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Archives de pédiatrie
Volume 16, n° 7
pages 1028-1032 (juillet 2009)
Doi : 10.1016/j.arcped.2009.03.012
Received : 28 May 2008 ;  accepted : 25 Mars 2009
La coqueluche du nouveau-né en Afrique
Neonatal pertussis in Africa: A case report
 

K. Nagalo
Service de pédiatrie, clinique El Fateh-Suka, avenue du Golfe de Syrte, BP 8297, Ouagadougou 04, Burkina Faso 

Résumé

La coqueluche est une maladie contagieuse due à Bordetella pertussis , qui peut être prévenue par la vaccination. Elle est grave chez les enfants de moins de 3 mois. Ceux-ci sont dans la plupart des cas contaminés par leurs parents alors qu’ils sont peu ou pas protégés contre la maladie. Les présentations atypiques sont fréquentes et la forme du nouveau-né est rare. Nous présentons un cas de coqueluche maligne chez un nouveau-né, probablement contaminé par sa mère. Le diagnostic suspecté cliniquement devant des quintes de toux persistantes a été confirmé par la sérologie et le traitement a permis la guérison. Nous discutons des problèmes diagnostiques, thérapeutiques et préventifs de la coqueluche dans les pays en développement. En Afrique, où les examens complémentaires tels que la PCR sont peu accessibles, une étude clinique soigneuse et l’analyse du taux absolu de lymphocytes peuvent être une alternative pour le diagnostic de coqueluche. La vaccination des jeunes adolescents et des adultes étant elle aussi problématique dans les pays pauvres, la mise au point de vaccins d’efficacité accrue peut contribuer à un meilleur contrôle de cette maladie.

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Summary

Whooping cough (pertussis) is a contagious disease caused by Bordetella pertussis that can be prevented by vaccination. The disease is particularly severe in infants who are less than 3 months old, who are not protected against the disease and are often contaminated by their parents. Atypical presentations are frequent and neonatal pertussis is rare. We report a case of malignant whooping cough in a newborn infant probably contaminated by her mother. Diagnosis was suspected clinically because of persistent coughing fits and was confirmed by serology. Treatment was successful. We discuss the diagnostic, therapeutic, and preventive issues of whooping cough in developing countries. In Africa, where complementary investigations such as PCR are seldom accessible, a careful clinical study and the analysis of the absolute rate of lymphocytes could be an alternative for the diagnosis of whooping cough. Vaccination of teenagers and adults is also problematic in poor countries. High-performance new vaccine candidates may contribute to a better control of whooping cough.

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Mots clés : Coqueluche, Nouveau-né, Bordetella pertussis, Vaccination




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