Evaluation of Antibiotic Prescribing in the Pediatric Department of Gabriel TouréTeaching Hospital, Bamako, Mali

Objectives: The main objective was to evaluate antibiotic prescribing in the Department of Pediatrics at Gabriel Touré teaching hospital. Methods: This was a prospective descriptive study conducted from September 1 to November 31, 2018, in the Department of Pediatrics at Gabriel Touré teaching hospital. All children aged 0 to 15 years hospitalized for any pathology during the study period and having received at least one antibiotic had been included. Results: We collected 445 children’s records out of 1032 admissions during the study period, representing a hospital frequency of 43.1%. The sex ratio was 1.3%. The 2 - 5 age group accounted for 48.1%. Fever was the reason for consultation in 45.6% of cases. Patients’ general condition was altered in 60% of cases. The fathers were blue-collar workers in 65.4% and the mothers housewives in 85%, and had no education in 42.9% and 64.5% respectively. Hepatomegaly was present in 18.2%, splenomegaly in 9.6% and peripheral adenopathy in 3.1%. The site of infection was pulmonary in 37.6% and ENT in 9.2%. Bacterial infection was assumed on admission in 54% of cases, and meningitis in 57.7%. The discharge diagnosis was malaria in 54.6%, severe acute malnutrition in 18.6% and meningitis in 6.7%. The death rate was 3.8%. Neutrophilic leukocytosis was present in 47.3% of patients. CRP was positive in 85% of patients. Blood cultures taken in 27.6% of patients were positive in 5. CSF analysis in 30% of patients showed elevated leukocytes in 6.5%. No cultures were positive. Antibiotic prescription was justified by infectious hypotheses in 43.1% of patients. β-lactam antibiotics were prescribed in 98.6%. Antibiotic therapy was not adapted to national/international recommendations in 68.3% of cases, and was not justified in 16.3% of cases on D5 of hospitalization. Conclusion: Antibiotic use was justified in more than half of patients, but remained inadequate in almost two-thirds of cases, in line with national and international recommendations.

Time to recovery from severe pneumonia and its predictors among pediatric patients admitted in Mizan-Tepi University Teaching Hospital,South West Ethiopia,2022

Objective:Despite trials and programs for the prevention of childhood mortality due to pneumonia,Ethiopia is among the top five countries with the highest number of deaths due to pneumonia.Although the prevalence of pneumonia has increased in the abovementioned trials,little is known about the recovery time from severe pneumonia and its predictors in the study area.Therefore,this study aimed to assess the time to recovery from severe pneumonia and its predictors among pediatric patients admitted to Mizan-Tepi University Teaching Hospital,Ethiopia,in 2022.Methods:A total of 591 children admitted for severe pneumonia were selected using simple random sampling.Data were entered into Epi-data version 4.4.2.1 and expor ted to STATA version 14 for analysis,and the assumptions of Cox propor tional hazard models and goodness of fit were assessed through Shoenfeld residual and Cox-Snell residual,respectively.Bivariate and multivariable Cox regression models were used to identify the predictors of mor tality.Results:This study revealed that 91.54%(95%confidence interval[CI]:89.00–93.53)of participants recovered with an incidence rate of 24.10(95%CI:22.15–26.21)per 100 person-day–observations.The hmedian recovery time of children was 4 days(95%CI:2–6).Children who were not exclusively breastfed(AHR=1.3;95%CI:1.03–1.66),who had a history of inability to suck/feed(AHR=0.81;95%CI:0.65–0.99)were independent predictors of the time to recovery.Conclusions:Children with severe pneumonia who had not exclusively breastfed and who had a history of inability to suck/feed were independent predictors of time to recovery.Therefore,all stakeholders and concerned health care providers should focus more on early diagnosis and management and hasten early recovery based on the identified factors.

