Malnutrition: prevalence and risk factors among the children younger than five years in a semi-urban area of Abidjan.

INTRODUCTION: In Côte d'Ivoire, the prevalence of malnutrition among children younger than 5 years exceeded 5% in 2011 and was thus considered serious. This overall prevalence may nonetheless mask differences and specificities between regions and municipalities. This study sought to determine the prevalence and risk factors of malnutrition among children in this age group in a semi-urban area of Abidjan. METHODS: This exhaustive, descriptive, cross-sectional survey took place from May 6 to July 31, 2010. The children's nutritional status was determined according to the WHO criteria. Univariate and multivariate analysis of factors associated with malnutrition (social and demographic characteristics, immunization status, children's eating practices, and household characteristics) were studied. RESULTS: We visited 668 households and recruited 809 children. The prevalence of malnutrition was 22.5%. Multivariate analysis showed that the introduction of porridge after 6 months halved the risk of malnutrition. Risk tripled for children whose father's occupation did not guarantee a regular income. CONCLUSION: Among the factors highlighted by this study, dietary practices seem the most amenable to corrective action. For example, the adoption of outreach programs by the Maternal and Child Protection services could improve nutritional practices in households.

[Complete immunization coverage and reasons for non-vaccination in a periurban area of Abidjan]. / Couverture vaccinale complete des enfants de 12 a 59 mois et raisons de non-vaccination en milieu periurbain abidjanais en 2010.

An immunization coverage survey was conducted among children aged 12-59 months in a suburban neighbourhood in Abidjan. The objective was to determine the complete immunization coverage, the reasons for non-vaccination and factors influencing the immunization status of children. The method of exhaustive sampling enabled us to interview the mothers of 669 children using a questionnaire. Overall vaccination coverage was 68.6% with 1.2%, with 1.2% of children never having received vaccine. The logistic regression analysis showed that the level of education, knowledge of the immunization schedule and the marital status of mothers, as well as the type of habitat, were associated with full immunization of children. These determinants must be taken into account to improve vaccination coverage.

Ambulatory Monitoring of Preterm Infant During Their First Year of Life at the Pediatric Deparment of Cocody Teaching Hospital. / Suivi Ambulatoire Du Premature La Premiere Annee De Vie Au Service De Pediatrie Du CHU Du Cocody.

The prematurity remains in our developing countries a problem of current events. The deficiency in human resources and the low level of the technical equipment exposes premature babies to a high risk of morbidity and mortality in neonatal period. Those who survive need a closer follow-up after their discharge from hospital. Our objective through this study was to appreciate the quality of following-up premature babies in ambulatory. It was a longitudinal study with descriptive aim which took place from January, 2007 till December, 2008 in the paediatric service of the Teaching Hospital of Cocody. Our population was constituted by 100 premature babies selected in a random way. The premature babies had on average 31,7 weeks of gestationel age. The sex ratio was 0,96. The born weight was between 900 and 2550g. The main causes of prematurity were multiple pregnancies (18 %), malaria (15 %), premature break of membranes (12 %) and éclampsia (10 %). Most of premature babies were hospitalized for a problem of breeding ( 47 %.). The average number of consultation was 6,25. Only 25 children were effectively followed during 12 months with a middleweight of 9112g. The follow-up had been interrupted before 3 months of native age in 31 % of cases and before 3 months of real age in 52 % of cases. The mothers had preferred the feeding in 48 % of cases, but the curves of weight development were superposables whatever the type of food supply. The pathology during the follow-up was dominated by digestive disorders, respiratory infections and anaemia. Forty percent of the premature babies was able to have an haemoglobin test and 8 %, a neuroradiological scraeming. A third of the premature babies (30 %) had been hospitalized again for anaemia (10 %) and respiratory infections (10 %). We recorded 3 deaths. CONCLUSION: The follow-up of premature babies getting out of hospital remains difficult in our context of life. The mothers must be sensitived on the consequences of prematurity and the importance of their follow-up. This follow-up has to be the affair of all, as well parents, health workers that government.

