Epidemiological, clinical and etiological aspects of non-traumatic coma in children in the pediatric department of the Dubréka prefectural hospital, Guinea.

Abstract

Introduction: Coma is defined by the suppression of alertness and consciousness. Clinically, it is characterized by an absence of eye opening and an appropriate reaction to painful stimulation in a patient who otherwise has effective ventilation and hemodynamics. The objective of this study was to determine the epidemiological, clinical and etiological aspects of non-traumatic coma in children in the pediatric department of Dubreka Prefectural Hospital.

Patients and method: This was a prospective and descriptive, study over a period of six months (August 1, 2021 to January 31, 2022) in the pediatric department of the Dubréka prefectural hospital.

Results: The hospital frequency of coma was 12%. The children were aged less than one year (30%), 1-4 years (51%), 5-9 years (6%) and 10-14 years (13%). There was a male predominance (60%) with sex ratio M/F of 1.5. The reasons for consultation were dominated by fever (97%), physical asthenia (97%), anorexia (97%), the notion of convulsive seizures (92%). The physical signs observed were respiratory distress (93%), tachycardia (94%), deterioration of general condition (87%), mucocutaneous pallor (76%). Coma stages II (53%) and III (34%) dominated the clinical picture. Severe malaria (74%), bacterial meningitis (19%), complicated measles (4%) and gastroenteritis + severe dehydration were the etiologies encountered.

Conclusion: Severe malaria and bacterial meningitis were the main etiologies of non-traumatic childhood coma in our study. Children under 5 years old were the most affected. Healing without after-effects was achieved in most of our patients.

Keywords: coma, child, pediatrics, Kamsar hospital.