Ranque B.,Internal Medicine |
Ranque B.,University of Paris Descartes |
Ranque B.,Groupement Des Hopitaux Of Luniversite Catholique Of Lille |
Menet A.,Center Hospitalo Universtaire Of Fann |
And 23 more authors.
The Lancet Haematology | Year: 2014
Background: Chronic kidney disease is one of the leading causes of mortality in patients with sickle cell disease. However, it has been almost exclusively studied in patients with the SS phenotype and in high-income countries, despite more than 80% of patients living in Africa. We looked for the determinants of glomerulopathy in a multinational cohort of patients with sickle cell disease of diff erent phenotypes in sub-Saharan Africa. Methods: In the CADRE cohort, we prospectively included patients 3 years and older with sickle cell disease of all haemoglobin phenotypes in Cameroon, Côte d'Ivoire, Mali, and Senegal. All individuals were assessed at steady state. The main outcome of interest was albuminuria defi ned as a urine albumin-to-creatinine ratio of greater than 30 mg/g. We investigated the clinical and biological determinants (including haemolysis markers) of albuminuria in two main phenotype groups (SS and Sβ° SC and Sβ+) with further stratifi cation by age and country. Findings: The study is ongoing because of follow-up. 2582 patients with sickle cell disease were included (1776 SS, 136 Sβ°, 511 SC, and 159 Sβ+). 644 patients with the SS and Sβ° phenotypes (33·7%, 95% CI 31·6-35·8) and 110 with the SC and Sβ+ phenotypes (16·4%, 13·6-19·2) had albuminuria. In the SS and Sβ° group, albuminuria was detected in 144 (27%) of 527 children younger than 10 years and its frequency increased with age (29 [48%] of 60 patients aged >40 years). Multivariable analysis showed that albuminuria was associated with age (odds ratio 1·43, 95% CI 1·20-1·71; p<0·0001), female sex (1·35, 1·02-1·82; p=0·045), low haemoglobin (0·79, 0·66-0·93; p=0·006), high lactate dehydrogenase concentrations (1·33, 1·14-1·58; p=0·0009), and, using Côte d'Ivoire as the reference, Mali (2·49, 1·64-3·79; p=0·042) and Cameroon (1·59, 1·01-2·51; p=0·0007) in patients with the SS and Sβ° phenotypes. The magnitude of the association of albuminuria with haemoglobin and lactate dehydrogenase concentrations increased with age. In the SC and Sβ+ patients, only low haemoglobin (0·69, 0·48-0·97; p=0·029), high blood pressure (1·63, 1·17-2·27; p=0·0017), and Mali (3·75, 1·75-8·04; p<0·0001) were associated with albuminuria. Interpretation: Hyperhaemolysis is associated with albuminuria, with an age-dependent eff ect, in the SS and Sβ° phenotypes only, suggesting a diff erent pathological mechanism for glomerular disease in the patients with SC andSβ+ phenotypes. However, both phenotypes are associated with a high prevalence of albuminuria in childhood. Therefore, screening for albuminuria is advised in African children with sickle cell disease to detect early renal damage.
Hemolytic-uremic syndrome (HUS) in children at the university hospital center in Dakar: About four cases [Syndrome hémolytique et urémique de l’enfant au Centre Hospitalier Universitaire (CHU) de Dakar: À propos de quatre observations]
Thiongane A.,Center Hospitalier National Denfants Albert Royer |
Ndongo A.A.,Hopital d'Enfants de Diamniadio |
Ba I.D.,Center Hospitalier National Denfants Albert Royer |
Boiro D.,Service de Pediatrie de l'Hopital Abass Ndao |
And 13 more authors.
