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Six (6) formulations of BASSI based on a mixture of maize and soybeans have been developed. Soy flour was incorporated in amounts of 0, 10, 20, 30, 40 and 50%. The results showed that the nutritional value significantly increases with the incorporated soy rate, except the carbohydrate content which decreases. The water absorption capacity, oil absorption capacity and emulsifying activity also increased. As for the emulsion stability and the bulk density, the values decrease. The incorporation of soy improves the nutritional and functional properties of BASSI.

The use of a threshold for cost-utility studies is of major importance to health authorities for making the best allocation decisions for limited resources. Regarding the increasing number of studies worldwide that seek to establish a value for a quality-adjusted life year (QALY), it is necessary to review these studies to provide a global insight into the literature. A systematic review on willingness to pay (WTP) studies focusing on QALY was conducted in eight databases up to June 26, 2020. From a total of 9991 entries, 39 studies were selected, and 511 observations were extracted for the meta-analysis using the ordinary least squares method. The results showed a predicted mean empirical value of $52,619.39 (95% CI 49,952.59; 55,286.19) per QALY in US dollars for 2018. A 1% increase in income led to an increase of 0.6% in the WTP value, while a 1-year increase in respondent age led to a decrease of 3.3% in the WTP value. Sex, education level and employment status had significant effects on WTP. Compared to face-to-face interviews, surveys conducted by the internet or telephone were more likely to have a significantly higher value of WTP per QALY, while out-of-pocket payment tended to lower the value. The prediction made for the province of Quebec, Canada, provided a QALY value of approximately USD $98,450 (CAD $127,985), which is about 2.3 times its gross domestic product (GDP) per capita in 2018. This study is consistent with the extant literature and will be useful for countries that do not yet have a preference-based survey for the value of a QALY.

Six (6) formulations of BASSI based on a mixture of maize and soybeans have been developed. Soy flour was incorporated in amounts of 0, 10, 20, 30, 40 and 50%. The results showed that the nutritional value significantly increases with the incorporated soy rate, except the carbohydrate content which decreases. The water absorption capacity, oil absorption capacity and emulsifying activity also increased. As for the emulsion stability and the bulk density, the values decrease. The incorporation of soy improves the nutritional and functional properties of BASSI.Read Complete Article at ijSciences: V92020062358 AND DOI: http://dx.doi.org/10.18483/ijSci.2358

This study provides an overview of potential renewable energy (RE) projects for Africa. Pan African University master students were asked by their lecturer to characterize African projects they had in minds in uniform tables. Items of the project investment plan include project synopsis, the sponsors, market analysis and strategy, project scope, regulation and environmental information, project costs, financial projections, business model, and project innovativeness. Students' RE projects are assessed with emphasis put on employed business models and project innovativeness. Criticalities for the implementation of these projects are discussed in African contexts providing outlook for future investment opportunities in the African continent. The work provides insights from the local students' perspective for the various stakeholders interested in RE project investments in Africa. Useful suggestions formulated directly by young Africans are presented which may contribute to improved risks management when these or other potential RE projects will be deployed. Inputs from local people on how they understand the process of implementing RE projects in Africa might be interesting for investors seeking information about suitable ways for RE project deployment. Students characterize local contexts and identify numerous barriers for deployment of RE systems in Africa. Overall, this study explains the potential lying in renewable energy harvesting in Africa, seeks to emphasize major barriers for implementation of RE projects as well as investigates investment opportunities to implement economically feasible RE projects for cleaner and climate friendly energy future of this continent.

The authors report a case of a sudden antenatal death, by severe strangulation, unlikely related in a term pregnancy; multiple loops of nuchal umbilical cord (UC) (ten), rarely describe in literature, were observed around the fetal neck. The in utero fetal death (IFD) was suspected by the non-attendance of fetal movements and confirmed by US scan. The tight nuchal cord around the neck (tCAN) diagnostic was made during caesarean delivery, as it was not discovered in pregnancy US scan monitoring nor in the US scan made in emergency. The newborn examination shows severe fetal strangulation by the presence of many spires of a too long UC (1.50 m). Autopsy was not been accepted by the family. Through this reported case the authors wanted to show the difficulties of its diagnosis in less developed Sub-Saharan country were US scan practice is not usual.

