Introduction: Acute myeloblastic leukaemia (AML) is a haematological malignancy with a poor prognosis, despite significant therapeutic progress. This study presents the results of AML management in Mali according to G...Introduction: Acute myeloblastic leukaemia (AML) is a haematological malignancy with a poor prognosis, despite significant therapeutic progress. This study presents the results of AML management in Mali according to GFAOP recommendations. Methodology: This was a retrospective, cross-sectional study. It included patients aged 0 - 15 years treated in the paediatric oncology unit for AML and followed up between January 2016 and December 2020. Results: During the study period, 85 cases of acute leukaemia were diagnosed in the paediatric oncology unit (including 51 cases of ALL), of which 34 cases of AML were included in this study. The majority were boys (59%). The mean age was 8 years, with extremes of 18 months and 15 years. The mean time to diagnosis was 68 days. In 79% of cases, patients were referred by 1st or 2nd level hospitals. Anaemia was observed in 91% of cases, an infectious syndrome in 68%, haemorrhage in 56% and a tumour syndrome in 85%. The haemogram showed hyperleukocytosis in 15% of cases, thrombocytosis in 22% and severe anaemia in 73%. Death occurred in 85% of cases, most often in the context of sepsis or haemorrhage. Conclusion: AML is probably underestimated in Mali and diagnosis delayed, which may be explained by patient-related factors (lack of knowledge, financial constraints) and a cumbersome referral system. These results suggest the need to implement an appropriate diagnostic and therapeutic strategy, with strong involvement of the political authorities.展开更多
Juvenile systemic lupus erythematosus is a rare entity, affecting children under 16 years of age. Girls are more often affected than boys and the female predominance increases significantly with age. The initial manif...Juvenile systemic lupus erythematosus is a rare entity, affecting children under 16 years of age. Girls are more often affected than boys and the female predominance increases significantly with age. The initial manifestations are highly variable with an insidious and progressive onset. Non-specific symptoms include fever, anorexia, weight loss and asthenia. Pericarditis is the most common cardiac manifestation in systemic lupus erythematosus (SLE), occurring in 10% to 40% of cases. The biological elements of the diagnosis and follow-up of pediatric SLE are identical to those of adults and are based on regular measurement of complement, native anti-DNA antibodies, and inflammatory findings. Treatment is essentially based on corticosteroid therapy.展开更多
Sickle cell disease is a hereditary disease that remains a public health problem in Mali. Our objective was to study strokes in children with sickle cell disease aged from 6 months to 15 years in the pediatrics depart...Sickle cell disease is a hereditary disease that remains a public health problem in Mali. Our objective was to study strokes in children with sickle cell disease aged from 6 months to 15 years in the pediatrics department of the Gabriel Toure university hospital center. This was a retrospective descriptive study from April 1, 2019 to March 31, 2021 and prospective from April 1, 2021 to April 30, 2022, i.e. 3 years, which took place in the Pediatrics department of the Gabriel Toure university hospital center. During this study, we identified 22 cases of stroke among 714 children with sickle cell disease. The frequency of stroke in this population is 3.08%. The age group from1 to 5 years was the most affected with 40.9%. The average age of the patients was 7 years with extremes ranging from 1 year to 15 years and a median of 5 years. The male gender was predominant with 54.5%, for a sex ratio of 1.2. Headaches were the most common neurological antecedents (63.5%). Half of the patients were diagnosed with sickle cell disease after the onset of the stroke. The installation of the deficit was progressive in 54.5% of cases. Consciousness disorders were the most frequent reason of consultation (27.2%), followed by convulsions (18.1%). The most common neurological signs were impaired consciousness and hemiparesis with 45.5% each. The stroke was ischemic in 100% of cases. There were 95.5% of SS forms and 4.5% of Sβ<sup>0</sup>thalassemia forms. Our patients had a hemoglobin level less than 7 g/dl in 57.1% of cases and between 7 and 9 g/dl in 42.8% of cases and hyperleukocytosis (leukocytes > 10,000/mm<sup>3</sup>) in 95.4% of cases. The Sylvian artery was the most affected (45.5%). The fatality rate was 22.7%.展开更多
