Epidemiological, clinical, and treatment-related features of children with cerebral palsy in Cameroon: A hospital-based study.

BACKGROUND: Pediatric cerebral palsy (CP) remains a poorly studied public health problem in sub-Saharan Africa, especially in Cameroon. This study aimed at determining the epidemiological, clinical, and treatment-related characteristics of CP in Cameroonian children. METHODS: A cross-sectional study was conducted at the pediatric department of the Douala Gynaeco-Obstetric and Pediatric Hospital (DGOPH). Medical records of children attending the department during the study period were reviewed. Only medical records of children aged from 3 months to 15 years and diagnosed with CP were included. Parents/guardians of children presenting with CP were contacted and invited to come with their children to the DGOPH where they were examined by a pediatric neurologist. A questionnaire designed for the study was used to collect sociodemographic, clinical, paraclinical, and treatment data for each child. RESULTS: Out of the 4064 medical records reviewed, CP was diagnosed in 198 children (4.86%). These children were predominantly male (53.6%), aged 3-24 months (54.0%). Perinatal disorders were the main CP etiologies, especially neonatal asphyxia (55.1%), jaundice (32.8%), and neonatal infections (25.8%). Most of the children were born at term (81.6%) and by vaginal delivery (62.6%), with a normal birth weight (83.2%). Several comorbidities were found including speech delay (74.2%) and epilepsy (34.4%). The patients with CP presented predominantly with the spastic form of the disease, especially spastic quadriplegia (44.3%). Less than half of the children were managed at hospital, while the majority of parents were following various traditional treatments. CONCLUSION: Addressing preventable causes of CP and improving awareness in the population will be of great help to reduce CP in Cameroon.

Impact and projections of the COVID-19 epidemic on attendance and routine vaccinations at a pediatric referral hospital in Cameroon.

BACKGROUND: At the beginning of March 2020, Cameroon experienced its first cases of infection with the new coronavirus (SARS-COV-2). Very quickly, there was a drop in the rate of hospital attendance. The purpose of this study was to observe the variations in the uptake of pediatric consultations and vaccinations in a pediatric hospital. METHODS: A descriptive and retrospective cross-sectional study was carried out using consultation and vaccination statistics from a pediatric hospital in the city of Yaoundé, political capital of Cameroon, from January 2016 to May 2020. Data were entered in Microsoft Excel and exported to R software (Version 3.3.3) for statistical analysis. First, time series raw data (before and after COVID-19) were plotted and the trend estimated by locally weighted scatterplot smoothing (LOWESS) methods. Then a classic seasonal decomposition was performed to distinguish between seasonal trends and irregular components using moving averages. The Webel-Ollech overall seasonality test (WO test) was also run to formally check for seasonality. The results of the study are presented as narrative tables and graphs. RESULTS: Following the partial confinement recommended by the government of Cameroon, the number of pediatric consultations decreased by 52% in April and by 34% in May 2020 compared with rates during the same periods in 2019 (P=0.00001). For antenatal visits, the rates dropped by 45% and 34%, respectively, in April and May 2020 compared with 2019. The demand for immunization services also declined. As a result, the demand for BCG vaccines, third-dose tracer vaccines (diphtheria, tetanus, pertussis), polio, and MMR in children as well as tetanus vaccines in childbearing women dropped significantly. CONCLUSION: The start of the COVID-19 pandemic was accompanied by a significant drop in consultation and vaccination activities. If no action is taken to correct this phenomenon, the ensuing months could be marked by a considerable increase in patients, sometimes suffering from vaccine-preventable diseases. The death rate could increase considerably in the pediatric population.

Impact of the COVID-19 pandemic on pediatricians' clinical activity in Cameroon.

BACKGROUND: The outbreak of COVID-19 has imposed many challenges on health systems. The purpose of this study was to describe the impact of the COVID-19 pandemic on the clinical activity of pediatricians. METHODS: We conducted a cross-sectional and descriptive online survey among pediatricians practicing in Cameroon. Data were collected through an anonymous pre-tested Google Form®. RESULTS: Among the 118 pediatricians eligible for the survey, 101 responded (85.6%), of whom 61.2% were women. The pediatric outpatient consultations dropped significantly from 60.4% of pediatricians seeing more than 30 patients per week before the pandemic to 9.9% during the pandemic (P<0.000). According to the occupancy rate of hospitalisation beds, 45.5% of pediatricians reported having 76-100% of pediatric hospitalisation beds occupied per week before the pandemic but no pediatrician reported a similar rate during the pandemic (P<0.000). There was a significant increase in the use of telehealth, ranging from no pediatrician using telehealth "very frequently" before the pandemic to 23.8% using it during the pandemic (P<0.000). Most of the pediatricians had at their disposal surgical masks (96%), care gloves (80.2%), hydroalcoholic gel (99.0%), and soap and water (86.1%). For the management of children, 90.1% and 71.3% of pediatricians experienced difficulties accessing COVID-19 PCR and chloroquine, respectively, and 74.3% declared difficulties for proper isolation of patients. More than half (65.3%) of the pediatricians interviewed were "very afraid" or "extremely afraid" of being infected with SARS-Cov-2, respectively 45.5% and 19.8%. The most frequent reasons included fear of infecting their relatives (85.1%) and of developing a severe form of the disease (43.6%). The reluctance to consult health services expressed by the parents was due to: fear of being infected when leaving their home and especially in the health facility (96%), strict compliance with confinement (30.7%), and financial difficulties of families (13.9%). CONCLUSION: This work highlights the impact of the coronavirus pandemic on the clinical activity of Cameroonian pediatricians. Since the beginning of the pandemic, there has been a significant drop in the use of health facilities, which probably has a negative impact on children's overall level of health. Although the preventive measures explain this drop in attendance at health facilities, the parents' fear of being infected when leaving the house was the predominant reason likely to explain this drop in attendance at health facilities. This could constitute an axis for developing messages to parents to encourage a gradual return to child health services.

