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Background: Reducing neonatal mortality of preterm infants is a public health priority in developing countries. The objective of this study was to study the risk factors for mortality of preterm infants in the neonatology department of UHCME-JEF. Methods: A retrospective, analytical study was done over 36 months (January 2019-December 2021) in the neonatology department of UHCME-JEF. Maternal and newborn parameters were studied. All hospitalized preterm newborns were included. Results: The prevalence of prematurity was 44.6%. The mortality rate was 18.7%. The mean age of mothers was 28.05±6.5 years. They were unemployed (69.4%) and single (73.6%). The three main causes of death were sepsis (41.7%), respiratory failure (26.0%), and anoxic-ischemic encephalopathy (15.3%). The risk factors associated with death were multiparity [p=0.001, OR=2.0, IC 95% (1.32-3.00)], pre-existing maternal diabetes [p=0.007, OR=2.4, IC 95% (1.31-4.52)], prenatal check-up not done [p=0, 024, OR=1.5 IC 95% (1.04-2.05)], GA

Background: Sickle cell disease (SCD) is the world’s most common genetic blood disorder. Most infant deaths from SCD occur in sub-Saharan Africa, and the mortality rate is exceptionally high in Gabon in Central Africa. In Gabon, there are limited resources for early and accurate detection of sickle cell or trait conditions. Most affected individuals reside in low-resource areas where access to diagnostic testing is often very limited. The most commonly used diagnostic methods require trained staff, adequate infrastructure, electric power, and enough time to perform the analysis. These requirements do not currently allow mass screening to be performed in remote areas of Gabon. The purpose of this pilot study is to develop a standardized screening procedure for SCD in order to determine its prevalence in the southeast area of Gabon by using a rapid and reliable test that does not require significant resources, such as the Sickle SCAN® device. Methods: The accuracy of the Sickle SCAN® device was assessed based on testing 272 blood samples. The exact hemoglobin was identified in 100% of the samples. The test comprises three proprietary indicators that detect the presence of hemoglobin A, S, and C, thus allowing the user to rapidly distinguish between normal (HbAA, N=142), carrier (HbAS, N=41), and sickle cell disease (HbSS, N=88; HbSC, N=1) samples. Hemoglobin variants (S and C) were confirmed by capillary electrophoresis (MinicapR; Sebia). The sensitivity and specificity were calculated for each phenotype. Results: The Sickle SCAN® test analysis revealed the following normal and abnormal phenotypes, including sickle cell trait (HbAS=14,71%) and SCD [HbSS (32.35%) and HbSC (0,74)]. There are no false positives in Sickle SCAN® result for the presence of hemoglobin variant, compared to gold standard approaches to capillary electrophoresis. The estimated sensitivity of the Sickle Scan® test was 92.2%, 100%, and 100% for HbSS, HbAS, and HbSC, respectively. The specificity exceeded 88.23% for all phenotypes (HbSS, HbAS, and HbSC). Conclusion and Implications for Translation: The Sickle Scan® device was found to be reliable with a sensitivity of 92.2%, 100%, and 100% for HbSS, HbAS, and HbSC, respectively. The specificity exceeded 88% for all phenotypes. RESUME Contexte: La drépanocytose est la maladie génétique du sang la plus répandue dans le monde. La plupart des décès de nourrissons dus à la drépanocytose surviennent en Afrique subsaharienne, et le taux de mortalité est particulièrement élevé au Gabon, en Afrique Centrale. Au Gabon, les ressources pour la détection précoce et précise de l’anémie falciforme ou du trait de l’anémie sont limitées. La plupart des personnes touchées résident dans des zones à faibles ressources où l’accès aux tests de diagnostic est souvent très limité. Les méthodes de diagnostic les plus couramment utilisées nécessitent un personnel formé, une infrastructure adéquate, de l’électricité et suffisamment de temps pour effectuer l’analyse. Ces exigences ne permettent pas actuellement de réaliser un dépistage de masse dans les zones reculées du Gabon. L’objectif de cette étude pilote est de développer une procédure standardisée de dépistage de la drépanocytose afin de déterminer sa prévalence dans la région sud-est du Gabon en utilisant un test rapide et fiable qui ne nécessite pas de ressources importantes, tel que le dispositif Sickle SCAN®. Méthodes: La précision du dispositif Sickle SCAN® a été évaluée sur la base de 272 échantillons de sang. L’hémoglobine exacte a été identifiée dans 100% des échantillons. Le test comprend trois indicateurs exclusifs qui détectent la présence d’hémoglobine A, S et C, permettant ainsi à l’utilisateur de distinguer rapidement les échantillons normaux (HbAA, N=142), porteurs (HbAS, N=41) et drépanocytaires (HbSS, N=88; HbSC, N=1). Les variantes d’hémoglobine (S et C) ont été confirmées par électrophorèse capillaire (MinicapR; Sebia). La sensibilité et la spécificité ont été calculées pour chaque phénotype. Résultats: L’analyse du test Sickle SCAN® a révélé les phénotypes normaux et anormaux suivants, y compris le trait drépanocytaire (HbAS=14,71%) et l’anémie disséminée [HbSS (32,35%) et HbSC (0,74)]. Il n’y a pas de faux positifs dans le résultat de Sickle SCAN® pour la présence de variante d’hémoglobine, comparé aux approches de référence que sont l’électrophorèse capillaire. La sensibilité estimée du test Sickle Scan® était de 92,2%, 100% et 100% pour HbSS, HbAS et HbSC, respectivement. La spécificité était supérieure à 88,23 % pour tous les phénotypes (HbSS, HbAS et HbSC). Conclusion et Implications pour la Traduction: Le dispositif Sickle Scan® s’est avéré fiable avec une sensibilité de 92,2 %, 100 % et 100 % pour HbSS, HbAS et HbSC, respectivement. La spécificité était supérieure à 88 % pour tous les phénotypes. Copyright © 2022 Delicat-Loembet et al. Published by Global Health and Education Projects, Inc. This is an open-access article distributed under the terms of the Creative Commons Attribution License CC BY 4.0.

