Neonatal mortality in a referral hospital in Cameroon over a seven year period: trends, associated factors and causes.

BACKGROUND: The fourth Millennium Development Goals targets reduction of the mortality rate of under-fives by 2/3 by the year 2015. This reduction starts with that of neonatal mortality representing 40% of childhood mortality. In Cameroon neonatal mortality was 31% in 2011. OBJECTIVES: We assessed the trends, associated factors and causes of neonatal deaths at the Yaounde Gynaeco-Obstetric and Pediatric Hospital. METHODS: The study was a retrospective chart review. Data was collected from the hospital records, and included both maternal and neonatal variables from 1(st) January 2004 to 31(st) December 2010. RESULTS: The neonatal mortality was 10%. Out-borns represented 49.3% of the deceased neonates with 11.3% born at home. The neonatal mortality rate followed a downward trend dropping from 12.4% in 2004 to 7.2% in 2010. The major causes of deaths were: neonatal sepsis (37.85%), prematurity (31.26%), birth asphyxia (16%), and congenital malformations (10.54%). Most (74.2%) of the deaths occurred within the first week with 35% occurring within 24 hours of life. Mortality was higher in neonates with birth weight less than 2500 g and a gestational age of less than 37 weeks. In the mothers, it was high in single parenthood, primiparous and in housewives and students.. CONCLUSION: There has been a steady decline of neonatal mortality since 2004. Neonatal sepsis, prematurity, birth asphyxia and congenital malformations were the major causes of neonatal deaths. Neonatal sepsis remained constant although at lower rates over the study period.

[Factors associated with the survival of very low birth weight neonates at the Yaounde gynaeco-obstetric and pediatric hospital, Cameroon]. / Facteurs associés à la survie des nouveau-nés de très faible poids de naissance à l'hôpital gynéco-obstétrique et pédiatrique de Yaoundé, Cameroun.

OBJECTIVES: The rate of survival of very low birth weight neonates (less than 1500 g) is still low in most developing countries, such as Cameroon. The aim of this study was to assess the maternal and neonatal factors that can influence the survival of neonates with birth weights under 1500 g. MATERIAL AND METHODS: This was a retrospective, descriptive, and analytic study of 397 neonates weighing less than 1500 g who were admitted to the Yaounde gynaeco-obstetric and pediatric hospital from May 2003 to December 2011. The chi-squared test and the odds ratio were used to identify risk factors for death. The threshold of significance was P<0.05. RESULTS: The overall survival rate was 26.5%. The main comorbidities were prematurity (99%), neonatal sepsis (36%), and intrauterine growth retardation (27.2%). The factors that statistically influenced outcome were: parity, birth weight, gestational age, the 5th-min Apgar score, advanced resuscitation at birth, and respiratory distress. CONCLUSION: The survival of neonates weighing less than 1500 g depends on several factors, which if acted upon could improve the survival rate.

[Pasteurella multocida meningitis with cerebral abscesses]. / Méningite à Pasteurella multocida compliquée d'abcès cérébral.

Pasteurella multocida is classically responsible for local soft tissue infections secondary to dog bites or cat scratches. It can be responsible for meningitis in infants and elderly persons. We report the case history of a 5-year-old male child admitted to our pediatric unit for meningitis. Cerebrospinal fluid analysis revealed an infection with P. multocida. The suspected mode of contamination was either from the saliva of a pet dog or through an unnoticed skull fracture sustained after an accident 1 year prior to the occurrence of meningitis. In spite of the neurologic complication (cerebral abscess), the progression was favorable after drainage of the abscess, 5 weeks of parenteral treatment, and 3 weeks of oral antibiotic therapy. Meningitis due to Pasteurella sp. is rare and can lead to neurologic complications. The notion of bites or scratches can be absent and the mode of contamination is sometimes difficult to unveil.

