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Abstract
BUT. Reporter les principales causes de cécité chez l’enfant de la naissance à l’âge de 10 ans, et répertorier les maladies associées qui l’accompagnent.
PATIENTS ET MÉTHODES. Il s’agit d’une étude rétrospective sur 5 ans (janvier 2007- décembre 2011), réalisée dans le service d’ophtalmologie du CHU de Brazzaville. Elle a concerné les enfants âgés de zéro à 10 ans, souffrant de cécité unilatérale ou bilatérale, quelque soit la cause et les maladies associées. De zéro à 3 mois et de 3 mois à 3 ans, la cécité était définie respectivement par l’absence du reflexe de Peiper et par l’absence du reflexe de poursuite associée, dans les deux cas, à un reflexe photomoteur direct nul. Après 3 ans, la cécité était définie par une acuité visuelle inferieure à 3/60.
RÉSULTATS. 112 dossiers (correspondant à 85 yeux en état de cécité) ont été retenus sur un ensemble de 345 (correspondant à 243 yeux malades). L’âge moyen était de 4,7 ± 1,7 ans [2 jours-10 ans]. Le sex ratio garçon/fille était de 1,03. Les traumatismes 36,47% (n=31 yeux), les opacités cornéennes 25,88% (n=22 yeux) et la cataracte congénitale 10,58% (n=9 yeux) étaient les principales causes de cécité. Les principales maladies associées étaient les toxidermies bulleuses liées aux sulfamides et la rougeole. Dans 44,7% des cas la cécité était évitable.
CONCLUSION. La cécité chez l’enfant à Brazzaville est essentiellement due aux traumatismes, et aux séquelles cornéennes de la rougeole et des toxidermies. La vaccination anti rougeoleuse et l’abandon des sulfamides peuvent réduire son incidence.
ABSTRACT
AIM. To report the main causes of blindness in children from birth to age of 10 years, and identify the related diseases.
METHODS. This was a retrospective study of 5 years (January 2007 - December 2011), carried out in the ophthalmology department of the University Hospital of Brazzaville. The study involved children aged zero to 10 years, suffering from unilateral or bilateral blindness, whatever the cause and related diseases. From zero to 3 months and 3 months to 3 years, blindness was respectively defined by the absence of Peiper reflex and the absence of tracking reflex associated, in both cases, with no direct pupillary light reflex. After 3 years, blindness was defined as visual acuity less than 3/60.
FINDINGS. 112 cases (corresponding to 85 eyes in a state of blindness) were recruited on a total of 345 (corresponding to 243 patient eyes). The mean age was 4.7 ± 1.7 years [2 days-10 years]. The sex ratio male / female was 1.03. Trauma 36.47% (n = 31 eyes), corneal opacities 25.88% (n = 22 eyes) and congenital cataract 10.58% (n = 9 eyes) were the leading causes of blindness. The main diseases associated were bullous drug eruptions due to sulfonamides and measles. In 44.7% of cases, blindness was preventable.
CONCLUSION. Blindness in children in Brazzaville is mainly due to trauma, and corneal sequelae of measles and drug eruptions. Measles vaccination and the abandonment of sulfamides may reduce its incidence.
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References
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References
- Foster A, Resnikoff S. The impact of vision 2020 on global blindness. Eye (Lond) 2005 Oct, 19 (10): 1133-5
- Atipo-Tsiba PW, Messe Ambia Koilimaya R, Mongo VA. Cécité au Congo-Brazzaville : causes et maladies associées. Ann. Afr. Med. Mars 2012, Vol.5, Nº2 :1025-9
- Negrel AD, Massembo-Yako B, Botaka E, Minassian DC, Coddy-Zitsamele R. Prévalence et causes de la cécité au Congo. Résultat d’une enquête nationale en 1988. Bulletin de l’OMS 1990 : 68 (2) : 237-43
- Olatunji FO, kirupananthan S, Ayanniyi AA, Abuh S. Causes of childhood blindness at ECWA Eye Hospital, Kano Nigeria. Afr J Med Med Sci, 2009 Mar ;38(1) :29-32
- Demissie BS, Solomon AW. Magnitude and causes of childhood blindness and severe visual impairment in Sekoru district, Southwest Ethiopia: a survey using the key informant method. Trans R Soc Trop Med Hyg, 2011 Sep; 105(9):507-11
- Njuguna M, Msukwa G, Shilio B, Tumwesigye C, Courtright P, Lewallen S. Causes of severe visual impairment and blindness in children in schools for the blind in eastern Africa: changes in the last 14 years. Ophthalmic Epidemiol, 2009 May-Jun; 16(3):151-5
- Bandrakalli P, Ganekal S, Jhanji V, Liang YB, Dorairaj S. Prevalence and causes of Monocular Childhood Blindness in a Rural Population in southern India.tric J pediatr Ophthalmol Strabismus, 2012 May 22:1-5
- Ntim-Amponsah CT, Amoaku WM. Causes of chilghood visual impairment and unmet low-vision care in blind school student in Ghana. Int Ophthalmol, 2008 Oct, 28 (5): 317-23
- Atipo-Tsiba PW, Bayonne S, Messe Ambia Koulimaya R. Atteintes oculaires au cours de la toxidermie médicamenteuse : à propos de 10 cas. Mali Médical 2011, Tome XXVI Nº4 :65-8
- Nallasamy S, Anninger WV, Quinn GE, kroener B, Zetola NM, Nkomazana O. Survey of childhood blindness and visual impairment in Botswana. Br J Ophthalmol, 2011 Oct; 95(10):1365-70
- Krishnaiah S, Subba Rao B, Lakshmi Narasamma K, Amit G. A survey of severe visual impairment in children attending schools for blind in a coastal district of Andhra Pradesh in South India. Eye (Lond), 2012 May 11. doi: 10.1038/eye.2012.88.[Epub ahead of print]
- Togo Boubacar, Sylla Fatou, Traoré Fousseyni, Sylla Mariam, Dicko-Traoré Fatoumata, Sidibé Toumani et al. A 30 month prospective study on the treatment of retinoblastoma in the Gabriel Touré Teaching Hospital. Br J Ophthalmol 2010, 94: 467-469
- Sant M, Capocaccia R, Badioni V. Survival for retinoblastoma in Europe. Eur J Cancer 2001, 37: 730-735.