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Resume Introduction L’infection urinaire figure au second rang des infections bacteriennes de l’enfant, apres celle des voies respiratoires. L’objectif du present travail etait d’etudier l’ecologie bacterienne et la sensibilite aux antibiotiques des germes isoles au cours des infections urinaires de l’enfant au Centre hospitalier universitaire pediatrique Charles-de-Gaulle de Ouagadougou. Patients et methode Il s’est agi d’une etude retrospective descriptive portant sur la periode du 1er juillet 2010 au 30 juin 2015, incluant 141 enfants âges de 0 a 15 ans, hospitalises dans le service de pediatrie medicale pour une infection urinaire. Resultats La frequence hospitaliere de l’infection urinaire etait de 0,7 %. L’âge moyen des patients etait de 43,1 mois. Les patients de sexe feminin representaient 57,4 %, soit un sex-ratio de 0,7. Les bacilles a Gram negatif etaient souvent en cause (67,4 %) avec Escherichia Coli et les Klebsielles sp dans 35,5 % et 22 % des cas respectivement. Les principales bacteries a Gram positif etaient les staphylocoques (15,5 %), les enterocoques (11,3 %) et les streptocoques (5,6 %). Les enterobacteries isolees etaient sensibles a la netilmicine (80 %), au chloramphenicol (76,4 %) et au furane (82,6 %). Toutes les souches de staphylocoque etaient sensibles au furane, a la gentamicine, au chloramphenicol et au cefixime. Dans 66,7 % des cas, les souches de staphylocoque isolees etaient resistantes a l’amoxicilline. Conclusion L’infection urinaire est une pathologie frequente en pediatrie. Sa prise en charge doit etre precoce et adequate, en se basant sur la connaissance de l’ecologie bacterienne afin de reduire le risque de complication renale a long terme.

PURPOSE Multidisciplinary management of Wilms tumor has been defined through multicenter prospective studies and an average expected patient cure rate of 90%. In sub-Saharan Africa, such studies are uncommon. After the encouraging results of the first Groupe Franco-Africain d'Oncologie Pédiatrique (GFAOP) study, we report the results of the GFAOP-NEPHRO-02 study using an adaptation of the International Society of Paediatric Oncology 2001 protocol. PATIENTS AND METHODS From April 1, 2005, to March 31, 2011, seven African units participated in a nonrandomized prospective study. All patients who were referred with a clinical and radiologic diagnosis of renal tumor were screened. Those older than age 6 months and younger than 18 years with a unilateral tumor previously untreated were pre-included and received preoperative chemotherapy. Patients with unfavorable histology or with a tumor other than Wilms, or with a nonresponding stage IV tumor were excluded secondarily. RESULTS Three hundred thirteen patients were initially screened. Two hundred fifty-seven patients were pre-included and 169 with histologic confirmation of intermediate-risk nephroblastoma were registered in the study and administered postoperative treatment. Thirty-one percent of patients were classified as stage I, 38% stage II, 24% stage III, and 7% stage IV. Radiotherapy was not available for any stage III patients. Three-year overall survival rate was 72% for all study patients and 73% for those with localized disease. CONCLUSION It was possible to conduct sub-Saharan African multicenter therapeutic studies within the framework of GFAOP. Survival results were satisfactory. Improvements in procedure, data collection, and outcome are expected in a new study. Radiotherapy is needed to reduce the relapse rate in patients with stage III disease.

Urinary tract infection is the second most common bacterial infection in children, after respiratory tract infection. The objective of this work was to study the bacterial ecology and antibiotic susceptibility of germs isolated during childhood urinary tract infections at the Paediatric University Hospital Charles-de-Gaulle in Ouagadougou.This was a descriptive retrospective study covering the period from July 1The hospital frequency of urinary tract infection was 0.7%. The mean age of the patients was 43.1 months. Female patients accounted for 57.4%, a sex-ratio of 0.7. Gram-negative bacilli were often involved (67.4%) with Escherichia Coli and Klebsiella in 35.5% and 22% of cases respectively. The main Gram-positive bacteria were staphylococci (15.5%), enterococci (11.3%) and streptococci (5.6%). Enterobacteriaceae isolated were sensitive to netilmicin (80%), chloramphenicol (76.4%), and furan (82.6%). All strains of staphylococcus were susceptible to furan, gentamicin, chloramphenicol and cefixime. In 66.7% of cases, the isolated strains of staphylococcus were resistant to amoxicillin.Urinary tract infection is a common problem in pediatrics. Its management must be early and adequate based on knowledge of the bacterial ecology in order to reduce the risk of long-term renal complications.

