Acute Bilirubin Encephalopathy: A Propos of 151 Cases Collected during a Multicentric Study in Senegal

Introduction: Bilirubin encephalopathy is a debilitating complication of severe neonatal unconjugated bilirubin jaundice. The aim of this study was to determine the frequency of occurrence of this complication and to describe the diagnostic and prognostic aspects in Senegal. Materials and Methods: This was a multicenter, descriptive and analytical study conducted in 32 neonatal units of various levels, with retrospective (January to December 2020) and prospective (January to August 2021) collection. All neonates hospitalized for acute bilirubin encephalopathy were included. The diagnostic criteria were the presence of jaundice associated with neurological signs (muscle tone disorders, abnormal movements, convulsions, etc.), with no other obvious etiology found. The data were entered and analyzed using SPSS version 23 software. The significance threshold was retained for a p-value Results: We registered 151 patients. The mean age was 6 days and the sex ratio was 2.5 (clear male predominance). The majority of newborns were from Dakar (51%). Twenty-two (22%) were premature and 32% had low birth weight. Half of the newborns (50%) came from home and 87% were exclusively breastfed. The average time to consult was 3 days. Neurological signs were dominated by decreased primitive reflexes (74%), abnormal movements (59%) and lethargy (50%). Dehydration (30%) and anemia (26%) were often associated. The mean bilirubin level was 416 umol/l. Neonatal infections (19%) and Rhesus (16.7%) and ABO (8.7) incompatibility were the main causes. One third (33%) of patients had received intensive phototherapy and only 2% had received exchange blood transfusion. The case fatality was 48.9%. Conclusion: Bilirubin encephalopathy remains a major concern in Senegal. It is associated with high mortality and numerous neurological sequelae. Progress in terms of early detection and appropriate management is urgently needed on a national scale.

Quality of Well Water Used for Market Gardening from Lendeng Area Located in Common of Rufisque (Senegal)

This study analysis was conducted to know the quality of well water around the market gardening area of Lendeng located in the common of Rufisque Est (Senegal). In this study, six groundwater samples were taken near the Lendeng market gardening area. The physicochemical parameters of water such as pH, temperature, electrical conductivity (EC), calcium (Ca2+), magnesium (Mg2+), potassium (K+), iron (Fe2+), chloride (Cl-), sulfate (SO3-4) and phosphate (PO3-4) were measured. The analysis results obtained show sulphate and phosphate have the highest levels. These results were compared to drinking water standards from the World Health Organization (WHO). The correlation coefficient ANOVA was applied to the test result of the samples. The statistical study showed that the well water in the market gardening area of Lendeng is not polluted.

COVID-19 Infection and Homozygous SS Sickle Cell Disease in Children: About Two Cases in Ziguinchor/Senegal

The World Health Organization declared that corona virus diseases-19 (COVID-19) is a public health emergency. The COVID-19 pandemic is more likely to cause disaster in developing area including West Africa due to limited medical resources. COVID-19 reportedly causes severer conditions in adults with advanced age and in patients with underlying comorbidities including sickle cell anemia. We recently experienced two pediatric patients with sickle cell disease (SS), who had COVID-19. We here highlight the difficulties of management and the severity of COVID-19 infection in children with homozygous sickle cell SS.

Epidemiological, Diagnostic and Therapeutic Aspects of Cardiogenic Shock in Children at the Albert Royer Children’s Hospital in Dakar

Introduction: The objective of this study was to evaluate the epidemiological, diagnostic and therapeutic aspects of cardiogenic shock in children at the Albert Royer Children’s Hospital in Dakar. Methods: This was a retrospective, descriptive and analytical study from January 2020 to February 2021, including all children aged 2 months to 16 years hospitalised for cardiogenic shock diagnosed on the basis of clinical and ultrasound criteria. Results: During the study, 38 patients were hospitalised for cardiogenic shock. The hospital prevalence was 4.2%. The mean age of onset of shock was 64 months, and there was a predominance of females with a sex ratio of 1.92. Consanguinity was found in 42% of the patients. Consanguinity was found in 42% of patients. Infection was identified as a trigger for cardiogenic shock in 18 (52.9%) of our patients. The most common type of heart disease was rheumatic heart disease in 12 (32%) of the patients. The mortality rate was 65.8%. Conclusion: Cardiogenic shock is a diagnostic and therapeutic emergency. Its prevalence and mortality are still high in developing countries.