Resume Objectif Actualiser les caracteristiques cliniques et bacteriologiques des nouveau-nes admis pour suspicion d’infection neonatale dans l’unite de neonatalogie du CHU de Cocody dix ans apres les recommandations de l’ANAES. Methode Etude prospective a visee descriptive effectuee de fevrier a juillet 2010 et portant sur 352 nouveau-nes admis pour suspicion d’infection bacterienne. Resultats Les nouveau-nes outborn representaient 42,6 % des cas (150 nouveau-nes) et etaient admis avant la 12e heure de vie (43,5 %). Le sex-ratio etait de 1,4. Les facteurs de risque infectieux retrouves etaient le liquide amniotique teinte ou fetide (26,1 %), le mauvais APGAR (23,5 %) et la fievre maternelle (22,4 %). Les principaux signes cliniques etaient la detresse respiratoire (41,2 %), la fievre (37,2 %) et la souffrance cerebrale (32,8 %). Le diagnostic d’infection bacterienne neonatale a ete confirme dans 22,7 % des cas. Les germes les plus frequents dans le LCR ont ete le Staphylococcus aureus (29,7 %) et le streptocoque B (22,2 %). Dans l’hemoculture, il s’agissait de S. aureus (54,2 %) et de Klebsiella sp. (16,9 %). L’association cephalosporine de 3e generation et aminoside a ete l’antibiotherapie de premiere intention. A l’antibiogramme, nous n’avons retrouve aucune resistance des souches isolees aux betalactamines et aux aminosides contrairement au Klebsiella sp. qui s’est revele resistant aux betalactamines. Le taux de mortalite etait de 11,6 %. Conclusion Les infections bacteriennes du nouveau-ne en milieu tropical presentent les caracteristiques suivantes : une prevalence elevee des infections a S. aureus temoin des efforts a realiser au niveau de l’asepsie et l’hygiene hospitaliere ; la rarete, voire l’absence, de depistage systematique du portage maternel au dernier trimestre de grossesse du streptocoque B et donc une absence de prophylaxie per-partum ; une ecologie bacterienne particuliere qui devrait faire discuter le choix et la duree des antibiotiques notamment des aminosides en « monotherapie » qui semblent efficaces sur la plupart des germes de l’ecologie locale.

Newcastle disease (ND) and infectious bronchitis (IB) are two major viral diseases affecting the respiratory tracts of birds and whose impact on African poultry is still poorly known. In the present study we aimed at assessing NDV and IBV prevalences in Ivory-Coast by molecular screening of > 22,000 avian swabs by nested PCR and by serology testing of close to 2000 avian sera from 2010 through 2012. The NDV and IBV seroprevalences over the study period reached 22% and 72%, respectively. We found 14.7% pooled swabs positive by PCR for NDV and 14.6% for IBV. Both pathogens are therefore endemic in Ivory-Coast. Economic losses associated with NDV and IBV infections still need to be evaluated., Highlights • Surveillance of avian influenza virus is found negative in backyard poultry farm. • Study of Newcastle disease and infectious bronchitis as differential diagnosis diseases • Newcastle disease virus seroprevalence is much lower than infectious bronchitis virus. • First study of infectious bronchitis revealed high prevalence in backyard poultry. • Both pathogens are endemic, cause economic losses and need to be fully evaluated.

