Introduction: Stillbirths are estimated at 2 million each year, of which more than 40% occur during labour. Our objective was to study the epidemiological aspects of stillbirth and neonatal deaths in the delivery room...Introduction: Stillbirths are estimated at 2 million each year, of which more than 40% occur during labour. Our objective was to study the epidemiological aspects of stillbirth and neonatal deaths in the delivery room in our health facility. Patients and methods: Prospective, descriptive and analytical study, conducted at the Jeanne Ebori Foundation Mother-Child University Hospital over 4 years (January 2019-December 2022). All neonatal deaths in the delivery room or foetal death in utero, were included. Results: Among the 18,346 deliveries performed, 512 newborns were declared dead in the delivery room (27.9‰ live births), divided into in utero foetal death (19.0‰) and immediate neonatal death (8.9‰). The mean age was 34.3 weeks of amenorrhea. The rate of preterm birth was 60.4%. The sex ratio was 1.1. The average weight was 2186.6. The main causes were vascular (46.1%), foetal (20.2%), adnexal (17.1%) and asphyxia per partum (16.6%). Foetal causes were more likely to result in IUFD than other causes (OR = 6.4 [2.4 - 15.7], p < 0.001). After birth, partum asphyxia was more likely to lead to death before 15 minutes of life than other causes (OR = 11 [6.1 - 18.9], p Conclusion: The causes of stillbirth and early neonatal mortality are dominated by maternal vascular pathologies. However, the proportion of childbirth-related causes remains worrying. Better monitoring of pregnancy and labour will minimize this prevalence in our hospital.展开更多
Introduction: Low birth weight is a key indicator of newborn health. The objective of this study was to contribute to the reduction of low birth weight-related morbidity and mortality. Patients and Methods: cohort stu...Introduction: Low birth weight is a key indicator of newborn health. The objective of this study was to contribute to the reduction of low birth weight-related morbidity and mortality. Patients and Methods: cohort study conducted from January 2019 to July 2020 at the “Mère-Enfant” University Hospital Centre (UHC) of Libreville. All newborns with a birth weight 2500 g were included. The clinical data of patients were studied. They were followed over a period of 12 months and assessed psychomotorly by the Brunet-Lézine scale. Results: 1260/9035 births of low birth weight (14.0%) were observed, and 300 among them were included. The mortality rate was 27.0% (81) and 219 were followed for 12 months. The sex ratio was 0.8, the average birth weight was 2008.6 ± 215.2 g. The average gestational age was 34 ± 12 weeks with 75.3% prematurity. An infant disease was observed in 61.6% of cases and respiratory pathologies were more observed except at 3 months of age where the proportion of digestive pathologies was 20.5%. At the time of the last consultation at 12 months of life, 76.2% of infants had no pathology. The quotients of postural development, language and coordination were normal (between 110 - 70) respectively in 75.4%, 99.1% and 68% of cases at the age of 12 months. The psychomotor development quotient was correlated with the birth weight in the language area r = 0.15 (p = 0.024), posture r = 0.15 (p = 0.015) and coordination r = 0.15 (p = 0.026) respectively. Conclusion: Low birth weight is a public health problem at UHCME-JEF. Despite the fact that psychomotor development can be said to be satisfactory, many efforts remain to be made to reduce low birth weight levels and improve survival.展开更多
Sickle-cell disease (SCD) represents a substantial public health problem in Gabon. Fever is one of the principal reasons for the hospitalization of children afflicted by major sickle-cell disorder, since it can be a c...Sickle-cell disease (SCD) represents a substantial public health problem in Gabon. Fever is one of the principal reasons for the hospitalization of children afflicted by major sickle-cell disorder, since it can be a clinical reflection of severe infections that have the potential to become life threatening. Objectives: Identification of the main causes of fever in children with SCD in our clinical setting, with the aim of optimizing treatments. Patients and Methods: This is a retrospective study of all the medical files for children with SCD that were admitted to our ward, over a two year period, due to fever (>38.5°C) lasting more than 24 hours. Only those files that contained at least the following five fundamental medical examinations were retained for further evaluation: Complete Blood Count (CBC), blood smear, blood culture, urine culture and chest X-ray. Out of a total of 118 admissions (103 patients), 87 (73.7%) were due to the incidence of fever. The medical files of 11 patients were deemed to be unusable. Seventy-six episodes of fever were observed among 69 children, of which 42 were male