[Clinical and etiological aspects of focal epilepsy in children at Yaoundé Gynaeco-obstetric Hospital (Cameroon)]. / Aspects cliniques et etiologiques de l'epilepsie focale de l'enfant a l'hopital Gyneco-obstetrique et pediatrique de Yaounde (Cameroun).

OBJECTIVE: To describe the clinical and etiological aspects of child focal epilepsy at Yaoundé Gynaeco-Obstetric and Pediatric Hospital (YGOPH) in Cameroon. PATIENTS AND METHODS: It was a cross-sectional descriptive study carried out in pediatric neurology and epileptology unit of YGOPH from October 1st 2011 to March 30th 2012. We included 218 patients aged 0-16 years with a diagnosis of focal epilepsy in whom an electroencephalogram (EEG) was performed. The studied variables were epidemiological, etiological factors, type of epilepsy, EEG abnormalities, abnormalities in brain CT-scan, and probable etiology. RESULTS: The sex ratio was 1.34 M/1F. The mean age of patients was 8 ± 4 years. In 58.71% (128/218) the onset of crises was before the age of five and decreased gradually until adolescence. The EEG showed an epileptic focus in 161 patients (73.85%). The main foci were centro-temporal (19.9%), frontal (19.2%), temporal (14.9%) and fronto-temporal (14.9%). The CT-scan was abnormal in 58 (56.86%) of 102 patients, who performed head CT-scan, with as major abnormalities, brain atrophy and after-effects lesions. Etiological factors were found in 76.15 % of patients, it was mainly neonatal asphyxia (21%), family history of epilepsy (20.6%) and febrile seizures (19.7%). Focal epilepsies were of structural (51.4%), genetic (24.3%) or unknown causes. Neurological abnormalities associated were more frequently in focal epilepsies of structural causes. CONCLUSION: The focal child epilepsies are mostly of structural causes and preferentially temporal and/or frontal in location. The main etiological factors are family history of epilepsy and neonatal asphyxia.

OBJECTIF: Décrire les caractéristiques cliniques et étiologiques de l'épilepsie focale de l'enfant à l'Hôpital Gynéco-obstétrique et pédiatrique de Yaoundé (HGOPY) au Cameroun. PATIENTS ET MÉTHODE: Il s'agissait d'une étude transversale descriptive réalisée dans l'unité de neuropédiatrie et d'épileptologie de HGOPY du 1er octobre 2011 au 30 mars 2012. Elle incluait 218 patients âgés de 0 à 16 ans ayant un diagnostic d'épilepsie focale et chez qui un électroencéphalogramme (EEG) avait été réalisé. Les variables étudiées étaient les données épidémiologiques, les facteurs étiologiques, le type d'épilepsie, les anomalies EEG, les anomalies au scanner cérébral, et l'étiologie probable. RÉSULTATS: Le sex-ratio était de 1,34M/1F. L'âge moyen des patients était de 8 ± 4 ans. Les crises débutaient dans 58,71% (128/218) avant l'âge de cinq ans et diminuaient progressivement jusqu'à l'adolescence. L'EEG révélait un foyer épileptique chez 161 patients (73,85%). Les principaux foyers étaient centro-temporal (19,9%), frontal (19,2%), temporal (14,9%) et fronto-temporal (14,9%). Le scanner était pathologique chez 58 (56,86%) des 102 patients ayant fait le scanner cérébral, avec pour principales anomalies l'atrophie cérébrale et les lésions séquellaires. Les facteurs étiologiques étaient retrouvés chez 76,15% des patients; ils s'agissaient principalement de l'asphyxie néonatale (21%), des antécédents familiaux d'épilepsie (20,6%) et des convulsions fébriles (19,7%). Les épilepsies focales étaient de causes structurelles (51,4%), génétiques (24,3%) ou inconnue. Les anomalies neurologiques associées étaient plus fréquentes dans les épilepsies focales de cause structurelle. CONCLUSION: Les épilepsies focales de l'enfant sont en majorité structurelles et préférentiellement temporales et/ou frontales. Les principaux facteurs étiologiques sont les antécédents familiaux d'épilepsie et l'asphyxie néonatale..

