Particularités de l'infection néonatale bactérienne précoce en milieu hospitalier du CHU Gabriel Touré de Bamako / Particularities of early neonatal bacterial infection in the hospital environment of the CHU Gabriel Touré in Bamako

Introduction : L'infection néonatale bactérienne précoce (INBP) est une préoccupation majeure en néonatologie. Au Mali, aucune étude n'avait abordé cet aspect d'où l'initiation du présent travail afin d'étudier le profil épidémio-clinique, biologique et bactériologique de l'INBP. Matériel et méthodes :Il s'est agi d'une étude longitudinale descriptive qui s'est déroulée du 27 juin au 03 septembre 2016 ayant concerné les nouveau-nés d'âge ≤ à 72 heures hospitalisés pour INBP confirmée à l'hémoculture dans le service de néonatologie du département de pédiatrie du Centre Hospitalier et Universitaire (CHU) Gabriel Touré de Bamako. Les paramètres étudiés étaient les caractéristiques sociodémographiques et obstétricales des mères, les caractéristiques cliniques, biologiques et bactériologiques des nouveau-nés infectés précocement. Résultats : Sur les 324 hémocultures réalisées, 52 étaient positives soit une fréquence d'INBP de 11,04 %. Le sex-ratio était de 1,3 avec 73,1% de petit poids de naissance. A l'admission, 90,4 % des nouveau-nés avait moins de 24 H de vie et 86, 5%étaient des naissances hors du CHU Gabriel Touré. Les principaux signes cliniques étaient l'hyperthermie ou l'hypothermie et la détresse respiratoire. Les principales bactéries isolées à l'hémoculture étaient Staphylococcus aureus (55,8%), Klebsiella pneumoniae (13,5 %) et Escherichia coli (07,7 %). La sensibilité à la biantibiothérapie de première intention (ceftriaxone + gentamicine)était faible (63,6%) et celle de l'amikacine était meilleure (100 %). La moitié des nouveau-nés infectés précocement est décédée et 19,2% d'exéat sans accord médical a été enregistrée. Conclusion: L'infection néonatale bactérienne précoce est une cause majeure de morbi-mortalité néonatale. Dans notre contexte, l'amikacine pourrait être une meilleure alternative thérapeutique

Introduction: Early neonatal bacterial infection (ENBI) is a major concern in neonatology. In Mali, no study had addressed this aspect, hence the initiation of this work to study the epidemiological-clinical, biological and bacteriological profile of ENBI. Materials and methods: This were a descriptive longitudinal study that took place from june 27 to september 3, 2016 involving newborns aged ≤ 72 hours hospitalized for ENBI confirmed by blood culture in the neonatology service of the pediatrics department of the Center Hospitalier et Universitaire (CHU) Gabriel Toure in Bamako. The parameters studied were the socio-demographic and obstetrical characteristics of the mothers, the clinical, biological and bacteriological characteristics of newborns infected early. Results: Of the 324 blood cultures performed, 52 were positive, i.e. an ENBI frequency of 11.04%. The sex ratio was 1.3 with 73.1% low birth weight. On admission, 90.4% of newborns had less than 24 hours of life and 86.5% were births outside the CHU Gabriel Toure. The main clinical signs were hyperthermia or hypothermia and respiratory distress. The main bacteria isolated in blood culture were Staphylococcus aureus (55.8%), Klebsiella pneumoniae (13.5%) and Escherichia coli (07.7%). Sensitivity to first-line biantibiotic therapy (ceftriaxone + gentamicin) was low (63.6%) and that of amikacin was better (100%). Half of the newborns infected early died and 19.2% of exeat without medical agreement was recorded. Conclusion: Early neonatal bacterial infection is a major cause of neonatal morbidity and mortality. In our context, amikacin could be a better therapeutic alternative

[Knowledge of epilepsy and practices of parents in Mali: a community study]. / Connaissances a propos de l'epilepsie et attitudes des parents d'enfant au Mali: etude communautaire.

The prevalence of epilepsy in Sub-Saharan Africa is about 15 per thousand; against 6 to 8 per thousand in industrialized countries. Health, social, economic conditions and misknowledge could explain this situation. The objective of this survey was to study the knowledge of parents of children with or without epilepsy about this disease in Mali. 423 adults were interviewed, 15% children with epilepsy. The mean age was 34 ± 9,3 years; females represents 60% of the population. 26% of interviewed subjects heard about epilepsy from their neighbourhood, 20% from traditional healers, 11% from health care professional; the tonic-clonic crisis was the most known form of the disease. 59% thought epilepsy to be contagious. The organicity of the disease was known by 51% of the population. 23 % of the population believed there was a link between the onset of the crisis and the presence of the hole moon. 78% of subjects have already seen at least one crisis of epilepsy, but only 33% have got an attitude of first help that was to pour fresh water on the face of the patient in 22% of cases. 57% of subject's acknowledge having as first recourse traditional medicine. The fight against epilepsy in Mali as in the others countries of the third world should go through information and education of the population, in particular parents.