Resume Contexte La recommandation de l’OMS et l’UNICEF d’utiliser le solute de rehydratation orale (SRO) et les mesures dietetiques pour traiter la diarrhee aigue ne semble pas etre appliquee par de nombreux personnels de sante en Afrique sub-saharienne d’ou une morbi-mortalite infanto-juveniles elevees. Objectif Decrire les habitudes de prescription du personnel de sante lors de la diarrhee aigue de l’enfant a Abidjan. Patients et methodes Etude transversale realisee dans 52 structures sanitaires publiques non specialisees d’Abidjan du 1 er juin au 31 juillet 2012. Elle a porte sur les habitudes de prescription de 151 personnels de sante consentants prenant en charge des enfants. Resultats Ce sont 100 medecins (pediatre 18, DES en pediatrie 28, generalistes 54) et 51 soignants qui ont ete interviewes. L’âge moyen etait de 39 ans (25–59 ans) ; la moyenne d’annee d’exercice de 8,4 annees (1–35 ans). Les enquetes affirmaient prescrire de facon systematique le SRO (53 %) et les mesures dietetiques (28,5 %). Ils affirmaient conseiller la poursuite du lait maternel 97,4 %, le lait de regime 43 % et le regime alimentaire anti-diarrheique 24,5 %. Les medecins prescrivaient plus le SRO et le regime alimentaire anti-diarrheique par rapport au personnel soignant (32,8 vs 16,9 %, p p Conclusion Les habitudes de prescription du personnel de sante s’eloignent des recommandations de l’OMS et de l’UNICEF. La sensibilisation du personnel sur les directives de prise en charge de la diarrhee aigue s’avere necessaire pour l’amelioration du pronostic de cette affection.

SETTING: Drug resistance threatens tuberculosis (TB) control, particularly among human immunodeficiency virus (HIV) infected persons.OBJECTIVE: To describe practices in the prevention and management of drug-resistant TB under antiretroviral therapy (ART) programs in lower-income countries.DESIGN: We used online questionnaires to collect program-level data on 47 ART programs in Southern Africa (n = 14), East Africa (n = 8), West Africa (n = 7), Central Africa (n = 5), Latin America (n = 7) and the Asia-Pacific (n = 6 programs) in 2012. Patient-level data were collected on 1002 adult TB patients seen at 40 of the participating ART programs.RESULTS: Phenotypic drug susceptibility testing (DST) was available in 36 (77%) ART programs, but was only used for 22% of all TB patients. Molecular DST was available in 33 (70%) programs and was used in 23% of all TB patients. Twenty ART programs (43%) provided directly observed therapy (DOT) during the entire course of treatment, 16 (34%) during the intensive phase only, and 11 (23%) did not follow DOT. Fourteen (30%) ART programs reported no access to second-line anti-tuberculosis regimens; 18 (38%) reported TB drug shortages.CONCLUSIONS: Capacity to diagnose and treat drug-resistant TB was limited across ART programs in lower-income countries. DOT was not always implemented and drug supplies were regularly interrupted, which may contribute to the global emergence of drug resistance.

Introduction : Exclusive breastfeeding (EBF) has the benefits of reduced rates of infectious morbidity and mortality. However, the EBF rate remains low worldwide including in Cote d'Ivoire despite efforts by health authorities. Objective : The study was carried out to describe the knowledge and practices of mothers concerning infant feeding especially with regards to breastfeeding from birth to six months and to identify factors influencing these practices. Methods : This was a descriptive and cross-sectional study conducted over a one-month period (1st to 31st August 2014)at a hospital in Abobo-Avocatier. Results : A total of 318 mothers and their infants were recruited. The median (range) age of the mothers was 27 (14-40)years. Over half (64.5%) had some form of formal education, 78.9% lived with a partner while 24.5% were unemployed. The HIV status was unknown in 29.6% of cases. The majority of infants (94%), were born at term through vaginal route (91.5%) and the median (range) age was 74 (2-180) days with a M:F ratio of 1.18. More than half of mothers received advice on breastfeeding (57.2%) mainly by a health care provider (83%). The overall breastfeeding, EBF, predominant breastfeeding and mixed feeding rates were 79.9%, 43.3%, 46.84% and 18.9% respectively. Initiation rate of breastfeeding within the first hour was 29%.The maternal age (p=0.007) and low birth weight of the infant (p=0.023) were significantly associated with EBF. Other factors associated with EBF include the mother’s occupation and being married. Conclusion : Despite the high overall rate of breastfeeding in the study, EBF rates and timely initiation of breastfeeding after birth need to be improved. Awareness campaigns need to be strengthened and interventions instituted to scale up optimal breastfeeding practices. Keywords : Infants, breastfeeding, determinants, birth, Cote d’Ivoire, six months.