Introduction: Respiratory distress is a frequent cause of morbidity and mortality in neonates. The aim of this study was to assess its frequency and describe its clinical and evolutionary characteristics in the neonat...Introduction: Respiratory distress is a frequent cause of morbidity and mortality in neonates. The aim of this study was to assess its frequency and describe its clinical and evolutionary characteristics in the neonatology department of the Gabriel Touré University Hospital in Bamako. Methodology: This was a prospective cross-sectional study conducted from 1 January 2021 to 30 June 2021. All term neonates aged 0 to 28 days hospitalised with signs of respiratory distress (tachypnoea, nasal flaring, expiratory whining, intercostal and subcostal indrawing, xiphoid funneling and cyanosis) were included. The sociodemographic and clinical variables of the newborns and their mothers were analysed using SPSS.20 software. Results: During the study period, 1272 newborns were admitted to hospital, including 705 born at term, of whom 188 were included in the study. The mothers’ ages ranged from 14 to 45 years, with an average of 24 years. The pregnancy was not followed up in 15% of cases. Newborns were resuscitated at birth in 51% of cases. The main clinical signs observed were hypoxia, neurological disorders and fever. Perinatal asphyxia (55%), neonatal infections (34%) and congenital malformations (6%) were the main causes of respiratory distress. Mortality was estimated at 37%. Conclusion: Neonatal respiratory distress is a major cause of death. Most causes can be avoided if pregnancy and delivery are properly managed.展开更多
Objectives: The main objective was to study the epidemiological, diagnostic and therapeutic aspects of medullary aplasia (MA). Methods: This was a prospective and descriptive retro study conducted from January 1, 2008...Objectives: The main objective was to study the epidemiological, diagnostic and therapeutic aspects of medullary aplasia (MA). Methods: This was a prospective and descriptive retro study conducted from January 1, 2008 to December 31, 2018 in the pediatric oncology unit of the pediatrics department of the Gabriel Touré teaching Hospital in Bamako. Results: We collected 29 children’s cases out of 1632 admissions during the study period, representing a frequency of 1.8% and an incidence of 2.6 cases per year. The sex ratio was 2.6. The 11 - 15 age group accounted for 45%, with an average age of 8.93 years. The majority of fathers (55.2%) and mothers (62.1%) had received no education;they were mainly farmers (62.1%) and housewives (86.2%). The average consultation time was 92.21 days. Anemia was the reason for consultation in 69% of cases. Pallor was present on admission in 96.5%;infectious syndrome accounted for 79.3%, anemic syndrome for 51.7% and hemorrhagic syndrome for 27.6%;the three syndromes were associated in 27.6%. Malaria was associated with bone marrow aplasia in 58.6%. Anemia was present in 93.1%, neutropenia in 65.5% and thrombocytopenia in 86.2%. All had received a labile blood product (LBP) transfusion, and 24 (83%) had received antibiotics. Patients were treated with corticosteroids (58.6%), androgens (20.7%) and immunosuppressants (20.7%). The death rate was 34.6%. At last count, 15 (83%) had discontinued treatment, 2 (11%) were undergoing treatment and 1 (6%) was in remission. Conclusion: Effective treatment of MA requires improved technical facilities and better economic conditions for parents.展开更多
Objective: The main objective was to study the disturbances of the Blood Count of children hospitalized in the general pediatric of the Gabriel Touré teaching hospital. Methods: This was a prospective and descrip...Objective: The main objective was to study the disturbances of the Blood Count of children hospitalized in the general pediatric of the Gabriel Touré teaching hospital. Methods: This was a prospective and descriptive study conducted from September 1 to November 30, 2018 in the general pediatrics department of the Gabriel Touré teaching hospital in Bamako. Data were collected on patient records using a survey sheet. Results: We collected 512 files of children out of 1030 admissions during the study period;the rate of completion of the blood count is 50%. The male sex was predominant with a sex ratio of 1.3. The majority of patients were under 5 