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Ki KB, Sanou FF, Ndoye Diop M, Guibla I, Traore M, Donamou J, Mangane M, Kabre Y, Daddy H, Cikwanine BJP, Sama H, Akodjenou J, Bonte AKDAN, Metogo Mbengono J, Nguessan Yapi F, Kabore F, Zoumenou E, Ouedraogo N, Brouh Y. Advances in pediatric anesthesia services over the past 10 years in French-speaking sub-Saharan Africa. Paediatr Anaesth 2024. [PMID: 38655778 DOI: 10.1111/pan.14904] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/28/2023] [Revised: 04/03/2024] [Accepted: 04/04/2024] [Indexed: 04/26/2024]
Abstract
INTRODUCTION To improve and maintain quality and safety in anesthesia, standards have been proposed regarding human resources, facilities and equipment, medications and intravenous fluids, monitoring, and the conduct of anesthesia. Compliance with these standards remains a challenge in French-speaking sub-Saharan Africa (SSA) and results in high morbidity and mortality particularly in children. This aim of this study was to assess the progress made in improving the pediatric anesthesia infrastructures, human resources, education, medications, and equipment in French-speaking SSA over the past 10 years (2013-2022). METHODS This is a descriptive, multicenter, cross-sectional study with retrospective data collection, conducted from September 1 to November 5, 2023. Comparative data from 2012 to 2022 were collected through an online survey. Descriptive statistics were used to summarize data. RESULTS Data were obtained from 12 countries out of 14. The number of hospitals providing pediatric surgery and anesthesia rose from 94 in 2012 to 142 in 2022 (+51%). The total number of physician anesthesiologists rose from 293 (0.1 physician anesthesiologists/100 000 inhabitants) in 2012 to 597 (0.2 physician anesthesiologists/100 000 inhabitants) in 2022 (+103.7%). Five (0.006 physician anesthesiologists/100 000 children) had completed a fellowship in pediatric anesthesia and intensive care in 2012, and 15 (0.01 physician anesthesiologists/100 000 children) in 2022 (+200%). Five physician anesthesiologists had an exclusive pediatric anesthesia practice in 2012, whereas they were 32 in 2022 (+540%). There is no specialized training in pediatric anesthesia and intensive care in any of these countries. Halothane was always available in 81.5% of the hospitals in 2012, and in 50.4% of the hospitals in 2022. Sevoflurane was always available in 5% of the hospitals in 2012, and in 36.2% in 2022. Morphine was always available in 32.2% in 2012, whereas it was available in 52.9% of them in 2022. Pediatric pulse oximeter sensors were available in 36% of the hospitals in 2012, and in 63.4% in 2022. Capnography was available in 5.3% of the hospitals in 2012, and in 48% in 2022. CONCLUSION Progress have been made over the last 10 years in French-speaking SSA to improve infrastructures, human resources, education, medications, and equipment for pediatric anesthesia in French-speaking SSA. However, major efforts must be continued. Standards adapted to the local context should be formulated.
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Affiliation(s)
- Kélan Bertille Ki
- Charles de Gaulle Pediatric University Hospital, Ouagadougou, Burkina Faso
| | | | | | - Ismael Guibla
- Sourô Sanou University Hospital, Bobo-Dioulasso, Burkina Faso
| | | | | | | | - Yvette Kabre
- Charles de Gaulle Pediatric University Hospital, Ouagadougou, Burkina Faso
| | | | | | - Hamza Sama
- Sylvanus Olympio University Hospital, Lomé, Togo
| | | | | | | | | | - Flavien Kabore
- Tengandogo University Hospital, Ouagadougou, Burkina Faso
| | - Eugène Zoumenou
- Hubert Koutoukou Maga National University Hospital, Cotonou, Benin
| | | | - Yapo Brouh
- Mother-and-children hospital Bingerville, Abidjan, Ivory Coast
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Koffi N, Pete Y, N’Da K, Ory O, One J, Ogondon B, Kouadio S, Able E, Irie B, Kouame K, Brouh Y. Ibuprofen Lyell's Syndrome In An Eight-Year-Old Child. Ann Burns Fire Disasters 2023; 36:68-73. [PMID: 38680905 PMCID: PMC11044737] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Subscribe] [Scholar Register] [Received: 10/08/2021] [Accepted: 10/16/2021] [Indexed: 05/01/2024]
Abstract
Lyell's syndrome or toxic epidermal necrolysis (TEN) is a rare but serious drug-like toxiderma. Treated as a recent extensive burn in intensive care, its management must be urgent, and adapted in order to improve the vital prognosis of patients and reduce their mortality. We report a severe case of Lyell's syndrome occurring 24 hours after oral administration of an anti-inflammatory drug (ibuprofen) as a self-medication in an eight-year-old child.
