Regional University Teaching Hospital Research Articles

Blood bank programs and transfusion sustainability. A serial mediating model

IntroductionResearchers establish that the current challenges of blood safety and shortage are based on relationship between master production scheduling and blood transfusion sustainability of blood banks. ObjectiveThe objective of this study is to evaluate program relationship between master production scheduling and blood transfusion sustainability through total quality management and blood production. MethodsA survey questionnaire was adopted with staff from regional and government university teaching hospital blood banks. Simple random sampling was used to collect data from respondents. Preliminary and main data analysis was done using SPSS AMOS23. ResultsThe results revealed that master production scheduling influence blood transfusion sustainability when serially mediated by total quality management and blood production with 34% variation change at 95% confidence interval. Again, the results obtained show that master production scheduling influence total quality management significantly. Furthermore, total quality management influence blood production significantly. Finally, blood production influence blood transfusion sustainability significantly. Conclusion and recommendationsMaster production scheduling program actions has a positive significant relationship with blood transfusion sustainability through total quality management and blood production programs as serial mediators. This research contributes to the management of blood banks and suggests to have a greater relational management of total quality management, blood production and master production scheduling program actions in order to achieve high levels of blood transfusion sustainability, and in general, a greater benefit for society.

The mediation effect of total quality management on the relationship between master production schedul-ing and blood transfusion sustainability in Uganda

This paper seeks to examine the relationship between determinants of blood transfusion sustainability (BTS) that is master production scheduling (MPS) and total quality management (TQM) of Uganda. The study was founded on four objectives. The study looked at the direct relationship between MPS and the BTS, direct relationship between MPS and TQM, direct relationship between TQM and BTS. It also assessed how TQM mediated the direct relationship between MPS and BTS. The study used a quantitative method. A survey questionnaire was administered to collect data from 367 staff of regional blood banks and government university teaching hospital blood banks; and 213 were found to be usable. The main analysis was done using structural equation modeling. The study found that MPS had a positive and significant relationship with the BTS. The study found that the relationship between MPS and TQM was positive and significant. The study also found that the relationship between TQM and BTS was positive and significant. The study concluded that the effect of MPS on BTS was not mediated by TQM. It was recommended that blood banks seeking to achieve transfusion sustainability must invest in understanding the sector in which they operate. This includes understanding the blood demand requirement, customer focus, people involvement and timely delivery. The various stakeholders in the blood supply chain i.e. blood banks, hospital blood banks, funding agents, ministry of health, must also integrate to enhance the transfusion sustainability. Blood banks performance measures essentially timely delivery was very critical for saving lives of patients in need of blood. The study has provided a new conceptual framework that investigates the TQM mediating effect on the relationship of MPS and BTS, and thus can serve as an incentive for more research to be conducted in this regard in blood banks of different developing countries. The authors also proposed identifying the effect of other TQM factors such as process management, system management, supplier relationship and top management on BTS.

The mediation effect of blood production on the relationship between master production scheduling and transfusion sustainability in Uganda

Background: This paper examines the relationship between determinants of blood transfusion sustainability (BTS) that is master production scheduling (MPS) and blood production (BP) of Uganda. The study was founded on four objectives. The study looked at the direct relationship between MPS and the BTS, direct relationship between MPS and BP, direct relationship between BP and BTS. It also assessed how BP mediated the direct relationship between MPS and BTS. The study used a quantitative method. Methods: A survey questionnaire was administered to collect data from 367 staff of regional blood banks and government university teaching hospital blood banks; and 213 were found to be usable. The main analysis was done using structural equation modeling. Results: This study found that MPS had a negative and insignificant relationship with the BTS. The study found that relationship between MPS and BP was positive and significant. The study also found that relationship between BP and BTS was positive and significant. The study concluded that the effect of MPS on BTS was fully mediated by BP. It was recommended that blood banks seeking to achieve transfusion sustainability must understand the sector in which they operate. The various stakeholders in the blood supply chain ie blood banks, hospital blood banks, funding agents, ministry of health, must also integrate to enhance the transfusion sustainability. Blood banks performance measures essentially timely delivery was very critical for saving lives of patients in need of blood. Conclusion: The study has provided a new conceptual framework that investigate the BP mediating effect on the relationship of MPS and BTS, and thus can serve as an incentive for more research to be conducted in this regard of different developing countries. The authors also proposed identifying the effect of other BP factors such as blood donor management and hospital transfusion practices on BTS.