Breastfeeding Practices by Women Attending the Vaccination and Pediatric Out-Patient Clinics at the Yaounde Gynaeco-Obstetric and Pediatric Hospital Cameroon

Despite the well-known benefits of exclusive breastfeeding in sustaining infant well-being; breastfeeding rates still remain low in many countries. We aimed at investigating the practice and determinants of exclusive breastfeeding for the first six months of life in Cameroonian women. METHODS In this cross-sectional study; we interviewed a consecutive sample of 310 mothers at the Yaounde Gynaeco-Obstretic and Pediatric. The study was conducted from 1st September 2011 to 29th February 2012. Variables related to the practice of breastfeeding within the first 6months of life were assessed. Odds ratio was used to determine the predictive variables of exclusive breastfeeding for 6 months. RESULTS The reported rates of exclusive breastfeeding were 84.8 at birth and 23.5 at six months. Medical advice (49.3) and concern for the child's health (42.5) were the two main reasons for practicing exclusive breast-feeding for the first six months of life; while resumption of studies or work (38.4) and the belief that the newborn was not 'satisfied' (34.2) were the main reasons for introducing other foods. Most children (84.5) did not receive any foods first breastfeed. Breast milk substitutes were given to 70.5 of the babies. Most women (87.1) breastfed on demand; and breast pain was the main difficulty in 60.5 of the mothers. Being a housewife was positively associated with exclusive breast-feeding (OR:2.18; 95 CI: [1.25-3.81]; P= 0.005 ). CONCLUSION Exclusive breastfeeding in the first 6 months remains low in this setting. Sensitization and education of mothers during prenatal visits and routine consultations should be reinforced

Intracranial suppurations in the African child: a severe but preventable complication.

INTRODUCTION: Intracranial suppurations (ICS) are collections of pus of infectious origin in the skull. The authors present their experience. PATIENTS AND METHOD: All children operated for ICS at the Central Hospital of Yaoundé from January 2000 to December 2008 were retrospectively included. RESULTS: Thirty-five patients were recruited: 26 (74.29 %) males and 9 (25.71 %) females. These represent 82.9 % of all ICS operated in our institution. ICS represented 14.3 % of intracranial space-occupying lesions. The mean age was 8.34 years. They presented with headaches (80.77 %), altered consciousness (20 %), convulsions (76 %), vomiting (20 %), unilateral motor deficit (69.23 %), speech disorders (12 %), and fever (89.29 %). Bergman's triad (51.86 %) was frequent. The primary infection was: meningitis, eight cases (22.85 %); sinusitis, six cases (17.14 %); head trauma, five cases (14.28 %); otitis media, one case (2.85 %); suppurations of the face, three cases (8.56 %); cardiopathy, one case (2.85 %); and craniotomy, one case (2.85 %). In seven cases (20 %), the origin was unknown. The lesions were empyema in 23 cases (65.71 %), cerebral abscess in 8 cases (22.85 %) and pyoventriculitis in 2 cases (5.72 %). The surgical procedures were burr holes (88.89 % of empyemas) and trepano-puncture-aspiration (75 % of abscesses). The mortality (21.42 %) and morbidity (42.85 %) were recorded. CONCLUSION: ICS are frequent but preventable (early treatment of the primary infection) pathologies of childhood in developing countries. Burr hole drainage (empyemas) and puncture-aspiration (abscesses) are simple, safe, and effective techniques.

Bilateral intraorbital abscesses with intracranial complications in a young Cameroonian girl: a case report.