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Affiliation(s)
- N.R. Koffi
- Service d’Anesthésie Réanimation, Centre Hospitalier Universitaire de Bouaké, Côte d’Ivoire
| | - Y. Pete
- Service d’Anesthésie Réanimation, Centre Hospitalier Universitaire de Bouaké, Côte d’Ivoire
| | - K.C. N’Da
- Service d’Anesthésie Réanimation, Centre Hospitalier Universitaire de Bouaké, Côte d’Ivoire
| | - O.A. Ory
- Service de Stomatologie et Chirurgie Maxillo-faciale, Centre Hospitalier Universitaire de Bouaké, Côte d’Ivoire
| | - J.L. One
- Service d’Anesthésie Réanimation, Centre Hospitalier Universitaire de Bouaké, Côte d’Ivoire
| | - B. Ogondon
- Service d’Anesthésie Réanimation, Centre Hospitalier Universitaire de Bouaké, Côte d’Ivoire
| | - S. Kouadio
- Service d’Anesthésie Réanimation, Centre Hospitalier Universitaire de Bouaké, Côte d’Ivoire
| | - E. Able
- Service d’Anesthésie Réanimation, Centre Hospitalier Universitaire de Bouaké, Côte d’Ivoire
| | - B. Irie
- Service d’Anesthésie Réanimation, Centre Hospitalier Universitaire de Bouaké, Côte d’Ivoire
| | - K.E. Kouame
- Service d’Anesthésie Réanimation, Centre Hospitalier Universitaire de Bouaké, Côte d’Ivoire
| | - Y. Brouh
- Service d’Anesthésie Réanimation, Centre Hospitalier Universitaire de Bouaké, Côte d’Ivoire
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Mobio MP, Abhe CM, Ouattara A, Coulibaly KT, Olama MC, Netro D, Bedie YV, N'Guessan YF, Tétchi YD, Brouh Y. [Anesthesic practice for gynecological and obstetric emergency in the Cocody CHU]. Mali Med 2021; 36:31-34. [PMID: 37973565] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Key Words] [Subscribe] [Scholar Register] [Indexed: 11/19/2023]
Abstract
OBJECTIVE To evaluate the anesthetic practice in the operating theater of gynecological and obstetric emergencies. MATERIAL AND METHOD Prospective, descriptive and analytical study on patients admitted to the operating room for a gynecological and or obstetric emergency over a period of six months. RESULTS We collected 3,486 patients out of 7,574 admissions, or 46.02%. The average age was 27.3 years with extremes of 15 and 45. SFA was the first operative indication for obstetric emergencies while gynecological emergencies were dominated by first trimester bleeding. 99.39% of the patients benefited from a CPA and 45.40% of them, were classified ASA I u. LAR by spinal anesthesia was the most commonly performed anesthetic regimen. Maternal lethality was 0.005. For the mother, the age group [30-45 years], the provenance, the hemorrhagic syndromes, the ASA III and IV classes, the long delays in transfusion and block management were factors of poor prognosis. (P≤0.05) For the fetus, hemorrhagic syndromes and general anesthesia were factors of poor prognosis. (P ≤ 0.05). CONCLUSION Spinal anesthesia was the most widely used anesthetic regimen.
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Irie BGS, Asse KV, Kadiane NJ, Kofi N, Nda-Koffi C, Ogondon B, Kouadio S, Kouame KE, Brouh Y. Tetanus after application of traditional topical treatment to a severe burn. Med Sante Trop 2018; 28:446-447. [PMID: 30095076 DOI: 10.1684/mst.2018.0803] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/08/2023]
Abstract
A 2-year-old child was accompanied by his parents to the pediatric emergency room for refusal to eat, trismus and generalized contractures four days after the application of a traditional topical treatment (Cassava leaves) on lesions of a severe thermal burn. A temperature of 38̊C, a heart rate of 114 beats/min, and a blood pressure of 90/60 mm Hg were recorded. The tetanus vaccination was not up to date. The diagnosis of tetanus was immediately suggested. Antitetanus serum (immunoglobulin), an antibiotic (amoxicillin and clavulanic acid), and a myorelaxant (benzodiazepine) were administered. Local treatments were also performed. The child died within 24 hours.
