression were absent in 43 (58.1%) patients and present in 31 (41.9%) patients (mild: 19, moderate: 12). The patients total score of quality of life was 65.4. Higher socioeconomic status (p = 0.03) was a protective factor against Symptoms of anxiety, while the age above 14 years (p = 0.01) was a risk factor for symptoms of depression. The quality of life was lower in patients from low socio-economic status (p = 0.01), those with poor glycemic control (p = 0.03), and when symptoms of depression were present (p = 0.02). CONCLUSIONS: Patients with type 1 diabetes in Congo experienced a significant elevated symptoms of anxiety and depression, and a fairly good quality of life. These findings support recommendations for integrating psychosocial aspects in the management of these patients.

Ingestions de caustiques chez l'enfant à Brazzaville, Congo

Contexte et objectif. Les ingestions de caustiques chez l?enfant sont préoccupantes en raison de l?augmentation de leur fréquence et des difficultés inhérentes à leur prise en charge. L?objectif du présent travail était de décrire le profil clinique, épidémiologique et évolutif des enfants avec lésions caustiques.Méthodes. Il s?est agi d?une étude transversale, réalisée entre les 1er janvier 2014 et 31 décembre 2015, dans les services de Pédiatrie du CHU et les centres d?endoscopie digestive de Brazzaville. Tous les enfants ayant ingéré un produit caustique et hospitalisé pendant la période d?étude ont été inclus après l?obtention du consentement du parent et/ou tuteur légal. Les paramètres étudiés ont été : l?âge, le sexe, la nature et la quantité du produit ingéré, l?attitude de l?entourage de l?intoxiqué, les signes cliniques, les résultats endoscopiques selon la classification de Zargar, les modalités thérapeutiques et évolutives.Résultats. Sur 8292 enfants hospitalisés pendant la période étudiée, 68 avaient ingéré un caustique, soit une fréquence hospitalière de 0,8 %. Leur âge moyen était de 23,6 mois (extrêmes de 2 mois et 16 ans). Le sexe masculin était prédominant (57,4%). L?ingestion était accidentelle dans 88,2% des cas et volontaire dans 11,8% des cas. Les facteurs favorisants l?ingestion étaient fréquemment le mode de stockage du caustique (81,5%) et l?inattention ou négligence du tuteur (10,8%). L?eau de Javel était le caustique le plus incriminé : 37 cas (54,4%), suivi de la soude caustique 20 cas (29,4%). La quantité estimative ingérée était supposée minime dans 61,7% des cas. Des gestes inadaptés ont été pratiqués, par l?entourage avant la consultation médicale chez 45 enfants (66,1%). Les symptômes dominants étaient digestifs (47%) ou neurologiques (25%). Le délai moyen de réalisation de l?endoscopie était de 48 heures chez 60 enfants (88,2%). L?endoscopie avait mise en évidence des lésions dans 51,7% des cas au stade I (12 cas), stade II (16 cas) et stade III (3 cas). Les facteurs de gravité des lésions caustiques étaient les gestes inadéquats dans 85% des cas et le non-respect du jeûne dans 9%. Les Inhibiteurs de la pompe à protons (IPP) étaient administrés dans 50% des cas. L?évolution était favorable dans 73,5% des cas.Conclusion. Les lésions caustiques rendent compte de près d?un percent d?admissions infantiles hospitalières. Elles sont le plus souvent accidentelles, favorisées par le mode de conditionnement des produits caustiques dans des flacons d?eau minérale et stockés dans des endroits non appropriés. La prévention consiste à l?éducation des populations pour éviter la survenue de ces accidents

Knowledge, Attitudes, and Practices of Parents Facing Child and Adolescent Obesity in Brazzaville, Congo.

