Pediatric Traumatic Lesions in a District Hospital of Benin and Determinants of the Attendance of Children at the Follow up Visits

RESUME Objectifs. Decrire le profil des lesions traumatiques chez les enfants admis aux urgences hospitalieres pour traumatisme et les facteurs qui influencent leur presence aux visites subsequentes de controles des premiers, deuxieme et troisieme mois au Benin. Methodologies. Il s’agit d’une etude prospective, longitudinale, descriptive et analytique d’une duree de 10 mois (Novembre 2014 a aout 2015) effectuee dans un hopital de district du Benin. Les criteres d’inclusion etaient : âge inferieur ou egal a 15 ans, consultation au service des urgences pour un traumatisme suffisamment severe pour justifier une hospitalisation une mise en observation. La presence de l’enfant aux vistes de controle a ete evaluee au premier, deuxieme et troisieme mois et les raisons de l'absence ont ete etudiees. Resultats. 41 enfants ont ete recrutes. Leur âge moyen etait de 8 ans. Le sex ratio garcon/fille etait de 1.6. environ 2/3 des enfants venaient de la commune de Kandi. La distribution des lesions etait la suivante : trauma cranio-cerebral (12 cas ; 29.30%), fractures des membres ou du rachis (9 cas ; 22%), brulures (5 cas; 12.2%) et polytraumatisme (3 cas; 7.30%). The sejour hospitalier moyen etait de 2.81 jours. La presence des enfants a la premiere visite a ete faible (<50%) et elle etait liee avant tout au lieu de residence des parents et a la gravite des lesions initiales. Au 2eme et 3eme controle, la frequentation a continue de chuter. Malgre tout, le pronostic a ete globalement favorable, les sequelles n’ayant ete constatees que chez un enfant avec fracture du rachis. Conclusion. Au Benin, les principaux determinants de la presence des enfants victimes de traumatisme aux visites de controles est la distance par rapport au cerne de soins et la gravite des lesions initiales. ABSTRACT Objective. To describe the factors affecting the attendance of children consulting for physical trauma at the follow-up visits in Benin. Methods. This was a prospective, longitudinal, descriptive and analytical study conducted over a 10-month period starting from the 1st of November 2014 to the 31st of August 2015. Criteria of inclusion were age below 15 years, consultation at the emergency department for physical trauma severe enough to justify hospitalization or in patient observation. The presence of the child at the monthly monitoring visits was evaluated for three months and the reasons for absence were studied. Results. 41 children were recruited. The mean age was 8 years. Sex ratio male/female was 1.6. Children came mainly from the commune of Kandi (68.3). Distribution of lesion was head injury (12 cases; 29.30%), spine or limb fractures (9 cases; 22%), burns (5 cases; 12.2%) and polytrauma (3 cases; 7.30%). The average hospital stay was 2.81 days. Presence of children at the first follow up visit was generally low (<50%) and it was strongly related to the residence of the parents and the severity of the initial lesion. The presence of children dropped significantly at the 2nd and 3rd controls. Nevertheless, the outcome was good for most patients. Conclusion: in Benin, the presence of children consulting for trauma at follow up visits is related mainly to the distance from the hospital, but also to the severity of the initial lesions.