Background: Newborn attendance at pediatric emergency departments has sharply increased in France since the early 2000s. Early discharge from maternity is the main risk factor. The purpose of this study was to describe the demographic and perinatal factors involved in the readmission to hospital of newborn babies in Southern reunion Island.Methods: This was a 13-month, single-center, case-control retrospective study (December 2015 to December 2016) carried out in the neonatal and pediatric intensive care units of the Saint-Pierre university hospital. Cases were represented by any newborn released from the maternity hospital and having been re-hospitalized. Controls were represented by newborns born during the same study period and not readmitted during their first month of life. One case was matched with a control.Results: We included 109 newborns. The re-hospitalization rate was 2.08%. The most common presentation were: fever (35.7%), and neurological symptoms (34.8%). The main etiologies were infections (33.9%), respiratory pathologies (24.7%), and breastfeeding difficulties (11.9%). Breastfeeding OR=0.53; 95% CI [0.30-0.92] (p=0.03) and neonatal pathologies during the stay in the maternity hospital OR=0.49; 95% CI [0.28-0.45] (p=0.016) were protective factors.Conclusions: The lack of identification of a risk factor encourages us to expand our study population and to look for other factors such as the medical and paramedical supervision of the mother-child couple during the postpartum period and the follow-up of the new born after leaving the maternity ward.

Background: Acute neonatal renal failure is a health problem. Its risk factors and its clinical and evolutionary profile remain unknown in the Malagasy context. The main objective of this study was to determine its risk factors.Methods: This was a 14 month, single-center, retrospective, case-control study (November 2018 to December 2019). The cases were represented by newborns hospitalized and presenting an hypercreatininaemia (value >133 µmol/l or according to the KDIGO criteria) and controls by neonates without an hypercreatininaemia. One case was matched to 2 controls.Results: We included 75 cases. The prevalence was 14.5%. The mean age was 5±6.78 days (p=0.006). The sex ratio was 1.27. The mean gestational age was 36.69±3.84 WA (p=0.66). The mean serum creatinine value was 180.32 µmol/l. Thirty-one newborns had died (41.3%). The risk factors were: sepsis (OR=9.37, p≤0.001, CI=3.03, 33.5), perinatal asphyxia SARNAT 2 (OR=4.52, p=0.007, CI=1.53, 13.8) and SARNAT 3 (OR=7.90, p=0.021, CI=1.56, 60.4), increased weight loss (OR=4.04, p=0.006, CI=1.51, 11.2) and respiratory distress (OR=2.76, p=0.005, CI=1.37, 5.77).Conclusions: The risk factors were consistent with the data in the literature. Better management of parturients and the newborn as well as monitoring of serum creatinine in hospitalised newborns are recommended.

Background: An increase in the number of children hospitalized for bronchiolitis has been observed on February to April over the past 5 years. This study aimed to describe the bronchiolitis characteristic during the 2019 epidemic as well as its management at the Tsaralalàna Teaching Hospital.Methods: This is a 3 months retrospective descriptive study, from February to April 2019, including all children diagnosed with bronchiolitis.Results: Bronchiolitis was diagnosed in 1704 children (40.1%) and 425(29.4%) were hospitalized. Severe bronchiolitis was found in 212 children (49.9%) which were aged under 3 months in 46.7%. Secondary bacterial infection was noted in 359 children (84.5%) and cardiac failure in 145 children (34.1%). Hypertonic saline 3% was prescribed at 76.4% of children.Conclusions: Younger infant under 3 months were the most frequently admitted in hospitalization. Severe or complicated bronchiolitis are predominant. Using a pediatric plan adapted to bronchiolitis epidemic may improve care of children.

Background: Neonatal bacterial infection is one of the leading causes of new-born morbidity and mortality. Bacterial ecology is not known in our unit, no study has been devoted to this subject. This work aimed to determine the germs responsible for neonatal bacterial infections and their level of sensitivity to the usual antibiotics.Methods: This is a retrospective descriptive study conducted in the Neonatology Department from January 1, 2018 to April 30, 2019 (16 months) including all newborns under 29 days hospitalized during the study period and possessing positive bacteriological results regardless of the site of collection (blood, urine, cerebrospinal fluid).Results: The diagnosis of neonatal infection was confirmed in 47 cases, i.e. 26.1% of suspicions of neonatal bacterial infection hospitalized during the study period. The female predominance was found with a sex ratio of 0.81. The most frequently isolated germs are, in order of frequency, coagulase-negative staphylococci (10 cases), Escherichia coli (7 cases), Enterobacter cloacae (5 cases), Klebsiella pneumoniae (5 cases) and Enterobacter aerogenes (5 cases). Of the 47 cases studied, 16 cases were multidrug-resistant infections including 7 cases i.e. 14.9% of nosocomial infections. The majority of Enterobacteria are strains producing broad spectrum beta lactamases (12 cases to 22). The molecules that remained effective were mainly Imipenem and Amikacin.Conclusions: Neonatal infection remains a real public health problem. The emergence of multi-resistant bacteria complicates the management. The knowledge of bacterial ecology on a wider population is an important asset in its prevention and management.