Facteurs de retard de prise en charge des infections ostéo-articulaires de l’enfant au Centre Hospitalier Universitaire Joseph Ravoahangy Andrianavalona, Antananarivo

Introduction. Bone and articular infection is the invasion of bone or cartilage tissue with its destruction, by a pathogenic micro-organism. It is a serious pathology frequently encountered in infantile trauma. Aim: To report the epidemiological, radiological, microbiological aspects and the pre-hospital management of bone and joint infections inside the pediatric surgery department of the Ravoahangy Andrianavalona university hospital center. Materials and method. We carried out a descriptive cross-sectional retrospective study over a period of 14 months (january 2016 to february 2017). Were included in this study, all children hospitalized and treated for osteo-articular infections in the department, with radiographic and bacteriological. Results. Fifty-three cases were identified. The average age was 9.77 years with a sex ratio of 1.4. The mean time from the first suspected symptom to hospitalization was 73.3 weeks. Forty two percent had a notion of trauma in the affected limbs. Seventy-five percent had massages before hospitalization. Six out of 10 patients had antibiotics without antibiograms before admission. On admission, chroni c fistula was found in 45.29% of cases. The most frequent lesion found on radiography was sequestration in 40.06% of which 35% related to m assage. The pathology showed osteomyelitis in 66.04% of cases. The most frequent location was the lower limbs. The most common germ involved was Staphylococcus aureus (75.47% of cases). Conclusion. Insufficient resources, traditional massages, lack of knowledge about the disease and the rarety of specialized services favour the evolution towards the chronicity of osteo-articular infections and management becomes heavy in our context.