The mediation effect of blood production on the relationship between master production scheduling and transfusion sustainability in Uganda

Background: This paper examines the relationship between determinants of blood transfusion sustainability (BTS) that is master production scheduling (MPS) and blood production (BP) of Uganda. The study was founded on four objectives. The study looked at the direct relationship between MPS and the BTS, direct relationship between MPS and BP, direct relationship between BP and BTS. It also assessed how BP mediated the direct relationship between MPS and BTS. The study used a quantitative method. Methods: A survey questionnaire was administered to collect data from 367 staff of regional blood banks and government university teaching hospital blood banks; and 213 were found to be usable. The main analysis was done using structural equation modeling. Results: This study found that MPS had a negative and insignificant relationship with the BTS. The study found that relationship between MPS and BP was positive and significant. The study also found that relationship between BP and BTS was positive and significant. The study concluded that the effect of MPS on BTS was fully mediated by BP. It was recommended that blood banks seeking to achieve transfusion sustainability must understand the sector in which they operate. The various stakeholders in the blood supply chain ie blood banks, hospital blood banks, funding agents, ministry of health, must also integrate to enhance the transfusion sustainability. Blood banks performance measures essentially timely delivery was very critical for saving lives of patients in need of blood. Conclusion: The study has provided a new conceptual framework that investigate the BP mediating effect on the relationship of MPS and BTS, and thus can serve as an incentive for more research to be conducted in this regard of different developing countries. The authors also proposed identifying the effect of other BP factors such as blood donor management and hospital transfusion practices on BTS.

Progression of Frequency and Lethality of Severe Malaria from 2017 to 2020 in the Pediatric Unit of CHUD-Parakou (Benin)

Background: The latest WHO report shows a decline in the performances achieved concerning the fight against malaria since 2017. This research work aimed to investigate the progression of frequency and lethality due to severe malaria from 2017 to 2020 in the pediatric unit of the Borgou University Teaching Hospital in Parakou (CHUD-Parakou). Patients and Methods: This research work is a descriptive and analytical case-control study focused on all the children aged 1 month and more, hospitalized in the pediatric unit of CHUD-Parakou from January 1, 2017, to December 31, 2020. Recruitment criteria were the following: be admitted to hospital during the period specified above; have a usable medical record containing the diagnosis and type of discharge, and the findings of thick smear examination and/or of a rapid diagnostic test. Sampling was complete and takes into account all the medical records of children meeting the inclusion criteria. Epi Info 7.2.2 was the software used to perform data processing. Results: The frequencies of severe malaria in the unit were estimated at 19.89%, 22.65%, 29.65% and 27.51% respectively in 2017, 2018, 2019 and 2020. Lethality rates varied from 7.76% to 8.68 from 2017 through 2020. The death risk associated with severe malaria was 3.08 times higher in children suffering from severe acute undernutrition. Conclusion: Despite all the efforts made by the health authorities and the technical and financial partners, the frequency and lethality of severe malaria are increasing in the pediatric unit of the B/A Regional University Teaching Hospital (CHUD-B/A). It is therefore worth investigating the determinants of this situation.

The University of Vermont Larner College of Medicine.

The University of Vermont Larner College of Medicine.

Clinico-epidemiologic review of 91 cases of non-odontogenic sarcomas of the orofacial region in a Nigerian population

Introduction: Sarcomas are a rare group of malignant tumors. This study highlights important findings in 91 cases of non-odontogenic sarcomas of the orofacial region. Materials and Methods: Patients who presented with orofacial sarcoma at the Oral and Maxillofacial Surgery Department of a regional University Teaching Hospital between January 1997 and June 2017 were retrospectively studied. Excluded were cases of Kaposi and odontogenic sarcomas. Data obtained were analyzed using the Statistical Package for Social Sciences (SPSS) version 16 (SPSS Inc., Chicago, IL, USA). Results from descriptive statistics were represented in the form of charts. Results: A total of 91 cases were reviewed and consisted of 51 (56.0%) males and 40 (44.0%) females, with a male to female ratio of 1.3:1. The mandible (n=47; 51.6%) and the maxilla (n=26; 28.6%) were the major sites involved. Osteogenic sarcoma (n=44; 48.4%) and rhabdomyosarcoma (n=16; 17.6%) occurred more frequently. A total of 41 (45.1%) patients had surgery and the common hard tissue procedures were mandibulectomy (n=26; 28.6%) and maxillectomy (n=10; 11.0%). Non-surgical oncological treatment was administered to 32 (35.2%) patients, and this was the only modality of treatment in 8 (8.8%) cases. The period of follow-up Arranged from 1-43 months and within this period; there were 7 (17.1%) recurrences with 1 case of pulmonary metastasis. Discussion: Most recurrences were noted less than one-year post-treatment. There is a tendency for patients to present late and compliance with follow up review is poor in this environment.