Eagle’s Syndrome in Children: A Case Report

Eagle’s syndrome is a collection of symptoms caused by styloid process elongation or calcification of the stylohyoid ligament, measuring more than 2.5 centimeters. It is a radio-clinical entity characterized by a heterogeneous polymorphic symptomatology most often involving headaches, facial pain, dysphagia and a foreign body sensation in the throat. Its management is mainly surgical. It is a rarely diagnosed condition in children. Here we report a typical case of Eagle’s syndrome which was diagnosed in a 14-year-old child with a history of chronic right unilateral pharyngeal discomfort, odynophagia and oropharyngeal foreign body sensation. CT scan showed a long left styloid process. The patient underwent surgical removal of the elongated styloid process externally. The outcome was favorable after surgery.

Malaria Characteristics in Children with Sickle Cell Disease

Background: The relationship between sickle cell disease and malaria is the subject of much controversy. However, there is a lack of data in our services. Our objective was to study the epidemiological, diagnostic and evolutionary characteristics of malaria in children with sickle cell disease followed in a specialized setting. Patients and Methods: We conducted a retrospective, descriptive, and analytical study of children with sickle cell disease (SCD) who presented with malaria and were followed at the Ambulatory Care Unit for Sickle Cell Children and Adolescents (USAD) at the Albert Royer National Children’s Hospital in Dakar, from January 1st, 2017, to December 31th, 2019. We included all the followed pediatric patients, less than 16 years, with sickle cell disease who presented at least one episode of malaria, confirmed by a positive thick drop, during this 3 years. We did not include patients with incomplete records or those older than 16 years. The clinical and biological signs, the follow up was collected and analyzed with Excel package 2019. Results: Of 3773 patients followed for sickle cell disease, 21 had presented malaria. The frequency was 0.5% or 7 cases/year. However, we exploited the data of 14 of them. The sex ratio was 6 boys for a girl and the mean age at admission was 7.3 years. The highest number of malaria cases was observed in 2018 and the peak frequency was observed in November with 8 cases (57.1%). Fever was the most frequent symptom, observed in 10 patients (71.4%). All patients were SS homozygous, with a mean baseline hemoglobin level of 7.5g/dl. All patients had a positive thick blood smear and Plasmodium falciparum was the only species found in the blood smear, with a mean parasite density of 1693 parasites/ml of blood. All patients had anemia, with a mean hemoglobin level of 7.74 g/dl. Twelve patients (85.7%) were hospitalized and had all received injectable artesunate followed by oral Artemisinin Combination Therapy (ACT). Long-lasting insecticidal nets were used in 9 patients (69.2%). The evolution was favorable in all patients, any death was reported. NO REPRESENTATION OF YOUR DATA IN TABLES OR FIGURES: it was a little serial. Conclusion: The patients who presented the association of malaria and sickle cell disease were all SS homozygotes. However, malaria must be considered as serious in this chronic anemic setting. That’s why it is important to improve prophylaxis.

Primary Immune Deficiencies (PID): Diagnosis Challenges

Background: Primary Immune Deficiencies (PID) are rare, under-determined diseases particularly in sub-Saharan Africa. The diagnosis is often suspected with uncommon clinical signs. Infections are the main diagnostic circumstances in infants. Confirmation is often difficult because some additional examinations are unavailable in many of our countries. Aim: Our aim was to share the challenge of diagnosis and treatment in PID. Case Presentation: It is about two infants, a boy and a girl, with early several infections. Both of them presented a hypo-gammaglobulinemia and to the boy, the immuno-phenotyping lymphocyte showed a decreased level of lymphocytes CD19. We are looking for genetic confirmation but it is not easy. The treatment of these infants requires a substitution for life of immunoglobulin which is unavailable in our countries. Conclusion: PID are suspected with atypical clinical signs. Confirmation genetic diagnosis is difficult in low income countries. To improve the follow up, we need to strengthen clinical-biological collaboration.

Trace Metals in Mussels <i>Mytilus galloprovincialis</i>from Dakar Coast (Senegal)

Mussel samples from the Dakar coast (Senegal) were analysed using Inductively Coupled Plasma-Mass Spectrometry (ICP-MS). Microwave acid digestion was also employed for metals (Mn, Pb, Cd, As) determination. Dakar coast usually receives numerous domestic and industrial discharges without prior treatment. The contents of Arsenic were, in all cases, higher than other metals. However, the bivalve molluscs present themselves as effective bio-monitors when assessing marine aquatic pollution by contaminants in the Dakar coast. The ANOVA analysis allows concluding that significant differences were found between mussels from different sampling points. In all cases, the February samples have in all cases a higher content than those collected in October.