years old (58%). The majority of fathers (56%) and mothers (64%) of children had no education;they are mainly farmers (61%) and housewives (88%). Pallor was the reason for consultation in 29% of patients and present in 60%. On blood count, anemia was present in 92% of patients, half of whom (50%) had severe anemia with a hemoglobin level below 7 g/dL. The anemia was mainly microcytic (72%) and hypochromic (66%). Hyperleukocytosis (62%), eosinophilia (68%) and basophilia (58%) were the abnormalities observed in the white line. Thrombocytopenia accounted for 40%. Severe malaria (53%) was the main discharge diagnosis and almost all patients (99%) were alive at discharge. Conclusion: The characteristics of anemia require a study of the complete blood count in healthy children with dosage of serum iron and ferritin for a better understanding of the phenomenon.展开更多
Acrodermatitis enteropathica is a rare autosomal recessive genetic disorder characterised by periorificial dermatitis, alopecia and diarrhoea. It is caused by a mutation in the gene that codes for a membrane protein t...Acrodermatitis enteropathica is a rare autosomal recessive genetic disorder characterised by periorificial dermatitis, alopecia and diarrhoea. It is caused by a mutation in the gene that codes for a membrane protein that binds zinc. We report a case in a 7-month-old girl, admitted with altered general condition and scaly, pustular erythematous lesions, initially located in the occipital and cervical regions, and secondarily inguinal and on the knees. Management and outcome in this patient? Genetic assay was not available to confirm this rare genetic disease. A delay in establishing the diagnosis and a disastrous outcome did not save the patient despite the administration of zinc.展开更多
Introduction: Congenital heart disease is an important cause of mortality, chronic morbidity, and disability in children in poor countries. The objective of this study was to highlight the diversity of congenital hear...Introduction: Congenital heart disease is an important cause of mortality, chronic morbidity, and disability in children in poor countries. The objective of this study was to highlight the diversity of congenital heart defects in the neonatology department. Methodology: This work had taken place in a neonatology service over a period of six months from January 2019 to June 2019. It was a prospective descriptive study with information collected from the medical records of newborns with congenital heart disease. Results: Of 1478 neonates hospitalized during the study period, 41 had congenital heart disease, for a hospitalization rate of 2.77%. CHD accounted for 2.77% of neonatal hospitalizations. The sex ratio was 1.73 (26 boys/15 girls). Consanguinity was found in 19% of cases. The average time to consultation was 11 days. The main clinical signs were heart murmur (58%), respiratory distress (56%) and extracardiac malformations (54%). The main cardiac malformations found were atrial septal defect (46%), patent ductus arteriosus (44%), ventricular septal defect (17%), complete atrioventricular canal (15%), and transposition of the great vessels (5%). The case fatality rate was 29%. Conclusion: Delayed diagnosis, generally related to the long delay in consultation, and lack of surgical management partly explain this high case fatality.展开更多
Introduction: Idiopathic nephrotic syndrome (INS) is one of the leading causes of childhood morbidity worldwide. This study was undertaken to complete the epidemiological, clinical, therapeutic and evolutionary aspect...Introduction: Idiopathic nephrotic syndrome (INS) is one of the leading causes of childhood morbidity worldwide. This study was undertaken to complete the epidemiological, clinical, therapeutic and evolutionary aspects of NIS in hospitalized patients. Methodology: We conducted a retrospective study of patients with childhood NIS who had been admitted to our department from January 2017 to December 2018. Diagnosis, remission and relapse of idiopathic NS were defined according to the recommendations of the French Society of Pediatric Nephrology. We included all patients aged 2 to 14 years presenting a NIS picture. Results: During the study period, 35 patients with idiopathic NS had been hospitalized, representing a frequency of 1% of patients hospitalized in the department. The sex ratio was 2.22. The average age of the patients was 7.5 ± 3.5 years. Generalized edema was observed in all our patients. Arterial hypertension (36%) and abdominal pain (24%), hematuria (9%) were the main associated signs. Malnutrition was present in 66%, urinary tract infection in 20% and malaria in 24%. Cortico-sensitivity was obtained in 86% of patients, 14% were cortico-resistant and 11% were cortico-dependent. Relapses (6%) had been observed among cortico-sensitive patients. The mortality rate was 11%. Conclusion: This study calls for more trials to better elucidate prognostic indicators and develop better therapeutic approaches adapted to epidemio-clinical contexts.展开更多