Introduction:l’objectif de ce travail était d’analyser les aspects épidémiologiques, diagnostiques, thérapeutiques et évolutifs de l’hémoglobinurie chez l’enfant au CHU Pédiatrique Charles-De-Gaulle de Ouagadougou. Méthodes:il s’est agi d’une étude transversale à visée descriptive sur la période allant du 01 juillet au 31 décembre 2014. Ont été inclus dans l’étude, tous les enfants âgés de zéro à 15 ans hospitalisés dans le Service de Pédiatrie Médicale du CHU Pédiatrique Charles-de-Gaulle, chez qui une hémoglobinurie macroscopique a été diagnostiquée pendant la période de l’étude. Résultats:trente-huit patients ont été inclus dans l’étude. La fréquence hospitalière de l’hémoglobinurie était de 1,9%. L’âge moyen des patients était de 80,8 ± 44,1 mois (extrêmes = 21 et 168). Il s’agissait de 23 garçons (60,5%) et 15 filles (39,5%). Les principaux signes cliniques étaient: la fièvre (86,8%), les urines foncées « coca cola » (86,8%), la pâleur (63,2%), l’hépatomégalie (50%). Le débit de filtration glomérulaire (DFG) était inférieur à 80 mL/min/1,73m2chez 23 patients (69,7%); 21 patients avaient un déficit en G6PD. Les principales étiologies présumées de l’hémoglobinurie étaient: le paludisme grave, les infections bactériennes et virales, le déficit en G6PD, la fièvre bilieuse hémoglobinurique. Les traitements administrés étaient: les dérivées de l’artémisinine, les antibiotiques et les antipyrétiques. Le recours à la dialyse a été nécessaire chez un patient. Conclusion:l’hémoglobinurie est un symptôme qui pose surtout un problème de diagnostic étiologique dans notre contexte. Sa gravité réside dans le fait qu’elle peut provoquer une IRA sévère.

Background: Isolated or associated with other conditions, malaria is responsible for the death of a child every minute, mostly in sub-Saharan Africa. The main objective was to determine the epidemiological, clinical, and biological aspects and outcomes of severe malaria associated with invasive bacterial infections in children. Methods: A prospective analytical study was conducted at Charles de Gaulle Paediatric University Teaching Hospital between 1 July and 31 August 2014 in Ouagadougou, Burkina Faso. Children with severe malaria and invasive bacterial infections were included. Results: There were 140 children with severe malaria of whom 13.6% exhibited signs of invasive bacterial infection. Co-infection was significantly higher in children under 24 months (p = 0.02) who came from rural areas (p

Introduction: The management of congenital heart diseases in countries with limited technical facilities poses real problems to practitioners. Yet, a good medical follow- up permits to improve these children’s life quality before any eventual surgery. Our study aims at examining the evolutionary and prognostic aspects of these congenital heart diseases in order to understand their evolution in our context. Materials and Methods: Our work is a continuation of a prospective, transversal and descriptive survey concerning all the children with congenital heart diseases in hospitalization or in consultation led from January 1st 2012 to December 31st 2012 in the Charles De Gaulle Center Pediatric Teaching Hospital (CDG-PTH) in Ouagadougou. Results: In 2012, we kept under observation 101 cases of congenital heart diseases representing 69.18% of the 146 cases of heart diseases with an impact of 0.79% of the 12,838 patients who were admitted at CDG-PTH. The interventricular septal defect occupied the first place of all malformative heart diseases with 43.56% of cases. The average age of patients at the moment of the diagnosis was 17 months old with extremes ranging from two (2) days old to fifteen (15) years old. The sex-ratio was 1.06. Throughout the follow-up of the children until the end of the six months’ survey, it was possible for us to meet again 52 patients, we had no longer been in touch with 22 patients and 27 were dead. At the moment of the diagnosis, surgical treatment was recommended for 63.37% of the patients (64 cases) and only 7.81% (5 cases) were operated. The complicated cases were: Eisenmenger syndrome (6 cases representing 5.94%). We recorded a rate of 26.73% of death. Conclusion: Congenital heart diseases are relatively common at CDG-PTH. The high rate of mortality noticed is due to the lack of heart surgery and catheterism units in our country.

The newborn with partial atrio-ventricular defect is born quickly normal without functional signs, and then cardiac insufficiency appears in the first weeks of life respiratory unrests. The spontaneous evolution makes itself toward a complication of the shunts left-right with cardiac insufficiency, Osler illness, the death or toward the pulmonary obstructive illness about 6 months old. In order to fear the evolutionary possibilities and debate difficulties of hold in charge in countries with limited resources such as Burkina Faso, we return a clinic observation of a case of partial atrio-ventricular defect in a sixty years old man.

Introduction: Sickle cell disease (SCD) causes chronic hemolysis which is a risk factor for cholelithiasis. Its development may lead to severe and life-threatening complications. Objective: Determine the prevalence of cholelithiasis, the conditions of diagnosis and related factors. Materials and Method: We retrospectively reviewed records of 110 patients with sickle cell disease followed up in Charles de Gaulle University Pediatric Hospital from January 2003 to December 2013, including 103 patients who had abdominal ultrasonography. Results: Cholelithiasis prevalence was 24.3%. The mean age of patients was 10.8 years, (range 3 to 15 years). Sex ratio was 2.1. In 88% cases, cholelithiasis was diagnosed based on the characteristic symptoms of right hypocondrial pain, fever and icterus. Most factors associated with cholelithiasis were as follows: age above 10 years (OR = 4), occurrence of at least three (03) vaso-occlusive crises per year (OR = 7.6), history of blood transfusion (OR = 8), right hypochondrial pain (OR = 4.5) and icterus (OR = 15). Only 20% of patients suffering from a symptomatic cholelithiasis underwent laparoscopic cholecystectomy and results were conclusive. Conclusion: Patients with sickle cell disease, especially those aged above 10, should be routinely tested for cholelithiasis using abdominal ultrasonography at least once a year. Because of the difficulties in managing evolutive complications in case of an emergency in our context, we advocate laparoscopic cholecystectomy of any cholelithiasisas soon as it is diagnosed in children with sickle cell disease.

