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Household accidental child poisonings are frequent pediatric medical emergencies in developing countries.To study the epidemiological, etiological, clinical and therapeutic aspects of acute accidental domestic poisoning in children aged 0 to 15 years admitted to the pediatric emergency department of Gabriel Toure.This was a prospective, descriptive study that ran from January 1, 2014 to December 31, 2014. All patients aged 0 to 15 years admitted to pediatric emergencies for acute intoxication were included.A hundred cases of acute accidental poisoning were collected. Children under five accounted for 94%. The majority of mothers was housewives and had custody of children (83%). Forty-nine percent of the mothers were unschooled. The place of storage of the product was indoor in 96% of cases. The product was taken by the child himself (88%). A gesture at the scene of the accident was reported in 68% of cases, the ingestion of milk (72%) and water (10%) were the first acts used. The hospital was the first resort (72%). The time between taking the product and admission to hospital was 1 to 5 hours in 58% of cases. Vomiting (37 cases), agitation (17 cases) and respiratory distress (16 cases) were the most common symptoms. Domestic products (48%) followed by drugs (33%) ranked first among the families of poisons. Caustic soda (18%) and bleach (17%) were the most commonly found intoxication products. The evolution was good with a cure without sequelae (93%).Accidental acute intoxications to household products are common in Mali. The hospital admission deadline is still long; the actions taken by patients at the accident site often aggravate their states but are largely done by the parents before the use of health care.Les intoxications accidentelles domestiques de l'enfant sont des urgences médicales pédiatriques fréquentes dans les pays en développement. Le but de notre travail était d'étudier les aspects épidémiologiques, étiologiques, cliniques et thérapeutiques des intoxications aiguës accidentelles domestiques chez les enfants âgés de 0 à 15 ans admis aux urgences pédiatriques du CHU Gabriel Touré.Il s'agissait d'une étude descriptive à collecte prospective qui s'est déroulée du 01 janvier 2014 au 31 décembre 2014. Ont été inclus tous les patients âgés de 0 à 15 ans admis aux urgences pédiatriques pour intoxications aiguës accidentelles.Cent cas d'intoxications accidentelles aiguës ont étés colligés. Les enfants âgés de moins de cinq ans représentaient 94%. La majorité des mères était des femmes au foyer et avait la garde des enfants (83%). Quarante-neuf pour cent des mères n'étaient pas scolarisées. Le lieu de stockage du produit était intradomiciliaire dans 96% des cas. Le produit était pris par l'enfant lui-même (88%). Un geste sur le lieu de l'accident était rapporté dans 68% des cas, l'ingestion de lait (72 %) et de l'eau (10%) avaient été les premiers gestes utilisés. L'hôpital était le lieu du premier recours (72%). La durée entre la prise du produit et l'admission à l'hôpital était de 1 à 5 heures dans 58% des cas. Les vomissements (37 cas), l'agitation (17 cas) et la détresse respiratoire (16 cas) étaient les symptômes les plus rencontrés. La soude caustique (18%) et l'eau de javel (17 %) étaient les produits d'intoxication les plus retrouvés. Les produits domestiques (48%) suivis des médicaments (33%) venaient en tête parmi les familles de toxiques. L'évolution était bonne avec une guérison sans séquelle (93%).Les intoxications aiguës accidentelles aux produits domestiques sont courantes au Mali. Le délai d'admission à l'hôpital reste toujours long, les gestes inappropriés apportés aux patients sur le lieu de l'accident aggravent souvent le tableau mais sont largement effectués par les parents avant le recours aux soins de santé.

Malnutrition is a major public health problem in Mali, along with the country’s political and security instability. We initiated this work with the objective of determining the frequency as well as the risk factors favoring the occurrence of malnutrition in children aged 6 - 59 months hospitalized in the pediatrics department of the Gabriel Toure University Hospital in Bamako, country reference service to identify potential interventions to plan. A cross-sectional study was carried out over a period of 4 months. A bivariate logistic regression analysis allowed us to identify risk factors with degree of significance if p 0.05. During the study period, 2888 children were hospitalized, including 348 aged 6 to 59 months, or a frequency of 12.04%. One in two children was malnourished, i.e. a frequency of 50%. It more frequently affected infants aged between 6 and 23 months with a frequency of 33.7%, with a hospital frequency of growth retardation which was 23% including 14.7% of severe form. The emaciation was 27% of which 18.7% were severe form. The underweight was 42.2% with 31% in severe form. We found the diet inequality in all malnourished and non-malnourished children. A bivariate analysis showed that children with an out-of-school mother have a 2.4-fold risk of being malnourished (OR = 2.425; CI = 1.9 - 4.2; p 0.03). Also children from households with no stable income (non-salaried father) have twice the risk of children from a household with stable income (OR = 2.120; IC = 1.1 - 4.1; p 0.002). Finally, inappropriate nutrients (early introduction of food and early weaning) have been strongly associated with the occurrence of malnutrition. The prevalence of malnutrition reflects the way children eat. Emphasis should be placed on nutritional education and financial stability in households.

