Introduction: While acute respiratory tract infections are the main cause of paediatric mortality and morbidity worldwide, pathogen patterns shift due to factors such as hygiene, vaccinations, and antibiotic resistance. Knowledge about current cause of respiratory infections is lacking, particularly in low- and middle-income countries. The aim of this study was to identity the various respiratory pathogens causing acute respiratory tract infections in children below 5 years of age visiting a sub-urban primary care clinic in Senegal. Methods: A case-control study was performed in September and October 2018. Oropharyngeal swabs were collected from cases; infants with fever and respiratory symptoms, and controls; children involved in the vaccination programme. Viral identification was conducted by polymerase chain reaction for 21 different viruses; bacteria were identified by culture studies. Associations between microorganisms, acute respiratory infection and severity of disease were calculated by multivariate regression adjusting for confounders such as age, sex, and living area. Results: Overall, 102 cases and 96 controls were included. Microorganisms were detected in 90.1% of cases and 53.7% of controls ( P < .001). Influenza virus A (including H1N1), influenza virus B, respiratory syncytial virus (RSV), and Streptococcus pneumoniae were independently associated with acute respiratory tract infections. Co-detection of two or more pathogens was present in 49.5% of cases; 31.7% of cases had a pneumonia and 90.2% was treated with antibiotics. Conclusions: This case-control study in a primary care setting in sub-Saharan Africa found influenza virus A and B, RSV, and S pneumoniae to be the main causes of acute respiratory tract infections in children below 5 years of age. We recommend evaluation of antibiotics prescription behaviour in this setting.

Introduction: The state of epilepticus in children is considered as a medical emergency which involves the vital and functional prognosis of the patient. The difficulties of this support in our country are linked to the lack of pediatric intensive care unit. The aim of our study is to evaluate the clinical, therapeutic, scalable and etiological states of epilepticus in children at Hospital Albert Royer National Children, Dakar.Methods: This is a prospective study which includes all patients aged between 2 months and 16 years who were hospitalized between 1 August, 2014 and 31 May, 2015 for a prolonged convulsion over 5 minutes and/or with at least 3 episodes of successive convulsions. We have not included the newborns and non-convulsive state epilepticus patients. The treatment protocol consists of the use of diazepam as first line, after 60 minutes if the crisis persists; diazepam phenobarbital was associated with the second line. Results:We collected 53 cases of state epilepticus (29 boys and 24 girls), which turned out to be a hospital incidence of 4.2%. The mean age was 48.5 months. Three quarters of our patients (n=40) were received emergency beyond 30 minutes after the onset of convulsions where the generalized seizures (n=42) were more common than partial seizures (n=11). The convulsions occurred in a context of fever in 38 patients. The metabolic balance was in favor of hyponatremia in 13 cases. Twenty-four patients (45.3%) have received only phenobarbital diazepam combination within 60 minutes after the onset of seizures. Conclusions:The state epilepticus cases are frequent in the hospital emergency department especially for infants from 2 months to 3 years. It was observed that the patients unfortunately received emergency in late beyond 30 minutes after the onset of convulsions.

Vitamin D deficiency (VDD) is a public health problem which affects all human beings including darkskinned subjects. In children, it can cause disabilities associated with skeletal abnormalities such as rickets or stunted growth. VDD is also associated with a significant risk of extra-skeletal, infectious, auto-immune, neoplastic, and cardiovascular diseases. The concentration of 25 (OH) D is currently considered as the best VDD indicator. Whereas VDD has been well studied in Western countries and North America, very few studies have been conducted in sub-Saharan Africa. The aim of this study was to assess the prevalence and risk factors of VDD in children aged between 0 to 59 months. This is a cross-sectional prospective study conducted from August 5, 2019, to November 30, 2020. A total of three hundred children were included in this study, two hundred of whom were malnourished and the rest with a normal P/T ratio. The variables studied were vitamin D, serum calcium, magnesium, phosphorus and iron. Ferritin, haemoglobin, protein, albumin and prealbumin were also studied. The prevalence of VDD in the general population was 30%. No significant statistical difference in vitamin D concentration values was noticed between malnourished and nourished children with p = 0.388. Children over 24 months of age are 2.34 times more likely to be VDD than others. Given the prevalence of VDD in the study population, it would be necessary to integrate screening and supplementation into current medical practice.

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