Epidemiological, Clinical, and Evolutionary Profile of Children Admitted to the Pediatric Emergency Department of the Maroua Regional Hospital, Cameroon

Introduction: Pediatric emergencies in developing countries are associated with high morbidity and mortality. The Maroua Regional Hospital (MRH) is one of the referral centers for pediatric emergencies in the Far north region of Cameroon. Pediatric emergencies are frequent in Maroua and are associated with significant mortality. The aim of our study is to determine the epidemiological, clinical, and evolutionary profile of children admitted to the pediatric emergency department of the HRM. Methods: We conducted an observational, descriptive, and retrospective study over a period from April 10, 2023 to April 10, 2024, focusing on the records of patients admitted to the pediatric emergency department of the MRH. The variables studied included epidemiological, clinical, and evolutionary characteristics. Data analysis was performed using CSPro version 8.01 and SPSS version 27.0. Results: We included 1027 patients;the sex ratio was 1.2 infants under 2 years represented 54.33%. The main reasons for consultation were fever (62.22%) and seizures (30.18%). The most frequently prescribed additional test was the Complete Blood Count (CBC), performed in 97.37% of cases. The most common pathologies were severe malaria (45.18%), broncho-pulmonary infections (15.48%), and bacterial meningitis (12.26%). At admission, 32.9% were transfused. There were 68 deaths, representing 6.67%, and 86% of the deaths occurred within 24 hours of admission. The leading cause of death was severe malaria, with 28 (41.17%) cases. Conclusion: Febrile illnesses were the main reason for consultation, and mortality was linked to severe malaria. Therefore, in addition to the other preventive methods already used against malaria, it is recommended to consider the use of the malaria vaccine.

Study of the Management of Children with Major Sickle Cell Disease in Pediatric Emergencies at the Gabriel Toure University Hospital

Objective: To study the epidemiological, clinical and therapeutic aspects of sickle cell disease in children admitted to the pediatric emergency department of the Gabriel Toure University Hospital. Materials and methods: This was a prospective study over 12 months in sickle cell children aged 6 months to 15 years. Results: The frequency of sickle cell disease was 4.67% with 71.1% of SS form. The age range of 60 - 120 months predominated with 43.4% and the sex ratio 1.4. Vaso-occlusive crises (VOC) were the most frequent reason for consultation (50.6%) and osteoarticular pain was the main symptom followed by fever and pallor with respectively 67.5%, 60.2%, 39.8%. The pain subsided in less than 72 hours in 39.8% and hyper hydration was performed in 85.1% of patients. Analgesic treatment was given in 90.4%, antibiotic therapy in 51.8% and phenotyped red blood cells transfusion was performed in 36.1%. The average duration of treatment was 10 days. Conclusion: Vaso-occlusive crisis remains the main reason for consultation in sickle cell disease children at Gabriel Toure University Hospital. The management consisted, in addition to the correction of the triggering factors, of hyper hydration and the administration of analgesics and blood products.

Cardiac Echography in Pediatrics at the Regional Hospital of Diourbel: Indication and Result

Childhood heart disease is a real public health problem. In our contexts, care remains a major challenge. Doppler echocardiography remains the essential examination for diagnosis. The objective of our study was to describe the different clinical indications for cardiac ultrasound in children and the main pediatric heart diseases at the Diourbel Heinrich Lübke Regional Hospital. This was a descriptive and analytical retrospective study spanning from 2020 to 2022;covering a series of 140 cases. The study was carried out using patient clinical observation sheets and consultation sheets. We identified 140 ultrasounds. The average age of patients was 35.96 months with extremes of 0.03 months and 192 months. The female sex was predominant, with an M/F sex ratio of 0.72. Ultrasound was systematically requested in 67.14% of the study population. The indications found were mainly: heart murmur, polymalformative syndrome, respiratory failure, bronchiolitis, cardiomegaly, suspicion of heart disease, cardiomegaly, pre-therapeutic and pre-operative assessment. A total of 71 cardiac abnormalities were found in 65 patients, i.e. a prevalence of 46.42%. Congenital heart disease was more frequent (found in 49 patients, a prevalence of 35%) and was dominated by the CIA. There was a female predominance in almost all heart diseases except in the case of endocarditis where codominance is found. Our study has made it possible, through echocardiography, to evaluate the indications for echocardiography in children, to determine the prevalence of heart disease in children and also to assess the relevance of requests for echocardiography.