BACKGROUND: Intraorbital abscess is a very severe infection with ophthalmologic and neurologic complications that are sometimes life-threatening. OBJECTIVE: To report the etiologic, clinical, radiologic, and prognostic features of one case of bilateral intraorbital abscesses with intracranial complications. CASE REPORT: A 15-year-old Cameroonian girl in a comatose state (11/15 on the Glasgow Coma Scale) with meningeal signs, right hemiplegia, right facial palsy, and bilateral exophthalmia was admitted for meningitis and cerebral abscess secondary to orbital cellulitis. A lumbar tap was carried out, no organisms were seen by Gram stain, and culture was negative due to previous antibiotic therapy. A computed tomography scan showed a left internal capsule infarct and a pansinus opacification. Bilateral superior orbitotomies were performed and the abscess evacuated. Microscopy and culture of surgical material were negative. The patient was discharged 4 weeks after hospital admission with a visual acuity of 0.1 in both eyes, aphasia, and right hemiplegia. Nine months later, there was complete visual recovery (visual acuity 1.0 in both eyes). Anterior and posterior segments were normal on slit-lamp examination. There was no aphasia, but right-sided hemiparesis persisted. CONCLUSION: The authors emphasize the need for prevention, early diagnosis, and adequate treatment of orbital cellulitis in order to avoid complications.

[Clinical and CT-scan presentations in tuberous sclerosis complex: report of eight pediatric cases revealed by epilepsy]. / Aspects Cliniques Et Scanographiques De La Sclerose Tubereuse De Bourneville: à propos de huit cas pédiatriques révélés par une épilepsie.

OBJECTIVE: To describe the clinical and CT-scan features of the Tuberous sclerosis complex (TSC) revealed in children by epilepsy. PATIENTS AND METHOD: It was a cross sectional descriptive study carried out in the Yaounde Gyneco-Obstetric and Pediatric Hospital (YGOPH). Eight consecutive patients consulting for epilepsy between January 2005 and December 20010 with clinical and CT-scan diagnosis criteria of TSC were included in this study. RESULTS: There were two girls and six boys (aged 25months to 14years) with drug-resistant epilepsy and characteristics skin lesions of TSC (hypomelanotic macules, angiofibroma of Pringle, shagreen patches). The delay between the onset of epileptic crisis and the diagnosis of TSC varied from 10 months to 6years. One case of renal involvement and another of ophthalmic involvement were found. Cerebral CT-scan was abnormal for each patient with calcified sub-ependymal nodules in 100%, cortical tubers in 5 patients (62.5%) and one suspicion of giant sub-ependymal atrocytoma. CONCLUSION: Features of TSC are ruled by epilepsy, skin lesions, calcified sub-ependymal nodules and cortical tubers. Thus children presenting with epilepsy, should have a careful dermatological examination to search for TSC lesions. Cerebral CT-scan will afterwards seek for characteristic brain lesions.

Our experience in the management of infantile hydrocephalus: a study on thirty-five regrouped cases in Yaounde, Cameroon.

BACKGROUND: Hydrocephalus is a frequent central nervous system disorder in children, and despite its importance, it has not been sufficiently studied in developing countries. PATIENTS AND METHODS: A prospective and descriptive study on 35 cases of infantile hydrocephalus was carried out in the neurosurgery unit of the Yaounde Central Hospital, from March 2008 to January 2010. RESULTS: The mean age of the patients was 6.69±1.58 months, and the majority of them were in the 0-6 months age group (71.43%). The most frequent causes were congenital malformations, with stenosis of the aqueduct of Sylvius being the most represented (31.43%). As radiological workup, a CT scan was done in more than half of the cases (57.15%), and ventriculo-peritoneal shunting was the main surgical method of management used (94.29%). Infectious complications were observed in 22.86% of our cases. CONCLUSION: Hydrocephalus is a frequent disorder in this Cameroonian setting affecting mostly the 0-6 months age group. For early diagnosis to be made, the head circumference of neonates should be routinely measured in the labour room and followed-up in all medical visits. To avert complications following surgery, rigorous surgical procedures with effective asepsis and appropriate methods and materials for shunting should be used.

[Clinical, etiological, and therapeutic aspects of febrile convulsions. A review of 325 cases in Yaoundé]. / Aspects cliniques, étiologiques et thérapeutiques des convulsions fébriles. A propos de 325 cas à Yaoundé.