Profile of Children Born to HIV-Positive Mothers Followed-up in the Borgou/Alibori Regional University Teaching Hospital from 2005 to 2015

Introduction: Prevention of Mother-to-Child Transmission (PMTCT) of HIV is the best strategy for fighting pediatric HIV in developing countries. This study’s main objective was to describe the outcome of children born to HIV positive mothers, attended and followed up through the PMTCT program in the Borgou/Alibori Regional University Teaching Hospital (CHUD-Borgou/Alibori) from 2005 to 2015. Secondly, it aimed to identify factors associated with mother-to-child transmission of HIV at 18 months of age. Patients and Methods: This research work is a cross-sectional, retrospective, descriptive and analytical study of a cohort of children born to HIV-infected mothers and followed up in the pediatric ward of the Borgou/Alibori Regional University Teaching Hospital. It was conducted from May to December 2016 on the basis of data retrieval from medical records and registers. Results: Total of 1234 children was included in the study. Exclusive breastfeeding was the main source of nutrition for 91.6% of children. Antiretroviral prophylaxis was received by 82.7% of children at birth. 49.4% of the 1234 children (610/1234) were followed up till 18 months of age; 36.5% were lost to follow-up and 4.1% died. Overall rate of mother-to-child HIV transmission was 5.6% (34/610), of which 1.8% (9/509) was among children who received antiretroviral prophylaxis at birth. Two predictive factors for mother-to-child transmission of HIV were absence of clean and safe childbirth and lack of antiretroviral prophylaxis in children at birth. Conclusion: Improved antenatal care quality and efficient childbirth management with early mothers’ adherence to pediatric follow-up may help reduce vertical HIV transmission in this study environment.

Congenital Malaria in the Borgou/Alibori Regional University Teaching Hospital: Myth or Reality?

Introduction: The occurrence of malaria is classically described as uncommon or exceptional in the neonatal period. This work aims to describe the epidemiological, diagnostic, therapeutic, clinical features and outcomes of congenital malaria in the Borgou/Alibori Regional University Teaching Hospital (CHUD B/A) located in Parakou. Patients and Methods: This research is a cross-sectional and descriptive study that was conducted in the neonatal intensive care unit of the CHUD B/A from January to December 2017. It included and involved all newborns less than eight (08) days old with positive thick smears. Comorbidities were taken into account to establish the diagnosis of congenital malaria with accuracy. Findings: A total of 170 newborns out of 892 newborns admitted tested positive with Plasmodium falciparum thick smears, i.e., a hospital-based frequency of 19%. The sex ratio was 1.1. The mean age was 22.44 ± 2.72 hours. There was malaria-bacterial infection comorbidity in 39.3% of cases. Among the 91 cases of thick smears testing positive without stigma of bacterial infection, G6PD deficiency and fetal-maternal Rhesus incompatibility, the main reasons for admission were prematurity (51.6%), low birth weight (44%), neonatal distress (31.8%) and respiratory distress (15.3%). In addition, the main signs found during the physical examination were neurological disorders or impairments (43.9%), respiratory distress (30%), hyperthermia (12.1%) and jaundice (4.4%). The mean or median parasitemia was 490 parasites/μl, with extremes ranging from 100 to 6500 parasites/μl. Treatment was based on artemisinin derivatives. The patient condition improved in 88.7% of cases. Overall mortality was estimated at 11.9%, and the specific mortality was 13.2%. Conclusion: Congenital malaria is a reality that actually prevails in the CHUDB/A. It has become vital and urgent to explore innovative, effective and efficient strategies to ensure its management and prevention. A study using PCR as the gold standard should be conducted to better assess the extent and magnitude of the disease.

