[Professional absenteeism in the pediatric service of the general hospital of Loandjili in Pointe-Noire (Congo)]. / Absentéisme professionnel dans le service de pédiatrie de l'hôpital général de Loandjili de Pointe-Noire (Congo).

The supply and the quality of care dispensed in a service depend on the quality of the technical and human tray, but also from effective presence of the staff during the work time. The purpose of this study is to determine the absenteeism level of the paramedical staff in General Pediatric and Neonatology of Loandjili General Hospital (Pointe Noire) and identifying causes. A cross-sectional study has been conducted from January 1(st) to June 30(th) 2011 on 21 nurses in General Pediatric and 20 in Neonatology. The absenteeism level was obtained by the link of the number of missing days out of the number of the work days x 100. The absence was justified when it relieved from a reason informed by the administrative texts of the firm; and authorized when it requested the authorization of the administration of the firm. In total, 370 absences have been unregistered, the average absenteeism level was of 8.4%. The absence was justified in 242 cases (65.4%) and authorized in 178 cases (48.1%) which 84 times in writing and 94 times verbally. When the absence was justified, it was the fact of the disease of a member of the family in 82 cases, of the death or the burial of a member of the family in 81 cases, of the agent disease, 84 cases, or other reasons in the remains of cases. The absence occurred between 7 a.m. and 14 p.m. in 57.3%, 14 p.m. and 7 p.m.in, 25.7% and between 7 p.m. and 7 a.m. in 17.0%. The absenteeism was mainly observed (85.7%) for the nurses of about 30 years old and those (59.5%) whom the seniority in the service was inferior or equal 5 years. The absences justified were more observed (p< 10(-4)) for nurses of about 30 years old and those whom the seniority did not pass 5 years. The absenteeism of nurses constitutes a real social and administrative problem that deserves a particular attention considering its impact on the supply and the quality of cares.

[Scarification in children hospitalized in Congo]. / Scarifications chez l'enfant hospitalisé au Congo.

OBJECTIVE: The purpose of this report is to describe the epidemiologic, prognostic and clinic features of scarification in children in Congo. MATERIAL AND METHOD: A transversal study of scarification was conducted from January 1, 2006 to December 31, 2008 in children hospitalized in neonatology and pediatrics department of Loandjili General Hospital. RESULTS: During the study period, therapeutic scarifications were observed in 130 patients including 74 (56.9%) girls. Median age was 17 months (range, 1 month to 9 years). Multiple scarifications were observed in 31.5% of cases. The main site of scarification was the hypochondrias (82.4%) followed by the flanks (14.6%) and hemithorax (13.8%). Scarification was performed for curative purposes in 114 cases (88%; p 0.001) and prophylaxis in the remaining cases. The main indications for curative scarifications were big belly in 46 cases, ponderal stagnation in 23 and recurrent bronchitis in 22. The most frequently used scarification instrument was a razor blade in 102 cases (78.5%). Risk factors included being the oldest sibling child and low socioeconomic level. In all cases, the influence of the grandparents was clear. Complications were treated in 34 cases including local infection in 26 cases, distant infection (particularly severe sepsis) in 7 cases and pulmonary-pleurostaphylococci in one case. CONCLUSION: These findings show that scarification is still common in the Congo. Because of potential complications and therapeutic inefficiency of scarification, an effort should be made to eliminate this practice.

[Hydrocholecystis, a rare etiology of painful abdominal crisis in sickle cell disease. About two cases]. / Hydrocholécyste, cause rare de crises douloureuses abdominales chez le drépanocytaire. A propos de deux cas.

The authors report two cases of hydocholecystis causing abdominal pains in the sickle cell child. The patients were two girls aged respectively 4 and 12. Hydrocholecystis is defined by acute distension of the gallbladder The diagnosis was made by scan which allowed to follow the evolution in the two sickle cell children. After two crises, no more recurrence was noted in the first patient, on the other hand in the second child recurrences became more frequent. Some authors indicate surgery systematically while others recommend it only after several recurrences.

[Schooling of the child and teenager suffering from sickle-cell disease in 2004, Brazzaville, Congo]. / Scolarité de l'enfant et de l'adolescent drépanocytaire en 2004 a Brazzaville, Congo.

A case-control transversal study has been carried out in March 2004 in the paediatric unit of the Brazzaville teaching Hospital to assess the impact of the sickle cell disease on school-age children. School-age children and teenagers of both sex were distributed in 228 homozygote sickle cell children (group I) aged of 5 years old and 8 months old to 21 and 245 children recruited in state schools aged of 5 years old and 6 months to 19 years old. In the group I, 78 children suffering from sickle cell disease are ahead in their school achievement, 59 have a normal education and 91 meet some difficulties with no significant difference; in the group II, 122 children are ahead in their school achievement, 81 have a normal education and 42 meet difficulties (p < 0,001). The average of children having school difficulties was 2,4 +/- 1,5 years in the group I with extremes ranging from 1 to 3 years. By comparing both groups in primary school, no difference was to be found in children doing well at school and children having a normal education: 54 children of the group II are reported being ahead in their school achievement (39, 7%) and 81 children in the group II (55, 1%); normal education for 38 children of the group 1 (28%) and 58 children in the group II (39, 5%). On the other hand, 44 children are having school difficulties in the group I (32, 3%) against 8 children in the group II (5, 4%) (p < 0,001). As a matter of form we have observed that ahead schooling is to be found in 24 sickle cell children at HbF < 10% (41, 4%) and 54 sickle cell children at HbF < 10% (34, 2%) (p < 0,05); normal education in 14 children with sickle cell disease at HbF > 10% (24, 1%) and 45 children with sickle cell disease at HbF < 10% (25, 9%) and school difficulties in 20 children with sickle cell disease at HbF > 10% (34, 5%) and 71 children with sickle cell disease at HbF < 10% (39, 9%).

[Body composition in Negro African children suffering from sickle cell disease. A mixed cross-sectional longitudinal study in Brazzaville, Congo]. / Composition corporelle d'enfants drépanocytaires homozygotes congolais. Etude longitudinale a Braz- zaville, Congo.

This study evaluates the changes of body composition in homozygous children suffering from sickle cell disease and appreciates the interaction between some factors of severity of the disease. A mixed cross-sectional longitudinal study with control cases cohort was conducted in Brazzaville (Congo) among 91 children with sickle cell disease (45 boys and 46 girls) and 95 healthy children (48 boys and 47 girls), aged of 8-17 years old. Each group was initially divided into three subgroups of age: 8, 11, 14. These children were subsequently followed for 3 years. Each year, at the same period, body mass, percentage of body fat, lean body mass and body mass index were evaluated in the two groups and then compared. The effects of frequency of painful episodes, the number of severe anaemia crisis and haemoglobin F on different variables were also appreciated. The children with sickle cell disease had stunting, lower values of body mass (p < 0.001), percentage of fat (p < 0.01), lean body mass (p < 0.01), and body mass index (p <0.001) between 8 and 17 years of age. In addition, we observed a non linear association between body mass index and fat percentage, but this interaction was stronger in girls. Finally the yearly frequency of painful episodes, the number of severe anaemia crisis and haemoglobin F had most of the time an influence on body composition. Children with sickle cell disease had a decreased body composition influenced by the complications associated with the disease . These limitations are modulated by haemoglobin F but the body composition is affected by painful episodes and severe anaemic crisis. Therefore more care and attention are recommended for the children suffering from sickle cell disease in order to control this severe disease.