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1.
Bull Soc Pathol Exot ; 109(5): 368-375, 2016 Dec.
Article in French | MEDLINE | ID: mdl-27848101

ABSTRACT

In Niger, the tuberculosis (TB) screening among people living with human immunodeficiency virus (HIV) (PLHIV) is nonsystematic and the use of additional tests is very often limited. The objective of this research is to evaluate the performance and the cost-effectiveness of various paraclinical testing strategies of TB among adult patients with HIV, using available tests in routine for patients cared in Niamey. This is a multicentric prospective intervention study performed in Niamey between 2010 and 2013. TB screening has been sought in newly diagnosed PLHIV, before ART treatment, performing consistently: a sputum examination by MZN (Ziehl-Nielsen staining) and microscopy fluorescence (MIF), chest radiography (CR), and abdominal ultrasound. The performance of these different tests was calculated using sputum culture as a gold standard. The various examinations were then combined in different algorithms. The cost-effectiveness of different algorithms was assessed by calculating the money needed to prevent a patient, put on ART, dying of TB. Between November 2010 and November 2012, 509 PLHIV were included. TB was diagnosed in 78 patients (15.3%), including 35 pulmonary forms, 24 ganglion, and 19 multifocal. The sensitivity of the evaluated algorithms varied between 0.35 and 0.85. The specificity ranged from 0.85 to 0.97. The most costeffective algorithm was the one involving MIF and CR. We recommend implementing a systematic and free direct examination of sputum by MIF and a CR for the detection of TB among newly diagnosed PLHIV in Niger.


Subject(s)
AIDS-Related Opportunistic Infections/diagnosis , Algorithms , Anti-Retroviral Agents/therapeutic use , HIV Infections/drug therapy , Tuberculosis/diagnosis , Tuberculosis/drug therapy , AIDS-Related Opportunistic Infections/drug therapy , AIDS-Related Opportunistic Infections/economics , AIDS-Related Opportunistic Infections/epidemiology , Adolescent , Adult , Aged , Cost-Benefit Analysis , Female , HIV Infections/complications , HIV Infections/economics , HIV Infections/epidemiology , HIV-1 , Humans , Male , Mass Screening/economics , Microscopy, Fluorescence/economics , Middle Aged , Niger/epidemiology , Predictive Value of Tests , Radiography, Thoracic/economics , Sensitivity and Specificity , Tuberculosis/economics , Tuberculosis/epidemiology , Ultrasonography/economics , Young Adult
2.
Med Sante Trop ; 22(1): 97-8, 2012.
Article in French | MEDLINE | ID: mdl-22868738

ABSTRACT

The purpose of this retrospective study, which examined data collected from January 2007 through September 2010, was to evaluate the seroprevalence of human immunodeficiency virus (HIV), hepatitis B virus (HBV), and hepatitis C virus (HCV) among 2946 new blood donors at the Nianankoro Fomba Hospital (NFH). The overall seroprevalence of HIV was 0.88%, of HBV 5.3%, and of HCV 0.55%. Donors infected with HIV and HBV were younger than healthy donors, while those infected with HCV were older. These findings at the NFH show that HIV, HBV, and HCV remain major public health problems in Mali.


Subject(s)
Blood Donors , HIV Infections/blood , HIV Infections/epidemiology , Hepatitis B/blood , Hepatitis B/epidemiology , Hepatitis C/blood , Hepatitis C/epidemiology , Adolescent , Adult , Female , HIV/immunology , Hepacivirus/immunology , Hepatitis B/immunology , Hepatitis B virus/immunology , Hepatitis C/immunology , Humans , Male , Mali , Middle Aged , Seroepidemiologic Studies , Young Adult
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