Fibrous histiocytoma of the orofacial region in Nigerians: A retrospective review of 11 cases

Background: Fibrous histiocytoma (FH) is a rare tumor that may exhibit benign, borderline, or malignant features. It has a site predilection for the skin of the extremities. Occurrence in the orofacial area is very rare. Objective: This review highlights the clinic-epidemiologic characteristics of 11 patients with orofacial FH (OFH) diagnosed at a tertiary health facility Materials and Methods: All cases with a histological diagnosis of OFH seen at the oral and maxillofacial surgery clinic of a regional university teaching hospital in Nigeria between May 1995 and June 2016 were retrospectively studied. Data retrieved were analyzed using the Statistical Package for the Social Sciences version 16 (SPSS Inc., Chicago, IL, USA). Findings from descriptive statistics were represented in the form of tables and charts. Results: Eleven patients were seen within the years reviewed, and the most common clinical presentation was jaw swelling. There were gender and site predilections for male individuals and mandible, respectively. Surgery was the main modality of treatment used and this consisted of maxillectomy (n = 1; 9.1%), mandibulectomy (n = 3; 27.3%), soft-tissue excision (n = 2; 18.2%), and a combination of jaw resection with soft-tissue excision (n = 1; 9.1%). Two patients (18.2%) presented with recurrence 1 year and 5 months postsurgery, respectively. Conclusions: OFH is rare. Early diagnosis and adequate margin of excision/resection at the first surgery is important in achieving control, and long-term follow-up remains the rule.

Prevalence of traumatic injuries visiting the emergency department of a regional university teaching hospital in Nigeria

Background: Traumatic injuries are important causes of death and disability among adults and children. Trauma is one of the most common causes of emergency department visits in most part of the world. Objectives: The objective of the study is to evaluate the prevalence of the traumatic injuries in the accident and emergency department of our institution, to establish the burden of traumatic injuries. Patients and Methods: The study spans over 2 years, January 2013–December 2014. Patient's biodata, type of injuries sustained, etiology of injuries, and rate of patient transfer to the wards were extracted from the emergency department attendance and transfer registers and entered into a designed questionnaire. Statistical analysis was with SPSS version 20. Results: Of the 11,393 patients who visited the emergency department during the study, 2381 (20.90%) were traumatic injury patients. The mean age was 29.25 years ± 1.57 STD. Road traffic accidents (RTA) constituted 1200 (50.40%) of all traumatic cases, followed by assaults and falls which constituted 449 (18.86%) and 174 (11.17%) respectively. The part of the body mostly affected by injury was the head 478 (20.1%) patients. A total of 757 (31.8%) cases of traumatic injury were transferred to the hospital ward after being stabilized in the emergency department. Conclusion: This study had highlighted the burden which traumatic injuries and especially RTA imposed on the health facility and the need to provide adequate resources and increase the staff strength for smooth running of the emergency department.

Factors Associated with Perinatal Mortality in Africa

Background: Pregnancy in the society is a typical sign and a promise to gain a new member of the family and celebrations as well, unlike in poor world pregnancy are sometimes associated with problems. Unfortunately cause death of the newborn immediately after birth or few days before delivery. Critical Review: In this article review four articles were reviewed for the factors affecting perinatal mortality, according to Abdoulaye Hama DIALLO’s study titled as Epidemiology of perinatal mortality in rural Burkina Faso, three main risk factors were the young age of the mother where mothers younger than 20 had odds ratio of OR=2.93, the season of birth with OR of 1.85, and the intention to EBF with OR of 1.7., we argued that, the focus was to be cause of home delivery despite of 99% ANC attendance. According to two different retrospective studies conducted in Nigeria in years 2003, 2004, 2005, 2008 and 2013, which were Perinatal Mortality in Southern Nigeria and First-day and Early Neonatal Mortality in Nigeria, both studies demonstrated a constant perinatal mortality that doesn’t improve over the study period. unbooked pregnancies resulting in difficult labors, ruptured uterus, chorio-amnionitis, preterm or low-birth weight babies and severe neonatal asphyxia, outside the hospital deliveries , c-section delivery, being twins and low antenatal visits were risk factors highlighted , ANC again was an issue to be argued about to cause the constant mortalities. According to d’Almeida M1, Noudamadjo A, Obossou AAA, Agossou J, Adedemy JD2 2013 describing perinatal morbidity and mortality in the Regional University Teaching Hospital of Borgou (Benin), the study identified acute fetal suffering and premature rupture of the membranes as the common morbidities and ½ of registered women come for delivery themselves among them only 58.90% attended ANC 4 times, which significantly poor follow up of pregnant women who were to be transferred in active ANC system. According to Aimable Musafili and his colleagues in 2013, conducted an audit research in Rwanda reviewing perinatal deaths at hospitals in Kigali, Rwanda, results showed that Out of 8424 births, there were 269 perinatal deaths giving a stillbirth rate of 20/1000 births and a perinatal mortality rate of 32/1000 births, furthermore factors contributing to mortality were highlighted as delay in care-seeking was identified in 39% of deaths, delay in arriving at the health facility in 10%, and provision of suboptimal care at the health facility in 37%. The argument was that, insufficient care is more likely to be brought by shortage of staff. Therefore concrete measures and their implementation should be put in place followed via multidimensional bnhuycollaborations to eliminate preventable causes of perinatal mortality.

