Factors Associeted with Home Accidents in Childhood at Regional Teaching Hospital of OuéméPlateau

Introduction: Home accidents (HA) are often unknown in Benin compared to infectious pathologies. The aim of this work was to determine the prevalence and the factors associated with HA in children admitted to the CHUD-OP. Method: This was a cross-sectional study conducted from August 1st to October 31th 2021. We studied children aged 0 to 18 who presented with HA to the pediatrics and emergency reception and triage departments at CHUD-OP. We defined HA as “any event occurring inside the home or in the immediate vicinity of the home that resulted in an injury which was not done deliberately. Results: The hospital frequency of HA was 8.4% (61/725). The median age was 5 years with a male to female ratio of 1.6. Trauma was the leading cause of HA (59%) followed by poisoning (23%). Falling was the main mechanism of trauma (80.6%). The toxins causing poisoning were dominated by caustics (28.6%). The age of the children (p = 0.02), the level of education of the mothers (p , and the area they occur (kitchen with p = 0.04 and on the stairs with p = 0.03) were statistically associated with the occurrence of trauma. Conclusion: HA are common among children admitted at CHUD-OP and factors associated with HA are identified. Measures to prevent home accidents among children in the community should be considered.

Febrile Seizures in Children at the Departmental Teaching Hospital of OuéméPlateau: Etiologies and Risk Factors for Death

Background: Febrile seizures are the most frequent neurological disorder in pediatrics. They have multiple etiologies and require urgent management. The aim of this survey was to study febrile seizures in children at the Departmental Teaching Hospital of Ouémé Plateau (DTH/OP). Method: This was a cross-sectional survey, conducted from January 1, 2020, to December 31, 2020, in the pediatric department of the DTH/OP. Children aged 1 month to 18 years, hospitalized for febrile seizures recognized at the anamnesis and/or during the physical examination were included in this study. Results: The frequency of seizures was 17.08% (510/2986). The male to female ratio was equal to 1.4. The mean age was 44.27 ± 40.75 months. The seizure was generalized tonic-clonic in 77.9% of cases and localized in 11.6% of cases. The main etiologies were severe malaria (75.5%), sepsis (21.6%), enteric infections (14.9%) and pneumonia (10.2%). Diazepam was the anticonvulsant treatment used in the first intention (79.7%). Most of the children were hospitalized for 3 to 7 days. The recovery rate was 82.3% and the fatality rate was equal to 17.7%. Eight children presented sequelae. There was a statistically significant link between the children’s clinical outcome and age (p < 0.001);severe malaria (p < 0.001);sepsis (p < 0.001) and enteric infections (p = 0.003). Conclusion: Febrile seizures were frequent in the pediatric emergency department of the DTH/OP. There is a need to intensify sensitization on malaria prevention measures in the community and improve case management at the hospital.

Prise en Charge des Pleuresies Infectieuses de L’Enfant Dans Trois Hopitaux du Sud du Benin Management of Infectious Pleurisies in Three Hospitals in the South of Benin

Objective: Infectious pleurisy is a frequent hospitalization indication in pediatrics in developing countries. This study aims to describe infectious pleurisies’ features and to identify its death factors in three teaching hospitals in Benin. Design: This was a prospective, descriptive and analytical study including children aged 01 months to 17 years who were hospitalized in pediatrics in the three hospitals for pleurisy from September to December 2019. Results: Among the 3379 children admitted, 25 presented with an infectious pleurisy, making a hospital frequency of 0.74%. The sex ratio was 0.8. The majority (19/25) of the children were less than 5 years old. The mean age was 38 ± 5.88 months. Most of the parents had a low education (42/50) and socio-economic status (18/25). The main symptoms were fever (25 cases), dyspnea (23 cases) and cough (22 cases). The majority of the children (21/25) were up-to-date in regards with the Expanded Immunization Program (EIP) vaccines and none had received non-EIP vaccines. Almost all children (24 cases) had a respiratory distress (24/25). On chest X-ray, there were abundant pleural extravasations in 12 cases. The main pathogens found were Staphylococcus aureus (16 cases), Streptococcus pneumoniae (3 cases) and Streptococcus A (1 case). All children received oxygen and antibiotic therapy;pleural drainage was performed in 22 children. The average length of stay was 14 days ± 6.4. Twenty-one children were healed without sequelae, one child had a post-drainage keloid scar, and two children died. Factors associated with the death of these children were admission delay for more than 7 days (p = 0.035) and presence of respiratory distress (p = 0.049). Conclusion: Pleurisy remains a concern for children admitted in our hospitals and early management is imperative.