Context Duikers play a vital role in maintaining forest ecosystems, as both seed dispersers and prey. In West Africa, duikers are also an important source of food and income; however, it is likely that some species are now being hunted at unsustainable levels. So as to contribute to duiker conservation, we used line-transect data and additional information on dung and track counts to estimate relative abundance and establish distribution patterns of forest duikers in Côte d'Ivoire's Dassioko Sud Forest Reserve (DSFR), a poorly known, remnant coastal rainforest. We also collected basic information on hunting pressure. Methods Forest duiker counts were made twice per month from July 2013 to March 2014 on six line transects of varying lengths (5.6–6.7km) and in different regions of the DSFR, representing different habitat types. The number of sightings per kilometre walked, defined as ‘encounter rate', was used to compute an index of relative abundance. We recorded all evidence of poachers and used these data to generate a poaching index (# poaching signs per kilometre) for different habitat types. Key results The DSFR has lost three of seven total forest duiker species and populations of the four remaining species are declining. Encounter rates were greatest for Philantomba maxwellii (0.46 indices km–1) and accounted for 68% of total encounters. Cephalophus niger, C. dorsalis and C. silvicultor were encountered at similar (0.07 indices km–1) but much lower rates. For all species, mean encounter rates were highest in degraded forest (0.38–0.73 indices km–1), followed by secondary (0.2–0.44 indices km–1) and primary (0.19–0.44 indices km–1) forest. Conclusions Of the four forest duiker species still present in the DSFR, the black, bay and yellow-backed duikers are the most affected by anthropogenic pressures. Duiker abundance in the DSFR varies with habitat type. This variation is apparently influenced by differences in forest structure, poaching pressure and proximity to villages. Implications The study provides baseline data for future managing of ungulate populations in the DSFR. We recommend that a biomonitoring study of duiker populations be initiated immediately to help determine population trends, investigate habitat preferences, and help curb illegal hunting activities in this important forest reserve.

Goats were infected subcutaneously with different African and Indian isolates of peste-des-petits-ruminants virus. Typical signs of disease were recorded from day 6 post infection for all isolates. Ocular, nasal and mouth samples were tested for the presence of virus antigen or nucleic acid using the immunocapture ELISA (ICE) and the RT-PCR technique. Using ICE, virus antigen was detected at day 4 in ocular and nasal samples of goats infected with Cote-d'Ivoire 89 and in the ocular, nasal and mouth samples with the India, Calcutta strains. By day 5, all samples from both these groups were positive while ocular and nasal samples from groups with Sudan-Sennar and Nigeria 75/1 strains became positive. With the RT-PCR technique virus nucleic acid, presumed to be associated with infectious virus excretion, was detected at day 3 in oral and nasal samples in groups infected with Cote-d'Ivoire 89 and India-Calcutta strains. From day 6-9, all samples from all groups were positive with both techniques. This experiment demonstrated that PPR virus antigens and nucleic acid, presumed to be related to infectious virus, is excreted 2-3 days before the appearance of clinical signs whatever the technique used which is of epidemiological importance in controlling the spread of the disease. The ICE being easier to perform in developing countries can be recommended as a useful method to investigate PPR in small ruminants flocks at an early stage to prevent the diffusion of the disease.

Context Duikers play a vital role in maintaining forest ecosystems, as both seed dispersers and prey. In West Africa, duikers are also an important source of food and income; however, it is likely that some species are now being hunted at unsustainable levels. So as to contribute to duiker conservation, we used line-transect data and additional information on dung and track counts to estimate relative abundance and establish distribution patterns of forest duikers in Côte d’Ivoire’s Dassioko Sud Forest Reserve (DSFR), a poorly known, remnant coastal rainforest. We also collected basic information on hunting pressure. Methods Forest duiker counts were made twice per month from July 2013 to March 2014 on six line transects of varying lengths (5.6–6.7km) and in different regions of the DSFR, representing different habitat types. The number of sightings per kilometre walked, defined as ‘encounter rate’, was used to compute an index of relative abundance. We recorded all evidence of poachers and used these data to generate a poaching index (# poaching signs per kilometre) for different habitat types. Key results The DSFR has lost three of seven total forest duiker species and populations of the four remaining species are declining. Encounter rates were greatest for Philantomba maxwellii (0.46 indices km–1) and accounted for 68% of total encounters. Cephalophus niger, C. dorsalis and C. silvicultor were encountered at similar (0.07 indices km–1) but much lower rates. For all species, mean encounter rates were highest in degraded forest (0.38–0.73 indices km–1), followed by secondary (0.2–0.44 indices km–1) and primary (0.19–0.44 indices km–1) forest. Conclusions Of the four forest duiker species still present in the DSFR, the black, bay and yellow-backed duikers are the most affected by anthropogenic pressures. Duiker abundance in the DSFR varies with habitat type. This variation is apparently influenced by differences in forest structure, poaching pressure and proximity to villages. Implications The study provides baseline data for future managing of ungulate populations in the DSFR. We recommend that a biomonitoring study of duiker populations be initiated immediately to help determine population trends, investigate habitat preferences, and help curb illegal hunting activities in this important forest reserve.