Frequency and Sociodemographic Factors Associated with Congenital Malaria at the Borgou Regional University Teaching Hospital (CHUD-B) in Benin in 2015

Background: Every minute a child dies from malaria in Sub-Saharan Africa. Despite this high infant and child mortality associated with malaria, congenital malaria is still not adequately understood as regarding its frequency, severity and management. The objective of this research work was to determine the frequency and identify the socio-demographic factors associated with the onset of congenital malaria at the gynecological and pediatric units of the Borgou Regional Teaching Hospital (CHUD-B) in Benin in 2015. Methods: This study was a cross-sectional survey with analytical purpose, based on exhaustive census performed from April to July 2015 on newborns delivered at CHUD-B and their mothers. The dependent variable was the presence of congenital malaria and the independent variables were socio-demographic characteristics. The data were processed and analyzed using Epi Info software version 7.0 with a significant threshold of 0.05. Findings: The frequency of congenital malaria in newborns was 19%. No sociodemographic factor was associated with congenital malaria. Conclusion: Nearly one in five newborns delivered at CHUD-B had congenital malaria. Due to malaria’s contribution to perinatal morbidity and mortality and subsequent receptivity of child victims to malaria, a longer study covering a whole year and focused on the determinants of congenital malaria should be carried out.

Acute Renal Failure during Progressive Systemic Sclerosis in the Regional University Teaching Hospital of Brest-La Cavale Blanche (France)

Systemic scleroderma is a rare disease in which visceral manifestations occur, particularly peripheral vascular, digestive, cardiopulmonary and renal. It is pathology with a predilection for women. The present clinical case is that of a man with the renal complications of scleroderma and the difficulties of the treatment even in the developed countries like France. In the present case, the management of this disease required a high dose of corticosteroid therapy and extra-renal purification. Early detection of complications through a minimal clinical examination supplemented with paraclinic tests has proved necessary.

Epidemiological, Clinical, Biological, Therapeutic Features and Outcome of Congenital Malaria at the Borgou Regional University Teaching Hospital (CHUD-B) in Benin in 2015

Background: The prevalence of congenital malaria is getting more and more significant in Sub-Saharan Africa where is a malaria-endemic area. This study aimed to identify the clinical and therapeutic features as well as the outcome of congenital malaria in CHUD-B in 2015. Method: It was a cohort and descriptive study with analytical purpose, carried out in the Mother and Child Department which includes the Gynecology & Obstetrics and Pediatric Unit of CHUD-B. The study target population consisted of all the infants born in the CHUD-B as well as their mothers. The main variable was the presence of congenital malaria. The independent variables were those related to clinical, therapeutic features and outcome. Results: In the study, among the 300 newborns registered, 57 carried congenital malaria i.e. a prevalence of 19%. 171 (57.0%) of them were males versus 129 (43.0%) females. Among the 281 mothers involved, 48 presented with malaria in pregnancy i.e. a prevalence of 17.0%. At the end of this research work, the factors associated with congenital malaria were fever in the 3rd quarter and malaria in pregnancy in the mother. Conclusion: Nearly one out of five infants born in the CHUD-B was carrier of congenital malaria and approximately one out six mothers presented with malaria detection during pregnancy. A method based on Polymerase Chain Reaction (PCR) should be implemented during the diagnosis in order to confirm malaria cases among both newborns and mothers.

Central Myxoma / Myxofibroma of the Jaws: A Clinico-Epidemiologic Review.

