TITLE:
The Bronchiolitis in Paediatric Emergencies at the University Teaching Hospital of Gabriel Touré
AUTHORS:
Adama Dembélé, Abdoul Karim Doumbia, Belco Maïga, Mohamed Elmouloud Cissé, Younoussa Koné, Pierre Togo, Oumar Coulibaly, Karamoko Sacko, Djéneba Konaté, Hawa Diall, Lala Ndrainy Sidibé, Koné Oumou, Fatoumata Leonie Diakité, Fatoumata Dicko, Abdoul Aziz Diakité, Mariam Sylla, Boubacar Togo
KEYWORDS:
Bronchiolitis, Epidemiology, Clinic, Pediatrics
JOURNAL NAME:
Open Journal of Pediatrics,
Vol.12 No.2,
May
20,
2022
ABSTRACT: Introduction: Bronchiolitis is a generally benign condition
characterised by acute inflammation, oedema and necrosis of the epithelial
cells lining the small airways, and increased mucus production. Symptoms
usually begin with rhinitis and cough, which may progress to tachypnoea,
wheezing, and rales. The most common etiology is a respiratory
syncytial virus (RSV). Bronchiolitis occupies an important place among Acutes Respiratory
Infections (ARI) and represented the fifth cause of hospitalisation in the
paediatric emergency department of the Gabriel Touré University Hospital in
2008 with a frequency of 10% and a mortality rate of 3.2%. This shows that we
are constantly confronted with the management of this pathology. The objective of our study was to study the
epidemiological, clinical, and therapeutic aspects of bronchiolitis in the
paediatric emergency room of the Gabriel Touré University Hospital. Materials
and Method: This was a prospective cross-sectional and descriptive study from April 1, 2018, to
March 31, 2020, i.e. 2 years in
infants aged 1 to 23 months. Data were collected using an individual survey
form by questioning parents and physically examining patients. Results: During the study period, we were able to collect 342 patients meeting our
inclusion criteria out of 4207 hospitalized patients, or a frequency of 8.1%.
The age range of 1 to 5 months represented 64.9%. The sex ratio was 1.2. The
most common reason for consultation was respiratory discomfort (86.8%). Most
patients (46%) were hospitalised during the period from September to November.
In the majority of cases (74%), patients consulted within five days of the
onset of symptoms. The physical examination was mainly dominated by signs of
respiratory struggle, fever (51.8%), and sibilants (37%) on
auscultation. Complications associated with bronchiolitis were mainly
respiratory infections with 57.6% of cases. The main management steps were:
nasopharyngeal decontamination (78.9%), oxygen therapy (72.5%), nebulisation
with β2 mimetics (69%), and infusion
of solution (76.3%). However, 89% of patients received antibiotic therapy using
Amoxicillin + clavulanic acid in 37% of cases. The average stay of the patients
was 5.5 days. The evolution was marked by 12% of deaths and respiratory
infections were the main cause of death (41.5%). Conclusion: Bronchiolitis is a frequent pathology whose peak is in September in our
country. Its seriousness lies in the complications it causes, which can lead to
death in the absence of early and adequate treatment.