Risk factors and prognosis of pediatric rhegmatogenous retinal detachment in Egypt:a university hospital based study

AIM:To study and compare the predisposing factors and clinical features of pediatric,adult,and elderly rhegmatogenous retinal detachment(RRD).METHODS:This is an observational analytic crosssectional study in which patients with RRD admitted for surgery during 6mo period were divided into 3 age groups:pediatric(<18y),adult(18-60y),and elderly(>60y).Patients’demographic data,clinical features,RRD predisposing factors/features including myopia(axial length≥26.5 mm),aphakia/pseudophakia,blunt trauma,peripheral retinal degenerations,history of RRD in the fellow eye,and surgical interventions/findings were recorded and analyzed.RESULTS:Totally 142 patients(142 eyes)were studied:26(18.31%)pediatrics,86(60.56%)adults,and 30(21.13%)elderly.Elderly patients had a significantly higher intraocular pressures and cataracts compared to the other 2 groups(P=0.04).The RRD extent was larger in pediatric group(mostly 4 quadrants)compared to adults and elderly(mostly 2 quadrants),but it was not statistically insignificant(P=0.242).There were not statistically significantly differences in proliferative vitreoretinopathy(PVR)rate,posterior vitreous detachment(PVD)rate,number,site,shape,and size of breaks in three groups.All three groups had macular detachment in all eyes.Myopia and peripheral retinal degenerations were found to be more significant in adults(P=0.049,P=0.035,respectively),while blunt trauma was higher but insignificant in pediatric eyes(P=0.052).Pars plana vitrectomy(PPV)with silicone oil as a tamponade was the most used surgery in all groups.CONCLUSION:There are no significant difference in PVR rate in pediatric eyes but a significant higher rate of total RRD.Blunt trauma is more frequent in pediatrics eyes while myopia and/or peripheral retinal degenerations are more frequent in older ages.The rate of PPV as a choice for surgery is similar among all age groups.

Violence on Health Professionals: Experience of the Obstetrics &Gynecology and Pediatrics Departments at the University Teaching Hospital of Bouake;, Cote d’Ivoire

Introduction: Violence in hospital is a major Public Health issue. In Cote d’Ivoire, acts of violence against health professionals exist and may sometimes take a dramatic turn. Objective: To research the causes of this violence for the purpose to prevent them. Materials and Methods: This is a cross-sectional, descriptive study conducted in the Obstetrics & Gynecology and Pediatrics departments at the University Teaching Hospital of Bouaké from 26 January 2016 to 24 February 2016. It included 129 health workers who gave their consent. The data collection was done through individual interviews followed by a focus group according to the socio-professional category. Results: Out of 129 health professionals included, 100 were a victim of violence i.e. a frequency of 77.5%. Most of the violence occurred during “on-call hours” (55.8%) in the emergency units (34.8%). The violence was verbal (52.5%), physical (28.6%), moral and psychological (11.6%), theft (7.3%). The aggression was mainly related to patient’s care (32.1%), visiting hours (26%) and the low level of understanding of the person (16.5%). The victim’s immediate feelings were dominated by frustration (26.7%), discouragement (21.3%) and insecurity (18.3%). The victims received a medical assistance in 9% of cases. To prevent this violence, the staff mainly offered to raise awareness about violence (27.6%) and the respect for hospital staff (25%). Conclusion: Violence against health professionals is common and has negative impacts on staff and hospital activity. Its prevention requires a holistic approach centered on awareness. Keywords: Violence, Hospital, Pediatrics, Staff, Cote d’Ivoire.

Medication Error (ME) in the Pediatrics Service of the University Teaching Hospital (CHU) of Bouaké(Côte d’Ivoire)

Introduction: Medication error (ME) is a common cause of childhood morbidity and mortality reported in developed countries. It has not yet been described in the pediatric services in Cote d’Ivoire. Objective: To evaluate ME in pediatrics for the improvement of professional practice. Materials and Methods: This was a cross-sectional, descriptive and analytical study conducted in the service of pediatrics at the University Teaching Hospital (CHU) of Bouaké from January 11 to February 25, 2016. It involved 204 children hospitalized and treated with drugs. The variables studied were the prescription, dispensing and administration of the drugs. Results: A total of 483 prescriptions notes were recorded for 733 therapeutic lines, i.e. 2.3 prescriptions notes and 3.6 lines per child. The overall prevalence of ME was 31% (prescription 83%, dispensing 0%, administration 11%). The prescription error concerned the illegible writing (20%), the omission of the stamp & signature (47%), the omission of the date (33%), weight (66%), age (25%) and name of the child (9%).The drug name and the dosage were incorrect in 99% and 1% respectively. Regarding the administration error, care was provided by a person without a nursing qualification in 65.5% of cases. On the patient’s care record, the care giver’s name was omitted in 100%, the child’s name in 57% and the date in 47%. The route of administration and the administered dose were each incorrect in 5%. The student nurses and assistant nurse caregivers committed more prescription errors than doctors and nurses and midwives (p= 0,000 X2 = 44.91). Administration error was not significantly related to the service, the socio-professional category, the gender and the age of the patient. Conclusion: EM is common in pediatrics at the University Teaching Hospital (CHU) of Bouaké. To prevent it, it is necessary to strengthen the staff’s capacity to prescribe and administer the drug in children.