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Affiliation(s)
- B G S Irie
- Service d'anesthésie-réanimation, CHU de Bouaké, BP 1174 Bouaké, Côte d'Ivoire
| | - K V Asse
- Service d'anesthésie-réanimation, CHU de Bouaké, BP 1174 Bouaké, Côte d'Ivoire
| | - N J Kadiane
- Service d'anesthésie-réanimation, CHU de Bouaké, BP 1174 Bouaké, Côte d'Ivoire
| | - N Kofi
- Service d'anesthésie-réanimation, CHU de Bouaké, BP 1174 Bouaké, Côte d'Ivoire
| | - C Nda-Koffi
- Service d'anesthésie-réanimation, CHU de Bouaké, BP 1174 Bouaké, Côte d'Ivoire
| | - B Ogondon
- Service d'anesthésie-réanimation, CHU de Bouaké, BP 1174 Bouaké, Côte d'Ivoire
| | - S Kouadio
- Service d'anesthésie-réanimation, CHU de Bouaké, BP 1174 Bouaké, Côte d'Ivoire
| | - K E Kouame
- Service d'anesthésie-réanimation, CHU de Bouaké, BP 1174 Bouaké, Côte d'Ivoire
| | - Y Brouh
- Service d'anesthésie-réanimation, CHU de Bouaké, BP 1174 Bouaké, Côte d'Ivoire
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Bi Gohi SI, Yaich P, N'guessan K, Ogondon B, Brouh Y. [Gestational diabetes revealed by inaugural diabetic ketoacidosis: about a case]. Pan Afr Med J 2017; 27:148. [PMID: 28904676 PMCID: PMC5567969 DOI: 10.11604/pamj.2017.27.148.12155] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/04/2017] [Accepted: 06/12/2017] [Indexed: 12/02/2022] Open
Abstract
L'acidocétose compliquant un diabète gestationnel est une affection rare, responsable d'une mortalité materno-fœtale importante. C'est une urgence métabolique aigue dont la prise en charge est multidisciplinaire. La précocité du diagnostic et du traitement conditionnent le pronostic vital de la mère et du fœtus. Nous rapportons l'observation d'une gestante de 27 ans à terme, avec un antécédent familial de diabète, qui a été admise aux urgences obstétricales pour un trouble de la vigilance associé à une dyspnée. Le diagnostic d'acidocétose inaugural décompensée par un paludisme grave sur un diabète gestationnel a été retenu sur la base de l'anamnèse, de l'examen clinique et du bilan paraclinique. Elle a bénéficié d'une insulinothérapie, d'une réhydratation, d'une correction des troubles ioniques et d'une traitement antipaludique. Une césarienne a été réalisée en urgence sous anesthésie générale et a permis d'extraire un macrosome de sexe masculin mort-né macéré. L'évolution a été favorable avec une reprise de la conscience et une normalisation des paramètres biologiques.
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Affiliation(s)
- Serge Irie Bi Gohi
- Service d'Anesthésie-Réanimation du Centre Hospitalier Universitaire de Bouaké, Côte d'Ivoire
| | - Pete Yaich
- Service d'Anesthésie-Réanimation du Centre Hospitalier Universitaire de Bouaké, Côte d'Ivoire
| | - Koffi N'guessan
- Service d'Anesthésie-Réanimation du Centre Hospitalier Universitaire de Bouaké, Côte d'Ivoire
| | - Bernard Ogondon
- Service d'Anesthésie-Réanimation du Centre Hospitalier Universitaire de Bouaké, Côte d'Ivoire
| | - Yapo Brouh
- Service d'Anesthésie-Réanimation du Centre Hospitalier Universitaire de Bouaké, Côte d'Ivoire
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Brouh Y, Jean KK, Ouattara A, Tétchi Y, Pete Y, Koffi N, Abhé C, Kane M. Brain lesions in eclampsia: A series of 39 cases admitted in an Intensive Care Unit. Indian J Crit Care Med 2016; 20:178-81. [PMID: 27076731 PMCID: PMC4810897 DOI: 10.4103/0972-5229.178183] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/04/2022] Open
Abstract
The aim of this study was to identify the encephalic lesions in the eclampsia occurrences. Within a period of 18 months, computed tomography (CT) of the brain was performed in all patients admitted in intensive care for eclampsia. These CTs were analyzed and intracerebral lesions were identified. Thirty-nine patients were included. We noted 10 cases of ischemic stroke, 9 cases of cerebral edema, and 3 cases of hemorrhagic stroke and subarachnoid hemorrhage. The CT scan came back to normal in 20 eclamptic patients. Overall, delays in obstetric and intensive care and time of completion of the CT were long. CT has allowed highlighting in patients with eclampsia varied intracerebral lesions. The early performance of the CT is therefore essential for a better support of patients.
