Assessment of the Vaccination Status of Children Aged 6 to 30 Months in a Tertiary Level Health Care Center in Côte d’Ivoire

Introduction: Vaccination coverage in Côte d’Ivoire over the period 2011 to 2015 was below the target of 95% for all antigens. The objective of this study was to analyze the vaccination status of children aged 6 to 30 months with a view to improving vaccination coverage. Patients and Methods: This was a descriptive cross-sectional study which took place from June to September 2018 in a tertiary health center, focusing on children aged 6 to 30 months with a correctly completed health record. The parameters studied were sex, age, educational level of mothers, dates of vaccine administration and reason for missed vaccination opportunities. Results: We retained 212 children. The sex ratio was 1.21 and 93% had received the BCG vaccine before the age of 1 month. The average ages of combined and co-administered vaccines for the 1st and 2nd doses were 7.66 ± 3.81 and 12.88 ± 3.95 weeks, respectively. The median was 16.57 weeks for the 3rd dose. The proportion of vaccinated subjects was greater than 90% for the BCG vaccine and the 3 doses of combined vaccines, and 77% for the yellow fever and measles vaccines. The reasons for non-vaccination were attributable to the children’s parents and health facilities. Conclusion: Improving vaccination coverage requires regular supply of vaccines to centers, and the involvement of all health professionals, community and religious leaders in the vaccination awareness process.

Psychological Experience of Mothers of Children with Sickle Cell Disease Followed at the Pediatric Department of Bouaké University Teaching Hospital

Introduction: Sickle cell disease has physical and emotional repercussions on the child and his family. The aim of this study was to describe the psychosocial experiences of mothers of children with sickle cell disease in order to improve the overall care of the child. Methods: This was a descriptive cross-sectional study carried out in the pediatrics department of Bouaké University Teaching Hospital from June to September 2023. It focused on mothers of major sickle-cell-affected children followed up in the pediatrics department of the Bouaké University Teaching Hospital. The variables studied were sociodemographic, psychological, social and economic. Results: Of the 40 mothers surveyed, 15% were not in school and 32.5% were unemployed. For them, sickle cell disease was of natural (genetic) origin in 90% and supernatural in 10%. They stated that the child had an average age of 36 months (extremes 7 and 108 months) when the disease was discovered. And 52% of them were satisfied with the way the disease was clearly and completely announced. Following the announcement, the questioned mothers said they had felt shock (35%), sadness (31.7%), guilt (23.3%) and discouragement (10%). Anxiety and depression were experienced by 77.5% and 22.5% respectively. In 60% of cases, they stated that the disease was incurable, and the outcome was fatal in 2.5% of cases. The child’s illness was a source of problems in the home in 25% of cases, represented by arguments in 92% and divorce in 8%. In 97.5% of cases, the mother told her family and friends about the child’s illness. In 90% of cases, the mother and child benefited from psychological support from family and friends. Conclusion: Sickle cell disease is a serious illness with a psychological and social impact on mothers. We recommend psychological support for mothers from the moment of diagnosis and throughout follow-up.

Type VI Aplasia Cutis Congenita: About a Case Report at University Teaching Hospital of Bouaké

Introduction: Aplasia cutis congenita is a rare congenital dermatosis of which type VI represents the Bart’s syndrome. The aim of this case is to describe the epidemiological, clinical, therapeutic and prognostic characteristics of this condition in a country with limited resources, for the improvement of prognosis and professional practice. Observation: This is a eutrophic newborn, born at term by vaginal delivery, who presented at birth with a unilateral absence of skin on the anteromedial aspect of the right leg starting from the knee and extending to the medial aspect of the right foot, with a dystrophy of the nail of the right big toe without any other visible physical malformation. The evolution was marked at D3 of life by the appearance of bullae on the right hand and elbow as well as on the posterior aspect of the neck, making epidermolysis bullosa suspect. The mother was 38 years old, 8th gesture, 7th pare with history of consanguinity and collodion baby. The association of a localized congenital absence of skin on the lower limbs, epidermolysis bullosa and a nail anomaly led to the diagnosis of congenital cutaneous aplasia of type VI of Frieden’s classification or Bart’s syndrome. The evolution was satisfactory on the 7th day of life with the beginning of scarring. The management was medical. The outcome was unfavorable with the appearance of sepsis and hemorrhage leading to death. Conclusion: Although rare, the clinical diagnosis of Bart’s syndrome is simple. However, the management is complex and the prognosis is reserved. To improve this prognosis, the treatment must guarantee excellent control of the infectious and hemorrhagic risks, an adhesion and good therapeutic compliance by the parents and a rigorous monitoring.