文摘Introduction: Acute myeloblastic leukaemia (AML) is a haematological malignancy with a poor prognosis, despite significant therapeutic progress. This study presents the results of AML management in Mali according to GFAOP recommendations. Methodology: This was a retrospective, cross-sectional study. It included patients aged 0 - 15 years treated in the paediatric oncology unit for AML and followed up between January 2016 and December 2020. Results: During the study period, 85 cases of acute leukaemia were diagnosed in the paediatric oncology unit (including 51 cases of ALL), of which 34 cases of AML were included in this study. The majority were boys (59%). The mean age was 8 years, with extremes of 18 months and 15 years. The mean time to diagnosis was 68 days. In 79% of cases, patients were referred by 1st or 2nd level hospitals. Anaemia was observed in 91% of cases, an infectious syndrome in 68%, haemorrhage in 56% and a tumour syndrome in 85%. The haemogram showed hyperleukocytosis in 15% of cases, thrombocytosis in 22% and severe anaemia in 73%. Death occurred in 85% of cases, most often in the context of sepsis or haemorrhage. Conclusion: AML is probably underestimated in Mali and diagnosis delayed, which may be explained by patient-related factors (lack of knowledge, financial constraints) and a cumbersome referral system. These results suggest the need to implement an appropriate diagnostic and therapeutic strategy, with strong involvement of the political authorities.
文摘Juvenile systemic lupus erythematosus is a rare entity, affecting children under 16 years of age. Girls are more often affected than boys and the female predominance increases significantly with age. The initial manifestations are highly variable with an insidious and progressive onset. Non-specific symptoms include fever, anorexia, weight loss and asthenia. Pericarditis is the most common cardiac manifestation in systemic lupus erythematosus (SLE), occurring in 10% to 40% of cases. The biological elements of the diagnosis and follow-up of pediatric SLE are identical to those of adults and are based on regular measurement of complement, native anti-DNA antibodies, and inflammatory findings. Treatment is essentially based on corticosteroid therapy.
文摘Sickle cell disease is a hereditary disease that remains a public health problem in Mali. Our objective was to study strokes in children with sickle cell disease aged from 6 months to 15 years in the pediatrics department of the Gabriel Toure university hospital center. This was a retrospective descriptive study from April 1, 2019 to March 31, 2021 and prospective from April 1, 2021 to April 30, 2022, i.e. 3 years, which took place in the Pediatrics department of the Gabriel Toure university hospital center. During this study, we identified 22 cases of stroke among 714 children with sickle cell disease. The frequency of stroke in this population is 3.08%. The age group from1 to 5 years was the most affected with 40.9%. The average age of the patients was 7 years with extremes ranging from 1 year to 15 years and a median of 5 years. The male gender was predominant with 54.5%, for a sex ratio of 1.2. Headaches were the most common neurological antecedents (63.5%). Half of the patients were diagnosed with sickle cell disease after the onset of the stroke. The installation of the deficit was progressive in 54.5% of cases. Consciousness disorders were the most frequent reason of consultation (27.2%), followed by convulsions (18.1%). The most common neurological signs were impaired consciousness and hemiparesis with 45.5% each. The stroke was ischemic in 100% of cases. There were 95.5% of SS forms and 4.5% of Sβ<sup>0</sup>thalassemia forms. Our patients had a hemoglobin level less than 7 g/dl in 57.1% of cases and between 7 and 9 g/dl in 42.8% of cases and hyperleukocytosis (leukocytes > 10,000/mm<sup>3</sup>) in 95.4% of cases. The Sylvian artery was the most affected (45.5%). The fatality rate was 22.7%.
