Obstacles to the Integrated Care of Children Aged 6 to 59 Months Suffering from Acute and Severe Malnutrition at the Chu-Me and HATC of N’Djamena/Chad

Introduction: the problem of Severe Acute Malnutrition (SAM) and its consequences concern and challenge all social actors worldwide. The objective of the study was to identify the real obstacles that actors face in the integrated management of children aged 6 - 59 months suffering from SAM at the University Hospital of Mother and Child (CHUME) and the Chad-China Friendship Hospital (HATC) of N’Djamena. Methodology: this is a cross-sectional descriptive and interpretative study conducted from January to October 2023 at the CHUME and HATC of N’Djamena. It is based on questionnaires and direct observation of two hundred and thirty-six (236) parents or guardians of malnourished children admitted to these health facilities. All 236 agreed to participate freely in this study. Results: it appears from this study that the obstacles to the integrated management of malnourished children were: poor care-care relationship (26.7%) permanent product breaks (22.9%), the direct costs of services ranged from 30,000 to 60,000 FCFA (41.53%), drugs used for the treatment of patients came from the street (66.10%), malaria and anemia occupy an important place (27.5%), 57.2% respondents had monthly income below 60,000 CFAF. Conclusion: the present study carried out has identified the real bottlenecks to the integrated management of children suffering from SAM in the therapeutic nutritional units of the city of N’Djamena. .

Effectiveness of Enriched Flour in the Recovery of Children Aged 6 to 59 Months with Moderate Acute Malnutrition

Introduction: In Chad, malnutrition is a silent emergency. Yet the use of local products in the fight against malnutrition is essential. The purpose of this study was to compare the efficacy of locally sourced enriched flour in the recovery of children 6 to 59 months of moderate acute malnourishment compared to Ready-to-Use Therapeutic Foods (Plumpy’ Sup) in the city of Abéché-Chad. Methodology: This study took place from 1 October 2021 to 31 January 2022 in the city of Abéché, capital of the province of Ouaddaï. It was conducted in eight (8) urban health centers in the city of Abéché and concerned eighty (80) children with moderate acute malnutrition. It was based on a consumption assessment of two complementary foods by two groups of children. The assessment of nutritional status was made through anthropometric data such as weight, height and brachial perimeter. Results: All 80 children were tested for moderate acute malnutrition. Two complementary foods have been used which are locally produced flour and the Ready-to-Use Therapeutic Food. The study showed that the group 1 who consumed the locally produced flour had an average weight gain of 1100 g and the group 2 who consumed the Plumpy sup had an average weight gain of 400 g. Conclusion: The present study carried out in Abéché allowed us to compare the effectiveness of locally produced weaning flours with Ready-to-Use Therapeutic Foods on moderate malnourished child weight growth in the nutritional units of the town of Abéché.

Different Species of Salmonella spp and Shigella spp and Their Risk of Infection in N’Djamena Chad

Introduction: Salmonella and Shigella are gram-negative bacilli that are resistant to most antibiotics and play an important role in an etiology of diarrhea disease. The aim of the study was to determine the prevalence of Salmonella spp and Shigella spp isolated from stool and blood samples in the city of N’Djamena. Materials and Method: This was a prospective study conducted in the four district hospitals of N’Djamena from 14 July 2022 to 31 December 2022. A questionnaire form was drawn up to collect the information sent to the study patients. The samples were analyzed at the CHU de la Mère et de l’Enfant, Labo-Redes laboratory according to their protocols and the standard of the antibiogram committee of the French microbiology society. Results: Of the 803 biological samples analyzed, 39 were positive for Salmonella spp and Shigella spp, including 15 for Salmonella and 24 for Shigella, giving an overall prevalence rate of 4.85%. Borehole water, uncooked food and lack of access to a latrine constitute a risk of being infected by Salmonella spp and Shigella spp species. Of the 8 antibiotics tested, Salmonella spp and Shigella spp strains showed good sensitivity to nalidixic acid (100% for Salmonella and 90 for Shigella) and to ciprofloxacin (90.9% for Salmonella and 75% for Shigella). Resistance to ampicillin was found in 81.81% of Salmonella species and 78.57% of Shigella species, as was resistance to chloramphenicol (81.81% of Salmonella species and 67.85% of Shigella species). Similarly, cleanliness of the service and equipment is an essential factor in preventing Salmonella and Shigella infections.