Déshydratation Aiguë chez les Enfants de 1 à 35 Mois Atteints de Diarrhée Aiguë au CHU Gabriel Touré

2020 
RESUME Introduction. La deshydratation induite par la diarrhee est une cause importante de mortalite dans les pays en developpement. Le but de notre travail etait de decrire les aspects epidemiologiques, cliniques, therapeutiques et evolutifs de la deshydratation aigue. Methodologie. Il s’agit d’une etude longitudinale prospective, descriptive ayant porte sur 59 cas de deshydratation aigue par diarrhee colliges dans le service de pediatrie generale, du 1er janvier au 31 juillet 2018. Nous avons inclus les enfants âges de 1 a 35 mois hospitalises pour deshydratation aigue consecutive a la diarrhee. Resultats. Nous avons inclus 59 enfants, avec un âge moyen de 9 mois et un sex-ratio de 0,88. Le delai moyen de consultation etait de 6 jours et 98% avaient recu un traitement avant leur admission.  Les enfants recevaient une alimentation diversifiee dans 71% des cas et 27% etaient sous allaitement maternel exclusif. Un quart (25%) des patients n’etait pas completement vaccinee contre le rotavirus. Les selles etaient liquidiennes dans 86% des cas. La deshydratation etait moderee chez 24%  des enfants et severe chez 76%. Le ringer lactate a ete administre chez 85 % des patients ; 63% des enfants ont recu une antibiotherapie. La duree moyenne d’hospitalisation etait de 8 jours. Le taux de letalite etait de 17%. Conclusion : des efforts supplementaires sont necessaires pour maitriser la mortalite infantile par diarrhee. ABSTRACT Introduction. Dehydration induced by diarrhea is an important cause of death in developing countries. The aim of our work was to describe the epidemiological, clinical and therapeutic and evolutionary aspects of acute dehydration. Methodology. This was a longitudinal prospective descriptive study in the general pediatric department of the CHU Gabriel Toure (Mali), from January 1 to June 31, 2018. We included children aged 1 to 35 months hospitalized for consecutive acute dehydration with diarrhea. Results. We included 59 children, with a mean age of 9 months and a sex ratio of 0.88. The mean time to consultation was 6 days and 98% had received treatment prior to admission. Children received a varied diet in 71% of cases and 27% were exclusively breastfeeding. A quarter (25%) of patients were not fully vaccinated against rotavirus. The stools were liquid in 86% of cases. Dehydration was moderate for 24% of children and severe for 76% of cildren. The lactate ringer was administered in 85% of patients;  63% of them received antibiotic therapy. The average length of hospital stay was 8 days. The case fatality rate was 17%. Conclusion. Tremendous efforts are still needed to control infant mortality from diarrhea.
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