[Epidemiological, clinical and therapeutic features of pediatric ocular injuries in an eye emergency unit in Île-de-France]. / Aspects épidémiologiques cliniques et thérapeutiques des traumatismes oculaires de l'enfant dans un service d'urgences ophtalmologiques en Île-de-France.

INTRODUCTION: Ocular and orbital trauma is a leading cause of acquired monocular blindness in childhood. These injuries differ from those in adults in some aspects of the management and prognosis, notably the risk of amblyopia. The goal of this study was to analyze the epidemiological, clinical and therapeutic features of ocular trauma in children who consulted in an eye emergency department in Île-de-France. PATIENTS AND METHODS: This was a descriptive, prospective and longitudinal study. Over a period of 6 months, we included children aged 15 years old or less, who consulted during calls for ocular trauma. Each child received an ophthalmologic examination as complete as his or her condition and cooperation permitted. Mechanical injuries of the eyeball and chemical ocular burns were distributed respectively according to the Birmingham Eye Trauma Terminology and Dua's classification. The visual prognosis was defined as the best corrected visual acuity of the affected eye, measured at the conclusion of treatment. RESULTS: Among 586 children who consulted during the study period, 265 suffered from ocular trauma (45.22%). The male:female ratio was 1.6:1. The main places of occurrence of the injuries were home (64.15%) and school (18.11%). Injuries from finger nail scratch were the most frequent (12.45%). One hundred and fifty-seven patients consulted within 6 hours (59.19%). The cornea was the predominant site of the injury (44.40%). Mechanical injuries of the eyeball accounted for 75% of cases. The incidence of ocular chemical burns was 6.41%. Eyelid and orbital injuries were observed in 22.26% and 2.26% of cases respectively. Surgical treatment was required in 6.79% of cases. The incidence of hospitalization was 3.02% with a mean length of stay of 3 days. Four children developed sequelae, including 2 corneal scars and 2 cataracts. No case of blindness was recorded. DISCUSSION: The high frequency of traumatic ocular and orbital pathology in our study may be due to its sudden and accidental onset, leading parents to seek emergency care. Most injuries occurred at home and at school, which reflects the presence in these places of potential hazards, often unrealized or neglected. The low frequency of open-globe injury may be related to the ubiquitous recruitment. Indeed, in studies including only severe trauma, this rate may reach 73.4%. This clinical presentation is associated with a poor prognosis because of the risk of infection and sequelae causing decreased visual acuity and amblyopia. Few children were hospitalized. This could be explained by the predominance of mild to moderate trauma. CONCLUSION: Ocular trauma accounts for nearly half of pediatric conditions encountered in the eye emergency unit. Adequate emergency care improves the visual prognosis.

Profil bacteriologique et de sensibilite aux antibiothiques dans les septicemies neonatales a l'hopital gyneco-obsetetrique et pediatrique de Yaounde

Les septicemies neonatales representaient 25des causes de mortalite neonatalite au Cameroun en 2004 .Ce travail a pour but de decrier le profile bacteriologique des septicemies neonatales ainsi que la sensibilite des germes cultives aux antibiotiques usuels. Soixante hemocultures ont pousse chez des nouveau-nes ages de 0 a 28 jours .Les germes retrouves se repartissent comme suite 39 enterobacteries (65); 12 staphylocoques (20) et 9 streptocoques (15).Au sein des enterobacteries; klebsiella pneumonie represente 27; Enterobacter cloacae 20; et Escherichia coli 13.Soixante sept pour cent des staphylocoques trouvent sont presentes chez les nouveau- nes age au moins de 7 jours. Concernant la sensibilite de ces germes aux antibiotiques jusque la utilises dans notre hopital ; nous avons constate une forte resistance des enterobacteries aux cephalosporines de troisieme generation; atteignent 77pour les cefotaximes et la ceftazadime. Ces enterobacteries restent sensibles a l'imipeneme dans 61des cas Les steaoptocoques sont sensibles a l'ampicilline et a la ceftriaxone dans 67des cas et la gentamicine est active sur 58des souches de staphylocoques. Ces resultats suggerent que l'antibiotherapie de premiere intention jusque la utilisee et comportant l'association de l'ampicilline avec une cephalosporine de troisieme generation et un aminoside ne presente plus une efficacite optimale .Cependant ; en raison du cout eleve de l'imipeneme dans notre contexte ; cette molecule pourrait etre reservee en premiere intention aux infections neonatales severes