Background: Stunting and undernutrition mark the nutritional status of the sickle cell patient, but some surveys show trends to overweight in some countries. The primary objective of this study was to compare the growth of children with sickle cell, with non-sickle cell children in Gabon. Methods: It was a prospective case-control study, conducted from April to June 2016 in Libreville and Lambarene in Gabon. Cases were homozygous (SS) sickle cell children aged from 0 to 15 years; controls were normal hemoglobin-AA documented, matched by sex and age. We compared their weight, height, arm and head circumferences measured according to conventional techniques. Results: We compared 118 cases to 118 controls, mean age was 85 ± 7.2 months, and the sex ratio was 1.07. Before 59 months, there was no significant difference in the comparison of the averages of the anthropometric indices except for the z-score of the brachial perimeter for age which was smaller in the cases (-0.85 versus -0.19, P = 0.04). The risk of stunting in cases was greater (odds ratio (OR) = 6.9, 95% confidence interval (CI): 5.4 - 8.3), the growth retardation increased with age, correlated factors with growth retardation were male gender (relative risk (RR) = 2.04, 95% CI: 1.2 - 2.7), a mother with no remunerative activity (r = 0.11, P 3 (r = 0.2, P = 0.003), and mean hematocrit of 9.6-15.9% (r = 0.4, P < 0.004). There were no obese subjects in cases. Conclusions: Growth retardation of children suffering from sickle cell in Gabon appears and increases with age. Male gender, low socioeconomic conditions and signs of severity or non-controlled disease are correlated with this retardation. Int J Clin Pediatr. 2018;7(1-2):1-5 doi: https://doi.org/10.14740/ijcp290w

Introduction: Vitamin A deficiency is responsible for severe disorders, and sometimes irreversible consequences in children. We aimed to evaluate the Vitamin A status of newborns in Gabon. Method: prospective study from August to December 2017 at the maternity of the University Teaching Hospital of Angondje (Gabon). We included at random mother-child pairs. A nutritional inquiry on Vitamin A was ran in the selected parturient. We performed the measurement of serum retinol booth in mother and child according to standardized and strict criteria, in Gabon and in France. World Health Organization defines Vitamin A deficiency by serum retinol .7 μmol/L. Results: We included 75 mother-child couples. The mean age of the mothers was 25.7 ± 7 years, 89.3% of neonates were an age gestational ≥ 36 weeks, and 10.7% were premature. Mango was the most commonly used source of Vitamin A and 27% of women consumed more than 3 times a week. The mean serum retinol of the mothers was 0.87 μmol/L ± 0.35 extremes [0.22 μmol/L - 1.79 μmol/L], the mean serum retinol of the newborns was 0.92 μmol/L ± 0.30 extremes [0.24 μmol/l - 1.84 μmol/L].Vitamin A deficiency was observed in 23.3% (n = 25; CI 95% [22.1% - 25.8%]) of mothers and 20% (n = 15; CI 95% [18.2% - 22%]) newborns. There was a weak correlation between the serum retinol of mothers and serum retinol of newborns (r = 0, 17). Conclusion: The prevalence of Vitamin A deficiency is quite important in neonates of our investigation, and justifies a systematic supplementation.