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Affiliation(s)
- Y Brouh
- Anaesthesia and Intensive Care Unit, University Hospital of Cocody, Abidjan, Cote d'Ivoire
| | - Konan Kouassi Jean
- Emergency Department and, Anaesthesia and Intensive Care Unit, University Hospital of Yopougon, Abidjan, Cote d'Ivoire
| | - A Ouattara
- Anaesthesia and Intensive Care Unit, University Hospital of Cocody, Abidjan, Cote d'Ivoire
| | - Y Tétchi
- Anaesthesia and Intensive Care Unit, University Hospital of Cocody, Abidjan, Cote d'Ivoire
| | - Y Pete
- Anaesthesia and Intensive Care Unit, University Hospital of Bouaké, Cote d'Ivoire
| | - N Koffi
- Anaesthesia and Intensive Care Unit, University Hospital of Bouaké, Cote d'Ivoire
| | - C Abhé
- Anaesthesia and Intensive Care Unit, University Hospital of Cocody, Abidjan, Cote d'Ivoire
| | - M Kane
- Anaesthesia and Intensive Care Unit, University Hospital of Cocody, Abidjan, Cote d'Ivoire
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Assouakon P, Brouh Y, Kouadio AS, N’Guessan J, Brou E. Rupture de rate d’origine paludéenne. Ann Fr Med Urgence 2014. [DOI: 10.1007/s13341-014-0441-3] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/24/2022]
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Tetchi YD, Ouattara A, Coulibaly KT, Abhé CM, N’guessan YF, Brouh Y. Difficultés de prise en charge des intoxications au méthanol en Afrique subsaharienne. Ann Fr Med Urgence 2014. [DOI: 10.1007/s13341-014-0402-2] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/25/2022]
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Brouh Y, Ndjeundo PG, Tetchi YD, Amonkou AA, Pete Y, Yapobi Y. Les éclampsies en centre hospitalier universitaire en Côte d’Ivoire: prise en charge, évolution et facteurs pronostics. Can J Anaesth 2008; 55:423-8. [DOI: 10.1007/bf03016308] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/24/2022] Open
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Doumbouya N, Brouh Y, Attié R, Keita M, Agbo-Panzo D, Diallo AF, Barry OT, Camara A, Baldé I. Malformations apparentes en milieu africain : facteurs du retard à la consultation en chirurgie pédiatrique. Arch Pediatr 2006; 13:1029-33. [PMID: 16697615 DOI: 10.1016/j.arcped.2006.03.148] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/09/2005] [Accepted: 03/14/2006] [Indexed: 11/25/2022]
Abstract
AIM To analyze the attitudes of the Guinean and of the Ivory Coast communities leading to delayed consultation despite apparent malformations in children. PATIENTS AND METHODS From January 1, 2000 to December 31, 2002, we carried out a prospective investigation in the paediatric surgery units of the Donka teaching hospital (Conakry) and Cocody, Treichville and Yopougon (Abidjan) teaching hospital. One hundred and two children affected with apparent malformations were included. The studied variables were: age, sex, ethnos group, religion, socio-economic level and the cultural designs of the families. RESULTS Sex ratio male/female was 1,5 and the average age at first consultation was 17 months. Seventy-six per cent of the children carrying apparent malformations at birth were seen at an age ranging from 1 to 30 months. Orthopaedic malformations were prominent (44%) and led especially to negative reactions of the entourage of the patients. Some religious beliefs took a part of the delayed consultation and impaired relationships between the 2 parents. The low socio-economic level (54%) was determining in the delayed consultation. The birth of a child with malformation in the malinké, akan krou community could be understood like a parchment from a god or a witchcraft. CONCLUSION The contributive factors of the delay to the consultation of the children carrying apparent malformations in the communities Guinean and of the Ivory Coast are poverty, ignorance and some religious beliefs. Education and well understanding of these reasons in developing country should improve the acceptance and taking care of these children as well as the development of medical insurance system.