Myxomas are a group of benign rare tumors of connective-tissue origin that occur in both hard (central) and soft tissues of the body. The aim of this study is to highlight our experience in the management of central myxoma of the jaw, with emphasis on its clinic-epidemiologic features as seen in our environment. All patients who were managed for central myxoma of the jaw at the Oral and Maxillofacial Surgery department of a regional University Teaching Hospital between September 1997 and October 2015 were retrospectively studied. Details sourced included age, sex, site of tumor, duration, signs/symptoms, treatment given, and complications. Data were analyzed using Statistical Package for Social Sciences (SPSS) version 16 (SPSS Inc., Chicago, IL, USA) and Microsoft Excel 2007 (Microsoft, Redmond, WA, USA). Results from descriptive statistics were represented in the form of tables and charts, with a test for significance (ρ) using Pearson Chi-square (χ2) set at 0.05. A total of 16 patients were managed within the period reviewed, consisting of 10 (62.5%) females and six (37.5%) males, giving a male-to-female ratio of 1:1.7. The ages of patients ranged from 5 to 70 years, with a mean of 27.06±15.45 years. The mandible accounted for nine (56.3%) cases and the maxilla for six (37.5%) cases, while a combination of the maxilla and the zygoma were involved in one (6.3%) case. Bucco-lingual or bucco-palatal expansion were the most common presentation (six [46.2%] cases each). Histological assessment of tissue specimens showed that fibromyxoma accounted for seven (43.8%) cases, while the remaining nine (56.3%) cases were diagnosed as myxoma. All patients had jaw resections, and these consisted of mandibulectomies in nine (60.0%) patients and maxillectomies in six (40.0%) patients. The duration of hospital stay ranged from 5 to 29 days, with a mean of 17.86±7.68 days. Complications were noted in three patients, and all were surgical wound infections. Most patients in our environment present late with large tumors and are usually not compliant with follow-up review. Thus, a radical approach is favored in most patients.

Perinatal Morbidity and Mortality in the Regional University Teaching Hospital of Borgou (BENIN) In 2013

Introduction: Perinatal mortality is still high in the developing countries, with a significant proportion for early neonatal mortality. Its reduction depends on identification of causes in view of priority actions to achieve the fourth Millennium Development Goal. Objective: Describe perinatal morbidity and mortality in the major hospital facility of North-Benin. Settings and method: It was a cross-sectional, descriptive and prospective study conducted over the period from March 1 through August 31, 2013 in the Mother & Child Unit of the Borgou Regional University Hospital (CHUD-Borgou) located in Parakou i.e. in the North-Benin. Findings: Perinatal mortality rate was 153.55% still birth rate 87.39% and early neonatal mortality rate 66.16%. Fetal suffering (48.21%), morbidity associated with fetal membranes, through premature rupture of the membranes (60.58%) and neonatal morbidity through neonatal infections (26.32%) were the leading causes of fetal morbidity. Fetal suffering (31.43%) was the leading cause of late fetal deaths; and neonatal infections (33.96%), prematurity (28.30%) and perinatal asphyxia (18.87%) were the leading causes of early neonatal deaths. Conclusion: Perinatal mortality is high in the Borgou Regional University Teaching Hospital (CHUD). Its reduction requires a holistic approach based on new-born care policy

Serotypes of Bacteria Encountered in Childhood Purulent Meningitis in Children in Parakou (Benin) in 2011

Introduction: In the North-Benin, there are three agents causing pediatric purulent meningitis outside the neonatal period. These are: Streptococcus pneumoniae, Neisseria meningitidis and Haemophilus influenzae type b. The aim of this research work was to investigate bacteria serotypes that caused childhood purulent meningitis in the pediatric unit of the Borgou a Regional University Teaching Hospital (CHUD-Borgou) located in Parakou (North-Benin). Patients and Methods: Through a prospective and descriptive study centered on children aged 0 to 5 years old suspected of meningitis and hospitalized, the cerebrospinal fluid (CSF) samples of those children were analyzed at the WHO reference laboratory in Banjul for serotyping by real time polymerase chain reaction (RT/PCR). Results: Among the 1396 children hospitalized during that period, 366 were suspected of meningitis and had benefitted from lumbar puncture. Among those 366 suspected cases, 51 cases of purulent meningitis were confirmed after CSF cytobacteriological and biochemical test at the CHUD-Borgou laboratory. Among 51 CSF samples in which purulent meningitis was confirmed, 44 were sent to Banjul. In addition, 310 CSF samples from non-confirmed cases of meningitis were also sent to Banjul. In the whole set of samples sent for real time PCR, 151 cases of Streptococcus pneumoniae (42.7%) were found, 5 cases of Neisseria meningitidis (1.4%) and 1 case of Haemophilus influenzae (0.3%) were also encountered. As regards Streptococcus pneumonia, the serotypes encountered were: 1, 3, 4, 5, 7F, 8, 9V, 9V/9A, 9N/9L, 14, 18C, 19A, 23F, 33F as well as non typed and non typable serotypes. As for Neisseria meningitidis, only serogroup A was found in it. For Haemophilus influenzae, only serotype b was identified. Conclusion: Four non vaccine serotypes (8, 9V/9A, 9N/9L and 33F), non typed and non typable serotypes which are not covered by 13-valent pneumococcal conjugate vaccine (PCV 13) were identified. This highlights the need to enhance surveillance of pediatric purulent meningitis and serotyping by RT/PCR of all CSF samples in order to adapt if necessary future new pneumococcal vaccines to circulating non vaccine serotypes.

