G. Moyen

Étude de onze nouveaux cas congolais de maladie de Kawasaki

Kawasakis disease (KD) is a rarely described entity in Africa. The purpose of this work is to describe the clinical, biological and evolutionary aspects of KD in the Congolese child. This is a retrospective study of 11 cases of KD collected from 2003 to 2014 at the University Hospital of Brazzaville. The diagnosis was based on the criteria proposed by the Mucocutaneous Lymph Node Syndrome Research Commitee and validated by the Center for Disease Control grouping the major criteria originally described by Kawasaki and updated by the American Heart Association. The sex-ratioM/F was 2.7 and the mean age of 16.5 ± 5.9 months (range 9 to 43 months). The average intake time was 12.8 ± 5.9 days (range 6 and 30). In nine cases there was a complete form. The symptoms began with an invasion of the upper airway in 8 cases. Achieving oropharyngeal was in the form of oral enanthema with strawberry tongue and / or angular cheilitis; it was associated with perineal erythema in 7 cases. Reaching the end realized swelling and/or redness and / or peeling finger gloves or flap toes. The latter occurred at an average of 11 ± 3.5 days (range 8 to 16) after the start of the fever. The treatment with acetylsalicylic acid administered to all children, began within varying between 4 and 15 days of admission. The defervescence was obtained after 5.3 ± 2.6 days (range 4 to 11). The average hospital stay was 16.6 ± 9.7 days (range: 11 to 25 days). The evolution after discharge was considered favorable in all cases. However, no control echocardiography was performed. KD remains an ubiquitous condition but with a variable incidence from one continent to another. The arrival of the twodimensional ultrasound should enable the systematic investigation of coronary abnormalities to catch up unnoticed past cases but also to prevent complications related there.

Priapisme chez l’enfant et l’adolescent drépanocytaire homozygote à Brazzaville

OBJECTIVE To determine the prevalence of priapism, assess knowledge and appreciate its characteristics in childhood sickle cell disease. METHODOLOGY A case-control study was conducted at the University Hospital of Brazzaville (Department of Pediatrics, Hematology and Clinical Urology). The cases consisted of 202 sickle cell anemia who are at least 5 years. Witnesses consisted of 112 children with sickle cell disease not of the same age from the same family as the previous. RESULTS Priapism was found in 68 (34%) affected children, divided into 54 cases (79.4%) of chronic intermittent priapism and 14 cases (20.6%) of acute priapism. In the control group no cases were observed (p=0.001). Priapism was known by six (3%) patients in the group of children with sickle cell disease. In the control group, it was known by 25 (22.3%) children. It was seen in the group of sickle cell disease as any: 113 children (56%), a natural phenomenon that can occur in life: 57 children (28%), a complication of sickle cell disease: 26 children (13%). In the control group, it was considered a natural phenomenon that can occur in life: 60 children (53.6%), a complication of sickle cell disease: 52 children (46.4%). The average age of priapism occurred in the first episode was 10.4±9.5 years. CONCLUSION The importance of the prevalence of priapism, and insufficient knowledge needed strengthening information, education and communication with children and their parents.

Knowledge, Attitudes, and Practices of Parents Facing Child and Adolescent Obesity in Brazzaville, Congo

The study aimed to assess obesity-related knowledge, attitudes, and practices of parents when facing child and adolescent obesity in order to improve the quality of care. A case-control study was conducted from February 1 to July 1, 2013. The study compared parents of obese school children (group 1 or cases; n = 254) and those school children without obesity (group 2 or controls; n = 254). These children were drawn from public and private primary schools of Brazzaville (Congo). Obesity-related knowledge was satisfactory in 83.5% of the cases, attitudes were correct in 29% of the cases, and the practices good in 25.6% of the cases. The parents’ obesity-related knowledge was satisfactory when the socioeconomic level of the family was high (P < .02), the mothers’ educational level greater than primary (P < .001), and the fathers’ educational level was greater than primary (P < 10−4). The same observation was obtained with obesity-related attitudes and practices of the parents when correct. This influence remained after the adaptation of fathers’ educational level. In conclusion, the disease-related knowledge of parents can be considered satisfactory in the majority of the cases; however, obesity-related attitudes and practices remain incorrect in most of the cases.