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Affiliation(s)
- N Doumbouya
- Service de chirurgie pédiatrique Donka, Conakry, BP 234, République de Guinée.
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Diané B, Lebeau R, Brouh Y, Boua N, Kouamé KE. [Rectal and colonic injuries induced by enemas: a 10-case series at the university hospital center in Bouake, Ivory Coast]. Med Trop (Mars) 2006; 66:79-82. [PMID: 16615621] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 05/08/2023]
Abstract
The purpose of this study is to report our experience in the management of rectal and colonic injuries induced by enemas. A retrospective analysis was carried out in a series of 10 patients treated at the Bouake, Ivory Coast University Hospital Centre for rectal and colonic injuries induced by enemas between January 1, 1997 and December 31, 2001. There were 6 men and 4 women with a mean age of 26.2 +/- 5.6 years. Based on history taking five enemas involved criminal intent. The other five were carried out for abortion (n=3), therapy (n=1) or autolysis (n=1). The injurious product was known in 7 cases, i.e., sulphuric acid (n=4) and hot pepper (n=3). The mean quantity administered was 158 +/- 64 ml. The presenting picture involved diffuse acute peritonitis in 7 cases and abdominal pain with bloody mucoid rectal discharge in 3. One patient died at the time of admission. The remaining patients underwent either operative (n=6) or medical (n=3) treatment. Prognosis was unfavourable. Four patients died and one patient required colostomy that could not be removed due to sclerosis of the anal sphincter. Management of rectal and colonic injuries induced by enemas requires differential diagnosis to distinguish patients that require emergency laparotomy from patients that can be treated medically. For patients treated medically, close surveillance based on imaging and repeated clinical examination is of paramount importance to allow diagnosis of complications requiring surgical treatment.
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Affiliation(s)
- B Diané
- Service de chirurgie générale et digestive, CHU de Bouaké, République de Côte d'Ivoire
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Abstract
The authors report the case of an infant who survived a massive poisoning of honey bees (>350 bees stings) in 2002. The infant presented convulsions, anaemia, renal failure and haematuria. The main treatment consisted in administration of adrenaline. Systematic and early administration of this drug has limited the severe clinical picture despite massive attack.
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Affiliation(s)
- E K Kouamé
- Service d'anesthésie-réanimation, CHU de Bouaké, Bouaké, République de Côte-d'Ivoire.
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Abstract
OBJECTIVES To review the current data on pathophysiology, causes and management of postoperative hyponatremia in children. DATA SOURCES AND EXTRACTION The Pubmed database was searched for articles, combined with references analysis of major articles on the field. DATA SYNTHESIS The incidence of postoperative hyponatremia has been evaluated at 0.34% and its mortality significant. Postoperative hyponatremia is triggered by the diminished renal ability to excrete free water, due to antidiuretic hormone release. Inappropriate secretion of antidiuretic hormone is frequently seen after spine, cardiac and neurosurgery but can occur even after minor surgery. In this context, the infusion of hypotonic fluids represents a strong risk factor for developing hyponatremia. Other causes of hyponatremia are represented by extrarenal fluid losses, cerebral salt wasting syndrome, desalination phenomenon, adrenal insufficiency or some medications. Preventive treatment is essential and based on prohibition of hypotonic fluids infusion and the use of isotonic fluids infusions, maintenance of a normal total blood volume, the observance of the good practice recommendations for fluid infusion in children, and frequent blood and urine sodium concentration determinations in patients at risk for developing hyponatremia. Hyponatremic encephalopathy requires an emergent management, consisting in respiratory care and hypertonic sodium chloride infusion. Chronic hyponatremia is most often asymptomatic and the main neurological risk factor is represented by a too rapid correction of plasma sodium, which may lead to centropontine myelinolysis.
