Clinical epidemiogical study of references to pediatric emergencies at Gabriel Toure teaching hospital

Abstract

Introduction: The national health care system in Mali can be schematized in the form of a pyramid whose base represents the Community Health Center (CSCom) for primary care, the Reference Health Center (CSRef) constitutes the first level of reference followed. regional hospitals and at the top, national hospitals or (last medical resort in the country). The objective of our study was to study the epidemiological and clinical aspects of referrals to pediatric emergencies at the Gabriel Toure Teaching Hospital. Material and methods: We carried out a cross- sectional prospective study from January to June 2017, i.e. a period of 6 months. It concerned children aged 1 month to 15 years referred to the pediatric emergencies of the Gabriel Toure Teaching Hospital whatever the reason. The survey was conducted by interviewing mothers or those accompanying the child on admission with a survey sheet after consent obtained beforehand. Results: During our study period, 234 children were referred out of a total of 565 children hospitalized in the emergency room, a frequency of 41.4%. The sex ratio was 1.9 and infants under 12 months were the most affected with 51.3% of cases. For the majority of cases (126/234), the patients referred came from the CSRref, ie 53.8%. Dyspnea was the most frequent reference reason (105 cases / 234) followed by fever (72 cases). It was during on-call hours (5 p.m. to 8 a.m.) that the majority of referred patients were seen in the emergency room, i.e. 59%. Malaria was the most frequent reference pathology (29.4% of cases) followed by bronchopulmonary pathologies, 17.1%. The length of hospital stay was 3 days in 28.6%. The case fatality rate was 12.39%. Conclusion: Despite multitudes of health structures, a well-codified health pyramid, the reference remains low in our country.

Keywords: referral, emergency, pediatrics.