Socio-cultural representation of epilepsy at the teaching hospital of point G, Mali.

Background: Epilepsy is a significant public health concern with psychosocial impacts, including fear, stigma, and misconceptions. These factors contribute to human rights violations and discrimination. The objective of this study was to describe the sociocultural representation of epilepsy in Mali. Materials and methods: This cross-sectional descriptive study was carried out from April 2015 to November 2016 at the University Hospital of Point G. Patients with epilepsy were identified prospectively, and a questionnaire was administered to each patient and their parents. Results: A total of 104 patients were enrolled with an average age of 35 years, ranging from 15 to 89 years. Males were slightly predominant, accounting for 53.85%, resulting in a sex ratio (M/F) of 1.17. In terms of occupation, workers comprised 68.27% of participants. Patients residing in urban areas represented 61.54%, and the most level of education was secondary (40.38%). The majority of patients (57.69%) and their relatives (69.23%) thought that epilepsy was caused by mystical causes. Stigma was reported by 66.35% of our patients. Conclusion: The sociocultural perception of epilepsy hinders evidence-based diagnosis and management in Africa. This study suggests a need to focus on raising awareness to change these misconceptions.

Clinical, paraclinical and genetic aspects of autosomal recessive cerebellar ataxias (ARCA) in Mali.

Introduction: Autosomal recessive cerebellar ataxias (ARCA) are a group of rare and heterogynous neurodegenerative diseases mainly characterized by unbalance and walking difficulty and movement incoordination. Objectives: To clinically and paraclinically characterize ARCA in the department of Neurology at the Teaching Hospital of Point G and identify the underlying genetic defect. Patients and method: We have conducted a longitudinal and prospective study from January 2018 to December 2020. Patients with ARCA phenotype seen in the Department of Neurology at the Teaching Hospital of Point "G" were enrolled. Results: We have enrolled 7 families totaling 13 patients after giving an informed verbal and written consent. The sex ratio was 2.2 in favor of males, Kayes region and Fulani ethnic group were respectively the most represented region and ethnic group.Walking difficulty represented the major symptom followed by loss of vibration and joint sense, nystagmus, dysarthria and skeletal deformities. Alpha-foetoprotein level was high in one patient. Genetic testing confirmed Friedreich ataxia in one family and was not conclusive in 4 families. Conclusion: This study showed that ARCA are not uncommon in Mali and genetic testing is crucial to confirm the diagnosis.

Introduction: Les ataxies cérébelleuses autosomiques récessives (ACAR) constituent un groupe de maladies neurodégénératives rares et hétérogènes caractérisées essentiellement par un trouble de l'équilibre et de la marche, et un trouble de la coordination des mouvements. Objectifs: Caractériser les signes cliniques, paracliniques et génétiques des ataxies cérébelleuses autosomiques récessives au Service de Neurologie du CHU du Point "G". Patients et méthodes: Nous avons réalisé une étude de cas enrôlé dans le cadre d'une étude longitudinale et prospective allant de Janvier 2018 à Décembre 2020, portant sur des patients présentant des symptômes d'ACAR et ayant donné leur consentement éclairé. Résultats: Nous avons enrôlé sept familles totalisant 13 patients. Le sexe ratio était de 2,2 en faveur des hommes, la région de Kayes était la plus représentée et l'ethnie peulh était majoritaire. Les troubles de la marche ont représenté les signes majeurs suivis de troubles de la sensibilité profonde, de nystagmus, de dysarthrie, et des déformations ostéoarticulaires. L'alpha-foetoprotéine était élevée chez une patiente. Le test génétique a retrouvé l'ataxie de Friedreich dans une famille et n'a pas été concluant dans quatre autres. Conclusion: Cette étude montre que les ACAR ne sont pas rares au Mali et l'exploration génétique constitue un outil indispensable pour leur diagnostic de certitude.

[Progressive myoclonic epilepsy in the department of neurology of the University Teaching hospital Point "G"]. / EPILEPSIES MYOCLONIQUES PROGRESSIVES AU SERVICE DE NEUROLOGIE DU CENTRE HOSPITALIER UNIVERSITAIRE DU POINT "G".