Isolated Right Pulmonary Agenesis in a 2-Month-Old Infant in the Pediatric Ward of Hospital of Mali

Introduction: Pulmonary agenesis is a rare congenital abnormality defined by the absence of parenchyma, bronchi and pulmonary vessels, frequently associated with other malformations. We describe a case of isolated right pulmonary agenesis diagnosed in the pediatric ward of the Mali Hospital. Clinical case: He was a month-old baby boy, born at term by cesarean section of a well-followed pregnancy. He was not resuscitated. He developed dyspnea after a cold. An emergency chest X-ray revealed a right opaque lung. He was referred to the hospital for the exploration of this opacity. At the entrance, it weighed 3910 g, size: 54 cm and the temperature was 36.9°C. He had a polypnea, an intercostal print. The sounds of the heart were diverted to the right. The rest of the clinical examination was without much particularity. The chest CT scan confirmed the right pulmonary agenesis. Abdominal and cardiac ultrasound was normal. A healing includes oxygenotherapy, serum glucose 10% minding 100 ml/ Kg/day and amoxicillin minding 100 mg/ Kg/day at 3 times by oral way. After 24 hours of treatment, we observed an improvement in dyspnea. On D2, he was weaned off oxygen and resumed feeding. Conclusion: Pulmonary agenesis is a rare congenital anomaly that is frequently associated with other malformations, thus making its prognosis poor. The search for malformative abnormalities should be systematic in right pulmonary agenesis.

Epidemiological Profile of Pediatric Vital Emergencies at Laquintinie Hospital of Douala, Cameroon

Introduction: In the absence of health coverage in resource limited-settings, life-saving pediatric emergencies remain a challenge. The objective of our study was to describe the epidemiological profile of life-threatening pediatric emergencies at Laquintinie Hospital in Douala (HLD). Methods: A cross-sectional study was carried out for a period of 3 months, from March to May 2017 in the pediatric emergency unit of HLD enrolling all children presenting a life-threatening emergency on admission. Local emergency kits and an internal deferred cost recovery voucher or “green voucher” were used to facilitate access to care for children on admission. The socio-demographic, clinical, therapeutic and evolutionary characteristics were collected and analyzed using SPSS software version 20.0. Results: A total of 135 children were enrolled and the sex ratio was 1.54. The mean age was 3.8 years ± 4.05 and 80.7% of the children were under 5 years old. The majority of children (82.9%) admitted to the emergency room came from peripheral health structures. The hospital prevalence of life-saving emergencies was 42.4%. The mean time to consultation after the onset of symptoms was 5.9 days and 66.0% of admissions were made during the 3 p.m. to 8 a.m. time slot. More than 4/5 of emergencies were neurological, respiratory and cardio-circulatory emergencies representing 35.6% and 18.5% respectively. Severe malaria accounted 31.9% of the etiologies, bronchopneumopathies and meningo-encephalitis were involved in 18.5% and 17.8% of cases respectively. Patients were managed within 30 minutes of admission in 75.6% of cases and 52.6% of them received a “green voucher”. The average length of stay in the emergency room was 6 days. The death rate from life-threatening emergencies was 17.8% and represented 61.5% of total deaths recorded in pediatric emergencies. Conclusion: The profile of life-threatening emergencies at the HLD was that of a child under 5 years old, coming from a peripheral health facility and presenting a neurological emergency.