Pneumomediastinum is sometimes observed in adult patients but its occurrence in pediatric patients (especially infants) is very rare. We here report a 14-month-old male infant who had subcutaneous emphysema, pneumomediastinum, and importantly, pneumopericardium. He had no particular past histories. He abruptly had cough, fever, and eruption on the abdomen. Computed tomography and echocardiography revealed pneumomediastinum and pneumopericardium. Antibiotics, rest, and supportive therapy ameliorated the condition. We must be aware that pneumomediastinum, and importantly pneumopericardium, can be present in a pediatric patient with subcutaneous emphysema. The infant’s symptoms disappeared under strict monitoring of respiratory status, nasal oxygen therapy and antibiotic therapy.

Introduction: According to Mali’s National Immunization Center, the Haemophilus influenzae b (Hib) vaccine coverage rate was 90% in 2015. Our work aimed to study invasive bacterial infections due to Haemophilus influenzae type b in children aged 0 - 15 years hospitalized in the pediatrics department of the UH-GT. Method: We carried out a retrospective descriptive study from January 2017 to December 2018 (i.e. 2 years) among children aged 0 - 15 years and hospitalized for Haemophilus influenzae type b infection confirmed by culture (blood culture, Cerebro-spinal Fluid, and pleural and skin fluid). Results: Thirty-three cases of Hib infections were collected giving a frequency of 0.2% and the age group 3 months to 3 years was the most affected (72.73%). Children who received no vaccine accounted for 21.21%. The Cerebro-spinal Fluid culture and other samples (pleural and skin) identified the bacterium in 100% of cases, against 72.72% in the blood culture Meningitis was the most frequent pathology (78.79%) and the lethality was high (21.21%). Conclusion: Despite the introduction of the Hib vaccine in the routine immunization program in Mali, Hib infections remain with a high lethality linked to meningitis.

Objective: Pediatric jaundice is caused by various conditions. Although some data is available on this issue, data from Mali is insufficient. The present retrospective observational study was an attempt to determine the etiology of pediatric jaundice in the pediatric department of Gabriel Toure teaching hospital in Bamako, Mali. Methods: We reviewed all pediatric patients with jaundice who were hospitalized and treated in this department during January 1 to December 31, 2016 (n = 168). Result: Pediatric jaundice patients accounted for 1.88% of the hospitalized patients, with median age of 6 years and male/female ratio being 1.6. Infectious, cholestatic, and hemolytic jaundice accounted for 75%, 11% and 10%, respectively. Malaria and sickle cell disease accounted for 67% and 9%, respectively. Hepatomegaly and splenomegaly were observed in 49 (29%) and 23 (13.7%) patients, respectively. Of 168, 9 patients died. Conclusion: Infectious jaundice, especially jaundice due to malaria, was the most frequent. However, variety of etiologies was observed, of which the practitioners should be aware. The observation presented here may become fundamental data in health-policy making in this area.

In Mali society, female excision is a cultural practice. Despite the awareness campaigns, it affects nearly 85% of the female population (EDSM IV). This study was initiated to assess the knowledges, attitudes and practices of mothers about female circumcision.We conducted a prospective, cross-sectional study from June 1 to July 31, 2011, in the Department of Pediatrics of the teaching hospital of Gabriel Touré, Bamako, regarding the knowledge, attitudes and practices of mothers related to the female excision.We interviewed 224 mothers. The prevalence of female circumcision was 73%. In 72.7% of cases, the area affected by the mutilation was unknown to the mother. Nearly seventy percent (69.6%) of mothers thought that female circumcision had advantages only and should even be mandatory (74.6%). Female circumcision was associated with tradition, and it would be a religious obligation for 65%, and 21.4% of mothers, respectively. More than half of the girls were circumcised before their first year (76.3%) and 26.3% in the neonatal period. The majority of mothers were against a law banning the practice of female circumcision (54%). Ninety five percent of mothers reported that they would renew the experience of female circumcision.Female circumcision remains a well-established practice. Policies to fight against female circumcision are faced to very deep beliefs.Au Mali, l'excision est une pratique culturelle dans la société. Malgré les campagnes de sensibilisation, elle toucherait 85% de la population féminine (EDSM IV). Ce travail a été initié pour évaluer les connaissances, les attitudes et les pratiques des mères sur l'excision de leurs filles.Nous avons effectué une étude prospective transversale du 1Nous avons interrogé 224 mères. La prévalence de l'excision était de 73%. Dans 72,7% des cas, la zone concernée par la mutilation était méconnue de la mère. Les mères pensaient dans 69,6% des cas que l'excision n'avait que des avantages et qu'elle doit être obligatoire (74,6%). L'excision était associée à la tradition pour 65% des mères. Elle serait une obligation religieuse pour 21,4% des mères. Plus de la moitié des filles était excisée avant leur première année (76,3%) et 26,3% dans la période néonatale. La majorité des mères étaient contre une loi interdisant la pratique de l'excision (54%). Sur 100, 95 mères affirmaient qu'elles renouvelleraient l'expérience de l'excision.L'excision reste une pratique bien ancrée. Les politiques de lutte contre l'excision se heurtent ainsi à des croyances très profondes.