Les infections urinaires neonatales a Abidjan : problematique de la resistance bacterienne

Les infections neonatales sont frequentes avec un taux de letalite de 20 a 70dans les pays en voie de developpement. Parmi ces infections neonatales; l'infection urinaire peut etre grave chez le nouveaune car elle met en jeu aussi bien le pronostic renal; avec l'atrophie ou l'insuffisance renale en l'absence de traitement adequat; que le pronostic vital. Le diagnostic de l'infection urinaire repose sur l'examen cytobacte-riologique des urines. Mais il est rarement effectue a cause de la pauperisation de nos populations. Le but de cette etude etait d'identifier les germes responsables des infections urinaires chez le nouveau-ne afin d'adapter le traitement. Patients et methodes : De juillet a decembre 2004; 720 nouveau-nes hospitalises en neonatalogie au service de pediatrie pour infection neonatale ont fait l'objet de prelevements d'urines en vue d'examen cytobacteriologique. Resultats La culture bacterienne a ete positive pour 136 echantillons soit 18;. Concernant les etiologies des infections urinaires; les bacilles a Gram negatif de la famille des Enterobacteriaceae etaient predominantes avec 77;5contre 26;5pour les cocci a Gram positif Streptococcus et Staphylococcus. La frequence d'isolement dans l'ordre decroissant des enterobacteries etait la suivante : Escherichia coli; Klebsiella; Enterobacter et Levinea avec respectivement 32; 28; 28et 12. Les taux de resistance globale des enterobacteries aux antibiotiques usuels variaient de 66;7a 85;7pour l'amoxicilline associee a l'acide clavulanique ; de 25a 66;7pour la ceftriaxone ; et de 0 a 33;3pour l'amikacine

Traitement de l'acces palustre a plasmodium falciparum par Artemether

Quarante cinq patients (31 enfants et 14 adultes); hospitalises pour un acces palustre a plasmodium falciparum; ont ete traites par Artemether (Paluther). La gravite des acces palustres a ete appreciee selon les criteres recommandes par l'OMS. Quinze enfants et cinq adultes presentaient un acces palustre grave (six acces pernicieux stricto sensu chez les adultes). L'Artemether a ete administre; en deux injections quotidiennes; a la posologie de 3;3 mg/kg le premier jour et 1;6 mg/kg les jours suivants chez les enfants et 160 mg/24 h chez les adultes. Ce traitement a permis la guerison de tous les adultes et de 26 enfants evaluables sept jour apres le debut du traitement. Ces resultats confirment l'efficacite et la rapidite d'action de l'Artemether dans le traitement des acces palustres a plasmodium falciparum; quelles que soient leur gravite et la sensibilite de la souche vis-a-vis des antipaludiques disponibles

[Suppurative meningitis in the newborn infant: experience with 107 cases in the Ivory Coast]. / Les méningites purulentes du nouveau-né: expérience à partir de 107 cas en Côte d'Ivoire.

A retrospective study of 107 neonates with meningitis showed that in 45% of cases the condition occurred during the first 48 hours after birth, probably following a materno-foetal infection. Male neonates accounted for 70% of the cases. In 15% of cases, the mothers previously had a known infectious disease and 55% of cases came from an unfavourable socio-economic environment. Over 50% of the infants had to be resuscitated at birth. The majority of organisms isolated were Gram-negative bacteria or Enterobacteriaceae; the commonest organism was Haemophilus influenzae. The most effective specific treatment (91% favourable results) was intravenous amoxycillin plus intramuscular gentamicin. It is recommended that the newborn infant of parents living in unfavourable socio-economic circumstances should receive careful follow-up during the first week after birth so that the diagnosis of bacterial meningitis can be made at the start of infection. The neonate should receive effective prophylactic antibiotic cover if resuscitated, if the mother has suffered from an infectious disease during pregnancy or if premature rupture of the membranes has occurred.