Perception of the Hospital Nutrition Service by Internal Clients: Example of the Results Obtained in the Area of Production of Pediatric Formulas and Enteral Diets

Aim: Client perception was important to indicate points requiring interventions or adjustments and to permit refinement of the services offered. This study aimed to determine the perception of internal clients regarding the quality of the service after integrating these items into the system of electronic prescription. Methods: We applied a questionnaire elaborated based on the SERVQUAL about the five dimensions of service quality (tangibility, reliability, responsiveness, safety, and empathy) with adaptation of the four-point Likert scale, ranging from “I fully disagree” to “I fully agree”. Results: The instrument was applied to 138 professionals, with a 56% return. Analysis revealed that the strong points were related to tangibility, safety and empathy, while the aspects related to reliability showed a lower score regarding time of delivery, occurrences and waste, and those related to responsiveness showed a lower score regarding service to be provided in a timely manner. The Cronbach Alpha Coefficient indicated that the investigation had a high degree of consistency and that the results could be considered reliable. Conclusion: Application of the adapted SERVQUAL questionnaire revealed that the perception of internal clients about the five quality dimensions after the changes made and provided valuable information for the scoring of aspects that still needed adjustment to improve interventions.

Study of Tuberculosis in Children Aged 1 Month to 15 Years in the Pediatric Ward of the Hospital of Mali 2015-2021

Introduction: In 2020, an estimated 9.9 million people are living with tuberculosis worldwide, including 1.1 million children. Tuberculosis is the 2nd leading cause of death from infectious disease after COVID-19 and the 13th leading cause of death worldwide. Objective: To collect cases of tuberculosis in children aged 1 month to 15 years in order to study the epidemio-clinical aspects in the pediatric department of the Mali Hospital during the period 2015-2021. Materials and Methods: This was a descriptive, retrospective study from January 1, 2015, to December 31, 2020, and a prospective study from January 1 to December 31, 2021, among children aged 1 month to 15 years admitted for suspected tuberculosis in the pediatric ward of the Mali Hospital. Results: From January 2015 to December 2021, we collected 69 cases of tuberculosis among 9438 hospitalized children, i.e. a frequency of 0.73%. The average age was 6.16 years with extremes of 3 months and 15 years. The sex ratio was 1.1% in favor of boys. The majority of children were vaccinated against tuberculosis (88.4%). The most frequent symptoms were fever (76.8%) and weight loss (73.9%). The pulmonary form was the most frequent (54.9%). Bacteriological confirmation was done in 43.5% of our children. It was Mycobacterium tuberculosis in all confirmed cases. More than half of our children (65.2%) were treated with first-line anti-tuberculosis drugs for 6 months. We observed a cure in 42.0% of our patients and a case fatality rate of 39.1%. Conclusion: Tuberculosis in children is frequent in Mali Hospital despite good BCG vaccination coverage. Its mortality remains high and is maintained by malnutrition, HIV, and the emergence of resistant strains of bacilli.

Reducing Extended Hospital Lengths of Stay

In the United States, the costs of health care have become a major burden for the health care system. In order to address this problem, the hospitals of Syracuse, New York, developed programs to provide subacute and complex care. The Subacute programs provided patient transportation services for dialysis and other types of care outside hospitals. They also developed programs for services such as intravenous therapy in nursing homes. The Complex Care Programs, such as intravenous therapy and mental health services, have provided alternatives to extended care in hospitals. During the past five years, utilization of these programs has varied, declining between 2019 and 2022, and then increasing between 2022 and 2024. The programs have avoided the need for 1530 - 2974 patient days in hospitals. The programs saved the Syracuse hospitals approximately $600 per inpatient day. This amounted to savings of $918,000 - $1,784,400 per year. These programs demonstrated how relatively small mechanisms can save large amounts of health care resources.

Non Hodgkin Lymphomas (NHL) in the Pediatric Oncology Unit of the Gabriel TouréTeaching Hospital, Bamako Mali

