[Apparent malformations in an African area: factors influencing consultation delay in pediatric surgery].
OBJECTIVE
To analyze the attitudes of the Guinean and of the Ivory Coast communities leading to delayed consultation despite apparent malformations in children.


METHODS
From January 1, 2000 to December 31, 2002, we carried out a prospective investigation in the paediatric surgery units of the Donka teaching hospital (Conakry) and Cocody, Treichville and Yopougon (Abidjan) teaching hospital. One hundred and two children affected with apparent malformations were included. The studied variables were: age, sex, ethnos group, religion, socio-economic level and the cultural designs of the families.


RESULTS
Sex ratio male/female was 1,5 and the average age at first consultation was 17 months. Seventy-six per cent of the children carrying apparent malformations at birth were seen at an age ranging from 1 to 30 months. Orthopaedic malformations were prominent (44%) and led especially to negative reactions of the entourage of the patients. Some religious beliefs took a part of the delayed consultation and impaired relationships between the 2 parents. The low socio-economic level (54%) was determining in the delayed consultation. The birth of a child with malformation in the malinké, akan krou community could be understood like a parchment from a god or a witchcraft.


CONCLUSIONS
The contributive factors of the delay to the consultation of the children carrying apparent malformations in the communities Guinean and of the Ivory Coast are poverty, ignorance and some religious beliefs. Education and well understanding of these reasons in developing country should improve the acceptance and taking care of these children as well as the development of medical insurance system.
Doumbouya
N
N
Service de chirurgie pédiatrique Donka, Conakry, BP 234, République de Guinée. doctdoumbouya@yahoo.fr
Brouh
Y
Y
Attié
R
R
Keita
M
M
Agbo-Panzo
D
D
Diallo
A-F
AF
Barry
O-T
OT
Camara
A
A
Baldé
I
I
D002675:Child, Preschool; D000013:Congenital Abnormalities / Q000453:epidemiology* / Q000601:surgery; D007560:Cote d'Ivoire / Q000453:epidemiology; D003466:Cultural Characteristics; D005260:Female; D016701:Guinea / Q000453:epidemiology; D006801:Humans; D007223:Infant; D007231:Infant, Newborn; D008297:Male; D011203:Poverty; D011446:Prospective Studies; D012017:Referral and Consultation; D012067:Religion; D013997:Time Factors