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Affiliation(s)
- Y Brouh
- Département d'anesthésie et de réanimation pédiatrique, faculté de médecine, université de la Méditerranée, CHU Timone-enfants, Marseille, France
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Seka-Seka J, Brouh Y, Yapo-Crézoit AC, Atseye NH. The role of serum immunoglobulin E in the pathogenesis of Plasmodium falciparum malaria in Ivorian children. Scand J Immunol 2004; 59:228-30. [PMID: 14871301 DOI: 10.1111/j.0300-9475.2004.01337.x] [Citation(s) in RCA: 22] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/29/2022]
Abstract
The aim of the study was to determine the role of immunoglobulin E (IgE) in the pathogenesis of Plasmodium falciparum malaria in Ivorian children. The study comprised of 90 Ivorian children of both sexes, aged 6-72 months: 30 children suffering from severe malaria, 30 suffering from mild malaria and 30 in good heath (serving as the control population). The children underwent a total serum IgE test for the determination of haemoglobin and platelet level and parasite density. We noted a significant rise in IgE level in the children affected with malaria. The level was higher when the malaria was more severe, increasing from 84.61 kUI/l in the control children to 339.9 kUI/l in the children with mild malaria and 659.9 kUI/l in children with severe malaria. Among the comatose patients with severe malaria, the increase in IgE level was related to the level of deterioration of the consciousness. Moreover, we noted a negative correlation between IgE level and the level of haemoglobin and between the IgE level and platelet level. These results are in accordance with the results found in literature and confirm the use of IgE level as an indicator of P. falciparum malaria.
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Affiliation(s)
- J Seka-Seka
- Teaching Hospital of Cocody, Abidjan, Ivory Coast.
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Aguéhoundé C, da Silva SA, Dieth AG, Roux C, Brouh Y, Sanogo I, Sangaré A, Agbodjan PJ. [Antibiotherapy in osteoarticular infections in children suffering from hemoglobinopathy in the University Teaching Hospital of Yopougon]. Sante 2003; 13:143-7. [PMID: 14693473] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 04/27/2023]
Abstract
OBJECTIVE The objective of this work was to evaluate antibiotherapy in osteo-articular infections found in children with henioglobinopathy, by identifying the antibiotics used and their mode of action. Their cost and efficacy were also assessed. MATERIALS AND METHOD The study was retrospective and it took place in the haematology unit, the paediatric surgical department and the central pharmacy of the University Teaching Hospital of Yopougon from 1991 through 1998. Thirty-two medical records of children, carriers of osteo-articular infections (OAI), were selected. Amongst these patients, most of whom had sickle-cell anaemia (97%), 50% were homozygous. Osteomyelitis represented 78% of these infections (salmonella infections being the most frequent cause, amounting to 35%). RESULTS Fifteen types of antibiotics amongst 57 from 5 families of drugs were used, with biotherapy (association of two drugs) being used in 69% of cases. The association of pefloxacine and netilmicine was the most frequently used and it was found to be the most expensive. The treatment was judged efficacious, with a satisfactory result in 75% of cases, based on the clinical criteria. DISCUSSION Bitherapy is the type of treatment, which is often of concern to many authors and relies on the general consensus surrounding the most likely emergency treatment of osteo-articular infections. Certain particularities are worth mentioning regarding this utilisation: the multiplicity of the molecules due to frequent rupture of hospital stock; the use of fluoroquinolones exceptionally prescribed in children under 15. CONCLUSION This antibiotherapy is justified owing to its efficacy on a sensitive issue concerning a pathology with grave sequellae, where long-term monitoring is necessary.
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Affiliation(s)
- Cosme Aguéhoundé
- Service de chirurgie pédiatrique, CHU de Yopougon, 22 BP 1771, Abidjan, Cote d'Ivoire.