A prospective study of 325 children with febrile seizures was conducted in 2 hospitals in Yaoundé, from 15 January to 15 December 2008. The proportion of patients with febrile seizures among all admitted patients was 6.1%. The mean age was 24.6 months; the peak age of these patients was 12-17 months. The sex ratio was 1.5. The mean temperature on admission was 39.2 degrees C. There was a family history of febrile seizures in 36.4%. Simple febrile seizures were seen in 58.7% and the complex type in 41.3%. Malaria was the main etiology in 67.7%, followed by upper and lower respiratory tract infection in 14.1% and 9.8%, respectively. Lumbar puncture was performed in all patients. The commonest anticonvulsant used to stop seizures was rectal diazepam in 88%. Febrile seizure prophylaxis was administered to 43% of the patients; antipyretics were the most widely used, either alone or combined with rectal diazepam.

Clinical trial of beta-arteether versus quinine for the treatment of cerebral malaria in children in Yaounde, Cameroon.

One hundred and two children aged 0-10 years with cerebral malaria (Blantyre coma score of 2 or less) were randomly treated either with intramuscular arteether (3.2 mg/kg on Day 0, followed by 1.6 mg/kg on Days 1 to 4) or intravenous (i.v.) quinine dihydrochloride (20 mg of the salt/kg, followed by 10 mg of the salt/kg every 8 hr up to Day 6). Treatment with oral quinine sulfate (10 mg/kg every 8 hr) was substituted for i.v. quinine when the patient was able to take oral medicine. All patients were followed up in the hospital for 7 days; thereafter, they were treated as outpatients on Days 14, 21, and 28. Mortality rate, the main efficacy parameter, was 11.8% lower in the arteether treatment group than in the quinine group (15.7% versus 27.4%); however, the difference was not significant (P = 0.25). Means for fever clearance time, coma resolution time, and parasite clearance time were similar in the 2 treatment groups (42.2 +/- 34.9 hr; 34.8 +/- 18.8 hr, and 46.3 +/- 28.5 hr, respectively for arteether, versus 45.0 +/- 26.7 hr; 30.3 +/- 18.9 hr, and 40.7 +/- 18.9 hr, respectively, for quinine). At 28 days, the cure rates were 73.2% and 64.9% for the arteether and quinine treatment groups, respectively. Arteether is safe and therapeutically at least as effective as quinine for the treatment of cerebral malaria in children in Cameroon. Because of its ease of administration, arteether appears to be suited for use in the rural zones where monitoring facilities do not exist.

Influence of a past history of Gambian sleeping sickness on physical growth, sexual maturity and academic performance of children in Fontem, Cameroon.

Little has been published on the long-term complications of Gambian sleeping sickness (GSS) following treatment. A case-control study to compare physical growth, sexual maturity and academic performance of children with and without a past history of GSS was therefore conducted. The study took place over a period of 6 months, in the 10 villages of the Fontem GSS focus, which is known to be very endemic for the disease. Overall, 100 young subjects (aged 6-20 years) with a past history of GSS were pair-matched for age (+/- 5 months), sex, place of residence, and socio-economic and cultural backgrounds with 100 other, control subjects who had no history of GSS and who were sero-negative for GSS when checked with a card agglutination test (Testryp-CATT). On average, the cases weighed 4.25 kg less, were 3 cm shorter and had 1.15-cm smaller mid-upper-arm circumferences than the controls (P < 0.05 for each). The mean sexual-maturity rating of the two groups was similar but the controls tended to have attained puberty earlier than the cases. When the cases were subdivided into those treated with melarsoprol and those given pentamidine, only the melarsoprol-treated sub-group was significantly different from the corresponding controls in terms of physical growth and sexual maturity.

Prolonged dysphagia caused by congenital pharyngeal dysfunction.

