Introduction: In emerging countries where studies are rarer, the epidemiological profile of infective endocarditis resembles that of developed countries at the beginning of the antibiotic era. There is little data ava...Introduction: In emerging countries where studies are rarer, the epidemiological profile of infective endocarditis resembles that of developed countries at the beginning of the antibiotic era. There is little data available in Mali on this subject, motivating this study, the aim of which was to study the etiological factors of infective endocarditis in children aged between 1 month and 15 years hospitalised in the paediatric department of the CHU Gabriel Touré. Patients and Methods: We conducted a cross-sectional and descriptive study, which took place from August 2018 to August 2019 (13 months), in children aged between 1 month and 15 years hospitalised in the paediatric department of the Gabriel Touré University Hospital with an ultrasound- confirmed cardiac disease and a temperature above 38°C. Results: The hospitalization rate was 0.4%. The average age was 11 months, the sex ratio was 1.35. Respiratory distress (63.6%) and fever (30.3%) were the most common reasons for referral. Congenital heart disease (87.9%) and dyspnoea on feeding (24.2%) were the most common medical histories. IVC was the most frequent congenital heart disease (36.4%). The mean temperature was 39.1°C. Blood cultures were taken in 24 patients (72.7%) and were positive in 27.3%. Staphylococcus aureus was found in 55.6% of cases. Trans-thoracic ultrasound found vegetations in 03 cases. According to the modified DUKE criteria, the diagnosis of endocarditis was retained in 27.30%. The evolution was marked by a high case fatality rate (45.45%). Conclusion: Endocarditis is an uncommon disease in children with a pulmonary portal of entry and Staphylococcus aureus as the main germ. Its mortality remains high.展开更多
Introduction: Children’s heart disease is a major public health problem in developing countries and especially in Mali. The purpose of our work was to determine frequency, different types of heart disease and their s...Introduction: Children’s heart disease is a major public health problem in developing countries and especially in Mali. The purpose of our work was to determine frequency, different types of heart disease and their short term evolution in the pediatric department. Methods: We performed a retrospective study among children aged 0 to 15 years, hospitalized in the pediatric department from January to December 2015 and whose diagnosis was confirmed using trans-thoracic echocardiography. Results: We included 103 cases of heart disease out of a total of 8613 admissions in the pediatric department, giving an hospital prevalence of 1.2%. Mean age was 4.1 years (from 1 day to 15 years) and children under 5 years were the most affected with 73.80% of cases. Male predominance was noted (sex ratio = 1.2). Respiratory distress was the most common circumstance of discovery (93.20%). Cardiac murmur and tachycardia were the most common cardiac signs with respectively 88.35% and 83.50%. Congenital heart disease accounted for 70.87% and was dominated by ventricular septal defect (VSD) with 30.13%. Acquired heart disease (29.13% of the sample) was dominated by mitral regurgitation (MR) with 56.67%. Mortality rate was 31.9% for congenital heart disease and 11.1% for acquired heart disease. Conclusion: children’s heart disease is responsible for high mortality. Early detection improves the management of this pathology, which remains frequent.展开更多
Introduction: It is known for decades that a correlation among child blood pressure and adult pressure exist. There are few publications on Hypertension (HTN) in pediatric area. We therefore conducted this study to es...Introduction: It is known for decades that a correlation among child blood pressure and adult pressure exist. There are few publications on Hypertension (HTN) in pediatric area. We therefore conducted this study to estimate the extension of HTN among children and looking for associated factors. Methods: Blood pressure was assessed using the references released by the National institutes of health in the United States, those of the French Society of Pediatric Nephrology and z-score. We used the auscultation method with appropriate cuff adapted to the child’s upper arm. We got for each arm 3 blood pressure measures taken children seated or lying on the back and mean blood pressure was calculated and used for the evaluation of the pressure level. The arm with the higher blood pressure was considered for the study. Socio-demographical and clinical data were collected anonymously on a formulary and then inserted in a Microsoft Access Database. Analysis was done using Statistical Package for the Social Sciences (SPSS) software using appropriate tests. Results: The study involved 154 patients (boys:girls = 56.5:43.5) aged 3 to 16 years. Patients of 11 years and older made 57.1% of the sample. Most patients suffered from severe malaria (35.1%, glomerular and heart diseases with respectively 16.2% and 9.1%. The global proportion of hypertensive patients was 27%, 39% and 5.2% respectively based on references of the French society of nephrology, those of the 4th report of the NHBPEP and standard deviation. Looking for associated factors with hypertension the logistic regression found no predictor for hypertension using pressure cut-offs values based on the French society of nephrology and those of the 4th report of the National High Blood Pressure Education Programm (NHBPEP). Conclusion: Children must be checked for hypertension to avoid organ damage and later cardiovascular complications. Blood pressure assessment should be preferably done on outpatients as the role of the stressful hospitalization environment can be attenuated.展开更多
