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Unilateral pulmonary agenesis with absence of pulmonary artery is an unusual congenital malformation, in Burkina Faso. We report hereby the first case having experienced respiratory distress due to unilateral pulmonary agenesis associated with a heart malformation (inter-auricular and inter-ventricular communications). Difficulties of diagnostic and therapeutic management in the context of limited access explain the fatal issue. L’agénésie pulmonaire unilatérale avec absence d’une artère pulmonaire est une malformation congénitale exceptionnelle, au Burkina Faso. Nous rapportons le premier cas Burkinabé ayant présenté une détresse respiratoire secondaire à une association complexe d’agénésie pulmonaire unilatérale et une malformation cardiaque (communications inter auriculaire et inter ventriculaire). Les difficultés de prise en charge diagnostique et thérapeutique, dans un contexte de ressourcée très limitée expliquent l’issue fatale.

Background Serotype-specific diagnosis of pneumococcal community-acquired pneumonia in children under age 5 years would mark a major advancement for understanding pneumococcal epidemiology and supporting vaccine decision-making. Methods A Luminex technology-based multiplex urinary antigen detection (UAD) diagnostic assay was developed and subsequently validated in adults, but its applicability to children is unknown. This study aimed to set appropriate cutoffs for use of the UAD in a healthy pediatric population and apply these cutoffs in children with pneumonia in sub-Saharan Africa. The cutoffs were determined by assessing 379 urines obtained from healthy children under age 5 years from the Bobo-Dioulasso area for serotypes included in 13-valent pneumococcal conjugate vaccine (UAD-1) and the 11 other serotypes unique to 23-valent pneumococcal polysaccharide vaccine (UAD-2). Results Based on the assigned cutoff values, among 108 children who met the World Health Organization consolidation endpoint criteria, UAD-1 and UAD-2 were positive in 23.3% and 8.3%, respectively; among 364 children with clinically suspected pneumonia who did not meet the World Health Organization criteria, UAD-1 and UAD-2 were positive for 6.6% and 3.6%, respectively. Pneumococcal carriage prevalence was similar among pneumonia cases (30%) versus controls (35%) as was semiquantitative carriage density. Conclusions UAD-1 and UAD-2 were able to distinguish community controls from children with pneumonia, particularly pneumonia with consolidation. Future studies are needed to confirm these results and more fully assess the contribution of pneumococcal carriage and concurrent viral infection.

Introduction: Stroke is defined as a sudden onset focal neurological deficit of presumed vascular origin. Although it is essentially adult and elderly condition, stroke can occur in children. Their diagnosis essentially radiological is based on two main imaging modalities namely Computed Tomography (CT) and/or Magnetic Resonance Imaging (MRI). Our study aimed to study radiological features of stroke in children with an etiologic approach in three health facilities of Ouagadougou. Material and Method: We conducted a retrospective study with descriptive focus during 11-year period from January 1st, 2006 to September 1st, 2017 among children aged between 02 months and 16 years who underwent brain CT scan and/or MRI; in whom diagnosis of stroke had been established in radiology department of Yalgado Ouedraogo Teaching Hospital (CHU-YO), Schiphra Methodist Medical Center (CM Schipphra) and Saint Camille Hospital of Ouagadougou (HOSCO). Results: 40 cases of pediatric stroke were collected including 23 at HOSCO, 15 at CHU-YO and 03 at CM Schipphra. Mean age was 6.45 years, with extremes of 2 months and 192 months. Unilateral contralateral motor weakness was the most common clinical presentation (32.5%) followed by seizures (17.5%). Ischemic stroke dominated in 82.5% of cases. Sino-venous thrombosis was rare and suspected in only one case. Sylvian artery was mostly affected in ischemic stroke for 56.25% of patients. The main etiologic factors found were hematologic (67.50%) then infectious factors (25%). Sickle cell disease was always incriminated in hematologic factor. Homozygous SS patients were the most numerous (82%). Conclusion: Stroke diagnosis in children is based on etiologic investigation, biology with a major role of medical imaging. Sickle cell disease accounts a lot in occurrence of stroke in children in our context.