Pan African Medical Journal | Year: 2016
Hemolytic-uremic syndrome (HUS) is a common cause of organic acute renal failure (ARF) in children. It is a progressive complication of acute gastroenteritis (AGE), especially caused by Escherichia coli in children. This study aimed to describe the clinical, therapeutic and evolutionary aspects of this affection in four children. We collected four cases of HUS. The average age was 10,5 months (5-15mois), exclusively boys. Clinical examination revealed a hemolytic anemia (pallor and jaundice), oligoanuria and edematous syndrome (2 cases), arterial hypertension (1 patient), AGE associated with severe dehydration and hypovolemic shock (2 patients), consciousness disorders. ARF was found in all patients as well as thrombocytopenia and schizocytes smear. Direct Coombs test was negative. Hyperkalemia was found in 3 patients, of whom 1 with hyperkalemia level of more than 9.2 mmol/L, hyponatremia at 129 mmol/l (1 patient) and hypernatremia at 153 mmol/l (1 patient). HUS was secondary to pneumococcal pneumonia (1 patient) while AGE was secondary to E. coli (1 patient). The treatment was mainly symptomatic and included fluid restriction, transfusion of red cell concentrates, diuretics, peritoneal dialysis and hemodialysis. The evolution was marked by the onset of chronic renal failure (1 patient) after 6 months of follow-up and by recovery (1 case). Three patients died. HUS is the most common cause of organic acute renal failure in newborns. Diagnosis is essentially biological, treatment is mostly symptomatic. © Aliou Thiongane et al.
PubMed | Service de Pediatrie de lHopital Aristide Le Dantec, Center Hospitalier National dEnfants Albert Royer, Service de Pediatrie de lHopital Abass Ndao and Hopital dEnfants de Diamniadio
Type: | Journal: The Pan African medical journal | Year: 2016
Hemolytic-uremic syndrome (HUS) is a common cause of organic acute renal failure (ARF) in children. It is a progressive complication of acute gastroenteritis (AGE), especially caused by Escherichia coli in children. This study aimed to describe the clinical, therapeutic and evolutionary aspects of this affection in four children. We collected four cases of HUS. The average age was 10,5 months (5-15mois), exclusively boys. Clinical examination revealed a hemolytic anemia (pallor and jaundice), oligoanuria and edematous syndrome (2 cases), arterial hypertension (1 patient), AGE associated with severe dehydration and hypovolemic shock (2 patients), consciousness disorders. ARF was found in all patients as well as thrombocytopenia and schizocytes smear. Direct Coombs test was negative. Hyperkalemia was found in 3 patients, of whom 1 with hyperkalemia level of more than 9.2 mmol/L, hyponatremia at 129 mmol/l (1 patient) and hypernatremia at 153 mmol/l (1 patient). HUS was secondary to pneumococcal pneumonia (1 patient) while AGE was secondary to E. coli (1 patient). The treatment was mainly symptomatic and included fluid restriction, transfusion of red cell concentrates, diuretics, peritoneal dialysis and hemodialysis. The evolution was marked by the onset of chronic renal failure (1 patient) after 6 months of follow-up and by recovery (1 case). Three patients died. HUS is the most common cause of organic acute renal failure in newborns. Diagnosis is essentially biological, treatment is mostly symptomatic.
Knowledge and practices of Senegalese mothers living in rural or suburban area on children feeding from birth to six months of age [Connaissances et pratiques de mères sénégalaises vivant en milieu rural ou suburbain sur lalimentation de leurs enfants, de la naissance à lâge de six mois]
Diagne-Guye N.R.,Center Hospitalier National dEnfants Albert Royer |
Diack-Mbaye A.,Center Hospitalier National dEnfants Albert Royer |
Drame M.,University of Reims Champagne Ardenne |
Drame M.,Center Hospitalier University Of Reims |
And 8 more authors.
Journal de Pediatrie et de Puericulture | Year: 2011
Breastfeeding practice is very common in Senegal. Indeed, it is the way nearly 100% of women feed their child. However, in 42% of cases, this practice is accompanied by early water administration (before sixth months). This is very often because of socio-cultural representations. Our work aimed to describe and analyze knowledge and practices of a sample of women on children feeding, from birth to six months of age. Population and methods: It was a cross-sectional prospective study carried out from May 1st to June 30th, 2009. Qualitative data were recoded by face-to-face interviews with the mothers of six to 12 months old infants who frequented the two sites of the Institute of social and preventive paediatrics of the Cheikh Anta Diop university of Dakar (Senegal): the one being in the suburbs of Dakar (Pikine) and the other in a rural area (Khombole). Several topics were addressed: general knowledge on infants feeding, exclusive breastfeeding and the difficulties encountered in its practice, food introduced during exclusive breastfeeding and factors associated with their use. Results: The study dealt with 44 mothers. The average time of first breastfeeding after birth was 6 ± 12 h (range: 1 to 72 h). The first food received by the newborn was the mother's milk for 64% of the mothers (n = 28). The 16 other mothers (36%) administered the "Tokental" (traditional drink for the newborn) before the first breastfeeding. Thirty-eight mothers held information about exclusive breastfeeding. Early breastfeeding was carried out by 22 mothers (50%). Exclusive breastfeeding up to six months was done by 29 mothers (66%). The reasons put forward by the 15 other mothers to choose another food are various. Among the factors influencing the practice of exclusive breastfeeding, the educational level of the mothers appeared, even if the difference were not statistically significant. Conclusion: The practice of exclusive breastfeeding and early breastfeeding do not seem to be limited by knowledge but by sociocultural representations. Among the factors limiting the early breastfeeding, the most important seems to be the "Tokental". To improve the practices on infants feeding, it would be important to reinforce information by healthcare professionals about newborn babies. © 2010 Elsevier Masson SAS. All rights reserved.