Etiologies and Prognostic Factors of Dyspnea in Infants at the University Hospital Center (CHU) of Bouaké (Ivory Coast)

Identify the epidemiological characteristics, etiologies and evolutionary aspects of dyspnea in infants. This was a retrospective study of infants hospitalized for dyspnea from January 1 to December 31, 2020. The parameters studied were sex, age, origin, vaccination status, existence of underlying pathology. Underlying, the diagnosis and the evolutionary modalities. Data analysis and processing were possible using Word, Excel and EPI info version 7 software. We retained 152 infants. The sex ratio was 1.34 and the median age was 4 months. Vaccines according to expanded immunization program (EPI) were up to date in 76.32%. The main antecedents with risk identified were malnutrition, hypotrophy at birth, interventricular communication. The pathologies observed were low acute respiratory diseases in 90.79%, ENT diseases in 04.60% and cardiac diseases in 03.95%. The median length of hospitalization was 4 days. Infants who died accounted for 15.13%. The median age of infants who died was 4 months. The median time to onset of death was 1.63 days. The risk factors for death were age < 6 months (p = 0.003;CI [1.27;9.33]), outdated vaccines (p = 0.012;CI [1.18;5.17]), history with risk (p = 0.031;CI [1.02;4.54]). Dyspnea in infants remains a concern in our service. Reducing mortality involves developing procedures for the management of lower respiratory ailments, continuous staff training and strengthening the technical platform.

Epidemiological, Clinical, Therapeutic, Evolutionary and Prognostic Aspects of Children with COVID-19 in Bouaké(Côte d’Ivoire)

Context: Compared to adults, there are relatively few studies on pediatric COVID-19 due to the high rate of asymptomatic or paucisymptomatic forms. The aim of this study is to determine the epidemiological, clinical, therapeutic, evolutionary and prognostic aspects of COVID-19 infection in children. Patients and Methods: This was a prospective analytical study carried out from February 27, 2021 to January 27, 2022 at the COVID-19 Care Center of the Infectious and Tropical Diseases Department of the Bouaké University Teaching Hospital. The study population consisted of all children under the age of 16, seen in consultation and/or hospitalized with a positive COVID-19 RT-PCR. Data analysis was performed with Epi Info 7 software. The statistical tests used were the chi-square test and Fisher’s exact test depending on the conditions of validity with a significance threshold of p Results: Out of 955 patients received at the COVID-19 Care Center in Bouaké, there were 56 children (26 boys/30 girls), or, a prevalence of 5.86%. The mean age was 9.18 years ± 4.48 [extremes 3 months and 15 years]. Children over the age of 11 accounted for 48.21% of cases. They were contact cases in 35.71% and the contact person was the mother in 75% of cases. The main reasons for screening were cough (67.86%), fever (25%) and sneezing (21.43%). The pathological histories were asthma (83.33%), heart disease (33.33%) and sickle cell disease (16.67%). The medical examination revealed 6 cases of children in vital distress. The care consisted of home confinement for simple cases (89.29%) and hospitalization for cases presenting with vital distress (10.71%). The duration of confinement or hospitalization was between 10 and 15 days in 83.93% of cases. No cases of death were noted. The factors associated with the occurrence of symptomatic forms were age (p = 0.028), pathological history (p Conclusion: The proportion of pediatric cases of COVID-19 is low with a predominance during the season of harmattan. Pediatric infection with COVID-19 is benign and has a favorable evolution, with an almost intra-family transmission wich symptomatology is different from that of adults. Age and pathological history were the factors associated with the occurrence of symptomatic forms.

Knowledge, Attitudes and Practices of the Health Personnel of the Pediatric and Gynecology-Obstetrics Departments of the BouakéUniversity Hospital Center (CHU) regarding the Intestinal Microbiota and the First 1000 Days of Life

Introduction: The harmonious development of the intestinal microbiota during the first 1000 days of life promotes the child’s immediate and future good health. The objective of the study was to evaluate the knowledge and practices of health personnel on the intestinal microbiota and the first 1000 days of life for the improvement of child health. Methods: Knowledge, attitudes and practices (KAP) type survey conducted among health personnel of the pediatric and gynecology-obstetrics departments of the Bouaké University Hospital from July 1 to 31, 2017. All consenting agents working in the said services and present at the time of the study were included. The parameters studied concerned socio-professional characteristics, knowledge of the intestinal microbiota, and knowledge and practice of the first 1000 days. The data analysis was descriptive and analytical with a significance threshold p ≤ 0.05. Results: Out of 224 active agents, 76 (30 men, 46 women) participated in the survey, i.e. 33.9%. The respondent came from the gynecology-obstetrics (54%) and pediatrics (46%) departments and had professional experience >5 years in 38%. Thirty-eight percent of the respondents had a good knowledge of the intestinal microbiota. Concerning the first 1000 days of life, 64.5% of the respondents had a good knowledge of the first 1000 days overall. They advised exclusive breastfeeding for up to 6 months in 95% of cases. When breastfeeding was not feasible, the main criterion for choosing the infant formula was the composition (57.1%). They proposed a standard infant formula (43%), enriched with prebiotic (29.4%), enriched with probiotic (21.6%), a symbiotic (6%). Good knowledge of the intestinal microbiota was associated with belonging to the paediatric service (p = 0.013), socio-professional category (p = 0.031), year of experience >5 years (p = 0.032) and the first 1000 days of life to year of experience >5 years (p < 0.01). Conclusion: The health personnel interviewed did not have a good knowledge of the intestinal microbiota and the first 1000 days. Capacity building is needed.

