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Abstract

Résumé
Contexte. Au Cameroun, la mortalité des enfants de moins de 5 ans reste élevée et serait fortement influencée par la qualité des soins. Nombre de parents recourent aux soins inappropriés pour leurs enfants et ne se rendront à l’hôpital qu’à un stade critique. Certains enfants décèdent par conséquent avant leur arrivée à l’hôpital. Le but de l’étude était d’analyser le profil familial de ce groupe d’enfants et de rechercher les causes de décès à l’aide de l’autopsie verbale (AV).
Méthodologie. Cette étude transversale conduite entre octobre 2013 et avril 2014, a porté sur 40 enfants qui sont décédés avant l’arrivée dans un centre pédiatrique à Yaoundé. Les familles étaient contactées par téléphone 5 à 6 semaines après le décès de l’enfant et un seul membre de la famille était interviewé à domicile grâce au questionnaire d’AV. La méthode de lecture par des médecins était adoptée pour l’analyse des données. Les pédiatres ont indépendamment attribué à chaque décès, une cause médicale ainsi qu’une possible cause sous-jacente basées sur les définitions de la classification internationale des maladies de l’OMS. Les informations portaient essentiellement sur les caractéristiques sociodémographiques des familles et les causes de décès.
Résultats. Les répondants étaient généralement jeunes: 50,0% avaient moins de 30 ans et la tranche de 20 à 30 ans prédominait (47,5%). Il s’agissait surtout des géniteurs (87,5%). Les enfants décédés, étaient majoritairement (82,5%) âgés de moins de 5 ans avec 50% < 1 an. 40,0% ‘entre eux étaient malades depuis au moins 3 jours. La méningite (27,5%) et le paludisme (22,5%) représentaient la moitié des causes directes probables de décès. Les principales causes sous jacentes étaient a malnutrition aigue sévère (43,8%), le VIH/SIDA (12,5%) et la drépanocytose (12,5%).
Conclusion. L’autopsie verbale a permis d’attribuer les causes médicales aux décès survenus chez les enfants en cours de transport vers notre site. Une sensibilisation des jeunes parents sur la recherche précoce des soins médicaux dans des structures appropriées permettrait d’éviter les décès en communauté chez les enfants qui convulsent surtout en contexte de fièvre.

Abstract
Introduction. In Cameroon the rate of infanto-juvenile mortality remains high, and is significantly influenced by the quality of the treatment offered. Many parents go in for inappropriate medical treatment for their sick children, thus leading to death of some of them before arrival at the hospital. Our study analysizes the family background of this group of children and also tries to find out the causes of deaths using verbal autopsy (VA).
Methods. It was a cross sectional descriptive study carried out between October 2013 and April 2014 on 40 children who died before arrival, in a pediatric health facility in Yaounde. The families of these children were contacted by telephone 5 to 6 weeks after their death. One family member was interviewed at the residence of the deceased child, and the information obtained recorded on a verbal autopsy questionnaire. The data analysis was done using the physician review approach. The assignment of VA was random and each was certified by 2 pediatricians. They independently assigned to each dead a medical cause and a possible underlying cause following the World Health Organization international diseases classification. The variables analysed were essentially the socio-demographic characteristics of the families and the causes of death.
Results. The majority of the respondents were young; 50.0% being less than 30 years with the 20 to 30 years age group being predominant (47.5%). They were mostly the parents (87.5%). Most of the deceased children were less than 5 years (82.5%); 50.0% of them were less than 1 year of age. Close to half of them (40.0%) had been ill for more than 3 days. Two diseases were responsible for about half of the probable direct causes of death [meningitis (27.5%) and malaria (22.5%)]. The underlying causes were acute severe malnutrition (43.8%), HIV/AIDS (12.5%) and the sickle cell disease (12.5%).
Conclusion. VA permitted the assignment of the medical causes of death in children before arrival at our hospital. Sensitization of young parent on the need to seek medical care early in an appropriate health care facility could reduce the death of children occurring in the community. This is particularly true for children who convulse in febrile context.

 

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Chelo, D., Nguefack, F., Ntoude II, A., Kamgno, J., Ngu, P., & Koki Ndombo, P. O. (2016). Décès d’enfants avant l’arrivée au Centre Mère et Enfant de la Fondation Chantal Biya, Yaoundé- Cameroun. HEALTH SCIENCES AND DISEASE, 17(2). https://doi.org/10.5281/hsd.v17i2.651
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