Background: Infants with latent tuberculosis are often subject to high morbidity, nutritional deficiency and mortality. Early treatment can prevent the onset of TB by reducing morbidity and improving nutritional status. This paper assessed whether preventive chemotherapy for TB can improve health and nutritional status of infants diagnosed with latent TB in Kisangani City. Method: Children diagnosed TB+ by tuberculin skin test and other clinical examinations were treated with Rifampicin, Isoniazid, Pyrazinamide and Ethambutol. Clinical symptoms and nutritional status were determined before to start treatment and at the 5 th month of treatment. Results: Out of 161 infants treated, 73 (45.3%) were <1 year old, 49 (30.4%) were 1-2 years old and 39 (24.2%) were 3-5 years old. Both boys and girls were almost equally represented (50.3/49.7%). The proportion of infants with fever (T > 37˚C) was 62.7% before treatment and 17.4% at the 5 th month of treatment; the difference was statistically significant (p < 0.001). Similarly, the proportion of children with weights below the ideal weight adjusted for each age decreased from 21.7% before treatment to 8.1% after treatment. Infants younger than one year were more likely to have fever than older children, while girls were more likely to be malnourished than boys (p < 0.05) before treatment, but the recovery rates were not different. Conclusion: Treatment of infants diagnosed of latent TB prevents TB disease and improves nutritional status, but not in all cases. Control of fever and weight gain can be an indicator of good How to cite this paper:
Aims: To determine patterns of childhood mortality and its trends over a 4 years’ period in a private pediatric hospital. Study Design: A cross-sectional descriptive study. Place and Duration of Study: Study conducted in the Nouveau Village de Pédiatrie (NVDP), in Kisangani town, Democratic Republic of Congo, between June 2014 and June 2018. Methodology: Socio-demographic, clinical and biological data of children of 0-16 years were retrospectively recorded. Descriptive statistics were used to analyse patterns of childhood mortality and its trends during the four years’ period. Results: From June 2014 to June 2018, 3789 children of 0 to 16 years were hospitalised in the Nouveau Village de Pédiatrie. The global mortality was 16.1% in 2014 and 2.4% in 2018. Mortality within 24 hours of admission was 58%. Neonatal mortality decreased from 22.4% in 2014 to 7.4% in 2018. The leading diagnosis was neonatal causes: sepsis, prematurity, neonatal asphyxia, severe, congenital abnormalities. Most of older children died from severe pneumonia, meningitis, severe anaemia and severe malaria. Severe pneumonia was the most frequent and common cause of children death in all ages. Conclusion: Microbiological data, point of care exams, high quality antimicrobials and antibiotic stewardship in antimicrobial prescribing had a great impact in the significant reduction of childhood mortality in the Nouveau Village de Pédiatrie. Efforts must be focused on the reduction of neonatal mortality.
Aims: To present features of two cases of diabetes keto-acidosis observed in the Nouveau Village de Pédiatrie, Democratic Republic of Congo (DRC), between 2014 and 2018. Cases Presentation: The first case was a male patient, 13 years-old, who arrived with fever, vomiting, polyuria, unconsciousness, respiratory distress and coma. His fasting plasma glucose was 570 mg/dl. Urea nitrogen 56,4 mg/dl; Creatinine 2,1 mg/dl. C reactive protein was 27 mg/l. The treatment of diabetes ketoacidosis (DKA) was based on insulin, fluids and antibiotics. Despite glycemic normalization, he died with cerebral edema and sepsis. The second case was a female child of 6 years, received with fever, polydipsia, asthenia, polyuria, a familial history of diabetes. Random plasma glucose was 500 mg/dl and C reactive protein 10 mg/l. Despite insulin and antibiotics, her clinical state worsened by a pyelonephritis and pulmonary edema and, probably tuberculosis. She also died. Conclusion: Diabetes mellitus type 1 in children, complicated with DKA and sepsis, have worse prognosis. More children death would be avoidable by correct global treatment including insulin and hydro-electrolytic balance to prevent cerebral or pulmonary edema. Children with tuberculosis should realize routine screening for diabetes mellitus and inversely.
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