[Tuberculosis in the elderly: Epidemiology and outcomes of ambulatory followed-up in Abidjan]. / La tuberculose du sujet âgé : épidémiologie et devenir des patients suivis en ambulatoire à Abidjan.

BACKGROUND: Very few works approach elderly's tuberculosis (TB) in developing countries. The aim of this study is to present elderly's TB epidemiology and the outcomes of the ambulatory follow-up of the tuberculous patients aged more than 65years old (TBE) compared to the TB among patients less than 65years old (TBY). METHODS: Our study is retrospective covering period of January 1999 to June 2006 activities of Adjamé's antituberculous center. It is a comparative study between patients of at least 65 years and patients of less than 65years when the diagnosis of TB was made. RESULTS: Among 36,923 cases of TB, the proportion of TBE is 2.33%. In case of TBE, the sex-ratio is 2.16 versus 1.50 among TBY (P<0.001). Localization of TB is pulmonary in 61.70% among TBE versus 67.26% among TBY (P=0.058). Among elderly's TB, the osteoarticular localization is more frequent. TB-VIH co-infection prevalence is estimated to 9.05% among elderly's TB versus 44.38% among patients of less than 65 years (P<0.001). The therapeutic success rate within elderly patients is 52.16% years versus 61.42% when it was patients of less than 65 years. The proportion of lost at follow-up and the rate of patient transfers within the elderly's TB are the most raised. CONCLUSION: The elderly's TB is rare with a more masculine predominance. TB-VIH co-infection is not important among elderly's TB. The aged patient follow-up must be improved.

[Predictive factors of lost to follow-up status during tuberculosis treatment]. / Facteurs prédictifs du statut « perdus de vue ¼ au cours du traitement de la tuberculose.

INTRODUCTION: Patients with contagious tuberculosis who are lost to follow-up risk sowing the disease among their circle of acquaintances. Moreover, a history of inadequate anti-tuberculous treatment is an important risk factor for the development of drug-resistant organisms. The purpose of this study was to identify risk factors for loss to follow-up among patients undergoing treatment for tuberculosis. METHODOLOGY: We performed a prospective cohort study among patients with contagious tuberculosis, beginning with anti-tuberculous treatment followed during six months, after initial education-information about their condition. We compared the characteristics of 152 patients lost to follow-up from tuberculosis treatment against those of 492 patients who were not lost to follow-up. RESULTS: Independent factors associated with a reduction in the risk of being lost to follow-up were: the presence of night-sweats (OR=0.46 [0.24-0.88]; P=0.018), the presence of thoracic pain (OR=0.27 [0.14-0.54]; P<0.001), screening for HIV (OR=0.41 [0.17-0.98]; P=0.045), fact to inform a person of its disease (OR=0.06 [0.01-0.41]; P=0.004), the application of directly observed treatment in the community (OR=0.34 [0.17-0.66]; P<0.001). CONCLUSION: Reducing loss to follow-up during treatment for tuberculosis requires the development of a "good attitude" through education-information about tuberculosis.