Interest of Prevention of Immediate Postpartum Hemorrhage with Misoprostol during Cesarean Section

Objective: The purpose of this study was to compare the efficacy of sublingual misoprostol to oxytocin for the prevention of Immediate Postpartum Hemorrhage (IPPH) during caesarian section in the Borgou Regional University Teaching Hospital (CHUDB). Methods: It was a prospective randomized controlled clinical trial conducted over a period of 6 months from January 26 to July 26, 2015, on 230 female patients meeting inclusion criteria: cesarean section on term singleton pregnancy, under spinal anesthesia, without any bleeding. The patients were selected at random and divided into two groups: the first group had received 600 micrograms (μg) of misoprostol by sublingual route during umbilical cord clamping; the second one was administered 20 UI of oxytocin through intravenous route. The primary endpoint was drop in hematocrit. The secondary endpoints were drop in hemoglobin level, perioperative blood loss and postoperative complications. Findings: The socio-demographic and obstetrical characteristics of both groups’ patients were comparable. Average drop in hematocrit was identical: 0.05 ± 0.04 in both groups (p=0.573). The same applies to mean hemoglobin level: 1.7 ± 1.2 g/dl (p=0.886). As well, no significant difference was noted in average blood loss between the misoprostol group and the oxytocin group, respectively 281.8 ± 124.4 ml and 282.2 ± 120.8 ml (p=0.271). The incidence of side effects such as fevers and chills was significantly higher in the misoprostol group, respectively (79.1% vs. 9.6% and 79.1% vs. 0.0% p<0.001). However, those side effects were tolerable. Conclusion: 600 μg of misoprostol dose by sublingual route is also as effective as oxytocin in the prevention of postpartum hemorrhage without significant side effects.

Management of Severe Burns in Children at the Intensive Care Unit of the Borgou Regional University Teaching Hospital (CHUD-B) in Benin

Background: Severe burns in children are common and their mortality is very high, particularly in developing countries. Objective: This study aims to investigate the epidemiological, clinical and therapeutic aspects of severe burns admitted to the CHUD-B intensive care unit. Patients and methods: It was a case-control study with descriptive and analytical purpose carried out in the CHUD-B from January 1st, 2010 to December 31, 2014. The study involved patients under 15 years of age with severe burns admitted to the intensive care unit. Findings: Among the 65 patients hospitalized for severe burn, 49 were children i.e. 75.3%. The mean age of burned children was 3.5 years (2 months and 12 years as extremes). Children under 5 years of age represented 71.4%. Males were predominant (57.1%). Average waiting time for admission after accident was 2 hours. Burn was accidental and most burns occurred at home (93.9%). The causative agent was thermal (100%); scalding represented 67.3%, and then flames 32.7%. Average body surface area burned (BSAB) was 30% and 2nd degree burns represented 95.9%. At the scene of the accident 46.5% of patients had received care. Treatment consisted of occlusive dressing with Biafine® and vascular filling. The administration of analgesic and antibiotics was systematic. No surgical treatment was provided. The average length of stay in the intensive care unit was 7 days. Complications were noted in 73.5% of the patients. Anemia (75.0%), hypovolemic shock (33.3%) and local infection (22.2%) were the main complications. Mortality rate was 40.8%. This high mortality was correlated to three major complications with P value less than 0.05. These complications were: hypovolemic shock, pneumonia and septicemia. Conclusion: Severe burn is life-threatening for the child. Primary prevention is the best way to combat against that condition.