Postnatal weight growth among low birth weight newborn in the neonatal unit of Albert Royer National Children Hospital Center (ARNCHC) of Dakar: Incidence of extra-uterine growth retardation [Croissance pondérale postnatale des nouveau-nés de faible poids de naissance au service de neónatologie du centre hospitalier national denfants Albert Royer: incidence du retard de croissance extra-utérin]
Faye P.M.,Center Hospitalier National dEnfants Albert Royer |
Diagne-Gueye N.R.,Hopital Pour Enfants |
Paraiso I.L.,Center Hospitalier National dEnfants Albert Royer |
Ba A.,Center Hospitalier National dEnfants Albert Royer |
And 9 more authors.
Journal de Pediatrie et de Puericulture | Year: 2016
Introduction.-Low birth weight (LBW) newborns (< 2500 g) need optimal caloric and nutritionalintakes to avoid extra-uterine growth retardation (EUGR), which have bad consequences fortheir future. This study aimed to evaluate frequency and factors associated with EUGR, at 40weeks post-conceptional (WPC) age (SPC) at the neonatal unit of Albert Royer National ChildrenHospital Center (ARNCHC) of Dakar.Materials and methods.-It was a retrospective study, from January 2011 to 31 December2012, including LBW newborn admitted in the unit. The data collected were: sociodemographic,obstetrical and perinatal, feeding and nutrition, immediate postnatal growth compared withthe reference growth curves. Data were analyzed with Epi Info version 3.5.1.Results.-We studied 98 LBW newborns, 78 preterm (79.6%) and 20 term (20.4%). Mean gesta-tional age at birth was 34.08 weeks of amenorrhea (WA) (28 to 39 WA) and mean birth weight was1643.7 g (700 to 2480 g). Enteral feeding was begun at mean age of 2.5 days (0 to 13 days). Atdays 3 and 7 of life, caloric intakes (respectively 53 ± 23 kcal/kg/day and 86 ± 37 g/kg/day) andprotidic intakes (respectively 0.9 ± 1.1 g/kg/day and 2.3 ± 1.6 g/kg/day) were low. Birth weightwas reached on average at 13.1 days (0 to 41). Mean weight gain was 7.85 g/kg/day duringadmission. EUGR at 40 WPC was present in 85.7% of newborn, weight insufficiency frequencyat 3 and 6 months corrected ages was respectively 60.5% and 41.2%. Variables associated withrisk of EUGR were: birth weight < 1643 g (P = 0.04), intra-uterine growth retardation (P = 0.003),beginning enteral feeding after day 2 of life (P = 0.004), neonatal infection (P = 0.027); lowcaloric intakes at day 3 < 53 kcal/kg/day (P = 0.0001), low lipidic and protidic intakes at day 3(P = 0.004).Conclusion.-EUGR is frequent in LBW newborns admitted in our unit. Low caloric and nutri-tional intakes in the first days of life are the main factors identified. We must urgently correctnutrition of seven first days by using parenteral nutrition and early enteral fortified nutrition. © 2015 Elsevier Masson SAS.