Introduction: The aim of our study was to describe the morbidity and mortality patterns in HIV-positive pediatric patients followed at the unit in charge of Pediatric HIV, in the pediatrics department of Cocody University Teaching Hospital (CHU-Cocody). Method: This hospital-based retrospective study focused on 218 pediatric patients enrolled at the CHU-Cocody from November 28th 2005 until June 30th 2010. Outcomes of children with anti-retroviral therapy (group A) and children without (Group B) anti-retroviral therapy were described and compared. Antiretroviral Therapy (ART) - eligibility followed national guidelines thus withholding treatment for immune-competent children or those with contraindications to ARTs such as increased transaminases (>10x) or vital distress. Results: The average age of children in group A, was 66.11 months, they were symptomatic in 84.74% of cases, and presented with severe immunodeficiency in 54.74%. The children in group B were younger (mean age=49.14 months), mostly only mildly symptomatic (39.80%) and thus usually without severe immunodeficiency (64.29%). Nearly all children were infected with HIV-1 and receiving cotrimoxazole prophylaxis. There were 764 disease events that occurred during follow-up including 633 in group A and 131 in group B. Anemia (p=0.036) and pneumonia (p=0.011) were more frequent in group A. Hospitalizations were more common in group A children (124/190) than group B children (10/28, p=0.0027). In Group B, the mortality rate was very high (75%) (OR=16, 95% CI [5.79-45.90.], P

The prematurity remains in our developing countries a problem of current events. The deficiency in human resources and the low level of the technical equipment exposes premature babies to a high risk of morbidity and mortality in neonatal period. Those who survive need a closer follow-up after their discharge from hospital. Our objective through this study was to appreciate the quality of following-up premature babies in ambulatory. It was a longitudinal study with descriptive aim which took place from January, 2007 till December, 2008 in the paediatric service of the Teaching Hospital of Cocody. Our population was constituted by 100 premature babies selected in a random way. The premature babies had on average 31,7 weeks of gestationel age. The sex ratio was 0,96. The born weight was between 900 and 2550g. The main causes of prematurity were multiple pregnancies (18 %), malaria (15 %), premature break of membranes (12 %) and éclampsia (10 %). Most of premature babies were hospitalized for a problem of breeding ( 47 %.). The average number of consultation was 6,25. Only 25 children were effectively followed during 12 months with a middleweight of 9112g. The follow-up had been interrupted before 3 months of native age in 31 % of cases and before 3 months of real age in 52 % of cases. The mothers had preferred the feeding in 48 % of cases, but the curves of weight development were superposables whatever the type of food supply. The pathology during the follow-up was dominated by digestive disorders, respiratory infections and anaemia. Forty percent of the premature babies was able to have an haemoglobin test and 8 %, a neuroradiological scraeming. A third of the premature babies (30 %) had been hospitalized again for anaemia (10 %) and respiratory infections (10 %). We recorded 3 deaths. CONCLUSION: The follow-up of premature babies getting out of hospital remains difficult in our context of life. The mothers must be sensitived on the consequences of prematurity and the importance of their follow-up. This follow-up has to be the affair of all, as well parents, health workers that government.