Adrenocortical carcinoma is a malignant tumor of the adrenal gland, very rare in pediatric pathology. Authors presented a pediatric case of adrenocortical carcinoma which showed neurology symptoms at 1st visit and Cushing syndrome secondarily. The patient received a ketoconazole-based treatment. The outcome was fatal before the surgical excision of the tumor, because of delayed diagnosis. Early diagnosis and multidisciplinary management of adrenocortical carcinoma could improve the prognosis in children.

Penile fracture is a rare urological emergency. It occurs mainly in young adults during sexual intercourse. In many instances, one of the corpora carvanosus is involved though bilateral injuries with or without corpus spongiosus involvement is not uncommon. However, isolated injury to corpus spongiosus is extremely rare. We report a case of isolated rupture of corpus spongiosum secondary to penile injury during coitus in a 43-year-old man that presented to University Hospital Souro Sanou of Bobo Dioulasso. He presented with history of persistence bleeding per urethra following penile injury during sexual intercourse. The Retrograde urethrography (RUG) showed a partial rupture of urethra, Moore type 3. Complementary penile ultrasound revealed extensive contusion of the urethra with circumferential hematoma and rupture of the distal 1/3 of the corpus spongiosus. He had gentle per urethral catheterization which was left for one month. Penile ultrasound sound done after removal of catheter showed residual injury and narrowing of the urethra.

A 34-year-old man, trader, and married with four wives, otherwise healthy, without any remarkable medical history, was admitted in urology ward in emergency with superficial venous thrombosis of the penis known also as Penile Mondor’s Disease (PMD), a rare nosologic entity of the penis associated with pain and an indurated dorsal cord of the root of the penis. The patient receives nonsteroidal anti-inflammatory drugs and coagulation and platelet aggregation inhibitors drugs. Healing and total recovery occur after eight weeks without any complications.

International audience; BACKGROUND:Tuberculosis is a major cause of morbidity and mortality in HIV-infected children, but is difficult to diagnose. We studied mortality and its determinants in antiretroviral treatment (ART)-naive HIV-infected children presenting with suspected tuberculosis.METHODS:In this observational cohort study, HIV-infected children aged 13 years or younger with suspected tuberculosis were followed up for 6 months as part of the ANRS 12229 PAANTHER 01 cohort in eight hospitals in four countries (Burkina Faso, Cambodia, Cameroon, and Vietnam). Children started ART and antituberculosis treatment at the clinician's discretion and were retrospectively classified into one of three groups by tuberculosis documentation: confirmed by culture or Xpert MTB/RIF, unconfirmed, and unlikely. We assessed mortality and associated factors using Kaplan-Meier methods and Cox proportional hazard models. The ANRS 12229 PAANTHER 01 study is registered at ClinicalTrials.gov, number NCT01331811.FINDINGS:266 (61%) of 438 children enrolled in the study between April 27, 2011, and May 31, 2014, were ART-naive and included in the analysis (40 had confirmed tuberculosis, 119 unconfirmed tuberculosis, and 107 unlikely tuberculosis). 112·5 person-years of follow-up were available. 154 children (58%) started antituberculosis treatment and 212 (80%) started ART. 50 children (19%) died. Mortality by 6 months was higher in children with confirmed tuberculosis (14 deaths; 2 month survival probability 65·0% [95% CI 50·2-79·8]) compared with unconfirmed tuberculosis (19 deaths; 83·5% [76·8-90·3]) and unlikely tuberculosis (17 deaths; 83·5% [76·3-90·7]; log-rank p=0·0141) and was lower in children with confirmed or unconfirmed tuberculosis who started antituberculosis treatment (p