Sickle cell disease is a genetic disease most common in blacks. We retrospectively collected records for patients with sickle cell disease who were seen from January 2002 through September 2006 to assess the care provided for this disease at Charles de Gaulle University Children's Hospital of Ouagadougou. In all, 88 patients were monitored quarterly at outpatient visits for sickle cell disease, in the absence of any crisis. Their age ranged from 6 months to 16 years, with an average age of 7. There were more boys than girls, with a sex ratio of 1.44. The distribution according to sickle cell genotype showed that SC accounted for 62% of cases, while SS forms were more frequent until the age of 5. All children have received the immunizations in the standard Expanded Programme on Immunization (EPI) [diphtheria, tetanus, pertussis, polio, measles and yellow fever]. The immunization rates for non-EPI vaccines including hepatitis B, Haemophilus influenzae B, Salmonella typhi, meningitis, pneumonia and the combined vaccine against measles, mumps and rubella ranged from 94 to 100%. A prophylactic anti-anaemic agent was made with folic acid often associated with iron. In addition, patients receive malaria chemoprophylaxis. Chloroquine was initially provided, and since 2006, children have been receiving sulfadoxine-pyrimethamine. Our encouraging results deserve reinforcement in the short-term - at the local level by neonatal screening, the creation of an immunization unit, and the systematization of antibiotic prophylaxis, and in the medium-term by implementation of a National sickle cell disease programme to help meet the objective of a 40% reduction in mortality among affected children younger than 5 years by 2015, set by the Sickle Cell Disease International Organization.

L'ostéogenèse imparfaite (OI) regroupe un ensemble d'affections constitutionnelles de gravité variable dû à une anomalie de la production du collagène et de la matrice de l'os entraînant une fragilité osseuse. La présente étude rapporte quatre cas d'ostéogenèse imparfaite suivis aux Centres Hospitaliers Universitaires Charles de Gaulle et Yalgado Ouédraogo. Le but de ce travail était d'analyser les aspects cliniques, thérapeutiques et évolutifs de la maladie. Cette étude souligne la nécessité d'améliorer la prise en charge de cette maladie rare mais non exceptionnelle et handicapante.

L'ostéogenèse imparfaite (OI) regroupe un ensemble d'affections constitutionnelles de gravité variable dû à une anomalie de la production du collagène et de la matrice de l'os entraînant une fragilité osseuse. La présente étude rapporte quatre cas d'ostéogenèse imparfaite suivis aux Centres Hospitaliers Universitaires Charles de Gaulle et Yalgado Ouédraogo. Le but de ce travail était d'analyser les aspects cliniques, thérapeutiques et évolutifs de la maladie. Cette étude souligne la nécessité d'améliorer la prise en charge de cette maladie rare mais non exceptionnelle et handicapante.Key words: Ostéogenèse imparfaite, anomalies osseuses, Burkina-Faso

Sickle cell disease is a genetic disease most common in blacks. We retrospectively collected records for patients with sickle cell disease who were seen from January 2002 through September 2006 to assess the care provided for this disease at Charles de Gaulle University Children's Hospital of Ouagadougou. In all, 88 patients were monitored quarterly at outpatient visits for sickle cell disease, in the absence of any crisis. Their age ranged from 6 months to 16 years, with an average age of 7. There were more boys than girls, with a sex ratio of 1.44. The distribution according to sickle cell genotype showed that SC accounted for 62% of cases, while SS forms were more frequent until the age of 5. All children have received the immunizations in the standard Expanded Programme on Immunization (EPI) [diphtheria, tetanus, pertussis, polio, measles and yellow fever]. The immunization rates for non-EPI vaccines including hepatitis B, Haemophilus influenzae B, Salmonella typhi, meningitis, pneumonia and the combined vaccine against measles, mumps and rubella ranged from 94 to 100%. A prophylactic anti-anaemic agent was made with folic acid often associated with iron. In addition, patients receive malaria chemoprophylaxis. Chloroquine was initially provided, and since 2006, children have been receiving sulfadoxine-pyrimethamine. Our encouraging results deserve reinforcement in the short-term - at the local level by neonatal screening, the creation of an immunization unit, and the systematization of antibiotic prophylaxis, and in the medium-term by implementation of a National sickle cell disease programme to help meet the objective of a 40% reduction in mortality among affected children younger than 5 years by 2015, set by the Sickle Cell Disease International Organization.