Background: The place of blood glucose abnormalities in severe malaria is poorly defined. The objective of the study was to determine the incidence of glycemic abnormalities and to identify the factors associated with their occurrence and death. Patients and Methods: A prospective study was conducted from January to October 2016 at the Teaching Hospital of Brazzaville. The blood glucose levels of all children hospitalized for severe malaria were measured for 3 days. The variables were compared in univariate and multivariate analysis. Results: A total of 158 children with an average age of 69.6 months ± 43.2 (ranges: 5 months and 15 years) were hospitalized for severe malaria. Moderate hyperglycemia was observed in 52.53% of children, severe hyperglycemia: 17.72%, moderate hypoglycemia: 15.19% and severe hypoglycemia: 2.53%. Children aged < 5 years (p = 0.03), females (p = 0.03), with disease duration before admission ≥ 7 days (p = 0.03) and referred from private hospitals (p = 0.04) had an increased risk of hypoglycemia. Age > 5 years was associated with hyperglycemia (p = 0.0006). The presence of hypoglycemia (blood glucose ≤ 3.3 mmol/L) on admission was associated with the risk of death (OR = 9.59, p = 0.02), no death occurred in children with hyperglycemia (p = 0.4) on admission. Conclusion: The incidence of blood glucose abnormalities is high in severe malaria. Hyperglycemia is more common than hypoglycemia, but only hypoglycemia is associated with an increased risk of death.
Macrophagic Activation Syndrome (MAS) is a rare disorder and is thought to result from non-malignant activation and proliferation of macrophages and T-cells. It can be of primary or secondary origin and its prognosis is often poor. Authors report a case of a three-year-old boy admitted in the intensive care unit for MAS secondary to an overdose of sodium valproate to remind practitioners to think about it in the presence of a febrile pancytopenia.
Background: Home related accidents have emerged as an important public health issue in pediatrics. However, very few studies have been conducted in sub-saharan countries on domestic accidents among children. The purpose of this study was to determine the hospital frequency of domestic accidents in Brazzaville children, the type of accident, establish etiological factors and mortality. Methods: A total of 173 cases of domestic accidents were collected through a prospective study conducted from 1 January to 31 December 2017 in the pediatric intensive care unit of the University Hospital of Brazzaville. Medical records of children victims of unintentional trauma at home or in its immediate surroundings were collected. The following variables were recorded: the age and sex of the child, the hour, day and month of occurrence of the accident, parental attitudes in the management, and the prognosis (mortality). Results: Domestic accidents accounted for 9.2% of all admissions. The average age was 28.8 ± 10.5 months, a male predominance was noted (sex ratio equal to 1.6). Domestic accidents were found in 57.5% of children under two years (p < 0.05). These children belong with more than 3 children in 63% of the cases. Accidents were dominated by ingestions (56.1% of cases), followed by falls (16.2%), burns (10.9%) and drug poisoning (9.2%). They often occurred between 12 pm and 8 pm, most often in the yard, the kitchen and the surroundings of the home. Three cases of death (1.53%) were enrolled including 2 cases of burns. Conclusion: domestic accidents are common in Brazzaville but their frequency is underestimated. Accidental ingestion remains the most frequent type of accident and mortality is high. Control of the causative factors is necessary to undertake effective preventive actions.
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