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Les urgences pediatriques sont peu documentees dans nos pays francophones d’Afrique sub-saharienne. Objectif : Evaluer le profil epidemiologique des urgences pediatriques afin d’ameliorer leur prise en charge. Methodologie : Etude transversale d’aout 1999 a juillet 2000 des enfants hospitalises de 0 a 15 ans au CHU-Campus (700 cas) presentant un tableau d’urgence a l’admission (630 cas). L’analyse a porte sur l’etat civil, le moment et le motif de consultation, le diagnostic et l’evolution. Resultats : Les urgences representaient 22,7% des consultations, 90% des hospitalisations et concernaient dans 69,3% les moins de 5 ans. Frequentes entre 17h30 - 00 h et 7h00 - 12h30, 97% de ces urgences provenaient de Lome. Elles ont ete dominees par les urgences digestives (34,6%), neurologiques (28,6%), hematologiques (19%) et respiratoires (19%). Le taux de mortalite est de 8% (50 deces). L’anemie (34%), le paludisme (16%), les infections respiratoires aigues basses (14%), les meningites (12%) et les infections neonatales (12%) ont ete les principales causes des deces. Conclusion : Representant la majorite des hospitalisations pediatriques, les urgences demeurent un probleme de sante publique necessitant une bonne organisation pour leur prise en charge. Introduction : Pediatric emergency cases are not well documented in our francophone countries in Africa South of Sahara. Objective : To assess epidemiological cases in order to improve their medical care. Patients and methods : it’s a cross-sectional study from August 1999 to July 2000 conducted in Campus Teaching Hospital on admitted children of 0 to 15 year-old (700 cases) who were emergency cases at admission (630 cases). The study considered the civil status, moment and reasons of consultation, diagnosis and evolution of the sickness. Results: Emergency cases represented 22.7% of the consultation, 90% of the admissions and concerned less than 5 years old (69.3%). These emergency cases were more frequent between 5:30 pm - 00 pm. and 7:00 am-12:30 am, and 97% of them come from Lome. Infectious emergency cases were the most frequent (79%) followed by digestives ones (34.6%), neurological (28.6%), hematological (19%) and respiratory ones (19%). The death rate was 8% (50 deaths cases), caused by anemia (34%), malaria (16%), acute lower respiratory tract infections (14%), meningitis (12%) and new-borne infections (12%). Conclusion : Emergency cases are represented the majority of child admissions in hospital and constitute a public health problem which needs a better organization for improve management.

Introduction. L’objectif de ce travail etait d’etudier l’epidemiologie et d’analyser les facteurs de risque de la bronchiolite du nourrisson CHU-Campus de Lome. Methodologie. Il s’est agi d’une etude prospective sur 12 mois portant sur les nourrissons ayant consulte pour bronchiolite au CHU-Campus. Ont ete inclus dans le travail les nourrissons âges de 1 a 30 mois. Les parametres etudies ont ete : les antecedents personnels, familiaux et le cadre de vie du nourrisson. Resultat : Les nourrissons inferieurs a 6 mois (41,67%) et de sexe masculin (65,28%) etaient les plus concernes. Les antecedents etaient domines par la rhinite (27,77%), Conclusion : La frequence de la bronchiolite reste elevee. Les jeunes nourrissons de sexe masculin sont les plus concernes. Mots cles : Bronchiolite, nourrisson, antecedents, Togo. Introduction: This article aims at studying the epidemiology of bronchitis and analyse its risk factors in babies at the Campus teaching hospital of Lome. Methodology: It is a 12 month prospective study, involving babies who were consulted for bronchitis at the Campus Teaching Hospital. The study included babies aged 1 to 30 months. The main parameters studied relate to personal and family antecedents as well as the living environment of the babies. Results: Babies under 6 months (41.67%) and male were more concerned. Personal and family antecedents were dominated by rhinitis (27.77%). Conclusion: The frequency of bronchitis is high particularly among younger mal babies. Key words: Bronchitis, babies, antecedent, Togo.