We describe two patients with severe, isolated, congenital dysphagia caused by paralysis of the pharyngeal muscles, who recovered at the ages of 40 months and 20 months, respectively. No other evidence of neurologic or muscular dysfunction was present except for a transient paralysis of the adductors of the vocal cords in one child. Radiocinematographic studies showed paralysis of the pharyngeal stage of swallowing, with minimal involvement of the oral stage. One child refused oral feeding for several months after apparent radiologic recovery. Two other patients with a similar disorder died of tracheal aspiration at the ages of 8 months and 4 months, respectively. Autopsies showed no abnormality of the central nervous system, and the cranial nerves involved in swallowing were normal. Only five other well-studied cases of this syndrome have been reported. These observations demonstrate the existence of a type of severe, idiopathic, congenital dysphagia related to paralysis of the constrictor muscles of the pharynx, with a propensity to recover after several months or years if properly managed. The cause of the disorder is obscure, but it is probably related to a dysfunction of the central nervous system.

Approche etiologique des anemies severes de l'enfant a partir d'examens paracliniques simples

Les auteurs de ce texte ont eu pour objectif d'etudier l'apport de cinq examens complementaires simples; peu couteux; dans l'approche etiologique des anemies severes de l'enfant. 78 enfants ages de 1 mois a 5 ans ayant un taux d'hemoglobine inferieur a 8g/100ml ont eu une numeration sanguine; une numeration des reticulocytes; une goutte epaisse; une electrophorese de l'hemoglobine. 48 d'entre-eux ont eu un examen parasitologique des selles. Le taux moyen d'hemoglobine etait de 4;5g/100ml. 52 malades (66;7 pour cent) avaient une microcytose et/ou une hypochromie; faisant evoquer une carence martiale isolee ou associee a d'autres causes. 9 (11;5 pour cent) avaient une macrocytose; faisant suspecterune carence en acide folique. 49 (62;8 pour cent) avaient une goutte epaisse positive a Plasmodium falciparum. 51 malades (65;4 pour cent) presentaient un ou plusieurs signes cliniques en faveur d'une hemolyse. 3 enfants seulement sur 48 ayant produit des selles (6;2 pour cent) portaient des parasites intestinaux anemiants (2 cas d'ankylostomes; 1 cas d'entamoeba histolytica). 1 enfant etait drepanocytaire homozygote. Au total; ces anemies severes avaient des etiologies multifactorielles dominees par la carence martiale et l'hemolyse palustre

Accidents neurologiques de la vaccination anticoquelucheuse : a propos de 17 observations

Les sequelles neurologiques et les cas mortels representent tout le danger et la gravite de la vaccination anticoquelucheuse. De l'analyse de 17 observations; le traitement curatif des accidents neurologiques de cette vaccination ne peut etre que symptomatique alors que sa prevention reside dans le respect scrupuleux des contre-indications qui meritent d'etre enumerees: maladie infectieuse aigue; recente ou evolutive; les affections malignes; les cardiopathies decomposees; la nephropathie aigue; le traitement immuno-suppresseur; les antecedents personnels de souffrance aigue ou perinatale; de prematurite ou d'hypotrophie foetale; la survenue des convulsions et/ou d'autres signes neurologiques a la suite d'une vaccination anticoquelucheuse anterieure; les encephalopathies et la comitialite

Sequelles neurologiques des meningites bacteriennes chez le nourrisson et l'enfant a Yaounde

144 enfants ages de 1 mois a 14 ans ont ete hospitalises pour meningite bacterienne du 1er septembre 1992 au 31 juillet 1993. 43 sont decedes (29;86 pour cent) et 101 gueris ont fait l'objet d'une surveillance pluridisciplinaire (ORL; opthalmo; neuropediatrique) pendant une periode de 9 a 18 mois. 23;61 pour cent presentent des sequelles neurologiques: deficit auditif 25 pour cent; epilepsie 17;85 pour cent; deficit moteur 12;5 pour cent; trouble du comportement 10;71 pour cent; hydrocephalie 8;92 pour cent; cephalee 5;25 pour cent; trouble d'apprentissage scolaire 1;78 pour cent. La meningite purulente est la cinquieme cause d'hospitalisation et la troisieme cause de mortalite infantile a Yaounde. Les auteurs insistent sur la necessite de prendre en compte les facteurs de risques dans la prise en charge des meningites bacteriennes et la necessite d'une surveillance pluridisciplinaire

