TITLE:
Epidemiological, Clinical and Etiological Aspects of Non-Traumatic Comas in Children at the Pediatric Teaching Hospital in Bangui
AUTHORS:
Olivier Brice Bogning Mejiozem, Moyen Engoba, Evodie Pierrette Bogning Kakounguere, Jean Chrysostome Gody
KEYWORDS:
Non-Traumatic Coma, Child, Epidemiological-Clinical, Etiological, CHUPB
JOURNAL NAME:
Open Journal of Pediatrics,
Vol.12 No.3,
June
28,
2022
ABSTRACT: Background: Non-traumatic coma is the most common pediatric medical emergency. Its clinical
diagnosis is easy. The difficulty lies in finding the etiology. Objective: To determine the prevalence and clinical profiles of non-traumatic Coma at the Centre Hospitalier Universitaire Pédiatrique de Bangui (CHUPB). Methodology: This was a descriptive and analytical cross-sectional study conducted between January 1 and June 31, 2021, at CHUPB. Children
aged 1 month to 15 years, admitted to the
emergency room with a Glasgow score less than or equal to 8 without any
traumatism were included. The variables studied were sociodemographic, clinical
and paraclinical. Data were entered and analyzed using SPSS 20.0 statistical
software. The statistical test used was Pearson’s chi2, any p-value
Results: Of 8551
children hospitalized during the study period, 370 were hospitalized for
non-traumatic coma: 4.32%. They were divided into 57.5% (n = 213) boys and
42.44% (n = 157) girls, giving a sex ratio of 1.35. Their mean age was 35.95 ±
27.21 months. Children aged 1 to 24 months represented 54.59% (n = 202) of
cases. The mean time to the consultation was 2.91 days ± 1.8. Fever 86.48% (n = 320) and convulsions
80% (n = 296) were the main reasons for consultation. Coma stages II - III and
IV represented 52.44% (n = 194), 42.97% (n = 159) and 4.59% (n = 17)
respectively. Neuromalaria (29.72%; n =
110), meningitis-meningoencephalitis-encephalitis (30%; n = 111), sepsis
(19.72%; n = 73) and acidosis Coma (5.40%; n = 20) were the main
etiologies. Conclusion: Non-traumatic coma is common at CHUPB.
Infections were the main etiology, particularly cerebral malaria. The reduction
of its frequency requires, among others, the strengthening of the national monitoring malaria program. The strengthening of the
technical platform for a good etiological diagnosis constitutes the other axis
of prevention.