and 27 female (sex ratio of 1.5). Among these, seven (10%) were admitted twice. Results: The age groups that were most affected included 12 - 18 year-olds (30 cases: 43.5%) and 6 - 12 year-olds (26 cases: 37.7%). The most common accompanying symptoms were bone and joint pain (43.4%), asthenia (22.4%), cough (19.7%), vomiting (17%) and headache (15.8%). The specific cause of the fever could not be pinpointed in 29 cases (38.1%). Aside from these cases, the main causes of fever were malaria (30.3%) and bronchopulmonary infections (22.4%). The white blood cell count was >20,000/mm3 in 47% of respiratory infections, 43.5% of the cases involving malaria and 55.2% of cases of fever with unknown cause. Hemoglobin levels were <5g/dl for 52.2% of the cases involving malaria and 22.6% for those of unknown origin. For four patients, all less than 10 years of age, the disease was fatal. Conclusion: For the majority of fever episodes, the underlying cause could not be determined. Nonetheless, malaria was identified as one of the principal identifiable causes of fever among children with SDC in Libreville. Treatment for malaria upon admission, and the promotion of preventative measures, therefore seems to be appropriate for our clinical setting. In light of the large number of unresolved cases, systematic prescription of broad-spectrum antibiotics may also be called for.展开更多
The purpose of this work is to evaluate the epidemiological aspects of vision problems and their repercussions in the schooling of children in Libreville and Owendo. Methodology: This transversal and descriptive study...The purpose of this work is to evaluate the epidemiological aspects of vision problems and their repercussions in the schooling of children in Libreville and Owendo. Methodology: This transversal and descriptive study was carried out in May and June 2011. Included in the study were children in the 7th and 8th grades of the primary schools in Libreville and Owendo. For each child, an eye exam, including the subjective measure of visual acuity, was carried out using the Monoyer scale, and the color vision assessment was carried out with the Ishihara test. Any visual capacity under or equal to 7/10th in at least one eye was considered to be pathological. We gathered information about demographic characteristics, any preceding vision issues on the record, data on other medical problems on the record and the eye examination on computer cards. Results: Nine hundred and sixty-three children (416 boys and 517 girls, with a gender ratio of 0.86) were examined. The average age was 12 ± 1.7 years old. The prevalence of the drop in visual acuity was 16.2%. The prevalence of color vision anomalies was 15.5%. Complaints concerning vision problems were significantly more present from children with a drop in visual acuity (p 0.01). Visual anomalies had an impact on the children’s schoolwork, and yet, visits to the ophthalmologist’s office were few. Conclusion: The frequency of anomalies in vision justifies systematic screening in schools and organization of an appropriate treatment.展开更多
Introduction: Vitamin A deficiency is responsible for severe disorders, and sometimes irreversible consequences in children. We aimed to evaluate the Vitamin A status of newborns in Gabon. Method: prospective study fr...Introduction: Vitamin A deficiency is responsible for severe disorders, and sometimes irreversible consequences in children. We aimed to evaluate the Vitamin A status of newborns in Gabon. Method: prospective study from August to December 2017 at the maternity of the University Teaching Hospital of Angondje (Gabon). We included at random mother-child pairs. A nutritional inquiry on Vitamin A was ran in the selected parturient. We performed the measurement of serum retinol booth in mother and child according to standardized and strict criteria, in Gabon and in France. World Health Organization defines Vitamin A deficiency by serum retinol .7 μmol/L. Results: We included 75 mother-child couples. The mean age of the mothers was 25.7 ± 7 years, 89.3% of neonates were an age gestational ≥ 36 weeks, and 10.7% were premature. Mango was the most commonly used source of Vitamin A and 27% of women consumed more than 3 times a week. The mean serum retinol of the mothers was 0.87 μmol/L ± 0.35 extremes [0.22 μmol/L - 1.79 μmol/L], the mean serum retinol of the newborns was 0.92 μmol/L ± 0.30 extremes [0.24 μmol/l - 1.84 μmol/L].Vitamin A deficiency was observed in 23.3% (n = 25;CI 95% [22.1% - 25.8%]) of mothers and 20% (n = 15;CI 95% [18.2% - 22%]) newborns. There was a weak correlation between the serum retinol of mothers and serum retinol of newborns (r = 0, 17). Conclusion: The prevalence of Vitamin A deficiency is quite important in neonates of our investigation, and justifies a systematic supplementation.展开更多
