BackgroundCystic fibrosis is rare in Tunisia. Its diagnosis requires experienced specialists. Its prognosis is poor in developing countries.ObjectivesTo study the epidemiologic, clinical, genetic features and the therapeutic challenges of cystic fibrosis in Tunisian children.MethodsCovering a period of 21 years, this retrospective study included all patients with a definite diagnosis of cystic fibrosis from the Pediatrics Department B of The Children's Hospital of Tunis.ResultsData from 32 children (14 boys and 18 girls) were collected. The diagnosis was made during the first year of life in 28 cases. Meconium ileus was found in 5 cases, respiratory manifestations in 22 cases, chronic diarrhea in 19 cases, faltering growth in 17 cases and a pseudo Barter syndrome in 2 cases. The sweat chloride test was positive in all cases. The most frequent mutation was F508del (56% of cases). Respiratory complications marked the outcome. Among our 32 patients, 15 patients (50%) died at an average age of 5 years and 3 months, mainly due to respiratory failure. The mean age of the surviving patients was 5 years.ConclusionCystic fibrosis prognosis is poor in our series compared to developed countries due to the longer diagnostic delay and the limited therapeutic options.

Objective: Our study aimed at assessing the role of flexible bronchoscopy (FB) in improving diagnosis and management of children's respiratory conditions in the pediatric unit of FB, newly created and unique in Tunisia. Methods: Retrospective study including all the FB achieved in our pediatric unit from 2009 to 2014. Results: We performed 365 FB in 333 patients aged 46 months on average (1 month -15 years), often under conscious anesthesia (81.6%). FB was performed for diagnostic purposes in 341 cases and for therapeutic purposes in 24 cases. Eight anatomical abnormalities were revealed in 22 patients. An intraluminal bronchial obstruction was found in 71 FB, mainly due to a foreign body (n=36). A vascular anomaly was responsible for nine cases out of 17 extraluminal obstructions. Airways malacia was observed in 60 FB. Bronchoalveolar lavage was performed in 196 cases. It was determinant in 43.9% of the cases. FB was of great diagnostic value in 74.8% of the cases. It influenced the management of the patients in 58% of the cases. The FB for therapeutic purposes was beneficial in all cases. Few complications occurred (5.5%). Conclusion: FB is a safe tool providing precious diagnostic and/or therapeutic help for the clinician. Tunisia. Afri Health Sci. 2016;16(1): 51-60. http://dx.doi.org/10.4314/ahs.v16i1.7 Introduction Pediatric pulmonology has experienced significant progress in recent decades in the understanding and management of respiratory diseases of children, becoming a specialty in itself. The development of diagnostic tools, including flexible bronchoscopy (FB), has contributed much to the development of this specialty.

Introduction Depuis décembre 2019, la propagation du nouveau coronavirus (le SARS-CoV-2) constitue le premier souci mondial. Étant un virus à tropisme respiratoire, l’asthme constitue-t-il un facteur de mauvais pronostic ? À l’heure actuelle on prédispose de peu de données pouvant établir cette relation. L’objectif de notre travail est de faire le point à travers une série de 40 malades sur la présentation clinique et évolutive des enfants asthmatiques atteints de la COVID 19. Méthodes Étude rétrospective incluant les enfants hospitalisés pour infection par le SARC-Cov2, à l’hôpital d’enfants de Tunis, durant la période allant du 1 octobre au 31 décembre 2021. Résultats Nous avons colligé 40 cas de COVID 19 dont 24 garçons. L’âge moyen était de 5 ans avec des extrêmes allant de 25 jours à 12 ans. Huit parmi nos malades étaient suivis pour asthme sous traitement de fond. Ils étaient hospitalisés pour une crise d’asthme induite par le SARS-Cov2 (une sévère, six modérées et une légère). Cinq patients ont eu recours à une oxygénothérapie (4 par lunettes nasales simples et 1 par lunettes nasales à haut débit) avec une durée moyenne de 3 jours. Un seul malade était hospitalisé en réanimation pendant 24 h. L’évolution était favorable pour tous les patients avec une durée d’hospitalisation moyenne de 3,5 jours. Parmi les enfants non asthmatiques ( n = 32), 4 étaient hospitalisés pour une crise d’asthme (une sévère et 3 modérées). Une oxygénothérapie par lunettes nasales simples était indiquée dans un cas pendant 48 h. La durée moyenne d’hospitalisation était de 3 jours. Discussion Les dernières études démontrent que l’asthme n’est pas un facteur de risque pour la COVID-19 sévère. Les patients[p1] asthmatiques semblent être protégés contre les formes graves du SARS-COV2 du fait de leur plus grande prudence vis-à-vis des mesures de distanciation sociale et de leur traitement de fond. Conclusion L’asthme ne semble pas être un facteur prédictif d’atteinte sévère par le SARS-Cov2. Toutefois, il faut rester vigilant avec tous les enfants suivis pour asthme et assurer un bon contrôle afin de limiter le risque d’exacerbation de la maladie.

Background: Pesticide poisoning is very common in Tunisia. Various factors are involved in the analysis of the clinical presentations and the severity of this condition. Major factors are the chemical nature of the pesticides and the quantity entered the body. Methods: This is a retrospective study, reporting the pediatric cases that presented to us with signs and symptoms of pesticide poisoning. Fifty cases pesticide poisoning were admitted to the hospital between January 2013 and October 2016. Results: A total of 50 pediatric cases were included in this study with the mean age of 3 years and 4months. The poisoning was accidental in 49 cases and self-inflicted in one, with the mode being oral (N=45), respiratory (N=2) and cutaneous (N=3). The average duration of hospital care for these patients was 2 hours and 30 minutes (range: 30 min-24 hr). The clinical manifestations of poisoning noted were due to muscarinic and nicotinic receptors inhibition. Upon clinical examination, 29 patients had no pesticide in the gastric lavage fluid and urine and demonstrated no abnormal cholinesterase activity. The therapeutic management was mainly symptomatic with antidote medications prescribed (atropine and oxime). All patients had favorable outcomes and no death occurred. Conclusion: This study demonstrated the frequency of pesticide poisoning in a pediatric setting and the importance of early management. Optimal therapeutic approaches were evaluated, demonstrating that prevention still remains the best solution in such cases.

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