Sudanese journal of paediatrics最新文献

Background: Acute gastroenteritis (GE) is a clinical syndrome and harbours a significant global burden. Nosocomial acquisition of gastroenteritis results in a significant economic burden. We aim to determine gastroenteritis frequency, disease severity, nosocomial acquisition and clinical spectrum in our region for 2016-2017.

Methods: This is a prospective study of all children up to 3 years of age who presented to Mayo University Hospital with vomiting and diarrhoea, from 18 November 2016 to 18 November 2017. All children had their clinical severity of gastroenteritis assessed using the internationally recognised Vesikari scoring system.

Results: A total of 159 cases were detected, 157 were studied, 87 were male (55%) and 90 were severe (57%). Nosocomial gastroenteritis is rare (2 cases) (1.1%); 129 cases were admitted and the majority of paediatric gastroenteritis cases (68%) stayed between 1 and 2 days. Diarrhoea was noted in all cases, vomiting in 130 cases (82%), fever in 136 cases (86%) and dehydration in 89 cases (56%). Oral rehydration therapy was successful in 33 cases (21%). The fourth week of June was the peak week of the year for gastroenteritis (7 cases). The largest number of presentations with GE was noted in May (20 cases), followed by December and June (18 cases each) with the largest number of severe GE noted in June (12 cases), followed by December and May (11 cases each).

Conclusion: Diarrhoea is the most predominant feature of gastroenteritis. Acute viral gastroenteritis occurs throughout the year. Seasonal variations of gastroenteritis were noted throughout the year. Nosocomial infection is rare.

Neurological diseases in children may be associated with mortality and long-term morbidity when they recover from acute ailments. The pattern of neurological disorders in an outpatient service may highlight the burden of these diseases. The objective of the present study is to describe the pattern of neurological disorders at the Pediatric Neurology Clinic of Olabisi Onabanjo University Teaching Hospital (OOUTH), Sagamu, Nigeria. A retrospective analysis of consecutive patients in a Pediatric Neurology Clinic of OOUTH, from 1st January 2011 till 31st December 2014, was carried out. A total of 4,476 patients attended the pediatric outpatient unit. Of these, 433 children had neurological disorders with a prevalence of 9.67%. The most frequent pediatric neurological disorders included seizure disorders (37.7%), cerebral palsy (37.7%), and central nervous system infections with complications (6.2%). The subjects with cerebral palsy were the youngest, while the subjects with seizures were the oldest. This study emphasizes that neurological disease contributes substantially to childhood morbidity in a semi-urban African tertiary hospital.

Telehealth (TH) is defined as the entire spectrum of activities used to deliver care remotely. It could either be provider-to-patient or provider-to-provider communications. TH can take place synchronously (via telephone and video), asynchronously (via patient portal messages, e-consults), and through virtual agents (chat) and wearable devices. It has been used to support access to specialised medical advice in remote areas in many countries all over the world. We discuss the potential use of TH Clinics in Sudan and propose guidance for establishing such services. The current pandemic of SARS-COVID-19 has increased the pressure on most health systems. This has challenged and urged for significant changes in the way we provide health care for both COVID and non-COVID cases. There is a great potential for improvement in services in many countries including Sudan with the use of TH.

Subcutaneous fat necrosis (SCFN) is an uncommon cause of neonatal hypercalcaemia. It is usually seen in neonates after a complicated delivery within the first month of life. While uncommon, hypercalcaemia can be fatal. It is characterised by red-purple plaques in fatty points along with firm subcutaneous nodules. Rarely, SCFN may cause severe hypercalcaemia with no visible skin lesion. In this rare case, we report severe infancy hypercalcaemia without characteristic skin lesion on first physical examination, unresponsive to hydration, diuretic, prednisolone and standard dose of pamidronate treatment. As timely diagnosis and treatment are so important, this complication should be kept in mind even in such clinical presentations.

Henoch-Schönlein purpura (HSP) is the most common vasculitis in childhood and is clinically characterised by purpura, abdominal pain, arthritis and renal involvement. Scarcely, some patients with HSP may not always show visible rash and can present with insidious abdominal symptoms. We present two patients: an 8-year-old boy who was initially considered as having infectious diarrhoea and mesenteric lymphadenitis, then intussusception, appendicitis, appendicopathia oxyuriaca and post-operative ileus. However, he was finally diagnosed with HSP, as the typical rash appeared 10 days after onset of abdominal symptoms. The second patient was a 5-year-old boy with recurrent vomiting, abdominal pain and mild dehydration, where swollen joints and typical rash appeared on day 3. Both patients were successfully managed with orally administered corticosteroids. The patients did not have any further consequences of HSP.

Rheumatic heart disease (RHD), a preventable complication of group A beta-haemolytic streptococcal infection, is highly prevalent in Sudan. Echocardiographic (echo) screening has an established role in disease surveillance. This study aims to measure the echo prevalence of RHD using handheld echo (HHE) in West and North Darfur and Kassala states and initiate control programs. School children 10-18 years of age were selected from the three states and HHE screening was performed by trained paediatric residents supervised by cardiologists using a pre-tested protocol. Health worker training and public awareness sessions were carried out. The study was conducted between November 2020 and December 2021. In West Darfur, 1,547 children were screened, echo prevalence was found to be 17.4/1,000, and 22% had moderate to severe disease. In North Darfur, 800 children were screened and echo prevalence was 16.2/1,000, 23% had moderate to severe disease while in Kasala 2,225 children were screened and the prevalence was 3.1/1,000 and all cases were mild. One hundred and fifty-eight health workers were trained and 20,150 people benefited from health education sessions. The prevalence of RHD in Darfur is 5 times more than in Kassala. This may reflect socioeconomic and genetic differences between the two regions. RHD control in Darfur needs to be consolidated, and echo surveillance is an important tool for early detection and the institution of secondary prophylaxis.