Background :Non-Hodgkin lymphomas are the first childhood cancer in sub-Saharan Africa. Objective: The purpose of this study was to assess non-Hodgkin lymphomas cases in our setting. Methodology: A retrospective and descriptive study carried out in the pediatric oncology unit of the Gabriel Touré Teaching Hospital Bamako over 10 years from 1st January 2005 to 31th December 2015. Results: We exploited 274 (21.6%) cases of Non-Hodgkin Lymphoma out of 1295 cancer cases registered, the age group 6 - 10 years was the most represented (46.4%);the male sex was predominant with a sex-ratio of 1.8;digestive signs were the most common signs of discovery (44.2%) followed by maxillary swelling (42.7%);the majority of patients (52.9%) consulted between 1 and 3 months after the onset of signs;the malnutrition rate was 39.8%, of which 24.1% were severe cases and 15.7% were moderate rate. Abdominal localization was the most common (43.1%) followed by maxillofacial localization (33.9%). Almost all were Burkitt type cytology (92.7%), the majority (73.4%) were in Murphy stage III. Almost all (96%) had received chemotherapy and the modified LMB 01 protocol was widely used (62.4%). The majority of patients (85%) were chemosensitive at day 7 or after the third cyclophosphamide injection but at the end of induction only 31% were in complete remission. Gastrointestinal toxicity was the most common (37.13%) followed by hematologic toxicity 35.09 %;9.12 % of patients were lost of follow-up and 22.26% died. Tumor progression was the most common cause of death (60.66%) followed by infection (21.31%). Conclusion: In light of these findings, the late diagnosis and the poor management of NHL, as well as the limited ability to primarily treat metabolic complications, explain the high case-fatality rate, hence the important role of early diagnosis and treatment multidisciplinary.

A Centralized Report on Pediatric Japanese Encephalitis Cases from Beijing Children's Hospital,2013

Fifteen pediatric cases of suspected Japanese encephalitis （JE） were reported in Beijing Children＇s Hospital during the late summer of 2013. The clinical manifestations in most cases included high fever, seizures, and abnormal magnetic resonance imaging findings. Twelve of 15 cases were laboratory-confirmed as JE cases by pathogen identification. Epidemiological investigations showed that five of the 12 laboratory-confirmed patients had an incomplete JE vaccination history. Follow-up investigations after discharge indicated that seven laboratory-confirmed JE patients without JE vaccinations had relatively poor prognoses, with an average Modified Rankin Scale （MRS） score of 2.6 when compared with the other five laboratory-confirmed, JE-vaccinated patients with an average MRS score of 0.5. The observation of pediatric JE cases among those with a history of JE vaccination warrants further attention.

Pneumothorax in Children: A Study of 47 Pediatric Cases at Mali Hospital 2017-2020

Objectives: Pediatric pneumothorax, whether primary or secondary (infection, trauma, or iatrogenic), is sometimes life-threatening. We tried to determine the clinical characteristics of pediatric pneumothorax in Mali. Materials and Methods: We collected all pediatric patients (0 - 15 years) admitted for pneumothorax in the pediatric department of the Mali Hospital from January 2017 to December 2020. Results: During this period, a total of 5569 children aged 0 - 15 years were hospitalized, of whom 47 had pneumothorax or 0.84%. Children under 5 years of age were the most affected (80%). Dyspnea was the most common reason for hospitalization (95.7%). The causes of pneumothorax were (in order): infectious causes dominated by bullous dystrophies (70.2%), traumatic (25.5%), and iatrogenic (4.2%). Pneumothorax was compressive in 42.6%. The frequency of anemia was 79.3%. Surgical drainage was performed in 87.2% and almost all (97.6%) were treated with amoxicillin/clavulanic acid. The mean duration of hospitalization was 10.06 days (range: 0 - 35 days): 74.5% were cured while 25.5% died. Conclusions: We reconfirmed that pneumothorax is a pediatric emergency. Children under 5 years of age are the most affected. The main etiologies are infectious bronchopneumonia. The prevention and treatment of respiratory infections, the implementation of good bacteriological diagnostic tools, and the use of surgical video-thoracoscopy will reduce its mortality rate.

A diagnosis with a twist:Ultrasonographic sensitivity and predictors of pediatric ovarian torsion within a large pediatric hospital

The diagnosis of ovarian torsion(OT)in girls is challenging compared to that of testicular torsion in boys for many reasons,but it behooves the medical community to continue to strive to better identify this uncommon but clinically important pathology^([1]) OT occurs when the ovary and associated structures rotate around its vascular pedicle,leading to eventually irreversible necrosis.^([2,3])Studies attempting to identify clinical features for early diagnosis have not reached a consensus on the best clinical predictors of this condition,making radiographic imaging of the ovaries even more crucial.^([4,5])

Ten-year Etiologic Review of Chinese Children Hospitalized for Pediatric Cataracts