Neonatal morbidity and mortality is a real concern in our context. Several factors including the organization of the reference contribute to it. Our work was aimed at studying the conditions of newborns transfer of the towards the service of pediatrics of teaching hospital Gabriel Touré.Our study proceeded from October 15th, 2006 to January 15th, 2007 in the unit of neonatology of the service of Pediatrics of the CHU of the Hospital Gabriel Touré. It was a cross sectional and descriptive study. All the newborns referred by a health structure were included.We included 760 referred newborns out of 1072 neonatal admissions which means a frequency of reference of 71%. In 91.6% of the cases, the newborn were referred on the very day of their birth. Prematurity (29%), perinatal anoxia (24%), respiratory distress (13.9%) were the main reasons for reference. In no case, the service of pediatrics was contacted in advance by the referring health agent. More than half of the cases (58.6%), the public transport was used. Ambulance car transported 17.4% of the newborns. All the newborns came held in the arms of a member of their family. The referring agent was a physician in 70.3% of cases. Hypothermia was found for all the newborns (759/760) when being received. More half of the newborns (56.4%) had a small weight at birth and the quarter (25.8%) was resuscited. Lethality was 32%. Mother illiteracy, small weight at birth, the outborn birth were factors related to neonatal mortality.In our context, the reduction of neonatal morbidity and mortality has to go through an improvement of the reference system.

Objectif Notre etude avait pour objectif de determiner l’etiologie des pneumonies chez les enfants âges de 2 a 59 mois Methodologie L’etude s’est deroulee dans le service de pediatrie du CHU Gabriel Toure de juillet 2011 en Avril 2012. Il s’agissait d’une etude prospective chez les enfants âges de 2 a 59 mois hospitalises pour pneumonie. Les inclusions etaient faites selon la definition OMS de la pneumonie. Les pathogenes ont ete recherches dans le sang par hemoculture et PCR et dans le prelevement nasopharynge par une technique PCR en temps reel. Nous rapportons les resultats preliminaires. Resultats L’âge moyen etait 12,14 mois avec un sexe ratio de 1,4. Les germes retrouves dans le sang etaient surtout le Streptococcus pneumoniae (71,43%) et l’Hemophilus influenzae b (28,57%). Dans les secretions nasopharyngees, les virus predominaient, 55% versus 45% de bacteries avec une co-infection virus/bacterie dans 90% des cas. Les principaux virus etaient le virus respiratoire syncitial (39%), le rhinovirus et le para influenzae virus ; le Streptococcus pneumoniae, le Staphylococcus aureus et l’Hemophilus influenzae b etaient les bacteries retrouvees dans les nasopharynx.

Les femmes enceintes constituent l’un des groupes vulnerables de la population. Objectif Notre travail avait pour but d’evaluer les connaissances generales sur le VIH/SIDA et la transmission verticale des gestantes. Materiel et Methodes Notre etude qui s’est deroulee dans le Centre de Reference de la Commune IV a porte sur 322 femmes enceintes recues en consultation prenatale recensees durant 3 mois du 1er juin au 31 aout 2007. Resultats Tres peu des gestantes interrogees avaient fait la demarche de depistage du VIH (24 %), generalement au cours de CPN (15,21 %). Une faible proportion (14,3 %) des sujets de notre etude connaissait la serologie du pere. La majorite des femmes (93 %) etait informees de la possibilite de la transmission mere enfant du VIH. La transmission pendant la grossesse est la periode la plus citee (83,85 %) puis l’allaitement maternel (12,42 %) ; l’accouchement n’a jamais ete evoque comme periode de TME. Les moyens evoques pour reduire la TME du VIH ont ete la prise de medicaments pendant la grossesse (20,8 %) ou l’accouchement (1,5 %), le depistage precoce (12,42 %) et l’allaitement artificiel (6,21 %). Conclusion Les connaissances des gestantes sur le VIH et la transmission verticale du VIH sont satisfaisantes.

La mortalite neonatale en general et celle des prematures en particulier reste preoccupante dans notre contexte. But Notre travail avait pour objectif d’etudier les facteurs associes a la mortalite des prematures dans notre contexte. Materiel et Methodes Il s’agit d’une etude transversale, descriptive qui s’est deroulee du 15 octobre 2006 au 15 janvier 2007 dans l’unite de neonatologie du CHU Gabriel Toure. Ont ete inclus tous les nouveau-nes referes prematures hospitalises. Resultats Nous avons inclus 327 prematures. Les naissances out born ont representees 85,9 %. Le transfert a ete fait par taxi dans 50,2 % des cas. Une hypothermie a ete retrouvee chez 60,5 % a l’admission. Le taux de mortalite a ete de 33,3 %. Les facteurs associes a la mortalite ont ete le poids de naissance p p p p = 0,002), le transport a pied ( p = 0,004). Conclusion La reduction de la mortalite des prematures passe par une amelioration du systeme de transfert et des conditions de prise en charge dans notre contexte.