Background: Gabon is endemic for hepatitis B, but they have still not reached the WHO goal for Hepatitis B vaccination coverage. We aimed to determine the rate of completeness and timeliness of hepatitis B vaccination...Background: Gabon is endemic for hepatitis B, but they have still not reached the WHO goal for Hepatitis B vaccination coverage. We aimed to determine the rate of completeness and timeliness of hepatitis B vaccination among children under 15 years of age in Libreville. Methods: Cross-sectional study conducted over 9 months, including children randomly selected from vaccination centres, nurseries and kindergartens. We collected data on the child, socio-economic characteristics of the families, and dates of administration of hepatitis B vaccines. We determined the compliance of the vaccination dates according to the vaccination start pattern. Results: We included 453 children, of whom 236 were girls, for a sex ratio of 0.92. A total of 87% (95% CI [83.9% - 90.1%]) of children had started and completed their 3 doses of vaccine before the 12<sup>th</sup> month of age. 149 subjects had received their 3 doses on time according to the original vaccination schedule, i.e. 32.9% (95% CI [28.6% - 37.2%]). Factors significantly associated with completeness were vaccination in a public centre OR = 114 [47.2 - 347] p <sup>st</sup> dose OR = 3 [1.6 - 5.5] p < 0.001. Age at first dose was the predictor of timeliness aOR = 1.3 (95% CI [1.2 - 1.5] p 0.001). Conclusion: The respect for the vaccination deadlines is insufficient in our context, solutions exist to improve this situation.展开更多
<strong>Introduction:</strong><span><span><span><span><span><span style="font-family:""><span style="font-family:Verdana;"> Hepatitis B is...<strong>Introduction:</strong><span><span><span><span><span><span style="font-family:""><span style="font-family:Verdana;"> Hepatitis B is a significant public health problem. Infected children <6 years represent a risk population of evolution to chronicity. </span><b><span style="font-family:Verdana;">Objective: </span></b><span style="font-family:Verdana;">We aimed to assess newborns’ management and outcome from reactive HBs Ag mothers at the El Rapha Polyclinic in Libreville, Gabon. </span><b><span style="font-family:Verdana;">Methodology: </span></b><span style="font-family:Verdana;">Prospective longitudinal study, carried out over four years, including all neonates born from reactive HBsAg mothers admitted in the delivery room. The parameters studied were maternal age, gestation, marital status, pregnancy follow-up, hepatitis B vaccination status, knowledge of hepatitis B, anti-Hbc antibodies’ levels, HBeAg. For the newborn: term, birth weight, management at birth, and hepatitis B serological status at 12 months.</span><b><span style="font-family:Verdana;"> Results:</span></b><span style="font-family:Verdana;"> We included 45 newborns. Mothers’ mean age was 30.9 ± seven years. In 32.6% of cases, antenatal consultations were ≤4, and 9.3% were vaccinated for hepatitis B. Mothers had chronic hepatitis in 74.4% of cases. All neonates were vaccinated for hepatitis B at birth;68.9% received hepatitis B immunoglobulin. At 12 months, 77.8% had HBs antibody positive, and 6.7% were HBsAg positive.</span><b><span style="font-family:Verdana;"> Conclusion: </span></b><span style="font-family:Verdana;">Hepatitis B prevalence is significant among parturients. It is essential to set up a national strategy for managing the mother-child couple in a context of positive HBsAg.</span></span></span></span></span></span></span>展开更多
文摘Introduction: Stillbirths are estimated at 2 million each year, of which more than 40% occur during labour. Our objective was to study the epidemiological aspects of stillbirth and neonatal deaths in the delivery room in our health facility. Patients and methods: Prospective, descriptive and analytical study, conducted at the Jeanne Ebori Foundation Mother-Child University Hospital over 4 years (January 2019-December 2022). All neonatal deaths in the delivery room or foetal death in utero, were included. Results: Among the 18,346 deliveries performed, 512 newborns were declared dead in the delivery room (27.9‰ live births), divided into in utero foetal death (19.0‰) and immediate neonatal death (8.9‰). The mean age was 34.3 weeks of amenorrhea. The rate of preterm birth was 60.4%. The sex ratio was 1.1. The average weight was 2186.6. The main causes were vascular (46.1%), foetal (20.2%), adnexal (17.1%) and asphyxia per partum (16.6%). Foetal causes were more likely to result in IUFD than other causes (OR = 6.4 [2.4 - 15.7], p < 0.001). After birth, partum asphyxia was more likely to lead to death before 15 minutes of life than other causes (OR = 11 [6.1 - 18.9], p Conclusion: The causes of stillbirth and early neonatal mortality are dominated by maternal vascular pathologies. However, the proportion of childbirth-related causes remains worrying. Better monitoring of pregnancy and labour will minimize this prevalence in our hospital.
