Search PubMed⌕ Search

Biomedical subjects

F Davachi

Publications and source records attributed to F Davachi.

At least 37 records · Page 2Linked to original sources
PubMed1989

Hospital-based surveillance of malaria-related paediatric morbidity and mortality in Kinshasa, Zaire.

Although Plasmodium falciparum malaria is a leading cause of paediatric morbidity and mortality in Africa, few quantitative estimates are available about the impact of malaria on childhood health. To quantify the impact of the disease in an urban African setting, we reviewed the paediatric ward and mortuary records at Mama Yemo Hospital in Kinshasa, Zaire. From June 1985 to May 1986, 6208 children were admitted to the hospital, 2374 (38.2%) of whom had malaria; 500 of those with malaria died (case fatality rate, 21.1%). During this same period, there were 10,036 paediatric deaths, 1323 (13.2%) of which were attributed to malaria; 823 (62.2%) of these occurred in the emergency ward prior to hospitalization. Minimum population-based malaria mortality rates were highest for children aged less than 1 year (4.0 per 1000 per year). Over 70% of children admitted with malaria and greater than 80% of children who died from the disease were less than 5 years old. The total number of paediatric admissions and deaths remained relatively constant between 1982 and 1986; however, the proportional malaria admission rate increased from 29.5% in 1983 to 56.4% in 1986, and the proportional malaria mortality rate, from 4.8% in 1982 to 15.3% in 1986. These increases were temporally related to the emergence of chloroquine-resistant Plasmodium falciparum malaria in Kinshasa. Malaria is therefore a major cause of paediatric morbidity and mortality in the city, and this study indicates that hospital-based surveillance may be useful in monitoring disease-specific morbidity and mortality elsewhere in Africa.

Adolescent↗
PubMed1987

Plasmodium falciparum in Kinshasa, Zaire: in vitro drug susceptibility studies.

In June 1986, Plasmodium falciparum parasites were collected from 33 children presenting at the Mama Yemo Hospital in Kinshasa (Zaire) and were successfully tested in vitro by a 48-hr reinvasion test for their susceptibility to various antimalarial drugs. In vitro resistance to chloroquine was found in 82% of the isolates, a marked increase over findings obtained by the same technique 3 years ago in Kinshasa. In vitro chloroquine resistance was not associated with a history of previous drug intake. The inhibitory endpoints for quinine varied from 0.03 to 1 microM, and correlated with the chloroquine endpoints in the corresponding isolates (r = 0.64). Pyrimethamine resistance in vitro was demonstrated in 52% of the isolates tested.

Animals↗
PubMed1987

Evaluation of a clinical case definition of AIDS in African children.

In July 1986, a provisional clinical case definition of AIDS in children, developed by the World Health Organization (WHO) for surveillance purposes in Africa, was tested on 159 patients hospitalized in the Department of Pediatrics at Mama Yemo Hospital, Kinshasa, Zaire. Twenty-one (13%) of these children were seropositive for HIV. In this population, the clinical case definition of pediatric AIDS was found to be fairly specific (87%) but lacked sensitivity (35%). The positive predictive value for HIV seropositivity was 25%. This study suggests that it is more difficult to define AIDS clinically in children than in adults and that the utility of the proposed WHO clinical case definition for pediatric AIDS for surveillance of children's AIDS in Africa is limited.

Acquired Immunodeficiency Syndrome↗
PubMed1987

Absence of association between Plasmodium falciparum malaria and human immunodeficiency virus infection in children in Kinshasa, Zaire.

The possible associations between Plasmodium falciparum malaria and HIV (human immunodeficiency virus) seropositivity were investigated in 1986 at the Mama Yemo Hospital in Kinshasa, Zaire. No significant difference was found in the HIV seropositivity rate of 164 children presenting with P. falciparum malaria (1.2%) and 169 healthy controls (0.6%). Secondly, no association was found between P. falciparum slide positivity (51.6%) and HIV seropositivity (3.8%) among 1046 children presenting to the hospital with medical complaints. Infants less than 6 months old had the lowest slide-positivity rate, but among infected children the younger ones more frequently had high parasitaemias. HIV seropositivity rates were highest for children less than 6 months old. In older children, seropositivity was strongly associated with a history of blood transfusion. Thus, in Kinshasa children, P. falciparum malaria is a major public health problem; perinatal transmission and blood transfusions constitute important mechanisms of HIV infection; and P. falciparum does not appear to act as an opportunistic agent in children infected with HIV.

