Acute Infant Bronchiolitis at the University Hospital of Bouake (Cote d'ivoire) about 404 Cases

Background: Acute bronchiolitis is a common cause of morbidity and mortality that is not well studied in Côte d’Ivoire. The objective of the study was to describe the main epidemiological, diagnostic, therapeutic and evolutionary aspects of this condition for the improvement of prognosis.

Methods: This was a retrospective, descriptive and analytical study conducted in the paediatric ward of the Bouaké University Hospital from January 2016 to December 2018. Included were all infants from 1 to 24 months hospitalized for acute bronchiolitis diagnosed on clinical and/or radiological grounds. The variables studied were epidemiological, diagnostic, therapeutic and evolutionary aspects. The analysis was descriptive and analytical. The Chi 2 test or the exact Fisher test was used to compare proportions to the significant threshold <5%.

Results: 15,695 admissions recorded, including 404 cases (232 males, 172 females) of bronchiolitis or 2.6%. The age was less than 6 months in 62% and 50.7% of admissions recorded between July and October. Promiscuity, exposure to wood smoke and the notion of family asthma were noted in 79.2%, 73% and 17.3% of cases respectively. The triad dyspnea-fever-fever-cold accounted for 84.8% of the general and functional signs recorded. Pulmonary auscultation revealed an anomaly in 83.4% represented by bronchial rales in 72%. X-ray of the chest face incidence revealed chest distension in 74.3%. The main associated diseases were bacterial superinfection (36%), malaria (7.42%) and heart disease (4.45%). The trend was favourable in 86.1%. Lethality was 6.7%. The risk factors for death were age 6 months or less (p=0.003) and the existence of an associated pathology (p<0.001).

Conclusion: Bronchiolitis is a frequent viral infection that progresses favourably in the majority of cases under symptomatic treatment. It is potentially fatal in infants under 6 months of age with an associated pathology. Well-coded care, as well as improved technical support and capacity building for health workers, will improve their prognosis.

Keywords: acute bronchiolitis, infection, infant, Bouaké.