Background: Progressive Myoclonic Epilepsy (PME) is a heterogeneous group of pathologies associating epileptic seizures and other neurological and non-neurological disorders. Objectives: We aim to characterize patients with symptoms of PME and identify the underlying genetic disorder. Methods: After informed consent, the patients seen in the protocol for hereditary neurological diseases and presenting signs of epilepsy without a secondary cause were clinically evaluated over a three-year period in the Department of Neurology of the CHU Point "G". EEG, brain imaging and laboratory tests were performed to consolidate our diagnosis. DNA was extracted for genetic analysis. Results: 141 families including five families with PME totaling eight cases were enrolled. The predominant symptoms in our patients were myoclonus in 87.5% (N = 8), followed by GTCS and cognitive impairment in 50%, each. A notion of parental consanguinity was found in 60% and autosomal recessive transmission evoked in 80% (N = 5). The EEG was pathological in 62.5% and imaging showed ponto-cerebellar atrophy in 25% (N = 8). The combination of sodium valproate and clonazepam was the main treatment. One case of death was recorded. Conclusion: We report cases of PME in Mali with a possibility of discovering new genes.

[Clinical and laboratory features of recessive Limb Girdle Muscular dystrophies in the Department Neurology of University Hospital of Point G]. / Aspects Cliniques et Paracliniques des Myopathies des Ceintures Récessives au Service de Neurologie du CHU Point G.

INTRODUCTION: Limb-Girdle Muscular dystrophies (LGMD) is a group of inherited diseases characterized by predominantly proximal and limb muscle weakness. These are rare diseases that have not been well studied in sub-saharan Africa. The aim of our was the clinical and paraclinical characterization of patients with recessive LGMD at the Department of Neurology of the Teaching Hospital of Point G. PATIENTS AND METHODS: We conducted a longitudinal prospective study which took place from March 2014 to May 2019. Patients with recessive LGMD phenotype were enrolled. Sociodemographic, clinical and laboratory data were analyzed. RESULTS: We enrolled 46 families (67 patients), i.e. a frequency of 16.7% among the neurodegenerative diseases seen in the service. Among them, 45.6% came from the Sikasso region. Autosomal recessive inheritance pattern was suspected in 67.4% of the families. Symptoms appeared mainly in the first decade of life. Proximal muscle weakness was found in almost all patients. Cardiac examination showed dilated cardiomyopathy in 4.5% of cases. CONCLUSION: Limb-Girdle muscular dystrophy is a disabling disease that is found in Mali. Further study of these cases could elucidate the underlying genetic defects.

Analysis of diagnosis announcements in Abidjan pediatric oncology unit 2 years after introduction of the African Pediatric Cancer Announcement Guideline.

INTRODUCTION: Announcing the diagnosis allows the therapeutic alliance between physicians and patients to be sealed and it prevents abandonment of treatment. To compensate for the deficit in information received by the families, the Franco-African Group of Pediatric Oncology (FAGPO) has published an "African Pediatric Cancer Announcement Guide" for the group's pediatric oncology units. OBJECTIVE: To analyze the announcements made to parents and children 2 years after the provision of this guide. METHODS: Cross-sectional survey conducted from March to July 2016. In total, 69 parents of children followed up in the pediatric oncology unit of Abidjan were interviewed regarding the characteristics of the announcement that was made to them and the information given to the sick child. RESULTS: Of all the accompanying individuals, 91% reported having benefited from the announcement made with empathy, mainly by a physician. In approximately one quarter of the cases the information had been given to a third party. The main barriers to information were: the negative experiences of parents, the medical terminology, and communication problems. The sick child was rarely informed. DISCUSSION: The information given was in accordance, in content and form, with the data from Western and African literature. The lack of information given to the child has a dual explanation: the primacy of the community over the individual advocated by African culture and the non-integration of the rights of children in the current code of ethics. CONCLUSION: The information provided could be improved by practical training of physicians in the technique of breaking bad news to patients and their families and the use of a code of ethics in accordance with the principle of autonomy.

Development of a new automatic on-site detector of pesticides in natural waters by photo induced fluorescence, application to three phenylurea and benzoylurea herbicide.