Study of 9 Cases of Tuberculosis Pneumonia in Children at Chu of Brazzaville, Congo

In the Republic of Congo, a country where tuberculosis is endemic, there have not been many reports about tuberculosis pneumonia. This study aimed to describe the epidemiology, clinical features, and outcome of tuberculosis pneumonia in children. This was a retrospective study of 9 cases of children admitted from 2002 to 2015, that is, 0.7 cases per year. The average age was 37 months. The mean delay from the beginning of symptoms to the visit to a medical center was 36 days (range = 4-93 days). Physical examination indicated a pulmonary consolidation in 6 cases. Chest X-ray revealed a unilateral opacity in all cases. Sputum and gastric washing bacilloscopies were positive in all cases, and HIV serology was positive in 2 cases. Therapeutic observance was perfect and the evolution favorable. Tuberculosis pneumonia must be systematically proposed for children under 5 years of age, who present symptoms that are in contrast with the seriousness of chest X-ray injuries.

Étude de onze nouveaux cas congolais de maladie de Kawasaki Study of 11 new cases of Kawasaki disease Congolese

Kawasakis disease (KD) is a rarely described entity in Africa. The purpose of this work is to describe the clinical, biological and evolutionary aspects of KD in the Congolese child. This is a retrospective study of 11 cases of KD collected from 2003 to 2014 at the University Hospital of Brazzaville. The diagnosis was based on the criteria proposed by the Mucocutaneous Lymph Node Syndrome Research Commitee and validated by the Center for Disease Control grouping the major criteria originally described by Kawasaki and updated by the American Heart Association. The sex-ratioM/F was 2.7 and the mean age of 16.5 ± 5.9 months (range 9 to 43 months). The average intake time was 12.8 ± 5.9 days (range 6 and 30). In nine cases there was a complete form. The symptoms began with an invasion of the upper airway in 8 cases. Achieving oropharyngeal was in the form of oral enanthema with strawberry tongue and / or angular cheilitis; it was associated with perineal erythema in 7 cases. Reaching the end realized swelling and/or redness and / or peeling finger gloves or flap toes. The latter occurred at an average of 11 ± 3.5 days (range 8 to 16) after the start of the fever. The treatment with acetylsalicylic acid administered to all children, began within varying between 4 and 15 days of admission. The defervescence was obtained after 5.3 ± 2.6 days (range 4 to 11). The average hospital stay was 16.6 ± 9.7 days (range: 11 to 25 days). The evolution after discharge was considered favorable in all cases. However, no control echocardiography was performed. KD remains an ubiquitous condition but with a variable incidence from one continent to another. The arrival of the twodimensional ultrasound should enable the systematic investigation of coronary abnormalities to catch up unnoticed past cases but also to prevent complications related there.

Profil évolutif de l’anémie grave due au paludisme chez les enfants congolais

Le paludisme dans sa forme grave a fait l’objet de plusieurs travaux abordant aussi bien les aspects épidémiologiques que cliniques et thérapeutiques [1,2]. Dans sa forme anémique, il se singularise par les difficultés de prise en charge inhérentes aux dysfonctionnements rapportés dans les hôpitaux des pays en développement. D’autre part, la physiopathologie de cette forme explique certaines de ses particularités. Ce travail se propose de décrire les aspects évolutifs du paludisme grave dans sa forme anémique. Une étude prospective a été conduite du 1er septembre 2012 au 31 août 2013 dans le service de pédiatrie du centre hospitalier universitaire (CHU) de Brazzaville. Cette étude a concerné les enfants de moins de 5 ans admis pour anémie sévère due au paludisme tel que défini par l’Organisation mondiale de la santé (OMS) [3]. Tous les enfants qui présentaient des antécédents d’hémoglobinopathies, ceux dont l’anémie était associée à d’autres formes du paludisme grave et ceux dont la recherche d’hématozoaires par goutte épaisse était négative ont été exclus. Le traitement a reposé sur l’administration des sels de quinine en perfusion ou des dérivés de l’artémisinine. Les transfusions sanguines ont fait appel aux culots érythrocytaires conformément aux règles transfusionnelles. Pour les enfants ayant eu une numération formule sanguine (NFS) avant la transfusion, la dose de sang à transfuser a été calculée selon la formule : (hémoglobine souhaitée – hémoglobine du