The obturating prostheses of the jawbone and the prostheses of rebuilding of the mandible make it possible to restore the losses of substance of the jawbone and of the mandible and to cure the functional and Aesthetic disorders which result from these losses of substance. The success of these prosthetic restorations can be compromised by technical, economic and cultural factors. The principal factors are the importance of the losses of substance, the reduced number of teeth, the poverty of the technical plate, the persistence of certain traditional concepts. The fight against these factors requires the promotion of therapeutic associations in maxillo-facial cancerology, the sensitizing of the populations to the early hospital consultations, the improvement of the technical plate of the prosthesis of the jawbone and the face, the facilitation of the access of the most underprivileged groups to the prosthetic restorations, the promotion of multi-field collaboration, the whole co-operation of the patient throughout the treatment and the follow-up postprothetic.

Anemia is a common and life threatening pathology among new born babies from premature. It has the potential to delay the child's growth if appropriate care if not taken. In order to improve care to new born babies with anemia, we carried out a retrospective study on a group of 195 records obtained from the neonatology ward and from 46 outpatients in the CHU of Cocody between January 2001 and December 2003. At the end of the study, we made the following reports: Incidence of early anemia is 17.5% and several risk factors are involved such as absence of anemia and malaria prophylaxis during pregnancy. Anemia whether it is secondary or early is often masked. Palor is observed in small proportions among anemic prematures at birth. Thus, cell blood chemistry is important to confirm the diagnosis. Early anemia is generally normochrome normocytaire and secondary one is hypochronic. Care about anemia cases must rely on clinical data as well as bioiogical and epidemiological data. Early iron supplementation (2 to 3 iron element mg/kg/day) could prevent late and secondary anemia in non-anemic prematures at birth.

The HIV pandemic has led a resurgence of tuberculosis which did reach developing as well as developed countries. In Côte d'Ivoire, tuberculosis represented 40-50 per cent of HIV opportunist infections. The incidence rate of this infection, in 2004 was 110/100,000 inhabitants all type of tuberculosis together. As we know, a few studies haven't been devoted to child military pulmonary tuberculosis. Our objectives in this study are to precise circumstances of diagnosis, to assess treatment of the miliary tuberculosis to children below 15 years, to analyze evolving aspects of military tuberculosis. Retrospective study of medical hill of children center anti tuberculosis from 1st December 1999 to 31st December 2002. In the result, miliary tuberculosis is the third extra pulmonary tuberculosis, and concerns children from 6 to 11 years leaving in the social precarious the age where miliary tuberculosis is the most frequent. HIV seroprevalence rate is 40.62 per cent Clinical signs are: Cough expectoration and impregnation signs among which first have fever, weight loss. The radiological signs are opacity in the shape of seeds of millet. The treatment is efficacy if it is correctly administered.Diagnostic of miliary pulmonary tuberculosis is essentially radiologic. The rate of cure of 94% could be improved if health authorities, population and the government combine their efforts to struggle against tuberculosis.

La prise en charge des enfants infectes par le VIH dans les pays a ressources limite rencontre de nombreuses difficultes dont celle des enfants perdus de vue apres leur enrolement. Objectif Decrire les caracteristiques epidemiologiques, cliniques et therapeutiques des enfants perdus de vue au cours de leur suivi dans l’unite de prise en charge pediatrique du CHU de Cocody. Methodologie Il s’agit d’une enquete retrospective a visee descriptive portant sur 54 enfants enroles dans le service pour leur infection a VIH de Novembre 2005 a Decembre 2009 et declares perdus de vue c’est a dire n’ayant plus eu de contacts avec le centre depuis une periode de six mois. Resultats Le taux de perdus de vue etait de 18,4 %. L’âge moyen des enfants etait de 4 ans avec des extremes allant de 3 mois a 14 ans et un quart d’entre eux avaient moins d’an (26,4 %). Le sex ratio etait de 0,7. La majorite des enfants (75,9 %) habitait a Abidjan et sa banlieue et moins de la moitie des parents (46,3 %) avait un contact telephonique. 44,4 % des enfants appartenaient a la categorie C de la classification CDC. La majorite des enfants a ete mis sous cotrimoxazole (68,5 %) et etait eligible au traitement anti retroviral (77,8 %). Le traitement a pu etre institue chez seulement 23 enfants (42,6 %) et le protocole utilise etait 2 IN + 1 INN (100 %). 45 % des enfants ont ete perdus de vue avant leur mis sous traitement car ne sont plus revenus au centre apres la realisation du bilan initial. Les enfants etaient le plus souvent accompagnes en consultation par leur mere (77,8 %). Le nombre de contact variait de 1 a 10 avec une duree moyenne de suivi de 3 mois. Toutes les meres etaient seropositives tandis que la serologie des peres n’etait renseignee que dans 31,5 % des cas. On notait 12 % de deces maternel. Conclusion La connaissance du statut serologique de toute la famille reste primordiale pour une prise en charge optimale de l’enfant infecte par le VIH.

