Archives francaises de pediatrie最新文献

Background: The immediate medical causes of childhood death in developing countries are low birthweight, inadequate nutrition and serious infectious diseases. This report describes the main diseases causing infant mortality in Algeria.

Population and methods: 1% of Algerian household was investigated in December 1989 in a cross-sectional single-interview survey. Sampling was simple random stratified based on the population dispersion, with a second degree cluster for district and household. Questionnaires included 6 data on the deaths: birthdate, day of death, sex, associated factors, diagnosis of the mother, and diagnosis of the survey team.

Results: 32,945 births were registered between 1985 and 1989. There were 1,608 deaths. The main factors linked to these deaths were acute diarrhea (18.4%), acute respiratory diseases (13.8%), premature birth (11.6%). Premature birth was the main factor (31.9%) linked to mortality before the age of 1 month. Factors linked to mortality were not influenced by sex but were influenced by population dispersion. The mortality rate and the factors linked to it remained unchanged between 1985 and 1989.

Conclusions: These results will help target the national program to reduce infant mortality.

Background: A hemolytic-uremic syndrome associated with methylmalonic aciduria and homocystinuria is seen during the first weeks of life. A molecular defect in the CbIC mutation has been found. This report describes a new case with this association.

Case report: A girl, the second in this family, was born at term: her birth weight was 2,100 g, height was 47 cm and head circumference 31.5 cm. She was admitted at 32 days of age with hemolytic anemia and fragmencytosis, renal failure and thrombocytopenia. The renal failure required peritoneal dialysis followed by hemofiltration. The signs of pancytopenia of central origin and liver failure seen at that time raised the possibility of an intracellular defect of B12 metabolism. Chromatography of the amino acids and organic acids in the urine and plasma revealed homocystinemia, hypomethioninemia, homocystinuria and methylmalonic aciduria. The deficient B12 metabolism was confirmed in fibroblasts which showed deficits in both methyl and adenosyl-cobalamin synthesis. The metabolic disturbances were completely resolved after intravenous administration of hydroxy-cobalamin (2,000 micrograms per day) and folinic acid (25 mg per day) for 5 days. But the neurological abnormalities persisted, with retinitis pigmentosa and major leukodystrophic changes seen by MRI, and the infant died one month later.

Conclusion: This new case emphasizes the importance of systematically screening all cases of neonatal hemolytic-uremic syndrome for this autosomal recessive disorder.

Background: Belgian growth standards have until now been based on cross-sectional studies. This paper describes the first Belgian longitudinal growth standards for height and height velocity and recent cross-sectional standards of weight-for-age.

Population and methods: The study was conducted between 1955 and 1975, initially on 259 Belgian boys and girls born in Brussels between 1955 and 1958. Only 48 boys and 50 girls were still being checked for height and weight at the end of the study. The distance charts show the classical centile lines; the height standards are provided with growth curves for the typical early average and late-maturing child in the population. The velocity charts show centiles for whole-year increments in height. Individual-type velocity curves are also provided.

Results: Comparison between these standards and those for British children shows that the Belgian children (essentially the girls) are taller than the British, probably due to more rapid maturation.