The prevalence of acute kidney injury in neonates with birth asphyxia is higher in the Democratic Republic of Congo than in Western countries.

AIM: There is very little data on acute kidney injury in neonates in Africa. The aim of this study was to describe the frequency of acute kidney injury and the outcome in neonates admitted to hospital for asphyxia in the Democratic Republic of Congo. METHODS: A descriptive study was conducted in the country's capital Kinshasa. Acute kidney injury was diagnosed within three days of life when the creatinine clearance was ≤16 mL/min/1.73 m². RESULTS: Acute kidney injury occurred in 54.3% of the 35 neonates with severe perinatal asphyxia and 31.4% of the 35 neonates with moderate perinatal asphyxia, and this rate was higher than the prevalence reported in Western countries. Prerenal acute kidney injury occurred in 12 (40%) of the 30 neonates with acute kidney injury. The frequency of oliguria was significantly higher in neonates with severe perinatal asphyxia than moderate perinatal asphyxia (73.7% vs. 45.5%), and mortality was also higher in neonates with severe rather than moderate perinatal asphyxia (57.9% vs. 36.4%). CONCLUSION: The prevalence of acute kidney injury was higher in asphyxiated patients in the Democratic Republic of Congo than in Western countries. It was also higher in neonates with severe rather than moderate perinatal asphyxia.

A descriptive study of perinatal asphyxia at the University Hospital of Kinshasa (Democratic Republic of Congo).

BACKGROUND: Perinatal asphyxia is the third cause of neonatal death after prematurity and infection. OBJECTIVE: The purpose of this study was to determine the incidence, the etiology and the HIE score at the first day in term and near-term newborns with perinatal asphyxia at the University Hospital of Kinshasa. METHODS: 50 term and near-term neonates with perinatal asphyxia were studied prospectively after they were admitted in neonatal intensive care from November 2009 to January 2011. For each patient admitted the perinatal data were collected. Clinical assessment was performed by the Sarnat grading and the Thompson score within twenty-four hours. Medcalc® was used for statistics. RESULTS: 50 babies were scored. The median maternal age was 31 years. In 22% of the mothers preeclampsia was diagnosed. Urogenital infection, IUGR were other prenatal diagnoses. Median Apgar score was 4 after 1 minute, 5 after 5 minutes and 6 after 10 minutes. Sarnat grade 1 was seen in 16 patients, Sarnat grade 2 in 20 patients and grade 3 in 8. Thompson score in the first 24 hours was more than 7 in 60% of the patients. A good correlation was found between the Thompson score and the Sarnat grade (r: 0,77; p < 0,0001). 14 of the 50 babies died. Both Sarnat and Thompson score correlated significantly with mortality. CONCLUSION: The incidence of perinatal asphyxia at the University Hospital of Kinshasa remains high and the majority of patients had a severe HIE.

A rare occurrence of neonatal nephroblastoma in sub-saharan Africa: a case report and management in a resource-constrained region.

Neonatal nephroblastoma has been rarely reported in African neonate. A premature newborn (a 5-day-old male) was transferred with a history of neonatal abdominal mass. Ultrasonography revealed 75×46 mm, well-defined mass with mixed echogenicity replacing the right kidney. The patient underwent right radical nephrectomy and the tumor was confirmed to be a blastemal predominant Wilms' tumor by the histopathological examination and has an unfavorable prognosis. The child died secondary to multiple organ failure, three days after surgery. Our case report serves to remind us the need to bear in mind the possibility of the diagnosis of neonatal nephroblastoma in neonate with renal mass.

Skinfold over toenail is pathognomonic for the popliteal pterygium syndrome in a Congolese family with large intrafamilial variability.

KEY CLINICAL MESSAGE: We report on three related Congolese popliteal pterygium syndrome (PPS) patients concordant only for the skinfold over the toenail. Mutation analysis revealed that the three affected individuals carried a heterozygous missense mutation in the Exon 4, NM_006147.2:c.250C>T; p.Arg84Cys. This is the first molecularly confirmed PPS family from central Africa.