Resume Introduction L’objectif est de rechercher la presence de germes nosocomiaux multiresistants dans la flore digestive des nouveau-nes hospitalises. Methodologie Etude prospective, incluant 51 nouveau-nes ayant une coproculture de la premiere selle et des selles a j15 de vie positive a un germe nosocomial multiresistant. La colonie suspecte devait avoir une concentration > 1010 bacteries/gramme de selles. Resultats L’âge moyen etait de 35,5 ± 4,3 SA. La prematurite etait observee dans 39,21 % de cas. Le poids moyen etait de 2346,17 ± 1022,5 g. La rupture prematuree des membranes etait presente dans 45,09 % des cas. Une antibiotherapie etait administree a l’admission dans 76,90 % des cas. La premiere alimentation etait faite avec un substitut de lait maternel dans 76,50 % des cas. L’analyse des premieres selles montrait la presence de bacteries multiresistantes et de Candida albicans respectivement dans 7,84 % et 11,76 % des cas. A j15 de vie, 70,59 % avaient un portage digestif de germes multiresistants. C. albicans etait le plus frequent (25 %), suivi d’Escherichia coli (22,22 %) dont 3 producteurs de betalactamase a spectre elargi. Une translocation digestive etait observee dans 30,56 % de cas. Le deces survenait chez trois nouveau-nes, du a E. coli K1 BLSE dans un cas et dans deux cas, a C. albicans. La prematurite (p Conclusions La maitrise des facteurs de risque d’infection nosocomiale pour une prise en charge preventive est primordiale.

Background: Poor information about neonatal tetanus cases are assembled in Gabon. Aim: To recall practitioner about the existing danger of neonatal tetanus despite efforts made by immunization in the country and worldwide. Observations: We write about two observations in two teaching hospitals at the same period. One treated, and the other lethal. We assess their cases with the commonly used scale in Africa: Dakar Classification. Conclusion: Despite the worldwide actions against neonatal tetanus, cases appear, and we must screen the mothers with exposure factors.

First described embryo fetopathy, congenital syphilis remains a public health problem mostly in developing countries. The diagnosis mainly based on bacteriological and immunological evidence of mother-child couple is not always easy, as it is shown in our three clinical cases. Those three clinical observations demonstrate the difficulties encountered in the diagnosis of congenital syphilis in our country where only the TPHA (Treponema Pallidum Haemaglutination Assay) and VDRL (Venereal Disease Research Laboratory) tests are the only ones to be routinely carried out. Actually, these tests can be negative at the earliest stage of the syphilis or in case of zonal phenomenon. In addition, maternal antibodies could be found in child blood, even if the baby is in good health. At last, the child could have been contaminated belatedly while tests were negative at the third month of pregnancy. Congenital syphilis still exists in our developing countries and, in order to better manage this pathology, a proposition of an efficient algorithm is submitted.

Sickle-cell disease (SCD) represents a substantial public health problem in Gabon. Fever is one of the principal reasons for the hospitalization of children afflicted by major sickle-cell disorder, since it can be a clinical reflection of severe infections that have the potential to become life threatening. Objectives: Identification of the main causes of fever in children with SCD in our clin- ical setting, with the aim of optimizing treatments. Patients and Methods: This is a retrospective study of all the medical files for children with SCD that were admitted to our ward, over a two year period, due to fever (>38.5˚C) lasting more than 24 hours. Only those files that contained at least the following five fundamental medical examinations were retained for further evaluation: Com- plete Blood Count (CBC), blood smear, blood culture, urine culture and chest X-ray. Out of a total of 118 admissions (103 patients), 87 (73.7%) were due to the incidence of fever. The medical files of 11 patients were deemed to be unusable. Seventy-six episodes of fever were observed among 69 children, of which 42 were male and 27 female (sex ratio of 1.5). Among these, seven (10%) were admitted twice. Results: The age groups that were most affected included 12 - 18 year-olds (30 cases: 43.5%) and 6 - 12 year-olds (26 cases: 37.7%). The most common accompanying symptoms were bone and joint pain (43.4%), asthenia (22.4%), cough (19.7%), vomiting (17%) and head- ache (15.8%). The specific cause of the fever could not be pinpointed in 29 cases (38.1%). Aside from these cases, the main causes of fever were malaria (30.3%) and bronchopulmonary infec- tions (22.4%). The white blood cell count was >20,000/mm 3 in 47% of respiratory infections, 43.5% of the cases involving malaria and 55.2% of cases of fever with unknown cause. Hemoglobin levels * Corresponding author.

