Les séquelles motrices et sensorielles du neuropaludisme chez l’enfant à Kinshasa, bilans et perspectives de prise en charge

Abstract

ObjectiveIdentify and evaluate the severity of post-neuropaludism motor and sensory sequelae in children in Kinshasa, the scales used to quantify them, and the effective rehabilitation techniques used to manage them. MethodologyThis is a multicenter, transversal and descriptive study, carried out in Kinshasa, during the period from July to September 2019. It consisted in evaluating the frequency and severity of motor and sensory sequelae in children aged 0 to 15 years, within three weeks of an episode of neuropaludism with sequelae. Prior informed consent had been obtained from their parents. ResultsThe frequency of post-neuropaludism motor and sensory sequelae in Kinshasa was 33%. Spastic hypertonia was the most objective tone disorder in 78.8% of patients. Dysarthria and aphasia were the most objective language disorders in 42.4 and 24.2% of cases. Late consultation (87.0%) and convulsions (78.3%) significantly influenced the severity of hypertonia and severity of sequelae. In 93.9% of the cases, no evaluation scale was applied in patients undergoing rehabilitation. Only in patients of the university hospital of Kinshasa (6.1%), the scales were realized and benefited from the protocol including all other rehabilitation techniques according to our perspectives, with a satisfactory evolution. ConclusionPost-neuropaludism motor and sensory sequelae are present in Kinshasa but are very insufficiently evaluated, with inadequate management increasing their severity. So, the need for a standard protocol, advocating prior assessments through specific measurement scales as well as early and multidisciplinary management.