Interest of Procalcitonin Measurement in Children with Cerebral Malaria in Southern Benin

Introduction: Cerebral malaria is a major complication of the Plasmodium falciparum infection with a high case fatality rate. The objective of this study was to determine the relationship between cerebral malaria and high serum procalcitonin (PCT) level in children. Method: This was a prospective descriptive and analytical cohort study conducted over 12 months, on a series of PCT blood tests in children aged 6 months to 15 years old hospitalized for cerebral malaria in the pediatric wards of four hospitals in southern Benin. The cerebral malaria diagnosis was done based on WHO criteria. Blood samples for PCT measurement were collected on admission, 24 hours and 48 hours after the malaria therapy initiation. Student’s test, Pearson’s chi2 test, Fisher’s test and Kruskal-Wallis test were used where appropriate. For all comparisons the difference was significant when p was less than 5%. Results: Sixty-five children were included in the study with a sex ratio of 1.41. The age group of children under 5 years was the most represented, at 57%. PCT levels were high in 92.3% of children at admission, 90.8% at 24 hours and 84.6% at 48 hours. Forty-nine children had a positive clinical outcome while 16 died (24.6%). PCT levels were generally high over the three days of hospitalization, but higher at admission in case of death (p = 0.000). The association between PCT level and parasitemia at admission was significant (p = 0.04). Conclusion: In the view of the results, blood PCT level measured at admission could be predictive of the disease outcome in children with cerebral malaria.

Benefits of Artesunate versus Quinine in the Treatment of Children with Severe Malaria at the National University Teaching Hospital of Cotonou

Introduction: Severe malaria is one of the leading causes of death in Sub-Saharan African countries, and artesunate is recommended as a first-line treatment by the Word Heath Organization (WHO.). Objective: Identify the advantages of artesunate compared with quinine in the treatment of severe malaria in children. Methods and patients: This study was a cross-sectional, descriptive and analytical study focused on children hospitalized for severe malaria in the CNHU who were treated with quinine or artesunate. Findings: The hospital-based frequency rate of severe malaria in pediatric patients was estimated to be 28.3% (n = 848). One hundred five children were treated with artesunate, and 743 were treated with quinine. The mean age of the children was 47 months old. The primary signs of severity were anemia (n = 776), neurological manifestations (n = 309) and hemolysis (n = 137). The average duration of treatment was 1.95 days for artesunate versus 2.45 days for quinine, and the difference was statistically significant (p = 0.001). The average length of stay (ALOS) in the hospital was 5 days for the artesunate group versus 5.75 days for the quinine group, and the difference was statistically significant (p < 0.001). Six of the children who received artesunate died, whereas 24 children who treated with quinine died. The total average cost of healthcare was 50,600 FCFA (77 euros) per child treated with artesunate versus 57,100 FCFA (87 euros) per child treated with quinine. Conclusion: The treatment of severe malaria with artesunate is superior to quinine-based treatment.