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Brouh Y, Kouamé KE, Boua N. [Prognostic value of WHO criteria defining severe malaria in expatriates treated in an intensive care unit in the Ivory Coast]. Med Trop (Mars) 2003; 62:564. [PMID: 12616952] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 03/01/2023]
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Asse KV, Brouh Y, Plo KJ. [Acute severe malaria in children in CHU Bouaké, Ivory Coast]. Arch Pediatr 2003; 10:62. [PMID: 12818785] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 03/03/2023]
Affiliation(s)
- K V. Asse
- Service de pédiatrie, centre hospitalier universitaire de Bouaké 01BP1174 01, Bouaké, Côte d'Ivoire
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Asse KV, Plo KJ, Brouh Y. [Severe malaria in children at the Central University Hospital of Bouake in the Republic of the Ivory Coast]. Arch Pediatr 2003; 10:61-2. [PMID: 12825301] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 03/03/2023]
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Brouh Y, Paut O, Léna G, Paz-Paredes A, Camboulives J. [Shaken baby syndrome: improvement of cerebral blood flow velocity after a subdural external derivation in a six-month old infant]. Ann Fr Anesth Reanim 2002; 21:676-80. [PMID: 12471789 DOI: 10.1016/s0750-7658(02)00698-6] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 01/08/2023]
Abstract
The shaken baby syndrome is a severe form of child abuse. The intracranial injuries are associated with a high morbidity and mortality rates. A 6 month-old healthy infant presented at home a cardiorespiratory arrest. After a cardiopulmonary resuscitation, radiological survey showed sub-dural haematomas and retinal haemorrhages, without a history of trauma. The diagnosis of shaken baby syndrome was made. Despite medical management and a fontanelle tap, clinical signs of intracranial hypertension worsened. Transcranial Doppler examination found the cerebral blood flow velocities to be decreased while the pulsatility index was increased. A sub-dural-external drainage allowed the cerebral blood flow to increase and the pulsatility index to decrease. We conclude that transcranial Doppler examination can be helpful for the clinician caring children presenting a shaken baby syndrome.
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Affiliation(s)
- Y Brouh
- Département d'anesthésie et de réanimation, CHU Timone-Enfants, Boulevard Jean-Moulin, 13385 Marseille, France
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Kouamé K, Brouh Y, Soro L, Bissagnéné E, Eholié S, Amonkou A. [Severe malaria in expatriates in an intensive care unit in Abidjan (Ivory Coast)]. Ann Fr Anesth Reanim 2002; 21:359-64. [PMID: 12078427 DOI: 10.1016/s0750-7658(02)00637-8] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 10/27/2022]
Abstract
OBJECTIVE To analyse clinical and prognosis aspects of severe malaria in expatriates hospitalized between 1990 and 1999 in the intensive care unit in Abidjan. STUDY DESIGN Retrospective survey. METHODS According to the World Health Organization's criteria, the retrospective study of severe cases of malaria who received treatment and care at the intensive care unit. Epidemiological, clinical manifestations and evolution were analysed on each patients. RESULTS 66 upon 927 expatriates hospitalised in the period of the study, had severe malaria with falciparum Plasmodium (7.12%). The average age was 42 years. Eleven patients took prophylactic treatment (17%). The clinical aspects were neurological (83%) followed by renal failure (48%), haemoglobinuria (48%) and hyperparasitemia (59%). During the hospitalisation we recorded 12 deaths (18%). The criteria that were associated with mortality in pejorative order were: coma (RR = 8.04), respiratory distress (RR = 5.06), metabolic acidosis (RR = 5.06), shock (RR = 3.67) and convulsions (RR = 2.86). CONCLUSION Severe malaria was frequent and associated with high mortality in expatriates who are living in Africa. This study reinsists the necessity of prophylactic treatment to be reinforced in informing the travellers. This study showed frequency and mortality rate of survey of malaria and the criteria associated with high mortality rate.
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Affiliation(s)
- K Kouamé
- Département d'anesthésie-réanimation, UFR des sciences médicales d'Abidjan, Côte d'Ivoire
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Doumbouya N, Aguehounde C, Brouh Y, Agbopanzo D, Diallo AF, Dieth AG, Ouattara O, Anoma SDS, Roux C. [Gas gangrene after injection of quinine salts: apropos of 2 severe pediatric cases]. Med Trop (Mars) 1999; 59:101-2. [PMID: 10472592] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 02/13/2023]
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Aye D, Brouh Y, Soro L, Amonkou A, Yeo T, Kouame KE, Coffi S, Bondurand A. Rupture spontanée de rate au cours d'un paludisme à Plasmodium falciparum chez un sujet immun. ACTA ACUST UNITED AC 1997. [DOI: 10.1016/s0923-2524(97)84088-x] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/18/2022]
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