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ABSTRACT
Background: Anorectal malformations (ARM) consist of a wide spectrum of congenital malformations involving the anus and rectum. Their incidence varies from 1 in 2000 to 1 in 5000 live births. The aim of our study was to determine the prevalence, assess the management and outcomes of anorectal malformations in Douala. Materials and methods: This was a hospital based retrospective and descriptive study at the paediatric and surgical units in three hospitals in Douala (Laquintinie hospital, Protestant Hospital and the Obstetric and Gynaecologic and Paediatric Hospital). All medical records of patients aged 0-14years hospitalized for Anorectal Malformations from January 2013 to December 2019 were reviewed. Data was collected using a structured data collection tool. Data analysis was done using the statistical package for social sciences (SPSS) version 25.0. Results: We had a total of 68 patients with ARM, 42 were males and 26 females with a male to female ratio of 1.6:1. The children’s age ranged from 1 day to 270 days (average of 2.5days). There was delayed presentation in 50% of patients. 41(60.3%) had low ARM, 16(23.5%) had intermediate ARM and 11(16.2%) had high ARM. The most common in males was imperforate anus without fistula while in females was the rectovestibular fistula. Associated malformations were found in 8(11.8%) with genitourinary anomalies being the most common. Diagnosis was made following results of physical examination, invertogram and colostogram. Low ARM were managed by YV anoplasty with or without protective colostomy. High and intermediate ARM were managed by PSARP following colostomy. The mortality rate was 17.6%. Conclusion: The prevalence of anorectal malformations is low in Doualabut difficulties still arise during the management. Low anorectal malformations are the most common and males are more affected than females.Late presentations coupled with inadequate peri-operational reanimation services adversely influence the outcome.


RÉSUMÉ
Contexte. Les malformations anorectales (MAR) consistent en un large éventail de malformations congénitales impliquant l'anus et le rectum. Leur incidence variant de 1 sur 2000 à 1 sur 5000 naissances vivantes. Le but de notre étude était de déterminer la prévalence, d'évaluer la prise en charge et les résultats des malformations anorectales à Douala. Matériels et méthodes. Nous avons mené une étude rétrospective descriptive dans les unités pédiatriques et chirurgicales de trois hôpitaux de Douala (l'hôpital Laquintinie, l'hôpital protestant et l'hôpital obstétrique, gynécologique et pédiatrique). Tous les dossiers médicaux des patients âgés de 0 à 14 ans hospitalisés pour des malformations anorectales de janvier 2013 à décembre 2019 ont été examinés. Les données ont été recueillies à l'aide d'un outil de collecte de données structuré. L'analyse des données a été effectuée à l'aide du progiciel statistique pour les sciences sociales (SPSS) version 25.0. Résultats. Nous avons eu un total de 68 patients atteints de MAR, 42 étaient des hommes et 26 des femmes avec un ratio homme/femme de 1,6/1. L'âge des enfants allait de 1 jour à 270 jours (moyenne de 2,5 jours). La présentation a été retardée chez 50 % des patients. 41(60,3 %) avaient une MAR faible, 16(23,5 %) une MAR intermédiaire et 11(16,2 %) une MAR élevée. L'anus imperforé sans fistule était le plus fréquent chez les hommes, tandis que la fistule rectovestibulaire était la plus fréquente chez les femmes. Des malformations associées ont été trouvées dans 8 cas (11,8 %), les anomalies génito-urinaires étant les plus fréquentes. Le diagnostic a été posé en fonction des résultats de l'examen physique, de l'invertogramme et du colostogramme. Les MAR faibles ont été prises en charge par une anoplastie YV avec ou sans colostomie de protection. Les MAR élevés et intermédiaires ont été pris en charge par PSARP après colostomie. Le taux de mortalité était de 17,6 %. Conclusion. La prévalence des malformations anorectales est faible à Douala. Les malformations anorectales basses sont les plus fréquentes et les hommes sont plus touchés que les femmes. Les présentations tardives couplées à des services de réanimation péri-opératoire inadéquats influencent négativement le résultat.

Keywords

anorectal malformations prevalence perineal examination PSARP Douala malformations anorectales prévalence examen périnéal Douala PSARP

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Pauline, M., Basile, E., Mildred, A., Thierry, T., Eric Ralph, B., Théophile, K., Frederic, A. M., Mefire, C. A., & Jean Paul, E. (2022). Prevalence, Management and Outcome of Anorectal Malformations in Children between 0-14 Years Old: a 7 Years Retrospective Study in three Hospitals in Douala: Malformations Anorectales de l’Enfant à Douala. HEALTH SCIENCES AND DISEASE, 23(4). https://doi.org/10.5281/hsd.v23i4.3541
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