Purpose:Our aim was to obtain a better understanding of the etiologies and characteristics of pediatric cataracts treated at a single facility in China.Methods:.Medical records accrued over a 10-year period(from August, 2003 to July, 2013) at Shengjing Hospital of China Medical University were reviewed retrospectively,ide ntifying all patients treated for various subtypes of pediatric cataract..A database with 367 subjects under 14 years of age(598, including second-round surgeries) was generated.Results:.Of this cohort(n =367; males: 232, 63.2%; females: 135, 36.8%), 200 patients(54.5%) had bilateral cataracts,and 258(70.3%) were under 3 years of age. In all age groups and in all subtypes of pediatric cataract,.males were most commonly affected..Congenital cataract was the most prevalent subtype, accounting for 296 patients(80.7%). Most congenital cataracts were associated with other ocular or systemic abnormalities;.and in 48 patients(16.22%),.they were hereditary..Traumatic cataract was the most common subtype(85.92%) of acquired cataract. The few instances of cataracts due to steroids(n=3) or to metabolic disorders(n=2) occurred in males and involved both eyes.Conclusion: The majority of pediatric cataracts in this patient population were congenital in nature. A significant lag in ophthalmologic evaluation of Chinese infants was evident and should be addressed by educating both children and parents on risk factors for cataract development. Regular assessments are especially important in children subjected to long-term systemic steroid treatments.

Risk Factor for Malnutrition in Children Aged 6 to 59 Months Hospitalized in a Pediatric Ward in the South of the Sahara

Malnutrition is a major public health problem in Mali, along with the country’s political and security instability. We initiated this work with the objective of determining the frequency as well as the risk factors favoring the occurrence of malnutrition in children aged 6 - 59 months hospitalized in the pediatrics department of the Gabriel Touré University Hospital in Bamako, country reference service to identify potential interventions to plan. A cross-sectional study was carried out over a period of 4 months. A bivariate logistic regression analysis allowed us to identify risk factors with degree of significance if p < 0.05. During the study period, 2888 children were hospitalized, including 348 aged 6 to 59 months, or a frequency of 12.04%. One in two children was malnourished, i.e. a frequency of 50%. It more frequently affected infants aged between 6 and 23 months with a frequency of 33.7%, with a hospital frequency of growth retardation which was 23% including 14.7% of severe form. The emaciation was 27% of which 18.7% were severe form. The underweight was 42.2% with 31% in severe form. We found the diet inequality in all malnourished and non-malnourished children. A bivariate analysis showed that children with an out-of-school mother have a 2.4-fold risk of being malnourished (OR = 2.425;CI = 1.9 - 4.2;p < 0.03). Also children from households with no stable income (non-salaried father) have twice the risk of children from a household with stable income (OR = 2.120;IC = 1.1 - 4.1;p < 0.002). Finally, inappropriate nutrients (early introduction of food and early weaning) have been strongly associated with the occurrence of malnutrition. The prevalence of malnutrition reflects the way children eat. Emphasis should be placed on nutritional education and financial stability in households.

Epidemiology of Renal Failure in Children at the Pediatric University Hospital Charles De-Gaulle of Ouagadougou (Burkina Faso)

Objective: Renal failure (RF) is a serious condition that is still insufficiently evaluated in our context. We wanted to know its epidemiology at the Pediatrics University Hospital Center Charles De-Gaulle (PUHC-CDG) of Ouagadougou. Patients and Methods: We retrospectively studied all children aged from three to fifteen years old who were diagnosed with renal failure (RF) in the Department of Medical Pediatrics, from January 1, 2011 to December 31, 2013. RF was defined by a glomerular filtration rate (GFR) less than 80 mL/min/1.73m2, estimated by the formula of Pottel et al., which ignored the size that was rarely found in the medical records. The department constantly lacked pediatric blood pressure monitors or urinary strips. Results: In total, 119 cases of RF (3.3% of all admissions) were collected. They were about acute RFs (ARFs), chronic RFs (CRFs), and Unclassified RFs (URFs), respectively in 28.6%, 2.5% and 68.9% of cases. The overall average age of patients was 6.7 ± 3.4 years old. The average GFR was 35.2 ± 22.2 mL/min/1.73m2. The mechanism of ARF was presumed to be organic in 26 cases (76.5%). The most common presumed etiology was malaria (47.9%). Twelve patients (10.1%) died. Conclusion: RF was common at the PUHC-CDG but it was unclassified in over half of the cases. The diagnosis was based on the estimation of the GFR by Pottel et al.’s formula which was a good alternative to the Schwartz’s formula. The improvement of human and material resources would certainly help for a screening and characterization of RF at the PUHC-CDG.