OBJECTIVES Adverse events during antiretroviral treatment are frequent and various. Their diagnosis incurs some various difficulties according to the geographic context. Our aim was to describe the frequency, nature, and preventability of adverse drug reactions (ADRs) due to antiretroviral treatment in Malian outpatient children. METHODS The study was a 6-month (June 1 to November 30, 2010) prospective, observational study of 92 children admitted to a pediatric hospital in Sikasso, Mali. The patients were treated with a generic drug and/or drug combinations. Prior to treatment initiation, demographic characteristics, clinical history, and biologic parameters, including CD4 cell counts, were collected for each patient. The World Health Organization's adverse drug reactions classification was used to characterize the side effects. Adverse effects and toxicities were graded 1, 2, and 3. Analysis of data was performed using SPSS Version 17.0 software. RESULTS Ninety-two human immunodeficiency virus–infected children met the criteria of inclusion. After 24 weeks of treatment, we observed that 14.1% of children had at least one side effect during our study. Side effects were many and varied, with the most frequent being cutaneous rash, nausea, vomiting, and diarrhea (38.5%, 23.1%, 15.4%, and 15.4%, respectively). Side effects were grade 1 in most cases. One case of grade 2 and one case of grade 3 were observed with rash. We observed one case of grade 3 side effects during our study. The treatment regimen was changed in 15.2% of cases, including one case because of side effects. CONCLUSION ADRs are not rare in Mali, particularly in children. These ADRs have an impact on quality of life for patients. We recommend a pharmacovigilance system for sustainable management of side effects in patients infected with human immunodeficiency virus in Mali.

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Introduction: Tuberculosis is one of the top ten killers worldwide. In 2015, an estimated one million children developed the disease and 170,000 died from it. We report three cases of pulmonary tuberculosis in infants diagnosed and treated in the pediatric ward of the Mali Hospital. Clinical cases: Observation 1: He is a 7 month old infant hospitalized for fever and weight loss. He received the BCG. There was no notion of TB contagion. On admission, he had poor nutritional status with a Zscore <- 3 and pallor. He had bronchial groans. Xpert / RIF returned positive to M. tuberculosis sensitive to rifampicin. An anti-tuberculosis treatment (2RHZ / 4RH) associated with the transfusion of the globular concentrate at a rate of 20 ml / Kg / 1d over 1 hour and nutritional management have been instituted. After 2 months of treatment, we observed clinical radiological improvement. Xpert control of gastric fluid returned negative. Observation 2: He was an 8-month-old infant hospitalized for fever and weight loss. He did not receive BCG. There was no notion of family storytelling. On admission, he had a poor nutritional status with a Z score <-3. The respiratory rate was 32 cycles / min. There were crackling groans. Direct gastric fluid examination and Xpert / RIF were positive for M. tuberculosis sensitive to rifampicin. He could not be treated because the family requested discharge against all medical advice. Observation 3: He was a 10 month old infant admitted for cough, fever and weight loss. He received the BCG, there was the notion of family contagion. At the entrance, he had a poor nutritional status with a zscore <- 3. He had a polypnea at 45 / min and crackling groans. Direct examination and culture of gastric fluid were positive for rifampicin-sensitive M. tuberculosis. A treatment including oxygen, anti-tuberculosis drugs (2RHZ / 4RH) and nutritional management was initiated. Within 2 months of treatment, we observed clinical and radiological improvement. Direct examination and culture of gastric fluid returned negative. Conclusion: tuberculosis in infants is poorly documented because of unspecific symptoms and difficulties in obtaining bacteriological confirmation. It should be systematically sought in all malnourished infants in endemic countries.

Introduction: Every year, nearly 4 million people pass away from acute respiratory infections. 98% of such deaths are due to lower respiratory tract infections. Even though studies have been carried on lower respiratory infections x-ray aspects in Mali, very few studies have been done to reveal bacteriological and virological evidence of this disease. Materials and methods: It is about a descriptive prospective study carried out from January to December 2018 having involved patients of all ages, coming for medical consultation at the Yirimadio Community-based health center as well as children from 6 months to 15 years old coming at the pediatric department of UHC Hôpital du Mali for a lower respiratory infection. They had all undergone chest X-ray and a PCR. The purpose: of this work is to study etiological and x-ray aspects of acute lower respiratory infections at the Yirimadio Community-based Health Center and at the UHC pediatric department of Hôpital du Mali. Findings: From January to December 2018, we recorded a frequency of 1.19%. The age group 0 -5 years was the most represented (64.5%) with a sex ratio of 0.97 for women. Cough was the most common clinical sign (98.

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