En Cote d’Ivoire, la prevalence de l’infection a VIH est de 4,7 % avec une nette feminisation (6,4 % chez la femme contre 2,9 % chez l’homme). Objectif general Decrire le profil des enfants decedes au cours de leur suivi pour infection a VIH. Methodologie Etude retrospective de type descriptive, qui a eu lieu dans le service de Pediatrie du CHU de Cocody de Novembre 2005 a Decembre 2009. Resultats Sur 4 ans, 393 enfants ont ete suivis dans le cadre de l’infectiona VIH. 44,27 % ont ete mis sous traitement ARV, 13,99 % ont ete perdu de vue et 13,99 % sont decedes. Le profil des decedes etait le suivant. – Le sexe ratio = 0,93. – Les tranches d’âge variaient de 2 mois a 16 ans et 43,63 % des enfants decedes avaient moins d’un an. – Parmi les enfants de moins de 5 ans, seulement 3 avaient un poids normal pour l’âge.- Les meres etaient seropositives dans 63,63 % des cas et 36,36 % ne connaissait pas leur statut serologique. – Seulement 7 peres (16,27 %) avaient accepte de faire le test de depistage – 50 % des enfants mourraient dans le mois qui suivait le depistage et le bilan initial. Conclusion : Le fort taux de mortalite a moins d’un an de vie confirme la necessite d’un depistage precoce et d’une mise en route systematique du traitement antiretroviral a cet âge.

La prematurite reste dans nos pays en voie de developpement un probleme d’actualite. La carence en ressources humaines et le faible niveau du plateau technique expose le premature a un risque eleve de morbidite et de mortalite en periode neonatale. Ceux qui survivent ont besoin d’un suivi rapproche apres leur sortie d’hospitalisation. Objectif Apprecier les difficultes du suivi du premature en ambulatoire Methode Il s’agissait d’une etude longitudinale prospective a visee descriptive qui s’est deroulee de janvier 2004 a decembre 2005 en consultation du service de pediatrie du CHU de Cocody. Notre population d’etude etait composee de 100 nouveau-nes prematures selectionnes de facon aleatoire. Resultats L’âge moyen des meres etait de 28 ans. Les nouveau-nes prematures avaient en moyenne 31,7 semaines d’âge gestationnel. Le sex-ratio etait de 0,96. Le poids de naissance variait entre 900 g et 2550 g. Les principales causes de prematurite etaient : les grossesses multiples (18,0 %), le paludisme (15,0 %), la rupture prematuree des membranes (12,0 %) et la pre eclampsie (10,0 %). Les prematures etaient hospitalises dans 47,0 % des cas pour un probleme d’elevage. Seul 25 enfants ont ete effectivement suivis pendant 12 mois avec un poids moyen de 9112 g. Le suivi avait ete interrompu avant 3 mois d’âge post natal dans 31,0 % des cas et avant 3 mois d âge reel dans 52,0 % des cas. Les meres avaient prefere l’allaitement dans 48 % des cas mais les courbes du developpement staturo ponderable etaient superposable quelque soit le type d’alimentation. La pathologie au cours du suivi etait dominee par les troubles digestifs, les infections respiratoires aigues, et l’anemie. Seuls 40 % des prematures ont pu avoir une numeration formule sanguine de controle. Un tiers des prematures (30,0 %) avait ete re hospitalises pour anemie (10,0 %) et IRA (10,0 %). Nous avons enregistre 3 deces. Conclusion Le suivi du premature de retour a domicile reste difficile dans notre contexte de vie. Les meres doivent etre sensibilisees sur les consequences de la prematurite et l’importance de leur suivi. Ce suivi doit etre l’affaire de tous, aussi bien des parents mais egalement du personnel et du gouvernement.