Prototypes of on-site automatic photo induced fluorescence detectors of pesticide in natural waters are set up and applied for the determination of the benzoyl- and phenylurea pesticides, namely fluometuron, monolinuron and diflubenzuron. As these pesticides present no native fluorescence the set up system use the photo conversion under UV irradiation of these pesticides into highly fluorescent photoproducts. A first system, called AUTOPIF, (evolution the commercial AQUAPOD system) is develop using a detection via a diode array spectrometer. To improve the sensitivity of the method, a second system, called AUTOPIF+, is developed with a more resolute spectrometer and an intensified CCD camera detection. Analytical applications were carried out in aqueous solution and detected on line with the AUTOPIF and AUTOPIF+ system. The calibration curves are linear over one order of magnitude, and the limits of detection are in the µg mL-1 range. The analytical performances of these methods for the determination of the three pesticides are satisfactory in comparison to other classical PIF methods published for the determination of phenylurea pesticides in aqueous solutions. Our results show that the AUTOPIF and AUTOPIF+ methods are versatile, sensible and can be easily applied as an alert system to detect pollutant residues in naturals waters over a threshold value.

[Epidemiological and clinical aspects of prurigo in HIV infected patients in Fousseyni N'Daou hospital of Kayes, Mali]. / Aspects Epidemiologiques et Cliniques du Prurigo Chez les Personnes Vivant avec le VIH a L'Hopital Fousseyni N'Daou de Kayes, Mali.

INTRODUCTION: Prurigo is one of the most common dermatological conditions during HIV infection and AIDS. It appears as an immunosuppression marker associated with HIV infection. The study objective was to determine the prevalence of prurigo in people living with the human immunodeficiency virus (PLHIV) in Fousseyni N'Daou Hospital of Kayes, and to describe the socio-demographic aspects of patients and lesions associated with prurigo among PLHIV. METHODS: It was a descriptive cross-sectional study included all cases of HIV infected patients with prurigo in the Dermatology-Venomology Department of Fousseyni N'DAOU Hospital from January 1, 2015 to August 31, 2015. RESULTS: We collected 121 cases of prurigo. The hospital prevalence was 14.5% among PLHIV with 65% Female and the average age was 34.8 years old (SD: 15-81 years). The elementary lesions associated with prurigo were seropapules (40.2%), vesiculo-crusts (13%), excoriated papules (33.3%), lichenified papules (10.8%), and cicatricial lesions (2.7%). The prurigo was generalized in 68.5% of cases and localized in 31.24%. More than half of our patients had weight loss, fever, diarrhea and oral candidiasis in their medical history. Patients were infected with HIV1 in 60.03% and HIV1+ 2 in 24.3%. More than the half of our patients had a CD4 count inferior to 250 cells/mm3 at the time of prurigo diagnosis. CONCLUSION: In our study, prurigo remains a common condition in PLHIV, particularly in patients with low CD4 counts. Early detection and rapid antietroviral therapy can reduce the frequency of prurigo in PLHIV.

INTRODUCTION: Le prurigo est l'une des affections dermatologiques les plus fréquentes au cours de l'infection à VIH et du sida. Il apparait comme un marqueur de l'immunodépression associée à l'infection VIH. L'objectif était de déterminer la prévalence du prurigo chez les personnes vivant avec le virus de l'immunodéficience humaine (PVVIH) à l'hôpital Fousseyni N'Daou de Kayes (HFDK) et décrire le profil sociodémographique des patients et les lésions associées au prurigo chez les PVVIH à HFDK. PATIENTS ET MÉTHODES: Il s'agissait d'une étude transversale descriptive de tous les cas de prurigo chez les PVVIH dans le service de Dermatologie-Vénéréologie de l'hôpital Fousseyni N'DAOU durant la période du 1er janvier 2015 au 31 août 2015. RÉSULTATS: Nous avons colligé 121 cas de prurigo. La prévalence hospitalière a été de 14,5% chez les PVVIH. Le sexe féminin a représenté 65% des cas. L'âge moyen a été de 34,8 ans (extrêmes :15 ­ 81 ans). Les lésions élémentaires associées au prurigo ont été les séropapules (40,2%), vésiculo-croutes (13%), papules excoriés (33,3%), papules lichenifiés (10,8%), lésions cicatricielles (2,7%). La forme généralisée a représenté 68,5% et la forme localisée 31,24%. Plus de la moitié de nos patients avait la notion d'amaigrissement, de fièvre, de diarrhée et des candidoses buccales dans leurs antécédents. Le VIH1 a représenté 60,03% et l'association VIH1 et VIH2 a représenté 24,3% des cas. Plus de la moitié de nos patients avait un taux de CD4 inférieure à 250 cellules/mm3 au moment du diagnostic du prurigo. CONCLUSION: Dans notre étude, le prurigo reste une affection fréquente chez les PVVIH, particulièrement lorsque le taux de CD4 est bas. Un dépistage précoce et le traitement antirétroviral rapide permet de réduire la fréquence du prurigo chez les PVVIH.