文摘Introduction: Low birth weight is a key indicator of newborn health. The objective of this study was to contribute to the reduction of low birth weight-related morbidity and mortality. Patients and Methods: cohort study conducted from January 2019 to July 2020 at the “Mère-Enfant” University Hospital Centre (UHC) of Libreville. All newborns with a birth weight 2500 g were included. The clinical data of patients were studied. They were followed over a period of 12 months and assessed psychomotorly by the Brunet-Lézine scale. Results: 1260/9035 births of low birth weight (14.0%) were observed, and 300 among them were included. The mortality rate was 27.0% (81) and 219 were followed for 12 months. The sex ratio was 0.8, the average birth weight was 2008.6 ± 215.2 g. The average gestational age was 34 ± 12 weeks with 75.3% prematurity. An infant disease was observed in 61.6% of cases and respiratory pathologies were more observed except at 3 months of age where the proportion of digestive pathologies was 20.5%. At the time of the last consultation at 12 months of life, 76.2% of infants had no pathology. The quotients of postural development, language and coordination were normal (between 110 - 70) respectively in 75.4%, 99.1% and 68% of cases at the age of 12 months. The psychomotor development quotient was correlated with the birth weight in the language area r = 0.15 (p = 0.024), posture r = 0.15 (p = 0.015) and coordination r = 0.15 (p = 0.026) respectively. Conclusion: Low birth weight is a public health problem at UHCME-JEF. Despite the fact that psychomotor development can be said to be satisfactory, many efforts remain to be made to reduce low birth weight levels and improve survival.
文摘Sickle-cell disease (SCD) represents a substantial public health problem in Gabon. Fever is one of the principal reasons for the hospitalization of children afflicted by major sickle-cell disorder, since it can be a clinical reflection of severe infections that have the potential to become life threatening. Objectives: Identification of the main causes of fever in children with SCD in our clinical setting, with the aim of optimizing treatments. Patients and Methods: This is a retrospective study of all the medical files for children with SCD that were admitted to our ward, over a two year period, due to fever (>38.5°C) lasting more than 24 hours. Only those files that contained at least the following five fundamental medical examinations were retained for further evaluation: Complete Blood Count (CBC), blood smear, blood culture, urine culture and chest X-ray. Out of a total of 118 admissions (103 patients), 87 (73.7%) were due to the incidence of fever. The medical files of 11 patients were deemed to be unusable. Seventy-six episodes of fever were observed among 69 children, of which 42 were male and 27 female (sex ratio of 1.5). Among these, seven (10%) were admitted twice. Results: The age groups that were most affected included 12 - 18 year-olds (30 cases: 43.5%) and 6 - 12 year-olds (26 cases: 37.7%). The most common accompanying symptoms were bone and joint pain (43.4%), asthenia (22.4%), cough (19.7%), vomiting (17%) and headache (15.8%). The specific cause of the fever could not be pinpointed in 29 cases (38.1%). Aside from these cases, the main causes of fever were malaria (30.3%) and bronchopulmonary infections (22.4%). The white blood cell count was >20,000/mm3 in 47% of respiratory infections, 43.5% of the cases involving malaria and 55.2% of cases of fever with unknown cause. Hemoglobin levels were <5g/dl for 52.2% of the cases involving malaria and 22.6% for those of unknown origin. For four patients, all less than 10 years of age, the disease was fatal. Conclusion: For the majority of fever episodes, the underlying cause could not be determined. Nonetheless, malaria was identified as one of the principal identifiable causes of fever among children with SDC in Libreville. Treatment for malaria upon admission, and the promotion of preventative measures, therefore seems to be appropriate for our clinical setting. In light of the large number of unresolved cases, systematic prescription of broad-spectrum antibiotics may also be called for.
文摘The purpose of this work is to evaluate the epidemiological aspects of vision problems and their repercussions in the schooling of children in Libreville and Owendo. Methodology: This transversal and descriptive study was carried out in May and June 2011. Included in the study were children in the 7th and 8th grades of the primary schools in Libreville and Owendo. For each child, an eye exam, including the subjective measure of visual acuity, was carried out using the Monoyer scale, and the color vision assessment was carried out with the Ishihara test. Any visual capacity under or equal to 7/10th in at least one eye was considered to be pathological. We gathered information about demographic characteristics, any preceding vision issues on the record, data on other medical problems on the record and the eye examination on computer cards. Results: Nine hundred and sixty-three children (416 boys and 517 girls, with a gender ratio of 0.86) were examined. The average age was 12 ± 1.7 years old. The prevalence of the drop in visual acuity was 16.2%. The prevalence of color vision anomalies was 15.5%. Complaints concerning vision problems were significantly more present from children with a drop in visual acuity (p 0.01). Visual anomalies had an impact on the children’s schoolwork, and yet, visits to the ophthalmologist’s office were few. Conclusion: The frequency of anomalies in vision justifies systematic screening in schools and organization of an appropriate treatment.