The purpose of this work is to evaluate the epidemiological aspects of vision problems and their repercussions in the schooling of children in Libreville and Owendo. Methodology: This transversal and descriptive study was carried out in May and June 2011. Included in the study were children in the 7th and 8th grades of the primary schools in Libreville and Owendo. For each child, an eye exam, including the subjective measure of visual acuity, was carried out using the Monoyer scale, and the color vision assessment was carried out with the Ishihara test. Any visual capacity under or equal to 7/10th in at least one eye was considered to be pathological. We gathered information about demographic characteristics, any preceding vision issues on the record, data on other med- ical problems on the record and the eye examination on computer cards. Results: Nine hundred and sixty-three children (416 boys and 517 girls, with a gender ratio of 0.86) were examined. The average age was 12 ± 1.7 years old. The prevalence of the drop in visual acuity was 16.2%. The prevalence of color vision anomalies was 15.5%. Complaints concerning vision problems were significantly more present from children with a drop in visual acuity (p < 0.01). Visual anomalies had an impact on the children's schoolwork, and yet, visits to the ophthalmologist's office were few. Conclusion: The frequency of anomalies in vision justifies systematic screening in schools and organization of an appropriate treatment.

Summary: Purpose: Cerebral malaria (CM) is suspected to be a potential cause of epilepsy in tropical areas. The purpose of this article was to evaluate the relationship between CM and epilepsy in Gabon. Methods: A matched case–control study was carried out on a sample of subjects aged six months to 25 years and hospitalized between 1990 and 2004 in three hospitals in Libreville, Gabon. Cases were defined as patients suffering from epilepsy and confirmed by a neurologist. Controls were defined as patients without epilepsy. The exposure of interest was CM according to WHO criteria. Results: In total, 296 cases and 296 controls were included. Of these, 36 (26 cases and 10 controls) had a CM history. The adjusted odds ratio (aOR) to develop epilepsy after CM was 3.9 [95% CI: 1.7–8.9], p < 0.001. Additional risk factors were identified: family history of epilepsy: aOR = 6.0 [95% CI: 2.6–14.1], p < 0.0001, and febrile convulsions: aOR = 9.2 [95% CI 4.0–21.1], p < 0.0001. Conclusions: This first case–control study on that issue suggests that epilepsy-related CM is an underrecognized problem. It emphasizes the need for further studies to better evaluate the role of convulsions during CM.

Ce travail avait pour but de determiner le type, la frequence, et etablir les facteurs etiologiques, des differents accidents domestiques a Libreville. Etude prospective transversale menee de septembre 2005 a janvier 2006 dans les services d’urgences pediatriques du Centre hospitalier de Libreville et de l’Hopital pediatrique d’Owendo. Etaient inclus des enfants de moins de 15 ans, victimes d’accidents ou traumatismes non intentionnels survenus a domicile ou dans ses abords immediats. Ont ete analyses l’âge, le sexe, l’environnement, les circonstances de survenue et le type d’accident. Les 56 enfants inclus se repartissaient en 31 garcons et 25 filles. Les enfants de moins de 6 ans (62,5%) etaient frequemment touches. La chute etait le principal accident domestique (46%) suivi des intoxications (16%). La cour etait le principal lieu des accidents (47%) suivie de la chambre (13%) et la cuisine (12%). L’environnement de l’enfant, le niveau professionnel des parents etaient lies a la frequence des accidents (p < 0, 01).

Background Improving the understanding of childhood malarial anaemia may help in the design of appropriate management strategies. Methods A prospective observational study over a two-year period to assess the burden of anaemia and its relationship to Plasmodium falciparum infection and age was conducted in 8,195 febrile Gabonese children. Results The proportion of children with anaemia was 83.6% (n = 6830), higher in children between the ages of six and 23 months. Those under three years old were more likely to develop moderate to severe anaemia (68%). The prevalence of malaria was 42.7% and P. falciparum infection was more frequent in children aged 36–47 months (54.5%). The proportion of anaemic children increased with parasite density (p < 0.01). Most of infected children were moderately to severely anaemic (69.5%, p < 0.01). Infants aged from one to 11 months had a higher risk of developing severe malarial anaemia. In children over six years of age, anaemia occurrence was high (>60%), but was unrelated to P. falciparum parasitaemia. Conclusion Malaria is one of the main risk factors for childhood anaemia which represents a public health problem in Gabon. The risk of severe malarial anaemia increases up the age of three years. Efforts to improve strategies for controlling anaemia and malaria are needed.