Introduction: Neonatal asphyxia (NA) is one of the most likely causes of neuro-developmental abnormalities in children. In Mali it is responsible for half of the early deaths and the third of neonatal mortality. Updated data would help understand and improve intervention strategies to reduce mortality. Objective: It is the study of epidemiological and clinical characteristics, the immediate outcome and the factors associated with newborn (NB) mortality with NA. Material and Methods: This was a prospective cross-sectional study from June 27 th to September 3 rd 2016 about the NBs admitted for NA in the Hospital Teaching Gabriel Touré of Bamako. The clinical and biological data including the prognosis were collected from the health records of women, the liaison sheets and the medical file. The analysis was done using the software Epi info version 3.5.1. Results: 76 NBs were included which represented 23.45% of hospitalizations. The majority (89.5%, n = 68) were admitted to less than 24 hours of life for NA grade III according to the Sarnat classification (43.4%, n = 33). The average age of mothers was 24.17 ± 5.5 years. Almost half (41.3%, n = 31) were primigravida. The most common obstetrical event was dystocia (64.5%, n = 49). The prognosis was poor in grade III anoxia in our patients (56%) of deaths. Conclusion: The périnatal anoxia (PA) is a major health issue in Mali because of its frequency and severity. Monitoring of pregnancies, delivery assisted by skillful and qualified personnel, mastery of neonatal resuscitation techniques are good means of prevention.

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Introduction: Congenital heart disease is an important cause of mortality, chronic morbidity, and disability in children in poor countries. The objective of this study was to highlight the diversity of congenital heart defects in the neonatology department. Methodology: This work had taken place in a neonatology service over a period of six months from January 2019 to June 2019. It was a prospective descriptive study with information collected from the medical records of newborns with congenital heart disease. Results: Of 1478 neonates hospitalized during the study period, 41 had congenital heart disease, for a hospitalization rate of 2.77%. CHD accounted for 2.77% of neonatal hospitalizations. The sex ratio was 1.73 (26 boys/15 girls). Consanguinity was found in 19% of cases. The average time to consultation was 11 days. The main clinical signs were heart murmur (58%), respiratory distress (56%) and extracardiac malformations (54%). The main cardiac malformations found were atrial septal defect (46%), patent ductus arteriosus (44%), ventricular septal defect (17%), complete atrioventricular canal (15%), and transposition of the great vessels (5%). The case fatality rate was 29%. Conclusion: Delayed diagnosis, generally related to the long delay in consultation, and lack of surgical management partly explain this high case fatality.

The nephroblastoma is the third pediatric cancer in Mali, this study aimed to describe the prevalence and prognosis of nephroblastoma relapses. Methods: It was a descriptive retrospective study over a 10-year period from January 2005 to March 2015. We collected children aged 0 to 15 years followed for relapse of nephroblastoma in the pediatric oncology unit of university hospital center (UHC) Gabriel Toure. Results: The frequency of relapse of nephroblastoma was 7.4% (19 cases) whose mean age was 42 months with a sex ratio of 1.3. The relapse occurred before the end of the postoperative course in 16% of cases (3 patients). It was local recurrence in 52% of cases (10 patients), pulmonary 16% (3 patients), and hepatic 11% (2 patients). According to the SIOP classification, 47% of patients were diagnosed in stage III (9 patients) and 21% (4 patients) in stage IV. The tumor was high risk in 37%. Palliative chemotherapy was performed in 63% of the patients (12 patients) and the remaining seven were put on a high risk diet. The overall survival at 5 years was 21% or 4 patients. Conclusion: Our results showed all the difficulties in the management of nephroblastoma relapses in our context.

Introduction: Acute post-infectious glomerulonephritis (APIGN) can be serious due to its complications that still occur in our countries. In this work, we aimed to study the epidemiological, clinical, biological and evolutionary aspects of APIGN. Patients and methods: We conducted a retrospective, descriptive study from January 1 st , 2015 to December 31 st , 2017 in the pediatric ward of the Gabriel Touré Teaching Hospital in Bamako. All children hospitalized for APIGN were included. Results: In two years, we included 10 children aged 7 years old on average; all from low socioeconomic backgrounds. The sex ratio was 1.5. On average, the children spent 15.8 days before our consultation. Edema was the main reason for consultation. We found a history of infection and high blood pressure in 30% each, and renal failure in 10% of the children. Hematuria and proteinuria were detected in 100% and 90%, respectively. Hypocomplementemia was observed in 66.6%. One third of the children had a positive antistreptolysin O. The average duration of hospital stay was 11.2 days. The evolution was favorable in 90%. Kidney failure was the leading cause of death. Conclusion: Acute post-infectious glomerulonephritis is still a reality in our context. Emphasis should be put on its prevention by improving the hygienic conditions, detection and the management of infections.