Factors Associated with the Unsuppressed Viral Load of Children on Antiretroviral Therapy Followed Up in the GbêkêRegion (Côte d’Ivoire)

Introduction: Unsuppressed viral load (VL) in immunocompromised children on antiretroviral therapy (ART) increases the risk of child morbidity and death. The aim of the study was to identify factors associated with unsuppressed viral load in children on ART for the improvement of prognosis. Patients and Methods: this is a retrospective, descriptive and analytical study carried out from July 2015 to December 2019 in the 28 pediatric HIV/AIDS treatment centers supervised by the NGO IRAA in the region of Gbêkê. It Included children from 0 to 15 years who were HIV positive, on ART for at least 6 months with at least one viral load. The variables studied were socio-demographic, diagnostic and evolutionary. Data analysis was descriptive and analytical with a significance level of p < 0.05. Results: out of 329 children included, 118 (62 boys, 53 girls) had a non-suppressed VL, i.e. a prevalence of 36%. The mean age at diagnosis was 61 months. The mother was a small trader (36.4%), illiterate (45.8%). Unsuppressed viral load was significantly associated with poor nutritional status at the start of treatment (p < 0.001), non-compliance with treatment (p < 0.001), poor maternal education (p = 0.011) and the lack of follow-up of the mother in the context of PMTCT (p = 0.03). Conclusion: Unsuppressed viral load is common in children on ART in the Gbêkê region. It mainly concerns the child who did not comply with ART, and whose mother was not followed within the framework of PMTCT. Strengthening early detection, early initiation of ART, PMTCT and increased therapeutic education strategies would improve the prognosis of children infected with HIV.

Knowledge, Attitudes and Practices of Mothers Regarding Exclusive Breastfeeding in Rural Areas of Brobo (Côte d’Ivoire)

Introduction:In C?te d’Ivoire, despite awareness raising among mothers by health authorities and health care providers, the exclusive breastfeeding rate is still low, 23%. This rate seems even lower in rural areas. The objective of the study was to evaluate the knowledge, attitudes and practices of mothers regarding exclusive breastfeeding for the reduction of malnutrition in rural areas. Methods: This was a descriptive and analytical cross-sectional study conducted in Brobo from July to September 2020. It included consenting mothers of infants aged 0 to 24 months. Mothers’ knowledge, attitudes and practice were assessed by an anonymous structured questionnaire with a performance threshold set at 75%. Factors associated with exclusive breastfeeding were investigated by the Chi-square test at the 5% level of significance. Results: The average age of the 183 mothers was 25 years (extremes 13 and 49 years). They were primigravida (33%) and had a low socioeconomic level (84%). The mothers knew the definition of exclusive breastfeeding (33%). They knew that breastfeeding promoted ideal infant growth (64%) and protected against diarrhea and infection (18%). They also knew that breastfeeding reduced the mother’s risk of cancer (16%) and strengthened the mother-infant bond (7%). The mothers interviewed stated that they had put the baby to the breast within the first hour after delivery in 2% and 63% of them gave the baby colostrum. Mothers were confident about breastfeeding (91%) and exclusive breastfeeding until 6 months of age represented 9%. The factor associated with lack of knowledge of exclusive breastfeeding was not attending school (OR 0.26;95%CI 0.14 - 0.48;p < 0.01) and those associated with good practice of exclusive breastfeeding were not attending school (OR 4.94;95%CI 1.09 - 22.21;p = 0.03) and multiparity (OR 0.30;95%CI 0.09 - 0.97;p = 0.04). Conclusion: The mothers interviewed in the rural areas of Brobo have insufficient knowledge, attitudes and practices regarding exclusive breastfeeding. To improve this situation, we recommend capacity building of mothers through awareness raising.

Primary Abscess of the Psoas of the Child: About a Case Observed at the University Hospital Center of Bouake

The primary abscess of the psoas of the child is a rare affection, the pathogenesis of which is still unexplained. The positive diagnosis of this condition is difficult and relies mainly on medical imaging. We report a case of primary psoas abscess in an immunocompetent child, whose diagnosis was facilitated by the provision of abdominal radiography without preparation and abdominal ultrasound. The evolution was favorable thanks to the combination of antibiotic therapy and surgery.