[Squamous cell carcinoma associated with use of skin-lightening cream]. / Carcinome épidermoïde associé à une dépigmentation volontaire.

BACKGROUND: Women widely use skin-lightening products for cosmetic purposes in sub-Saharan Africa despite numerous reported cutaneous and systemic complications. The occurrence of epidermoid carcinoma has long been reported, but only three cases have been published so far. We report the first case in Mali. PATIENTS AND METHODS: A 30-year old woman with no noteworthy medical history was seen at our outpatient center for cervical ulceration that had been present for the last 5 years. She had used cosmetic bleaching cream over a period of around ten years. Physical examination revealed extensive ulceration on the left side of her neck. Blood tests for viral hepatitis and human immunodeficiency virus were negative. The pathological examination of the skin biopsy confirmed the diagnosis of squamous cell carcinoma. After failure of the initial excision with early relapse, multiple surgical ablations were performed 3 months later. DISCUSSION: The high prevalence of skin-lightening cosmetic use contrasts with the rarity of epidermoid carcinoma in depigmented skin. However, a large chronic ulcer on uncovered parts of the upper body, particularly the neck, should prompt physicians to consider skin cancer. Appropriate preventive measures include the promotion of educational messages for the general population, the use of sun-protection devices, and routine skin biopsy for all women presenting chronic cervical ulceration after long-term use of skin-lightening products.

Les motifs d'hospitalisation chez les enfants de moins de 16 ans à Bamako

Introduction : Les maladies de peau constituent un motif fréquent de visite dans les centres de santé au Mali où elles représentent 10% des consultations. Le but de ce travail était de décrire les motifs d'hospitalisation chez les enfants de moins de 16 ans à Bamako.Matériel et méthodes : Du 1er janvier 2010 au 31 Décembre 2014, nous avons mené une étude transversale dans le service dermatologie du CNAM. Les patients âgés de moins de 16 ans hospitalisés ont été inclus et les dossiers correspondant ont été revus.Résultats : Au total sur 398 patients hospitalisés durant la période d'étude, 69 enfants de moins de 16 ans ont été recensés, soit une proportion de 17,34%. Parmi ces enfants hospitalisés, seuls 50 dont les dossiers étaient complets ont été inclus. L'âge des malades variait entre 1 et 15 ans avec une moyenne d'âge de 11,9±0,58 ans. Les principaux motifs d'hospitalisation étaient les dermatoses infectieuses (29 cas/58%), les toxidermies (7 cas/14%), les dermatoses bulleuses auto-immunes (5cas/10%), l'eczéma érythrodermique (2 cas/4%), les ulcères drépanocytaires (3 cas/6%), la dermatomyosite (3 cas/6%), l'épidermolyse bulleuse congénitale (1 cas/2%) et l'ecthyma gangreneux (1 cas/2%). Nous avons enregistré 3 cas de décès suite à une dermatomyosite sévère, d'une fasciite nécrosante et d'un syndrome de Lyell.Conclusion : Cette étude a monté la fréquence élevée des dermatoses bactériennes dominées par les dermo-hypodermites. Elle nous a également permis de confirmer l'effet aggravant des AINS et des médicaments de la pharmacopée traditionnelle sur les dermo-hypodermites

[Neonatal and child tetanus morbidity and mortality in the University hospitals of Abidjan, Côte d'Ivoire (2001-2010)]. / Morbidité et mortalité du tétanos des nouveau-nés et des enfants dans les Centres hospitaliers universitaires d'Abidjan, Côte d'Ivoire (2001-2010).