Morbidite hospitaliere; lesions echoencephalographiques; et etat neurologique d'une population d'anciens petits poids de naissance a la sortie d'hopital

Les auteurs ont etudie; chez 152 anciens petits poids de naissance au moment de leur sortie d'hopital; l'etat neurologique; les lesions echoencephalographiques; et les relations avec la morbidite hospitaliere. Leur poids de naissance moyen etait de 1 685 g; leur age gestationnel moyen de 33 semaines; et leur age corrige moyen de 37;3 semaines. 7 nouveau-nes etaient hypotrophes a terme (4;6 pour cent). 26 etaient prematures et hypotrophes (17;10 pour cent); 119 etaient prematures et eutrophiques (78;30 pour cent). La morbidite hospitaliere etaient dominee par les hypothermies et les infections. Les hemorragies cerebrales etaient les lesions echographiques les plus frequentes (6;23 pour cent). 15 enfants avaient un examen neurologique anormal (9;87 pour cent); dont 5 presentaient une lesion cerebrale a l'echographie. Toutes les lesions hemorragiques etaient survenues chez les prematures d'age gestationnel compris entre 29 et 34 semaines. L'existence d'une lesion cerebrale a l'echographie exposait 7 fois plus a un risque d'anomalie neurologique. En conclusion; de nombreuses pathologies peuvent etre prevenues. Le depistage echographique des lesions doit etre precoce

Aspects cliniques et etiologiques de l'epilepsie du nourrisson et de l'enfant a Yaounde

9392 enfants ages de 0-15 ans ont ete examines aux urgences et consultations de l'hopital central de Yaounde (Cameroun) pendant la periode d'etude. Sur la base des criteres essentiellement cliniques; 174 enfants presentent l'epilepsie qui represente 1;85 pour cent des affections pediatriques a Yaounde. Les convulsions febriles precedent l'epilepsie chez 83 enfants (47;70 pour cent). Les auteurs ont trouve des antecedents personnels probablement en rapport avec l'epilepsie dans les proportions suivantes: antecedents antenataux chez 33 enfants (18;96 pour cent); antecedents perinataux chez 36 enfants (20;68 pour cent); antecedents post-nataux chez 45 enfants (25;86 pour cent). Les differents types d'epilepsie ont ete rencontres; dans des proportions variables

[Cerebral malaria in children in Yaounde, Cameroon. Clinical, paraclinical and developmental aspects]. / Le neuro-paludisme de l'enfant à Yaoundé, Cameroun. Aspects cliniques, paracliniques et évolutifs.

Cerebral malaria is one of the major and deadly complications of malaria. In Cameroon, recent reports indicate that severe cases of malaria are increasingly more prevalent, particularly in children. The present study aims at describing the clinical presentation and laboratory findings of cerebral malaria in children in Yaounde. All patients admitted in the paediatric ward of Yaounde Central Hospital with malaria, who presented neurological signs and were tested positive for Plasmodium in their peripheral blood were recruited into the study. 36 cases were enrolled in all, making up 2.7% of all admissions. The patients' median age was 4.5 years. 52.8% were on malaria prophylaxis. Convulsions and coma with preceding hyperthermia were present in more than 90% of the patients. Blood parasites level median was 1.3% on admission. One patient had hypoglycaemia on admission and two others had it later on after admission; 16.7% had neurological sequels at discharge and two children died (5.6%). Delay in diagnosis and initiation of treatment with quinine adversely affected the prognosis of cerebral malaria in the study group.