文摘Introduction: Respiratory distress is a frequent cause of morbidity and mortality in neonates. The aim of this study was to assess its frequency and describe its clinical and evolutionary characteristics in the neonatology department of the Gabriel Touré University Hospital in Bamako. Methodology: This was a prospective cross-sectional study conducted from 1 January 2021 to 30 June 2021. All term neonates aged 0 to 28 days hospitalised with signs of respiratory distress (tachypnoea, nasal flaring, expiratory whining, intercostal and subcostal indrawing, xiphoid funneling and cyanosis) were included. The sociodemographic and clinical variables of the newborns and their mothers were analysed using SPSS.20 software. Results: During the study period, 1272 newborns were admitted to hospital, including 705 born at term, of whom 188 were included in the study. The mothers’ ages ranged from 14 to 45 years, with an average of 24 years. The pregnancy was not followed up in 15% of cases. Newborns were resuscitated at birth in 51% of cases. The main clinical signs observed were hypoxia, neurological disorders and fever. Perinatal asphyxia (55%), neonatal infections (34%) and congenital malformations (6%) were the main causes of respiratory distress. Mortality was estimated at 37%. Conclusion: Neonatal respiratory distress is a major cause of death. Most causes can be avoided if pregnancy and delivery are properly managed.
文摘Objectives: The main objective was to study the epidemiological, diagnostic and therapeutic aspects of medullary aplasia (MA). Methods: This was a prospective and descriptive retro study conducted from January 1, 2008 to December 31, 2018 in the pediatric oncology unit of the pediatrics department of the Gabriel Touré teaching Hospital in Bamako. Results: We collected 29 children’s cases out of 1632 admissions during the study period, representing a frequency of 1.8% and an incidence of 2.6 cases per year. The sex ratio was 2.6. The 11 - 15 age group accounted for 45%, with an average age of 8.93 years. The majority of fathers (55.2%) and mothers (62.1%) had received no education;they were mainly farmers (62.1%) and housewives (86.2%). The average consultation time was 92.21 days. Anemia was the reason for consultation in 69% of cases. Pallor was present on admission in 96.5%;infectious syndrome accounted for 79.3%, anemic syndrome for 51.7% and hemorrhagic syndrome for 27.6%;the three syndromes were associated in 27.6%. Malaria was associated with bone marrow aplasia in 58.6%. Anemia was present in 93.1%, neutropenia in 65.5% and thrombocytopenia in 86.2%. All had received a labile blood product (LBP) transfusion, and 24 (83%) had received antibiotics. Patients were treated with corticosteroids (58.6%), androgens (20.7%) and immunosuppressants (20.7%). The death rate was 34.6%. At last count, 15 (83%) had discontinued treatment, 2 (11%) were undergoing treatment and 1 (6%) was in remission. Conclusion: Effective treatment of MA requires improved technical facilities and better economic conditions for parents.
