Descriptive and Analytical Study of Factors Associated with Mortality in Severe Malaria among Children in Dakar Emergency Departments from July to December 2022

Background: Malaria is the most widespread parasitic disease and remains a public health priority worldwide. The severe form is fatal if not treated early and appropriately. The aim was to carry out a descriptive and analytical study of the factors associated with mortality during severe malaria in children attending emergency departments in Dakar, Senegal. Methods: This is a prospective, observational and analytical study conducted over a 6-month period (July 1 to December 31, 2022), focusing on children hospitalized for severe malaria according to WHO severity criteria. Results: A total of 403 patients were hospitalized, including 78 cases of severe malaria (19.35%). Males predominated (60.26%) (sex ratio 1.51). The average age was 6.56 years [8 months - 14 years], with the [5 - 10 years] age group the most represented (40.26%). The average consultation time was 5.33 days (1 - 19 days). The main reasons for consultation were fever (70.51%), vomiting (24.35%) and convulsions (14.10%). Biological signs of severity were severe anemia (17.95%), renal failure (6.4%) and hypoglycemia (3.85%). Thrombocytopenia was noted in 52.56% of patients, including 32.05% of severe cases (sis in 61.41% of cases. Hyponatremia was noted in 39.74% of cases and hyperkalemia in 2 patients. Artesunate was the main drug used (93.59% of cases). Mortality was estimated at 1.5%. Factors leading to death were coma (P < 0.01), respiratory distress (P Conclusion: Malaria is still a public health problem, with a high mortality rate in emergency departments. Reducing this mortality rate requires effective management of the factors associated with death.

Particularities of Tuberculosis in Children and Adolescents with Sickle Cell Disease in Senegal

Introduction: Tuberculosis and sickle cell disease are one of the main global health priorities particularly in Africa. We aimed to determine the epidemiological, diagnostic and therapeutic aspects of tuberculosis in children and adolescents with sickle cell disease. Patients and methods: Patients aged 0 - 20 years with sickle cell anemia presented with tuberculosis at the Centre Hospitalier National d’Enfants Albert Royer (CHNEAR), Dakar, Senegal were included in the study. Medical history, risk factors, clinical, bacteriological, and outcome data was collected. Data was analyzed using the SPSS software, version 16. Results: A total of 25 cases of tuberculosis were documented from January 1st, 1991 to December 31st, 2019 (hospital prevalence: 0.97%). Mean age was 12.5 years. The sex ratio was 1.5 (15 girls and 10 boys). Pulmonary tuberculosis in 14 cases was the most frequent followed by lymph nodes in 7 cases involvement and Pott’s disease in 4 cases. In 5 patients Tb was multifocal. Mean duration of treatment was 8.27 months (6 to 12 months). Outcome was good on antituberculosis treatment. None patient died. Conclusion: Children and adolescents with sickle cell disease can be infected with Mycobacterium tuberculosis. Pulmonary tuberculosis, lymph nodes and bone involvement are the most frequent localizations. Outcome is good on antituberculosis treatment.

Epidemiology of Admissions in a Pediatric Emergency Department in Albert Royer Hospital Dakar

Background: Pediatric emergencies are a public health priority in Senegal. The objective was to describe the epidemiology of admissions to the emergency department of the Albert Royer National Children’s Hospital in Dakar, Senegal. Methods: Prospective, descriptive and analytical study over a period of 4 months (January-April 2020). The study population was children admitted for vital distress. Results: A total of 300 children met the inclusion criteria and represented the study population (2.83%). The majority (70.67%) were younger than 60 months, compared with 2.00% of newborns. Boys represented 53.8%, sex ratio 1.16. A proportion of 35.1% was referred. More than half of our patients (55.88%) were managed within 30 minutes of arrival. Medicalized transport concerned 21.5% against 78.5% of nonmedicalized. Emergencies were dominated by respiratory distress (56.33%), dehydration (29%) and shock (13.33%). We recorded 16 deaths (5.3%). This mortality was significantly related to the low socio-economic level (p = 0.000), as well as the young age of the children (p = 0.01). Conclusion: Life-threatening emergencies are frequent and responsible for significant lethality. Health policy efforts are still needed to reduce this infant and child morbidity and mortality.