The study aimed to assess obesity-related knowledge, attitudes, and practices of parents when facing child and adolescent obesity in order to improve the quality of care. A case-control study was conducted from February 1 to July 1, 2013. The study compared parents of obese school children (group 1 or cases; n = 254) and those school children without obesity (group 2 or controls; n = 254). These children were drawn from public and private primary schools of Brazzaville (Congo). Obesity-related knowledge was satisfactory in 83.5% of the cases, attitudes were correct in 29% of the cases, and the practices good in 25.6% of the cases. The parents' obesity-related knowledge was satisfactory when the socioeconomic level of the family was high (P < .02), the mothers' educational level greater than primary (P < .001), and the fathers' educational level was greater than primary (P < 10-4). The same observation was obtained with obesity-related attitudes and practices of the parents when correct. This influence remained after the adaptation of fathers' educational level. In conclusion, the disease-related knowledge of parents can be considered satisfactory in the majority of the cases; however, obesity-related attitudes and practices remain incorrect in most of the cases.

Study of 9 Cases of Tuberculosis Pneumonia in Children at Chu of Brazzaville, Congo.

In the Republic of Congo, a country where tuberculosis is endemic, there have not been many reports about tuberculosis pneumonia. This study aimed to describe the epidemiology, clinical features, and outcome of tuberculosis pneumonia in children. This was a retrospective study of 9 cases of children admitted from 2002 to 2015, that is, 0.7 cases per year. The average age was 37 months. The mean delay from the beginning of symptoms to the visit to a medical center was 36 days (range = 4-93 days). Physical examination indicated a pulmonary consolidation in 6 cases. Chest X-ray revealed a unilateral opacity in all cases. Sputum and gastric washing bacilloscopies were positive in all cases, and HIV serology was positive in 2 cases. Therapeutic observance was perfect and the evolution favorable. Tuberculosis pneumonia must be systematically proposed for children under 5 years of age, who present symptoms that are in contrast with the seriousness of chest X-ray injuries.

Prehypertension and Hypertension among Schoolchildren in Brazzaville, Congo.

Background. To determine the prevalence and associated factors of prehypertension (pre-HT) and hypertension (HT) in schoolchildren at Brazzaville (Congo). Methods. This cross-sectional study was conducted from March to May 2011 in five representative urban schools in Brazzaville. American Pediatric Society's definition of pre-HT and HT was used. The measurement of blood pressure was obtained using auscultator method. Univariable and multivariable analyses were performed to establish associations between blood pressure levels and sociobiographical factors. Results. 603 children were included. The mean age was 11.8 ± 3.6 years (range 5-18 years). The prevalence of pre-HT was 20.7% (n = 125). Factors associated with pre-HT were secondary school (P = 0.02), private schools (P < 0.004), migrants (P = 0.03), the obese (P = 0.004), high socioeconomic level (P < 0.01), and overweight (P = 0.02). In logistic regression, the independent determinants of pre-HT were secondary school (P = 0.0001), migration (P = 0.04), obesity (P = 0.004), and overweight (P = 0.01). The prevalence of HT was 10.1% (n = 61) during the first screening and 3.3% (n = 20) in second screening. The independent determinants of HT were obesity (P = 0.0001) and overweight (P = 0.0001). Conclusion. Pre-HT and HT are emerging as a mass problem in Congolese schoolchildren with urban migration and overweight/obesity to be controlled and prevented.

[Alcohol consumption among teenagers in Brazzaville (Congo)]. / Consommation de l'alcool chez l'adolescent à Brazzaville (Congo).

The objectives of the present paper are to assess the frequency of alcohol use among Congolese teenagers and to identify the epidemiological factors linked with problem drinking. A cross-sectional survey, conducted throughout Brazzaville (Congo), targeted a representative sample of 4315 adolescents (1984 girls and 2334 boys), aged 10 to 19 years. Physicians from outside the area (to optimize confidentiality) interviewed the subjects according to a questionnaire that included both open and closed questions. Overall, 984 teenagers (22.8%) were alcohol users. This frequency was higher among boys than girls, but not significantly. It was also higher among older teenagers (those aged 15-19 years compared with those aged 10-14 years, p < 0.001), those no longer attending school (compared with those still in school, p < 0.01), and those with no religious beliefs (p < 0.001). In addition, alcohol use was less prevalent among those living with their parents than among orphans (p < 0.001). Most subjects were moderate users, and the most common alcoholic beverage for both boys and girls was beer (95.4%). Episodes of drunkenness concerned more boys (49.2%) than girls (11.9%). Our results show the value of epidemiological investigations for planning prevention programs and the need for such programs among these adolescents to prevent excess drinking and the numerous health problems associated with it.