文摘Objective: The main objective was to study the disturbances of the Blood Count of children hospitalized in the general pediatric of the Gabriel Touré teaching hospital. Methods: This was a prospective and descriptive study conducted from September 1 to November 30, 2018 in the general pediatrics department of the Gabriel Touré teaching hospital in Bamako. Data were collected on patient records using a survey sheet. Results: We collected 512 files of children out of 1030 admissions during the study period;the rate of completion of the blood count is 50%. The male sex was predominant with a sex ratio of 1.3. The majority of patients were under 5 years old (58%). The majority of fathers (56%) and mothers (64%) of children had no education;they are mainly farmers (61%) and housewives (88%). Pallor was the reason for consultation in 29% of patients and present in 60%. On blood count, anemia was present in 92% of patients, half of whom (50%) had severe anemia with a hemoglobin level below 7 g/dL. The anemia was mainly microcytic (72%) and hypochromic (66%). Hyperleukocytosis (62%), eosinophilia (68%) and basophilia (58%) were the abnormalities observed in the white line. Thrombocytopenia accounted for 40%. Severe malaria (53%) was the main discharge diagnosis and almost all patients (99%) were alive at discharge. Conclusion: The characteristics of anemia require a study of the complete blood count in healthy children with dosage of serum iron and ferritin for a better understanding of the phenomenon.
文摘Acrodermatitis enteropathica is a rare autosomal recessive genetic disorder characterised by periorificial dermatitis, alopecia and diarrhoea. It is caused by a mutation in the gene that codes for a membrane protein that binds zinc. We report a case in a 7-month-old girl, admitted with altered general condition and scaly, pustular erythematous lesions, initially located in the occipital and cervical regions, and secondarily inguinal and on the knees. Management and outcome in this patient? Genetic assay was not available to confirm this rare genetic disease. A delay in establishing the diagnosis and a disastrous outcome did not save the patient despite the administration of zinc.
文摘Introduction: Congenital heart disease is an important cause of mortality, chronic morbidity, and disability in children in poor countries. The objective of this study was to highlight the diversity of congenital heart defects in the neonatology department. Methodology: This work had taken place in a neonatology service over a period of six months from January 2019 to June 2019. It was a prospective descriptive study with information collected from the medical records of newborns with congenital heart disease. Results: Of 1478 neonates hospitalized during the study period, 41 had congenital heart disease, for a hospitalization rate of 2.77%. CHD accounted for 2.77% of neonatal hospitalizations. The sex ratio was 1.73 (26 boys/15 girls). Consanguinity was found in 19% of cases. The average time to consultation was 11 days. The main clinical signs were heart murmur (58%), respiratory distress (56%) and extracardiac malformations (54%). The main cardiac malformations found were atrial septal defect (46%), patent ductus arteriosus (44%), ventricular septal defect (17%), complete atrioventricular canal (15%), and transposition of the great vessels (5%). The case fatality rate was 29%. Conclusion: Delayed diagnosis, generally related to the long delay in consultation, and lack of surgical management partly explain this high case fatality.
文摘Introduction: Idiopathic nephrotic syndrome (INS) is one of the leading causes of childhood morbidity worldwide. This study was undertaken to complete the epidemiological, clinical, therapeutic and evolutionary aspects of NIS in hospitalized patients. Methodology: We conducted a retrospective study of patients with childhood NIS who had been admitted to our department from January 2017 to December 2018. Diagnosis, remission and relapse of idiopathic NS were defined according to the recommendations of the French Society of Pediatric Nephrology. We included all patients aged 2 to 14 years presenting a NIS picture. Results: During the study period, 35 patients with idiopathic NS had been hospitalized, representing a frequency of 1% of patients hospitalized in the department. The sex ratio was 2.22. The average age of the patients was 7.5 ± 3.5 years. Generalized edema was observed in all our patients. Arterial hypertension (36%) and abdominal pain (24%), hematuria (9%) were the main associated signs. Malnutrition was present in 66%, urinary tract infection in 20% and malaria in 24%. Cortico-sensitivity was obtained in 86% of patients, 14% were cortico-resistant and 11% were cortico-dependent. Relapses (6%) had been observed among cortico-sensitive patients. The mortality rate was 11%. Conclusion: This study calls for more trials to better elucidate prognostic indicators and develop better therapeutic approaches adapted to epidemio-clinical contexts.
