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Master Thesis

Toux chronique des enfants d’âge scolaire à Mahajanga, Madagascar

Abstract : Objectives: our objective was to study the different aetiologies of chronic cough affecting the children of Mahajanga, Madagascar for more than three weeks. The purpose was to enhance the diagnostic process and therefore facilitate the prevention or treatment of such disease. Methods: the prospective study was carried out from the 7th to the 16th of November 2016 in two schools, targeting students over 5 years old presenting symptoms of chronic cough. Results: 47 children included in the category of coughers; 31 in the category non-coughers, aged from 5 to 13 years old: 29 girls, 18 boys. Four major diagnoses: asthma (36% among the coughers); 19% allergies; 43% intestinal parasites; 2 cases of tuberculosis. In both categories: 44% of positive parasitology of faeces, with a prevalence of Amoebae and Ascaris. There was no correlation between parasites and chronic cough. Seven children had severe malnutrition (15%) and 13 had chronic malnutrition (28%). We observed a statistically insignificant link (p=0.08) between intestinal parasites and malnourishment. Conclusion: the main diagnoses of children’s chronical cough in Madagascar are similar to those found in developing countries: asthma and allergies. However, regarding these widespread aetiologies, we are facing ethical constraints. As of now, and given the lack of financial resources, further medical care cannot be considered. No overexpression of tropical infectious pathologies was detected within the aetiologies of chronical cough (e.g. tuberculosis and intestinal parasites) even though their prevalence represents a real public health issue. As for the test of tuberculosis, the criterion of chronical cough is not sufficient by itself. Anti-parasite chemoprophylaxis and nutritional support are to be distributed to all deprived school-aged children of the public system.
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Master Thesis
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Submitted on : Friday, January 5, 2018 - 2:53:49 PM
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Julie Bernard-Colombat. Toux chronique des enfants d’âge scolaire à Mahajanga, Madagascar. Médecine humaine et pathologie. 2017. ⟨dumas-01676347⟩

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