文摘Introduction: Vitamin A deficiency is responsible for severe disorders, and sometimes irreversible consequences in children. We aimed to evaluate the Vitamin A status of newborns in Gabon. Method: prospective study from August to December 2017 at the maternity of the University Teaching Hospital of Angondje (Gabon). We included at random mother-child pairs. A nutritional inquiry on Vitamin A was ran in the selected parturient. We performed the measurement of serum retinol booth in mother and child according to standardized and strict criteria, in Gabon and in France. World Health Organization defines Vitamin A deficiency by serum retinol .7 μmol/L. Results: We included 75 mother-child couples. The mean age of the mothers was 25.7 ± 7 years, 89.3% of neonates were an age gestational ≥ 36 weeks, and 10.7% were premature. Mango was the most commonly used source of Vitamin A and 27% of women consumed more than 3 times a week. The mean serum retinol of the mothers was 0.87 μmol/L ± 0.35 extremes [0.22 μmol/L - 1.79 μmol/L], the mean serum retinol of the newborns was 0.92 μmol/L ± 0.30 extremes [0.24 μmol/l - 1.84 μmol/L].Vitamin A deficiency was observed in 23.3% (n = 25;CI 95% [22.1% - 25.8%]) of mothers and 20% (n = 15;CI 95% [18.2% - 22%]) newborns. There was a weak correlation between the serum retinol of mothers and serum retinol of newborns (r = 0, 17). Conclusion: The prevalence of Vitamin A deficiency is quite important in neonates of our investigation, and justifies a systematic supplementation.
文摘Background: Gabon is endemic for hepatitis B, but they have still not reached the WHO goal for Hepatitis B vaccination coverage. We aimed to determine the rate of completeness and timeliness of hepatitis B vaccination among children under 15 years of age in Libreville. Methods: Cross-sectional study conducted over 9 months, including children randomly selected from vaccination centres, nurseries and kindergartens. We collected data on the child, socio-economic characteristics of the families, and dates of administration of hepatitis B vaccines. We determined the compliance of the vaccination dates according to the vaccination start pattern. Results: We included 453 children, of whom 236 were girls, for a sex ratio of 0.92. A total of 87% (95% CI [83.9% - 90.1%]) of children had started and completed their 3 doses of vaccine before the 12<sup>th</sup> month of age. 149 subjects had received their 3 doses on time according to the original vaccination schedule, i.e. 32.9% (95% CI [28.6% - 37.2%]). Factors significantly associated with completeness were vaccination in a public centre OR = 114 [47.2 - 347] p <sup>st</sup> dose OR = 3 [1.6 - 5.5] p < 0.001. Age at first dose was the predictor of timeliness aOR = 1.3 (95% CI [1.2 - 1.5] p 0.001). Conclusion: The respect for the vaccination deadlines is insufficient in our context, solutions exist to improve this situation.
文摘<strong>Introduction:</strong><span><span><span><span><span><span style="font-family:""><span style="font-family:Verdana;"> Hepatitis B is a significant public health problem. Infected children <6 years represent a risk population of evolution to chronicity. </span><b><span style="font-family:Verdana;">Objective: </span></b><span style="font-family:Verdana;">We aimed to assess newborns’ management and outcome from reactive HBs Ag mothers at the El Rapha Polyclinic in Libreville, Gabon. </span><b><span style="font-family:Verdana;">Methodology: </span></b><span style="font-family:Verdana;">Prospective longitudinal study, carried out over four years, including all neonates born from reactive HBsAg mothers admitted in the delivery room. The parameters studied were maternal age, gestation, marital status, pregnancy follow-up, hepatitis B vaccination status, knowledge of hepatitis B, anti-Hbc antibodies’ levels, HBeAg. For the newborn: term, birth weight, management at birth, and hepatitis B serological status at 12 months.</span><b><span style="font-family:Verdana;"> Results:</span></b><span style="font-family:Verdana;"> We included 45 newborns. Mothers’ mean age was 30.9 ± seven years. In 32.6% of cases, antenatal consultations were ≤4, and 9.3% were vaccinated for hepatitis B. Mothers had chronic hepatitis in 74.4% of cases. All neonates were vaccinated for hepatitis B at birth;68.9% received hepatitis B immunoglobulin. At 12 months, 77.8% had HBs antibody positive, and 6.7% were HBsAg positive.</span><b><span style="font-family:Verdana;"> Conclusion: </span></b><span style="font-family:Verdana;">Hepatitis B prevalence is significant among parturients. It is essential to set up a national strategy for managing the mother-child couple in a context of positive HBsAg.</span></span></span></span></span></span></span>