The lack of data on neonatal tetanus and children in university hospitals (UH) in Abidjan for over a decade has motivated the realization of this study. The objective of this study is to evaluate the morbidity and mortality related to neonatal tetanus (NT) and child tetanus (CT) in Abidjan University Hospital from 2001 to 2010. It is a retrospective study, multicenter analysis with records of newborns and children suffering from tetanus in the three UH of Abidjan. The collection and analysis of data were made by the SPHINX 4.5 and EPI.INFO 6.0 software. In ten years, 242 cases of tetanus (53 NT cases and 189 CT cases) were collected with a predominance of cases after the fifth year of life (59.5%). The incidence rate of NT was less than 1 case per 1,000 live births. All mothers of the newborns were inhabiting the city of Abidjan. Their median age was 19 years [16-32] and 64% were teenagers. Gateways were dominated by umbilical wounds (77.3%) in the NTand skin wounds (59%) in CT. The cure rate was 30.2% in the NT and 60% in the CT. Lethality was 60% for NT and 22% for CT with a positive correlation with young age (neonates: p = 4.10-7, age <5 years: p = 0.01), lack of intraspinal injection of tetanus serum (p = 8.10-6), the absence of conventional antibiotic therapy (p = 0.023), the existence of metabolic complications (p = 2.10-5), the score of ≥ 4 Dakar (p = 0.005). Tetanus remains a real morbidly cause among children in Abidjan University Hospital with high lethality. However, the incidence of NT seems consistent with the incidence threshold desired by WHO.

Sleep quality assessment in 35 Parkinson's disease patients in the Fann Teaching Hospital, Dakar, Senegal.

INTRODUCTION: Sleep disorders are diverse in Parkinson's disease. We aimed to assess the quality of sleep in patients with Parkinson's disease in an African population. METHODS: In a transversal and prospective study from April to June 2014, all parkinsonian patients followed at the Fann Teaching Hospital Neurology Clinic (Dakar, Senegal) were assessed using the Hoehn and Yahr's scale and filled out the following questionnaires: Parkinson's disease sleep scale (PDSS), the Pittsburgh Sleep Quality Index (PSQI), and the Epworth Sleepiness Scale (ESS). A PDSS score<82 (or a subscore<5) and a PSQI score>5 indicated poor quality or impaired sleep. An ESS score>10 indicated excessive daytime sleepiness. We used the Pearson coefficient to search for correlation between age, disease stage, disease duration, and the importance of sleep impairment. RESULTS: Hoehn and Yahr staging was 2.42±0.90 in the 35 patients (60% male, mean age 65.7±7.4years, disease duration 32.4±23.4months). The mean total PDSS score was 99.5±24.1 and 74.3% of the patients had an abnormally high PSQI score, indicating high frequency and intensity of sleep disorders. Most frequent disorders were pain or cramps interrupting sleep, night waking to urinate and fatigue or sleepiness on waking. Patients exhibited excessive diurnal sleepiness in 22.9% of the cases; they often had an abnormal PSQI score. Both the total PDSS score and the difficulty to sleep increased with disease stage, but not with age or disease duration. CONCLUSION: We found evidence of major alteration of sleep quality in Senegalese Parkinson patients.

Quality of care in women's, children's, and adolescent health. Methods for assessing evaluation and implementation in West Africa. Experience in the Côte d'Ivoire.

A tool developed by WHO was used to assess the quality of care for mothers, newborns, and children in some healthcare facilities in French-speaking Africa; this study led to the development of recommendations for the implementation of actions intended to resolve the problems observed and to optimize patient management. We report here the experience of the maternity units of the university hospital center of Treichville, in Abidjan, discuss the presentation of the results of the assessment, and make some recommendations as part of an action program. The experience of the monthly review of referred cases is also reported.

[Extravasation injuries in newborns: our experience about 15 cases]. / Les accidents d'extravasation perfusionnelle chez le nouveau-né : une expérience de 15 cas.

Extravasation injuries are common complications that occur during infusion for diagnostic or therapeutic purposes by the peripheral or central venous catheters. In pediatric settings, iatrogenic extravasations are serious. When they are viewed late, they are sources of functional sequelae. The purpose of this study was to report our experience with the management of iatrogenic extravasations for therapeutic purposes. Between January 2010 and December 2012, fifteen newborns were supported for accidents of infusion of the upper and the lower limbs. The male was mostly affected. The mean age was 3.6days, with extremes of one and nine days. The average birth weight was 2900g. The range was 1200g and 3550g. Serum 10 % glucose and calcium chloride were implicated in all cases. The lesions were seen in the late stages III in six cases and IV in nine cases. The upper limbs were frequently affected. Nine lesions were in the upper limbs and six in the lower limbs. The dorsal surfaces, feet and hands were frequently affected in six and five cases, respectively. Two lesions were in the anterior aspect of the forearm and elbow. Elbows lesions were circular and realized a tourniquet effect. Treatment was conservative in eleven cases: five pro-inflammatory fatty dressings and six alcoholic dressings. The surgery was delayed in four cases. It combined excision-full thickness skin graft, excision-dressing-thin skin grafting, debridement and two-full thickness skin graft for retractable wrist scars. Two deaths were related to associate pathologies. One patient was lost for follow-up. Our results were satisfactory in functional, aesthetic and psychological aspects. Extravasation injuries are serious iatrogenic lesions. If the lesions are seen at an early stage in usual circumstances, in extreme exercise, they are seen late, sometimes at the stage of functional, psychological and cosmetic sequelae. The difficulty of the therapeutic management of these lesions requires prevention through the development of protocols and the permanent training of nursing staff for an efficient practice of infusion.