>Objective: To investigate the compliance of computed tomography (CT) scan requests in the X-ray units of Sub-Saharan Africa. Methods: Multi-centric, exhaustive, descriptive and cross-sectional study (Burkina Faso and Benin) focused on CT scan requests implemented and interpreted from May 1 to July 31, 2014. Request compliance was assessed according to the criteria of the French High Authority for Health to which was added a criterion for fulfillment of description of patient clinical information. An exam was deemed compliant when all criteria were met. Ratios were compared by means of Chi2 test at 0.05% significance level. Results: Among the 426 colligated computed tomography prescriptions, the least filled fields were allergy concept (0%), creatinine-mia (0.3%), examination purpose (50.2%). The overall compliance rate was 35%. The requests made by medical specialists were more compliant than those made by general practitioners and students (p = 0.003). Fulfillment of clinical information description was also better among medical specialists compared to the other prescribers (p = 0.002). Conclusion: It is important to improve the quality of computed tomography (CT) scan requests in the hospitals of Bobo-Dioulasso (Bur-kina Faso) and Parakou (Benin).

Emphysematous cystitis is a severe urinary tract infection which threatens patients’ life. Thus, it requires early diagnosis and computed tomography (CT) is the reference medical exam used to address it. However, ultrasound, which is a non-ionizing and very accessible technique, may also contribute to diagnosis. The aim of this study was to illustrate the contribution of ultrasound to the diagnosis of emphysematous cystitis. We report three cases of emphysematous cystitis diagnosed by ultrasound. In all the cases, ultrasound identified basic signs showing presence of gas, including a hyperechoic cystic parietal thickening, repeat echoes and dirty shadow cones of intraluminal focus. Diagnostic confirmation was made in two cases through X-ray and in one case by means of computed tomography. Through simple basic signs, ultrasound directs most usefully towards an emphysematous urinary tract infection. CT enables a more accurate diagnostic work-up of lesions and differential diagnosis with vesico-digestive fistula.

The authors describe three cases of trilateral retinoblastoma, a rare syndrome that occurs most often in young children. Two of these children were 3 years old at diagnosis, and the other 4 years old. The retinoblastoma was unilateral in one child and bilateral in the others. All underwent computed tomography (CT) imaging, which made it possible to locate the intraocular tumor lesions, to specify the extent of the tumor and to look for a possible intracranial neoplasm. Unfortunately, the cost of CT is high, which limits its use in our context.

Introduction : Decrire les differents aspects echographiques de carcinome hepatocellulaire (CHC) et preciser l’apport de l’echographie dans le diagnostic des CHC dans le contexte burkinabe. Methodes : Etude prospective descriptive de 12 mois, realisee dans les services de medecine interne et d’imagerie medicale du CHU Souro Sanou de Bobo Dioulasso, portant sur 58 patients ayant un CHC. Tous les patients ont beneficie d’une exploration echographique abdominale et dans certains cas d’un dosage du taux d’alpha-foetoproteine et d’un examen histologique hepatique. Les caracteres echographiques des tumeurs et les signes extra tumoraux associes ont ete notes. Resultats : Cinquante huit patients d’âge moyen de 45,6 ±12,5 ans (extremes 22-77 ans), avec une nette predominance masculine (n=44) etaient inclus dans l’etude. Le retard diagnostic etait de plus de 3 mois dans 50,7%. L’echographie decrivait des grosses tumeurs (69% des cas), multinodulaires (67,2%), a majorite hyperechogenes (70,7%). Cinq formes pseudo suppuratives etaient notees (8,7%). L’ascite (60,3% des cas) et la thrombose portale (56,8%) etaient les signes extra-tumoraux les plus frequents. La thrombose cave inferieure (n=1) etait rare. L’alpha-foetoproteine etait significativement elevee chez 10 patients (43,5%). L’examen histologique (n=20) decrivait un CHC chez 18 patients (90%). Conclusion : Au Burkina Faso, le CHC est multinodulaire, hyperechogene et de grosse taille avec une forme particuliere pseudo abcedee. L’imagerie echographique est un examen complementaire indispensable decrivant des aspects presque pathognomoniques du CHC. Toutefois, son association a l’histologie est plus utile que le dosage de l’alpha-foetoproteine dans le diagnostic des CHC.