L’erythropoietine recombinante (EPOr) est utilisee en neonatalogie afin de prevenir l’anemie et de limiter le nombre de transfusions, qui sont essentiellement administrees dans les 3 ou 4 premieres semaines de vie chez les nouveau-nes prematures de moins de 1500 g ou de moins de 36 semaines d’amenorrhee (SA). Un nourrisson de 25 mois presentant un paludisme grave forme anemique decompense avec un taux d’hemoglobine de 1,9 g/dl dont les parents sont des Temoins de Jehovah a ete traite par de l’EPOr en lieu et place d’une transfusion sanguine. En effet, les parents etaient contre la transfusion sanguine en raison de leur foi. L’utilisation de l’EPOr n’est pas habituelle a cet âge mais il est necessaire qu’on s’en approprie pour les situations ou nous ne disposerons pas de sang, tout en tenant compte du cout. C’est le lieu aussi de sensibiliser les Temoins de Jehovah a etre plus realistes surtout devant des cas comme celui de ce nourrisson. Mots cles : Anemie, Erythropoietine, transfusion, Temoins de Jehovah. Recombinant erythropoietin (EPOr) is used in neonatology to prevent anaemia and to limit the number of transfusions which are essentially administered in the first 3 or 4 weeks of the life in preterm infants with birth weights below 1500 g. or below 36 SA. An infant of 25 months presented an acute malaria and anaemia, the haemoglobin rate was 1,9 g/dl, whose parents were Temoins de Jehovah, was treated by EPOr instead of blood transfusion. In fact, the parents were against blood transfusion because of their faith. The EPOr’s use is not usual at this age but it is necessary we appropriate for the situations for which we didn’t have blood. It’s the moment to sensitize Temoins de Jehovah to preserve children life in the situations like of this infant. Keys words: Anaemia, Erythropoietin, transfusion, Temoins de Jehovah.

Ayant constate, grâce a une etude anterieure, que les cas d’hypertension arterielle chez l’enfant sont souvent reveles chez la plupart de nos patients par des accidents paroxystiques hypertensifs qui compliquent une hypertension arterielle jusque-la meconnue, nous avons mene une etude prospective sur la prise systematique de la tension arterielle au cours de l’examen clinique de l’enfant. Cette etude a concerne 162 examinateurs d’enfants : medecins, assistants medicaux et infirmiers, dans diverses structures sanitaires. Seuls 24% d’entre eux : 35% des medecins, 20% des assistants medicaux et 18% des infirmiers, possedaient un sphygmomanometre pediatrique sur leur lieu de travail. D’entre eux, 83% prenaient la tension arterielle surtout devant des accidents paroxystiques hypertensifs ou des symptomes persistants, mais jamais systematiquement lors de tout examen clinique de l’enfant, comme ils le font chez l’adulte. Le retard au diagnostic, les problemes de prise en charge des malades a l’hopital et hors de l’hopital, et l’insuffisance de la prise systematique de la tension arterielle au cours de tout examen de l’enfant, expliquent en partie le diagnostic de l’hypertension arterielle par ses accidents paroxystiques et le pronostic severe de celle-ci. A former study showed that about all the cases of high blood pressure in children were revealed by hypertensive paroxysmal strokes (HPS). In most of patients, these HPS complicated a high blood pressure unknown until then. This situation made us carry out a cross-study about systematic checking of blood pressure during any child examination. That study concerned 162 child health practitioners of all grades in various health centres. Only 24% of practitioners: 35% of physicians, 20% of medical assistants and 18% of nurses, had a paediatric sphygmomanometer in their work places and 83% of them took children’s blood pressure during examinations especially in case of attacks or some persistent symptoms, but never systematically as they did during adult examinations. The belated diagnosis, the care problems for in patients or outpatients, the lack of systematic checking of blood pressure in children, might explain the revelation of high blood pressure in children through paroxysmal attacks as well as its severe prognosis at HPS stage.