Seizures in Children in the Lagoon Mother and Child University Hospital Center (CHUMEL) of Cotonou: Community Practices and Risk Factors for Death in Benin

Introduction: The experience of convulsions is full of myths in our socio-cultural context. Objectives: To determine the frequency of seizures, to identify community practices in the care of seizures and the death risk factors. Methods: We conducted a prospective, descriptive and analytical study between April and August 2015 in the pediatric ward of the Lagoon Mother and Child University Hospital Center (CHUMEL) of Cotonou. We included children aged from 1 month to 15 years old hospitalized for either febrile or non-febrile convulsions happened at home. Results: A total of 102 cases of convulsion were included, 11.3% of hospitalizations. These were mostly children under 5 years, 87/102 (85.3%). Traditional resuscitation procedures were performed on 81 children (79.4%). They consisted of the forced introduction of objects in the mouth in 46 cases (46.1%), the oral administration of various products in 39 cases (38.2%), the ocular instillation of products in 10 cases (9.8%). Nineteen bodily injuries were found. The lethality was 15.8%. The risk factors for death identified were the use of traditional healers and the delay in consultation. Conclusion: The high frequency of seizures, the severity of seizures, the harmful traditional practices performed, and the delay to consultation require to strengthen the education of the population.

Contribution of the Urine Dipstick to Urinary Tract Infection Diagnosis among Children in Two Hospitals in Cotonou-Benin

Introduction: Urinary tract infections are a daily concern in pediatric nephrology with long-term risks for high blood pressure and renal failure. The purpose of this study was to determine the contribution of a urine dipstick (UD) to the diagnosis of urinary infections among children at the CNHU-HKM and the Lagoon Mother and Child University Teaching Hospital (CHU-MEL) of Cotonou. Patients and Methods: This study is a cohort, descriptive and analytical study focused on children with suspected urinary infections in the pediatric units of the CNHU-HKM and CHU-MEL of Cotonou from March 25 to August 25, 2015. Results: Two hundred and four children out of a total of 5125 admitted children (4%) presented with at least one clinical sign of a urinary tract infection. Children under 36 months of age were predominant (41%). The main clinical signs of urinary infections were fever (60.8%) and urinary disorders (38.2%). The urinary dipstick test was positive in 145 children (71.2%). A urinary tract infection was confirmed by urine culture in 38 children (18.6%). In cases with leucocyturia- and nitrituria-positive urine dipstick tests, the sensitivity was estimated to be 13.2%, and the specificity was 95.2%, with a negative predictive value (NPV) of 82.8%. Only when the leucocyturia test was positive, the sensitivity was 76.3%, and the specificity was 31.9%. When the leucocyturia test was negative, the specificity was estimated to be 94%, and the sensitivity was 83% in the nitrituria-positive cases and 15.8% in the nitrituria-negative cases. The main isolated pathogens were Escherichia coli (n = 21) and Klebsiella pneumoniae (n = 14). Conclusion: In our environment, a negative leucocyturia test may help exclude urinary tract infections in most cases.

The Determinants of Fatal Outcomes during Severe Malaria in Children at the HKM University Teaching Hospital of Cotonou-Benin

Introduction: Malaria particularly affects children in sub-Saharan African countries. This study aimed to investigate the factors associated with death in cases of severe childhood malaria to better understand the determinants of death in these children. Patients and Methods: This cohort, descriptive and analytical study was conducted from April 1 to August 15, 2015, at the CNHU-HKM pediatric clinic in Cotonou. Recruitment was exhaustive for all patients under 15 years of age who were admitted for severe malaria, as confirmed by thick smear microscopy. Results: Among the 1774 admitted patients, 449 had severe malaria caused by Plasmodium falciparum (i.e., a hospital frequency of 25.31%). The age group most affected consisted of children younger than 60 months of age (73%);female predominance was noted. The lethality rate of malaria was 13.1% (n = 59). The factors associated with death were coma (p = 0.032), poor convulsive status epilepticus (p = 0.08) and bacterial co-infection by gram negative bacteria (p = 0.021) with respectively correlations coefficient of 0.003, 3.940 and 2.424. Conclusion: Reduction of the malaria mortality rates in Benin hospitals will depend on appropriate management of poor prognostic factors, such as coma, bacterial co-infection and convulsive illness.