[Cerebral miliary tuberculosis, a case study]. / Miliaire tuberculeuse cerebrale: etude d'un cas.

Cerebral miliary tuberculosis is a rare and serious disease due to the hematogenic spread of bacillus tuberculous. It occurs more often in a debility context. Stereotaxic biopsy allows to establish the final diagnosis. But, in most of the cases it is presumptive based on clinical and biological features, and the regression of symptoms under anti tuberculosis treatment, of which depends the vital prognosis. We report the case of an immunocompetent patient, smoker who presented with cerebral military.

La miliaire tuberculeuse cérébrale est une affection rare et grave due à la dissémination hématogène des bacilles tuberculeux. Elle survient le plus souvent sur un terrain de débilité. La biopsie stéréotaxique permet d'établir le diagnostic définitif. Mais dans la plus part des cas il est présomptif basé sur d'éléments d'orientation clinique et biologique et la régression des signes sous traitement anti tuberculeux, dont dépend le pronostic vital. Nous rapportons le cas d'un patient immunocompétent, tabagique ayant présenté une miliaire cérébrale.

Evaluation de la satisfaction des patients hospitalises dans le service de pediatrie du Chu de Treichville

Introduction. La satisfaction des patients est un indicateur important dans la prise en charge globale du patient; car il definit au mieux la qualite des soins vue par le patient lui-meme. L'objectif general etait d'apprecier le degre de satisfaction des clients hospitalises au service de pediatrie du centre hospitalier et universitaire (CHU) de Treichville. Methodes. Il s'agissait d'une etude transversale a visee descriptive qui s'est deroulee sur une periode de trois mois; allant du 19 octobre 2011 au 19 janvier 2012. Elle a concerne 175 parents de patients hospitalises dans le service de pediatrie du CHU de Treichville et selectionnes de facon aleatoire. Resultats. La majorite des patients (soit 64%) etait agee de moins de deux ans avec un sex-ratio de 1;3 et 94% des patients n'avaient pas de couverture sociale. Les principaux motifs d'insatisfaction etaient la temperature surchauffee des salles d'hospitalisation (43;40%) et le niveau de bruit eleve pendant le jour (57;14%). Par ailleurs; les problemes de disponibilite en medicaments etaient decries dans 51;4% et le cout des medicaments et des examens complementaires etait juge eleve respectivement pour 47;4% et 52% des sujets. Conclusion. Cette etude a permis de mettre en evidence les principales raisons d'insatisfaction. Ce qui nous permettra de cibler les interventions les plus pertinentes et efficientes afin d'ameliorer la qualite de nos offres

[Knowledge and practices of the mothers of children from 6 to 18 months relative to the conduct of weaning: cases from the general hospital of Marcory]. / Connaissances et pratiques des meres d'enfants de 6 a 18 mois relatives à la conduite du sevrage: cas de l' hôpital général de Marcory.

Weaning is a high-risk phase in the life of infants around the world, because poorly managed, it raises protein-energy malnutrition to levels causing crucial problems to the health of infants. AIMS: The purpose is to estimate the knowledge and the practices of the mothers regarding the conduct of food weaning of their children aged 6 to 18 months. MATERIALS AND METHODS: We conducted a descriptive cross-sectional survey at the general hospital of Marcory in Abidjan-CI on a sample of 100 mother-child pairs who came to consult. RESULTS: It emerges from this survey that.The mothers are young, with 94% younger than 35 years old. 88% of the mothers were of a low socioeconomic level. Dietary restrictions still remained a real obstacle to a better practice of weaning.The vast majority of the mothers (74%) ignore the notion of weaning and 40% of them had no information regarding this process. Food weaning was not conventional with an early weaning at 1 to 6 months in 38% of the cases and a late weaning (30%) after 13 months. CONCLUSION: It is necessary to set up a program focusing on the adequate conduct of weaning in infants to improve mothers' knowledge and the practices.