PubMed | Unite pediatrique de soin et daccompagnement, Center Hospitalier National dEnfants Albert Royer and Montpellier University
Type: | Journal: Food and nutrition bulletin | Year: 2016
To assess the acceptability of ready-to-use food (RUF)-based outpatient protocols in HIV-infected children and adolescents with severe acute malnutrition (SAM) and moderate acute malnutrition (MAM).Plumpy Nut and Plumpy Sup were supplied every 2 weeks and prescribed by weight to SAM and MAM children, respectively. Forty-three children, 24 MAM and 19 SAM, were enrolled. Organoleptic appreciation, feeding modalities, and perceptions surrounding RUF were recorded at week 2. Sachets were counted to measure adherence throughout the study.Median age was 12.2 years (interquartile range: 9.3-14.8), and 91% were on antiretroviral treatment. Overall, 80%, 76%, 68%, and 68% of children initially rated RUF color, taste, smell, and mouth feeling as good. However, feelings of disgust, refusal to eat, fragmentation of intake, self-stigma, and sharing within the household were commonly reported. Eighteen MAM and 7 SAM experienced weight recovery. Recovery duration was 54 days (31-90) in MAM versus 114 days (69-151) in SAM children (P = .02). Their rate of RUF consumption compared to amount prescribed was approximately 50% from week 2 to week 10. Nine failed to gain weight or consume RUF and were discontinued for clinical management, and 9 dropped out due to distance to the clinic.Initial RUF acceptability was satisfactory. More than half the children had successful weight recovery, although adherence to RUF prescription was suboptimal. However, further research is needed to propose therapeutic foods with improved palatability, alternative and simpler intervention design, and procedures for continuous and tailored psychosocial support in this vulnerable population.NCT01771562 (Current Controlled Trials).
Kangaroo mother care for low birth weight infants at Albert-Royer National Children Hospital Center of Dakar [Les soins kangourou pour nouveau-nés de faible poids de naissance au centre hospitalier national denfants Albert-Royer de Dakar]
Faye P.M.,Center hospitalier national denfants Albert Royer |
Thiongane A.,Center hospitalier national denfants Albert Royer |
Diagne-Gueye N.R.,Center hospitalier national denfants Albert Royer |
Ba A.,Center hospitalier national denfants Albert Royer |
And 6 more authors.
Archives de Pediatrie | Year: 2016
Introduction: Kangaroo care (KC) is an effective method to care for low birth weight (LBW) newborns, particularly in developing countries. The objective of this study was to estimate the efficacy of this method and its impact on morbidity and mortality of LBW infants admitted to the KC unit of Albert-Royer National Children's Hospital Center (ARNCHC) in Dakar, Senegal. Material and methods: This was a retrospective, single-center study from July 2011 to July 2013. We collected sociodemographic, maternal, and obstetrical data, neonatal characteristics and information during KC (age and weight at inclusion, thermoregulation, feeding, growth, and overall progression). Data were entered and analyzed using SPSS version 9.0. Results: We included 135 newborns, with a female predominance (sex ratio: 0.78). One-third of the mothers (35.5%) were primiparous and only 21.1% had a socioprofessional activity and the majority had a low educational level. The mean gestational age (GA) was 33.08 ± 2.06 weeks of amenorrhea and the mean birth weight 1485 ± 370 g. There were 20 term babies with intrauterine growth restriction (IUGR) (14.8%) and 115 (85.2%) preterm newborns, 83 (72.2%) of whom, showed IUGR. The mean duration of conventional care was 12.3 days (range: 4-27 days) and the main complications were respiratory distress (46.2%), infection (36.9%), and necrotizing enterocolitis (15.1%). At KC admission, the mean post-conceptional age was 34.2 ± 2.46 weeks and the mean weight 1445 ± 319 g (minimum, 700 g). The main complications in KC were infections (20.2%), hypoglycemia (18.5%), and gastro-esophageal reflux disease (16.4%). Only 56.3% of the babies were exclusively breastfed. The mean weight gain during the stay in the KC unit was 15.3 ± 9.08 g/kg/day and the mean weight at discharge was 1761 ± 308 g. Only three episodes of hypothermia were noted. The mean duration in the KC unit was 10.2 days (range: 3-24 days). Five babies died (3.7%): one during KC, one at home, and the three others after readmission to neonatology. Conclusion: Kangaroo care for LBW infants is highly effective in our context. This method should be spread to a large majority of health centers in the country. © 2015 Elsevier Masson SAS.