[Clinical, paraclinic and evolutive profile of HIV infected subject compared with that of non-HIV infected subject in pneumology hospitalization at Abidjan]. / Profil clinique, paraclinique et évolutif du sujet infecté par le VIH comparé à celui du sujet non infecté par le VIH en milieu pneumologique hospitalier à Abidjan.

INTRODUCTION: The HIV infection is a problem of public health in Côte d'Ivoire. Voluntary screening is encouraged for the premature management of HIV infected patients before the stage of serious opportunist affections. Antiretroviral therapy became free. The purpose of this study was to describe the characteristics of HIV infected subject infected in hospitalization of pneumology. METHODOLOGY: Our retrospective and analytic study concerned the activity period from January 2001 to December 2012 of pneumology department of Cocody university hospital. RESULTS: On 1141 recorded files, the prevalence of HIV infection was 48.20%. The multi-varied analysis showed the following results. Male patients were less HIV infected (OR=0.490 [0.363-0.661]) as the old patients of more than 64 years (OR=0.150 [0.080-0.280]). In case of HIV infection, infectious pathology, severe anemia and renal insufficiency were dominating respectively with OR=1.763 (1.212-2.564), OR=3.167 (2.125-4.720) and OR=2.054 (1.335-3.161). A stronger mortality was associated with HIV infection (OR=1.920 [1.312-2.809]). CONCLUSION: HIV infection always remains frequented in pneumology hospitalization in Abidjan with late discovery, source of complications and abnormally high death rate.

[Dynamic of indicators of ambulatory care of tuberculosis in the antituberculous center of Adjamé]. / Dynamique des indicateurs de la prise en charge ambulatoire de la tuberculose au centre antituberculeux d'Adjamé.

INTRODUCTION: Tuberculosis (TB) remains a real problem of public health in Côte d'Ivoire. The aim of our study is to describe the dynamic of anti-TB fight indicators in anti-TB center (CAT) of Adjamé. METHODOLOGY: We realized a retrospective study, comparing the anti-TB activities of two periods (1999-2001 versus 2010-2012) at the CAT of Adjamé. Over two periods, 24,520 cases of TB were recorded in the registers of TB declaration. RESULTS: Logistic regression results were the following ones. The proportion of the patients of Adjamé municipality increased to detriment of the patients coming from other municipalities. Our study showed an increase of TB contagious forms, a reduction of new cases of TB. The rate of screening of HIV infection increased. We noted a reduction of TB-HIV co-infection prevalence. The proportion of smear positive at the 2nd month decreased. We noted an increase of the rate therapeutic success and a reduction of lost at follow-up. CONCLUSION: Important progresses were realized in the TB fight and TB-HIV co-infection.

[Pancytopenia: a severe complication of miliary tuberculosis]. / La pancytopénie : une complication grave de la miliaire tuberculeuse.

OBJECTIVE: To analyze the epidemiology, clinical features and outcome of patients with hematologic abnormalities in miliary tuberculosis. METHODS: This was a retrospective study in the pneumology department of the University hospital in Abidjan (RCI), between January 2000 and December 2009. We analyzed the medical records of patients with pancytopenia occurring in the context of miliary tuberculosis. We compared the clinical characteristics and the outcome in patients with pancytopenia versus patients without pancytopenia. RESULTS: Pancytopenia occurred in 12% of patients with miliary tuberculosis; 11 men (61%) and seven women (39%). The average age of patients was 33 years, [17-67 years]. Pancytopenia with miliary tuberculosis was frequently associated with HIV: 92.8% (P=0.0009). The clinical characteristics were: fever (88.9%), severe weight loss: 100% vs. 78.8% MT without pancytopenia (P=0.025), respiratory distress: 100% vs. 52.3% MT without pancytopenia (P=0.00032), splenomegaly: 77.8% vs. 5.30% MT without pancytopenia (P=0.0000), multiple lymph nodes: 66.7% vs. 29.5% MT without pancytopenia (P=0.0043). The occurrence of pancytopenia in military TB is associated with a bad prognosis and the outcome was unfavorable in 8.33% (P=0.00001). CONCLUSION: Patients with pancytopenia in miliary tuberculosis have a high mortality despite tuberculosis treatment.

[Non-tuberculous pleural infections versus tuberculous pleural infections]. / Atteintes pleurales non tuberculeuses versus atteintes pleurales tuberculeuses.

INTRODUCTION: In countries where tuberculosis is endemic, the main differential diagnosis for pleural infection by common bacteria is pleural tuberculosis. OBJECTIVE: The purpose of our study was to determine the differences between pleural infection by common bacteria and that caused by pleural tuberculosis. METHODOLOGY: Our study was a retrospective analysis and compared the characteristics of confirmed pleural infection by common bacteria (PIB) and that due to pleural tuberculosis (PT). RESULTS: For the PIB, the signs evolved for 2.4 ± 1.4 weeks versus 5.6 ± 2.2 weeks for the PT (P=0.01). In multivariate analysis, for PIB the onset of symptoms was more abrupt (OR=3.8 [1.5; 9.9]; P=0.01), asthenia was less frequent (OR=0.3 [0.1; 0.9]; P=0.03), pleural liquid was more purulent (OR=40.0 [15.0; 106.7]; P<0.01). The blood neutrophil count was more frequently raised in cases of PIB (OR=2.5 [1.2; 5.4]; P=0.02). Pneumothorax/hydropneumothorax was less frequent in PIB (OR=0.3 [0.1; 1.0]; P=0.04). CONCLUSION: Clinical differences exist between pleural effusions caused by tuberculosis (TB) and those due to other bacterial infections. However, they are not sufficiently sensitive and therefore the search for the tuberculous bacillus must be systematic while waiting for implementation of new diagnostic tests for the organism.