Le sevrage constitue une phase à haut risque dans la vie des nourrissons dans le monde , car mal conduit, le sevrage hisse la malnutrition protéino énergétique au rang des problèmes cruciaux de santé chez les nourrissons. OBJECTIF: Le but est d'évaluer les connaissances et les pratiques des mères concernant la conduite du sevrage alimentaire de leurs enfants âgés de 6 à 18 mois. MATERIEL: Nous avons réalisé une enquête transversale descriptive à l'hôpital général de Marcory à Abidjan-CI sur un échantillon de 100 couples mères enfants venus consulter. RESULTATS: Il ressort de cette enquête que.Les mères sont jeunes puisque 94% des mères avaient moins de 35 ans.88% des mères étaient d'un niveau socio économique bas. Les interdits alimentaires restaient encore un réel obstacle à une meilleure pratique du sevrage.La grande majorité des mamans (74%) méconnaissent la notion de sevrage et 40 % d'entre elles ne disposaient d'aucune information. Le sevrage alimentaire n'était pas conventionnel avec un sevrage précoce d'1 à 6 mois dans 38% des cas et un sevrage tardif (30%) au delà de 13 mois. CONCLUSION: Il faut mettre en place un programme axé sur la conduite adéquate du sevrage des nourrissons pour améliorer les connaissances et pratiques des mères.

[Hypothyroid goiter with tracheal compression in a child in Cote d'Ivoire]. / Goitre hypothyroidien compressif chez une enfant en Côte d'Ivoire.

The purpose of this report is to describe a case involving a primary form of hypothyroid goiter with tracheal compression discovered late in a four-year-old child. Slowing of height and weight gain and mental retardation was irreversible. The child was treated using L-thyroxin. Systematic screening for hypothyroidism during the neonatal period is recommended in developing countries.

[The psychological experience of the mothers whose babies were born deformed in the neonatological ward of the academic hospital center of Treichville (Côte-d'Ivoire)]. / Vécu psychologique des mères de nouveau-nés malformés dans le centre hospitalier et universitaire de Treichville (Côte-d'Ivoire).

OBJECTIVE: When a baby is born deformed, his birth breaks up plans his family has made for his life as well as for the family itself. So, our objective was to describe the experience undergone by the mothers who gave birth to babies with serious deformities. METHOD: A prospective and descriptive study was carried out during 12 months about 35 mothers whose babies were born seriously deformed. The data were collected from newborn's medical file and from a well-conducted interview with volunteered mothers. RESULTS: The incidence of the major deformities was 1.4% and the antenatal diagnosis was carried out on only 6 cases. The announcement of deformities in the 30 cases discovered at birth by the clinical staff brought about a shock among mothers. In fact, 28 mothers were disappointed, while 23 experienced fear and 10 others felt guilty. Six mothers thought in terms of aborting, followed by 25 mothers who without any psychological aid felt lonely. Furthermore, 30 mothers suffered from a lack of communication with nurses and with medical staff concerning deformities. The anxiety of mothers was linked, respectively to fear of their husband (33 cases), to the social environment (35 cases) and to the health care (10 cases). CONCLUSION: Mothers facing congenital deformity experienced painful and violent emotional distress. Therefore, the emphasis must be put on the improvement of the neonatal diagnosis and of relationship between physicians and parents in order to achieve a close support toward mothers.

Vecu psychologique des parents accompagneurs d'enfant hospitalises en oncologie pediatrique

La survenue d'un cancer chez un enfant entraine de nombreux bouleversements de la structure familiale. Il nous a paru important d'etudier les contours psychologiques de cette situation en milieu hospitalier a Abidjan. L'etude a ete retrospective; descriptive; sur une periode de douze mois. Elle a concerne 30 accompagnateurs majeurs d'enfants hospitalises dans l'unite d'oncologie du service de pediatrie du CHU de Treichville. Les donnees ont ete recueillies a partir des entretiens isoles ou en groupe avec des accompagnateurs et du dossier medical de l'enfant. 33;4 pour cent des parents accompagnateurs ont attribue l'origine de la maladie a un mauvais sort ou a une malediction; pour 66;6 pour cent il s'etait agi d'une maladie comme une autre. Notre objectif a ete de decrire les aspects psychologiques engendres par ce vecu hospitalier afin d'aider a l'amelioration de l'atmosphere autour de l'enfant lors de sa prise en charge