文摘Introduction: In emerging countries where studies are rarer, the epidemiological profile of infective endocarditis resembles that of developed countries at the beginning of the antibiotic era. There is little data available in Mali on this subject, motivating this study, the aim of which was to study the etiological factors of infective endocarditis in children aged between 1 month and 15 years hospitalised in the paediatric department of the CHU Gabriel Touré. Patients and Methods: We conducted a cross-sectional and descriptive study, which took place from August 2018 to August 2019 (13 months), in children aged between 1 month and 15 years hospitalised in the paediatric department of the Gabriel Touré University Hospital with an ultrasound- confirmed cardiac disease and a temperature above 38°C. Results: The hospitalization rate was 0.4%. The average age was 11 months, the sex ratio was 1.35. Respiratory distress (63.6%) and fever (30.3%) were the most common reasons for referral. Congenital heart disease (87.9%) and dyspnoea on feeding (24.2%) were the most common medical histories. IVC was the most frequent congenital heart disease (36.4%). The mean temperature was 39.1°C. Blood cultures were taken in 24 patients (72.7%) and were positive in 27.3%. Staphylococcus aureus was found in 55.6% of cases. Trans-thoracic ultrasound found vegetations in 03 cases. According to the modified DUKE criteria, the diagnosis of endocarditis was retained in 27.30%. The evolution was marked by a high case fatality rate (45.45%). Conclusion: Endocarditis is an uncommon disease in children with a pulmonary portal of entry and Staphylococcus aureus as the main germ. Its mortality remains high.
文摘Introduction: Children’s heart disease is a major public health problem in developing countries and especially in Mali. The purpose of our work was to determine frequency, different types of heart disease and their short term evolution in the pediatric department. Methods: We performed a retrospective study among children aged 0 to 15 years, hospitalized in the pediatric department from January to December 2015 and whose diagnosis was confirmed using trans-thoracic echocardiography. Results: We included 103 cases of heart disease out of a total of 8613 admissions in the pediatric department, giving an hospital prevalence of 1.2%. Mean age was 4.1 years (from 1 day to 15 years) and children under 5 years were the most affected with 73.80% of cases. Male predominance was noted (sex ratio = 1.2). Respiratory distress was the most common circumstance of discovery (93.20%). Cardiac murmur and tachycardia were the most common cardiac signs with respectively 88.35% and 83.50%. Congenital heart disease accounted for 70.87% and was dominated by ventricular septal defect (VSD) with 30.13%. Acquired heart disease (29.13% of the sample) was dominated by mitral regurgitation (MR) with 56.67%. Mortality rate was 31.9% for congenital heart disease and 11.1% for acquired heart disease. Conclusion: children’s heart disease is responsible for high mortality. Early detection improves the management of this pathology, which remains frequent.
文摘Introduction: It is known for decades that a correlation among child blood pressure and adult pressure exist. There are few publications on Hypertension (HTN) in pediatric area. We therefore conducted this study to estimate the extension of HTN among children and looking for associated factors. Methods: Blood pressure was assessed using the references released by the National institutes of health in the United States, those of the French Society of Pediatric Nephrology and z-score. We used the auscultation method with appropriate cuff adapted to the child’s upper arm. We got for each arm 3 blood pressure measures taken children seated or lying on the back and mean blood pressure was calculated and used for the evaluation of the pressure level. The arm with the higher blood pressure was considered for the study. Socio-demographical and clinical data were collected anonymously on a formulary and then inserted in a Microsoft Access Database. Analysis was done using Statistical Package for the Social Sciences (SPSS) software using appropriate tests. Results: The study involved 154 patients (boys:girls = 56.5:43.5) aged 3 to 16 years. Patients of 11 years and older made 57.1% of the sample. Most patients suffered from severe malaria (35.1%, glomerular and heart diseases with respectively 16.2% and 9.1%. The global proportion of hypertensive patients was 27%, 39% and 5.2% respectively based on references of the French society of nephrology, those of the 4th report of the NHBPEP and standard deviation. Looking for associated factors with hypertension the logistic regression found no predictor for hypertension using pressure cut-offs values based on the French society of nephrology and those of the 4th report of the National High Blood Pressure Education Programm (NHBPEP). Conclusion: Children must be checked for hypertension to avoid organ damage and later cardiovascular complications. Blood pressure assessment should be preferably done on outpatients as the role of the stressful hospitalization environment can be attenuated.