Animals↗
PubMed1986

Risk factors for human immunodeficiency virus seropositivity among children 1-24 months old in Kinshasa, Zaire.

A prevalence study of antibody to human immunodeficiency virus (HIV) was conducted in Kinshasa, Zaïre, among 258 children 2-24 months old who were in hospital, 191 children 1-20 months old who were attending a well-child clinic, and their mothers. 8% of the mothers of both groups of children were seropositive. Among children under 9 months old, 12 of 102 (12%) hospital inpatients and 11 of 136 (8%) clinic attenders were seropositive, while in the 9-24-month age group 20 of 156 (13%) hospital children and only 1 of 55 (2%) clinic children were seropositive (Fisher's exact test, p = 0.01). 61% of the seropositive children had seropositive mothers, indicating a high rate of vertical transmission. Factors associated with seropositivity among hospital children with seronegative mothers included male sex, increased lifetime number of medical injections, and previous blood transfusion or hospital admission. Among children who had not previously been transfused or admitted to hospital the seropositives had received more medical injections than the seronegatives (median 34.5 versus 14.5; Wilcoxon rank sum test, p = 0.006). HIV infection accounted for or complicated a substantial proportion of hospital paediatric admissions. Public health measures are urgently required to prevent parenteral and vertical transmission of HIV to infants and young children in Kinshasa.

Acquired Immunodeficiency Syndrome↗
PubMed1986

Human immunodeficiency virus seroprevalence in pediatric patients 2 to 14 years of age at Mama Yemo Hospital, Kinshasa, Zaire.

Seroprevalence to human immunodeficiency virus (HIV) was determined among 368 children 2 to 14 years of age who were admitted to the pediatric service at Mama Yemo Hospital in Kinshasa, Zaire. Forty (11%) of these patients and only one (1%) of 92 healthy siblings of these patients were HIV seropositive (chi 2 = 8.68, P less than .01). Seropositivity was associated with previous hospitalization, receipt of a blood transfusion prior to the current hospitalization (odds ratio 3.1; 95% confidence interval, 1.5 to 6.4), receipt of medical injections during the past year, and smaller household size. Clinically, HIV seropositivity was associated with the diagnoses of malnutrition and pneumonia. A higher proportion of seropositive children died during the current hospitalization (4/40 v 10/328); when patients with malaria were excluded, the in-hospital mortality of seropositive children was more than eight times higher than that of seronegative children (Fisher exact test, P = .006). Clarification of clinical, immunologic, and epidemiologic features of childhood HIV infection is urgently required because HIV appears to account for or complicate a substantial proportion of pediatric hospitalizations in Kinshasa.

Acquired Immunodeficiency Syndrome↗
PubMed1975

Postoperative left anterior hemiblock and right bundle branch block following repair of tetralogy of Fallot. Clinical and etiologic considerations.

Previous reports have indicated an incidence of right bundle branch block (RBBB) and left anterior hemiblock (LAH) pattern varying from 8-22% following corrective surgery in patients with tetralogy of Fallot. Among 207 patients with tetralogy of Fallot operated on at our institution, 8.7% developed an ECG pattern of RBBB and LAH. These patients were followed for 1-13 years (mean 6.2 years) for a total of 111 patient years. All patients are alive and none have had documented late atrioventricular dissociation, syncope, or other symptoms. Transient heart block was present in one patient in the immediate postoperative period but has not recurred. This group of patients differs significantly from other series in which such an ECG pattern was associated with a marked increase in morbidity and mortality. These data and the experimental evidence suggest that two distinct groups of patients exist: 1) a group in which this ECG pattern is secondary to lesions within the bundle of His and 2) a group in which the pattern is caused by lesions in the peripheral conduction system. It is postulated that these two groups which demonstrate the same ECG pattern may carry significantly different prognoses. Analysis of H-V intervals postoperatively may help identify patients at risk.

Adolescent↗